Diarrheal Infections Research Articles

A study to assess mother’s health seeking behaviour regarding oral rehydration solutions in diarrhoea in children 2 months to 5 years of age

Background: Diarrhoeal infections are the second leading cause of death worldwide in under-five children covering 9% of the total deaths. The objective of the study was to assess and compare mothers’ knowledge, attitude and practice of oral rehydration solutions (ORS) in diarrhoea in children. Methods: A cross-sectional hospital-based observational study was conducted in a tertiary centre amongst all 400 children between age group 2 months to 60 months admitted with acute watery diarrhoea. A pre-tested questionnaire and face-to-face interviews with the mothers was used as a data collection tool. Results: Most of the mothers 336 (84%) were 21-30-year-old, 150(37.5%) were illiterate, 74 (18.5%) were unemployed. 49% people came from rural background. The 250 (65%) mothers were aware about the role of ORS in diarrhea, 130 (32.5%) knew about the preparation of ORS and only 70 (17.5%) were aware about the ORS storage. Conclusions: Mother’s knowledge regarding management and prevention of diarrhea needs to be upgraded to allow better utilisation of health resources by the families.

Scoring Card for Characteristics of Mother, Child, and Environtment in Early Stunting Detection Efforts

Stunted children at an early age have lower fluid intelligence. 48.6% of children aged 7-8 years have less cognitive ability. This study uses a case-control research design. The sample in this study included 113 case groups and 113 control groups. The independent variables in this study were maternal anemia, Choric Energy Deficiency (CED) in pregnant women, pregnancy complications, maternal infection history, smoking habits, mother's height, age at pregnancy, mother's education, birth weight, birth length, gender of the baby, history of diarrheal infection, ARI, gestational age during pregnancy, birth gap, exclusive breastfeeding, weaning food, helminthiasis, child immunization, clean water, and family income. The dependent variable in this study is the incidence of stunting in children under five. The results showed that the variables related to stunting were maternal anemia, CED in pregnant women, mother's height, age at pregnancy, mother's education, birth weight, birth length, baby's gender, history of diarrheal infection, ARI, helminthiasis, and income. The analysis using the ROC obtained a confidence value of 8.5, which means very good, and the cut-off point that can be used in determining the risk of stunting is 8.5. It is necessary to socialize the use of stunting scoring cards to carry out early detection of toddlers to find out whether there is a risk of stunting so health workers can carry out proper assistance to apply the prevention efforts.

Phenotypic and Genotypic Characteristics of Antimicrobial Resistance in Citrobacter freundii Isolated from Domestic Ducks (Anas platyrhynchos domesticus) in Bangladesh.

Antimicrobial resistance (AMR) in Citrobacter freundii poses a serious challenge as this species is one of the sources of nosocomial infection and causes diarrheal infections in humans. Ducks could be the potential source of multidrug-resistant (MDR) C. freundii; however, AMR profiles in C. freundii from non-human sources in Bangladesh have remained elusive. This study aimed to detect C. freundii in domestic ducks (Anas platyrhynchos domesticus) in Bangladesh and to determine their phenotypic and genotypic antibiotic susceptibility patterns. A total of 150 cloacal swabs of diseased domestic ducks were screened using culturing, staining, biochemical, polymerase chain reaction (PCR), and matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) to detect C. freundii. Phenotypic and genotypic antibiotic susceptibility patterns were done by the disk diffusion method and PCR, respectively. In total, 16.67% (25/150) of the samples were positive for C. freundii. C. freundii isolates showed a range of 20% to 96% resistance to cefotaxime, gentamicin, levofloxacin, ciprofloxacin, cotrimoxazole, tetracycline, ampicillin, and cephalexin. More than 60% of the isolates were phenotypically MDR, and the index of multiple antibiotic resistance ranged from 0.07 to 0.79. Genes encoding resistance to beta-lactams [blaTEM-1-88% (22/25), blaCMY-2-56% (14/25), blaCMY-9-8% (2/25), and blaCTX-M-14-20% (5/25)], sulfonamides [sul1-52% (13/25), sul2-24% (6/25)], tetracyclines [tetA-32% (8/25) and tetB-4% (1/25)], aminoglycosides [aacC4-16% (4/25)], and fluoroquinolones [qnrA-4% (1/25), qnrB-12% (3/25), and qnrS-4% (1/25)] were detected in the isolated C. freundii. To the best of our knowledge, this is the first study in Bangladesh to detect MDR C. freundii with their associated resistance genes from duck samples. We suggest addressing the burden of diseases in ducks and humans and associated AMR issues using the One Health approach.

