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Visceral leishmaniasis (VL) is a neglected tropical disease caused by parasites from the Leishmania (L.) donovani complex. VL is characterised by uncontrolled parasite replication in spleen, liver and bone marrow, and by an impaired immune response and high systemic levels of inflammation. Monocytes have been poorly characterised in VL patients. The aim of this study was to evaluate the expression levels of markers involved in the regulation of T cell responses on different subsets of monocytes from the blood of VL patients and healthy non-endemic controls (HNEC). Monocytes can broadly be divided into three subsets: classical, intermediate and non-classical monocytes. Our results show that the percentages of all three subsets stay similar at the time of VL diagnosis (ToD) and at the end of anti-leishmanial treatment (EoT). We first looked at co-stimulatory receptors: the expression levels of CD40 were significantly increased on classical and intermediate, but not non-classical monocytes, at ToD as compared to EoT and HNEC. CD80 expression levels were also increased on intermediate monocytes at ToD as compared to EoT and HNEC, and on classical monocytes only as compared to HNEC. The levels of CD86 were similar at EoT and ToD and in HNEC on classical and intermediate monocytes, but significantly higher at EoT on non-classical monocytes. We also looked at an inhibitory molecule, PD-L1. Our results show that the expression levels of PD-L1 is significantly higher on all three monocyte subsets at ToD as compared to HNEC, and to EoT on classical and intermediate monocytes. These results show that monocytes from the blood of VL patients upregulate both co-stimulatory and inhibitory receptors and that their expression levels are restored at EoT. Author summary: Visceral leishmaniasis (VL) is a neglected tropical disease caused by Leishmania parasites. VL is characterised by uncontrolled parasite replication in internal organs and is often fatal if untreated. Monocytes are part of a group of cells called white blood cells. These cells can become activated and play an important role against infections. They have been poorly characterised in VL patients. The aim of this study was to evaluate the expression levels of markers of activation on different subsets of monocytes from the blood of VL patients and healthy non-endemic controls (HNEC). We assessed the expression levels of monocyte markers that are essential for activating and regulating the immune response. Our results how that these are increased on some monocyte subsets at the time of diagnosis as compared to the end of treatment and HNEC. We also looked at a marker that can inhibit the immune response and show that it is highly expressed at the time of diagnosis as compared to the end of treatment and HNEC. These results show that monocytes from the blood of VL patients upregulate both activating and inhibitory receptors and that their expression levels are restored at the end of treatment. [ABSTRACT FROM AUTHOR]

Cutaneous leishmaniasis (CL) is a neglected tropical disease caused by Leishmania parasites, that can cause long-term chronic disabilities. The clinical presentation of CL varies in both type and severity. CL presents as three main clinical forms: localised lesions (localised cutaneous leishmaniasis, LCL); mucocutaneous leishmaniasis (MCL) that affects the mucosa of the nose or the mouth; or as disseminated not ulcerating nodules (diffuse cutaneous leishmaniasis, DCL). Here we recruited a cohort of CL patients in a newly established leishmaniasis treatment centre (LTC) in Lay Gayint, Northwest Ethiopia, and collected detailed demographic and clinical data. The results of our study show that more males than females present to the LTC to seek diagnosis and treatment. 70.2% of CL patients presented with LCL and 20.8% with MCL. A small number of patients presented with DCL, recidivans CL (a rare form of CL where new lesions appear on the edges of CL scars) or with a combination of different clinical presentations. The duration of illness varied from 1 month to 180 months. Over a third of CL patients had additional suspected CL cases in their household. Despite the majority of CL patients having heard about CL, only a minority knew about its transmission or that it could be treated. Most CL patients lived in areas where environmental factors known to be associated with the transmission of CL were present. This work highlights that CL is an important public health problem in Lay Gayint and emphasises the urgent need for more CL awareness campaigns, better health education and better disease management practices. Author summary: Cutaneous leishmaniasis (CL) is a neglected tropical disease caused by species of the Leishmania parasite. It causes skin lesions that can be categorised into three main clinical presentations: i) localised cutaneous leishmaniasis (LCL), with one or several ulcerated lesions; ii) mucocutaneous leishmaniasis (MCL) that affects the mucosa of the nose or the mouth; iii) disseminated CL (DCL), that is characterised by widespread nodules. While LCL usually heals spontaneously, MCL and DCL require treatment; and patients often experience relapses. CL leaves disfiguring scars, that can result in societal stigmatisation. In this study, we recruited a cohort of CL patients in a newly established leishmaniasis treatment centre (LTC) in Lay Gayint, Northwest Ethiopia, and collected detailed demographic and clinical data. We found that most CL patients presented with LCL, followed by MCL, and that more males than females present to the LTC. The duration of illness varied from 1 to 180 months. Over a third of CL patients had additional suspected CL cases in their home. Despite most patients having heard about CL, only a minority knew about its transmission or that it could be treated. This work emphasises that CL is an important public health problem in this area of Ethiopia. [ABSTRACT FROM AUTHOR]

Background. Schistosomiasis is a common public health problem throughout the world and Schistosoma mansoni is the most prevalent species in Africa. Most endemic countries use the Kato–Katz (KK) stool smear examination for diagnosis, mapping, and monitoring of intervention programs. However, its poor sensitivity calls for an urgency to evaluate and use more accurate diagnostic tools, of which detection of circulating cathodic antigen (CCA) in urine seems promising. Methods. Studies published until May 2022 were searched from PubMed, Google Scholar, and grey literature for systematic review and meta‐analysis following the PRISMA guideline. Eligible studies were selected based on preset inclusion and exclusion criteria. Quality of included studies was assessed using the QUADAS‐2 tool. Heterogeneity between studies was assessed using Cochrane Q test and I2 test statistics. