Greatest Public Health Threat Research Articles

Effect of Tocilizumab and Remdesivir on the Outcome of Patients with Covid 19 Pneumonia Admitted to Alabbasia Chest Hospital ICU

Abstract Background Coronavirus is one of the major pathogens that primarily targets the human respiratory system. Previous coronaviruses outbreaks of (CoVs) include the severe acute respiratory syndrome (SARS)-CoV and the Middle East respiratory syndrome (MERS)-CoV which have been considered as great public health threat. Aim of the Work This study aimed to find Effect of Tocilizumab and Remdesivir on the outcome of Patients with Covid 19 Pneumonia Admitted to Alabbasia Chest Hospital ICU. Patients and Methods This retrospective observational study was conducted on 90 cases of COVID 19 patients admitted to Respiratory Intensive Care Unit (RICU) in Abbassia Chest Hospital during the period between January 2021 to June 2021 and all the cases were subjected to full history taking, laboratory investigations and radiological assessment with chest x-ray and computed tomography. Results This current study showed that there was no statistically difference in the need of mechanical ventilation beween the patients who received Tocilizumab, the patients who received Remdisivir and the patients who received standard treatment. This study found that there was no statistically difference in the number of days on mechanical ventilation when it happened beween the patients who received Tocilizumab, the patients who received Remdisivir and the patients who received standard treatment. This current work showed that there was no statistically difference in the total length of staying at ICU beween the patients who received Tocilizumab, the patients who received Remdisivir and the patients who received standard treatment. This study revealed that there was no statistically difference in the final outcome beween the patients who received Tocilizumab, the patients who received Remdisivir and the patients who received standard treatment. This work showed that there was no statistically difference in the cause of death when happened beween the patients who received Tocilizumab, the patients who received Remdisivir and the patients who received standard treatment. These results could be attributed to the small sample size included in the current study which could affect the statistical significance level. Conclusion From this study we concluded that there was no statistically significant difference in the need of mechanical ventilation, number of days on mechanical ventilation, total length of staying at ICU, final outcome, and cause of death when it happened between the patients who received Tocilizumab, patients who received Remdisivir and the patient who received standard treatment.

A molecular survey of zoonotic pathogens of public health importance in rodents/shrews and their ectoparasites trapped in Puducherry, India.

Globally, India has a high zoonotic disease burden and lacks surveillance data in humans and animals. Rodents are known reservoirs for many zoonotic diseases and their synanthropic behavior poses a great public health threat. In this study, trapped rodents/shrews from randomly selected villages within Puducherry, India, and their ectoparasites were screened for zoonotic pathogens, namely, Orientia tsutsugamushi, other pathogenic rickettsiae, Leptospira spp., Cryptosporidium spp., Coxiella burnetii and methicillin-resistant Staphylococcus aureus (MRSA) using conventional PCR. A total of 58 rodents/shrews were trapped from 11 villages. The species trapped were Suncus murinus (49/58, 84.48%), Rattus rattus (8/58, 13.79%) and Rattus norvegicus (1/58, 1.72%). All ectoparasites collected were identified as mites and its infestation rate was 46.55% (27/58). Real-time PCR targeting the 47 kDa gene of O. tsutsugamushi revealed positivity in one rodent and one shrew (3.45%) and two mite pools (7.41%). Conventional PCR targeting the 56 kDa gene revealed positivity in one shrew and two mite pools and the phylogenetic analysis of all three amplicons indicated the circulation of the Gilliam-related serotype. MRSA was detected in the alimentary tract of a shrew (1/32, 3.13%). Leptospira spp., Rickettsia, Cryptosporidium spp. and Co. burnetii tested negative. The detection of zoonotic pathogens within reservoir hosts and vectors poses a risk of transmission to humans. This study signifies the need for zoonotic pathogen surveillance in synanthropic rodents/shrews.

