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Malaria affects millions of lives annually, particularly in tropical and subtropical regions. Despite being largely preventable, 2021 witnessed 247 million infections and over 600,000 deaths across 85 countries. In the ongoing battle against malaria, a promising development has emerged with the endorsement by the World Health Organization (WHO) of the R21/Matrix-M ™ Malaria Vaccine. Developed through a collaboration between the University of Oxford and Novavax, this vaccine has demonstrated remarkable efficacy, reaching 77% effectiveness in Phase 2 clinical trials. It is designed to be low-dose, cost-effective, and accessible, with approval for use in children under three years old. This perspective paper critically examines the R21/Matrix-M malaria vaccine, its development, potential impact on global malaria eradication efforts, and the challenges and opportunities it presents.

This paper examines the far-reaching implications of Triple Artemisinin-Based Combination Therapy (TACT) in the global battle against malaria. Artemisinin-Based Combination Therapy (ACT) is recognized for its cost-effectiveness, lower likelihood of adverse events, and widespread acceptance by patients and healthcare providers. However, TACT introduces novel dimensions to the fight against malaria that make them a superior choice in several aspects. TACT has been demonstrated to address resistance, offer a broader spectrum of action, reduce the risk of treatment failure, and can be tailored to meet regional needs, strengthening the global effort to combat malaria. However, maximizing these benefits of TACT depends on accessibility, particularly in resource-limited regions where malaria is most prevalent. Collaborative efforts among stakeholders, sustainable pricing strategies, efficient supply chains, and public–private partnerships are essential to ensure that TACT reaches needy populations. Moreover, dispelling prevalent malaria myths through health education campaigns is critical in this endeavour. The paper underscores the significance of collaborative initiatives and partnerships among governments, international organizations, research institutions, acadaemia, pharmaceutical companies, and local communities. Together, these efforts can pave the way for the acceptance, adoption, and success of TACT, ultimately advancing the global goal of a malaria-free world.

Background Timely thrombolysis within the golden hour (≤ 60 min from onset) is critical for minimizing disability in acute ischemic stroke (AIS). Mobile stroke units (MSUs) enable prehospital thrombolysis, with effectiveness varying by urban versus rural settings, the presence of an onboard neurologist, and telemedicine models. This study maps evidence on MSU effectiveness in reducing time to thrombolysis in AIS compared to standard emergency medical services (EMS), examines factors modulating effectiveness (e.g., geographic setting, operational protocols), and identifies research gaps. Methods This scoping review followed the Arksey and O’Malley framework and PRISMA-ScR guidelines. PubMed, Embase, Google Scholar, Scopus, and Cochrane Library were searched from January 2008 to March 2025 for peer-reviewed studies reporting thrombolysis timing in AIS with MSUs. Included randomized controlled trials (RCTs), observational studies, and meta-analyses (using both fixed-effects and random-effects models) were synthesized narratively, with data on time reductions, treatment rates, outcomes, and limitations extracted by two blinded reviewers (NA and EK) and tabulated. Results Thirteen studies (five RCTs, six observational studies, and two meta-analyses) involving 39,800 patients across urban and mixed settings were included. MSUs reduced the median onset-to-needle time by 20–41 min, increasing golden-hour rates from less than 5% (EMS) to 21–33%. Urban settings reduced time by 25–41 min and onboard neurologists by up to 41 min, compared to 20–40 min in rural areas and 30–37 min with telemedicine. Thrombolysis rates increased by 10–20% with MSUs compared to EMS, with earlier treatment associated with improved 90-day mRS outcomes of 0–1. Gaps include limited rural data, sparse real-world evidence of cost-effectiveness, and inconsistent reporting of outcomes. Conclusion MSUs enhance access to thrombolysis in AIS, resulting in substantial time savings and potential benefits to outcomes, particularly in urban settings. Further research is needed on rural applicability, cost-effectiveness, and standardized outcomes to optimize global MSU implementation.

Objective To map the scope, nature, and extent of evidence on using Vagus Nerve Stimulation (VNS) for post-stroke arm motor recovery in preclinical and clinical settings, identifying key findings, safety profiles, and evidence gaps to guide future research. Data sources Following the Arksey and O’Malley framework and PRISMA-ScR guidelines, we searched PubMed, Embase, Scopus, Cochrane Library, Web of Science, and Google Scholar for studies published up to March 2025. Studies evaluated invasive or transcutaneous auricular VNS (taVNS) for arm or forelimb motor recovery in adult stroke survivors or animal models. Study selection The titles and abstracts of selected studies were screened against the eligibility criteria using Covidence software to ensure rigor and transparency. Studies that met the inclusion criteria or required a full-text review were retained. Discrepancies were resolved through discussion or consultation with a third reviewer. A full-text review was done to arrive at a final list of studies. Data extraction Data were extracted on study characteristics, intervention protocols, motor outcomes, safety profiles, and evidence gaps. Data synthesis A scoping synthesis approach was employed, with scoping synthesis organized by preclinical and clinical findings. Conclusions VNS is a promising adjunct to task-specific rehabilitation, enhancing arm motor recovery with a favorable safety profile. taVNS offers a scalable, non-invasive alternative but requires further optimization. Future research should focus on diverse stroke populations, standardize protocols, and investigate synergistic combinations with other rehabilitative strategies to optimize functional outcomes.

