Critical Health Research Articles

Maternal Mental Health: Addressing Postpartum Depression and Anxiety in Different Socioeconomic Contexts

Maternal mental health, particularly postpartum depression (PPD) and anxiety, is a critical public health concern affecting women globally. The postpartum period presents unique challenges, as new mothers navigate hormonal changes, caregiving responsibilities, and societal pressures. The prevalence of postpartum depression and anxiety is influenced by socioeconomic factors, and women from lower socioeconomic backgrounds often face a higher risk due to limited access to mental health resources, social support, and financial instability. This review highlights recent advances in understanding postpartum mental health disorders, their prevalence across different socioeconomic contexts, and strategies for effective intervention. We explore innovative therapeutic approaches, the role of healthcare policies, and the importance of early detection to reduce the long-term effects of maternal mental health disorders on both mothers and their children.

Novel Emerging Mechanisms in Acetaminophen (APAP) Hepatotoxicity.

Drug-induced liver injury represents a critical public health issue, marked by unpredictable and potentially severe adverse reactions to medications, herbal products or dietary supplements. Acetaminophen is notably a leading cause of hepatotoxicity, impacting over one million individuals worldwide. Extensive research has elucidated the intricate mechanisms driving APAP-induced liver injury, emphasising the significant roles of endoplasmic reticulum stress, oxidative stress, mitochondrial dysfunction and cell death. These insights pave the way for innovative therapeutic strategies, including the use of magnesium, bile acids, microbiota modulation and mesenchymal stem cells. This review explores into these pathological mechanisms, proposing viable therapeutic interventions for patients suffering from APAP-induced liver injury.

Dietary zinc deficiency promotes Acinetobacter baumannii lung infection via IL-13 in mice.

Dietary zinc deficiency is a major risk factor for pneumonia. Acinetobacter baumannii is a leading cause of ventilator-associated pneumonia and a critical public health threat due to increasing rates of multidrug resistance. Patient populations at increased risk for A. baumannii pneumonia are also at increased risk of zinc deficiency. Here we established a mouse model of dietary zinc deficiency and acute A. baumannii pneumonia to test the hypothesis that host zinc deficiency contributes to A. baumannii pathogenesis. We showed that zinc-deficient mice have significantly increased A. baumannii burdens in the lungs, dissemination to the spleen and higher mortality. During infection, zinc-deficient mice produce more pro-inflammatory cytokines, including IL-13. Administration of IL-13 promotes A. baumannii dissemination in zinc-sufficient mice, while antibody neutralization of IL-13 protects zinc-deficient mice from A. baumannii dissemination and mortality during infection. These data highlight the therapeutic potential of anti-IL-13 antibody treatments, which are well tolerated in humans, for the treatment of pneumonia.

Antimicrobial peptides-a promising novel antimicrobial agent

Abstract. Antibiotic resistance has become one of the most critical public health problems in the 21st century, and infections caused by drug-resistant bacteria severely threaten human health. Otherwise, the development rate of conventional antibiotics has been unable to keep up with the speed at which bacteria develop resistance. Therefore, it is urgent to develop antimicrobial agents with novel mechanisms of action. Antimicrobial peptides (AMPs) are naturally occurring polypeptides with antibacterial activity, which have different mechanisms of action from existing antibiotics and thus have incomparable advantages over traditional antibiotics in treating infections caused by drug-resistant bacteria. Up to now, AMPs have been used in several clinical studies to destroy drug-resistant bacteria. The review introduces the basic properties of AMPs and their therapeutic mechanisms, summarizes some advances in preclinical studies and clinical applications, and analyzes the factors limiting their application in clinical treatment. In addition, some new strategies to overcome the shortcomings of AMPs in clinical applications are also introduced. Efficient and diverse synthesis technologies and optimization strategies keep coming to overcome the difficulties of clinical applications for AMPs, which may become an important weapon against drug-resistant bacterial infections in the future.

Artificial intelligence-enhanced biosurveillance for antimicrobial resistance in sub-Saharan Africa.

