Global Health Today Research Articles

The One Health concept: a holistic approach to protect human and environmental health - how does it work in Total Worker Health strategy.

Human well-being is affected by demographic, geographical, environmental and economic changes in the modern world. Advanced and rapid technological advances have left countries without an adequate structural framework. The One Health concept, rooted in the interconnectedness of human health, animal health and the environment, addresses today's global health challenges. These include non-communicable and zoonotic diseases, antimicrobial resistance, ecosystem degradation and food security. All of these require a holistic approach, bringing together multiple disciplines. Therefore, an exploration of the One Health concept was undertaken, which focuses on the collaboration of professionals from different disciplines, as well as looking at human health in a multi-faceted way. The aim of the study was to explore how the One Health concept could contribute to effective pandemic prevention and a broader holistic understanding of human health. It was also relevant to identify its application in occupational medicine. The narrative review was adopted as the research method of choice. The authors emphasise the importance of interdisciplinary collaboration, education and international partnerships in preparing for future health emergencies. Human health should not only be assessed from a medical perspective, but also from an environmental point of view. International cooperation is therefore essential to prepare a unified response to threats and challenges. The system of teaching medical personnel needs to be improved, returning to anthropological assumptions. With zoonotic diseases systematically emerging, health professionals should be as prepared as possible for emergencies. Qualified teams are needed to assess risks and hazards in the workplace in a multidisciplinary manner. An in-depth knowledge of zoonotic pathogen transmission is crucial. The impact of environmental degradation on the immune system must be taken into account. A holistic view of workers' health is needed, taking into account ecological, environmental, social and economic factors. Med Pr Work Health Saf. 2024;75(5).

The Incidence of Hypertension of Posbindu PTM Participants

Non-communicable diseases cannot be transmitted to others, but their development occurs slowly over a long period of time. One of the non-communicable diseases that is a priority in global health today is hypertension. Hypertension often causes complications such as stroke, heart disease, and kidney failure. The aim is to describe the incidence of hypertension in Posbindu PTM Bumiroso participants. The quantitative descriptive method using the total sampling technique obtained 38 respondents. The data was analyzed descriptively to describe the results of the respondents' blood pressure examinations. The results of the study based on the classification of hypertension, participants who experienced pre-hypertension and hypertension level 1 were 12 (31.58%), hypertension level 2 was 9 (23.68%) and normal was 5 (12.16%). The conclusion is that more than half of Posbindu PTM participants experience hypertension, as a suggestion, they can carry out routine checks at the nearest health facility.

Regulation of Mitochondrial and Peroxisomal Metabolism in Female Obesity and Type 2 Diabetes.

Obesity and type 2 diabetes (T2D) are widespread metabolic disorders that significantly impact global health today, affecting approximately 17% of adults worldwide with obesity and 9.3% with T2D. Both conditions are closely linked to disruptions in lipid metabolism, where peroxisomes play a pivotal role. Mitochondria and peroxisomes are vital organelles responsible for lipid and energy regulation, including the β-oxidation and oxidation of very long-chain fatty acids (VLCFAs), cholesterol biosynthesis, and bile acid metabolism. These processes are significantly influenced by estrogens, highlighting the interplay between these organelles' function and hormonal regulation in the development and progression of metabolic diseases, such as obesity, metabolic dysfunction-associated fatty liver disease (MAFLD), and T2D. Estrogens modulate lipid metabolism through interactions with nuclear receptors, like peroxisome proliferator-activated receptors (PPARs), which are crucial for maintaining metabolic balance. Estrogen deficiency, such as in postmenopausal women, impairs PPAR regulation, leading to lipid accumulation and increased risk of metabolic disorders. The disruption of peroxisomal-mitochondrial function and estrogen regulation exacerbates lipid imbalances, contributing to insulin resistance and ROS accumulation. This review emphasizes the critical role of these organelles and estrogens in lipid metabolism and their implications for metabolic health, suggesting that therapeutic strategies, including hormone replacement therapy, may offer potential benefits in treating and preventing metabolic diseases.

