Strengthening serological studies: the need for greater geographical diversity, biobanking, and data-accessibility.

Serological studies uniquely strengthen infectious disease surveillance, expanding prevalence estimates to encompass asymptomatic infections, and revealing the otherwise inapparent landscape of immunity, including who is and is not susceptible to infection. They are thus a powerful complement to often incomplete epidemiological and public health measures (administrative measures of vaccination coverage, incidence estimates, etc.).

Sub-Saharan Africa's Contribution to Clinical Trials in International Acute Coronary Syndromes and Heart Failure Guidelines.

Background: There is a growing burden of acute coronary syndrome (ACS) and heart failure (HF) in sub-Saharan Africa (SSA), yet outcomes remain poor compared to high-income countries. The European Society of Cardiology (ESC) international guidelines are pivotal to the delivery of evidence-based care; however, their representation of populations from SSA remains unclear.

Objectives: The purpose of the study was to evaluate the representation of populations from SSA in randomized controlled trials (RCTs) that inform ESC ACS and HF guidelines.

Multiplication rate variation of malaria parasites from hospital cases and community infections.

The significance of multiplication rate variation in malaria parasites needs to be determined, particularly for Plasmodium falciparum, the species that causes most virulent infections. To investigate this, parasites from cases presenting to hospital in The Gambia and from local community infections were culture-established and then tested under exponential growth conditions in a standardised six-day multiplication rate assay. The multiplication rate distribution was lower than seen previously in clinical isolates from another area in West Africa where infection is more highly endemic.

Understanding the exodus: a 15-year retrospective cohort study on the pattern and determinants of migration among Nigerian doctors and dentists.

Background: Nigeria faces a critical shortage of healthcare professionals yet experiences a significant annual exodus of doctors and dentists. This alarming trend threatens the country's ability to provide equitable healthcare.

Objective: This study investigated the patterns and determinants of migration among doctors and dentists who graduated from the University of Benin, Nigeria, 15 years ago.

Two Sides of the Same Coin: Strategies to Address Under- and Over-Nutrition.

Although malnutrition in the form of child wasting, stunting, and micronutrient deficiencies remain prevalent on many of the poorest and war-torn places on earth, there has been major progress in other regions and the direction of travel remains generally good. However, as countries pass through the economic transition there has been a seemingly inevitable rise in overweight and obesity with its attendant personal health costs (reduced life span due to obesity-related chronic conditions) and a rise in the societal costs of care. Strategies, by healthcare professionals and others, to combat the two sides of the malnutrition coin must be built on a solid foundational knowledge of the causes of each condition.

The validation of an LC-MS/MS method for the quantification of vitamin D metabolites in human milk and their biological variability in Gambian women.

Vitamin D is required for healthy growth and development, but data on human milk vitamin D content is limited. We describe a liquid chromatography tandem mass spectrometry (LC-MS/MS) method for the analysis of vitamin D metabolites in human milk, and its application in samples collected on two consecutive days from women in rural Gambia. Vitamin D compounds were extracted from 1 mL of milk by liquid-liquid extraction and derivatised with 4-phenyl-1,2,4-triazoline-3,5-dione (PTAD) prior to analysis by LC-MS/MS.

COMMUNICATION AND INFORMATION NEEDS OF PARENTS OF PRETERM INFANTS IN A TERTIARY HEALTH FACILITY IN NIGERIA: A QUALITATIVE STUDY.

Introduction/background: Parents of hospitalized preterm infants often experience a range of emotions and seek accurate information about their child's health progress. In low-resource settings, there is limited data on the specific communication and information needs of these parents during hospitalization. While some studies in Africa have identified poor communication as a factor affecting parental care experiences, few have explored solutions from the parent's perspective.

Emerging threat of artemisinin partial resistance markers (pfk13 mutations) in Plasmodium falciparum parasite populations in multiple geographical locations in high transmission regions of Uganda.