Factors associated with knowledge of mother-to-child transmission of HIV among reproductive-age women in Indonesia: a multilevel analysis

BackgroundMaternal transmission of human immunodeficiency virus (HIV) commonly occurs from mother to child during pregnancy, delivery, and breastfeeding which accounts for almost all the new HIV infections among children aged 0–14 years. Despite major efforts and progress in controlling and preventing HIV, it continues to pose a great public health threat, especially in Indonesia. This study assessed the factors associated with the knowledge of mother-to-child transmission (MTCT) of HIV among reproductive-age women in Indonesia.MethodsThis study used data from the 2017 Indonesian Demographic and Health Survey (IDHS). We sampled 39,735 reproductive-age women (15–49 years) for analysis. Using Stata version 16.0, multilevel logistic regression models were fitted, and the results were presented as adjusted odds ratios (aORs) with their confidence intervals (CIs).ResultsThe study found that 72% of women had knowledge of MTCT of HIV. Women who were aged between 45 and 49 years (aOR = 1.65, 95%CI = 1.46–1.88) had higher odds of knowledge of MTCT of HIV than those aged 15–19 years. Women who attained higher education (aOR = 2.92, 95%CI = 2.06–4.15) had increased odds of knowledge of MTCT of HIV than those with no formal education. Women who had four children (aOR = 1.19, 95% CI = 1.05–1.35) had higher odds of knowledge of MTCT of HIV than nulliparous women. Women who frequently read newspapers/magazines (aOR = 1.14, 95%CI = 1.06–1.25) and frequently used the internet almost every day (aOR = 1.28, 95%CI = 1.19–1.38) had higher odds of knowledge of MTCT of HIV than those who did not read newspapers/magazines and non-users of internet, respectively. Women within the richer (aOR = 1.11, 95%CI = 1.02–1.20) and the richest (aOR = 1.14, 95%CI = 1.04–1.25) wealth quintile higher odds of knowledge of MTCT of HIV than those in the poorest wealth quantile. Women who resided in rural areas were less likely to have knowledge of MTCT of HIV (aOR = 0.79, 95% CI = 0.74–0.86) than those in urban settlements.ConclusionsKnowledge of MTCT of HIV was slightly above average. The study findings on the factors associated with knowledge of MTCT of HIV provide evidence for policymakers and clinicians to utilize in the quest to eliminate MTCT of HIV among children. We recommend that awareness programs should consider the key findings from this study when delivering public education or when developing interventions to improve women’s knowledge on MTCT of HIV.

Pan-Indian Clinical Registry of Invasive Fungal Infections Among Patients in the Intensive Care Unit: Protocol for a Multicentric Prospective Study.

Fungal infections are now a great public health threat, especially in those with underlying risk factors such as neutropenia, diabetes, high-dose steroid treatment, cancer chemotherapy, prolonged intensive care unit stay, and so on, which can lead to mycoses with higher mortality rates. The rates of these infections have been steadily increasing over the past 2 decades due to the increasing population of patients who are immunocompromised. However, the data regarding the exact burden of such infection are still not available from India. Therefore, this registry was initiated to collate systematic data on invasive fungal infections (IFIs) across the country. The primary aim of this study is to create a multicenter digital clinical registry and monitor trends of IFIs and emerging fungal diseases, as well as early signals of any potential fungal outbreak in any region. The registry will also capture information on the antifungal resistance patterns and the contribution of fungal infections on overall morbidity and inpatient mortality across various conditions. This multicenter, prospective, noninterventional observational study will be conducted by the Indian Council of Medical Research through a web-based data collection method from 8 Advanced Mycology Diagnostic and Research Centers across the country. Data on age, gender, clinical signs and symptoms, date of admission, date of discharge or death, diagnostic tests performed, identified pathogen details, antifungal susceptibility testing, outcome, and so on will be obtained from hospital records. Descriptive and multivariate statistical methods will be applied to investigate clinical manifestations, risk variables, and treatment outcomes. These Advanced Mycology Diagnostic and Research Centers are expected to find the hidden cases of fungal infections in the intensive care unit setting. The study will facilitate the enhancement of the precision of fungal infection diagnosis and prompt treatment modalities in response to antifungal drug sensitivity tests. This registry will improve our understanding of IFIs, support evidence-based clinical decision-making ability, and encourage public health policies and actions. Fungal diseases are a neglected public health problem. Fewer diagnostic facilities, scanty published data, and increased vulnerable patient groups make the situation worse. This is the first systematic clinical registry of IFIs in India. Data generated from this registry will increase our understanding related to the diagnosis, treatment, and prevention of fungal diseases in India by addressing pertinent gaps in mycology. This initiative will ensure a visible impact on public health in the country. DERR1-10.2196/54672.