Geopolitical determinants of mental health and global health inequities.

Geopolitical determinants of health have been well recognized by the World Health Organization and are increasingly being discussed across governments, institutions, academics, policy makers, and across global health sector. Geopolitical determinants of health are events, structures, processes, and factors that influence individual health including mental health, public and population mental health both directly and indirectly. Consequently, nation's responses to these factors will affect short-term and long-term health outcomes. Geopolitical factors are becoming increasingly more important as they influence directly and indirectly social determinants of health. These factors clearly impact both physical and mental health leading to health inequities and inequalities. It is important to factor in geopolitical determinants in resource allocation and funding as well as policy making as has been highlighted by the recent pandemic and variable access to vaccines. Geopolitical determinants would be integral when addressing all global health inequities. These play a major role in resource allocation, policy and planning to meet today's global health challenges.

Antibiotics Prescribing Pattern and Quality of Prescribing in Croatian Dental Practices-5-Year National Study.

Antibiotic resistance is one of the biggest threats to global health today. The aim of this study was to analyze antibiotic prescribing patterns and quality of prescribing in Croatian dental practices over a 5-year period. This is a retrospective observational study based on the analysis of the electronic prescriptions (medicines in ATC groups J01 and P01) from dental practices in Croatia prescribed from 1 January 2015 to 31 December 2019. Prescriptions were retrieved from the Croatian Health Insurance Fund (HZZO). The analyses included the number of prescriptions, type and quantity of prescribed drugs, indication, and the patient's and prescriber's characteristics. The consumption increased from 1.98 DID in 2015, to 2.10 DID in 2019. The most prescribed antibiotic was Amoxicillin with clavulanic acid followed by Amoxicillin, Clindamycin, Metronidazole and Cefalexin. The analyses showed that 29.79% of antibiotics were not prescribed in accordance with the contemporary guidelines for the proper use of antibiotics. Additionally, 22% of antibiotics were prescribed in inconclusive indications. The research showed an increase in antibiotic consumption over five years along with unnecessary prescribing of antibiotics in cases with no indications for its use. The development of national guidelines for antibiotic use is necessary.

STATUS TEKANAN DARAH PADA LANSIA PENDERITA HIPERTENSI

One of the main issues facing global health today is hypertension. Among the top five nations in the world for the proportion of senior population is Indonesia. According to estimates, there will be 36 million elderly people in Indonesia by 2025, and hypertension will be a major health issue. According to preliminary research survey data, there are twenty-one elderly in Nepo Village who suffer from hypertension. The purpose of this study was to ascertain the blood pressure status of Nepo Village's elderly hypertensive residents. At the time of the investigation, the sample size for this descriptive method utilising a quantitative approach and total sampling methodology which was based on inclusion and exclusion criteria was 21 respondents. Tensimeters and observation sheets are used in the data collection process. According to the study's findings, the majority of respondents had systolic blood pressure measured between 140 and 159 mmHg in 11 (52.4%) of the cases and diastolic blood pressure measured between 90 and 99 mmHg in 10 (47.5%) of the cases. The study's findings indicate that there is a correlation between gender and age in the blood pressure condition of elderly hypertensive patients.

Science and sacrifice: the pioneering journey of Dora Lush.

