Community Medicine Research Articles

New Pathogens in Blood Donors and Patients in Albania

Introduction: The emergence of novel pathogens poses a significant and immediate threat to global blood safety, particularly in regions experiencing epidemiological shifts. This study urgently examines the prevalence and impact of newly identified pathogens among blood donors and recipients in Albania, focusing on assessing their implications for public health and transfusion medicine. Results revealed a prevalence of new pathogens among donors and patients, highlighting the potential risk of transmission through blood transfusion. Travel history, socioeconomic status, and urban-rural disparities significantly influenced pathogen prevalence. This study underscores the urgent need for enhanced screening protocols and public health interventions to mitigate the risks associated with emerging pathogens. Our findings contribute to a growing body of evidence emphasizing the crucial role of continuous surveillance and adaptive strategies in transfusion medicine to ensure blood safety and protect vulnerable populations in Albania and beyond. Conclusion: The study highlights the presence of emerging pathogens in blood donors and patients in Albania, underscoring their potential to significantly impact blood safety and public health. The findings emphasize the necessity for improved screening protocols, continuous epidemiological surveillance, and targeted public health interventions to address the risks associated with these pathogens. Adopting adaptive strategies in transfusion medicine is critical to safeguarding the health of donors and recipients in the region.

Multidimensional vulnerability and financial risk protection in health in contexts of protracted conflict: Evidence from the Occupied Palestinian Territory.

This paper proposes a multidimensional vulnerability index for a setting of protracted conflict, which is applied to study the relationship between financial vulnerability and catastrophic healthcare expenditure (CHE) incidence in the Occupied Palestinian Territory in 2018. We find that our index better captures the extent of financial risk protection in health compared to conventional measures of financial welfare. Results indicate that the most vulnerable groups experience a significantly higher likelihood of incurring CHE, and this likelihood is increased for those living in the West Bank compared to the Gaza Strip. We also find a lack of protection from existing health insurance types against the risk of CHE. Our analysis provides valuable insights about key aspects, such as health financing and insurance bottlenecks, that will deserve careful policy attention in efforts to rebuild the Palestinian health system, following the Israel-Hamas war.

Health profile assessment of school children of Jodhpur District of Rajasthan

ABSTRACT Background: The health and nutritional status of young children is an index of national investment within the development of its future manpower. There is a limited data available on health profile among adolescents in India. Thus, this study was undertaken with the target of assessing the nutritional status and morbidity pattern of school children Jodhpur district of Rajasthan. The objectives of this study were to assess the health profile including general physical examination, anthropometric measurements, morbidity pattern and addiction among school-going children of Jodhpur. Material and Methods: A school-based observational cross-sectional study was carried out among the nearby schools pertaining to our urban and rural health centres associated with the Department of Community Medicine and Family Medicine, AIIMS Jodhpur. Result: A total of 525 school children participated in the study. On general physical examination, it was observed that the majority (4.1%) of the school children from rural area were seen with ‘flag sign’ in comparison with those in urban region. Fluorosis was observed in the majority (60.2%) in rural schools in comparison with urban and this was found to be statistically significant (P = 0.000). The majority (21, 0.04%) of them were suffering from hearing loss, among them (13,61.9%) were from rural area in comparison with (08, 38.1%) in urban and this difference was found to be statistically significant. (0.000*). Anaemia was observed in (210, 40.0%) of the school children. Conclusion: The study brings out the need for intensified and targeted school health awareness programmes for school-going children and utilization of various services.

Family adoption program (FAP) as a learning tool—perceptions of students and faculty of community medicine

ABSTRACT Introduction: The family adoption program, a newer initiative in the medical education curriculum, provides a learning opportunity toward community-based health care to Indian Medical Graduates. However, it has its own challenges and opportunities. The Objective of the study is to understand the perceptions of faculty and students regarding this program. Material and Methods: A descriptive cross-sectional study was done among the faculty of Department of Community Medicine and phase 1 medical undergraduates of the selected medical colleges. A pretested semi-structured questionnaire was administered in Google Forms. The responses received from the participants in Google Forms were retrieved and analyzed using MS Excel and SPSS version 25. Results: About 48 faculty of designation ranging from senior resident to professor participated in the study. A total of 190 students in phase 1 MBBS participated in the study. Out of 150 students, 86 (44%) were from private medical colleges and 104 (55%) were from government medical colleges. The perception of the faculty and students regarding FAP was taken in a Likert scale. Most of them agreed that it is a good academic tool to learn communication skills, identify health problems in the community and various determinants of health, develop creative thinking and reasoning. The faculty mentioned that they faced challenges in arranging logistics. The faculty also made some recommendations to improve the program. Conclusion: The current study showed despite the challenges faced during the implementation of the FAP program, it will empower the students and faculty for better training, community-oriented research, and community-oriented medical education in the long run.

