Lucy Ochola

Background: Schistosomiasis, a parasitic waterborne infection, remains a major public health challenge in disadvantaged regions, with schoolchildren (5–14 years) at high risk due to frequent water exposure. The study is aimed at assessing the knowledge, attitudes, and practices (KAP) related to schistosomiasis among school‐aged children in Nelson Mandela Bay (NMB) and examining how sociodemographic and environmental factors influence KAP outcomes. Methods: A quantitative, descriptive, cross‐sectional study was conducted among 759 schoolchildren aged 5–14 years, enrolled in Grades 0–7. Data were collected using a structured, closed‐ended, interview‐administered questionnaire, which included sections on sociodemographic characteristics, clinical history, and KAP related to schistosomiasis. Bivariate and multivariate analyses were performed to evaluate associations and describe the data using R software (Version 4.3.1). Results: Only 11% participants were aware of schistosomiasis, mainly learning from school (62%) or home (35%). Key environmental factors included urinating in rivers (44%), living near water bodies (21.1%), and swimming (11.3%). Knowledge and attitude scores showed a moderate positive correlation ( r = 0.33; p < 0.001). Gender and grade level significantly influenced KAP scores, with males and older children (Grades 4–7) exhibiting better knowledge ( p = 0.015), attitudes ( p = 0.023), and practices ( p = 0.001). Females had lower knowledge scores ( β = −0.15; p = 0.018), while older children displayed fewer positive attitudes ( β = 0.07; p = 0.038) and poorer practices ( β = 0.11; p = 0.001). Conclusion: Significant gaps in knowledge, poor attitudes, and inadequate hygiene practices highlight the need for targeted education and community‐based strategies to improve KAP and reduce schistosomiasis risk in NMB schoolchildren.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) continues to evolve, with mutations leading to the emergence of new variants. JN.1, a subvariant of omicron BA.2.86, has demonstrated marked immune escape and is now included in updated vaccine formulations. While reduced sensitivity has been reported for antibody assays using ancestral spike protein subunits to detect omicron-induced responses, the performance of full-length spike-based assays against omicron sublineages remains unclear. We aimed to compare the sensitivity of ELISA and Luminex assays using full-length spike proteins from the ancestral Wuhan strain and the JN.1 variant. Methods: Wuhan and JN.1 full-length spike protein constructs were designed and expressed in Expi293F mammalian cells. In-house ELISAs based on previously validated protocols were used to measure anti-spike IgG levels. Additionally, a Luminex-based assay for anti-spike antibody detection was developed and validated. Both assays were applied to the following sample groups: pre-pandemic samples (designated “gold standard negatives”); PCR confirmed 2020 positives (“gold standard wildtype positives”); PCR confirmed 2024 positives (“gold standard omicron positives”); 2022 vaccinated individuals with verbal confirmed infection (“gold standard hybrid positives”); and 2024 household samples (“unknowns”). Results: Wuhan spike protein showed a sensitivity of 100% (95% CI: 0.88–1.0) in detecting omicron-specific antibodies using gold standard omicron positives with JN.1 spike protein as a reference assay. Overall, across all samples, in ELISA, the Wuhan antigen had a sensitivity of 0.93 (95% CI: 0.89–0.95) and a specificity of 0.98 (95% CI: 0.94–0.99). The JN.1 antigen showed a sensitivity of 0.91 (95% CI: 0.87–0.94) and a specificity of 0.97 (95% CI: 0.93–0.99). In Luminex, sensitivity was 0.95 (95% CI: 0.91–0.97) for Wuhan and 0.94 (95% CI: 0.91–0.96) for JN.1. Specificity for both antigens in Luminex was 0.98 (95% CI: 0.94–0.99). Conclusions: Both ELISA and Luminex assays showed comparable sensitivity and specificity for both Wuhan and JN.1 antigens, indicating that mutations in the JN.1 variant do not significantly impact assay performance. This suggests preserved antigenic recognition across variants.

