Emergence Of Diseases Research Articles

Current development of severe acute respiratory syndrome coronavirus 2 neutralizing antibodies (Review).

The coronavirus disease 2019 pandemic due to severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) seriously affected global public health security. Studies on vaccines, neutralizing antibodies (NAbs) and small molecule antiviral drugs are currently ongoing. In particular, NAbs have emerged as promising therapeutic agents due to their well‑defined mechanism, high specificity, superior safety profile, ease of large‑scale production and simultaneous application for both prevention and treatment of viral infection. Numerous NAb therapeutics have entered the clinical research stages, demonstrating promising therapeutic and preventive effects. These agents have been used for outbreak prevention and control under urgent authorization processes. The present review summarizes the molecular targets of SARS‑CoV‑2‑associated NAbs and screening and identification techniques for NAb development. Moreover, the current shortcomings and challenges that persist with the use of NAbs are discussed. The aim of the present review is to offer a reference for the development of NAbs for any future emergent infectious diseases, including SARS‑CoV‑2.

Understanding underlying physical mechanism reveals early warning indicators and key elements for adaptive infections disease networks.

The study of infectious diseases holds significant scientific and societal importance, yet current research on the mechanisms of disease emergence and prediction methods still face challenging issues. This research uses the landscape and flux theoretical framework to reveal the non-equilibrium dynamics of adaptive infectious diseases and uncover its underlying physical mechanism. This allows the quantification of dynamics, characterizing the system with two basins of attraction determined by gradient and rotational flux forces. Quantification of entropy production rates provides insights into the system deviating from equilibrium and associated dissipative costs. The study identifies early warning indicators for the critical transition, emphasizing the advantage of observing time irreversibility from time series over theoretical entropy production and flux. The presence of rotational flux leads to an irreversible pathway between disease states. Through global sensitivity analysis, we identified the key factors influencing infectious diseases. In summary, this research offers valuable insights into infectious disease dynamics and presents a practical approach for predicting the onset of critical transition, addressing existing research gaps.

Spatial examination of social and environmental drivers of Middle East respiratory syndrome coronavirus (MERS-CoV) across Kenya.

Climate and agricultural land-use change has increased the likelihood of infectious disease emergence and transmissions, but these drivers are often examined separately as combined effects are ignored. Further, seldom are the influence of climate and agricultural land use on emerging infectious diseases examined in a spatially explicit way at regional scales. Our objective in this study was to spatially examine the climate, agriculture, and socio-demographic factors related to agro-pastoralism, and especially the combined effects of these variables that can influence the prevalence of Middle East respiratory syndrome coronavirus (MERS-CoV) in dromedary camels across northern Kenya. Our research questions focused on: (1) How MERS-CoV in dromedary camels has varied across geographic regions of northern Kenya, and (2) what climate, agriculture, and socio-demographic factors of agro-pastoralism were spatially related to the geographic variation of MERS-CoV cases in dromedary camels. To answer our questions, we analyzed the spatial distribution of historical cases based on serological evidence of MERS-CoV at the county level and applied spatial statistical analysis to examine the spatial relationships of the MERS-CoV cases between 2016 and 2018 to climate, agriculture, and socio-demographic factors of agro-pastoralism. Regional differences in MERS-CoV cases were spatially correlated with both social and environmental factors, and particularly ethno-religious camel practices, which highlight the complexity in the distribution of MERS-CoV in dromedary camels across Kenya.

Parasite prevalence is determined by infection state- and risk-dependent dispersal of the host.

The spread of parasites and the emergence of disease are currently threatening global biodiversity and human welfare. To address this threat, we need to better understand those factors that determine parasite persistence and prevalence. It is known that dispersal is central to the spatial dynamics of host-parasite systems. Yet past studies have typically assumed that dispersal is a species-level constant, despite a growing body of empirical evidence that dispersal varies with ecological context, including the risk of infection and aspects of host state such as infection status (parasite-dependent dispersal; PDD). Here, we develop a metapopulation model to understand how different forms of PDD shape the prevalence of a directly transmitted parasite. We show that increasing host dispersal rate can increase, decrease or cause a non-monotonic change in regional parasite prevalence, depending on the type of PDD and characteristics of the host-parasite system (transmission rate, virulence, and dispersal mortality). This result contrasts with previous studies with parasite-independent dispersal which concluded that prevalence increases with host dispersal rate. We argue that accounting for host dispersal responses to parasites is necessary for a complete understanding of host-parasite dynamics and for predicting how parasite prevalence will respond to changes such as human alteration of landscape connectivity. This article is part of the theme issue 'Diversity-dependence of dispersal: interspecific interactions determine spatial dynamics'.

