Background: The World Health Organization (WHO) has classified carbapenem-resistant Enterobacteriaceae, Pseudomonas aeruginosa (P. aeruginosa), and Acinetobacter baumannii (A. baumannii) as high-priority pathogens, and carbapenem-resistant bacteria (CRB) have been reported to spread between humans, animals, and the environment. Objective: This study aimed to conduct a systematic review of carbapenem resistance in animals, foods, and the environment on the African continent and to provide recommendations and perspectives for better prevention and control of carbapenem resistance in Africa. Results: A total of 137 research articles collected from 2009 to 2023 were selected for this review, including articles reporting carbapenem-resistant bacteria in animals (81/137; 59.1%), the environment (66/137; 48.2%), and foods (26/137; 19%). Carbapenem-resistant bacterial species belonged to 31 genera and 17 families, including mainly Escherichia spp. (68/127; 53.5%); Klebsiella spp. (45/127; 35.4%); Pseudomonas spp. (20/127; 15.7%), Enterobacter spp. (19/127; 15%) and Acinetobacter spp. (15/127; 11.8%). The prevalence of CRBs by country ranged from 1.1% to 48.5%, and the pooled prevalence of CRBs isolated from animal-environment-food in Africa was 19.1% (2804/14,684; Standard Deviation = 15). Twenty carbapenemase families belonging to A, B, C, and D Ambler classes were reported, including mainly carbapenemase genes from bla_OXA (44/84; 52.4%), bla_NDM (34/84; 40.5%), bla_SHV (23/84; 27.4%), bla_KPC (22/84; 26.2%), bla_VIM (19/84; 22.6%), and bla_IMP (12/84; 14.3%) families. The reported mobile genetic elements (MGE) carrying carbapenemase-encoding genes included plasmids (16/19; 84.2%), integrons (3/19; 15.8%), transposons (3/19; 15.8%), and insertion sequences (2/19; 10.5%). bla_OXA-48 was often carried by (60kb-65kb) IncL/M-type pOXA-48 plasmids, while bla_NDM-5 was often carried by (45– 50kb) IncX-type plasmids. Moreover, 25 articles investigated and reported virulent and hypervirulent CRBs that carried multiple virulence factors. Conclusion: Animal-environment-food ecosystems would constitute reservoirs of CRBs involved in human infections. The One Health approach and constant collaboration between governments are necessary to drastically reduce the mortality rates linked to antimicrobial resistance.

In 2022, approximately 56.5% of adults and 47.1% of children and adolescents were affected by Helicobacter pylori (H. pylori) infection in Africa, and clarithromycin-resistant H. pylori (CRHp) strains have become global priority pathogens. Therefore, this study aimed to conduct the first comprehensive systematic review and meta-analysis of CRHp in Africa. This investigation was conducted according to the guidelines of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (The PRISMA 2020). Literature search of electronic databases (Google Scholar, African Journals Online, ResearchGate, PubMed, Embase, and Scopus) was performed using keywords “clarithromycin”, “Helicobacter pylori”, “African country name”, “mutation in the 23S rRNA”. Sixty-five studies involving 5,313 H. pylori strains isolated over 26 years (1997–2022) from 23 African countries were included in this study. The samples from which CRHp was isolated included gastric biopsy (60/63; 95%), and stool (4/63; 6%). The pooled prevalence of CRHp in Africa was 27% (95% CI: 22, 33). There was a steady trend in the prevalence of CRHp isolated in Africa over the 26 years (R2 = 0.0001, p = 0.92, slope coefficient of -0.05x). Ten types of 23S rRNA mutations (conferring clarithromycin resistance) were identified, and included mainly A2143G (465 H. pylori strains out of 1178 tested) and A2142G (344 H. pylori strains out of 1027). To enhance the accuracy and validity of surveillance data for H. pylori in Africa, there is an urgent need for implementing standardized microbiological methods for resistance detection. The prevalence of CRHp reported in this study was very similar to the overall global prevalence and there is a need for more representative studies on CRHp in Africa. While waiting for this, the treatment of H. pylori infections must be based on the guidelines of the AHMSG first Lagos consensus.

OBJECTIVES:The World Health Organization (WHO) has reported carbapenem-resistantEnterobacteriaceae(CRE), carbapenem-resistantAcinetobacter baumannii(CRAb), and carbapenem-resistantPseudomonas aeruginosa(CRPa) as critical priority pathogens for human health. Therefore, this study aimed to review clinical carbapenem resistance systematically and comprehensively in West Africa.DATA SOURCES:A total of 102 research articles on carbapenem resistance from the sixteen countries forming the West African region were included in this review.DATA SYNTHESIS:Carbapenem-resistant bacteria (CRB) were isolated mainly from urine 73/300 (24.3%) and pus/wounds of patients 69/300 (23%). The mean prevalence of CRB in West Africa was 4.6% (1902/41635), ranging from 1.6% to 18.6%. CRB identified were mainlyEscherichiaspp. (34/130; 26.1%),Klebsiellaspp. (27/130, 20.8%),Pseudomonasspp. (26/130, 20%), andAcinetobacterspp. (25/130; 19.2%). Bacteria isolated in West African countries produced carbapenemases that belong to the four Ambler classes and include 13 types. Thebla_OXA-type (34/104; 32.7%),bla_NDM(31/104; 29.8%), andbla_VIM(13/104; 12.5%) were the most common carbapenemase genes. These genes are carried by plasmids, composite transposons, and integrons. The Kirby-Bauer disc diffusion method (74/172; 43.0%), PCR (38/172; 22.1%), and whole genome sequencing (17/172; 9.9%) were the most common methods for carbapenem resistance detection. The most reported alternative antibiotics active against CRB were amikacin, colistin, and fosfomycin.CONCLUSION:There is an urgent need to take synergistic action to delay, as much as possible, the occurrence of CRB epidemics in West Africa.

