Search Results (602)

Background: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are increasingly reported among gay, bisexual, and other men who have sex with men (GBMSM) engaging in chemsex, yet data remain limited. This ambispective cohort study conducted at Hospital Clínic of Barcelona (2018–2024) aimed to characterize CA-MRSA infections among GBMSM living with HIV. Methods: Epidemiological, behavioral, and clinical data were collected from medical records and standardized questionnaires. MRSA isolates from clinically indicated samples were identified by mass spectrometry and underwent antimicrobial susceptibility testing. Results: Among 446 participants, 62 (14%) were diagnosed with CA-MRSA, accounting for 109 infection episodes over a median follow-up of 3.21 years (IQR 1.39–5.05). All episodes involved skin and soft-tissue infections; 17% required hospitalization, 35% surgery, and 51% received non-active empirical antibiotics. Recurrent infections occurred in 32% of participants, and detectable HIV viral load was present in 28% of episodes. High levels of polydrug use were reported. Resistance to clindamycin (33%), cotrimoxazole (23%), and mupirocin (96%) was observed. Decolonization was attempted in 65% of participants. Conclusions: CA-MRSA infections were frequent, with substantial recurrence and antimicrobial resistance. These findings highlight challenges for infection control and antimicrobial stewardship and support further evaluation of preventive and decolonization strategies in this population. Full article

Background: Adolescents in low- and middle-income countries (LMICs) continue to face substantial challenges related to sexual and reproductive health (SRH), including high rates of unintended pregnancy, sexually transmitted infections (STIs), and limited access to accurate reproductive health information and services. Rural provinces of South Africa, such as Limpopo, are no exception, with notably higher pregnancy rates. Aim: This study aimed to explore adolescent girls’ perceptions and experiences associated with school-based comprehensive sexuality education (CSE) programs and their perceived role in pregnancy prevention in Bolobedu, Limpopo province, South Africa. Methods: A qualitative, descriptive, and contextual design was employed. Data were collected through individual interviews and field notes from adolescent girls aged 14–19 years who were accessing contraceptives or had given birth. Content analysis was conducted using Tesch’s method. Findings: Results suggest that the quality and contents of CSE programs varied widely, leading to CSE intervention programs not being successfully implemented, leading to poor uptake and no behavior change. Implications: While research on CES programs shows that the CSE programming varies and can be vital to reducing adolescent pregnancy, its success depends on the quality of the implementation, which leads to behavior change. The research finds that the adoption of Comprehensive Sexual Education in schools and communities is vital to tackling the high incidence of adolescent pregnancy. However, its success depends on the quality of implementation, facilitator training, and resource availability. Full article

The inappropriate utilization of traditional antimicrobials has expedited the development of multidrug-resistant bacterial strains, thereby generating an urgent demand for innovative, safe, and efficacious alternatives. Graphene oxide (GO), characterized by its distinctive physicochemical properties, holds significant potential for a wide range of biomedical applications, such as the prevention of oral diseases, periodontal therapy, control of gastrointestinal infections, wound healing, antibacterial therapy for the respiratory tract, and management of urogenital infections. The antimicrobial mechanisms of GO include physical disruption of microbial membranes, induction of reactive oxygen species (ROS), and its role as a photosensitizer. Moreover, improving the dispersion, stability, release behavior, and reusability of GO-based composites can markedly enhance their effectiveness. The antimicrobial activity of GO is further modulated by its physicochemical properties, synthesis methods, bacterial characteristics, and environmental conditions, while potential synergistic or antagonistic interactions remain to be elucidated. This review synthesizes recent advancements in GO-based antimicrobial strategies, elucidates key mechanisms and influencing factors, and addresses major challenges and future research directions, with the objective of facilitating the clinical translation of GO as a next-generation antimicrobial material. Full article