Female genital schistosomiasis (FGS) is a gynecological manifestation of urinary schistosomiasis in female genitals. FGS is a neglected tropical disease; not only are most patients unaware of the condition, but healthcare workers and policymakers have inadequate knowledge about it. The treatment and control of FGS relies on current guidelines for controlling and eliminating schistosomiasis without rigorous focus on clinical evidence of the presence of FGS. Neglect of FGS has led to the misconception that the disease is sexually transmitted. Diagnosing FGS remains challenging as there is no widely accepted reference assay. Urine examination, which is the gold standard in urogenital schistosomiasis has some limitations in diagnosing FGS as the demonstration of Schistosoma haematobium and/or eggs alone does not necessarily indicate FGS. In order to overcome challenges with the biopsy and colposcopy approach, some studies have evaluated the potential of PCR-based assays and isothermal amplification of Schistosoma DNA. Recent studies have reported hybridization between S. haematobium and other livestock schistosomes, but little is known about the impact of hybridization on schistosomiasis diagnosis. These hybrids not only affect livestock and humans but also have their genomes modified, and in some cases, abnormal egg morphology due to Schistosoma hybridization might affect the actual prevalence estimation. Herein, we highlight the potential impacts of S. haematobium hybridization on molecular diagnosis of schistosomiasis, with an emphasis on FGS.

Background Type 1 diabetes (T1D) is characterized by the immune-mediated destruction of pancreatic beta cells, resulting in insulin deficiency and hyperglycemia. Existing insulin therapies manage symptoms but do not fully stabilize blood glucose levels. Schistosoma mansoni infection or its eggs inhibit T1D in rodent models. This study evaluated the antidiabetic effects of Schistosoma mansoni-derived soluble egg antigen (SEA) and glycoproteins (IPSE and Omega-1) in a streptozotocin-induced diabetic rat model. Methods Glycoproteins were designed using in silico methods and synthesized following epitope prediction, antigenicity assessment, and molecular docking analysis. These glycoproteins were administered at doses of 50 μg and 100 μg per rat in a stratified randomized trial comprising eight treatment groups and two control groups, each containing five streptozotocin-induced diabetic rats: SEA (A-B), Omega-13 (C-D), IPSE2-3 (E-H), insulin-only (I), and PBS (J). Blood glucose, weight, IFN-γ, IL-4 levels, and pancreatic histology were assessed. Results In silico analysis of IPSE and Omega-1 showed strong antigenicity (epitopes >0.60), binding energies from -7.9 to -11.9 Kcal/mol, molecular weights of 1261.40–2034.30 Da, and theoretical pI of 8.23–9.70. In vivo, IPSE and Omega-1 significantly reduced glucose (from 5.76–26.16 mmol/L to 3.94–18.92 mmol/L, p < 0.05), promoted weight gain (192.3–235 g to 231.3–250.2 g), and caused mild-moderate pancreatic infiltration. Conclusions These findings suggest that SEA, IPSE, and Omega-1 are promising candidates for novel diabetes therapies, warranting further investigations.

Malaria remains a significant health challenge in sub‐Saharan Africa, accounting for 90% of the global burden of disease. Recent studies have reported an increase in the number of malaria cases and a decrease in deaths. However, these gains can be reversed by emerging resistance to artemisinin and changing climatic conditions. Over the past 30 years, Africa has adopted artemisinin combination therapy (ACT) to treat uncomplicated malaria. Increasingly, reports of parasitic mutations conferring tolerance to artemisinin have emerged in several countries, particularly in East Africa. Although markers of resistance to various partner drugs are known, the potential failure of artemisinin can rapidly alter the situation, especially as the Kelch 13 gene, which confers resistance to artemisinin, becomes less conserved. It is anticipated that there will be a need to switch from current ACTs to new combinations or create a framework for multiple first‐line deployment. However, this poses challenges ranging from timely review of policies, training of healthcare workers, access, and deployment to the most peripheral health facilities in remote areas. This review outlines several critical factors that can potentially influence decision making in this new paradigm shift, including insufficient funding and challenges in the development of pharmaceutical products.

