Search Results (246)

Background/Objectives: A key disadvantage of DNA vaccines is ineffective uptake of plasmid DNA, resulting in low immunogenicity. A way to overcome it is forced DNA delivery, which requires specialized equipment and/or reagents. Effective delivery of plasmids without specialized devices or using commonly available ones would significantly increase DNA vaccine applicability. Here, we delivered DNA by intradermal injections, facilitating them by optimized sonoporation (SP) or electroporation (EP), and we compared these methods by their capacity to support the production of foreign proteins in mice. Methods: DNA delivery was optimized using the plasmid encoding firefly luciferase (Luc) (pVaxLuc). Luc production was assessed by bioluminescence imaging (BLI) (IVIS, PerkinElmer, Shelton, CT, USA; LumoTrace Fluo, Abisense, Dolgoprudny, Russia). Female BALB/c mice were injected intradermally (id) with pVaxLuc in phosphate buffers of varying ionic strengths. Injection sites were subjected to SP (Intelect Mobile, Chattanooga, UK) or EP (CUY21EDITII, BEX Co., Tokyo, Japan) or left untreated. Optimal delivery protocols were selected based on the highest in vivo levels of photon flux according to BLI. Optimal protocols for id injections with/without EP were applied to DNA-immunized mice with HIV-1 clade A reverse transcriptase. Antibody response induced by DNA immunization was assessed by ELISA. Results: The optimal phosphate buffers for id delivery had ionic strengths from 81 to 163 mmol/L. The optimal SP regimen included an acoustic pressure of 2.4 W/cm² applied in a duty cycle of 2%. The optimal EP regimen included bipolar driving pulses of 100 V, a pulse duration of 10 ms, and an interval between the pulses of 20 ms. Optimized DNA delivery by id/SP injection was inferior to both id/EP and id alone. DNA immunization with HIV-1 RT by id injections induced anti-RT antibodies in a titer of 10⁴ and by id/EP in a titer of 10⁵. Conclusions: Electroporation of the sites of id DNA injection provided the highest levels of production of luciferase reporters and induced a strong antibody response against HIV-1 RT. Full article

Background: Women’s empowerment has been significantly associated with improved child health outcomes. Cambodia, amid a rapid socioeconomic transition, offers a critical setting to examine how advancements in women’s empowerment over the past decade have influenced child immunization completion within the first two years of life. Methods: Data from the Cambodia Demographic and Health Surveys conducted in 2010, 2014, and 2021–22, encompassing 9222 women with recent births, were analyzed. Empowerment was measured across literacy and information access, employment, and decision-making domains. Multinomial logistic regression assessed associations between empowerment factors and completion of oral polio (OPV), diphtheria–tetanus–pertussis (DTP), pneumococcal conjugate (PCV), and measles–rubella (MR) vaccines, adjusting for demographic and socioeconomic variables. Results: Between 2010 and 2022, women’s empowerment in Cambodia improved significantly, marked by higher literacy rates, nearly half of women completing primary education, and expanded digital access, with 82.4% owning mobile phones and approximately 50% using the internet daily. While non-working women slightly increased, agricultural employment declined by 20%, and cash earnings rose from 48.7% to 82.5%. Most women participated in major household decision-making, either independently or jointly. Completion rates for OPV, DTP, and PCV ranged from 79% to 83%, while just over half of children were fully vaccinated against measles. Higher maternal education and cash earnings were positively associated with OPV, DTP, and PCV completion but negatively associated with measles vaccination. Women in agricultural work were less likely to complete measles vaccination for their children than non-working women. Joint decision-making regarding the use of respondents’ income was associated with a higher likelihood of measles non-completion (OR = 2.26, 95% CI: 1.13–4.51), whereas joint decision-making about respondents’ health care was associated with a higher likelihood of measles completion (OR = 0.42, 95% CI: 0.21–0.83). Conclusions: Women’s empowerment remains a key determinant of vaccination outcomes in Cambodia. The distinct pattern observed for measles suggests that vaccines scheduled for older ages encounter greater structural and behavioral barriers. To overcome these challenges, strategies should focus on enhancing defaulter tracking, implementing reminder systems, expanding outreach and catch-up programs, and improving the convenience of vaccination services. Full article