Antimicrobial resistance (AMR) remains a critical global health threat, with significant impacts on individuals and healthcare systems, particularly in low-income countries. By 2019, AMR was responsible for >4.9 million fatalities globally, and projections suggest this could rise to 10 million annually by 2050 without effective interventions. Sub-Saharan Africa (SSA) faces considerable challenges in managing AMR due to insufficient surveillance systems, resulting in fragmented data. Technological advancements, notably artificial intelligence (AI), offer promising avenues to enhance AMR biosurveillance. AI can improve the detection, tracking and prediction of resistant strains through advanced machine learning and deep learning algorithms, which analyze large datasets to identify resistance patterns and develop predictive models. AI's role in genomic analysis can pinpoint genetic markers and AMR determinants, aiding in precise treatment strategies. Despite the potential, SSA's implementation of AI in AMR surveillance is hindered by data scarcity, infrastructural limitations and ethical concerns. This review explores what is known about the integration and applicability of AI-enhanced biosurveillance methodologies in SSA, emphasizing the need for comprehensive data collection, interdisciplinary collaboration and the establishment of ethical frameworks. By leveraging AI, SSA can significantly enhance its AMR surveillance capabilities, ultimately improving public health outcomes.

The impact on prevention and control strategies for HIV/STIs from COVID-19 pandemic to post-pandemic period in Southern China(2020-2023): A literature review

Abstract. To analyze the impact of the COVID-19 pandemic on the prevention and control strategies for HIV and sexually transmitted infections (STIs) in Southern China. It seeks to understand how the pandemic affected the management of these infections and make a better preparation for the next COVID-19-like situation. This literature review was conducted by analyzing data from 4 databases, focused on epidemiological characteristics before and after 2020, changes in health policies, resource redistribution, and the implementation of prevention measures during the pandemic. The results indicate that COVID-19 prevention was prioritized, leading to challenges in the management of HIV and STIs due to resource redistribution and pressures on the healthcare system. Despite these difficulties, some innovative approaches used in the COVID-19 prevention emerged to address the gaps, including the use of e-medicine and targeted community outreach which helps to compensate for the negative impacts on HIV/STI control. This review highlights the necessity of developing new strategies with innovative technologies that can balance the control of multiple infectious diseases during global health crises, ensuring that critical health services remain effective even in times of widespread disruption.

Gender differences in periodontal pocket microflora in patients with chronic generalized periodontitis

Background: Periodontal disease, the primary cause of tooth loss, is a critical public health concern with a considerable impact on quality of life. It is of interest to explore gender differences in the course of inflammatory periodontal diseases, as well as the prospects of their personalized treatment and prevention in males and females. Aim: To assess the dental health and quantitative composition of periodontal pocket microflora in periodontitis patients, taking into account gender differences. Materials and Methods: The study included 39 patients with moderate chronic generalized periodontitis aged 40–60 years. The diagnosis was made using both primary and secondary dental diagnostic tools. The study had two groups: males (41%, n=16) and females (59%, n=23). The following parameters were assessed: oral hygiene index (OHI-S), severity of gingival inflammation (PMA), and quantitative composition of periodontal pocket microflora (DENTOSCREEN, “Lytech” Co. Ltd., Russia), taking into account gender differences. The study findings were statistically processed using Microsoft Office Excel 2016 with Data Analysis and AtteStat 12.0.5 add-ins. The Shapiro–Wilk test was used. The data are presented as median and interquartile range: Me [Q1; Q3]. The frequency of microorganisms is presented as percentage of the mean and standard error of the mean. The confidence interval was calculated using the Wald method, according to the formula for proportions and frequencies. For small values, the Wald method with Agresti–Coull correction was used. Samples were compared using the following tests: the Mann–Whitney U test was used for quantitative data and Fisher’s angular transformation (φ*emp) for frequency (nominal) attributes. Significant differences were defined as a probability 95% (p 0.05). Results: The quantitative composition of periodontal pocket microflora in patients with moderate periodontitis revealed significant gender differences, as demonstrated by an increase in the count of Fusobacterium nucleatum and Prevotella intermedia, as well as the frequency of Porphyromonas gingivalis, in males compared to females (φ*emp=1.736; p 0.05). Dental health indices confirmed the hypothesis of significant differences between males and females in terms of plaque index (OHI-S) and РМА. In males, poor oral hygiene was reported in 93.7% cases, which was significantly higher (φ*emp=2.04; p 0.05) than in females (69.6%). Moderate gingival inflammation was more prevalent in males, while mild gingival inflammation was more prevalent in females (p 0.05). Conclusion: The study findings emphasize the importance of oral hygiene in the prevention of chronic periodontitis and can be used to improve complex treatment algorithms for patients with periodontal diseases. This includes more frequent dental check-ups and professional oral care sessions, as well as oral hygiene training and monitoring, in males compared to females. Diagnosis by polymerase chain reaction allows for the identification and quantitative determination of DNA from periodontopathogenic bacteria at low concentrations, as well as the justification of treatment algorithms and prediction of treatment outcomes.