Structural equation modeling to explain the relationship between intergenerational relationships and depressive symptoms with the mediation of social isolation in the Iranian older adults

Objectives There is ample evidence of the significant role of social isolation and reduced intergenerational relationships in the emergence of various problems and diseases, including depression. Therefore, the present study aims to investigate the relationship between intergenerational relationships, social isolation, and depression in the older adult population of Maku, Iran, in 2022. Methods The present study was a correlational study conducted on 407 older adult individuals in Maku. The sampling method was systematic random sampling. The inclusion criteria were age 60 and above, ability to communicate, no cognitive impairment, no experience of stressful events or incidents in the past six months, and incomplete questionnaire response as the exclusion criterion. The data were collected using the Shokoohi Intergenerational Relationships Questionnaire, Lubben Social Network Scale (LSNS), and Geriatric Depression Scale (GDS-15). The data were analyzed using SPSS16 software and descriptive statistics tests (percentage, frequency, mean, standard deviation, and confidence interval), Pearson correlation coefficient, and structural equation modeling using EQS6.4 software. Results Intergenerational relationships had a direct negative correlation with depressive symptoms in the older adult population (β = −0.18, p < 0.001), and social isolation was indirectly negatively correlated with depressive symptoms in the older adult population (β = −0.15, p < 0.001). Conclusion Considering that older adults who maintain solid intergenerational ties with their children often encounter less social isolation and display fewer signs of depression, it is crucial to devise suitable strategies to strengthen these relationships and foster social interaction in their later years.

Synchronous Telehealth Fatigue Among Health Care Providers

With the emergence of the coronavirus disease 2019 pandemic, health care quickly shifted from in-person visits to virtual care. Although telehealth offers numerous benefits, this change in workflow presented new challenges and potentially undesired outcomes for health care providers. Emerging research suggests that excessive time engaging in video conferencing can lead to fatigue and burnout. However, little is known about how telehealth providers are affected. This pilot study aimed to determine whether telehealth providers experience synchronous telehealth fatigue and its association with factors such as the number of hours worked daily, work environment, work location, characteristics of breaks, telehealth education, and resiliency.

Mechanisms of host adaptation by bacterial pathogens.

The emergence of new infectious diseases poses a major threat to humans, animals, and broader ecosystems. Defining factors that govern the ability of pathogens to adapt to new host species is therefore a crucial research imperative. Pathogenic bacteria are of particular concern, given dwindling treatment options amid the continued expansion of antimicrobial resistance. In this review, we summarize recent advancements in the understanding of bacterial host species adaptation, with an emphasis on pathogens of humans and related mammals. We focus particularly on molecular mechanisms underlying key steps of bacterial host adaptation including colonization, nutrient acquisition, and immune evasion, as well as suggest key areas for future investigation. By developing a greater understanding of the mechanisms of host adaptation in pathogenic bacteria, we may uncover new strategies to target these microbes for the treatment and prevention of infectious diseases in humans, animals, and the broader environment.

Impact of the COVID-19 Pandemic on Cockroach Allergy: A 4-Year Retrospective Study

Introduction: Sensitivity to indoor allergens increases the risks of asthma and the emergence of allergic diseases. Indoor allergens include house dust mite (HDM), pet dander, cockroach (CR), and molds. We investigated how CR sensitivity was affected during the pandemic period. Methods: This study included patients aged ≥18 years who visited the allergy unit of our clinic between March 2018 and March 2022 and who underwent skin prick tests (SPTs) for aeroallergens. Patients were divided into two groups: those of the prepandemic and pandemic periods, depending on the visit dates. Results: In all, 7,687 patients were recruited; 5,074 individuals with negative SPT results were excluded. Among the 2,613 atopic patients, CR sensitivity was detected in 278 (10.6%). The prevalence of CR sensitivity was significantly higher in the pandemic group than in the prepandemic group (12% vs. 8.6%; p < 0.05). The frequency of asthma was higher in patients with CR sensitivity than in others (33.1% vs. 26%, p = 0.011). In addition, individuals with CR sensitivity were older than others (p = 0.001). CR sensitivity was more common in males than in females (44.2% vs. 37.7%, p = 0.034). Moreover, dog and HDM sensitivities were more common in individuals with CR sensitivity than in others (p = 0.004, p < 0.001, respectively). Conclusion: This study reveals an increased sensitivity to CR during the pandemic and establishes an association between such sensitivity and the frequency of asthma. Variability in terms of CR sensitivity across different countries is emphasized. In addition, HDM and dog sensitivities were more common in individuals with CR sensitivity.