Maternal factors affecting foetal outcome in rural area of district Amritsar, Punjab

Background: Birth weight not only indicates health of mother, nutrition and quality of life but also a pivotal factor in determining growth, survival and development of children. The key aspect influencing birth weight is maternal factors. Stress during pregnancy also affects a child's growth and development. So the present study was planned to assess the maternal factors affecting foetal outcomes. The level of stress among antenatal women was also determined in the study. Methods: A prospective observational type of study was conducted from January to March, 2022. All the registered antenatal women were followed till outcome of pregnancy. Information was collected on predesigned and pretested proforma. Data analysis was done using SPSS version- 23. Results: A total of 114 antenatal were registered in rural field practice area under Department of Community Medicine, SGRDIMSAR, Amritsar. There were 108 singleton live births and 6 miscarriages among registered antenatal women. Almost half (47.2%) of subjects got their pregnancy registered before 12 weeks. Recommended more than minimum 4 antenatal visits were conducted in almost half (49.1%) of women. Three fourth (75.9%) women in first trimester of pregnancy were suffering from moderate stress while 24.1% women were suffering from low stress. Conclusions: In the present study maternal factors found to be significantly associated with birth weight of newborn were maternal age at first child, timing of 1st Antenatal visits, weight gain during pregnancy, number of Td (Tetanus diptheria) doses taken and consumption of IFA tablets. Perceived stress score (PSS) was also found to be significantly associated with birth weight of newborn.

Assessment of the living conditions in a rural setting through cross sectional study

Background: An important part of a healthy community comprises healthy families. Living conditions play a crucial role in defining the well-being of the family. The quality of housing, access to basic amenities, environmental factors and the overall socio-economic status of the families have a direct impact on the family health. Methodology: This is a cross sectional study done based on the survey of 200 families based in Hasan Nagar, conducted by the students of Deccan College of Medical Sciences under the guidance of the department of community medicine. The families were surveyed based on a pre-formed questionnaire and the data was analysed using descriptive analysis. Conclusion: In this study of 200 families, 77% were nuclear families, 69.5% had pucca houses. Majority of the families 26.5% had 5 family members. In 45% of the families overcrowding was present. All of the houses had electricity supply. Separate kitchen was present in 77% of the houses. In 85% of families rice was the staple food. 88.5% used public refuse bins for disposal of solid waste and 96% used sewerage systems for liquid waste disposal. Latrine was present in 94% of the houses.

Anthropometric Assessment of Children (1-6 Years) Attending Anganwadi in Rural Field Practice Area of Gulbarga Institute of Medical Sciences, Kalaburagi.

Context/Background: Undernutrition is conventionally assessed by prevalence of stunting, underweight and wasting. These methods even though widely used, do not give single measure of assessment of undernutrition. CIAF (Composite measure of anthropometer failure) gives single, comprehensive figure, as it identifies all the children experiencing anthropometric failure. Stunting Index, Underweight Index and Wasting index further identifies severity of individual parameter in relation to total undernutrition. Aims/Objectives: To estimate prevalence of undernutrition among 1–6-year children by conventional methods like stunting, underweight and wasting along with other methods like CIAF and anthropometric indices like Stunting Index (SI), Underweight Index (UI) and Wasting Index (WI). Methodology: A community based cross-sectional study was undertaken among 206 children belonging to 5 anganwadi centres in rural field practice area of department of community Medicine, GIMS Kalaburagi Karnataka. Results: Overall prevalence of stunting was 51.9%, underweight was 35% and wasting was 20%. CIAF (Composite Index of Anthropometric failure) was 65.5%. Stunting Index, Underweight Index and Wasting Index was 0.79, 0.53 and 0.30 respectively. Stunting was widely prevalent among boys and girls suffered more from wasting and underweight. Conclusions: CIAF should be widely used in assessing undernutrition in community along with Anthropometric Indices.