Intensifying Substance Use Trends among Youth: A Narrative Review of Recent Trends and Implications.

Substance use among adolescents and young adults remains a critical public health concern, with patterns shifting dramatically in recent years. This narrative review examines trends in substance use behaviors during and following the COVID-19 pandemic. Epidemiologic evidence shows declines in the proportion of youth who are using most substances but intensified consumption patterns with rising levels of disorder among adolescents who use substances. This picture may reflect the greater potency, availability and accessibility of substances, vulnerabilities related to poor mental health, minoritization, as well as social factors including pandemic stressors, commercial and regulatory forces - in short, features of the agent (substance), host (person), and environment (context), consistent with a public health formulation. Understanding trends in youth substance use and related problems, especially in the context of contributing factors, is critical for informing clinical care strategies and public health interventions to improve outcomes for youth across diverse populations.

A comprehensive study on tuberculosis prediction models: Integrating machine learning into epidemiological analysis

Tuberculosis (TB), the second leading infectious killer globally, claimed the lives of 1.3 million individuals in 2022, after COVID-19, surpassing the toll of HIV and AIDS. With an estimated 10.6 million new TB cases worldwide in 2022, the gravity of the disease persists, necessitating urgent attention. Tuberculosis remains a critical public health crisis, and efforts to combat this infectious disease demand intensified global commitment and resources. This study utilizes predictive modeling techniques to forecast the incidence of Tuberculosis (TB), employing a range of machine learning models. Additionally, the research incorporates impactful visualizations for comprehensive data exploration, analysis and comparison. Various machine learning models are developed to anticipate TB incidence, with the optimal performing model to customize a user-defined function. This research provides valuable insights into the potential determinants influencing TB incidence, contributing to the identification of strategies for preventing the spread of Tuberculosis.

Prevalence, transmission and genomic epidemiology of mcr-1-positive colistin-resistant Escherichia coli strains isolated from international airplane waste, local resident fecal and wastewater treatment plants.

The emergence and dissemination of mcr-1-positive Escherichia coli (MCRPEC) represent a critical public health threat. Here, we conducted a prospective analysis of MCRPEC isolates from wastewater treatment plants (WWTPs), local residents' fecal (LRF), and international airplane waste (IAW) to investigate their genetic characteristics and transmission patterns circulating in human-environment domains. The MCRPEC prevalence was 2.43 % in WWTPs, 1.37 % in IAW and 0.69 % in LRF. MCRPEC showed substantial genetic diversity, encompassing 61 sequence types (primarily ST1011, ST101, and ST2705), 7 plasmid types (primarily IncI2), 8 phylogroups (primarily A and B1), 9 mcr-1-flanked lineages (primarily L5), 6 clusters (primarily C2 and C4), diverse serotypes, and 61.95 % transposon-containing strains. The mcr-1 gene co-existed with 46 antibiotic resistance genes (ARGs) and 19 virulence factor genes (VFGs). Notably, 6 IncI2 plasmids carried the blaCTX-M, IS1380, and mcr-1 genes. MCRPEC from WWTPs harbored a greater number of ARGs (56.95 ± 5.99) but fewer VFGs (15.03 ± 6.40) compared to those from human-associated sources (LRF and IAW). ST1011, ST2705, IncHI2, and L7 were prevalent in WWTP-derived MCRPEC, whereas IncX4 and L3 were more common in human-derived MCRPEC. Genetic features such as ST101, ST48, IncI2, L4, L5, C2, and C4 were simultaneously present in strains from LRF, IAW, and WWTPs. Core genetic analyses also showed genetically similar MCRPEC strains across various geographic locations. The findings underscore the extensive dissemination, strong environmental adaptation, and clonal transmission of MCRPEC across diverse reservoirs, reinforcing the urgent need for coordinated multisectoral surveillance of human and environment interfaces to effectively mitigate further transmission.