Global wildlife trade and trafficking contribute to the world’s nonhuman primate conservation crisis

A growing global human population, habitat conversion, and the indiscriminate exploitation of natural resources have created unsustainable demands on nature, resulting in widespread biodiversity loss. Primates, which represent the third most specious Order of mammals, are facing an extinction crisis. Currently, 69% of primate species are listed by the IUCN as threatened (Vulnerable, Endangered, or Critically Endangered) and 94% have declining populations. Here, we examine two primary threats to primate population persistence, namely the commercialized hunting and capturing of wild primates and their body parts for food, traditional medicine, pets, and use in biomedical research. Both the legal wildlife trade and illegal wildlife trafficking represent multibillion-dollar industries that contribute to primate population decline, a reduction in genetic diversity, and local extirpation. Trade and trafficking also can lead to the emergence of infectious diseases, increasing biosecurity risks to humans. Between 2015 and 2021, CITES reported 337,511 live primates representing at least 99 species were legally traded, with 6.5% sourced directly from the wild. The recent indictment of Cambodian officials for allegedly laundering wild-caught long-tailed macaques into the U.S. by labelling them as captive-bred, highlights the need for greater transparency and accountability. Comprehensive data on the illegal trafficking of primates are extremely difficult to obtain. However, between 2009 and 2017, primates accounted for 20% of all seizures of illegally traded mammals in the air transport sector. International wildlife trafficking is dominated by criminal networks, corruption, and driven by the demands of wealthy consumers. In addition, the internet has expanded international opportunities to connect buyers and sellers of wild-caught primates and their body parts. Despite explicit bans on selling endangered primates, social media sites continue to do so. Moreover, data on the global food security index (GFSI) indicate that as the international demand for wild live primates, their meat, and other body parts has continued to increase, the majority of people in primate range nations have remained food insecure. Given that almost 70% of primate species are negatively impacted by hunting and trapping, we offer a set of recommendations to reduce the trade and trafficking of wild primates.

Microcystis viridis NIES-102 Cyanobacteria Lectin (MVL) Interacts with SARS-CoV-2 Spike Protein Receptor Binding Domains (RBDs) via Protein-Protein Interaction.

The emergence of coronavirus disease 2019 (COVID-19) posed a major challenge to healthcare systems worldwide, especially as mutations in the culprit Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) complicated the development of vaccines and antiviral drugs. Therefore, the search for natural products with broad anti-SARS-CoV-2 capabilities is an important option for the prevention and treatment of similar infectious diseases. Lectins, which are widely recognized as antiviral agents, could contribute to the development of anti-SARS-CoV-2 drugs. This study evaluated the binding affinity of six lectins (including the cyanobacterial lectin from Microcystis viridis NIES-102 (MVL), and Jacalin, a lectin from the breadfruit, Artocarpus altilis) to the receptor binding domain (RBD) of the spike protein on the original (wild) SARS-CoV-2 and three of its mutants: Alpha, Delta, and Omicron. MVL and Jacalin showed distinct binding affinity to the RBDs of the four SARS-CoV-2 strains. The remaining four lectins (DB1, ConA, PHA-M and CSL3) showed no such binding affinity. Although the glycan specificities of MVL and Jacalin were different, they showed the same affinity for the spike protein RBDs of the four SARS-CoV-2 strains, in the order of effectiveness Alpha > Delta > original > Omicron. The verification of glycan-specific inhibition revealed that both lectins bind to RBDs by glycan-specific recognition, but, in addition, MVL binds to RBDs through protein-protein interactions.