Background: Artemisinin-based combination therapy (ACT) is currently recommended for treatment of uncomplicated malaria. However, the emergence and spread of partial artemisinin resistance threatens their effectiveness for malaria treatment in sub-Saharan Africa where the burden of malaria is highest. Early detection and reporting of validated molecular markers (pfk13 mutations) in Plasmodium falciparum is useful for tracking the emergence and spread of partial artemisinin resistance to inform containment efforts.

Socioeconomic deprivation modifies green space and mental health associations: A within person study.

Living in an area with good availability and accessibility of residential green spaces such as parks, woodlands, and residential gardens can improve mental health and reduce the global disease burden. Unlike for physical health, it is not well understood if mental health and green space associations might be modified by local area deprivation. Existing evidence for this association comes from cross-sectional studies, widely considered vulnerable to confounding and bias.

Histidine-rich protein (hrp) 2-based RDT false-negatives and Plasmodium falciparum hrp 2 and 3 gene deletions in low, seasonal and intense perennial transmission zones in Cameroon: a cross - sectional study.

Background: False negative rapid diagnostic tests (RDTs) accruing to the non-detection of Plasmodium falciparum histidine-rich protein 2/3 (Pfhrp2/3) is threatening the diagnosis and management of malaria. Although regular monitoring is necessary to gauge the level of efficacy of the tool, studies in Cameroon remain limited. This study assessed Plasmodium spp.

Human-animal contact to inform zoonotic disease risk across gradients of agricultural land use change in the Central River Region (CRR) of The Gambia (ZooContact): a formative study.

Introduction: Pilot studies are important initial steps in research, providing a preliminary assessment of the practicality, feasibility, and potential challenges of a proposed study. This study attempts to assess the feasibility, practicality, and acceptability of a study that integrates a human-animal contact (HAC) questionnaire, animal biodiversity survey using acoustic analysis, and zoonotic disease investigation in animals among rural households in the Central River Region (CRR) of The Gambia. The pilot study revealed granular insights that would otherwise go unnoticed, providing vital information that directly guided the design and implementation of the subsequent full-scale study on zoonotic disease risk.

Effect of intrapartum azithromycin on gut microbiota development in early childhood: A post hoc analysis of a double-blind randomized trial.

Intrapartum azithromycin prophylaxis has shown the potential to reduce maternal infections but showed no effect on neonatal sepsis and mortality. Antibiotic exposure early in life may affect gut microbiota development, leading to undesired consequences. Therefore, we here assessed the impact of 2 g oral intrapartum azithromycin on gut microbiota development from birth to the age of 3 years, by 16S-rRNA gene profiling of rectal samples from 127 healthy Gambian infants selected from a double-blind randomized placebo-controlled clinical trial (PregnAnZI-2).

Accuracy of CAD4TB (Computer-Aided Detection for Tuberculosis) on paediatric chest radiographs.

Background: Computer-aided detection (CAD) systems hold promise for improving tuberculosis (TB) detection on digital chest radiographs. However, data on their performance in exclusively paediatric populations are scarce.

Methods: We conducted a retrospective diagnostic accuracy study evaluating the performance of CAD4TBv7 (Computer-Aided Detection for Tuberculosis version 7) using digital chest radiographs from well-characterised cohorts of Gambian children aged <15 years with presumed pulmonary TB.

Food biodiversity and gastrointestinal cancer risk in nine European countries: Analysis within a prospective cohort study.

Background: Food biodiversity in human diets has potential co-benefits for both public health and sustainable food systems. However, current evidence on the potential relationship between food biodiversity and cancer risk, and particularly gastrointestinal cancers typically related to diet, remains limited. This study evaluated how dietary species richness (DSR) was associated with gastrointestinal cancer risk in a pan-European population.

WHO global research priorities for antimicrobial resistance in human health.

