Reactive case detection (RACD) is the screening of household members and neighbors of index cases reported in passive surveillance. This strategy seeks asymptomatic infections and provides treatment to break transmission without testing or treating the entire population. This review discusses and highlights RACD as a recommended strategy for the detection and elimination of asymptomatic malaria as it pertains in different countries. Relevant studies published between January 2010 and September 2022 were identified mainly through PubMed and Google Scholar. Search terms included “malaria and reactive case detection”, “contact tracing”, “focal screening”, “case investigation”, “focal screen and treat”. MedCalc Software was used for data analysis, and the findings from the pooled studies were analyzed using a fixed-effect model. Summary outcomes were then presented using forest plots and tables. Fifty-four (54) studies were systematically reviewed. Of these studies, 7 met the eligibility criteria based on risk of malaria infection in individuals living with an index case < 5 years old, 13 met the eligibility criteria based on risk of malaria infection in an index case household member compared with a neighbor of an index case, and 29 met the eligibility criteria based on risk of malaria infection in individuals living with index cases, and were included in the meta-analysis. Individuals living in index case households with an average risk of 2.576 (2.540–2.612) were more at risk of malaria infection and showed pooled results of high variation heterogeneity chi-square = 235.600, (p < 0.0001) I2 = 98.88 [97.87–99.89]. The pooled results showed that neighbors of index cases were 0.352 [0.301–0.412] times more likely to have a malaria infection relative to index case household members, and this result was statistically significant (p < 0.001). The identification and treatment of infectious reservoirs is critical to successful malaria elimination. Evidence to support the clustering of infections in neighborhoods, which necessitates the inclusion of neighboring households as part of the RACD strategy, was presented in this review.
The COVID-19 pandemic has highlighted the critical need for accurate and efficient diagnostic tools for detecting severe acute respiratory coronavirus 2 (SARS-CoV-2) infections. This study presents a comparison of two diagnostic tests: RT-PCR and antigen detection rapid diagnostic tests (Ag-RDTs). This study focused on their performance, variant specificity, and their clinical implications. A simultaneous testing of 268 samples was carried out for SARS-CoV-2 using RT-PCR and Ag-RDTs [flourescence immunoassay (FIA) and lateral flow immunoassay (LFIA)]. Viral load was quantified, and variant identification was performed using a PCR-based assay. The prevalence was found to be 30.2% using reverse transcription PCR (RT-PCR), 26.5% using FIA, and 25% using LFIA. When comparing the FIA and LFIA, the overall diagnostic performance was found to be 80.25% vs 76.54%, 96.79% vs 97.33%, 91.55% vs 90.51%, and 91.88% vs 92.56% for sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), respectively. Both Ag-RDTs showed a strong agreement with RT-PCR (κ = 0.78–0.80). The overall accuracies of the FIA and LFIA were 92.41% and 92.13%, respectively. The FIA showed higher sensitivity (73.68%) and PPV (92.08%) than the LFIA (65.79% and 90.56%, respectively) in asymptomatic patients. At low Ct values ( 30. The diagnostic sensitivity of FIA compared to LFIA for detecting the Alpha variant was 78.85% vs. 69.23% and 72.22% vs. 83.33% for the Delta variant. Both Ag-RDTs had 100% sensitivity for detecting Omicron. Both Ag-RDTs performed well in patients with high viral loads and Omicron variant infections compared to those infected with Alpha and Delta variants. This study confirms the comparable performance of RT-PCR and Ag-RDTs, specifically FIA and LFIA, for SARS-CoV-2 detection. The FIA showed higher sensitivity and PPV in asymptomatic cases, while both Ag-RDTs exhibited strong agreement with RT-PCR results. Notably, Ag-RDTs, particularly FIA, proved effective in detecting the Omicron variant and cases with high viral loads, highlighting their potential clinical utility in managing the COVID-19 pandemic. IMPORTANCE: This study is of utmost importance in providing effective responses to manage the COVID-19 pandemic. It rigorously compares the diagnostic accuracy, variant specificity, and practical considerations of reverse transcription PCR (RT-PCR) and antigen detection rapid diagnostic tests (Ag-RDTs) for severe acute respiratory coronavirus 2 (SARS-CoV-2), answering critical questions. The results of this study will help healthcare professionals choose the appropriate testing methods, allocate resources effectively, and enhance public health strategies. Given the evolution of the virus, understanding the performance of these diagnostic tools is crucial to adapting to emerging variants. Additionally, the study provides insights into logistical challenges and accessibility issues, which will contribute to refining testing workflows, particularly in resource-limited settings. Ultimately, the study’s impact extends to global healthcare, providing valuable information for policymakers, clinicians, and public health officials as they work together for mitigating the impact of the pandemic.