The Effect of Hypokinesia on the Dynamics of the Formed Elements of Blood during the Embryonic Period of Prenatal Development in Pregnant Rabbits

The erythroformula and leucoformula indicators changed in the rabbits that experienced hypokinesia during the embryonic stage of pregnancy. Compared to the rabbits that spent the pregnancy period under normal conditions, changes in concentrations of leukoformula indicators such as leukocytes, lymphocytes, monocytes, and granulocytes were detected in rabbits exposed to hypokinesia. While significant changes in erythroformula indicators: erythrocytes, average corpuscular volume of erythrocytes and hemoglobin capacity, erythrocyte sedimentation rate did not occur. The results of our studies have shown that prenatal hypokinesia causes noticeable changes in the blood coagulation system. On the other hand, changes in the coagulation system under the influence of prenatal hypokinesia were found to occur in the first periods of postnatal ontogenesis, had a continuous nature, and were maintained until the full maturity of postnatal development. Due to the effect of the hypokinesia factor, the changes in the mentioned indicators lead to the emergence of severe pathological diseases in most cases.

Individual-level models of disease transmission incorporating piecewise spatial risk functions

Modelling epidemics is crucial for understanding the emergence, transmission, impact and control of diseases. Spatial individual-level models (ILMs) that account for population heterogeneity are a useful tool, accounting for factors such as location, vaccination status and genetic information.Parametric forms for spatial risk functions, or kernels, are often used, but rely on strong assumptions about underlying transmission mechanisms. Here, we propose a class of non-parametric spatial disease transmission model, fitted within a Bayesian Markov chain Monte Carlo (MCMC) framework, allowing for more flexible assumptions when estimating the effect on spatial distance and infection risk.We focus upon two specific forms of non-parametric spatial infection kernel: piecewise constant and piecewise linear. Although these are relatively simple forms, we find them to produce results in line with, or superior to, parametric spatial ILMs. The performance of these models is examined using simulated data, including under circumstances of model misspecification, and then applied to data from the UK 2001 foot-and-mouth disease.

Exploring viral diversity and metagenomics in livestock: insights into disease emergence and spillover risks in cattle.

Cattle have a significant impact on human societies in terms of both economics and health. Viral infections pose a relevant problem as they directly or indirectly disrupt the balance within cattle populations. This has negative consequences at the economic level for producers and territories, and also jeopardizes human health through the transmission of zoonotic diseases that can escalate into outbreaks or pandemics. To establish prevention strategies and control measures at various levels (animal, farm, region, or global), it is crucial to identify the viral agents present in animals. Various techniques, including virus isolation, serological tests, and molecular techniques like PCR, are typically employed for this purpose. However, these techniques have two major drawbacks: they are ineffective for non-culturable viruses, and they only detect a small fraction of the viruses present. In contrast, metagenomics offers a promising approach by providing a comprehensive and unbiased analysis for detecting all viruses in a given sample. It has the potential to identify rare or novel infectious agents promptly and establish a baseline of healthy animals. Nevertheless, the routine application of viral metagenomics for epidemiological surveillance and diagnostics faces challenges related to socioeconomic variables, such as resource availability and space dedicated to metagenomics, as well as the lack of standardized protocols and resulting heterogeneity in presenting results. This review aims to provide an overview of the current knowledge and prospects for using viral metagenomics to detect and identify viruses in cattle raised for livestock, while discussing the epidemiological and clinical implications.

Body-attachable multifunctional electronic skins for bio-signal monitoring and therapeutic applications

The lack of infrastructure and accessibility in medical treatments has been considered as a global chronic issue since the concept of treatment and prevention was presented. After the COVID-19 pandemic, the medical reaction capability for epidemic outbreak/spread has been spotlighted as a critical issue to the fore worldwide. To reduce the burden on the medical system from the simultaneous disease emergence, the personalized wearable electronic systems have arisen as the next-generation biomedical monitoring/treating equipment for infectious diseases at the initial stage. In particular, electronic skin (e-skin) with its potential for multifunctional extendibility has been enabled to be applied to next-generation long-term healthcare devices with real-time biosignal sensing. Here, we introduce the recent enhancements of various e-skin systems for healthcare applications in terms of material types and device structures, including sensor components, biological signal sensing mechanisms, applicable technological advancements, and medical utilization.

