Global estimated Disability-Adjusted Life-Years (DALYs) of diarrheal diseases: A systematic analysis of data from 28 years of the global burden of disease study

Socio-demographic disparities in global trends of lip and oral cavity neoplasms from 1990 to 2021

Oral cancer, the 13th most common globally, is primarily squamous cell carcinoma linked to tobacco, alcohol, and HPV. Despite advances in care, it remains a major health concern due to high mortality and its impact on quality of life. This study analyzed socio-demographic disparities in oral cancer burden using data from 1990 to 2021. We analyzed annual incidence, mortality, and DALYs across 204 countries, using age-standardized rates and the Socio-demographic Index (SDI) to assess development-related impacts. Statistical methods included Kruskal-Wallis tests, linear regression, joinpoint regression for trends, and Exponential Smoothing for forecasts (2022-2030), with analyses conducted in STATA and Python, and p < 0.05 as significant. Incidence was highest in high SDI countries, while mortality and DALYs were highest in low and middle SDI countries (p < 0.001). From 1990 to 2021, incidence increased (AAPC: 0.5-1.0%), while mortality (APC: - 0.5%) and DALYs (APC: - 0.6%) declined in low SDI regions. Significant disparities across SDI categories (p < 0.001) showed incidence rising with socio-demographic development (R2 = 0.102, p < 0.001), with high-middle SDI regions bearing the highest mortality and DALYs. These findings highlight the need for awareness, prevention, early detection, and accessible care, especially in lower SDI regions.

Antibacterial effects of thyme oil loaded solid lipid and chitosan nano-carriers against Salmonella Typhimurium and Escherichia coli as food preservatives

OBJECTIVES

Escherichia coli and Salmonella Typhimurium are frequent causes of foodborne illness affecting many people annually. In order to develop natural antimicrobial agents against these microorganisms, thyme oil (TO) was considered as active antibacterial ingredient. TO contains various bioactive compounds that exhibit antimicrobial properties. To increase the antibacterial effects and stability of thyme oil, two promising carrier systems, solid lipid nanoparticles (SLN) and chitosan nanoparticles have been fabricated in this study.

METHODS

Nanoparticles were made using natural-based lipids and polymers by a probe sonication method. They were characterized using infrared spectrometry (FTIR), transmission electron microscopy (TEM), particle size, cytotoxicity, etc. Antibacterial effects of TO, thyme oil loaded in SLN (TO-SLN) and thyme oil loaded in chitosan nanoparticle (TO-CH) was evaluated against E. coli and S. typhimurium using Minimum inhibitory/bactericidal concentrations (MIC/MBC) determination. Encapsulation efficiency (EE%) and drug release profile were also studied in vitro.

RESULTS

TEM analysis revealed spherical/ovoid-shaped particles with clear edges. TO-SLN had an average size of 42.47nm, while TO-CH had an average size of 144.8nm. The Encapsulation efficiency of TO-CH and TO-SLN nanoparticles were about 81.6±1% and 73.4±1%, respectively. Results indicated 92% cumulative release in TO-CH in comparison with 88% in TO-SLN in 72 h. MIC against E. coli and S. typhimurium for TO-CH, TO-SLN, and pure TO were 4 and 1.5 μg/mL, 60 and 40 μg/mL, and 180-150 μg/mL, respectively.

CONCLUSION

Nanoencapsulation of thyme oil significantly potentiated its antimicrobial effects. TO-CH exhibited a significantly higher antibacterial effect compared to TO-SLN (6-fold) and pure thyme oil (more than 10-fold).

Global burden of enteric infections related foodborne diseases, 1990-2021: findings from the Global Burden of Disease Study 2021

Background

Understanding the global burden of enteric infections is crucial for prioritizing control strategies for foodborne and waterborne diseases. This study aimed to assess the global burden of enteric infections in 2021 and identify risk factors from One Health aspects.