Escherichia coli from biopsies differ in virulence genes between patients with colorectal neoplasia and healthy controls.

Pathogenic strains of Escherichia coli have been clearly identified as the causative agents of extraintestinal and diarrheal infections; however, the etiopathogenic role of E. coli in other conditions, including colorectal cancer, remains unclear. This study aimed to characterize mucosal E. coli isolates (n = 246) from 61 neoplasia patients and 20 healthy controls for the presence of 35 genetic determinants encoding known virulence factors. Virulence determinants encoding invasin (ibeA), siderophore receptor (iroN), S-fimbriae (sfa), and genotoxin (usp) were more prevalent among E. coli isolated from patients with neoplasia compared to the control group (p < 0.05). In addition, the prevalence of these virulence determinants was increased in more advanced neoplasia stages (p adj < 0.0125). Compared to patients with advanced colorectal adenoma and carcinoma, the ibeA gene was rarely found in the control group and among patients with non-advanced adenoma (p < 0.05), indicating its potential as the advanced-neoplasia biomarker. Patients with neoplasia frequently had E. coli strains with at least one of the abovementioned virulence factors, whereby specific combinations of these virulence factors were found. These findings suggest that E. coli strains isolated from patients with colorectal neoplasia possess several virulence factors, which could contribute to the development of neoplastic processes in the large intestine.

Environmental determinants of access to shared sanitation in informal settlements: a cross-sectional study in Abidjan and Nairobi

BackgroundUniversal access to basic sanitation remains a global challenge, particularly in low- and middle-income countries. Efforts are underway to improve access to sanitation in informal settlements, often through shared facilities. However, access to these facilities and their potential health gains—notably, the prevention of diarrheal diseases—may be hampered by contextual aspects related to the physical environment. This study explored associations between the built environment and perceived safety to access toilets, and associations between the latter and diarrheal infections.MethodsA cross-sectional study was carried out between July 2021 and February 2022, including 1714 households in two informal settlements in Abidjan (Côte d’Ivoire) and two in Nairobi (Kenya). We employed adjusted odds ratios (aORs) obtained from multiple logistic regressions (MLRs) to test whether the location of the most frequently used toilet was associated with a perceived lack of safety to use the facility at any time, and whether this perceived insecurity was associated with a higher risk of diarrhea. The MLRs included several exposure and control variables, being stratified by city and age groups. We employed bivariate logistic regressions to test whether the perceived insecurity was associated with settlement morphology indicators derived from the built environment.ResultsUsing a toilet outside the premises was associated with a perceived insecurity both in Abidjan [aOR = 3.14, 95% confidence interval (CI): 1.13–8.70] and in Nairobi (aOR = 57.97, 95% CI: 35.93–93.53). Perceived insecurity to access toilets was associated with diarrheal infections in the general population (aOR = 1.90, 95% CI: 1.29–2.79 in Abidjan, aOR = 1.69, 95% CI: 1.22–2.34 in Nairobi), but not in children below the age of 5 years. Several settlement morphology features were associated with perceived insecurity, namely, buildings’ compactness, the proportion of occupied land, and angular deviation between neighboring structures.ConclusionsToilet location was a critical determinant of perceived security, and hence, must be adequately addressed when building new facilities. The sole availability of facilities may be insufficient to prevent diarrheal infections. People must also be safe to use them. Further attention should be directed toward how the built environment affects safety.Graphical

Formulation Studies to Develop Low-Cost, Orally-Delivered Secretory IgA Monoclonal Antibodies for Passive Immunization Against Enterotoxigenic Escherichia coli