In 1943, Australian scientist Miss Dora Lush's life was tragically cut short in her relentless pursuit of scientific knowledge. This article commemorates the 100-year anniversary of the journal, ICB, by celebrating the remarkable career of Lush, a renowned bacteriologist who achieved unparalleled success in an era when women faced formidable barriers to tertiary education and scientific recognition. Graduating with a Master of Science from the University of Melbourne in 1934, Lush's ground-breaking research in infectious diseases, conducted in collaboration with Frank Macfarlane Burnet AO at the Walter and Eliza Hall Institute (WEHI), played a pivotal role in advancing our understanding of viruses, including influenza, herpes and myxomatosis. Lush's pivotal work on influenza provided the foundational evidence to develop the influenza vaccine, a cornerstone of global public health today. Similarly, her investigation of myxoma virus in rabbits, with its potential for pest control and ecological impact, was used to instruct creation of the world's first biological control program against a mammalian pest. Tragically, Dora Lush succumbed to scrub fever in 1943, a disease she contracted during a laboratory accident. Her unwavering commitment to science led her to offer her own blood for research as she battled the infection, exemplifying her dedication to advancing knowledge even in the face of personal adversity. Lush's legacy endures through scholarships and fellowships that bear her name in Australia, fostering the careers of aspiring scientists. Her ground-breaking research and unwavering determination continue to inspire generations, reminding us of the importance of diversity in science and the enduring impact of pioneering women like Lush.

Design of Surfaces with Persistent Antimicrobial Properties on Stainless Steel Developed Using Femtosecond Laser Texturing for Application in "High Traffic" Objects.

Metal-based high-touch surfaces used for diverse applications in everyday use, like handrails, playground grab handles, doorknobs, ATM touch pads, and desks, are the most common targets for pollution with a variety of microbes; there is thus a need to improve their antimicrobial properties, an issue which has become a challenge in recent years, particularly after the COVID-19 pandemic. According to the World Health Organization (WHO), drug-resistant pathogens are one of the main concerns to global health today, as they lead to longer hospital stays and increased medical costs. Generally, the development of antimicrobial surfaces is related to the utilization of chemical methods via deposition on surfaces in the forms of various types of coatings. However, the addition of chemical substances onto a surface can induce unwanted effects, since it causes surface chemistry changes and, in some cases, cannot provide long-lasting results. A novel approach of utilising ultra-short laser radiation for the treatment of metallic surfaces by inducing a variety of micro- and nanostructuration is elaborated upon in the current research, estimating the optimum relation between the wettability and roughness characteristics for the creation of antimicrobial properties for such high-touch surfaces. In the current study, AISI 304-304L stainless steel metal was used as a benchmark material. Surface texturing via laser ablation with femtosecond laser pulses is an effective method, since it enables the formation of a variety of surface patterns, along with the creation of bimodal roughness, in one-step processing. In this investigation, a precise approach toward developing hydrophobic stainless steel surfaces with tunable adherence using femtosecond laser-induced modification is described. The impact of basic femtosecond laser processing parameters, like the scanning velocity, laser energy, and wettability properties of the laser-processed stainless steel samples, are examined. It is identified that the topography and morphology of laser-induced surface structures can be efficiently changed by adapting the laser processing parameters to create structures, which facilitate the transfer of surface properties from extremely low to high surface wettability.

A review on anti-cancer plants of India

India has a high level of endemism and a diverse range of floral species. Cancer is one of the most significant challenges facing global health today. The indigenous peoples and residents who live in India have, for a very long time, made use of specific medicinal plants to fight cancer. This practice is still prevalent today. Several different drugs may be utilized in the treatment of cancer. Because of the potential drawbacks associated with such treatments and the development of drug resistance, the quest for new therapies that are both safer and much more effective is still the most challenging field of study. Several cancer medicines used today come from natural sources. We're returning to our old ways because medicinal plants are a good, natural way to make medicines that prevent cancer without causing major side effects. Within the scope of this study, a few herbs traditionally used to treat cancer are looked at to see what they might be good for. The cytotoxicity of these plants, the processes that lead to them, and the different compounds they make were looked into. This study has tried to focus on how these plants fight cancer.