Designing a summative assessment blueprint in community medicine: an expert consensus approach at All India Institute of Medical Sciences

BackgroundDespite the increasing integration of competency-based education in medicine, there remains a significant gap in effectively assessing educational outcomes, underscoring the urgent need for designed assessment blueprints that accurately reflect both curriculum content and competency standards in Community Medicine for undergraduate students. This study, conducted across the All-India Institute of Medical Sciences (AIIMS) network, develops a summative assessment blueprint aimed at standardizing evaluations in medical education across diverse geographic locations in India.MethodsTwenty-five experts from 10 All India Institutes of Medical Science were invited via email and contributed for summative assessment for a theory paper. Each week, the study lead team sent an online form containing 25 topics. A total of 269 topics were selected to be included in the blueprint development. An Impact and Frequency score was obtained for each topic, with a score between 1 and 3 for both its “Impact (I)” and “Frequency” (F).ResultsThe overall response rate was 71%. “Principle of epidemiology” (14.7%) had the most weight, followed by “Epidemiology of communicable disease” (13.4%) and “National Health Program” (10%). These three chapters constituted more than one-third of the total weight of the summative assessment (theory). 20 out of 24 (83%) chapters have moderate-to-good interrater reliability.ConclusionsThe blueprint developed in this study is intended to serve as a guideline for setting question papers and aims to enhance objectivity, uniformity, and validity in assessment construction. While it provides a structured approach within the AIIMS network, its broader applicability may be limited, suggesting that its effectiveness in other educational contexts remains to be validated. Continued research is encouraged to explore its utility across diverse educational settings.

A Content Analysis of #Childhoodcancer Chatter on X.

Over a half million children are living with cancer in the United States. Social media platforms offer unique opportunities for cancer communication by public health organizations as well as health care providers, scientists, patients, and caregivers. Given the dearth of research on childhood cancer communication, the present study aimed to examine the nature of tweets on the social media platform X (formerly Twitter) that used the hashtag #childhoodcancer, the types of these tweets that attracted the most retweets, the types of users tweeting about childhood cancer (e.g., individuals, health care professionals), and the nature of tweets made by the different types of users. We performed a content analysis of tweets we captured on X via NCapture in October and December 2022. Of the 3217 tweets captured, we randomly sampled 1000 eligible tweets and manually double-coded them. Interrater agreement was 83% (κ = 0.75). Results revealed six themes in the tweets, including fundraising (21.2%), advocacy (20.2%), motivational (17.5%), educational (15.3%), science (12.8%), and shout-outs (12.1%). Motivational, advocacy, and science tweets attracted more retweets than fundraising tweets and shout-outs (p < 0.001). Individuals (i.e., patients, caregivers, and advocates tweeting on their own behalf) and nonprofit organizations made a majority of the tweets at 41.5% and 38.6%, respectively, followed by health care professionals (8.7%), academic and/or medical centers (4.2%), and for-profit companies (3.5%). Childhood cancer communication on X is dominated by individuals doing advocacy and fundraising. X may provide important opportunities for public health messaging and science communication about childhood cancer.

Health-promoting activities and facilitating/inhibiting factors in hospitals, clinics, and nursing care facilities: Public interest corporation survey results

Objective Medical and nursing care services within community-based integrated care systems are vital in community health. This study aimed to assess the current status of health-promoting activities across hospitals, clinics, and nursing homes operated by the Japan Association for Development of Community Medicine and explore differences depending on the type of facility and strategies for expanding these activities.Methods Between April 2022 and September 2023, we conducted web-based surveys, followed by telephone and email interviews. The survey covered three main areas; health-promoting activities for patients/users, the community, and staff (options), willingness to expand activities (10-point scale), and facilitating and inhibiting factors (open-ended responses). Responses were analyzed according to facility type, and activities were categorized according to the 2020 Standards for Health-Promoting Hospitals and Health Services (The 2020 HPH Standards).Results The response rate was 100%. Activities were implemented across all facilities. The percentages of facilities that implemented activities in hospitals, clinics, and nursing homes were as follows; patients/users (96.0, 84.5, 94.4, P = 0.011), community (96.0, 83.3, 100.0, P < 0.001), and staff (100.0, 72.9, 94.4, P < 0.001). The implementation rates were significantly lower in clinics than in hospitals and nursing homes. The mean number of activities in small clinics with < 50 staff (S) was significantly lower than that in large clinics with > 50 staff (L) for patients/users (S, L, difference) (4.1, 6.2, P = 0.034), community (4.9, 9.1, P < 0.001), and staff (1.6, 3.8, P < 0.001). Willingness did not vary by facility type (median of 7.0); however, conviction, as a determinant of willingness, was slightly higher in clinics and nursing homes than in hospitals (hospital = 7.0, clinics and nursing homes = 8.0). The most common facilitating factor for hospitals was "development of organizational structure," such as the establishment of a promotion committee, whereas for clinics and nursing homes, it was the "provision of educational materials and know-how." The most common inhibiting factor was "increasing workload." These activities aligned with almost all 2020 HPH standards; however, the evaluation system needed improvement.Conclusion All facilities are implementing health-promoting activities according to the 2020 HPH standards and have expressed eagerness to expand their activities. Developing organizational structures, ensuring the profitability of activities, developing evaluation indicators for measuring results, and establishing an evaluation system are crucial for expansion.