Enterotoxigenic Escherichia coli (ETEC) is a common cause for diarrheal infections in children in low- and middle-income countries (LMICs). To date, no ETEC vaccine candidates have been approved. Passive immunization with low-cost, oral formulations of secretory IgA (sIgA) against ETEC is an alternative approach to protect high-risk populations in LMICs. Using a model sIgA monoclonal antibody (anti-LT sIgA2-mAb), the stability profiles of different formulations were assessed during storage and in in vitro digestion models (mimicking in vivo oral delivery). First, by employing various physicochemical techniques and a LT-antigen binding assay, three formulations with varying acid-neutralizing capacity (ANC) were evaluated to stabilize sIgA2-mAb during stress studies (freeze-thaw, agitation, elevated temperature) and during exposure to gastric phase digestion. Next, a low-volume, in vitro intestinal digestion model was developed to screen various additives to stabilize sIgA2-mAb in the intestinal phase. Finally, combinations of high ANC buffers and decoy proteins were assessed to collectively protect sIgA2-mAb during in vitro sequential (stomach to intestine) digestion. Based on the results, we demonstrate the feasibility of low-cost, ‘single-vial’, liquid formulations of sIgA-mAbs delivered orally after infant feeding for passive immunization, and we suggest future work based on a combination of in vitro and in vivo stability considerations.

Brief Overview

This article reviews the burden of rotavirus (RV) disease and the role, types, and coverage of RV vaccines (RVVs) in India as well as globally. Establishing the epidemiology and burden of RV disease became an early priority. In the world, diarrheal infections are the second greatest cause of death in children, accounting for one in nine fatalities. Before the widespread use of RV vaccinations, an estimated 453,000 children under the age of 5 died worldwide from RV gastroenteritis (RVGE) in 2008. That's why the World Health Organization (WHO) recommends that RV vaccination should be included in national immunization programs to prevent RVGE. Several vaccines have been invented, and they are an efficient way to shield kids from RVGE. Four RVVs are currently approved by the WHO and accessible worldwide: the monovalent live attenuated human RVV (Rotarix); the pentavalent human-bovine reassortant RVV (RotaTeq); the naturally occurring monovalent neonatal bovine-human reassortant neonatal G9P[11], also known as 116E (Rotavac) and the Pentavalent, human-bovine RVV Rotasiil; all of them WHO prequalified, well tolerated with variable efficacy and protective value distributed globally. To control the RV disease among children, it is crucial to support the development of the next generation of vaccines. If the new vaccine is found to be secure, more efficient, simple to administer, and inexpensive for all, the disease may be controlled more efficiently in the near future.

Selection of G-rich ssDNA aptamers for the detection of enterotoxins of the cholera toxin family

Cholera and milder diarrheal disease are caused by Vibrio cholerae and enterotoxigenic Escherichia coli and are still a prominent public health concern. Evaluation of suspicious isolates is essential for the rapid containment of acute diarrhea outbreaks or prevention of epidemic cholera. Existing detection techniques require expensive equipment, trained personnel and are time-consuming. Antibody-based methods are also available, but cost and stability issues can limit their applications for point-of-care testing. This study focused on the selection of single stranded DNA aptamers as simpler, more stable and more cost-effective alternatives to antibodies for the co-detection of AB5 toxins secreted by enterobacteria causing acute diarrheal infections. Cholera toxin and Escherichia coli heat-labile enterotoxin, the key toxigenicity biomarkers of these bacteria, were immobilized on magnetic beads and were used in a SELEX-based selection strategy. This led to the enrichment of sequences with a high % GC content and a dominant G-rich motif as revealed by Next Generation Sequencing. Enriched sequences were confirmed to fold into G-quadruplex structures and the binding of one of the most abundant candidates to the two enterotoxins was confirmed. Ongoing work is focused on the development of monitoring tools for potential environmental surveillance of epidemic cholera and milder diarrheal disease.

Microbial Risk Assessment of Mature Compost from Human Excreta, Cattle Manure, Organic Waste, and Biochar

Lack of sanitation is the underlying cause of many diarrheal infections and associated deaths. Improving sanitation through the set-up of ecological sanitation dry toilets, followed by the thermophilic composting of human excreta, could offer a solution. In addition, treating the excreta via thermophilic composting allows us to recycle the nutrients to be used as fertilizer for agriculture. However, for this purpose, the compost should be free of pathogens. We conducted a thermophilic composting trial over 204 to 256 days with human excreta, along with vegetable scraps and teff straw, with and without biochar. A sawdust–cattle manure mixture with the same supplements served as a control treatment. To evaluate the hygienic quality of the mature compost, the bacterial indicators Escherichia coli and Salmonella were assessed using the cultivation-based most probable number method. In addition, Ascaris lumbricoides eggs were quantified through light microscopy. The amount of detected E. coli was below the thresholds of German and European regulations for organic fertilizer. Salmonella and Ascaris eggs were not detected. No significant differences between the treatments were observed. Thus, the composting process was efficient in decreasing the number of potential human pathogens. The mature compost fulfilled the legal regulations on organic fertilizer regarding potential human pathogens.