Toxocara spp. infection is a neglected zoonotic disease associated with exposure to companion animals and contaminated environments. However, information regarding its seroprevalence and associated risk factors among cat owners in Thailand, particularly in remote island communities, remains limited. This cross-sectional study aimed to determine anti-Toxocara spp. IgG seropositivity and identify associated risk factors among cat owners in Koh Yao District, Phang Nga Province, Thailand. A total of 291 cat owners participated in the study. Sociodemographic characteristics, health-related behaviors, serum anti-Toxocara spp. IgG antibodies, and hematological parameters were collected. Univariate and multivariable logistic regression analyses were performed to identify factors associated with seropositivity. The overall prevalence of anti-Toxocara spp. IgG seropositivity was 34.36%. In the univariate analysis, failure to wash hands after cat contact was significantly associated with higher odds of seropositivity (odds ratio [OR] = 1.96, 95% confidence interval [CI]: 1.16–3.33; p = 0.011). This association remained significant in the multivariable logistic regression model. These findings indicate substantial exposure to Toxocara spp. among cat owners in this island community and highlight the importance of personal hygiene, particularly handwashing after cat contact, in reducing exposure to infective Toxocara eggs. Targeted health education programs and preventive interventions should be strengthened to reduce the risk of Toxocara spp. exposure in endemic communities. Full article

Background: The COVID-19 pandemic has become a global public health emergency, causing substantial disruptions in societal norms and behaviors. Among the affected population, individuals with mental health disorders are particularly vulnerable, facing heightened infection rates and worse outcomes. These challenges can be linked to factors such as insufficient adherence to vaccination and other preventive measures. Objective: This study aims to investigate the literature on the adherence of individuals with mental disorders to vaccination and other preventive behaviors such as social distancing, use of face masks, and hygiene practices during the COVID-19 pandemic. Methods: This scoping review was performed following the methodological guidelines outlined by the Joanna Briggs Institute and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. A comprehensive search for published research containing original data was conducted in four databases (Embase, Medline, PsycINFO, and Web of Science). Results: The search yielded 2778 records, and 10 additional relevant papers were identified through handsearching, resulting in a total of 50 studies meeting all inclusion criteria. Most of them focused on vaccination adherence, with approximately half reporting lower adherence in the patient group, particularly among individuals with severe mental illnesses (SMIs), compared to the general population or to other control groups. However, some studies reported comparable—or, in specific psychiatric populations, even higher—levels of adherence to preventive behaviors. Out of the fifty selected studies, only four employed an interventional approach aimed at increasing preventative behaviors, but they were effective in most of the studies. Conclusions: This review underscores a noticeable lack of intervention studies employing psychoeducational strategies to mitigate risky behaviors among individuals with mental disorders. This gap emphasizes the urgent need for increased research focus in this area, as it holds promise for reshaping future approaches and strategies to address other crises within this vulnerable population. Full article

Tuberculosis (TB) remains a leading cause of infectious disease-related mortality worldwide despite major advances in diagnostics, treatment, and programmatic control. Achieving the goals of the World Health Organization End TB Strategy requires a greater emphasis on prevention alongside improvements in diagnosis and treatment. This viewpoint examines evolving priorities in TB prevention and highlights key insights from studies included in the Special Issue ‘New Perspectives in Tuberculosis Prevention and Control’. The articles published in the Special Issue highlight the importance of identifying populations at increased risk of infection, disease transmission, and disease progression; strengthening the implementation of tuberculosis preventive treatment among household contacts and people living with HIV; and addressing the behavioral, social, and structural determinants that influence access to TB prevention and care. They also demonstrate persistent challenges related to medicine availability, healthcare worker capacity, patient initiation and follow-up, program monitoring, and the implementation of preventive interventions in resource-constrained settings. Emerging developments in diagnostics, biomarkers, vaccines, and digital health may contribute to the longer-term TB prevention agenda but require further evaluation of their feasibility, affordability, and programmatic relevance. Collectively, the evidence indicates that effective TB prevention extends beyond individual biomedical interventions and requires coordinated approaches involving healthcare systems, communities, surveillance systems, and social support mechanisms. Continued investment in implementation research, health-system strengthening, program management, economic evaluation, and multisectoral action will be critical to translate existing evidence into sustainable, equitable, and context-specific strategies for reducing the global burden of TB. Full article

