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Aim To estimate the prevalence of retinopathy of prematurity (ROP) and investigate the prediction and validity of WINROP (Weight, Insulin-Like Growth Factor-1, Neonatal Retinopathy of Prematurity), an online monitoring algorithm in preterm infants at an African low/medium income country (LMIC) based neonatal intensive care unit (NICU). Methods Data from the ROP screening proforma for preterm infants between January 2020 and December 31, 2022, with gestational age (GA) from 24 to 32 weeks were entered into the WINROP algorithm system which signals an ROP risk alarm based on weekly weight gain and was compared with ophthalmology examination findings. Sensitivity, specificity, negative and positive predictive values were calculated, and statistical analysis was performed using EPI INFO (version 7.2.2.6). Results There were 168 preterm infants that met WINROP criteria. The median birth weight was 1380 g (IQR: 1141–1570 g), ranging from 600 g to 2100 g, while the median gestational age at birth was 31 weeks (IQR: 29.0–32.0 weeks), with a range of 24 to 32 weeks The overall prevalence of any ROP was 38.1% (64/168), type 1 ROP and type 2 ROP were 7.1% (12/168) and 8.9% (15/168) respectively. WINROP alarmed in 73 infants born at a gestational age (29.0 weeks, IQR: 28.0–31) and birth weight (1100 g, IQR: 912.5–1200 g). The specificity of WINROP for any ROP was 80.8% (84/104); the sensitivities for type 1 ROP and type 2 ROP were 91.7% (11/12) and 86.7% (13/15) respectively. The negative and positive predictive values were 88.4% (84/95) and 72.6% (53/73) respectively. Conclusion Overall, the WINROP algorithm identified 91.7% of preterm infants who had been diagnosed and treated for type 1 ROP. Though it led to a high number of false alarms, especially in the most vulnerable infants. The algorithm’s utility is likely greatest for the larger, more mature preterm infants. This confirms its usefulness to significantly reduce the number of preterm infants who need to go through stressful eye examinations in an African NICU setting where inadequate number of specialists is a major challenge.

To determine the perception and attitudes of a rural community regarding the etiology, prevention, and treatment of blindness in adults. A cross-sectional, descriptive study was performed in a rural community in Kwara State, Nigeria using semi-structured questionnaire. All adults aged 40 years or older who were residents for a minimum of 6 months in the community were included. Data were collected on patient demographics, knowledge, attitude, perception, and use of the eye care facility. A total of 290 participants were interviewed. The male-to-female ratio was 1:2. Consumption of certain types of food was an important cause of blindness as perceived by 57.9% of the respondents, followed by supernatural forces (41.7%) and aging (19%). Sixty percent of respondents thought blindness could be prevented. Age (P = 0.04) and level of education (P =0.003) significantly affected the beliefs on the prevention of blindness. Most respondents (79.3%) preferred orthodox eye care, but only 65% would accept surgical intervention if required. The level of education significantly affected the acceptance of surgery (P = 0.04). Reasons for refusing surgery were, fear (64%), previous poor outcomes in acquaintances (31%), belief that surgery is not required (3%), and cost (2%). About 65% used one form of traditional eye medication or the other. Over half (56.6%) believed that spectacles could cure all causes of blindness. Of those who had ocular complaints, 57.1% used orthodox care without combining with either traditional or spiritual remedies. This rural Nigerian community had some beliefs that were consistent with modern knowledge. However, the overall knowledge, attitude, and perceptions of this community need to be redirected to favor the eradication of avoidable blindness. Although an eye care facility was available, use by the community was suboptimal. Age and the level of education affected their overall perception and attitudes.

ObjectivesRetinopathy of prematurity (ROP) will become a major cause of blindness in Nigerian children unless screening and treatment services expand. This article aims to describe the collaborative activities undertaken to improve services for ROP between 2017 and 2020 as well as the outcome of these activities in Nigeria.DesignDescriptive case study.SettingNeonatal intensive care units in Nigeria.ParticipantsStaff providing services for ROP, and 723 preterm infants screened for ROP who fulfilled screening criteria (gestational age <34 weeks or birth weight ≤2000 g, or sickness criteria).Methods and analysisA WhatsApp group was initiated for Nigerian ophthalmologists and neonatologists in 2018. Members participated in a range of capacity-building, national and international collaborative activities between 2017 and 2018. A national protocol for ROP was developed for Nigeria and adopted in 2018; 1 year screening outcome data were collected and analysed. In 2019, an esurvey was used to collect service data from WhatsApp group members for 2017–2018 and to assess challenges in service provision.ResultsIn 2017 only six of the 84 public neonatal units in Nigeria provided ROP services; this number had increased to 20 by 2018. Of the 723 babies screened in 10 units over a year, 127 (17.6%) developed any ROP; and 29 (22.8%) developed type 1 ROP. Only 13 (44.8%) babies were treated, most by intravitreal bevacizumab. The screening criteria were revised in 2020. Challenges included lack of equipment to regulate oxygen and to document and treat ROP, and lack of data systems.ConclusionROP screening coverage and quality improved after national and international collaborative efforts. To scale up and improve services, equipment for neonatal care and ROP treatment is urgently needed, as well as systems to monitor data. Ongoing advocacy is also essential.