Bivariate spatial clustering in differential time trends of related tropical diseases: Application to diarrhea and intestinal parasite infections

There has been a rapid development of space–time multivariate disease mapping methods that focus on space–time variation of risks. Examining the posterior estimates of the space–time random effects can provide compelling epidemiological information that is necessary for public health monitoring. In this study, we propose and evaluate the posterior estimates of the random effects to examine spatial and temporal trends of two tropical diseases. Our model is a multivariate Bayesian space–time model with common spatial and temporal trends, and a space–time interaction term that allows different time trends for different areas. When applied to diarrhea and intestinal parasites data from Ghana, the model that consolidates all random effects as a multivariate conditional autoregressive prior was the best fit. The implementation is based on the notion that diarrheal and intestinal parasite infections share common risk factors Our novel contribution concerns the posterior joint evaluations of the spatial and temporal random effects into a 5 × 5 cross-tabulation table. The method presented is useful for developing and implementing joint epidemiological control strategies, especially in countries where resources are scarce.

Retrospective Cohort Analysis of Outpatient Antibiotic Use for Clostridioides difficile-Indicated Agents in British Columbia, from 2000 to 2018.

Clostridioides difficile (CDI) is the most common cause of nosocomial diarrheal infections. Historically, metronidazole was the first-line treatment, but guidelines now indicate oral vancomycin and fidaxomicin as primary antibiotics for initial episodes. A provincial stewardship program has operated in British Columbia (BC), since 2005. Since the program's inception, surveillance of antibiotic use has been ongoing. However, this is the first study to review community-acquired CDI-indicated antibiotic use. Moreover, this study offers the first interpretation of fidaxomicin use in BC since its addition to the provincial formulary. A retrospective cohort analysis included all outpatient dispensations for CDI-related antibiotics from January 1, 2000, to December 31, 2018. Antibiotic dispensations were extracted for metronidazole, vancomycin, and fidaxomicin. Consumption rates were calculated as prescriptions per 1000 population. Rates were examined overall and then stratified by medication, age, and sex. Secondary outcomes of interest included an examination of adherence to provincial special authority criteria; and proportions of outpatient antibiotic use attributable to administrative health records for CDI. The average annual rate of prescribing was 18.5 per 1000 population for all CDI-indicated antibiotics. The rate of prescribing increased (15%) over the 19-year study period, from 17.2 to 19.8 dispensations per 1000 population. Metronidazole accounted for the most antibiotics dispensed in every study year; however, by 2018 it demonstrated the most modest increase in use (15%). In comparison, fidaxomicin increased by 226% by 2018. Vancomycin had the highest percentage increase (621%), with the greatest change occurring from 2014 to 2015, correlating to the dissemination of new clinical practice guidelines. This is the first study to evaluate outpatient prescribing for CDI-indicated antibiotics, and one of the few studies to examine fidaxomicin since its introduction to Canadian formularies. Although causation cannot be inferred from study results, oral vancomycin, and fidaxomicin use has increased in line with, or in advance-of guidelines.

Predictors of stunting among children aged 6-59 months, Zimbabwe.

Stunted children have an increased risk of diminished cognitive development, diabetes, degenerative and CVD later in life. Numerous modifiable factors decrease the risk of stunting in children. This study aimed to assess the role of the individual, household and social factors on stunting in Zimbabwean children. A 1:2 unmatched case-control study. This study was conducted in two predominantly rural provinces (one with the highest national prevalence of stunting and one with the lowest prevalence) in Zimbabwe. Data were obtained from the caregivers of 150 children aged between 6 and 59 months with stunting and from the caregivers of 300 children without stunting. Multiple (39) correlates of stunting were identified. Child's age, birth length, birth weight, and weight-for-age outcome (child-related factors), caregiver's age, maternal HIV status, occupation, and education (parental factors), breast-feeding status, number of meals, and dietary quality (dietary factors), child's appetite, diarrhoeal and worm infection (childhood illnesses), income status, access to safe water, access to a toilet, health clubs and maternal support in infant feeding (household, socio-cultural factors) were all found to be significant predictors of childhood stunting. Nearly all aspects under review from the individual-, household- to social-level factors were significantly associated with childhood stunting. These findings add to the growing body of evidence supporting the WHO stunting framework and strengthen the need to focus interventions on a multi-sectoral approach to effectively address stunting in high prevalence countries.

