Bayode Romeo Adegbite

Background: Paragonimiasis is a neglected food-borne trematode infection endemic to parts of Africa, Asia, and the Americas acquired by raw/undercooked freshwater crab consumption. Pulmonary manifestations mimic pulmonary tuberculosis (TB). Diagnosis relies on microscopy, with low sensitivity. Development of molecular assays is constrained by an absence of genomic data for African Paragonimus species. Serological testing depends on crude worm antigen, resulting in restricted availability and reproducibility. Methods: This study was nested within a prospective cohort of adults with presumed TB in Lambaréné, Gabon. The reference standard for paragonimiasis consisted of sputum and stool microscopy. Molecular index tests included PCRs (ITS2, cox1) on sputum and stool, followed by sequencing. Serological index tests consisted of recombinant ELISAs using GST-tagged Myo-1, MDP, and Egg antigens. Diagnostic accuracy was evaluated using positive control sera (three individuals with confirmed P. westermani infection). Stool, urine and blood were examined for potentially serologically cross-reactive parasites. Results: Among 103 participants (enrolled September 2024–January 2025), no Paragonimus eggs were detected. PCR assays amplified only non- Paragonimus sequences, including other helminths. Control sera (confirmed P. westermani ) showed marked reactivity, particularly toward Myo-1 and Egg antigen, background reactivity in participants was generally low. Without confirmed cases of African paragonimiasis, we could only calculate analytical sensitivity for P. westermani -sera. Exploratory cut-offs resulted in tentative diagnostic sensitivity between 17 and 100%. Exploratory cut-offs yielded specificities of 76–100%, assuming that no infections were missed by the reference standard. No relevant cross-reactivity with other infections was observed. Conclusions: In this first real-life application of recombinant antigen-based ELISAs for the serodiagnosis of paragonimiasis, our results showed promise, particularly for Myo-1 and Egg antigen. These results require further validation in larger and diverse populations including cases with African Paragonimus species to better define the epidemiology and burden of paragonimiasis in Gabon and beyond.

This cross-sectional study investigates the spectrum and proportion of multidrug-resistant (MDR) bacteria isolated from clinical samples processed at the regional microbiology laboratory of Lambaréné, Gabon. Bacteriological results from 2017 to 2023 were retrospectively analysed to assess the rates of non-susceptibility among the most common isolates from urine, blood, stool, and swabs (wound, urethral, ear, and throat). Antimicrobial susceptibility testing and interpretation were performed according to Clinical Laboratory Standards Institute (CLSI) guidelines.A total of 5,401 cultures were reviewed, with 1,050 yielding clinically relevant bacterial isolates. The most frequently identified pathogens were Escherichia coli (273/1050; 26%), Staphylococcus aureus (192/1050; 18%), β-hemolytic Streptococci (160/1050; 15%), and Klebsiella pneumoniae (69/1050; 6.6%). Urine samples predominantly yielded E. coli and K. pneumoniae , while S. aureus was most common in wound and blood cultures. Overall, 23% (242/1050) of isolates were classified as MDR, with E. coli accounting for 40% (96/1050). The proportion of ESBL producers among Enterobacterales was 10% (55/522). Resistance to third-generation cephalosporins was notably high, especially among K. pneumoniae (28/69; 41%) and E. coli (34/273; 13%). Methicillin-resistant S. aureus (MRSA) represented 12% (22/192) of S. aureus isolates; 5.5% (58/1050) of isolates belong to the WHO critical-priority pathogen group.Clinical microbiology data from Lambaréné indicate that urinary infections are mainly associated with E. coli , whereas S. aureus predominates in wound swabs and blood cultures. The detection of WHO critical-priority pathogens in this setting supports the need for sustained microbiological monitoring and locally adapted measures to improve antibiotic use and infection prevention.