Human papillomavirus (HPV) vaccines elicit specific serum antibodies that confer long-lasting protection and may reduce HPV-related cancers. However, helminthic infections such as chronic schistosomiasis infection at the time of HPV vaccination are known to alter immune responses. This study investigated the impact of chronic S. mansoni infection on immune responses to the HPV vaccine in olive baboons. Baboons were assigned to three groups: (1) untreated S. mansoni-infected, (2) S. mansoni-infected and treated with Praziquantel, and (3) uninfected controls. All received two doses of the Cervarix HPV vaccine four weeks apart. Immune responses were measured using flow cytometry and ELISA. Gardasil® quadrivalent HPV vaccine antigen was used in both ELISA and PBMC stimulation for cytokine ELISA supernatants. HPV-specific whole IgG levels significantly increased in all groups except for the untreated S. mansoni-infected group, whose increase was significant after the second dose. Similarly, IgG1 levels increased only after the second dose. There was no significant difference between the treated and untreated infected groups. These findings emphasize the importance of a booster dose for strong antibody production and suggest that a delayed HPV-specific whole IgG response in untreated S. mansoni-infected individuals reinforces the need for booster HPV vaccination in endemic regions. The results affirm the vaccine's effectiveness in S. mansoni endemic areas.

Background: Influenza D Virus (IDV) presents a possible threat to animal and human health, necessitating the development of effective vaccines. Although no human illness linked to IDV has been reported, the possibility of human susceptibility to infection remains uncertain. Hence, there is a need for an animal vaccine to be designed. Such a vaccine will contribute to preventing and controlling IDV outbreaks and developing effective countermeasures against this emerging pathogen. This study, therefore, aimed to design an mRNA vaccine construct against IDV using immunoinformatic methods and evaluate its potential efficacy. Methods: A comprehensive methodology involving epitope prediction, vaccine construction, and structural analysis was employed. Viral sequences from six continents were collected and analyzed. A total of 88 Hemagglutinin Esterase Fusion (HEF) sequences from IDV isolates were obtained, of which 76 were identified as antigenic. Different bioinformatics tools were used to identify preferred CTL, HTL, and B-cell epitopes. The epitopes underwent thorough analysis, and those that can induce a lasting immunological response were selected for the construction. Results: The vaccine prototype comprised nine epitopes, an adjuvant, MHC I-targeting domain (MITD), Kozaq, 3′ UTR, 5′ UTR, and specific linkers. The mRNA vaccine construct exhibited antigenicity, non-toxicity, and non-allergenicity, with favourable physicochemical properties. The secondary and tertiary structure analyses revealed a stable and accurate vaccine construct. Molecular docking simulations also demonstrated strong binding affinity with toll-like receptors. Conclusions: The study provides a promising framework for developing an effective mRNA vaccine against IDV, highlighting its potential for mitigating the global impact of this viral infection. Further experimental studies are needed to confirm the vaccine’s efficacy and safety.