Uncovering social and environmental factors that increase the burden of climate-sensitive diarrheal infections on children.

Climate-sensitive infectious diseases are an issue of growing concern due to global warming and the related increase in the incidence of extreme weather and climate events. Diarrhea, which is strongly associated with climatic factors, remains among the leading causes of child death globally, disproportionately affecting populations in low- and middle-income countries (LMICs). We use survey data for 51 LMICs between 2000 and 2019 in combination with gridded climate data to estimate the association between precipitation shocks and reported symptoms of diarrheal illness in young children. Weaccount for differences in exposure risk by climate type and explore the modifying role of various social factors. We find that droughts are positively associated with diarrhea in the tropical savanna regions, particularly during the dry season and dry-to-wet and wet-to-dry transition seasons. In the humid subtropical regions, we find that heavy precipitation events are associated with increased risk of diarrhea during the dry season and the transition from dry-to-wet season. Our analysis of effect modifiers highlights certain social vulnerabilities that exacerbate these associations in the two climate zones and present opportunities for public health intervention. For example, we show that stool disposal practices, child feeding practices, and immunizing against the rotavirus modify the association between drought and diarrhea in the tropical savanna regions. Inthe humid subtropical regions, household's source of water and water disinfection practices modify the association between heavy precipitation and diarrhea. The evidence of effect modification varies depending on the type and duration of the precipitation shock.

A multidrug- resistance pattern of an Escherichia coli strain isolated from diarrheal stools at the China-Guinea Friendship Hospital of Kipé in Conakry

Introduction: Diarrheal infections associated to multidrug resistant bacteria are a public health problem, particularly in the tropics. Objective: The aim of this study was to describe a Multidrug resistant strain of Escherichia coli (E. coli) isolated from diarrheal stools. Patients and methods: A sample of diarrheal stools from a 30 years old housekeeper patient was analysed at China-Guinea Friendship Hospital of Kipé/Conakry. Parasitological examination by optical microscopy, followed by bacteriological analysis were done. Cultures were carried out on different agar media. Bacterial identification, antibiograms and minimum inhibitory concentrations (MIC) were performed using the Vitek 2 System. Results: The isolated E. coli strain was sensitive only to 4 of 29 antibiotics tested including imipenem, ertapenem, amikacin and nitrofurantoin. Intermediate sensitivity was detected towards minocycline. In contrast, this strain was resistant to piperacillin, cefuroxime, cefuroxime axetil, cefixime, ceftriaxone, cefepime, aztreonam, meropenem, levofloxacin, ofloxacin, tetracycline, tigecycline, chloramphenicol, trimethoprim, ampicillin, amoxicillin/clavulanic acid, ticarcillin, piperacillin/tazobactam, cephalothin, cefotaxime, ceftazidime, gentamicin, tobramycin, nalidixic acid, ciprofloxacin, ofloxacin and trimethoprim/sulfamethoxazole with high MICs. Conclusion: The treatment of this multidrug-resistant Escherichia coli diarrheal infection requires appropriate antibiotic therapy, based on the results of an accurate antibiogram to be performed with rapid means for better patient care.

PADUPADI YES OR NO (Pencegahan Diare dengan Edukasi PHBS menggunakan Media Video YES or NO)