Aims: Major Depressive Disorder (MDD) is a leading global health concern, significantly impacting quality of life. Conventional treatments like antidepressants are effective but not universally successful, prompting interest in adjunctive therapies. Omega-3 fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are thought to offer neuroprotective and anti-inflammatory benefits that may help manage MDD. This systematic review and meta-analysis assessed the efficacy of omega-3 supplementation in reducing depressive symptoms, improving remission rates, and enhancing overall treatment outcomes in adults with MDD. Methods: We conducted a systematic search of PubMed, PsycINFO, Scopus, and Google Scholar to identify relevant studies published up to March 2024. We included randomized controlled trials (RCTs) and observational studies that investigated omega-3 supplementation in MDD. Studies were selected based on their focus on depressive symptom reduction, remission rates, or relapse prevention. Data were extracted by two independent reviewers, and statistical analysis was performed using random-effects models for meta-analysis. Results: Twenty studies, including 15 RCTs and 5 observational studies with 2,300 participants, met inclusion criteria. Omega-3 supplementation significantly reduced depressive symptoms compared with placebo, with a pooled effect size of Hedge’s g = −0.45 (p<0.01). The most pronounced effects were observed in individuals with moderate-to-severe depressive symptoms. Subgroup analysis revealed that EPA supplementation was more effective when combined with antidepressants. Omega-3 supplementation was generally well tolerated, with mild gastrointestinal side effects. Conclusion: Omega-3 supplementation, particularly EPA and DHA, is effective in reducing depressive symptoms in adults with MDD. Its favourable safety profile makes it a promising adjunctive treatment, especially for patients who do not respond fully to antidepressants. Further research is needed to optimize dosage and identify patient characteristics that predict the best outcomes.

Aims: Schizophrenia is a psychiatric disorder characterized by diverse clinical presentations, posing challenges in early diagnosis and prognosis. Machine learning (ML) has emerged as a promising tool to enhance diagnostic accuracy, predict disease progression, and personalize treatment strategies. This systematic review and meta-analysis synthesized current evidence on the application of ML in schizophrenia diagnosis, prognosis, and treatment response prediction. Methods: A search was conducted across databases including PubMed, Embase, Scopus, Web of Science, and IEEE Xplore, adhering to PRISMA guidelines. Studies employing ML algorithms for schizophrenia classification, risk prediction, or treatment response modelling were included. Extracted data encompassed ML model types, sample sizes, data modalities (e.g., neuroimaging, clinical, genetic), and performance metrics such as accuracy, sensitivity, specificity, and area under the curve (AUC). A meta-analysis was performed to estimate pooled diagnostic performance, with heterogeneity assessed using I² statistics and publication bias evaluated via funnel plots and Egger’s test. Results: A total of 31 studies involving task-based functional MRI (t-fMRI) data were included in the meta-analysis. The pooled sensitivity and specificity for ML-based schizophrenia classification were both 0.83 (95% CI: 0.78–0.88), indicating a high level of diagnostic accuracy. Notably, studies focusing on selective attention tasks demonstrated higher specificity (0.86) compared with those assessing working memory tasks (0.79). Significant heterogeneity (I² = 72%) was observed, attributable to variations in neuropsychological domains, participant demographics, and clinical features. Conclusion: Machine learning exhibits substantial potential in improving schizophrenia diagnosis and outcome prediction, particularly when utilizing task-based neuroimaging data. However, challenges related to data heterogeneity, external validation, and clinical implementation persist. Future research should focus on standardizing ML methodologies, integrating multi-modal data, and enhancing model interpretability to facilitate translation into clinical psychiatry.

Crimean-Congo hemorrhagic fever (CCHF) is a lethal viral disease that has severe public health effects throughout Africa and a case fatality rate of 10%-40%. CCHF virus was first discovered in Crimea in 1944 and has since caused a substantial disease burden in Africa. The shortage of diagnostic tools, ineffective tick control efforts, slow adoption of preventive measures, and cultural hurdles to public education are among the problems associated with continued CCHF virus transmission. Progress in preventing virus spread is also hampered by the dearth of effective serodiagnostic testing for animals and absence of precise surveillance protocols. Intergovernmental coordination, creation of regional reference laboratories, multiinstitutional public education partnerships, investments in healthcare infrastructure, vaccine development, and a One Health approach are strategic methods for solving prevention challenges. Coordinated efforts and financial commitments are needed to combat Crimean-Congo hemorrhagic fever and improve all-around readiness for newly developing infectious illnesses in Africa.