Introduction: Malaria remains a significant health concern, particularly in regions with widespread prevalence. As the transmission rates decrease, there is a rise in low-density infections with the causative parasite, P. falciparum, that often escape detection through standard point-of-care diagnostic tools. In-low transmission areas, even few undetected cases can trigger outbreaks, necessitating rapid and sensitive diagnostics. Loop-mediated isothermal Amplification (LAMP) stands out as a nucleic acid technique that can easily utilizes un-processed samples such of saliva, urine, and lysed whole blood templates for a sensitive detection. However, most nucleic acid tests detect genes with few copies per parasite making it difficult to detect low-density parasitaemia.Methods: We selected Pfr364 multi-copy repeats of the P. falciparum genome as a target for amplification due to their higher copy number, ideal for rapid amplification, addressing amplification drawbacks of limited parasites DNA. We used a sequence clustering approach to design a novel set of LAMP primers, capable of binding to multiple sites. Subsequently, we developed a hydroxynaphthol blue (HNB) colorimetric LAMP assay, using genomic DNA obtained from the 3D7 strain cultivated in vitro. This assay’s performance was validated using archived clinical samples of both whole blood and matched saliva, ensuring accuracy through comparative analysis against gold standard, nested PCR, targeting the 18S RNA gene.Results: The HNB-LAMP assay achieved rapid amplification within 15 minutes and exhibited high sensitivity with a limit of detection of 1 parasite. Further, the LAMP assay was robust in whole blood lysed with Triton X-100 and heat-treated saliva clinical samples. Against nested PCR, the assay showed sensitivity of 100% for whole blood and 40% for saliva samples. Moreover, co-analysis with the nested PCR showed a perfect agreement between the two techniques. (K = 0.99 for whole blood, and 0.66 for saliva).Conclusion: Our study presents a method for detecting P. falciparum using LAMP, which results in increased sensitivity, shorter assay times, and a simpler workflow than nucleic acid tests relying on conventional DNA extraction and additional equipment for result interpretation. These findings hold great promise for improved malaria diagnosis, especially in settings where low-density parasitaemia is prevalent and rapid and accurate malaria detection is crucial.

The new WHO Roadmap for Neglected Tropical Diseases targets the global elimination of schistosomiasis as a public health problem. To date, control strategies have focused on effective diagnostics, mass drug administration, complementary and integrative public health interventions. Non-mammalian intermediate hosts and other vertebrates promote transmission of schistosomiasis and have been utilized as experimental model systems. Experimental animal models that recapitulate schistosomiasis immunology, disease progression, and pathology observed in humans are important in testing and validation of control interventions. We discuss the pivotal value of these models in contributing to elimination of schistosomiasis. Treatment of schistosomiasis relies heavily on mass drug administration of praziquantel whose efficacy is comprised due to re-infections and experimental systems have revealed the inability to kill juvenile schistosomes. In terms of diagnosis, nonhuman primate models have demonstrated the low sensitivity of the gold standard Kato Katz smear technique. Antibody assays are valuable tools for evaluating efficacy of candidate vaccines, and sera from graded infection experiments are useful for evaluating diagnostic sensitivity of different targets. Lastly, the presence of Schistosomes can compromise the efficacy of vaccines to other infectious diseases and its elimination will benefit control programs of the other diseases. As the focus moves towards schistosomiasis elimination, it will be critical to integrate treatment, diagnostics, novel research tools such as sequencing, improved understanding of disease pathogenesis and utilization of experimental models to assist with evaluating performance of new approaches.

: As coronavirus disease 2019 (COVID-19) spreads across Africa, little is known about the impact of the pandemic on health-care workers (HCWs) in the region. We designed an anonymous survey distributed via e-mail and phone messaging to 13 countries through the African Hepatitis B Network. We obtained 489 analyzable responses. We used risk ratio analysis to quantify the relationship between binary variables and χ² testing to quantify the statistical significance of these relationships. Median age of respondents was 30 years (interquartile range, 26–36 years) and 63% were physicians. The top three sources of information used by HCWs for COVID-19 management included the Ministry of Health of each country, the WHO, and social media. Forty-nine percent reported a decrease in income since the start of the pandemic, with the majority experiencing between a 1% and a 25% salary reduction. Sixty-six percent reported some access to personal protective equipment; only 14% reported appropriate access. Moreover, one third of respondents reported no availability of ventilators at their facility. Strikingly, the percentage of HCWs reporting never feeling depressed changed from 61% before the pandemic to 31% during the pandemic, with a corresponding increase in daily depressive symptoms from 2% to 20%. Most respondents (> 97%) correctly answered survey questions about COVID-19 symptoms, virus transmission, and prevention. Our survey revealed African HCWs face a variety of personal and professional context-dependent challenges. Ongoing support of HCWs through and after the COVID-19 pandemic is essential.