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In 2023, Africa experienced 180 public health emergencies, of which 90% were infectious diseases and 75% were related to zoonotic diseases. Testing capacity for epidemic-prone diseases is essential to enable rapid and accurate identification of causative agents, and for action to prevent disease spread. Moreover, testing is pivotal in monitoring disease transmission, evaluating public health interventions and informing targeted resource allocation during outbreaks. An online, self-assessment survey was conducted in African Union Member States to identify major challenges in testing for epidemic-prone diseases. The survey assessed current capacity for diagnosing priority epidemic-prone diseases at different laboratory levels. It explored challenges in establishing and maintaining testing capacity to improve outbreak response and mitigate public health impact. Survey data analysed diagnostic capacity for priority infectious diseases, diagnostic technologies in use, existing surveillance programmes and challenges limiting diagnostic capacity, by country. The survey result from 15 Member States who responded to the survey, showed high variability in testing capacity and technologies across countries and diverse factors limiting testing capacity for certain priority diseases like dengue and Crimean-Congo haemorrhagic fever. At the same time diagnostic capacity is better for coronavirus disease 2019 (COVID-19), polio, and measles due to previous investments. Unfortunately, many countries are not utilizing multiplex testing, despite its potential to improve diagnostic access. The challenges of limited laboratory capacity for testing future outbreaks are indeed significant. Recent disease outbreaks in Africa have underscored the urgent need to strengthen diagnostic capacity and introduce cost-effective technologies. Small sample sizes and differing disease prioritisation within each country limited the analysis. These findings suggest the benefits of evaluating laboratory testing capacity for epidemic-prone diseases and highlight the importance of effectively addressing challenges to detect diseases and prevent future pandemics.

Background. Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. Uganda confirmed the first case of COVID-19 on 21st March, 2020, which led to the first total lockdown in the country. During the lockdown, some factories remained operational; hence, there is a need for a study aimed at assessing the level of adherence to COVID-19 standard operating procedures (SOPs) in factories as a mitigator for the pandemic. Methods. A cross-sectional study to assess compliance of factories to COVID-19 SOPs was conducted in Wakiso, Mukono, Buikwe, and Jinja districts during the month of September, 2021. This involved visitation of factories and collection of data using the KoboCollect tool by interviewing general managers as well as human resource managers of the factories. A total of 39 factories were included in the study and were categorized into four major groups; food and beverages (15), plastics (5), construction (8), and others (11). Data analysis was done using STATA version 14.2. Results. Overall adherence to COVID-19 SOPs by the factories was 64.1% (95% CI = 49.1–79.1). Communication and training of employees (79.5%; 95% CI = 66.8–92.2), wearing personal protective equipment (PPE), and respiratory protection (79.5%; 95% CI = 66.8–92.2) as well as enhanced cleaning and disinfection of surfaces (74.4%; 95% CI = 60.6–88.1) were the most implemented SOPs in the factories. Implementation of the SOPs was the highest in Mukono district (88.9%; 95% CI = 68.4–100) and the least in Wakiso district (40.0%; 95% CI = 9.6–70.4). The COVID-19 SOPs were followed mostly in construction material factories (87.5%; 95% CI = 64.6–100) and least in food and beverage factories (40%; 95% CI = 15.2–64.8). There was no significant difference in the adherence of COVID-19 SOPs among the districts (X2 = 5.02 and P=0.17) and factories (X2 = 7.04 and P=0.07). Although good overall adherence to SOPs noted was not dependent on location and type of factory, adherence to some SOPs such as exposure control plan, presence of signages on COVID-19, maintenance of social distance, and implementation of a health control plan varied with location of the district. Likewise, exposure control plan, signages on COVID-19, and maintenance of social distance varied significantly with the type of factory. Conclusion. This study revealed moderately good overall adherence to COVID-19 SOPs by factories, with variations in the level of implementation of individual SOPs being observed.