Infection associated with orthopedic implants remains a major challenge in the development of biomimetic materials for bone tissue engineering. Surface modification strategies are widely employed to transform bioinert metallic substrates into bioactive interfaces that promote tissue integration while preventing bacterial colonization. This study investigated the effect of incorporating silver nanoparticles (nAg) into hydroxyapatite–barium titanate (HA–BT) coatings on their structural, mechanical, piezoelectric, biological, and antibacterial properties. Raw materials were characterized by X-ray diffraction (XRD) and transmission electron microscopy (TEM), whereas coatings were evaluated by XRD, scanning electron microscopy (SEM), tensile adhesion testing, electrochemical analysis, piezoresponse force microscopy (PFM), cell viability, and antibacterial assays. The coatings exhibited secondary phases, including β-tricalcium phosphate (β-TCP), tetracalcium phosphate (TTCP), and calcium oxide (CaO), generated during atmospheric plasma spraying (APS), while no silver oxide phases were detected after nAg incorporation. SEM observations revealed homogeneous phase distribution and strong coating–substrate adhesion. The addition of nAg did not significantly affect adhesive strength (44.58 ± 2.2 MPa for HA30BT and 43.28 ± 2.8 MPa for HA30BT–nAg). Protein adsorption studies indicated moderate albumin affinity (K_ads = 0.45) for nAg-containing coatings. Both coatings exhibited piezodynamic activity with d₃₃ values of approximately 13 pm/V. MTT assays confirmed non-cytotoxic behavior, with viability reductions below 2%. Osteocalcin expression demonstrated comparable osteogenic activity in coatings with and without nAg, regardless of low-intensity pulsed ultrasound stimulation. These findings highlight the potential of HA–BT–nAg coatings as multifunctional surfaces for bone regeneration and infection prevention. Full article

Pharyngeal infection with high-risk human papillomavirus (HPV), particularly HPV16, is biologically distinct from cervical infection because it occurs within the specialized lymphoepithelial environment of Waldeyer’s ring. This review evaluates nanoparticle materials for the prevention, detection, and treatment of pharyngeal HPV, with an emphasis on structure–property–function relationships, mucosal performance, and translational feasibility. Lipid nanoparticle platforms, polymeric nanoparticle platforms, inorganic systems, and hybrid platforms are compared with respect to composition, particle size distribution, surface charge, colloidal stability, biodegradability, payload compatibility, release behavior, and manufacturing complexity. Evidence suggests that lipid and polymeric systems are the most credible near-future candidates for mucosal vaccination and localized nucleic acid delivery because they offer the best balance between controllable fabrication, analytical tractability, and biologically plausible performance in mucus-exposed tissue. By contrast, the development of inorganic theranostics and CRISPR-enabled platforms remains at an earlier stage because repeated mucosal dosing, retention in lymphoid tissue, and combined product regulation impose substantial burdens. A translational roadmap is proposed in which material selection is guided by clinically relevant quality attributes, standardized saliva- and mucus-relevant assays, human tonsil organoid testing, and early attention to manufacturability, safety, and regulatory strategy. The field is promising, but direct pharyngeal HPV data remain limited; accordingly, there is an urgent need for comparative studies that connect nanoparticle architecture to measurable outcomes such as tonsillar deposition, epithelial uptake, immune activation, and local tolerability. Full article

Sporadic cases of trichinellosis have occurred almost every year in Serbia. The success of trichinellosis control in the country depends on effective communication among medical professionals who discover a case of trichinellosis, the Public Health Service, and the Veterinary Service, in line with the One Health concept. The collaborative approach, supported by a robust reporting and monitoring system, has been essential for identifying infection sources and preventing further spread. However, in March 2023, the National Reference Laboratory for Trichinellosis (NRLT) received reports of hospitalized patients with suspected trichinellosis, signaling the possibility of two outbreaks based on their socio-epidemiological history. The investigation revealed separate trichinellosis outbreaks occurred in Grocka, Belgrade municipality, and Dolovo, Pancevo municipality, with pork identified as the source of infection. Serological tests confirmed the presence of Trichinella-specific antibodies in the patients, including their family members and friends. A total of four patients required hospitalization. In accordance with regulations, veterinary inspectors took dried meat and meat products samples and Trichinella larvae were detected using the digestion method. The entire amount of dried meat and meat products was subsequently destroyed. Multiplex PCR confirmed the identification of Trichinella britovi at the species level in both outbreaks. These findings represent the first documented cases of T. britovi infection in domestic pigs in Serbia. The outbreak data once again highlight that inadequate animal husbandry practices, certain human behaviors, and a lack of awareness about the risks continue to be major contributors to the persistence of trichinellosis in Serbia. Full article