At this present stage of COVID-19 re-emergence, designing an effective candidate vaccine for different variants of SARS-CoV-2 is a study worthy of consideration. This research used bioinformatics tools to design an mRNA vaccine that captures all the circulating variants and lineages of the virus in its construct. Sequences of these viruses were retrieved across the six continents and analyzed using different tools to screen for the preferable CD8+ T lymphocytes (CTL), CD4+ T lymphocytes (HTL), and B-cell epitopes. These epitopes were used to design the vaccine. In addition, several other co-translational residues were added to the construct of an mRNA vaccine whose molecular weight is 285.29686 kDa with an estimated pI of 9.2 and has no cross affinity with the human genome with an estimated over 68% to cover the world population. It is relatively stable, with minimal deformability in its interaction with the human innate immune receptor, which includes TLR 3 and TLR 9. The overall result has proven that the designed candidate vaccine is capable of modulating cell-mediated immune responses by activating the actions of CD4+ T cells, natural killer cells, and macrophages, and displayed an increased memory T cell and B cell activities, which may further be validated via in vivo and in vitro techniques.

Background Neurofilament light chain (NfL) has emerged as a sensitive biomarker for neuronal injury across various neurological disorders. Recent studies suggest that its elevated serum levels are also associated with kidney disease, including chronic kidney disease, acute kidney injury, and diabetic nephropathy. Main body This paper explores the potential of NfL as a diagnostic and prognostic tool in renal medicine, evaluates its clinical implications, and outlines future research directions. We reviewed recent literature on NfL dynamics, the neuro-renal axis, and the role of the neurofilament light chain in kidney disease across PubMed, Embase, Web of Science, Google Scholar, Cochrane Library, and Scopus. We then analyzed the current evidence on the diagnostic and prognostic value of serum NfL levels in various renal conditions and discussed potential therapeutic implications. Elevated serum NfL levels are associated with several kidney diseases, including chronic kidney disease, acute kidney disease, and diabetic nephropathy. Its increased serum level is related to impaired renal clearance, hormonal changes, and inflammatory processes. NfL levels correlate with traditional renal biomarkers, such as serum creatinine and estimated glomerular filtration rate, and offer additional insights into disease progression and patient prognosis. Conclusion NfL holds promise as a novel biomarker for kidney disease, offering potential advantages for early detection, risk stratification, and monitoring disease progression. Future studies should focus on longitudinal and mechanistic studies to elucidate the pathways linking NfL and kidney function, and clinical trials should be conducted to evaluate the effectiveness of NfL-targeted interventions.

Meningitis is a serious and potentially life-threatening condition due to inflammation of the brain and spinal cord’s meninges. It has various etiologies, among which bacterial meningitis appears to be the most prevalent. Nigeria, the largest country in Africa has now become the first country to roll out a new vaccine called the Men5CV, being able to offer protective against five meningococcal bacterial strains (A, C, W, Y, and X), it offers hope to low-income and developing countries across the world. Clinical trials showed consistent efficacy with minimum adverse effects, and as such it has been approved by the World Health Organization (WHO). 1686 suspected cases were recorded within the last four years in Nigeria, with about 124 confirmed deaths. Despite the success with the MenA conjugate vaccine, other strains still persist. Through a 13-year collaborative effort, there has been significant protection. The rollout of the MEN4CV marks a critical step towards the goal of the WHO in completely eradicating meningitis by 2030. Although challenges like religious reasons and limited vaccine supply exist, we believe with effective training for healthcare practitioners and effective distribution of vaccines to remote areas, these obstacles can be overcome.