Gentrification of Communities Surrounding Chedi Luang Worawiharn Temple, Sri Phum Subdistrict, Muang District, Chiang Mai Province

Modification of building structure and use by new investors to achieve increased economic returns by pushing former residents out of the areas is the process of gentrification.The purpose of this article is to investigate the gentrification of communities surrounding Chedi Luang Worawiharn Temple, Sri Phum subdistrict, Muang district, Chiang Mai province, and to analyze changes in the gentrification phenomenon during the coronavirus disease 2019 situation. Data collection was composed of physical surveying, interviews, and questionnaires. Three major groups were interviewed including 18 persons from the original community, 15 newcomers, and 10 community leaders and government officials. The 268 questionnaires were sampled in three communities including the Phra Chao Mengrai Samakkhi community, the Chang Taem community, and the Phranon community. The study found that there is mostly commercial land use in all three communities. Most of the new occupants used to live in the central region. The study area has three stages of gentrification. The development process begins with the first stage, early development, and then completes development in the second stage, and lastly to the third stage, which is the community's adaptation to the emergence of the gentrification phenomenon. The study also discovered that, before the emergence of coronavirus disease in 2019, the communities were significantly impacted by the economy due to gentrification, such as increased living costs and rent/land prices. While the rise of commercial and service businesses is a beneficial result of gentrification. During coronavirus epidemics, certain localities witnessed population declines whereas land prices climbed with a stagnant economy, increased speculation, and a drop in commerce and services. However, gentrification improves better relationships between former inhabitants and newcomers for overcoming the 2019 coronavirus disease outbreak.

One Health Risk and Disease (OHRAD): a tool to prioritise the risks for epidemic-prone diseases from One Health perspective

BackgroundThe rise in epidemic-prone diseases daily poses a serious concern globally. Evidence suggests that many of these diseases are of animal origin and contribute to economic loss. Considering the limited time and other resources available for the animal and human health sectors, selecting the most urgent and significant risk factors and diseases is vital, even though all epidemic-prone diseases and associated risk factors should be addressed. The main aim of developing this tool is to provide a readily accessible instrument for prioritising risk factors and diseases that could lead to disease emergence, outbreak or epidemic.MethodsThis tool uses a quantitative and semi-quantitative multi-criteria decision analysis (MCDA) method that involves five steps: Identifying risk factors and diseases, Weighting the criteria, Risk and disease scoring, Calculating risk impact and disease burden score, and Ranking risks and diseases. It is intended to be implemented through a co-creation workshop and involves individual and group activities. The last two steps are automated in the MS Excel score sheet.ResultsThis One Health Risk and Disease (OHRAD) prioritisation tool starts with an individual activity of identifying the risks and diseases from the more extensive list. This, then, leads to a group activity of weighing the criteria and providing scores for each risk and disease. Finally, the individual risk and disease scores with the rankings are generated in this tool.ConclusionsThe outcome of this OHRAD prioritisation tool is that the top risks and diseases are prioritised for the particular context from One Health perspective. This prioritised list will help experts and officials decide which epidemic-prone diseases to focus on and for which to develop and design prevention and control measures.

Selective and sensitive CQD-based sensing platform for Cu2+ detection in Wilson’s disease

Excessive Cu2+ intake can cause neurological disorders (e.g. Wilson’s disease) and adversely affect the gastrointestinal, liver, and kidney organs. The presence of Cu2+ is strongly linked to the emergence and progression of Wilson's disease (WD), and accurately measuring the amount of copper is a crucial step in diagnosing WD at an early stage in a clinical setting. In this work, CQDs were fabricated through a facile technique as a novel fluorescence-based sensing platform for detecting Cu(II) in aqueous solutions, and in the serum samples of healthy and affected individuals by WD. The CQDs interact with Cu(II) ions to produce Turn-on and Turn-off states at nano-molar and micro-molar levels, respectively, with LODs of 0.001 µM and 1 µM. In fact, the Cu2+ ions can act like a bridge between two CQDs by which the charge and electron transfer between the CQDs may increase, possibly can have significant effects on the spectroscopic features of the CQDs. To the best of our knowledge, this is the first reported research that can detect Cu(II) at low levels using two different complexation states, with promising results in testing serum. The potential of the sensor to detect Cu(II) was tested on serum samples from healthy and affected individuals by WD, and compared to results obtained by ICP-OES. Astonishingly, the results showed an excellent correlation between the measured Cu(II) levels using the proposed technique and ICP-OES, indicating the high potential of the fluorimetric CQD-based probe for Cu(II) detection. The accuracy, sensitivity, selectivity, high precision, accuracy, and applicability of the probe toward Cu(II) ions make it a potential diagnostic tool for Wilson's disease in a clinical setting.