The WHO research agenda for antimicrobial resistance (AMR) in human health has identified 40 research priorities to be addressed by the year 2030. These priorities focus on bacterial and fungal pathogens of crucial importance in addressing AMR, including drug-resistant pathogens causing tuberculosis. These research priorities encompass the entire people-centred journey, covering prevention, diagnosis, and treatment of antimicrobial-resistant infections, in addition to addressing the overarching knowledge gaps in AMR epidemiology, burden and drivers, policies and regulations, and awareness and education.

Harnessing peer mentorship as a tool to turn human resource for health brain drain into brain gain: a case study of a Nigerian peer-mentored research group.

Background: Peer mentorship can be a potential tool to reduce the disparities in health research capacity between high- and low- and middle-income countries. This case study describes the potential of peer mentorship to tackle two critical issues: bridging health research capacity of doctors from low- and middle-income countries (LMICs) and the transformation of human resource for health brain drain into "brain gain".

Case Presentation: In 2021, a virtual peer mentorship group was established by 16 alumni of the University of Benin College of Medical Sciences' 2008 graduating class, residing across three continents.

Advanced HIV disease and associated factors among young people aged 15-24 years at a tertiary hospital in Sierra Leone: a cross-sectional study.

Background: Advanced HIV disease (AHD) in young people living with HIV (PLHIV) is an increasingly pressing public health issue in sub-Saharan Africa. Despite global progress in early HIV testing and reducing HIV-related deaths, many youths experience increased rates of HIV disease progression in sub-Saharan Africa. This study describes the burden, clinical manifestations, and factors for disease progression among young PLHIV aged 15 - 24 years seeking medical services at a major public hospital in Sierra Leone.

Hepatitis B discrimination: global responses requiring global data.

Over 250 million individuals live with chronic hepatitis B (CHB) infection worldwide. A significant proportion of these people often face discrimination defined as the unjust, unfair, or prejudicial treatment of a person on the grounds of their hepatitis B status. Hepatitis B related discrimination has not been widely documented in the literature.

Effects of maternal calcium supplementation on offspring blood pressure and growth in childhood and adolescence in a population with a low-calcium intake: follow-up study of a randomized controlled trial.

Background: The World Health Organization recommends calcium supplementation (1500-2000 mg/d) during pregnancy for women with a low-calcium intake.

Objectives: The purpose of this study was to investigate whether pregnancy calcium supplementation affects offspring blood pressure and growth in The Gambia where calcium intakes are low (300-400 mg/d).

Methods: Follow-up of offspring born during a randomized controlled trial of pregnancy calcium supplementation (ISRCTN96502494, 1996-2000) in which mothers were randomly assigned to 1500 mg Ca/d (Ca) or placebo (P) from 20 wk pregnancy to delivery.

Impact of Intrapartum Azithromycin on the Carriage and Antibiotic Resistance of Escherichia coli and Klebsiella pneumoniae in Mothers and Their Newborns: A Substudy of a Randomized, Double-Blind Trial Conducted in The Gambia and Burkina Faso.

Background: Limited data exist on the effects of intrapartum azithromycin on the prevalence of carriage and antibiotic resistance of Enterobacterales.

Methods: We conducted a randomized trial in The Gambia and Burkina Faso where women received intrapartum azithromycin (2 g) or placebo. We determined the impact of treatment on the prevalence of carriage and antibiotic resistance of Escherichia coli and Klebsiella pneumoniae by analyzing rectal swabs (RS), nasopharyngeal swabs (NPS), breast milk, and rectovaginal swabs (RVS).

Systematic review protocol of aetiology of mechanical bowel obstruction in low-and-middle income countries: Has anything changed in the last two decades?

The aetiology of mechanical bowel obstruction exhibits significant variability based on geographical location and age. In high-income countries, postoperative adhesions and hernias are frequently cited as the primary causes, whereas in low- and middle-income countries (LMCIs), hernias take precedence. Speculation exists within the surgical community regarding whether this trend has evolved in LMCIs.