Background: Lassa fever remains a major public health threat in West Africa, requiring coordinated scientific, policy, and financing responses. Regional scientific convenings are increasingly used to connect research evidence with policy action, yet their contribution to epidemic preparedness is not well documented. Methods: We conducted a qualitative health systems and policy analysis of the 2nd ECOWAS Lassa Fever International Conference (ELFIC 2025) in Abidjan, Côte d’Ivoire. Data sources comprised 302 scientific abstracts, plenary and ministerial session records, and the official Ministerial Joint Communiqué. Using the conference’s six thematic pillars as a deductive framework, we conducted a thematic content analysis and synthesized findings into four domains: scientific advances; surveillance and laboratory systems; policy and financing insights; and cross-cutting lessons for regional preparedness. Results: Progress was noted in diagnostics, therapeutics, vaccine development, decentralized laboratory capacity, genomic surveillance, and digital reporting. Persistent gaps remain at sub-national and community levels, in surveillance coverage, workforce capacity, and operational readiness. A major outcome was the Ministerial Joint Communiqué endorsing regional co-financing for Lassa fever vaccine development. Conclusion: ELFIC 2025 demonstrates the role of regional scientific platforms in aligning evidence with policy commitments. Sustained impact will require institutionalized coordination, strengthened accountability, and targeted investments in frontline capacity.

This study aimed to determine the national seroprevalence of natural immunity against COVID-19 in Benin and to identify factors associated with prior SARS-CoV-2 infection. A descriptive and analytical cross-sectional study was conducted between April and September 2023 across all 12 departments of Benin. A total of 3,802 participants were recruited using convenience sampling from selected health facilities, ensuring broad geographic representation of the population.Natural immunity was differentiated from vaccine-induced immunity through enzyme-linked immunosorbent assay (ELISA) testing for anti-nucleocapsid (NCP) IgG and anti-spike (S) IgG antibodies. The overall seroprevalence of natural immunity was estimated at 38.58% (95% CI: 37.0–40.1), indicating substantial exposure to SARS-CoV-2 nationwide. Despite this high seroprevalence, only 5% of participants reported a known history of COVID-19 infection, compared with approximately 10% among individuals with evidence of immunization, highlighting a large proportion of undiagnosed or asymptomatic infections.Multivariate logistic regression analysis identified several factors independently associated with natural immunity. These included increasing age (adjusted odds ratio [aOR] = 1.56; p = 0.01), residence within the former sanitary cordon (aOR = 1.34; p = 0.006), a history of hypertension or other cardiovascular diseases (aOR = 3.25; p < 0.001), and diabetes (aOR = 2.73; p < 0.001). The findings confirm significant and largely silent circulation of SARS-CoV-2 in Benin. The strong association between natural immunity and non-communicable diseases underscores the need for targeted vaccination strategies, improved risk communication, and strengthened surveillance systems, particularly for vulnerable populations in Benin and the wider West African region. Keywords: SARS-CoV-2; Natural Immunity; Seroprevalence; Comorbidities; Benin.

Introduction: Vaccination remains the primary strategy against COVID-19. However, data may not reflect actual population immunity. This study aims to determine the seroprevalence of post-vaccination immunity against COVID-19 in Benin and identify associated factors. Methods: A cross- sectional descriptive and analytical study was conducted from April to September 2023 in 21 hospital centers across Benin's twelve departments and included 3802. Post-vaccination immunity was defined by the presence of anti-SARS-CoV-2 Spike IgG antibodies and the absence of anti-NCP IgG antibodies, using the Euroimmun ELISA test. Data were analyzed using STATA software with multivariate logistics regression. Results: Seroprevalence of post-vaccination immunity was 41.56%. In multivariate analysis, factors associated with this immunity were age (adjusted OR=1.56; 95% CI [1.09-2.59]), residence within the former sanitary cordon (aOR=1.34; 95% CI [1.14-3.01]), history of hypertension/cardiovascular disease (aOR=3.25; 95% CI [1.41-4.63]), and history of diabetes (aOR=2.73; 95% CI [1.89-3.93]). Conclusion: Post-vaccination immunity is higher among vulnerable groups (elderly, comorbidities) and those in strategic urban zones, reflecting the prioritization of vaccination campaigns. Recommendations are proposed to target younger populations and rural areas to strengthen collective immunity.

