Chronic anemia is more prevalent in people living with HIV (PLWH) compared to the general population. The mechanisms that drive chronic anemia in HIV are multifaceted and include functional impairment of hematopoietic stem cells, dysregulation of erythropoietin production, and persistent immune activation. Chronic inflammation from HIV infection adversely affects erythropoiesis, erythrocyte lifespan, and erythropoietin response, leading to a heightened risk of co-infections such as tuberculosis, persistent severe anemia, and increased mortality. Additionally, chronic anemia exacerbates the progression of HIV-associated nephrotoxicity and contributes to cardiovascular risk through immune activation and inflammation. This review highlights the cardinal role of chronic inflammation as a link connecting persistent anemia and cardiovascular complications in PLWH, emphasizing the need for a universal understanding of these interconnected pathways for targeted interventions.

The malignant phenotype of tumour cells is fuelled by changes in the expression of various transcription factors, including some of the well-studied proteins such as p53 and Myc. Despite significant progress made, little is known about several other transcription factors, including ELF4, and how they help shape the oncogenic processes in cancer cells. To this end, we performed a bioinformatics analysis to facilitate a detailed understanding of how the expression variations of ELF4 in human cancers are related to disease outcomes and the cancer cell drug responses. Here, using ELF4 mRNA expression data of 9,350 samples from the Cancer Genome Atlas pan-cancer project, we identify two groups of patient’s tumours: those that expressed high ELF4 transcripts and those that expressed low ELF4 transcripts across 32 different human cancers. We uncover that patients segregated into these two groups are associated with different clinical outcomes. Further, we find that tumours that express high ELF4 mRNA levels tend to be of a higher-grade, afflict a significantly older patient population and have a significantly higher mutation burden. By analysing dose-response profiles to 397 anti-cancer drugs of 612 well-characterised human cancer cell lines, we discover that cell lines that expressed high ELF4 mRNA transcript are significantly less responsive to 129 anti-cancer drugs, and only significantly more response to three drugs: dasatinib, WH-4-023, and Ponatinib, all of which remarkably target the proto-oncogene tyrosine-protein kinase SRC and tyrosine-protein kinase ABL1. Collectively our analyses have shown that, across the 32 different human cancers, the patients afflicted with tumours that overexpress ELF4 tended to have a more aggressive disease that is also is more likely more refractory to most anti-cancer drugs, a finding upon which we could devise novel categorisation of patient tumours, treatment, and prognostic strategies.

AimThis study aimed to assess the awareness and acceptance of COVID-19 vaccines and associated factors among pharmacy studentsin Zambia.Materials and MethodsWe conducted a cross-sectional study among 326 undergraduate pharmacy students in Lusaka, Zambia, from February to April 2021.Data were analysed using Stata version 16.1. Multivariable logistic regression was used to determine key factors influencing vaccineacceptance.ResultsOf the 326 participants, 98.8% were aware of the COVID-19 vaccines, but only 24.5% would accept vaccination. Compared to otherreligions, being of Christian faith was associated with reduced odds of awareness of the COVID-19 vaccine (aOR=0.01, 95% CI:0.01-0.20). Conversely, factors associated with vaccine acceptance were being male, single and unemployed. Compared to females,male respondents were 86% more likely to accept the vaccine if it was made available (aOR=1.86, 95% CI: 1.10-3.14). In addition,unmarried respondents were 2.65 times as likely to accept vaccination than married respondents (aOR=2.65, 95% CI: 1.06-6.63).Conversely, unemployed respondents were less likely to accept vaccination than their employed counterparts (aOR=0.32, 95% CI:0.16-0.46). Barriers to the acceptability of the vaccine were possible side effects (78.5%) and scepticism about its effectiveness(10.2%).ConclusionThere was significant vaccine hesitancy toward COVID-19 vaccines among Zambian pharmacy students despite their awarenessof the vaccines. Health authorities must work collaboratively with training institutions to mitigate vaccine hesitancy, especially withhealthcare students being a key part of the future healthcare workforce overseeing disease prevention strategies.

As COVID-19 vaccines are becoming more available, there is also a growing need to understand the population receiving the doses, existing inequalities and the intention to getting the second vaccine dose among the populations that receive the vaccines. We evaluated gender inequalities and intention to uptake of the second dose of COVID-19 AstraZeneca vaccine among adult populations in selected urban facilities of Lusaka, Zambia. A cross-sectional study design was conducted between May and June 2021 among adults who received AstraZeneca vaccine from three selected urban facilities of Lusaka, Zambia. Phone-based interviews were conducted 6 weeks after the first dose of the vaccine. Descriptive analysis and mixed-effect logistic regression were done using STATA version 16.2. Of the 1321 adults who had received AstraZeneca vaccine, 868 respondents completed the questionnaire. About, 47% (408/868) were females and 53% (460/868) were males. Median age in the study was 40 years. Majority of males were educated (54%) and employed (57%). Furthermore, majority of females that got the first dose of AstraZeneca reported experiencing side effects (76.98%) compared to males (64.24%). Among study participants, 93.7% intended to receive the AstraZeneca vaccine, of whom 46.7% (380/814) were females and 52.9% (434/814) were males. Majority of participants that did not intend to get a second dose were not married (55.56%). Only age (AOR, 1.05; 95% CI, 1.02–1.08) predicted intention to getting a second dose of AstraZeneca vaccine. We found important gender-dependent differences in the side effects reported by females that received the first dose of Astra Zeneca. Finding that intention to get the second dose of the vaccine increased with age suggests a need for enhancing COVID-19 vaccination programmes targeting young people and a need for further research to identify specific adverse effects of COVID-19 Astra Zeneca vaccines.