Prevalence of carbapenem resistance in Acinetobacter baumannii and Pseudomonas aeruginosa in sub-Saharan Africa: A systematic review and meta-analysis.

Carbapenems are effective drugs against bacterial pathogens and resistance to them is considered a great public health threat, especially in notorious nosocomial pathogens like Acinetobacter baumannii and Pseudomonas aeruginosa. In this study, we aimed to determine the prevalence of carbapenem resistance in A. baumannii and P. aeruginosa infections in Sub-Saharan Africa. Databases (PubMed, Scopus, Web of Science, and African Journal Online) were systematically searched following the Preferred Reporting Items for Systematic review and meta-analysis protocols (PRISMA-P) 2020 statements for articles reporting carbapenem-resistant Acinetobacter baumannii (CRAB) and carbapenem-resistant Pseudomonas aeruginosa (CRPA) prevalence between 2012 and 2022. Pooled prevalence was determined with the random effect model and funnel plots were used to determine heterogeneity in R. A total of 47 articles were scanned for eligibility, among which 25 (14 for carbapenem-resistant A. baumannii and 11 for carbapenem-resistant P. aeruginosa) were included in the study after fulfilling the eligibility criteria. The pooled prevalence of CRPA in the present study was estimated at 8% (95% CI; 0.02-0.17; I2 = 98%; P <0.01). There was high heterogeneity (Q = 591.71, I2 = 98.9%; P<0.0001). In addition, this study's pooled prevalence of CRAB was estimated at 20% (95% CI; 0.04-0.43; I2 = 99%; P <0.01). There was high heterogeneity (Q = 1452.57, I2 = 99%; P<0.0001). Also, a funnel plot analysis of the studies showed high degree of heterogeneity. The carbapenemase genes commonly isolated from A. baumannii in this study include blaOXA23, blaOXA48, blaGES., blaNDM, blaVIM, blaOXA24, blaOXA58, blaOXA51, blaSIM-1, blaOXA40, blaOXA66, blaOXA69, blaOXA91, with blaOXA23 and blaVIM being the most common. On the other hand, blaNDM, blaVIM, blaIMP, blaOXA48, blaOXA51, blaSIM-1, blaOXA181, blaKPC, blaOXA23, blaOXA50 were the commonly isolated carbapenemase genes in P. aeruginosa, among which blaVIM and blaNDM genes were the most frequently isolated. Surveillance of drug-resistant pathogens in Sub-Saharan Africa is essential in reducing the region's disease burden. This study has shown that the region has significantly high multidrug-resistant pathogen prevalence. This is a wake-up call for policymakers to put in place measures to reduce the spread of these critical priority pathogens.

Klebsiella pneumoniae carbapenemase variants: the new threat to global public health.

Klebsiella pneumoniae carbapenemase (KPC) variants, which refer to the substitution, insertion, or deletion of amino acid sequence compared to wild blaKPC type, have reduced utility of ceftazidime-avibactam (CZA), a pioneer antimicrobial agent in treating carbapenem-resistant Enterobacterales infections. So far, more than 150 blaKPC variants have been reported worldwide, and most of the new variants were discovered in the past 3 years, which calls for public alarm. The KPC variant protein enhances the affinity to ceftazidime and weakens the affinity to avibactam by changing the KPC structure, thereby mediating bacterial resistance to CZA. At present, there are still no guidelines or expert consensus to make recommendations for the diagnosis and treatment of infections caused by KPC variants. In addition, meropenem-vaborbactam, imipenem-relebactam, and other new β-lactam-β-lactamase inhibitor combinations have little discussion on KPC variants. This review aims to discuss the clinical characteristics, risk factors, epidemiological characteristics, antimicrobial susceptibility profiles, methods for detecting blaKPC variants, treatment options, and future perspectives of blaKPC variants worldwide to alert this new great public health threat.