Background: Rotaviruses are among the most common causal pathogens of severe dehydrating diarrhoea in children. Little is known about the burden of rotavirus diarrhoea in Gabon. Aim: This study aimed to determine the proportion of rotavirus infection in children under 5 years with diarrhoea in Lambaréné and seen at the hospital and factors associated with rotavirus infection. Setting: The data used in this study were collected between February 2020 and February 2021 in children presenting with acute diarrhoea in the Albert Schweitzer Hospital paediatric ward. Methods: A cross-sectional study was carried out. Stool samples were tested for rotavirus antigens using the rotavirus Standard Diagnostic (SD) BIOLINE Rota and Adeno enzyme immunoassay detection kit. Results: A total of 178 children were included in the study. The proportion of rotavirus infection was 22% (n = 39/178; 95% confidence interval [CI]: 16% – 29%). In the multivariate analysis, the rotavirus was independently associated with dehydration (adjusted odds ratio [aOR] = 2.65; 95% CI: 1.09–6.86), vomiting (aOR = 3.15; 95% CI: 1.29–8.25), lethargy (aOR = 3.12; 95% CI: 1.16–8.71) and hospitalisation (aOR = 4.63; 95% CI: 1.7–13.65). Conclusion: Rotavirus infection was associated with severe diarrhoea and hospitalisation. This study shows the need to integrate and support free rotavirus vaccination into the expanded vaccination programme in Gabon. Contribution: This study provides evidence that could guide public health strategies and inform vaccine policies that could ultimately reduce the burden of rotavirus-associated diarrhoea in children.

Soil-transmitted helminths (STH) are common in (sub)tropical regions and primarily affect impoverished populations. These parasites reside in the gut, where they interact with both the microbiota and host immunity. Clinical STH detection is laborious and often not performed within the context of gut microbiome studies. Here, we present a proof-of-concept study assessing whether fecal metagenome data could be used to assess STH infection, and to relate STH infection to microbiome features. We leveraged 310 gut metagenomes obtained from mother-child pairs in two different locations in Gabon: one rural and one semi-urban, and assessed the presence of four STH species (Ascaris lumbricoides, Strongyloides stercoralis, Trichuris trichiura, and Necator americanus) using qPCR. Sequence data were used to characterize the microbiomes and to detect these parasites. Metagenomic read mapping and genome coverage metrics closely matched qPCR detection patterns. Within-location analyses revealed that parasite species richness was associated with microbiome diversity and taxonomic composition, with the strongest associations observed in children from the rural site. Applying this approach to published data from five additional African cohorts identified context-specific parasite-microbiome associations, as well as a modest but reproducible association between microbiome alpha diversity and parasite infection. These findings highlight the potential of shotgun metagenomics for concurrent parasite detection and microbiome profiling across diverse geographic and demographic contexts.

Introduction: Benin, as a West African country sharing borders with high-risk areas, is on the front lines of the threat of Monkeypox (Mpox) epidemics. This study aimed to assess the preparedness of the Beninese health system for this emerging zoonotic risk. Method: A cross-sectional, descriptive, and qualitative approach was conducted from April to September 2025, structured into three phases: documentary analysis of national regulatory documents, interviews with strategic managers (central and departmental directorates), and direct observation of Epidemic Treatment Centers (ETCs). Results: The analysis revealed a robust regulatory framework (National Preparedness and Response Plan for Monkeypox, updated Standard Operating Procedures (SOPs)) aligned with the International Health Regulations (IHR 2005). Interviews confirmed strong inter-institutional coordination, led by the Public Health Emergency Operations Center (PHEOC). Observation of the ETCs revealed high operational capacity, with trained human resources, Personal Protective Equipment (PPE), and medical supplies satisfactorily prepositioned. Conclusion: These results demonstrate good overall preparedness of the Beninese health system, transforming lessons learned from previous crises into a proactive and organized response strategy, although the sustainability of logistical supplies and regular simulation exercises must remain a priority.