Are vessel arrival and port operations affected by COVID-19? Evidence from the Hong Kong port

Efficient vessel arrivals and departures are crucial for the smooth functioning of port operations and global supply chains. Nonetheless, the emergence of the Coronavirus disease (COVID-19) at the end of 2019 has presented unprecedented challenges to the shipping industry worldwide, disrupting vessel schedules and operations due to measures aimed at minimizing in-person interactions and restricting the movement of goods and people. The influence of the COVID-19 on vessel arrivals at ports around the world has been significant and far-reaching, with many ports struggling to maintain their efficiency and effectiveness. This study takes the Hong Kong port (HKP) as an example to evaluate the impact of the COVID-19 pandemic on vessel arrivals and port operations. Data from 2019 to 2022 on vessel arrivals and port operations are collected to examine whether, how, and why the pandemic has affected these arrivals and the related port operations. Specifically, we use four general indicators, namely the number of vessel calls, vessel total net tonnage (NT), vessel average gross tonnage (GT), and port total throughput, to comparatively evaluate the COVID-19 impact on vessel arrival. Additionally, we quantitatively assess the effects of COVID-19 on vessel arrival punctuality and vessel turnaround time at the HKP. Our analysis reveals that the COVID-19 and associated restrictions have led to fewer vessel calls across various vessel types, a decrease in overall port throughput, and consequently, reductions in total vessel NT and average GT. Furthermore, the pandemic-related restrictions have exacerbated vessel arrival delays and increased vessel turnaround time during the pandemic, further reducing the efficiency of port operations. To address these challenges, our study also proposes policy recommendations and management guidance for the port to enhance its resilience and efficiency in the post COVID-19 pandemic era. By shedding light on effects of the COVID-19 pandemic on vessel arrival and port operations, our study contributes to a deeper understanding of the challenges faced by the shipping industry and provides insights and recommendations for the future development of port operations in the post COVID-19 era.

The prevalence and genotype distribution of human papillomavirus in central Fujian Province during the COVID-19 pandemic

BackgroundGlobal human activities were significantly impacted by the emergence of the coronavirus disease 2019 (COVID-19) pandemic caused by the 2019 novel coronavirus. This study aimed to investigate the prevalence and genotype distribution of HPV infection in Central Fujian Province during the pandemic.MethodsCervical samples were collected from 21,612 outpatients and 12,664 females who underwent physical examinations and HPV screening at the People’s Hospital of Fujian Province in Fuzhou from April 2020 to April 2023. HPV detection and genotyping were conducted using PCR hybridization.ResultsThe overall HPV infection rate was 16.1% during the COVID-19 pandemic, with the outpatient group exhibiting a greater infection rate (19.0%) than did the healthy group (12.3%). The top five high-risk HPV (HR-HPV) genotypes in both groups were HPV52, HPV53, HPV58, HPV16, and HPV51. Additionally, HPV81 and HPV43 were the two most common low-risk HPV (LR-HPV) genotypes in the patient group, while HPV81 and HPV42 were the two most common LR-HPV genotypes in the healthy group. The highest prevalence of HPV infection was observed in individuals aged ≤ 24 years (28.4%, 95% CI 25.9–30.9), followed by those aged ≥ 55 years (23.6%, 95% CI 21.6–24.7) and other age groups. The prevalence decreased from 23.0% (95% CI 22.4–23.7) in 2018–2019 to 13.8% (95% CI 12.0-15.5) in 2023.ConclusionThis study provides valuable insights into the prevalence and genotypes of HPV infection in the female population of Central Fujian Province from 2020 to 2023. The findings indicate that the prevalence of HPV infection in Central Fujian Province remains relatively low compared to the national average. Furthermore, the prevalence of HPV decreased during the COVID-19 pandemic; however, as the pandemic waned, there was potential for an increase in HPV infection rates. Therefore, it is crucial to strengthen HPV screening and vaccination strategies to prevent the potential spread of HPV.

Literature Review: Impact of the Double Burden Malnutrition

Double burden of nutrition is a nutritional problem where undernutrition and overnutrition occur together. It might happen at the level of the individual, the household, and the population. This article’s goal is to acertain how double burden of nutrition affects health, economy, and productivity. The literature review approach was used to construct this paper, results were sourced from the Google Scholar database and then selected and examined more deeply the findings. The findings of this literature review highlight the effects of the health aspect which include the emergence of infectious, chronic diseases, and cognitive impairment; the economic aspect which leads in poverty and difficulty in finding employment opportunities; and the aspect of the country's productivity will decrease.