Methods

Leveraging the Global Burden of Disease (GBD) 2021 database, the incidence, disability-adjusted life years (DALYs), and deaths of enteric infections and the subtypes were estimated, including diarrheal diseases, typhoid and paratyphoid fever, invasive non-typhoidal Salmonella (iNTS) infections, and other intestinal infectious diseases. The estimates were quantified by absolute number, age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR) and age-standardized DALY rate with 95% uncertainty intervals (UIs). Thirteen pathogens and three risk factors associated with diarrheal diseases were analyzed.

Results

In 2021, the global age-standardized DALY rate of enteric infections was 1020.15 per 100,000 popultion (95% UI: 822.70-1259.39 per 100,000 population) with an estimated annual percentage change (EAPC) of -4.11% (95% confidence interval: -4.31% to -3.90%) in 1990-2021. A larger burden was observed in regions with lower Socio-demographic index (SDI) levels. Diarrheal disease was the most serious subtype with Western Sub-Saharan Africa exhibiting the highest age-standardized DALY rate (2769.81 per 100,000 population, 95% UI: 1976.80-3674.41 per 100,000 population). Children under 5 and adults over 65 years suffered more from diarrheal diseases with the former experiencing the highest global age-standardized DALY rate (9382.46 per 100,000 population, 95% UI: 6771.76-13,075.12 per 100,000 population). Rotavirus remained the leading cause of diarrheal diseases despite a cross-year decline in the observed age-standardized DALY rate. Unsafe water, sanitation, and handwashing contributed most to the disease burden.

Conclusion

The reduced burden of enteric infections suggested the effectiveness of previous control strategies; however, more efforts should be made in vulnerable regions and populations through a One Health approach.

Influence of hydrometeorological risk factors on child diarrhea and enteropathogens in rural Bangladesh

BACKGROUND

A number of studies have detected relationships between weather and diarrhea. Few have investigated associations with specific enteric pathogens. Understanding pathogen-specific relationships with weather is crucial to inform public health in low-resource settings that are especially vulnerable to climate change.

OBJECTIVES

Our objectives were to identify weather and environmental risk factors associated with diarrhea and enteropathogen prevalence in young children in rural Bangladesh, a population with high diarrheal disease burden and vulnerability to weather shifts under climate change.

METHODS

We matched temperature, precipitation, surface water, and humidity data to observational longitudinal data from a cluster-randomized trial that measured diarrhea and enteropathogen prevalence in children 6 months-5.5 years from 2012-2016. We fit generalized additive mixed models with cubic regression splines and restricted maximum likelihood estimation for smoothing parameters.

RESULTS

Comparing weeks with 30°C versus 15°C average temperature, prevalence was 3.5% higher for diarrhea, 7.3% higher for Shiga toxin-producing Escherichia coli (STEC), 17.3% higher for enterotoxigenic E. coli (ETEC), and 8.0% higher for Cryptosporidium. Above-median weekly precipitation (median: 13mm; range: 0-396mm) was associated with 29% higher diarrhea (adjusted prevalence ratio 1.29, 95% CI 1.07, 1.55); higher Cryptosporidium, ETEC, STEC, Shigella, Campylobacter, Aeromonas, and adenovirus 40/41; and lower Giardia, sapovirus, and norovirus prevalence. Other associations were weak or null.

DISCUSSION

Higher temperatures and precipitation were associated with higher prevalence of diarrhea and multiple enteropathogens; higher precipitation was associated with lower prevalence of some enteric viruses. Our findings emphasize the heterogeneity of the relationships between hydrometeorological variables and specific enteropathogens, which can be masked when looking at composite measures like all-cause diarrhea. Our results suggest that preventive interventions targeted to reduce enteropathogens just before and during the rainy season may more effectively reduce child diarrhea and enteric pathogen carriage in rural Bangladesh and in settings with similar meteorological characteristics, infrastructure, and enteropathogen transmission.