Cancer is one of the biggest health burdens for women in the Middle East and North Africa (MENA), with the incidence of breast, cervical and colorectal cancer on the rise. Although preventive measures such as the HPV vaccination and population-based screening are available, access to them remains very unequal. Women in rural, low-income and refugee communities face additional barriers, cultural stigmatisation, low health literacy, gender norms and fragile health systems, leading to delayed diagnoses and poorer outcomes. This review summarises the results of 724 peer-reviewed publications to assess the current situation of cancer screening in MENA and Mediterranean countries. The studies were classified into four dimensions: cancer type (breast, cervical, colorectal), behavioural constructs (awareness, uptake, education), vulnerability factors (e.g., migrants, refugees, low-literacy groups), and geography (indigenous MENA populations versus diaspora and Mediterranean immigrant communities). The results show large inequalities in access and participation due to fragmented policies, socio-cultural resistance and infrastructure gaps. Nevertheless, promising approaches are emerging: community-led outreach, mobile screening programmes, AI-assisted triage and culturally appropriate digital health interventions. Comparisons between the local and diaspora populations make it clear that systemic and cultural barriers persist even in well-equipped facilities. Closing the screening gap requires a culturally sensitive, digitally enabled and policy aligned approach. Key priorities include engaging religious and community leaders, promoting men’s engagement in women’s health and securing sustainable funding. With coordinated action across all sectors, MENA countries can build inclusive screening programmes that reach vulnerable women and reduce preventable cancer mortality. Full article

This article presents a deterministic model describing the joint dynamics of canine and human rabies in a cross-border context. This model explicitly integrates dog mobility between two neighboring countries and allows us to assess the impact of these movements on disease persistence. We analyze the basic reproduction number ${\mathcal{R}}_0$, study the local and global stability of equilibrium points, identify the most influential parameters through sensitivity analysis, and perform numerical simulations to test the effectiveness of different vaccination and movement control strategies. Full article

Childhood immunization is one of the most effective public health measures, yet inequities remain in marginalized populations across Asia, where parental adherence is essential to sustaining the Expanded Program on Immunization. This narrative review examines determinants of adherence among under-five children in disadvantaged communities. Following PRISMA guidelines, searches of PubMed, Scopus, and Google Scholar identified studies published between 2015 and 2025, with earlier key works included as relevant. Twenty-one studies from South, Southeast, and East Asia were analyzed. Five domains were associated with adherence: socioeconomic and access factors, where maternal education, household income, and possession of immunization cards were positive predictors, while remote residence was a barrier; trust, cultural beliefs, and social norms, with misinformation and vaccine controversies reducing uptake, and provider trust and supportive norms improving it; migration and mobility, as migrant, stateless, and left-behind children had lower coverage due to weak registration and disrupted caregiving; household and caregiver dynamics, where decision-making by family or community members shaped uptake, while large family size and maternal employment limited adherence; and health system capacity, with inadequate infrastructure and follow-up hindering coverage and integration with maternal–child health services facilitating it. Addressing these intersecting barriers through equity-focused strategies is critical to achieving universal immunization coverage. Full article

Antibiotics have revolutionized medicine and animal production, yet their extensive use has accelerated the emergence and spread of antimicrobial resistance (AMR). Beyond clinical contexts, livestock and aquaculture are now recognized as major contributors to the global resistome. This review synthesizes evidence across cattle, poultry, swine, sheep and goats, and aquaculture, highlighting how antimicrobial usage shapes resistance at the human–animal–environment interface. A substantial proportion of administered drugs is excreted unmetabolized, leading to the accumulation of unmetabolized antimicrobial residues, antibiotic-resistant bacteria (ARB), and antibiotic resistance genes (ARGs) in soils, manures, waters, sediments, and air. These reservoirs function as long-term sources and dissemination pathways through runoff, leaching, bioaerosols, effluents, and biological vectors. Despite different production systems, similar ARG families dominate, particularly those conferring resistance to tetracyclines, sulfonamides, and β-lactams. Mobile genetic elements and co-selectors such as heavy metals, disinfectants, and microplastics reinforce their persistence. Aquaculture, where water serves both as habitat and vector, emerges as a critical hotspot, while small ruminant systems remain under-researched despite their importance in many low- and middle-income countries. This synthesis highlights convergent patterns across sectors: antimicrobial use drives ARG enrichment; manures, litters, sediments, and effluents act as persistent reservoirs; and dissemination routes connect farms, ecosystems, and human populations. Within a One Health framework, mitigation requires preventive strategies—vaccination, biosecurity, and optimized waste management—supported by harmonized stewardship policies and integrated environmental surveillance. Full article