Background: According to the World Health Organization (WHO), diarrhea is the number one cause of death for children under 5 years of age. In general, it is estimated that more than 10 million children under the age of 5 years die worldwide each year, of which about 20% are caused by diarrheal infections. In Indonesia, diarrheal disease is a special event (KLB) that is often accompanied by death. In the city of Bogor, the incidence of diarrhea in toddlers at the Tanah Sareal Health Center, Bogor City, in 2019 141 toddlers experienced diarrhea. In 2020, 107 children under five had diarrhea. And in 2021 21 toddlers had diarrhea. In PBL 1 and PBL 2, it is known that the main cause of diarrhea in children under five in the Tanah Sareal Work Area is the poor implementation of PHBS properly. Objectives: The purpose of this community service is to provide education in the form of counseling related to the application of PHBS in daily life at Posyandu Kartini RW 01 in the working area of ​​the Tanah Sareal Health Center, Bogor City. Methods: The method used is health education related to the prevention of diarrhea by implementing PHBS in the Tanah Sareal Health Center Work Area, Bogor City. This activity was carried out at the Kartini Posyandu RW 01 Tanah Seral, Bogor City with the title PADUPADI YES or NO (Diarrhea Prevention with PHBS education Using Video Media Yes or No). The target of this activity is parents or caregivers of toddlers who live in the Posyandu Kartini area, RW 01 Tanah Sareal, Bogor City. The educational media used are video and a crossword puzzle. To measure the success of this activity, the Pre Test and Post Test are used. Results: The results obtained from the provision of health education are increasing the knowledge of parents or caregivers of toddlers on the correct application of PHBS in daily life, which is 80.9% or as many as 17 parents or caregivers of toddlers. Conclusion: The conclusion obtained from the results of this counseling is that there are still many parents or caregivers of toddlers who do not know and have not implemented PHBS properly and correctly, this is one of the biggest causes of diarrhea in toddlers in the working area of ​​the Tanah Sareal Public Health Center, Bogor City.

The impact of temperature and precipitation on all-infectious-, bacterial-, and viral-diarrheal disease in Taiwan

BackgroundThe ongoing climate change will elevate the incidence of diarrheal in 2030–2050 in Asia, including Taiwan. This study investigated associations between meteorological factors (temperature, precipitation) and burden of age-cause-specific diarrheal diseases in six regions of Taiwan using 13 years of (2004–2016) population-based data. MethodsWeekly cause-specific diarrheal and meteorological data were obtained from 2004 to 2016. We used distributed lag non-linear model to assess age (under five, all age) and cause-specific (viral, bacterial) diarrheal disease burden associated with extreme high (99th percentile) and low (5th percentile) of climate variables up to lag 8 weeks in six regions of Taiwan. Random-effects meta-analysis was used to pool these region-specific estimates. ResultsExtreme low temperature (15.30 °C) was associated with risks of all-infectious and viral diarrhea, with the highest risk for all-infectious diarrheal found at lag 8 weeks among all age [Relative Risk (RR): 1.44; 95 % Confidence Interval (95 % CI): 1.24–1.67]. The highest risk of viral diarrheal infection was observed at lag 2 weeks regardless the age. Extreme high temperature (30.18 °C) was associated with risk of bacterial diarrheal among all age (RR: 1.07; 95 % CI: 1.02–1.13) at lag 8 weeks. Likewise, extreme high precipitation (290 mm) was associated with all infectious diarrheal, with the highest risk observed for bacterial diarrheal among population under five years (RR: 2.77; 95 % CI: 1.60–4.79) at lag 8 weeks. Extreme low precipitation (0 mm) was associated with viral diarrheal in all age at lag 1 week (RR: 1.08; 95 % CI: 1.01–1.15)]. ConclusionIn Taiwan, extreme low temperature is associated with an increased burden of viral diarrheal, while extreme high temperature and precipitation elevated burden of bacterial diarrheal. This distinction in cause-specific and climate-hazard specific diarrheal disease burden underscore the importance of incorporating differences in public health preparedness measures designed to enhance community resilience against climate change.

Bioinformatics analysis of structural protein to approach a vaccine candidate against Vibrio cholerae infection.

The bacteria Vibrio cholerae causes cholera, an acute diarrheal infection that can lead to dehydration and even death. Over 100,000 people die each year as a result of epidemic diseases; vaccination has emerged as a successful strategy for combating cholera. This study uses bioinformatics tools to create a multi-epitope vaccine against cholera infection using five structural polyproteins from the V. cholerae (CTB, TCPA, TCPF, OMPU, and OMPW). The antigenic retrieved protein sequence were analyzed usingBCPred and IEDB bioinformatics tools to predict B cell and T cell epitopes, respectively, which were then linked with flexible linkers together with an adjuvant to boost it immunogenicity. The construct has a theoretical PI of 6.09, a molecular weight of 53.85kDa, and an estimated half-life for mammalian reticulocytes in vitro of 4.4h. These resultsdemonstrate the construct's longevity. The vaccine design was docked against the human toll-like receptor (TLR) to evaluate compatibility and effectiveness; also otheradditional post-vaccination assessments were carried out on the designed vaccine. Through in silico cloning, its expression was determined. The results show that it has a CAI value of 0.1 and GC contents of 58.97% whichestablished theadequate expression and downstream processing of the vaccine construct, and our research demonstrated that the multi-epitope subunit vaccine exhibits antigenic characteristics. Additionally, we carried out an in silico immunological simulation to examine the immune reaction to an injection. Our results strongly suggest that the vaccine candidate on further validation would induce immune response against the V. cholerae infection.