In 2023, Africa experienced 180 public health emergencies, of which 90% were infectious diseases and 75% were related to zoonotic diseases. Testing capacity for epidemic-prone diseases is essential to enable rapid and accurate identification of causative agents, and for action to prevent disease spread. Moreover, testing is pivotal in monitoring disease transmission, evaluating public health interventions and informing targeted resource allocation during outbreaks. An online, self-assessment survey was conducted in African Union Member States to identify major challenges in testing for epidemic-prone diseases. The survey assessed current capacity for diagnosing priority epidemic-prone diseases at different laboratory levels. It explored challenges in establishing and maintaining testing capacity to improve outbreak response and mitigate public health impact. Survey data analysed diagnostic capacity for priority infectious diseases, diagnostic technologies in use, existing surveillance programmes and challenges limiting diagnostic capacity, by country. The survey result from 15 Member States who responded to the survey, showed high variability in testing capacity and technologies across countries and diverse factors limiting testing capacity for certain priority diseases like dengue and Crimean-Congo haemorrhagic fever. At the same time diagnostic capacity is better for coronavirus disease 2019 (COVID-19), polio, and measles due to previous investments. Unfortunately, many countries are not utilizing multiplex testing, despite its potential to improve diagnostic access. The challenges of limited laboratory capacity for testing future outbreaks are indeed significant. Recent disease outbreaks in Africa have underscored the urgent need to strengthen diagnostic capacity and introduce cost-effective technologies. Small sample sizes and differing disease prioritisation within each country limited the analysis. These findings suggest the benefits of evaluating laboratory testing capacity for epidemic-prone diseases and highlight the importance of effectively addressing challenges to detect diseases and prevent future pandemics., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Ashenafi, Sule, Peter, Mashate, Otieno, Kebede, Oio, Kao, Carter, Whistler, Ndlovu and Kebede.)

Lightweight and strong ceramic materials are attractive for tissue engineering, aerospace, armor systems, and many high-temperature applications. Cuttlebone, primarily composed of bioceramics, features a unique S-shaped wall structure that contributes significantly to its remarkable mechanical properties. Here, we explore the hierarchical structure and components of the cuttlebone and reveal the high ceramic content in S-shaped walls. Inspired by the design of the cuttlebone, we developed a high ceramic loading slurry for three-dimensional printing cuttlebone-like structures. As shown in the compression test, the fabricated bioinspired ceramics exhibit excellent mechanical properties and can withstand 1.07 million times their own weight, outperforming traditional ceramic foams. The specific strength and modulus are 59.5 and 785.6 MPa/(g cm -3 ), 9 and 36 times that of the natural cuttlebone. The failure mechanisms are also systematically studied on the basis of tuning the structural parameters. These findings provide effective solutions and inspiration in fabricating high-performance ceramic structural materials.