This research paper presents a smart IoT-based COVID-19 vaccine supply chain, monitoring, and control system. This proposed system is designed to efficiently and effectively monitor COVID-19 vaccine storage sites by tracking their temperature, humidity, quantity, and location on a map across various supply chain categories. It ultimately aims to monitor and control temperatures outside the range at the tracked location. The approach utilized temperature, humidity, and ultrasonic sensors, a GPS module, a Wi-Fi module, and an Arduino Uno microcontroller. The system was designed and implemented using Arduino and Proteus integrated design environments (IDEs) and coded using the embedded C/C++ programming language. A real-life working system prototype was designed and implemented. The measured sensor readings can be viewed via a computer system capability or any mobile device, such as an Android phone, iPhone, iPad, or laptop, with the aid of a cloud-based platform, namely, Thingspeak.com. The experimentally measured sensor readings are stored in a data log file for subsequent download and analysis whenever the need arises. The data aggregation and analytics are coded using MATLAB and viewed as charts, and the location map of vaccine carrier coordinates is sent to the web cloud for tracking. An alarm message is sent to the monitoring and control system if an unfavorable vaccine environment exists in either the store or the carrier container. A suitable sensor-based interface architecture and web portal are provided, allowing health practitioners to remotely monitor the vaccine supply chain system. This method encourages health workers by reducing the high levels of supervision required by vaccine supervisors to ensure the smooth supply of vaccines to vaccine collection centers, by using a wireless sensor network and IoT technology. Experimental results from the implemented system prototype demonstrated the benefits of the proposed approach and its possible real-life health monitoring applications. Full article

Background: During the COVID-19 pandemic, transgender and gender-diverse (TGD) people and people with disabilities in India faced disproportionate barriers to accessing vaccination services. Building on previous studies, this study explored the experiences of COVID-19 vaccine access in these two marginalized communities, using the WHO Behavioral and Social Drivers (BeSD) framework. Methods: Keeping community-based participatory methods (CBPR) at heart, we conducted a survey adapted from the BeSD COVID-19 survey tool. The survey was adapted using insights from a prior study, a literature review, stakeholder consultations, and discussions with a community leadership group (CLG) and an advisory board (AdB). Participants were recruited through transgender, gender-diverse, and disability rights networks. Data were analyzed descriptively, using percent analysis, and psychometrically, using exploratory factor analysis on polychoric correlations. Results: The adapted BeSD survey tool showed a high 0.85 (p < 0.05) internal consistency and criterion validity. Moreover, it showed a high willingness to be vaccinated (for ease of access to other services and community responsibility); however, systemic barriers hindered vaccination access. TGD people and people with disabilities faced multiple barriers in being vaccinated. The TGD community reported documentation mismatches and mistrust in health systems. People with disabilities reported mobility challenges, escort dependence, financial challenges, and variable accessibility at vaccination sites. Both groups faced digital exclusion, received inadequate information that did not address their specific needs, and experienced inconsistent implementation of inclusive policies. Community-led facilitation led to more uptake. Conclusions: Vaccine willingness alone is insufficient to ensure that vaccines reach everyone. Addressing trust deficits, infrastructural barriers, and digital exclusions requires diligent attention and commitment from the government to mitigate broader challenges faced by TGD people and people with disabilities. Full article

Cyclodextrins (CDs) have traditionally been recognized as excipients that enhance solubility and stability of drugs. However, growing evidence shows that CDs themselves can act as active therapeutic agents. Their unique supramolecular properties enable them to interact with biological membranes, mobilize cholesterol, and modulate immune responses. This review highlights four therapeutic areas where CDs demonstrate particular promise. First, in gene and mRNA therapy, cationic CD derivatives form nanoparticles that protect nucleic acids, promote endosomal escape, and achieve targeted delivery. Second, in neurodegenerative disorders such as Niemann–Pick type C and Alzheimer’s disease, hydroxypropyl-β-CD facilitates cholesterol clearance and reduces pathological lipid accumulation. Third, in detoxification, the γ-CD derivative sugammadex exemplifies a clinically approved agent that encapsulates neuromuscular blockers to reverse anesthesia. Finally, CDs have emerged as safe vaccine adjuvants, inducing robust systemic and mucosal immunity with reduced IgE responses compared to alum. Together, these examples illustrate a paradigm shift: CDs are not only versatile excipients but also active molecules with direct therapeutic effects. Future translation will require careful optimization of safety, scalability, and regulatory compliance, but CDs are poised to contribute meaningfully to next-generation medicines. Full article