Background Emergency airway management in resource-limited settings presents multifaceted challenges due to shortages in essential medical resources, healthcare professionals, and infrastructure. Methods We conducted a literature search using keywords “Emergency Airway Management” “Low Resource” “Africa” “Asia” from databases such as Pubmed, and Google Scholar, from where we extracted relevant literature for our study. Findings These limitations resulted in delayed interventions, suboptimal care, and higher complication rates during intubation procedures. However, innovative solutions have emerged to address these challenges, including cost-effective airway management devices and training programs tailored for non-medical personnel. Capacity building and local empowerment are critical components of improving emergency airway management in these settings. Additionally, advocating for policy support and investment in healthcare infrastructure is essential to ensure access to essential equipment and adequate staffing. Collaboration and knowledge-sharing networks among healthcare professionals and organisations are pivotal in disseminating best practices and advancing healthcare delivery in resource-limited regions. Conclusion Future efforts should focus on tailored training programs, rigorous research, innovative device development, telemedicine solutions, sustainable capacity building, and advocacy to enhance emergency airway management in resource-limited settings.

Malaria, a global health challenge, remains a leading cause of morbidity and mortality, particularly in sub-Saharan Africa, Southeast Asia, and South America. While traditionally associated with fever and systemic complications, the neurological impact of malaria, including stroke, has become a significant concern. This review aims to examine the incidence, clinical presentation, and outcomes of stroke in individuals with malaria, highlighting the role of malaria in both ischaemic and haemorrhagic strokes. A literature search identified nine studies published between 1999 and 2024, comprising case reports and case series involving malaria-related strokes in patients aged 2 to 47 years. Most cases involved Plasmodium falciparum, with a notable association between this parasite and haemorrhagic strokes. Plasmodium vivax, while less commonly implicated, was associated with ischaemic strokes, especially in younger patients. Diagnostic challenges, including misdiagnosis, were frequently encountered due to the overlap of neurological symptoms with cerebral malaria, emphasizing the need for a high index of suspicion. The pathophysiology of malaria-related strokes is multifactorial, with both mechanical obstruction of cerebral vessels and hypercoagulable states contributing to stroke development. Treatment generally involves a combination of anti-malarial therapy and supportive care, including management of complications such as raised intracranial pressure or seizures. Outcomes vary, with ischaemic stroke patients showing better recovery than those with haemorrhagic strokes. However, mortality remains high, particularly in cases with severe complications like cerebral venous thrombosis. Early diagnosis and intervention are crucial for improving survival and minimizing long-term neurological impairment. Further research is needed to refine diagnostic approaches, elucidate the underlying mechanisms, and optimize management strategies for stroke in patients with malaria.

AimsAutism Spectrum Disorder (ASD) poses unique challenges for social interaction and communication skills development in children. Various interventions, including virtual reality (VR) and social skills training, have emerged as potential approaches to address these challenges. This systematic review aims to evaluate and compare the effectiveness of VR Social Skills Training with Standard In-Person Social Skills Training in improving social interaction skills and reducing social anxiety levels in children with ASD.MethodsA search was conducted across electronic databases (PubMed, PsycINFO, Cochrane Library and Scopus) for relevant studies published from 2000 to December 2023. Inclusion criteria include randomised controlled trials (RCTs) and observational studies comparing VR Social Skills Training with Standard In-Person Social Skills Training in children diagnosed with ASD within the specified age range. Two independent reviewers assessed study eligibility, conducted data extraction, and evaluated study quality. The primary outcomes included changes in social interaction skills and reduced social anxiety levels.ResultsFrom 1,239 studies initially identified, 25 met inclusion criteria post-screening. VR interventions (n = 12) showed significant improvements (80%) in social interaction skills (15% average anxiety reduction). Varied platforms were utilised, including virtual social scenarios. Using conventional techniques, standard interventions (n = 13) demonstrated improvements (75%) with a 12% average anxiety reduction. Comparative effectiveness between VR and Standard approaches lacked consistent significance. Subgroup analyses showed shorter interventions (4–8 weeks) induced rapid skill improvements, while longer-term ones (12+ weeks) sustained anxiety reduction. Younger participants (6–8 years) exhibited more pronounced skill enhancements and higher baseline anxiety correlated with greater improvement.ConclusionThis review provides an overview of the current evidence on the comparative effectiveness of VR Social Skills Training and Standard In-Person Social Skills Training for children with ASD. The implications of this review extend to clinicians, educators, and policymakers involved in developing and implementing interventions aimed at improving social outcomes in children with ASD.