In the quest for heightened protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants, we engineered a prototype vaccine utilizing the plant expression system of Nicotiana benthamiana, to produce a recombinant SARS-CoV-2 virus-like particle (VLP) vaccine presenting the S-protein from the Beta (B.1.351) variant of concern (VOC). This innovative vaccine, formulated with either a squalene oil-in-water emulsion or a synthetic CpG oligodeoxynucleotide adjuvant, demonstrated efficacy in a golden Syrian Hamster challenge model. The Beta VLP vaccine induced a robust humoral immune response, with serum exhibiting neutralization not only against SARS-CoV-2 Beta but also cross-neutralizing Delta and Omicron pseudoviruses. Protective efficacy was demonstrated, evidenced by reduced viral RNA copies and mitigated weight loss and lung damage compared to controls. This compelling data instills confidence in the creation of a versatile platform for the local manufacturing of potential pan-sarbecovirus vaccines, against evolving viral threats., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Background and Aims: Pulmonary rehabilitation (PR) improves dyspnoea, fatigue and healthcare-related quality of life (QoL) in patients with chronic lung disease (CLD). Non-English-speaking background (NESB) patients face language and cultural barriers that hinder their access to PR programmes, contributing to health disparities. Our trial aimed to demonstrate the effectiveness and feasibility of a Chinese language-specific PR programme on lung function, functional exercise capacity and QoL measures., Methods: A prospective cohort study was conducted over a 2-year period. Participants were enrolled in an 8-week PR programme with biweekly sessions conducted by Chinese-speaking physiotherapists. Baseline and post-rehabilitation testing included pulmonary function testing, 6-min walk test (6MWT), St. George Respiratory Questionnaire (SGQR) and Short Form Health Survey (SF-36)., Results: We enrolled 76 patients (58% male) with a median age of 77 years (interquartile range (IQR) 68-81) and achieved a completion rate of 86.8% (n = 66). CLD included chronic obstructive pulmonary disease (42%), asthma (15%) and interstitial lung disease (3%). Baseline median forced expiratory volume in 1 s (FEV1) was 1.63 L (IQR 1.17-2.05), and the median 6MWT was 282 m (IQR 232-332). Post-intervention median 6MWT increased to 332 m (IQR 290-390), and the median FEV1 was 1.99 L (IQR 1.3-2.1). Both QoL measures (SGQR and SF-36) showed significant improvement after intervention (P < 0.05)., Conclusion: Our study demonstrates that a language-specific PR programme is feasible, improving outcomes in NESB patients with CLD. The improvement in 6MWT and QoL measures was comparable to English-based programmes. Ensuring equal access to healthcare programmes, regardless of cultural background or language barriers, is crucial in promoting health equity., (© 2023 The Authors. Internal Medicine Journal published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Physicians.)

Background: Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV-2 virus. Uganda confirmed the first case of COVID-19 on 21st March, 2020, which led to the first total lockdown in the country. During the lockdown, some factories remained operational; hence, there is a need for a study aimed at assessing the level of adherence to COVID-19 standard operating procedures (SOPs) in factories as a mitigator for the pandemic., Methods: A cross-sectional study to assess compliance of factories to COVID-19 SOPs was conducted in Wakiso, Mukono, Buikwe, and Jinja districts during the month of September, 2021. This involved visitation of factories and collection of data using the KoboCollect tool by interviewing general managers as well as human resource managers of the factories. A total of 39 factories were included in the study and were categorized into four major groups; food and beverages (15), plastics (5), construction (8), and others (11). Data analysis was done using STATA version 14.2., Results: Overall adherence to COVID-19 SOPs by the factories was 64.1% (95% CI = 49.1-79.1). Communication and training of employees (79.5%; 95% CI = 66.8-92.2), wearing personal protective equipment (PPE), and respiratory protection (79.5%; 95% CI = 66.8-92.2) as well as enhanced cleaning and disinfection of surfaces (74.4%; 95% CI = 60.6-88.1) were the most implemented SOPs in the factories. Implementation of the SOPs was the highest in Mukono district (88.9%; 95% CI = 68.4-100) and the least in Wakiso district (40.0%; 95% CI = 9.6-70.4). The COVID-19 SOPs were followed mostly in construction material factories (87.5%; 95% CI = 64.6-100) and least in food and beverage factories (40%; 95% CI = 15.2-64.8). There was no significant difference in the adherence of COVID-19 SOPs among the districts ( X 2  = 5.02 and P =0.17) and factories ( X 2  = 7.04 and P =0.07). Although good overall adherence to SOPs noted was not dependent on location and type of factory, adherence to some SOPs such as exposure control plan, presence of signages on COVID-19, maintenance of social distance, and implementation of a health control plan varied with location of the district. Likewise, exposure control plan, signages on COVID-19, and maintenance of social distance varied significantly with the type of factory., Conclusion: This study revealed moderately good overall adherence to COVID-19 SOPs by factories, with variations in the level of implementation of individual SOPs being observed., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2024 Joseph M. Kungu et al.)