Moving Beyond Thoughts and Prayers: Creating a Firearm-Related Injury Task Force

Firearm injuries among children have increased dramatically, creating a public health crisis. Academic medical centers should address this critical public health need, but often struggle to apply their resources and methodological expertise to move beyond public statements to real action. Cincinnati Children’s Hospital Medical Center, a large quaternary care academic medical center, serves as the American College of Surgeons Level I pediatric trauma center for the region. Cincinnati Children’s Hospital has established a task force to reduce firearm-related injuries in the area. Key challenges have included staying within scope, building momentum, standardizing communication, and balancing aspirational change with practical progress. Such initiatives require buy-in from institutional leaders and building a team that is balanced between members with decision-making authority and members who execute the work.

Practices of maize handling and nixtamalization to reduce fungal toxin exposure in rural Guatemala

Fungal toxins in local food supplies are a critical environmental health risk to communities globally. To better characterize hypothesized toxin control points among households, we conducted household surveys across four departments (first administrative division) in Guatemala. Data gathered included maize harvesting, processing, storage, and traditional nixtamalization practices. In total, n = 33 households participated in the survey and were from 4 unique departments, 17 unique municipalities, and represented 4 different languages. The results suggested that the majority of households consumed a combination of personally cultivated and purchased maize. There was significant variation in how this maize was stored, in regards to pre-processing (kernel vs whole cob), as well as storage system type. For nixtamalization, the largest differences in practices (e.g., cooking time) were based on household size while the majority of households reported practices that aligned with previously reported best practices. Lastly, all reported maize-based food products produced by households utilized the nixtamalization process except one. Current maize handling and nixtamalization practices reported by a majority of households aligned with best practices, however, with locally tailored and culturally sensitive guidance disseminated by key stakeholders, the prevalence of best practice use among households can be improved. Further community-based research on traditional farming and nixtamalization practices can improve these recommendations.

A case study on development of a spiral oral health curriculum for medical students.

Inadequate oral healthcare remains a critical public health issue in children and adults in the US affecting adverse social, psychological, economic, and health outcomes. Medical clinicians have a clear role in addressing oral health issues and improving outcomes. Oral health guidelines for health profession schools were developed by the Association of American Medical Colleges (AAMC) oral health core competencies, and the newer Center for Integration of Primary Care and Oral Health's (CIPCOH) Entrustable Professional Activities (EPAs). However, the majority of health professional school deans and residency directors in the US report they are not satisfied with the oral health knowledge and skills of their learners at graduation. To address this issue, faculty at the University of Massachusetts Chan Medical School (UMCMS) have worked for the past decade to develop and implement a true spiral curriculum building on lessons of knowledge, skills, and attitudes throughout the 4-year student experience. The current UMCMS curriculum involves most courses at the medical school, has community-based and interprofessional components, and is taught using multimedia. Most of the curriculum is mandatory with selective opportunities for those in specialty tracks or who are seeking more hands-on training. Our study evaluated the UMCMS curriculum using the AAMC and CIPCOH EPA guidelines. Findings show that all students receive training in 42 of 48 AAMC oral health competencies and seven of seven CIPCOH oral health EPAs with the opportunity to explore oral health further through elective courses. Assessments of students show they perform well and evaluation of the oral health curricula by students are positive. Although our oral health curriculum is robust, the next steps include expanding the evaluation of students to ensure they universally meet competencies. We expect that this case study can serve as a map for creating a generalizable, spiral curriculum for other medical schools.

Abstract 4146306: Rural Urban Disparities in Inpatient Outcomes of Chronic Limb-Threatening Ischemia in the United States