Enhancing Anemia Detection With Non-invasive Anemia Detection With AI (NiADA): Insights From Clinical Validations and Physician Observations.

Background Anemia, a critical public health issue, affects nearly two billion people globally. Frequent monitoring of blood hemoglobin levels is essential for managing its burden. While point-of-care testing (POCT) devices facilitate hemoglobin testing in resource-limited settings, most are invasive and have inherent limitations. The Non-Invasive Anemia Detection App (NiADA) (Monere, UT) offers a non-invasive alternative, utilizing artificial intelligence (AI) to estimate hemoglobin levels from images of the lower eyelid. This low-cost, real-time solution employs a custom computer vision deep-learning algorithm for hemoglobin levels, offering significant potential for early diagnosis and management of anemia. Methods This study evaluated NiADA in two phases. In the first phase, its performance was compared to laboratory measurements and the minimally invasive POCT device, Hemocue Hb 301. In this study, the current version of NiADA version 2 (V2)is also compared against the previous version of NiADA version 1 (V1) to show the improvement in the last six months. In the second phase, NiADA's results were compared against hemoglobin estimations made by a group of medical professionals, as well as against lab analyzers. For both phases, NiADA performance was evaluated using the Bland-Altman plot, regression coefficients, percentage of acceptable limit, Pearson correlation coefficient, andLin's concordance correlation coefficient. Results The mean difference between NiADA-V2 and laboratory-estimated hemoglobin values was -0.11 g/dL, with limits of agreement (LOA) ranging from +2.86 to -2.64 g/dL, where the upper limit is comparable with HemoCue. The NiADA-V2-acceptable range (percentage of samples falling within ±1 g/dL absolute error) increased to 54% compared to 40% in NiADA-V1. Additionally, NiADA outperformed medical professionals, showing a mean difference of 0.07 g/dL compared to medical professionals' 0.42 g/dL. Conclusion NiADA, as a non-invasive application, exhibits performance comparable to minimally invasive tools and other POCT devices. Its accuracy exceeds that of medical professionals, making it a viable option for anemia screening and monitoring, particularly in community medicine and regions with limited healthcare resources.

Suitability, acceptability, feasibility of modern menstrual methods: a qualitative study in Coimbatore district, Tamil Nadu, India.

To examine women's perceptions of modern menstrual hygiene methods (MMHM), such as tampons and menstrual cups, focusing on socio-demographic variations and special groups in the Coimbatore district of Tamil Nadu. A qualitative study among women of reproductive age (15-49 years) group was conducted using Focus Group Discussions (FGDs) among twelve women subgroups independently in 2023. The present study involved 23 focus group discussions (FGDs) across various groups of women, including those in formal and informal sectors, urban and rural areas, school and college students, healthcare workers, women in sports, tribal women, transgender women, and female sex workers (FSW), with a total of 188 participants. The age range varied across groups, from 15 to 45 years. Over half of the participants were married (51.1%), and 68.7% were literate, though illiteracy was higher in the informal sector, rural, tribal areas, transgender women, and FSW groups. Sanitary pads were the most used menstrual hygiene method (88.3%), followed by cloth (4.8%), and modern methods like menstrual cups or tampons (1.6%). Notably, 70% of FSW and 28.6% of tribal women still used cloths. Menstrual hygiene choices were often influenced by family recommendations, school-based menstrual hygiene sessions, institutional policies, and social media. Regarding satisfaction, 27.1% were content with their menstrual hygiene method, citing accessibility, affordability, and leakage prevention. However, issues with pads included heat, rashes, and discomfort. A significant number (31.4%) shifted from cloth to pads recently, mainly due to leakage and lack of adequate washing facilities. Only 6.1% had tried modern menstrual methods, with tampons and menstrual cups being considered more suitable but less feasible, especially among tribal women. Participant concerns ranged from the potential health risks of sanitary pads to waste disposal challenges. Recommendations included public menstrual hygiene management (MHM) dispensers, better waste collection practices, and increased awareness through advertisements. Some participants advocated for the concept of free menstruation, emphasizing informed choices and accessibility for all. The findings suggest that increasing access to modern menstrual hygiene products, coupled with comprehensive education and support, could improve acceptance and feasibility, especially for marginalized and underrepresented women.