Investigation of Antibiotics Residues in Imported and Locally Produced Red Meat in Muscat, Sultanate of Oman

Background: Antibiotics are heavily used for animal treatment, growth enhancer and protection from disease. The residues of antibiotics are related to antibiotic resistance which is the biggest threats to global health, food security and development today. The aim of this study was to investigate the presence of antibiotic residues in available red meat in the Sultanate of Oman. Methods: The extraction was done using QuEChERS method by Aglient and 11 standards were used. The extract was analyzed using The Aglient 6460 LC-MS/MS. Result: The results showed that investigated Omani goat muscle and liver were free of antibiotics as latter they used as blank sample. All investigated Somali goat samples didn’t contain Tetracycline, Amoxicillin, Ceftiofur, Oxacillin, Deoxytetracline, Tylosin and Phenoxymethylpenicillin. Only two samples had Tilmicosin with value of 18-32.2 µl/kg which was that was lower than maxiumam residual limit (MRL). Around 48% of total somali goat samples contained Oxytetracycline (OXY) and Chlorotetracycline (CTC) with value lower than MRL. However, two samples had values of CTC and OXY exceeding the MRL. Ciprofloxacin and Enrofloxacine were detected in 9 samples exceeding the MRL. The finding of this study showed unsafe food source supply to Oman as detection of antibiotic residues in meat.

The potential of endophytic bacteria isolated from atung fruit seeds as antibacterial against skin pathogens

Antibiotic resistance is one of the biggest threats to global health today. Estimated by 2050, antibiotic resistance will cause around 10 million deaths per year if alternative treatments have not been identified. This study was aimed to determine the potential of endophytic bacterial isolates from the seeds of atung fruit (Parinarium glaberrimum Hassk) as an antibacterial against skin pathogens Cutibacterium acnes and MDR Staphylococcus aureus, and Staphylococcus epidermidis. This research was a descriptive observational research with laboratory experimental methods. This study used isolates of endophytic bacteria isolated from the seeds of atung fruit which were tested with pathogenic bacteria. The results showed that 2 of 7 endophytic bacterial isolates were able to inhibit the growth of C. acnes with clear zone diameter of 4 mm and 9 mm, respectively, yet couldn’t able to inhibit MDR S. aureus and S. epidermidis. This study concluded that the 2 isolates (isolate BBA5 and BBA9) could have potential as antibacterial against C. acnes. While 5 other isolates had not been able to inhibit the whole pathogenic bacteria tested. An optimization is necessary in an effort to develop these isolates as antibacterial.

Biodegradable Polymers and Polymer Composites with Antibacterial Properties.

Antibiotic resistance is one of the greatest threats to global health and food security today. It becomes increasingly difficult to treat infectious disorders because antibiotics, even the newest ones, are becoming less and less effective. One of the ways taken in the Global Plan of Action announced at the World Health Assembly in May 2015 is to ensure the prevention and treatment of infectious diseases. In order to do so, attempts are made to develop new antimicrobial therapeutics, including biomaterials with antibacterial activity, such as polycationic polymers, polypeptides, and polymeric systems, to provide non-antibiotic therapeutic agents, such as selected biologically active nanoparticles and chemical compounds. Another key issue is preventing food from contamination by developing antibacterial packaging materials, particularly based on degradable polymers and biocomposites. This review, in a cross-sectional way, describes the most significant research activities conducted in recent years in the field of the development of polymeric materials and polymer composites with antibacterial properties. We particularly focus on natural polymers, i.e., polysaccharides and polypeptides, which present a mechanism for combating many highly pathogenic microorganisms. We also attempt to use this knowledge to obtain synthetic polymers with similar antibacterial activity.

THE RISE OF RESISTANT PROVIDENCIA SPECIES WORLDWIDE

We would like to draw attention to a critical and emerging public health concern: the rise and global dissemination of Providencia spp. that harbor resistance genes, rendering them resistant to a broad spectrum of antibiotics. This matter marks a significant escalation in the ongoing battle against antibiotic resistance, a problem that the World Health Organization (WHO) has identified as one of the greatest threats to global health, food security, and advancement today. Herein, I want to primarily focus on a few studies published after 2020 that highlight the problem.

Antibacterial and Antibiofilm Properties of Self-Assembled Dipeptide Nanotubes.