Background: Chronic limb-threatening ischemia (CLTI) is a severe form of peripheral artery disease characterized by chronic ischemic rest pain, non-healing wounds, or gangrene in one or both legs. With prevalence rates of 1-2% in the United States (increasing with age, with over 20% of adults over 70 diagnosed with CLTI) and 1-year mortality rates approaching 20-25%, CLTI is a critical public health issue due to its significant impact on patient morbidity, mortality, and healthcare resources. Aims: To understand if disparities exist between rural and urban inpatient outcomes for patients with CTLI. Methods: A retrospective analysis of the National Inpatient Sample database from 2016 to 2021 was conducted to identify patients admitted with CLTI according to ICD-10 codes. Patients were stratified by rural and urban status, followed by propensity-matched analysis to compare inpatient outcomes between these groups. Results: A total of 2,667,279 patients with CLTI, with 445255 (16.7%) categorized as rural status and the remaining 83.3% categorized as urban status, were included in this study. Patients belonging to rural status had an increased odds of in-hospital mortality (aOR)=1.35; 95% CI 1.26-1.45; p<0.001), in-patient sudden cardiac arrest (aOR=1.27; 95% CI=1.13-1.43; p<0.001), cerebrovascular accidents (aOR=1.31; 95% CI=1.19-1.45; p<0.001), venous thromboembolism (aOR=1.18; 95% CI=1.09-1.27; p<0.001), surgical site infection (aOR=1.25; 95% CI=1.16-1.35; p<0.001), requirement for vasopressors (aOR=2.02; 95% CI=1.76-2.32; p<0.001), invasive (aOR=1.18; 95% CI=1.10-1.26; p<0.001) and non-invasive (aOR=1.37; 95% CI=1.25-1.50; p<0.001) mechanical ventilation, hemodialysis (aOR=1.11; 95% CI=1.06-1.15; p<0.001), major amputation (aOR=1.38; 95% CI=1.32-1.43; p<0.001), surgical revascularization (aOR=1.53; 95% CI=1.46-1.60; p<0.001), endovascular revascularization (aOR=1.53; 95% CI=1.46-1.60; p<0.001), and blood transfusion (aOR=0.92; 95% CI=0.88-0.97; p=0.001). No difference was observed in the odds of acute myocardial infarction (aOR=1.06; 95% CI=0.99-1.14; p=0.082) and risk of acute kidney injury (aOR=0.99; 95% CI=0.96-1.02; p=0.485). Conclusions: Disparities in CLTI outcomes are evident, with patients from rural areas experiencing worse outcomes than their urban counterparts. Future research should focus on understanding the underlying causes of these disparities and developing targeted interventions to bridge the gap between rural and urban health care outcomes.

Alcohol and cause-specific mortality in Russia: the Know Your Heart Study 2015–23

BackgroundAlcohol-related mortality in Russia exceeds the world average and presents a critical public health concern. This study assesses the impact of alcohol consumption levels on mortality and investigates mortality predictors among Russians, including people treated for alcohol-related diagnoses (narcology patients).MethodsWe examined 2629 men and women aged 35–69 years who participated in the Know Your Heart study (2015–17), Arkhangelsk, Russia. The participants were categorized into five drinking levels (non-drinking, low-risk, hazardous, harmful, narcology patients) and followed up using a regional mortality database. We used Cox proportional hazards regressions to analyze sociodemographic and cardiovascular biomarkers as mortality predictors among narcology patients and general population and to compare mortality risks across the five drinking levels.ResultsDuring a median follow-up of 6.3 years, 223 (8.5%) participants died. Age- and sex-standardized all-cause mortality rates per 100,000 person-years were 1229 (95% CI: 691–1767) in non-drinking participants, 890 (95%CI: 684–1096) and 877 (95%CI: 428–1325) in low-risk and hazardous drinking participants, 2170 (95%CI: 276–4064) in those with harmful drinking, and 4757 (95%CI: 3384–6131) in narcology patients. The largest proportions of deaths were caused by cardiovascular diseases (37.2%), neoplasms (20.2%), and external causes (13.9%). Compared with low-risk drinkers, narcology patients had higher risks of death with hazard ratios of 3.23 (95%CI: 2.02–5.16) for all-cause mortality, 3.25 (95%CI: 1.52–6.92) for cardiovascular diseases, 9.36 (95%CI: 2.63–33.3) for external causes, and 7.79 (95%CI: 3.34–18.1) for other causes. Neoplasm-related mortality did not differ between groups. All-cause mortality in the general population had positive associations with smoking, waist-to-hip ratio, resting heart rate, systolic blood pressure, high-sensitivity C-reactive protein, and negative associations with left ventricular ejection fraction (LVEF) and higher education. These associations were substantially weaker and non-significant in narcology patients. Cardiovascular mortality in narcology patients was increased with higher education, while male sex, LVEF and N-terminal prohormone of brain natriuretic peptide had less impact compared to the general population sample.ConclusionNarcology patients face markedly higher mortality risks—threefold from all causes and cardiovascular diseases, ninefold from external causes, and sevenfold from other causes. Compared with the general population, conventional mortality risk factors were less predictive of deaths in narcology patients.

