Nouh Saad Mohamed

: As digital health tools are increasingly deployed to support community-based primary healthcare, understanding frontline user experiences is critical for effective implementation and scale-up. Here, community health workers’ (CHWs) perspectives on the digitally integrated disease management system (d-IDS) in Rwanda are discussed. The d-IDS intervention was intended to improve the cost-effectiveness of community-based screening, patient management, and disease surveillance through a mobile digital platform. Before implementation, user acceptance testing and cascade training prepared CHWs, their supervisors, and health facility staff. During implementation, continuous supervision and qualitative assessments of the system were conducted. Qualitative data were collected through focus group discussions and semi-structured key informant interviews. The CHWs widely appreciated the system’s ease of use, comprehensiveness, availability in Kinyarwanda (local language), offline functionality, improved data management, and ability to expedite effective patient management cascades compared with paper-based registers. Home-based screening reduced patient time and costs of care and enhanced equity and access to care, bringing Rwanda closer to achieving Universal Healthcare Coverage. However, challenges included increased workload, inadequate or lack of incentives, internet connectivity constraints, system rigidity in updating household records, and initially low digital literacy among some CHWs. Ongoing digitalization initiatives will inform national scale-up and policy choices.

Chikungunya virus (CHIKV) is an arthropod-borne Alphavirus primarily transmitted by Aedes mosquitoes, causing sudden outbreaks with high morbidity and chronic polyarthritis. Following the US FDA approval of the first CHIKV vaccine in November 2023, concerns remain regarding vaccine efficacy due to the existence of at least three major CHIKV lineages. We conducted an in-silico genomic analysis of the CHIKV E2 glycoprotein to evaluate genetic diversity and evolutionary patterns relevant to vaccine and therapeutic antibody-binding effectiveness. The E2 gene exhibited substantial variation, reflecting high polymorphism and both intra- and inter-lineage differences. The variations detected may reduce antibody-antigen binding affinity, potentially compromising vaccine and therapeutic antibody efficacy. Our findings underscore the importance of incorporating pathogen genetic diversity into vaccine and therapeutic design. Long-term, pan-CHIKV vaccines could offer sustainable, cost-effective protection. Validation through in vitro and in vivo studies, alongside strengthened vector surveillance and control, is recommended to mitigate ongoing outbreaks.

Ticks and tick-borne diseases (TBDs) represent a growing challenge to both animal and human health in Sudan. However, the absence of consolidated nationwide data limits accurate characterization of tick fauna, monitoring of shifts in species distribution, and detection of invasive species. This knowledge gap not only constrains understanding of vector ecology but also weakens efforts to link tick distribution with disease occurrence, thereby undermining targeted control strategies. Livestock TBDs, including theileriosis, babesiosis, anaplasmosis, and lumpy skin disease, cause substantial economic losses by reducing productivity, threatening food security, and hindering national development. In parallel, zoonotic infections such as Crimean-Congo hemorrhagic fever, Q fever, borreliosis, ehrlichiosis, rickettsioses, and potentially tularemia pose underrecognized public health risks. These infections are frequently misdiagnosed or overlooked due to limited diagnostic capacity and the predominance of malaria in the differential diagnosis of febrile illness. The persistence and spread of TBDs in Sudan are driven by interconnected factors, including high livestock mobility, widespread presence of competent vectors, weak veterinary and public health infrastructure, and inadequate surveillance systems. Addressing this multifaceted burden requires integrated approaches that combine improved vector control, expanded diagnostic capacity and surveillance, vaccination where available, and strengthened regional cross-border collaboration. This review synthesizes current knowledge on ticks and TBDs in Sudan, highlights critical gaps, and emphasizes the need for One Health strategies to reduce TBD transmission, protect livelihoods, and safeguard public health.

This case presents the perplexing journey of a 70‐year‐old woman with a decade‐long history of painless, gradually enlarging left‐side groin swelling. Despite initial suspicion of a hernia, the surgical exploration uncovered an unexpected finding: a well‐circumscribed oval mass. Histopathological analysis led to the final diagnosis of neurofibroma. This case sheds light on the importance of thorough investigation in puzzling presentations and provides valuable insights into the clinical manifestations, differential diagnosis, investigations, and management of neurofibromas.

Introduction: The escalating burden of antimicrobial resistance (AMR) presents a significant global health challenge. ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species), frequently exhibiting multidrug resistance (MDR), are especially alarming. This study evaluated the prevalence and antibiotic susceptibility profiles of ESKAPE infections in patients from Nigde, Türkiye. Methodology: This descriptive cross-sectional study was performed at Nigde Ömer Halisdemir University Training and Research Hospital from September 2022 to June 2024. Clinical specimens were collected and evaluated for antimicrobial susceptibility with the VITEK®2 compact system. Results: A total of 13,387 bacterial isolates were obtained from 7,438 patients. The majority of isolates were Gram-negative (9,671; 72.2%), of which 3,928 (39.6%) were ESKAPE. Gram-positive isolates accounted for 3,716 (27.8%), with 1,123 (30.2%) categorized as ESKAPE. Klebsiella pneumoniae (K. pneumoniae) was the most common Gram-negative ESKAPE pathogen (1,921; 19.9%), while Escherichia coli (E. coli) was the most frequent non-ESKAPE pathogen (4,747; 49.1%). Of the 5,051 ESKAPE isolates, 29.7% (1,501) were categorized as MDR and 30.9% (1,562) as extensively drug-resistant (XDR). MDR was widespread, with the highest prevalence observed in Enterococcus faecium (76.9%). Acinetobacter baumannii exhibited the highest prevalence of XDR isolates at 72.4%. Conclusions: This study emphasizes the substantial AMR burden linked to ESKAPE infections in Nigde, Türkiye, highlighting the necessity for effective infection management, antibiotic stewardship, and continuous research to track resistance patterns.

Malaria remains a major health issue worldwide, and has long been a challenging threat in Sudan. This study aims to provide analysis of malaria prevalence, incidence, and associated fever incidence and deaths, shedding light on the evolving burden of the disease in Sennar State, Sudan, to contribute valuable data to the global understanding of malaria epidemiology. A descriptive cross-sectional study was conducted in Sennar State from 2018 to 2020. Data were collected through individual interviews using open-ended questionnaires to assess malaria-related fever and death and through parasitological confirmation of malaria infection using rapid diagnostic tests. Frequencies of fever incidence, malaria prevalence, and malaria-related death were calculated, alongside malaria fever incidence rates per 1000 population and annual percentage changes in malaria prevalence. A total of 2027 households were surveyed, with 503 in 2018, 516 in 2019, and 1008 in 2020, covering 8372 individuals. Fever prevalence was 41.0% in 2018, increased to 58.5% in 2019, then declined to 48.4% in 2020, with incidence rates varying across localities. Overall malaria prevalence rose from 2.8% in 2018 to 4.8% in 2019 before falling to 3.3% in 2020. According to localities, Abu Hujar consistently reported the highest malaria prevalence (13.6% in 2019; 9.5% in 2020), while Aldali reported none in 2018–2019. Malaria-related deaths totaled 12 in both 2018 and 2019, increasing to 22 in 2020, mainly in Sharg Sennar and Alsouki. The annual percentage changes in malaria prevalence showed a 71.4% increase in Sennar locality between 2018 and 2019 and a 31.2% state-level reduction between 2019 and 2020, underscoring locality-specific fluctuations in transmission. Malaria prevalence, incidence, fever incidence, and mortality fluctuated across Sennar state, with higher burden in rural areas. Findings highlight the need for sustained surveillance, diagnostics, and tailored, cost-effective interventions to inform policy and advance malaria control.