Over recent decades, multidrug-resistant pathogens have become a global concern, with WHO even considering it one of the biggest threats to global health, food security, and development today, which led to the search for alternative antibacterial agents. A special class is formed by peptides composed by the diphenylalanine motif whose antibacterial properties result from their supramolecular arrangement into nanotubes. However, several other dipeptides that also form nanotubes have been largely overlooked. Here, we present the antibacterial activity of four dipeptide nanotubes. The results point to diverse mechanisms through which dipeptide nanotubes exert their effect against bacteria. Antibacterial activity was similar for dipeptide nanotubes sufficiently wide to allow water flux while dipeptides displaying smaller channels were inactive. This suggests that two of the tested dipeptides, L-Phe-L-Phe (FF, diphenylalanine) and L-Leu-L-Ser (LS), are pore forming structures able to induce membrane permeation and affect cellular hydration and integrity. Of these two dipeptides, only FF demonstrated potential to inhibit biofilm formation. The amyloid-like nature and hydrophobicity of diphenylalanine assemblies are probably responsible for their adhesion to cell surfaces preventing biofilm formation and bacteria attachment.

Going Remote: Evaluating a Global Health Practicum Program During COVID-19 Travel Restrictions

Short-term experiences in global health (STEGHs) are an important part of global health degree programs. Due to the COVID-19 pandemic, travel was not possible for students planning to participate in the Johns Hopkins Center for Global Health's Global Health Established Field Placement (GHEFP) program in 2020. Working with willing faculty mentors, in-country collaborators, and students, the Center allowed students to complete their practicums remotely so that students could gain practicum experience despite not being able to travel, and faculty and collaborators could receive the planned support on their projects. This evaluation aims to describe the experience of pivoting the GHEFP program from an in-person, in-country program to a remote practicum. We analyzed program evaluation data from 30 students, 20 faculty members, and 10 in-country collaborators. Surveys for each group consisted of multiple choice, scale rating, and open-ended questions. The quantitative data was analyzed using Microsoft Excel to calculate survey response frequencies. The open-ended responses were analyzed for emergent themes. The remote GHEFP experience enabled students to gain practice working on global health projects from a distance, but it came with challenges related to preparation, communication, shifting scopes of work, and contextualization. All participants would have preferred an in-person experience if given a choice, but most agreed that a remote practicum was better than not participating at all. The remote program served its purpose during the height of the pandemic. Given the hybrid nature of global health today, many aspects of the remote practicum experience are helpful for global health training. Future iterations of remote STEGHs should initially be designed for remote work to ensure meaningful scopes for students that are helpful to faculty mentors and collaborators. Hybrid models may also be useful. Mutually beneficial twinning relationships should also be incorporated into remote and in-person STEGHs to foster a more equitable global health training environment.

Cost-Effectiveness Analysis of Temocillin Treatment in Patients with Febrile UTI Accounting for the Emergence of Antibiotic Resistance.

BackgroundAntibiotic resistance has been listed as one of the biggest threats to global health today. A recent study has shown that treating febrile urinary tract infections with temocillin instead of cefotaxime leads to a reduced selection of antibiotic-resistant bacteria. However, a potential challenge with prioritizing temocillin over cefotaxime is the cost consequences.ObjectiveThis study aimed to assess the cost effectiveness of using temocillin compared to cefotaxime in treating febrile urinary tract infections in a model that takes the emergence of antibiotic resistance into account.MethodsWe used a Markov cohort model to estimate the costs and health effects of temocillin and cefotaxime treatment in febrile urinary tract infections in a Swedish setting. Health effects were assessed in terms of quality-adjusted life-years, and the primary outcome was the cost per quality-adjusted life-year gained with temocillin compared to cefotaxime. We used a 5-year time horizon.ResultsThe model results showed that temocillin treatment led to better health outcomes at a higher total cost. The cost per quality-adjusted life-year gained was approximately 38,400 EUR. Results from the sensitivity analysis suggested a 63% probability of temocillin being cost effective at a threshold of 50,000 EUR. Furthermore, results showed that the cost effectiveness of temocillin in febrile urinary tract infections is highly dependent on the drug cost.ConclusionsAs antibiotic consumption is a driving force of resistance, it is essential to consider the development of resistance when studying the health economic consequences of antibiotic treatments. In doing so, this study found temocillin to be cost effective for febrile urinary tract infections.