The forgotten threat of cholera in Syria.

Cholera is an ancient disease that persists as an issue of public health in many conflict-affected countries worldwide. Cholera is a diarrheal infection caused by ingested water or food contaminated with the bacterium Vibrio cholerae. On 10 September 2022, the Ministry of Health in Syria declared a cholera outbreak. Poor water and sanitation systems, disease surveillance breakdown, the collapse of the health system, and deteriorated socioeconomic conditions are potential risk factors for the outbreak's spread. Identifying the context-related factors associated with the spread of disease is a core to developing practical response mechanisms. In this study, we suggested a multisectoral approach that addresses context-specific elements contributing to the cholera outbreak spread in Syria; public health determinants, geopolitics, risk factors, and pandemic fatigue.

Review of the Zoonotic Importance of Salmonellosis and Associated Risk Factors

Salmonella is one of the most common and significant human and animal food-borne pathogens that cause salmonellosis, which has high medical and monetary costs. Salmonella has a big impact on public health because it can spread zoonotic and foodborne diseases to people. Many domestic and wild animals intestinal tracts serve as the main reservoir for Salmonella, which can result in the direct or indirect contamination of a variety of foods with fecal organisms. Salmonellae are etiological agents of diarrheal and systemic infections. They can be shed in large numbers on the faces of clinical cases and carrier animals, causing contamination of the environment and frequently resulting in subclinical infections. Infection in food animals often leads to contamination of meat, eggs, milk and cheese. The organism can also spread through direct contact with infected humans, animals, or feces contaminated environments. Infected food handlers may also act as a source of contamination for foodstuffs, because of the increasing antibiotic resistance of organisms and companion animals, animals are an important source of Salmonella infection for humans. Salmonella can colonize its hosts by invading, adhering, and bypassing the host’s intestinal defense mechanisms, such as gastric acid, thanks to a variety of virulence markers and determinants, including flagella, capsule, plasmids, adhesion systems, and secretion systems. Diagnosis is based on the isolation of the organism either from tissues collected aseptically at necropsy or from faces, rectal swabs or environmental samples, food products, and feedstuffs; prior or current infection of animals by some agents may also be diagnosed serologically.

Utilization of health belief model in comprehending diarrheal disease dynamics: a case of cryptosporidiosis in Uganda

BackgroundDiarrheal diseases contribute greatly to the reported global childhood mortality and morbidity with related social, economic consequences. This study was conducted to analyze the utilization of the Health Belief Model (HBM) theory to comprehend diarrheal disease dynamics in Uganda.MethodsOur study utilized a qualitative cross-sectional design among adult livestock farmers in selected farming communities. A total of 80 individuals were recruited and interviewed through Focus Discussion Groups (FDGs) (n = 6) and Key Informant Interviews (KIIs) (n = 8) to evaluate diarrheal disease dynamics. The scope of dynamics included but not limited to exposure risks, knowledge, and attitudes. Our results were presented using the five (5) constructs of the HBM.ResultsPerceived susceptibility; communities believed that both humans and their animals are at high risk of different kinds of diarrheal infections. The farmers believed that majority of these diarrhea infections are hard to treat especially among animals. Perceived severity; farmers believed that diarrheal diseases are characterized by loss of weight, fever, emaciation, dry eyes, severe prolonged diarrhea and sudden death. Perceived barriers; limited knowledge and misconceptions about the diarrheal infections were great inhibitors to successful disease prevention and control. Self-efficacy; farmers had fear of laxity that interventions being suggested and put in place to curb diarrheal diseases such as cryptosporidiosis would wither away with time thus endemicity of the problem in the community. Modifying factors and cues to action; most of the farmers treat animals by themselves based on; probability, traditional knowledge and previous experience.ConclusionSustained public health interventional activities should therefore be undertaken by both human and animal health sectors with maximum community involvement. Communities suggested the need to increase preventive measures and promote household hygiene efforts to always wash hands with soap and running water in order to reduce the burden of diarrhea diseases such as cryptosporidiosis.