Introduction: The longstanding presence of Sudanese refugees in Egypt—fueled by decades of political instability, conflict, and economic hardship in Sudan—has evolved with the recent 2023 crisis. This study investigates the living conditions, health status, and the impact of disabilities on healthcare access among newly displaced Sudanese in Egypt. Methods: A phone-based survey was administered to 531 Sudanese refugees. Descriptive statistics were first used to summarize the key demographic and household characteristics of the sample. The data was then analyzed using discriminant analysis to distinguish between families with and without healthcare challenges. Results: The sample had a mean age of 39.85 years, and the majority were female (75.5%), married (61.4%), and possessed a university-level education or higher (50.5%). On average, 4.92 family members migrated to Egypt with the respondent. The analysis revealed that chronic conditions such as spinal diseases and diabetes, along with the need for regular monthly treatment, were the strongest predictors of healthcare challenges among Sudanese refugee families. Additionally, disabilities including vision impairments, mobility difficulties, and intellectual disabilities were significantly associated with increased barriers to accessing healthcare services. Discussion: These findings underscore the compounded vulnerabilities of Sudanese refugees with disabilities and highlight the urgent need for targeted interventions to enhance healthcare accessibility and overall wellbeing. The results further stress the need for disability-sensitive health responses during refugee crises.

Tremors and rigid muscles are symptoms of Parkinson's disease (PD), which affects about 1% of the global population. To investigate the integrated therapeutic benefits of the phytopharmaceutical berberine and mucoadhesive nanoliposomes, administered via the nose-to-brain route, to enhance bioavailability, facilitate blood-brain barrier penetration, and augment efficacy against neurodegenerative progression in Parkinson's disease (PD). This study aimed to develop and characterize chitosan-decorated liposomes (chitosomes) loaded with berberine (BER) for targeted brain delivery via the intranasal route. In vitro characterization of BER loaded chitosomes was conducted including measurement of particle size, zeta potential, EE % and in vitro drug release. The optimized formulation was intranasally administered in rats with rotenone-induced PD animal model, motor function and coordination were investigated besides testing the levels of different biomarkers and histopathological examination. The prepared chitosomes had a particle size of 312 nm, zeta potential of 34 mV, and high encapsulation efficiency (89.3%) and sustained drug release. In vivo assessments conducted in a rotenone-induced PD animal model revealed notable improvements in motor function and coordination. Biochemical evaluations showed that BER chitosomes reduced α-synuclein by 49% and raised dopamine levels by 55% as compared to the model group. Additionally, BER chitosomes significantly decreased oxidative stress markers by a 67% decrease in NF-κB levels and a one-fold increase in Nrf2. Histological examination showed a noticeable reduction in neuronal degeneration and Lewy body formation. Our findings imply that BER chitosomes are a viable intranasal delivery tool for the efficient treatment of PD due to their enhanced bioavailability. and greater nasal mucosa penetration.

Gastroesophageal reflux disease (GERD) and its manifestation as reflux esophagitis (RE) involves mucosal inflammation and autonomic dysfunction. Vitamin D3 deficiency is increasingly implicated in gastrointestinal inflammation and immune imbalance. This study investigated the therapeutic and prophylactic effects of 1,25-dihydroxyvitamin D3 on esophageal inflammation and autonomic nervous system disruption in a non-surgical rat model of RE. RE was induced via intermittent fasting and refeeding. Rats received either no treatment, prophylactic vitamin D3 (1250 IU/day pre- and post-induction), or therapeutic vitamin D3 (post-induction only). We assessed esophageal histopathology, immunohistochemical expression of tumor necrosis factor α (TNF-α) and transforming growth factor β (TGF-β), serum interleukin 6 (IL-6) levels via ELISA, and heart rate variability (HRV) indices. RE rats exhibited characteristic mucosal damage, elevated IL-6 and TNF-α expression, and impaired HRV (reduced standard deviation of normal to normal intervals (SDNN), High frequency (HF); increased low frequency/high frequency ratio (LF/HF)). Vitamin D3 supplementation significantly reversed these alterations. Prophylactic administration showed superior efficacy in preserving mucosal integrity and autonomic function compared to therapeutic intervention. Notably, TNF-α expression was abolished and IL-6 was significantly reduced. 1,25-dihydroxyvitamin D3 exerts protective and therapeutic effects in RE through suppression of inflammatory cytokines and restoration of autonomic balance. These findings support its potential as a neuroimmune modulator in esophageal inflammatory diseases. Heart rate variability (HRV) was assessed as an autonomic marker, and correlations with cytokine levels were explored. Scale bars and schematic workflow diagrams were included for clarity. A Limitations section was added to acknowledge constraints such as absence of a DMSO control.