Background: Hearing-related disease is a significant cause of disability worldwide. In resource-limited settings, prevention and early detection are critical for preventing severe disease. Understanding what a population knows and believes with regards to hearing health can be critical in identifying knowledge gaps and developing targeted interventions. Objective: To assess community level awareness surrounding hearing health and the use of both modern and traditional treatments for otitis media (OM) to inform education programs. Methods: A retrospective review of clinical records from 52 patients (aged 1-79 years) diagnosed with OM during a 3-day hearing health clinic in Kasungu district, Malawi was conducted. Patients diagnosed with OM during the clinic were invited to provide additional details about their hearing health. Surveys contained open-ended questions to assess knowledge and beliefs regarding the cause of their infection and therapies they had previously used for treatment, including home remedies and prescribed medications from allopathic providers or traditional healers. A WHO adapted survey on hearing knowledge was also administered. Results: Hearing loss was identified in 60% of participants. Otoscopy revealed either bilateral or unilateral drainage in 69% of participants and perforation in 73%. Confidence in understanding the causes and treatments of OM was voiced by 60% of participants and 54% had used home remedies as treatment. Of the 11 home remedies used, none aligned with modern medical practice, and only two were recommended by local herbalists. Conclusions: Hearing-related disease contributes significantly to global disability, particularly in resource-limited settings. Educational campaigns to improve hearing health knowledge offer low-cost yet impactful solutions and implementation via partnerships with community leaders and traditional healers can be critical to addressing hearing health challenges. The use of non-antibiotic antimicrobials should be explored further as these are low-cost and readily available. However, therapeutic alliance between patients and healthcare providers remains crucial.

Introduction: Pulmonary echinococcosis, caused by the larval stage of Echinococcus granuloses, presents significant diagnostic challenges, often mimicking more common thoracic pathologies, such as lung cancer and bronchogenic cysts. This report underscores the importance of considering echinococcosis in differential diagnoses for lung lesions. Case Report: We discuss the case of a 24-year-old male, initially suspected to have an intrapulmonary bronchogenic cyst, later diagnosed with pulmonary echinococcosis. The diagnosis was established through a combination of radiological findings, surgical intervention, and pathological examination, highlighting the complexities involved in correctly identifying this parasitic infection. Conclusion: This case illustrates the critical need for heightened awareness and a comprehensive diagnostic approach to pulmonary echinococcosis, particularly in endemic areas. It emphasizes the role of detailed imaging and consideration of echinococcosis in the differential diagnosis of cystic lung lesions to prevent misdiagnosis and ensure appropriate treatment.

T follicular helper cells (Tfh) within germinal centers are among the most permissive cells for HIV infection and serve as a critical part of the viral reservoir. Given the key role of Tfh in affinity maturation and the production of plasma cells and memory B cells, an understanding of this critical viral reservoir is fundamental not only for cure strategies but also for understanding immunodeficiency in people living with HIV (PLWH). Using rare clinical specimens from PLWH, we demonstrate that HIV causes both a change in the cellular composition of germinal centers and changes in their overall architecture in ways that are consistent with the immunodeficiency seen in PLWH, independent of their CD4 count. We note a significant decrease in the number of GC Tfh cells and an increase in the number of follicular CD8 T cells in lymphoid tissues obtained from PLWH. Our data further show that GC size is decreased both by HIV and with increased age. Single-cell RNA sequencing data demonstrate that HIV acutely decreases the expression of Tfh B-cell support pathways and disrupts Tfh expression of cell trafficking receptors. Additionally, in a lymphoid organoid model of acute infection that forms GC-like structures, these findings are recapitulated, suggesting that New Approach Methodologies could be germane to understanding the impact of HIV on the reservoir and immunodeficiency. This study describes previously undocumented remodeling of the germinal center niche in PLWH, providing insight into the immune microenvironment of a key HIV reservoir that may help inform future cure strategies. Importance: Human immunodeficiency virus (HIV) is a chronic viral infection that affects more than 40 million people worldwide. Even with antiretroviral therapy, people living with HIV remain at increased risk for a variety of comorbidities and exhibit persistent immune dysfunction that may worsen with age. Understanding how HIV impacts key immune structures such as germinal centers is important for preventing or reversing these effects. This study reveals changes in germinal center composition and cellular function, including decreased T follicular helper cells and germinal center size, that may contribute to persistent immune dysfunction in people living with HIV. Our findings provide new insight into how HIV alters the lymphoid tissue microenvironment despite antiretroviral therapy and establish a lymphoid organoid model for investigating these changes, which may help identify new strategies to reduce HIV-associated morbidity.

Background: Hearing-related disease is a significant cause of disability worldwide. In resource-limited settings, prevention and early detection are critical for preventing severe disease. Understanding what a population knows and believes with regards to hearing health can be critical in identifying knowledge gaps and developing targeted interventions. Objective: To assess community awareness of hearing health and otitis media (OM) treatment, both modern and traditional, to inform educational programs. Methods: A retrospective review of clinical records from 52 patients (aged 1–79 years) diagnosed with OM during a 3-day hearing health clinic in Kasungu district, Malawi was conducted. Patients diagnosed with OM during the clinic were invited to provide additional details about their hearing health. Surveys contained open-ended questions to assess knowledge and beliefs regarding the cause of their infection and therapies they had previously used for treatment, including home remedies and prescribed medications from allopathic providers or traditional healers. A WHO adapted survey on hearing knowledge was also administered. Results: Hearing loss was identified in 60% of participants. Otoscopy revealed either bilateral or unilateral drainage in 69% of participants and perforation in 73%. Confidence in understanding the causes and treatments of OM was voiced by 60% of participants and 54% had used home remedies as treatment. Of the 11 home remedies used, none aligned with modern medical practice, and only two were recommended by local herbalists. Conclusions: Hearing-related disease contributes significantly to global disability, particularly in resource-limited settings. Educational campaigns to improve hearing health knowledge offer low-cost yet impactful solutions and implementation via partnerships with community leaders and traditional healers can be critical to addressing hearing health challenges. The use of nonantibiotic antimicrobials should be explored further, as these are low-cost and readily available. However, therapeutic alliance between patients and healthcare providers remains crucial.