Prevalence of Giardia duodenalis among Asian children: a systematic review and meta-analysis

Giardia duodenalis is one of the major causes of diarrhea among children. We performed a systematic review and meta-analysis to assess the prevalence of G. duodenalis and associated risk factors among Asian children. We searched online databases (PubMed, Scopus and Web of Science) and Google Scholar search engine for studies published from 1 January 2000 to 15 March 2022 that measured the prevalence of G. duodenalis among Asian children. Accordingly, the pooled prevalence and 95% CIs were estimated using a random-effects meta-analysis model for the included studies. A total of 182 articles from 22 Asian countries met the inclusion criteria. The pooled prevalence of G. duodenalis infection among Asian children was estimated as 15.1% (95% CI 14.1 to 16%). The highest and lowest pooled prevalence values of G. duodenalis infection were estimated for Tajikistan and China as 26.4% (95% CI 22.9 to 30%) and 0.6% (95% CI 0.001 to 1.02%), respectively. The infection had a higher prevalence in males than in females (OR=1.24; 95% CI 1.16 to 1.31; p<0.001), which was statistically significant. Giardiasis is common among Asian children, hence, a prevention and control scheme of this protozoan in children should be considered by health officials and health policymakers, especially in Asian countries where the prevalence is highest.

Tail-Engineered Phage P2 Enables Delivery of Antimicrobials into Multiple Gut Pathogens

Bacteriophages can be reprogrammed to deliver antimicrobials for therapeutic and biocontrol purposes and are a promising alternative treatment to antimicrobial-resistant bacteria. Here, we developed a bacteriophage P4 cosmid system for the delivery of a Cas9 antimicrobial into clinically relevant human gut pathogens Shigella flexneri and Escherichia coli O157:H7. Our P4 cosmid design produces a high titer of cosmid-transducing units without contamination by a helper phage. Further, we demonstrate that genetic engineering of the phage tail fiber improves the transduction efficiency of cosmid DNA in S. flexneri M90T as well as allows recognition of a nonnative host, E. coli O157:H7. We show that the transducing units with the chimeric tails enhanced the overall Cas9-mediated killing of both pathogens. This study demonstrates the potential of our P4 cas9 cosmid system as a DNA sequence-specific antimicrobial against clinically relevant gut pathogenic bacteria.

Nanomaterials to address the genesis of antibiotic resistance in Escherichia coli

Escherichia is a genus of prokaryotic gram-negative bacteria which forms a vital component of the gut microbiota of homeotherms including humans. Many members of this genus are commensals and pathogenic strains, which are responsible for some of the most common bacterial infections and can be fatal, particularly in the case of newborns and children. The fecal matter in wastewater treatment plants serves as major environmental sinks for the accumulation of Escherichia. The rise in antibiotic pollution and the lateral gene exchange of antibiotic-resistant genes have created antibiotic-resistant Escherichia strains that are often called superbugs. Antibiotic resistance has reached a crisis level that nowadays existing antibiotics are no longer effective. One way of tackling this emerging concern is by using nanomaterials. Punitively, nanomaterials can be used by conjugating with antibodies, biomolecules, and peptides to reduce antibiotic usage, whereas, preventatively, they can be used as either nano-antimicrobial additives or nano-photocatalytic sheets to reduce the microbial population and target the superbugs of environmental Escherichia. In this review, we have explored the threat posed by pathogenic Escherichia strains in the environment, especially in the context of antibiotic-resistant strains. Along with this, we have discussed some nanomaterial-mediated strategies in which the problem can be addressed by using nanomaterials as nanophotocatalytics, antimicrobial additives, drugs, and drug conjugates. This review also presents a brief overview of the ecological threats posed by the overuse of nanomaterials which warrants a balanced and judicious approach to the problem.

Zero malaria: a mirage or reality for populations of sub-Saharan Africa in health transition

The global burden of malaria continues to be a significant public health concern. Despite advances made in therapeutics for malaria, there continues to be high morbidity and mortality associated with this infectious disease. Sub-Saharan Africa continues to be the most affected by the disease, but unfortunately the region is burdened with indigent health systems. With the recent increase in lifestyle diseases, the region is currently in a health transition, complicating the situation by posing a double challenge to the already ailing health sector. In answer to the continuous challenge of malaria, the African Union has started a "zero malaria starts with me" campaign that seeks to personalize malaria prevention and bring it down to the grass-root level. This review discusses the contribution of sub-Saharan Africa, whose population is in a health transition, to malaria elimination. In addition, the review explores the challenges that health systems in these countries face, that may hinder the attainment of a zero-malaria goal.