Background: Online health information seeking emerged as a critical form of public health behavior during the COVID-19 pandemic, generating substantial research interest. However, empirical studies examining health information-seeking patterns among Korean populations and their behavioral outcomes during the pandemic remain limited. Grounded in the information–motivation–behavior skills model, this study investigates online health information-seeking behaviors, including information sources, search terms, and engagement patterns, while also exploring their association with actual health behaviors during the COVID-19 pandemic. Methods: A structured survey was developed based on 1014 adults aged 19 years or older using the 2021 Korean version of the Health Information National Trends Survey (K-HINTS) to obtain nationally representative data. We adopted a structural equation model and analyzed the data using SPSS 25.0 and the WordArt site. Results: Of the respondents, 74.2% sought health information online, with vaccine details being the most widely searched topic. Mobile phones were the most commonly used devices (75.8%), and 98% searched for health information online via mobile devices at least once a week. Information (β = 0.230, p < 0.001), motivation (β = 0.117, p < 0.01), and behavior skills (β = 0.117, p < 0.01) positively influenced consumers’ behavioral changes regarding health. Behavioral skills also mediated the influences that information seeking and motivation had on behavioral changes. Conclusions: This study examines four aspects of online health information seeking through nationally representative COVID-19 data in South Korea. Exploring the relationship between information-seeking and actual health behaviors provides crucial insights for predicting post-pandemic consumer behavior and developing effective public health communication strategies for future crises. Full article

Background: This study aimed to analyze the patterns and underlying reasons associated with population movement across Sindh, Pakistan. Methods: Cross-sectional surveys were conducted in response to the detection of WPV1 in various districts in Sindh province, where genetic linkages with poliovirus isolates in Karachi had been identified. The surveys targeted union councils (UCs) contributing sewage to the environmental sample collection sites where WPV1 was detected. Results: In the Karachi division a total of 1392 participants were interviewed, and outside Karachi 1471 participants were included. A significantly higher proportion of female participants were interviewed in Karachi (n = 72, 55.0%) compared to other divisions of Sindh (n = 794, 45.0%) (p < 0.001). Linguistic distribution varied significantly between regions, with Pashto speakers predominating in Karachi (n = 336, 86.4%), and Sindhi in other divisions (n = 501, 79.4%) (p < 0.001). OPV coverage exceeded 90% across all districts, and over 85% of children received RI vaccines. Travel patterns also differed significantly; participants from Karachi (n = 686, 44.2%) were less likely to report travel compared to other divisions (n = 865, 55.8%), who frequently traveled for family events, business, or employment (p < 0.001). Conclusions: It is critical to redefine high-risk populations annually based on updated mobility data, social survey analyses, and virus detection via surveillance to better identify and reach unvaccinated children in the Pakistan polio program. In addition, strategically placed PTPs along both formal and informal travel corridors based on an updated risk framework will enhance vaccination, thereby reducing the risk of virus spread. Full article

Cervical cancer remains a significant public health challenge, disproportionately affecting women in low- and middle-income countries (LMICs). Persistent infection with high-risk types of human papillomavirus (HPV), particularly HPV16 and HPV18, is the central cause of cervical carcinogenesis, driven by the viral oncoproteins E6 and E7, which disrupt the host tumor suppressors p53 and retinoblastoma protein (pRb). Advances in molecular understanding have catalyzed effective primary and secondary prevention strategies. Prophylactic HPV vaccination, especially the nonavalent formulation, has demonstrated high efficacy in reducing HPV infections and cervical precancer. Concurrently, HPV deoxyribonucleic acid (DNA) testing, self-sampling, and screen-and-treat protocols are transforming screening paradigms, particularly in resource-limited settings. However, global disparities in vaccine access, screening coverage, and health infrastructure persist, impeding progress toward the World Health Organization’s (WHO) 90–70–90 elimination targets. By synthesizing recent advances in virology, prevention strategies, and implementation innovations, such as therapeutic vaccines, artificial-intelligence (AI)-driven diagnostics, and mobile health solutions, this review sheds light on their potential to narrow these equity gaps. Full article