Background: Neisseria gonorrhoeae, the causative agent for sexually transmitted infection (STI) gonorrhoea, has emerged with a significant public health impact on acquiring resistance to antimicrobials available for treatment. The resistance ofN. gonorrhoeaelimit treatment options and contributed to high morbidity associated with gonorrhoea. Data on antimicrobial resistance (AMR) profiles inN. gonorrhoeaeis scares in Zambia. This study aimed to determine the antibiotic susceptibilities inN. gonorrhoeaeisolates from Lusaka, Zambia.Methods: A prospective cross-sectional study was conducted on 630 STI patients who presented with urethral or vaginal discharge from 2019 to 2020. Urethral and endocervical secretions were cultured on Modified Thayer Martin agar and incubated at 36 °C ± 1 °C in 5% CO₂for 24 h. Identification ofN. gonorrhoeaeisolates was achieved by Gram stain, oxidase, nitrocefin disk, BactiCardNeisseria, and Viteck® Compact. The AMR profiles were determined using E-test. Statistical significant was determined by Pearson’s Chi-square test, Mann-Whitney U test, or logistic regression withp-values of < 0.05 indicating significance.Results: A total of 630 patients were recruited of which 46% (290/630) with the median of 29 years and interquartile range (IQR) of 19–39 years were male. The median of the females was 26 years and IQR of 15–37 years.Neisseria gonorrhoeaewas isolated from 19.4% (122/630) patients of which 72.9% (89/122) were male, with highest prevalence of isolation in the age category of 25–34 years. The prevalence of resistance was high to penicillin (85.2%), tetracycline (68.9%) and ciprofloxacin (59.8%) with MIC₉₀of 32 µg/mL, 8 µg/mL, and 8 µg/mL respectively. The isolates had reduced susceptibility to cefixime (1.6%), spectinomycin (4.9%) and (4.9%) for azithromycin. All isolates were susceptible to ceftriaxone. Risk factors associated with AMR were douching in females (AOR 6.69, 95% CI; 1.11–40.31,p = 0.039), female gender (AOR 7.64, 95% CI; 1.11–52.33,p = 0.048), HIV-positivity (AOR 26.59, 95% CI; 3.67–192.7,p = 0.005), no condom use or unprotected sex (AOR 5.48, 95% CI; 1.17–22.75p = 0.026), sex trading (AOR 4.19, 95% CI; 1.55–11.33,p = 0.010), and over-counter treatment of ciprofloxacin (AOR 3.44, 95% CI; 1.17–22.75,p = 0.023).Conclusion: TheN. gonorrhoeaeresistance to penicillin, tetracycline and ciprofloxacin was high necessitating revision of the treatment guidelines. However, no resistance to ceftriaxone was detected. Therefore, monitoring of antibiotic resistance remains critical in Zambia.

Background: In Zambia, before rotavirus vaccine introduction, the virus accounted for about 10 million episodes of diarrhoea, 63 000 hospitalisations and 15 000 deaths in 2015, making diarrhoea the third leading cause of death after pneumonia and malaria. In Zambia, despite the introduction of the vaccine acute diarrhoea due to rotaviruses has continued to affect children aged five years and below. This study aimed to characterise the rotavirus genotypes which were responsible for diarrhoeal infections in vaccinated infants aged 2 to 12 months and to determine the relationship between rotavirus strains and the severity of diarrhoea in 2016. Methods: Stool samples from infants aged 2 to 12 months who presented to the hospital with acute diarrhoea of three or more episodes in 24 hours were tested for group A rotavirus. All positive specimens that had enough sample were genotyped using reverse transcriptase Polymerase Chain Reaction (RT-PCR). A 20-point Vesikari clinical score between 1–5 was considered as mild, 6–10 as moderate and greater or equal to 11 as severe. Results: A total of 424 stool specimens were tested of which 153 (36%, 95% CI 31.5% to 40.9%) were positive for VP6 rotavirus antigen. The age-specific rotavirus infections decreased significantly (p = 0.041) from 2–4 months, 32.0% (49/118) followed by a 38.8% (70/181) infection rate in the 5–8 months’ category and subsequently dropped in the infants aged 9–12 months with a positivity rate of 27.2%. 38.5% of infants who received a single dose, 34.5% of those who received a complete dose and 45.2% (19/42) of the unvaccinated tested positive for rotavirus. The predominant rotavirus genotypes included G2P[6] 36%, G1P[8] 32%, mixed infections 19%, G2P[4] 6%, G1P[6] 4% and G9P[6] 3%. Discussion and conclusion: Results suggest breakthrough infection of heterotypic strains (G2P[6] (36%), homotypic, G1P[8] (32%) and mixed infections (19%) raises concerns about the effects of the vaccination on the rotavirus diversity, considering the selective pressure that rotavirus vaccines could exert on viral populations. This data indicates that the rotavirus vaccine has generally reduced the severity of diarrhoea despite the detection of the virus strains.