INTRANASAL DELIVERY IN MANAGING ANTIBIOTIC RESISTANCE IN ‘BRAIN INFECTIONS’

According to World Health Organization, WHO, antibiotic resistance is one of the biggest threats to global health, food security and development today. The means of delivering antibiotics to treat several brain infections, especially meningitis and encephalitis, have been inherently difficult, due to the presence of highly protective physiological barriers, mainly the blood-brain barrier (BBB), cerebrospinal fluid (CSF) that impairs the efficacy and bioavailability of antibiotics from reaching the susceptive organism. Many attempts have been made to optimize the therapeutic prognosis of such infections through the parenteral and intrathecal route of administration. These alternative routes have incited inadequate efficacy along with associated adverse effects. However, scientists have now considered the intranasal route (non-invasive) as a breakthrough to such inherent challenges. Moreover, several in vivo and ex vivo studies suggested evidence of the effectiveness of nose-to-brain delivery in treating bacterial and viral infections, thereby limiting the chance of antibiotic resistance. Targeting the multidrug resistance gram-positive and negative bacterias, a study was reported using nanoemulsion of Syzygiumaromaticum and Thymus vulgaris essential oils via the intranasal route. The result indicated the maximum inhibition of multi-drug resistance bacterias upon intranasal administration. Therefore, this study focuses to highlight the potential of intranasal delivery in the optimization of CNS infections and the prevention of antibiotic resistance.

Prevalence of polymyxin resistance through the food chain, the global crisis

Antimicrobial resistance is one of the vital challenges facing global health today. Multi-drug resistant (MDR) infections are often treated with the narrow-spectrum drugs, colistin (polymyxin E) or polymyxin B, which are last-resort antibiotics for human therapeutics that are effective against Gram-negative bacteria. Unfortunately, resistance to these polymyxins has occurred because of selective pressure caused by the inappropriate use of those antibiotics, especially in farming. The mechanisms of resistance to polymyxins are mediated through intrinsic, mutational, or genetic alteration in chromosomal genes. The mechanism includes the regulatory network controlling chemical modifications of lipid A moiety of lipopolysaccharide, reducing the negative charge of lipid A and its affinity for polymyxins. Additionally, the unique mobile colistin/polymyxin B resistance (mcr) gene reported in Enterobacteriales is responsible for the horizontal dissemination of resistance to polymyxins via the food chain. There is now an urgent need to increase surveillance for detecting resistance to polymyxins. Therefore, this review presents an overview of presently available scientific literature on the mechanism of resistance to polymyxins, with their associated gene variants, evaluation methods, resistance transmission through the food chain via food bacteria, and related risk factors. We further focus on the significant implications of polymyxins usage in India and future views for food safety to preserve polymyxin activity.

Global health education for the post-pandemic years: parity, people, planet, priorities, and practices

Global health degree programs are now offered by institutions of higher education in most world regions. Based on our review of the curricula for many of these programs, we identified five domains that are central to current global health education. “Parity” emphasizes health equity as the ultimate goal of global health. “People” comprises the social, economic, cultural, and political contributors to health and access to medical care for individuals and communities. “Planet” encompasses various aspects of globalization and environmental health that affect population health. “Priorities” and “practices” include the values, data, and tools used to design, implement, and evaluate partnerships, policies, programs, and other global health interventions in countries of all income levels. The pandemic is likely to increase student demand for global health education from the undergraduate through the graduate and professional levels. Our “5 Ps model of global health education” provides a comprehensive framework for the core student learning objectives for global health today. Knowledge of each of these domains is essential for preparing students for meaningful experiential learning and skilled professional practice in global health.