Regulation of blood-screening in vitro diagnostics in sub-Saharan African countries remains a challenge.

According to the World Health Organization, blood must be screened for major transmitted infections before transfusion to prevent the possibility of passing an infection to the recipient. For accurate detection of infectious disease pathogens in the blood of donors, in-vitro diagnostic medical devices (IVDs) of high specificity and sensitivity should be used. In mature healthcare systems, the regulatory authorities authorize the usage of devices with the highest performance capabilities, which are also controlled through active market oversight. However, in Sub-Saharan African countries, the regulation of IVDs is often poorly developed. With the lack of stringent regulatory oversight, IVDs of poor quality can be put on the market and used for blood donor screening, which, ultimately, poses a great public health threat. The BloodTrain is a humanitarian project from the Germany Federal Ministry of Health that aims to help strengthen the regulatory authorities in Sub-Saharan partner countries. Here, we present the status of IVD regulation in the partner countries and the objectives that the BloodTrain project aims to achieve in the region toward regulating IVDs.

Plasminogen Activator Inhibitor-1 and Vitamin D Association in the Overweight and Obese Pediatric Population.

Childhood overweight and obesity have been described by the World Health Organization as noncommunicable diseases and among the greatest public health threats since they have reached epidemic proportions. A child with obesity risks becoming an adult with obesity and developing metabolic and hemostatic disorders which are the basis for the development of coronary heart diseases. Recently, a number of clinical reports have demonstrated that both an increase in plasminogen activator inhibitor-1 (PAI-1) and a deficiency in 25OH-vitamin D3 (VD) are associated with an increase in thrombotic episodes. PAI-1 and VD levels were measured in 259 clinically overweight and obese children aged between 2 and 18 years enrolled in the Nutritional Education Program of the Bambino Gesù Children's Hospital and Research Institute of Rome (Italy) and 80 normal-weight subjects. We observed increased HOMA-IR, PAI-1, and other inflammation indices associated with decreased VD levels when compared to normal-weight children. Our results demonstrated that overweight and obesity are correlated with higher levels of the inflammation index. Moreover, our patients show high PAI-1 and low VD levels, confirming the high thrombotic risk in our pediatric population.

Molecular typing of multidrug resistant bacteria isolated from health care professionals’ mobile phone: A pilot study in Jashore, Bangladesh

Background: Nowadays, Health Care Professionals’ (HCPs) are increasingly using mobile phones which may act as reservoirs and vector for transmission of pathogens. The presence of multidrug resistant nosocomial microbes on the surface of mobile phones used by HCPs in hospitals can pose a great public health threat. So, this research was conducted to identify the concerned multi-drug resistant (MDR) bacteria and also to explore the recent status of bacterial contamination on mobile phones of HCPs in the Jashore region of Bangladesh and determine their antibiotic resistance pattern. Methods: Swab samples of mobile phones were collected between June and September 2019 from 24 different users (i.e., manager, worker, doctor and nurse) associated to four distinct hospitals of Jashore region, Bangladesh. After suitable morphological and biochemical identification, we determined their antimicrobial susceptibility by Kirby- Bauer disc diffusion method by using 18 antibiotics for Gram positive bacteria and 19 antibiotics for Gram negative bacteria. Later, the MDR isolates were grouped by amplified ribosomal DNA restriction analysis (ARDRA) and 16S rRNA sequencing with phylogeny were performed to confirm the bacteria at species level. Results: A total of 38 bacterial isolates were obtained from the sample. Enterobacter spp. isolates showed maximum resistance against Amoxicillin, followed by Ampicillin and Aztreonam (80% each) and one isolate showed highest antibiotic resistance (15 out of 19) among all the isolates. In addition, Staphylococcus spp. and Exiguobacterium spp. isolates showed 100% resistance against Penicillin, Ampicillin, Oxacillin, Erythromycin, Lincomycin and Cefotaxime. On the contrary, all of the isolates of Escherichia spp., Bacillus spp., Proteus spp. were sensitive to all tested antibiotics. Surprisingly, 20 MDR isolates were showing resistance to at least 2 antibiotics. Subsequently, three distinct genera of these MDR isolates were identified by ARDRA; the strains Enterobacter cloacae (75%), Staphylococcus warneri (15%) and Exiguobacterium aurantiacum (10%) were confirmed by the 16S rRNA phylogenetic analysis. Conclusion: We found that cell phones can act as reservoirs of multidrug-resistant pathogens, causative agents for Hospital-acquired infections. An effective hygiene practice for health care personnel should be introduced to prevent the cross-contamination by their cell phone Bangladesh Journal of Medical Science Vol. 22 No. 03 July’23 Page : 643-656