Mitigating Health Risks Through Environmental Tracking of Pseudomonas aeruginosa.

Pseudomonas aeruginosa is a prevalent nosocomial pathogen and a significant reservoir of antimicrobial resistance genes in residential and built environments. It is also widespread in various indoor and outdoor settings, including sewage, surface waters, soil, recreational waters (both treated and untreated), and industrial effluents. Surveillance efforts for P. aeruginosa are primarily focused on hospitals rather than built environments. However, evidence links multidrug-resistant P. aeruginosa of human origin with activity in built environments and hospital settings. Consequently, tracking this pathogen across all environments is crucial for understanding the mechanisms of reverse transmission from built environments to humans. This review explores public health hygiene by examining the prevalence of P. aeruginosa in various environments, its sequence types, the factors contributing to multidrug resistance, and the identification methods through global surveillance. Whole-genome sequencing with sequence typing and real-time quantitative PCR are widely used to identify and study antimicrobial-resistant strains worldwide. Additionally, advanced techniques such as functional metagenomics, next-generation sequencing, MALDI-TOF, and biosensors are being extensively employed to detect antimicrobial-resistant strains and mitigate the ongoing evolution of bacterial resistance to antibiotics. Our review strongly underscores the importance of environmental monitoring of P. aeruginosa in preventing human infections. Furthermore, strategic planning in built environments is essential for effective epidemiological surveillance of P. aeruginosa and the development of comprehensive risk assessment models.

Assessment of dietary intake and its determinants in adult patients on anti-tubercular treatment in Aligarh, India: a cross sectional study

Background and objectives: Adequate nutrition and a good dietary practice play an important role in recovery from tuberculosis (TB). Improper dietary practice and poor nutrition lead to low immunity in the host and thus increase the risk of active TB in addition to relapse and mortality. The objective of the study was to assess the dietary intake and its determinants in patients on anti-tubercular treatment. Materials and methods: A cross-sectional study was conducted, in four Designated Microscopic Centres under the administration of the District TB Cell of Aligarh district from January 2020 to December 2021. Adult TB patients undergoing treatment between the ages of 18 to 60 years were enrolled. A semi-structured questionnaire was used as a study tool. The 24-hour recall method was used for eliciting dietary intake as it had less recall bias. The sufficient and insufficient dietary cut offs were chosen from the Indian Council for Medical Research (ICMR) nutrient guidelines for TB patients. The data was analyzed by appropriate statistical tests. Results: A total of 410 TB patients participated in the study. Majority (61.7%) of the patients were unemployed and 46.8% belonged to the lower middle class. Of the total cases, 83.2% patients were consuming energy below the Recommended Dietary Allowance (RDA). The protein intake was sub-optimal in 71%, while 52% were taking fat below RDA. Age, gender, and education of the participants were significantly associated (&lt; 0.05) with their energy and protein intake. Conclusions: The participants’ intake of nutrients was suboptimal compared to RDA. Thus, there is a need to improve the nutritional status of TB patients. Therefore, findings of the study could be utilised to plan programs for improved nutritional care for under privileged TB patients living in rural and urban areas. *Correspondence: S. Danish Iqbaal, Senior Resident, Department of Community Medicine, Indira Gandhi Institute of Medical Sciences, Patna-800014, Bihar, India. Email: iqbalsdalig@gmail.com; © 2025 The Author(s). This is an open access article distributed under the terms of the Creative Commons Attribution License(CC BY 4.0).