The Language of Disease: Writing Syphilis in Nineteenth-Century France by Steven Wilson

Reviewed by: The Language of Disease: Writing Syphilis in Nineteenth-Century France by Steven Wilson Beatrice Fagan The Language of Disease: Writing Syphilis in Nineteenth-Century France. By Steven Wilson. (Research Monographs in French Studies 62) Cambridge: Legenda. 2020. x+145 pp. £75. ISBN 978–1–781885–60–4. This timely reappraisal of syphilis in nineteenth-century French medical and literary texts examines the importance of language in shaping our understanding of the diseased body, and asks how this body generates, alters, and disrupts this language. Steven Wilson’s focus on ideological, disciplinary, and physical borders builds on previous research on digestive health and disciplinary knowledge (Gut Feeling and Digestive Health in Nineteenth-Century Literature, History and Culture, ed. by Manon Mathias and Alison M. Moore (Basingstoke: Palgrave Macmillan, 2018) and Larry Duffy, Flaubert, Zola and the Incorporation of Disciplinary Knowledge (Basingstoke: Palgrave Macmillan, 2015)). However, diverging from previous examinations of syphilis in nineteenth-century France, Wilson argues for the importance of literature in representing disease. Throughout this analysis, Wilson deftly draws comparisons between different forms of borders, describing how social, cultural, and disciplinary borders influenced descriptors of cells, the skin and blood, and patient-authors’ experience of pain, consequently shaping the language of disease and understandings of the syphilitic body. Beginning with a focus on language of contagion and invasion, and linking these motifs to the porous border of the skin and, in turn, textual porosity, Wilson then interrogates the centrality of blood and contamination within representations of [End Page 127] syphilis, arguing that the language used to describe blood is mirrored in a concurrent ‘diffusion’ of public health warnings and prophylaxis (p. 67). Although this analysis covers the well-trodden ground of Zola’s Nana (1880) and Maupassant’s ‘Le Lit 29’ (1884), the convincing close reading is reinforced by accounts of a number of less well-studied novels, reflecting the cultural value of middle-brow and popular novels and acknowledging their role in shaping understandings of the body. The first two chapters concentrate on identifying disease within sites of borders, transmission, mobility, and fluidity, illustrating how the language of blood facilitates these disciplinary and pathological ‘entanglements’ (p. 86). In contrast, Chapter 3 changes the focus to the lived experience of the patient-writer, arguing that in these instances, the language of disease is limited and restricted, ruptured by experiences of pain, resulting in an emphasis on visual imagery of crucifixion (pp. 110–20). Wilson’s study contributes significantly to an emerging area of research acknowledging the centrality of syphilis to broader social, medical, and hygienic anxieties, while employing methodologies from the critical medical humanities to focus specifically on the diseased body and its relationship to the language of disease. The importance of gender in representations of syphilis, particularly those relating to prostitutes, is pertinently reflected in developed readings of literary and medical texts, underscoring the contemporary perception of female ‘porosity’ (p. 48). However, despite this acknowledgement, Chapter 3’s focus on the patient-author is comprised exclusively of male accounts of the disease. Although no doubt this is due to a scarcity of material, it somewhat limits the conclusions drawn about how the language of disease was understood and shaped by experiences of syphilis. In addition to further clarification about how the analysis of representations of diseased bodies meshes with discussion of experiences of syphilis, Wilson’s use of ‘public health’ literature (pp. 65–68), which hints at the disciplinary fluidity of the terms ‘literary’ and ‘medical’, could have been supported by other popular sources such as pamphlets, satire, and caricature. Such sources also demonstrate the importance of language in understanding and representing the diseased body. As touched upon in Wilson’s Conclusion, the relevance of the research extends beyond syphilis in nineteenth-century France, providing a framework to interrogate the language of disease in global health today, an approach which is particularly reinforced by the COVID-19 pandemic. As we are constantly reminded of the importance of quarantine, contagion, and transmission, Wilson’s approach to the body and language raises questions for future study on how the diseased or sick body shapes and generates language, and how this language shapes our understanding of the...