The land-scape of immune response to monkeypox virus

Human monkeypox is a viral zoonotic smallpox-like disease caused by the monkeypox virus (MPXV) and has become the greatest public health threat in the genus Orthopoxvirus after smallpox was eradicated. The host immune response to MPXV plays an essential role in disease pathogenesis and clinical manifestations. MPXV infection leads to skin lesions with the genital area as the main feature in the current outbreak and triggers a strong immune response that results in sepsis, deep tissue abscess, severe respiratory disease, and injuries to multiple immune organs. Emerging evidence shows that the immunopathogenesis of MPXV infection is closely associated with impaired NK-cell function, lymphopenia, immune evasion, increased antibodies, increased blood monocytes and granulocytes, cytokine storm, inhibition of the host complement system, and antibody-dependent enhancement. In this overview, we discuss the immunopathology and immunopathogenesis of monkeypox to aid the development of novel immunotherapeutic strategies against monkeypox.

An inactivated recombinant rabies virus chimerically expressed RBD induces humoral and cellular immunity against SARS-CoV-2 and RABV

Many studies suggest that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can infect various animals and transmit among animals, and even to humans, posing a threat to humans and animals. There is an urgent need to develop inexpensive and efficient animal vaccines to prevent and control coronavirus disease 2019 (COVID-19) in animals. Rabies virus (RABV) is another important zoonotic pathogen that infects almost all warm-blooded animals and poses a great public health threat. The present study constructed two recombinant chimeric viruses expressing the S1 and RBD proteins of the SARS-CoV-2 Wuhan01 strain based on a reverse genetic system of the RABV SRV9 strain and evaluated their immunogenicity in mice, cats and dogs. The results showed that both inactivated recombinant viruses induced durable neutralizing antibodies against SARS-CoV-2 and RABV and a strong cellular immune response in mice. Notably, inactivated SRV-nCoV-RBD induced earlier antibody production than SRV-nCoV-S1, which was maintained at high levels for longer periods. Inactivated SRV-nCoV-RBD induced neutralizing antibodies against both SARS-CoV-2 and RABV in cats and dogs, with a relatively broad-spectrum cross-neutralization capability against the SARS-CoV-2 pseudoviruses including Alpha, Beta, Gamma, Delta, and Omicron, showing potential to be used as a safe bivalent vaccine candidate against COVID-19 and rabies in animals.

2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association.

2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association.

Prospects of contezolid (MRX-I) against multidrug-resistant tuberculosis and extensively drug-resistant tuberculosis.

Tuberculosis has become a great global public health threat. Compared with drug-susceptible tuberculosis (TB), the treatment regimens for multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) involve more severe adverse events and poorer treatment outcomes. Linezolid (LZD) is the first oxazolidinones used for TB. Thanks to its potent activity against Mycobacterium tuberculosis, LZD has become one of the key agents in the regimens against MDR/XDR-TB. However, this drug may cause intolerability and other adverse events. Contezolid, another novel oxazolidinone, can also inhibit M. tuberculosis, still with fewer adverse effects compared with LZD. This paper is to prospect the potentials of contezolid in the treatment of MDR/XDR-TB, with focus on its efficacy and possible adverse effects.

The Public Health Burden of Virulent Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae Strains Isolated from Diseased Horses.