Humans are being exposed to a variety of potentially toxic metal compounds through the diet and/or the intravenous administration of metal-containing medicinal drugs. The organomercurial thimerosal (THI) is a bactericidal that is present in vaccines, but its potential degradation by biomolecules in vivo is incompletely understood. To probe its interaction with low-molecular-weight thiols that are highly abundant within cells, we have employed an LC-based analytical approach in conjunction with a mercury-specific detector. The injection of THI into a C₁₈-HPLC column equilibrated with mobile phases that contained increasing concentrations of up to 15 mM of glutathione (GSH) and 30% acetonitrile revealed the elution of a GS-EtHg adduct in conjunction with THI, as evidenced by electrospray ionization mass spectrometry. These results were confirmed by ¹⁹⁹Hg-NMR spectroscopy. While these results imply a rapid degradation of THI by GSH at physiological pH, it is important to point out that our results were obtained in aqueous solutions containing 30% (v:v) acetonitrile. Further studies need to confirm if the GS-EtHg adduct is also formed in biological fluids. Our results nevertheless demonstrate that GSH and L-cysteine (Cys) are potential targets of THI at physiological pH, which is relevant to better understand its side effects, including previously reported effects on Ca²⁺ channels. Full article

Background: Respiratory viral infections such as influenza, COVID-19, and respiratory syncytial virus (RSV) are considered as major public health threats in Africa. Despite global advancements in vaccine development, persistent inequities in access, delivery infrastructure, and public trust limit the continent’s capacity to control these diseases effectively. This review aimed at providing insights on challenges, efforts, impacts, and opportunities for the future related to vaccination against respiratory viral infections in Africa. Methods: This narrative review synthesizes the peer-reviewed literature and global health reports to examine vaccination efforts against respiratory viruses in Africa. The analysis focuses on disease burden, vaccine coverage, barriers to uptake, enabling factors, progress in local vaccine production, and strategies for integrating vaccines into national immunization programs (NIPs). Results: Respiratory vaccines have significantly reduced hospitalizations and mortality among high-risk groups in African countries. Nonetheless, key challenges, including limited cold chain capacity, vaccine hesitancy, donor-reliant supply chains, and under-resourced health systems, continue to undermine vaccine delivery. Successful interventions include community mobilization, use of mobile health technologies, and leveraging existing immunization platforms. Emerging initiatives in local vaccine manufacturing, including Rwanda’s modular mRNA facility and Senegal’s Institut Pasteur, signal a shift toward regional self-reliance. Conclusions: Maximizing the impact of respiratory vaccines in Africa requires a multifaceted strategy: integrating vaccines into NIPs, strengthening domestic production, expanding cold chain and digital infrastructure, and addressing sociocultural barriers through community-driven communication. These efforts are essential to achieving vaccine equity, health resilience, and pandemic preparedness across the continent. Full article

Livestock-associated Staphylococcus species—particularly Staphylococcus aureus (S. aureus), Staphylococcus pseudintermedius (S. pseudintermedius), and coagulase-negative staphylococci (CoNS)—pose escalating threats to animal health, food safety, and public health due to their evolving antimicrobial resistance (AMR) profiles. This review synthesizes recent insights into the molecular epidemiology, resistance determinants, and host adaptation strategies of these pathogens across food-producing animals. We highlight the role of mobile genetic elements (MGEs), clonal dissemination, and biofilm formation in shaping multidrug resistance (MDR) patterns. Diagnostic advancements, including MALDI-TOF MS, whole-genome sequencing (WGS), and PCR-based assays, are discussed alongside treatment challenges arising from therapeutic failures and limited vaccine efficacy. The review critically examines current AMR surveillance gaps and the need for integrative One Health frameworks that encompass animals, humans, and the environment. Novel tools such as metagenomics, real-time genomic surveillance, and artificial intelligence (AI)-driven analytics are proposed to enhance predictive monitoring and resistance management. Together, these insights underscore the urgency of coordinated, evidence-based interventions to curb the spread of MDR staphylococci and safeguard One Health. Full article