Analysis of &lt;i&gt;post-mortem&lt;/i&gt; inspection outcomes in water buffalo (&lt;i&gt;Bubalus bubalis&lt;/i&gt;) slaughtered in the province of Caserta (Campania region, southern Italy)

To date, data on post-mortem inspection outcomes in water buffaloes are absent. The present study aimed to analyze the prevalence of lesions recorded in buffaloes slaughtered from 2018 to 2022 in the province of Caserta by analyzing the data extracted from the Management Information System for Food Safety and Veterinary Public Health (GISA Campania). Between 2018 and 2022, 185,583 buffaloes were slaughtered, with a growing trend from 2018 (n=29,705) to 2022 (n=47,366). A total of 3985 lesions were recorded. At least one lesion was found in 2846 animals (1.53%). The area most frequently affected by lesions was the reproductive system (n=1046/3985; 26.24%) followed by the udder (n=929/3985; 23.31%), liver (n=511/3985; 12.82%), lungs (n=386/3985; 9.69%) and musculoskeletal system (n=192/3985; 4.82%). Degeneration was the most commonly observed condition in the liver (n=387/511; 75.73%), while pneumonia and pleuritis were frequently reported in the lungs (n=197/386; 51.04%). Additionally, traumatic injuries to the musculoskeletal system were also prevalent (n=152/192; 79.17%), while pericarditis and myocarditis were commonly found in the heart (n=64/102; 62.74%). During the period analyzed, a tuberculous-related lesion was found in 186 animals (15.41%), with a decreasing trend observed over the years. The number of lesions observed in this study is relatively low and has been decreasing over the years. This decline may be related to the adoption of stricter biosecurity measures for controlling infectious diseases and the modernization of livestock practices toward precision farming. This study demonstrates how the slaughterhouse can be an important epidemiological tool. Incorporating increasingly specific data at the slaughterhouse provides epidemiological information that can be used to understand disease trends and causes.

Exploring the Impact of Video and Poster Media on Leprosy Education: a Study on Instagram

Introduction: Leprosy is a chronic infectious disease caused by Mycobacterium leprae that causes damage to the peripheral nerves. Leprosy prevalence data in Indonesia in 2020-2022 did not increase significantly. So secondary prevention is needed to minimize disability because the disability rate of leprosy in Indonesia is high. Methods: Health promotion activities regarding leprosy were carried out by making posters and educational videos related to leprosy and uploaded on Instagram. This activity was carried out by Public Health Science students offering B State University of Malang online through the Instagram account @komkes.ikmb22. Results: There is a significant difference in insight from health promotion media using videos and posters. The use of video media is preferred and reshared by the public compared to posters. Factors that support video health promotion media are preferred by the public because of the presence of images and sound so that it creates interest in learning and knowing information. Conclusion: video media is preferred than poster media because there are images and sounds that play at one time so that the audience is more interested in seeing and watching it and the information is easy to understand.

Integrated, Scaffolded, and Mandatory Community and Shelter Medicine Curriculum: Best Practices for Transformational Learning on Access to Veterinary Care.

Within veterinary medical education, there is increasing focus on equity and cultural competency/humility, especially within service learning in community and shelter medicine. This article reviews the current literature and draws from the experience of the Ontario Veterinary College Community Healthcare Partnership Program's development of a community and shelter medicine curriculum. We propose that to graduate veterinarians with the knowledge and skills to address inequities in access to veterinary care, a best practice is to integrate mandatory in-class and experiential learning activities, scaffolded across the curriculum. This is a best practice as it creates the best chance for transformational learning for students and is part of our responsibility to the communities we partner with to move toward cultural safety. This Best Practice report addresses the following questions: 1. What foundation of knowledge in community and shelter medicine is needed? (Five curricular pillars: animal welfare, vulnerable animals, spectrum of care, well-being, and cultural humility). 2. How should programs be structured? (Mandatory, integrated, and scaffolded curriculum). 3. What are the pedagogical goals? (Transformational learning). It is our hope that this synthesis is of value to other veterinary colleges seeking to develop programs and/or curricula in community and shelter medicine to address barriers to veterinary care access.

A Global Systematic Review and Meta-Analysis of Giardia duodenalis in Rabbits: Epidemiology, Genetic Diversity and Possible Zoonotic Concerns.