Background:Klebsiella pneumoniae has been associated with both nosocomial and community-acquired infections with mounting public health concern throughout the world. The purpose of this study was to investigate the burden of virulent extended-spectrum β-lactamase (ESBL)-producing K. pneumoniae among diarrheic horses or those with respiratory illness to underscore the public health implication of such strains. Materials and Methods: Rectal and nasal swabs were gathered from 100 diseased horses (50 diarrheic and 50 with respiratory illness). The collected swabs were processed for isolation of ESBL-producing K. pneumoniae using a selective medium followed by phenotypic and molecular identification of the isolates. All ESBL-producing K. pneumoniae strains were investigated for six virulence genes (type 3 fimbrial adhesin [mrkD], enterobactin [entB], regulator of mucoid phenotype A [rmpA], Klebsiella ferric iron uptake [kfu], mucoviscosity-associated gene A [magA], and type 2 capsular polysaccharide [K2]). Results: Of the 100 examined animals, ESBL-producing K. pneumoniae was recovered from 13 (13%), with isolation rates in horses suffering from diarrhea and respiratory illness being 20% and 6%, respectively. Among the obtained isolates, bla TEM and bla SHV were found in all strains (100%) followed by bla CTX-M in 92.3%, while none of the isolates had bla OXA. In addition, 13 ESBL-producing K. pneumoniae strains exhibited a multidrug resistance (MDR) pattern. Regarding the occurrence of virulence genes among the isolates, mrkD (100%) and entB (100%) were the most predominant virulence genes followed by rmpA (76.9%) and kfu (46.2%). On the contrary, magA and K2 were negative in all ESBL-producing strains. Furthermore, this work provides four K. pneumoniae mrkD partial sequences that displayed high genetic relatedness with those obtained from human to clarify the public health burden of such isolates. Conclusion: The occurrence of virulent ESBL-producing K. pneumoniae among diseased horses highlights the potential role of this animal in the epidemiology of such virulent and antimicrobial-resistant strains, which may have great public health threat.

Evaluation of the Spatiotemporal Epidemiological Modeler (STEM) during the recent COVID-19 pandemic

In early December 2019, some people in China were diagnosed with an unknown pneumonia in Wuhan, in the Hubei province. The responsible of the outbreak was identified in a novel human-infecting coronavirus which differs both from severe acute respiratory syndrome coronavirus and from Middle East respiratory syndrome coronavirus. The new coronavirus, officially named severe acute respiratory syndrome coronavirus 2 by the International Committee on Taxonomy of Viruses, has spread worldwide within few weeks. Only two vaccines have been approved by regulatory agencies and some others are under development. Moreover, effective treatments have not been yet identified or developed even if some potential molecules are under investigation. In a pandemic outbreak, when treatments are not available, the only method that contribute to reduce the virus spreading is the adoption of social distancing measures, like quarantine and isolation. With the intention of better managing emergencies like this, which are a great public health threat, it is important to dispose of predictive epidemiological tools that can help to understand both the virus spreading in terms of people infected, hospitalized, dead and recovered and the effectiveness of containment measures.

Creating an innovation ecosystem for rapid diagnostic tests for livestock to support sustainable antibiotic use

ABSTRACT Antimicrobial resistance (AMR) is one of today’s greatest public health threats and reducing antimicrobial use in livestock is essential to prevent its spread, requiring rapid diagnostic tests (RDTs) to ensure that the drug prescribed matches the sensitivity of the disease organism. However, despite decades of research on RDTs and a relatively permissive regulatory environment in the UK, few devices are in commercial use. Challenges discussed by RDT developers included identifying commercially-viable targets, and management of the innovation ecosystem, e.g. to create clear pathways to market supporting positive interactions between farmers, vets, and other actors along the value chain. Future support for RDT development could be provided through incorporation in: assured food systems; business service packages provided by centralised laboratories; or animal health monitoring packages related to the spread of AMR. Breeding stock sales could require an accompanying health package including RDTs, vaccines and/or antibiotics, linking to precision agriculture approaches. Unlike the example of RDT development for COVID-19, it seems that the urgency of the issue and the clarity of links between animal and human health outcomes are not yet sufficient to support a fast-tracking programme for the development of RDTs to combat AMR.

Immunizing North Carolina.