Background/Objectives: This study was conducted to determine the effect of a Health Belief Model–based education program implemented in Family Health Centers on women’s cervical cancer knowledge and their attitudes and beliefs toward HPV vaccination. Methods: This quasi-experimental pretest–posttest control group study was conducted between March and May 2026 at the Tuşba Training Family Health Center in Van, eastern Türkiye. The study included 150 women aged 18–49 years who had adolescent daughters aged 10–18 years. Data were collected using the Descriptive Information Form, the Cervical Cancer Knowledge Scale, and the Carolina HPV Immunization Attitudes and Beliefs Scale. The intervention group received a structured education program based on the Health Belief Model focusing on cervical cancer, HPV infection, and HPV vaccination. Descriptive statistics, chi-square tests, independent samples t-tests, paired samples t-tests, and mixed-design analysis of variance (ANOVA) were used for data analysis. Results: Following the educational intervention, cervical cancer knowledge scores increased from 2.13 ± 0.79 to 7.24 ± 0.84 in the intervention group, whereas no significant change was observed in the control group (p < 0.001). Total CHIAS scores increased from 24.32 ± 5.30 to 41.23 ± 2.51, accompanied by significant improvements in HPV vaccination attitudes and beliefs (p < 0.001). Significant Group × Time interaction effects were observed for cervical cancer knowledge, total CHIAS scores, and all CHIAS subdimensions (p < 0.001). Conclusions: The findings indicated that the Health Belief Model–based education program was associated with improved knowledge about cervical cancer and HPV and with more favorable attitudes and beliefs toward HPV vaccination. Structured educational programs implemented in primary healthcare settings may support the promotion of preventive health behaviors. Full article

Leishmaniasis is an endemic zoonotic disease caused by the protozoan parasite Leishmania and transmitted by infected female phlebotomine sandflies. The World Health Organization (WHO) classifies it among the 20 neglected tropical diseases (NTDs), ranking eighth globally. The disease predominantly affects resource-limited populations in tropical regions. Kenya bears a significant global burden of leishmaniasis, with Baringo County identified as a major endemic area. A cross-sectional survey on knowledge, attitudes, and practices (KAP) was conducted from July 2025 to January 2026 among 135 residents of Baringo South Sub-County using a structured questionnaire. The study evaluated sociodemographic characteristics, disease awareness, perceptions, preventive practices, and treatment-seeking behaviors. Additionally, 12 healthcare professionals were interviewed regarding their diagnostic and treatment capacities. Associations between variables were analyzed using Chi-square tests and multivariate logistic regression. Overall awareness of leishmaniasis was high (94.8%), with KAP scores of 86.7%, 76%, and 77.7%, respectively. Despite this, critical knowledge gaps persisted regarding transmission dynamics, the role of dogs as reservoir hosts, and preventive measures. Significant associations were found for awareness of local cases, recognition of clinical signs, knowledge of vector activity, community control measures, and attitudes toward treatment preferences. Age and education level predicted KAP outcomes. Healthcare practitioners demonstrated technical capacity to diagnose and treat human Leishmania infections, whereas veterinarians lacked awareness of Leishmania infection in dogs, including its diagnosis and treatment. Integration of human, animal, and vector surveillance within a One Health framework is recommended to enhance disease monitoring and control in Baringo County. Full article