Bacterial noncoding RNAs (ncRNA) regulate diverse cellular processes, including virulence and environmental fitness. The malS 5′ untranslated region (named malS-5′UTR) was identified as a regulatory ncRNA that increases the invasive capacity of Salmonella enterica serovar Typhi. An IntaRNA search suggested base pairing between malS-5′UTR and hisG mRNA, a key gene in the histidine biosynthetic pathway. Overexpression of malS-5′UTR markedly reduced bacterial growth in minimal medium without histidine. Overexpression of malS-5′UTR increased mRNA from his operon genes, independently of the bax gene, and decreased HisG protein in Salmonella Typhi. RNA structure analysis showed base pairing of the malS-5′UTR RNA with the hisG mRNA across the ribosome binding site. Thus, we propose that malS-5′UTR inhibited hisG translation, probably by base pairing to the Shine–Dalgarno sequence.
Background. In Ghana, Cymbopogon citratus leaves together with guava, pawpaw, and lime are processed into a decoction to treat fever. To encourage its usage, preclinical validation of the safety profile of the plant is required. The acute and subchronic toxicities of the conventional Soxhlet ethanolic Cymbopogon citratus leaves extract in Sprague–Dawley rats were investigated. Methods. Pulverized Cymbopogon citratus leaves were extracted with 98% ethanol using the conventional Soxhlet extraction (CSE) method and dried. In the acute toxicity study, a single dose of 5000 mg/kg body weight was administered to six female Sprague–Dawley rats and 1 ml/100 g body weight normal saline to control (6) once, and signs of toxicity were observed every hour for the first 12 hr, 24 hr, and 48 hr through to 14 days. In the subchronic study, the treatment groups were administered 200 mg/kg, 600 mg/kg, and 1200 mg/kg, respectively, of the CSE C. citratus leaves extract for six weeks. Analyses were conducted on the blood, urine, and serum samples of the rats. Histopathological examination of the liver, heart, kidney, spleen, and lungs was carried out at termination. Analysis of variance (ANOVA) was performed to determine statistically significant differences between the test and control rats at . Results. The results revealed that there were no statistically significant differences ( ) in the urinalysis and haematological analysis between control and test rats over the treatment period. Similarly, CSE C. citratus leaves extract did not induce any significant biochemical changes in the treatment group; however, there was a weight loss effect on the treated rats. There were no noticeable morphological changes in the heart, liver, spleen, lung, and kidney of the test rats compared to the control. Conclusion. CSE ethanolic C. citratus leaves extract has a weight loss effect, and long-term administration of the extract may not cause any organ-specific toxicity to the consumers.
Introduction: Antibiotic resistance (ABR) is a global health crisis and a significant public health challenge in Ghana. This narrative review aims to uncover the patterned landscape of ABR by systematically assessing regional heterogeneity across three key dimensions: (1) the geographic distribution and intensity of ABR surveillance and research; (2) the prevalence of ESKAPEE pathogens ( Enterococcus faecium , Staphylococcus aureus , Klebsiella pneumoniae , Acinetobacter baumannii , Pseudomonas aeruginosa , Enterobacter species, and Escherichia coli ); and (3) the distribution of their antimicrobial resistance profiles and underlying genetic mechanisms. The review maps data from clinical, animal, and environmental sources to provide a comprehensive sub-national picture. Methods: Four online databases (PubMed, Scopus, Web of Science, and African Journals Online) were searched for relevant articles published from 2016 to 2025, a timeframe chosen to align with the development and implementation of Ghana’s first National Action Plan (NAP) on AMR (2017–2021). A narrative synthesis was conducted to collate, analyze, and map regional data on ESKAPEE pathogen prevalence, resistance patterns, and underlying genetic mechanisms. Results: A total of 48 studies met the inclusion criteria. The findings reveal a significant disparity in research coverage, with a heavy concentration of studies in the Greater Accra (35.4%) and Ashanti (18.6%) regions. Widespread multidrug resistance was evident across all studied regions, with E. coli and K. pneumoniae consistently showing high resistance (>70%) to common antibiotics like ampicillin and third-generation cephalosporins. The review documents the emergence of critical carbapenemase genes (including blaNDM-1 and blaOXA-48 ), a notable prevalence of methicillin-resistant S. aureus (MRSA), and the detection of the colistin resistance gene mcr-1 in animal sources. Significant heterogeneity in study design and methodology was observed across the included literature. Conclusion: ABR in Ghana presents as a patterned landscape rather than a uniform national profile. Stark regional disparities and major surveillance gaps create “blind spots” that can hinder the effective implementation of national policy. Addressing this requires prioritizing surveillance in under-studied regions and standardizing methodologies. Furthermore, region-specific control strategies must be developed using a “One Health” approach, one that integrates surveillance and stewardship interventions across human healthcare, agricultural, and environmental sectors.