Knowledge and perception of older adults toward end of life and advanced directive in Nigeria.

Older adults often have a heightened awareness of death due to personal losses. In many low- and middle-income countries, including Nigeria, conversation about end-of-life issues and advanced care planning (ACP) among older adults is gradually emerging. Our study explored older adults' knowledge and perceptions towards advanced directives and end-of-life issues in a geriatric care setting in Nigeria. A cross-sectional study was conducted among older adults (aged ≥60 years) in a geriatric outpatient clinic. Data were collected using an interviewer-administered, semi-structured questionnaire, tested at a significance level set at alpha 0.05. The study included 204 participants with a mean age of 71.3 ± 7.2 years, predominantly female (67.2%). Few of the participants have heard about end of life (20.1%), living will (19.1%), power of attorney (19.6%), and ACP (25.9%). About 29.9% of the respondents considered having a living will, of which about 34.4% have written one. Only 23 (11.3%) would consider discussing ACP in the future, 32 (15.7%) would discuss place of care, and 30 (14.7%) place of death. Preparedness for end of life and knowledge of ACP was higher among males, those with formal education, and those with good self-rated health (p < 0.05). The study highlighted gap in awareness and engagement in ACP among older adults in a country like Nigeria. This lack of knowledge can lead to inadequate end-of-life care and unpreparedness for critical health decisions for older adults in Africa. Thus, improving awareness and understanding of ACP can empower older adults, ensuring their end-of-life preferences are respected, enhancing the quality of care, and reducing the emotional and financial burden on families.

Teaching infectious diseases during and in the aftermath of the COVID-19 pandemic – middle school teachers’ choice of content and instructional approaches

ABSTRACT The COVID-19 pandemic impacted immensely in schools worldwide, emphasising the pivotal importance of infectious diseases. This study aims to delineate the teaching of diseases in middle schools, investigating how content and instruction was influenced in the aftermath of the pandemic. Semi-structured individual interviews were conducted with teachers. The analytical method involved thematic analysis. The first analysis concerned teaching content was based on the framework of contagion literacy. The second analysis investigated the teaching approaches through an inductive analysis. The findings suggest that the pandemic had an impact on the biology teaching in relation to infectious diseases. During the pandemic, teaching largely revolved around student-initiated, question-driven discussions about current events related to societal health initiatives within schools, rather than expanding the planned biology curriculum. The main finding is that teachers focused on hygiene and to influence students’ behaviours interactively. The pandemic was not fully exploited by the participating teachers to develop more curriculum-based teaching including functional and critical health literacy perspectives. The study recommends that biology teachers collaborate with school health teams and engage in interdisciplinary work. We also suggest to amend primary science teacher education to meet the need to teach the young people in the event of future pandemics.

ADVOCACY STRATEGY IN OPTIMIZING THE USE OF VILLAGE FUNDS FOR THE STUNTING PREVENTION PROGRAM IN EAST SUMALATA DISTRICT

Stunting is a critical public health issue in North Gorontalo Regency, and efforts to prevent it during the First 1000 Days of Life face significant challenges, particularly due to insufficient allocation of village funds for stunting prevention initiatives. This research aims to explore effective communication and advocacy strategies for securing village fund support for the stunting prevention program focused on the First 1000 Days of Life at the village level in East Sumalata District, North Gorontalo Regency. The study employs a descriptive qualitative approach, utilizing document analysis, observations, interviews, and focus group discussions to examine village fund management and assess the effectiveness of advocacy strategies. The findings indicate that an effective advocacy strategy for securing village fund allocations for the stunting prevention program involves informal communication with a persuasive approach directed at regional leaders. Key elements include presenting accurate target data, referencing relevant regulations, submitting well-prepared activity proposals, and obtaining recommendation letters from local authorities such as the Head of the Office or the Subdistrict Head. Given the sensitivity and limitations of village budget discussions, consistent monitoring of advocacy proposals is essential to ensure program implementation. Support from regional leaders and partner organizations is crucial for successful advocacy efforts.