Giardia duodenalis is a pathogenic protozoan responsible for gastrointestinal infections in various hosts, including rabbits. Understanding its epidemiology, genetic diversity and zoonotic implications is vital for public health and veterinary medicine. This systematic review and meta-analysis aimed to synthesize global data on the prevalence of G. duodenalis in rabbit populations, assess the genetic diversity of the isolates and evaluate the associated zoonotic potential. We conducted a thorough literature search across multiple databases (PubMed, Scopus, Web of Science and Google Scholar) for studies published until 18 October 2024. Only peer-reviewed articles reporting original research on G. duodenalis in rabbits were included. We extracted data on prevalence rates, testing times, publication years, countries, continents, WHO regions, diagnostic methods, genes used, assemblages and sub-assemblages. A meta-analysis using random-effects models was performed to calculate pooled prevalence rates, with the I2 index used to assess heterogeneity. A total of 26 studies/datasets were analysed, covering data from 5543 rabbits across 15 countries. The estimated pooled prevalence of G. duodenalis in rabbits was 12.1% (95% CI: 7%-20%), with substantial heterogeneity (I2 = 96.5%). Geographic analysis showed higher prevalence rates in Africa and the AFR WHO region (72.3%, 95% CI: 61.7%-80.8%). Genetic analysis revealed three zoonotic assemblages (A, B and E) and two zoonotic sub-assemblages (AI and BIV) of G. duodenalis in rabbits, highlighting concerns over zoonotic transmission. The findings highlight the global presence and genetic diversity of G. duodenalis in rabbits, indicating potential zoonotic risks. Ongoing monitoring and research are essential to clarify the transmission dynamics and public health implications of G. duodenalis in these animals. Raising awareness among pet owners, veterinarians and public health officials is vital to mitigate potential zoonosis.

Organic vs. Conventional Milk: Uncovering the Link to Antibiotic Resistance in Bacillus cereus sensu lato.

Bacillus cereus sensu lato (B. cereus s.l.) comprises mesophilic and psychrotolerant bacteria commonly found in natural environments as well as in organic and conventional milk. Due to their potential toxigenicity and antibiotic resistance, these bacteria pose a significant threat to consumer health. Organic milk production, which prohibits the use of antibiotics and artificial additives, may influence the composition of microbiota between milk types. This study aimed to compare the antibiotic resistance profiles and enterotoxic potential of B. cereus s.l. isolates from organic and conventional milk. The results indicate that, although conventional milk contains on average 3 times fewer B. cereus s.l. isolates, it has 10-15% more resistant isolates to selected beta-lactams, macrolides, and aminoglycosides. Regarding drug resistance, 21% of B. cereus s.l. isolates were multidrug-resistant, and as many as 42% were non-susceptible to two classes of antibiotics. Even among the sensitive isolates, bacteria from conventional milk exhibited on average 2.05 times higher MICs (minimal inhibitory concentrations) for beta-lactams, 1.49 times higher for erythromycin, 1.38 times higher for vancomycin, and 1.38 times higher for azithromycin. Antibiotic resistance was mostly associated with the origin of the isolates. These findings underscore the need for ongoing monitoring of antibiotic resistance and enterotoxicity among opportunistic B. cereus s.l. strains, which may pose challenges for public health and veterinary medicine. The results highlight that selective pressure associated with antibiotic use can drive resistance development in bacteria that are not the primary targets of antimicrobial therapy.

Assessing the Safety and Efficacy of Self-Expanding Metallic Y Stents in a Community Medicine Setting

Self-Expanding Metallic (SEM) Y stents are a newer form of stent that is gaining popularity outside the USA, but still has limited data, especially in a community medicine setting. This study analyzed efficacy and complication rates in 14 patients who had a SEM Y stent placed between August 2022 and June 2024 at Harris Methodist Hospital in Fort Worth, Texas for either central airway obstruction (CAO) or fistulae. Of the 14 patients, 11 were requiring supplemental oxygen or mechanical ventilation prior to stent placement. Post-stenting 42.9% had decreased oxygen requirements, 21.4% unchanged, 14.3% increased, and 21.4% remained on room air. Complications included mucus plugging (42.9%), infection (35.7%), and granulation tissue (14.3%). There was no statistically significant correlation between gender/age and complications (p = 0.879/0.490, respectively). Complication rates were similar when compared to silicone Y stents based on literature review. In conclusion, SEM Y stents are a safe and effective alternative stent intended for palliative treatment with similar success and complications that can be easily and effectively implemented in a community hospital, with the added benefit of being able to be placed with flexible bronchoscopy.