Background: Congenital infections included in the TORCH complex remain an important cause of fetal and neonatal morbidity and mortality, being associated with miscarriage, intrauterine growth restriction, congenital malformations, neurological impairment, and long-term developmental sequelae. Prenatal serological screening may contribute to the early identification of maternal infections and facilitate preventive and therapeutic interventions. However, data regarding the utilization of TORCH screening and associated socio-demographic determinants in Romania remain limited. Objective: This study aimed to evaluate the self-reported uptake of prenatal serological testing for one or more infections included in the TORCH complex, particularly Toxoplasma gondii, rubella virus, cytomegalovirus (CMV), herpes simplex virus (HSV), and syphilis, and to identify socio-demographic, obstetrical, and prenatal care-related factors associated with TORCH testing among pregnant women in Romania. Materials and Methods: A cross-sectional observational study was conducted using an online self-administered questionnaire completed by 1301 pregnant women from Romania. Data collection was performed between August 2022 and March 2023 through digital platforms, including social media and pregnancy-related forums. The primary outcome was self-reported performance of serological testing for at least one TORCH-related infection during pregnancy. Associations between explanatory variables and TORCH testing were evaluated using chi-square tests and multivariable binary logistic regression models. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. Results: Overall, 75.6% of participants reported undergoing serological testing for at least one infection included in the TORCH complex during pregnancy, while 49.3% reported a complete TORCH panel. The most frequently reported investigations were for Toxoplasma gondii (92.8%) and rubella virus (89.9%), whereas HSV testing was less commonly reported (42.5%). Lower educational level was the strongest independent factor associated with reduced likelihood of TORCH testing (adjusted OR = 0.08; 95% CI: 0.03–0.19; p < 0.001) (adjusted OR—aOR). Unemployment status (aOR = 0.70; 95% CI: 0.50–0.99; p = 0.045) and multiparity (aOR = 0.62; 95% CI: 0.49–0.77; p < 0.001) were also associated with lower testing uptake. In contrast, participation in prenatal education programs was associated with increased likelihood of TORCH testing (aOR = 1.37; 95% CI: 1.04–1.80; p = 0.024). The number of prenatal consultations was not independently associated with testing uptake. Conclusions: The uptake of prenatal serological screening for congenital infections (assessed using an expanded Romanian panel that includes hepatitis B and HIV in addition to the classical TORCH agents) in Romania appears to be influenced predominantly by socio-educational and behavioral factors rather than by the quantitative utilization of prenatal care services alone. Given the online recruitment strategy and the predominantly urban and highly educated sample, the reported uptake rates may overestimate population-level coverage. Significant inequalities in access to preventive prenatal investigations were observed, particularly among women with lower educational and socio-economic status. Strengthening prenatal education programs and improving equitable access to standardized prenatal screening may contribute to optimizing congenital infection prevention and maternal–fetal health outcomes. Full article

The H5N1 highly pathogenic avian influenza (HPAI) virus has caused severe global losses, reaching South America in 2022 and Antarctica in 2024. Here, we synthesize outbreak reports submitted to the World Organization for Animal Health by South American countries and overseas territories in this continent, and document the virus’s unprecedented expansion into Antarctica, affecting wild birds, wild mammals, and domestic poultry. Phylogenetic and time-calibrated Bayesian analyses were performed on available genomic sequences. Over 6 million domestic birds were lost, mostly from commercial operations. Of the 11 South American countries and overseas territories that reported H5N1 to WOAH, 10 reported infections in wild birds, spanning 104 species, 59.62% of which are migratory and predominantly non-trans-equatorial. Marine mammal outbreaks followed wild bird detections, with the South American sea lion (Otaria flavescens) being the most reported species. Several Antarctic bird species with migratory behavior were also reported in South America. Genomic analyses revealed multiple introduction events, regional viral diversification, and patterns consistent with repeated cross-species spillover events. These findings highlight H5N1’s extensive ecological reach in the Southern Hemisphere and underscore the urgent need for a One Health approach that strengthens wildlife and backyard-poultry surveillance, alongside coordinated regional action to control and prevent further HPAI spread. Full article