Nuclear pore complexes undergo Nup221 exchange during blood-stage asexual replication of Plasmodium parasites.

Malaria, caused by Plasmodium species, remains a critical global health challenge, with an estimated 249 million cases and over 600,000 deaths in 2022, primarily affecting children under five. Understanding the nuclear dynamics of Plasmodium parasites, particularly during their unique mitotic processes, is crucial for developing novel therapeutic strategies. Our study leverages advanced microscopy techniques, such as ultrastructure expansion microscopy, to reveal the organization and turnover of nuclear pore complexes (NPCs) during the parasite's asexual replication. By elucidating these previously unknown aspects of NPC distribution and homeostasis, we provide valuable insights into the molecular mechanisms governing parasite mitosis. These findings deepen our understanding of parasite biology and may inform future research aimed at identifying new targets for anti-malarial drug development.

Geospatial Analysis of Malaria and Typhoid Prevalence Due to Waste Dumpsite Exposure in Kinshasa Districts with and Without Waste Services: A Case Study of Bandalungwa and Bumbu, Democratic Republic of Congo.

Municipal solid waste (MSW) management poses substantial challenges in rapidly urbanizing areas, with implications for both the environment and public health. This study focuses on the city of Kinshasa in the Democratic Republic of Congo, investigating whether the presence or absence of solid waste collection services results in varying health and economic impacts, and additionally, seeking to establish a correlation between residing in proximity to dumpsites and the prevalence of diseases like malaria and typhoid, thereby providing a comprehensive understanding of the health implications tied to waste exposure. Health data were collected through survey questionnaires, and the geospatial distribution of 19 dumpsites was analyzed using Google Earth Pro 7.3.1 for satellite imagery and GIS software 10.3.1 to map dumpsites and define 1 km buffer zones around the largest dumpsites for household sampling. Statistical analyses were conducted using R Version 4.2.3, employing Chi-square tests for disease prevalence and logistic regression to assess associations between waste management practices and health outcomes. A multivariate regression was used to evaluate correlations between discomfort symptoms (e.g., nasal and eye irritation) and waste activities. The geospatial analysis revealed significant variation in dumpsite size and location, with larger dumpsites near water bodies and flood-prone areas. The study contributes valuable insights into waste-related health risks, emphasizing the need for improved waste management policies in rapidly urbanizing areas like Kinshasa. The socio-demographic analysis reveals distinct traits within the surveyed populations of two communes, Bandalungwa (Bandal) and Bumbu. Bumbu, characterized by larger open dumpsites and limited waste collection services, exhibits a higher prevalence of certain diseases, particularly typhoid fever, and malaria. This discrepancy is statistically significant (p < 2.2 × 10-16), suggesting a potential link between waste exposure and disease prevalence. In Bandal, self-waste collection is a high risk of exposure to typhoid (OR = 4.834 and p = 0.00001), but the implementation of a waste collection service shows protective effect (OR = 0.206 and p = 0.00001). The lack of waste collection services in Bumbu increases the risk of exposure, although not significantly (OR = 2.268 and p = 0.08). Key findings indicate that waste disposal methods significantly differ between Bandal and Bumbu. Bumbu's reliance on burning and dumping creates environments conducive to disease vectors, contributing to elevated disease transmission risks. However, an in-depth correlation analysis reveals that specific waste management practices, such as burning, burying, and open dumping, do not exhibit statistically significant associations with disease prevalence, underlining the complexity of disease dynamics. This study contributes valuable insights into the importance for urban public health, particularly in rapidly urbanizing cities like Kinshasa, where inadequate waste management exacerbates health risks. By investigating the correlation between proximity to unregulated dumpsites and the prevalence of diseases such as malaria and typhoid fever, the research underscores the urgent need for targeted waste management policies. The stark health disparities between Bandal, with better waste services, and Bumbu, where services are lacking, highlight the protective effect of organized waste collection. These findings suggest that expanding public waste services and enforcing stricter regulations on waste disposal could reduce disease prevalence in vulnerable areas. Additionally, the study supports integrating waste management into urban planning as a critical public health measure. Its evidence-based approach offers valuable insights for policymakers in Kinshasa and other cities facing similar challenges, emphasizing the broader health implications of environmental governance in urban settings.