Background Nonalcoholic steatohepatitis (NASH), now metabolic-associated steatohepatitis (MASH), is a progressive liver disease with limited treatment options. This review evaluated the efficacy and safety of resmetirom, a selective thyroid hormone receptor beta (THR-β) agonist, for MASH treatment. Methodology A search was made on the prominent electronic database, and original studies such as randomised controlled clinical trials that met the inclusion criteria were selected. We analyzed data from seven studies investigating resmetirom’s effects on liver fat content, liver fibrosis, metabolic parameters, and safety profile in patients with MASH. Result Resmetirom demonstrated significant improvements in MASH resolution and liver fibrosis compared to placebo in Phase III studies in tandem with the surrogate endpoints suggested by the FDA. It also reduced hepatic fat content in most studies, with the exception of one investigating a healthy subject. Additionally, resmetirom improved lipid profiles and quality of life in some studies. The safety profile appeared favourable, with a low incidence of adverse events, mostly mild or moderate. Conclusion Resmetirom is a recently approved FDA drug for MASH. It targets multiple pathways involved in the disease, including fat metabolism, inflammation, and fibrosis. Clinical trials revealed reductions in hepatic fat, improvements in liver fibrosis, and positive effects on metabolic health and quality of life. While long-term safety data is still required, resmetirom offers promise for MASH treatment. Future research should focus on long-term studies and optimizing treatment regimens for MASH patients.

Antimicrobial resistance (AMR) poses a significant threat to human health as 4.95 million deaths were associated with bacterial AMR in 2019 and is projected to reach 10 million by 2050. To mitigate AMR, surveillance is an essential tool for determining the burden of AMR and providing the necessary information for its control. However, the global AMR surveillance is inadequate and particularly limited among forcibly displaced persons (FDPs) despite having higher risks of harboring these pathogens. Predisposing factors among this group include poor living conditions, limited access to treatment and diagnostic tests, and inadequate trained health professionals in refugee camps. Strengthening AMR surveillance among FDPs would address the identified gaps and facilitate formulation and implementation of evidence-based policies on AMR control and prevention response. This article provides information on the growing population of FDPs, factors contributing to the AMR burden and AMR surveillance gaps in FDPs and highlighted recommendations for control.

Community-randomized trial in Ethiopia and MORDOR clinical trials across 3 sSA countries, namely Malawi, Tanzania, and Niger, on MDA-azithromycin showed reduction in U5MRby 50% and 14% respectively compared to placebo.1 As a result, in 2018, the WHO developed a guideline to guide the population-level implementation of MDA-azithromycin in countries with high U5M and a heavy burden of morbidities due to diarrhoea, pneumonia and malaria. [...]a relevant question worth asking is \"Will the population-level implementation of MDA-azithromycin exacerbate AMR-related issues in sSA?\" While there is no clear-cut answer yet, evidence has shown that there is a possibility of a perpetual increase in macrolide and other antibiotic resistance in gut and respiratory bacteria after repeated MDA-azithromycin. Following MDA-azithromycin for trachoma control in rural Tanzania, Seidman et al demonstrated a significant increase in carriage of macrolide-resistant E. coli strains by 400% in young children.5 Similarly, 24 months after the commencement of the MORDOR clinical trial, Doan et al showed higher proportion of macrolide-resistant nasopharyngeal S. pneumonia in azithromycin-treated communities (mean 12.3%, 95% confidence interval 5.7- 20.0%) than in the placebo-treated communities (2.9%, 0-6.1%, P = 0.02).6 In the same vein, azithromycin-treated communities also had more macrolide-resistant determinants in the guts (68.1%, 60.4-74.8% vs 46.3%, 35.9-52.9%; P<0.001). Similar inconsistent trends were seen in pneumococcal resistance to sulfamethoxazole or chloramphenicol after MDA azithromycin. [...]there is a need to conduct more elaborate studies to fully understand the effects of MDA-azithromycin on AMR before scaling up the intervention across sSA.

Epstein–Barr Virus (EBV), structurally similar to other herpes viruses, possess significant global health challenges as it causes infectious mononucleosis and is also associated with various cancers. Due to this widespread impact, an effective messenger RNA (mRNA) vaccine is paramount to help curb its spread, further underscoring the need for its development. This study, following an immunoinformatic approach, aimed to design a comprehensive mRNA vaccine against the EBV by selecting antigenic proteins, predicting Linear B-cell epitopes, cytotoxic T-cell lymphocyte (CTL) and helper T-cell lymphocyte (HTL) epitopes, and assessing vaccine characteristics. Seventy-nine EBV isolates from diverse geographical regions were examined. Additionally, the vaccine construct's physicochemical properties, transmembrane domains, solubility, and secondary structures were analysed. Molecular docking was conducted with Toll-Like Receptor 5 (TLR-5). Population coverage was assessed for selected major histocompatibility complex (MHC) alleles, and immune response was simulated. The result of this study highlighted a vaccine construct with high antigenicity, non-toxicity, and non-allergenicity and possessed favourable physicochemical properties. The vaccine's 3D structure is native-like and strongly binds with TLR-5, indicating a solid affinity with TLR-5. The selected MHC alleles provided broad universal population coverage of 89.1%, and the immune simulations suggested a robust and wide-ranging immunogenic response, activating critical immune cells, antibodies, and cytokines. These findings provide a solid foundation for further development and testing of the EBV candidate vaccine, offering potential solutions for combating EBV infections.