The timeliness of this edition of the North Carolina Medical Journal could not be more profound, as we immunize North Carolinians with the COVID-19 vaccine to address our greatest public health threat since the 1918 influenza pandemic. An examination of North Carolina’s immunization history and

Interannual Climate Variability and Malaria in Mozambique

AbstractMalaria is among the greatest public health threats in Mozambique, with over 10 million cases reported annually since 2018. Although the relationship between seasonal trends in environmental parameters and malaria cases is well established, the role of climate in deviations from the annual cycle is less clear. To investigate this and the potential for leveraging inter‐annual climate variability to predict malaria outbreaks, weekly district‐level malaria incidence spanning 2010–2017 were processed for a cross‐analysis with climate data. An empirical orthogonal function analysis of district‐level malaria incidence revealed two dominant spatiotemporal modes that collectively account for 81% of the inter‐annual variability of malaria: a mode dominated by variance over the southern half of Mozambique (64%), and another dominated by variance in the northern third of the country (17%). These modes of malaria variability are shown to be closely related to precipitation. Linear regression of global sea surface temperatures onto local precipitation indices over these variance maxima links the leading mode of inter‐annual malarial variability to the El Niño‐Southern Oscillation, such that La Niña leads to wetter conditions over southern Mozambique and, therefore, higher malaria prevalence. Similar analysis of spatiotemporal patterns of precipitation over a longer time period (1979–2019) indicate that the Subtropical Indian Ocean Dipole is both a strong predictor of regional precipitation and the climatic mechanism underlying the second mode of malarial variability. These results suggest that skillful malaria early warning systems may be developed that leverage quasi‐predictable modes of inter‐annual climate variability in the tropical oceans.

Epidemiological Influences and Requirements of Global Childhood Obesity Research

Introduction: Obesity is classified as a global epidemic and judged to be the greatest public health threat in Western countries. The tremendously increasing prevalence rates in children lead to morbidity and mortality in adults. In many countries, prevalence has doubled since the 1980s. Other countries show a continuous increase or stagnate at a very high level. Given these regional differences, this study aims to draw a global world map of childhood obesity research, including regional epidemiological characteristics, to comprehensively assess research influences and needs. Methods: In addition to established bibliometric parameters, this study uses epidemiological data to interpret metadata on childhood obesity research from the Web of Science in combination with state-of-the-art visualization methods, such as density equalizing map projections. Results: It was not until the 1990s that belated recognition of the dangerous effects of childhood obesity led to an increase in the number of publications worldwide. In addition, our findings show that countries’ study output does not correlate with epidemiologic rates of childhood obesity. In contrast, the primary driver of the research efforts on childhood obesity appears to be largely driven government funding structures. Discussion/Conclusion: The geographical differences in the epidemiological background of childhood obesity complicate the implementation of transnational research projects and cross-border prevention programs. Effective realization requires a sound scientific basis, which is facilitated by globally valid approaches. Hence, there is a need for information exchange between researchers, policy makers, and private initiatives worldwide.

Impact of time of harvest and drying method on antimicrobial activity of Saccharina latissima against two Staphylococcus aureus strains

ABSTRACT Antibiotic resistance is one of the greatest public health threats of our time, and the bacterium Staphylococcus aureus, of which there are numerous drug-resistant and drug-sensitive strains, is a pathogen of worldwide concern. Scientists are turning their focus to underexplored marine ecosystems to identify novel antibacterial agents effective against S. aureus. Here, we report inhibition of S. aureus strains Newman and USA300 by extracts from Saccharina latissima (sugar kelp), grown and harvested in the Western Gulf of Maine, USA. We examined how time of harvest throughout the growing season as well as the drying method pre-extraction affected the antimicrobial activity of the kelp extracts. Optimal antimicrobial activity was observed at the beginning of April (203 days since sporing), when increased water pH and higher salinity levels were also observed. Oven-dried crude extracts showed greater inhibition against S. aureus Newman, whereas freeze-dried crude extracts demonstrated greater inhibition against S. aureus USA300. Overall, our data indicate that cultivated S. latissima from the Western Gulf of Maine possesses significant value-added antimicrobial activity and identify early spring as an optimal harvest time to harness antimicrobial activity.