Background: Inappropriate antibiotic use contributes significantly to antibiotic resistance (ABR), particularly in low- and middle-income countries. Understanding community-level knowledge, attitudes, and practices is essential for designing effective interventions. This study assessed Knowledge, Attitudes and Practices (KAP) related to antibiotic use, with consideration of awareness of antibiotic resistance, in Montserrado County, Liberia. Methods: A community-based cross-sectional survey was conducted among 1160 adults in Montserrado County, Liberia, using a structured questionnaire to assess knowledge, attitudes, and practices (KAP) related to antibiotic use and antibiotic resistance. Composite KAP scores were calculated from Likert-scale items and subsequently categorized into ordered levels (poor, moderate, and good) based on percentile thresholds. Ordinal logistic regression was used to examine associations between sociodemographic characteristics and KAP outcomes. Results are presented as crude and adjusted odds ratios (COR, AOR) with 95% confidence intervals (CI), and statistical significance was set at p < 0.05. Results: Participants demonstrated moderate knowledge, with correct identification of antibiotic use for bacterial infections (skin infections: 78.8%; ear infections: 76.8%), but widespread misconceptions were observed, including use for colds and flu (73.6%) and diarrhea (80.7%). Attitudes were mixed, with many recognizing inappropriate use, yet expectation-driven demand remained common (62.7% dissatisfied when antibiotics were not prescribed; 80.9% willing to suggest antibiotics to clinicians). Practices were inconsistent, with both appropriate and inappropriate behaviors reported. While 46.2% of participants always completed antibiotic courses, inappropriate practices were frequent, including antibiotic use for common symptoms (38.6%), preventive use (37.2%), and self-medication without prescription (20.1% always). In multivariable analysis, older age was associated with higher knowledge (AOR = 3.82, 95% CI: 1.26–11.1), while lower education predicted poorer knowledge and practices (e.g., AOR = 0.25, 95% CI: 0.07–1.00). Urban residence was associated with poorer practices (AOR = 0.42, 95% CI: 0.29–0.61). Conclusions: While overall knowledge of antibiotic use in Montserrado County is moderate, critical misconceptions remain, and appropriate practices are inconsistent. Weak relationships between knowledge, attitudes, and practices highlight the limitations of knowledge-based interventions alone. Efforts to improve antibiotic use should address structural drivers, including access to antibiotics, healthcare-seeking behavior, and regulatory enforcement, through targeted and context-specific strategies. Full article

Background/Objectives: Dry powder inhalation (DPI) is a promising strategy for the treatment of respiratory diseases such as cystic fibrosis (CF), where thick and viscous mucus limits drug penetration and contributes to persistent infection and inflammation. Although inhalation allows rapid drug action with reduced systemic exposure, its efficacy depends on the ability of inhaled drugs to achieve and maintain therapeutic concentrations in the lungs and to overcome airway barriers. This study aimed to develop and characterize effervescent dry powder formulations designed to enhance mucus permeabilization through mechanical disruption while delivering an antibiotic. Methods: Effervescent microparticles containing sodium bicarbonate, an organic acid (citric or tartaric acid), and levofloxacin were produced by spray drying using a triple-fluid nozzle to control component distribution and prevent premature effervescence. The influence of functional excipients, including L-leucine and mannitol, on particle formation, aerosol performance, and process yield was evaluated. Microparticles were characterized in terms of morphology, fine particle fraction (FPF), and effervescence-related properties. Results: Formulations containing L-leucine and citric acid reduced particle agglomeration and achieved a fine particle fraction of up to approximately 18%, although with a lower process yield. In contrast, formulations based on tartaric acid and mannitol improved both production yield and aerosol performance, with FPF values increasing up to 27.3% and more efficient CO₂ release. The resulting microparticles exhibited spherical, hollow, and partially fragmented morphology, consistent with premature CO₂ generation during spray drying. Conclusions: The effervescent approach, combined with controlled spray drying parameters, represents a promising formulation strategy to modulate particle behavior and drug release in mucus-relevant environments. These findings support further investigation of effervescent DPI systems for improved pulmonary drug delivery in CF. Full article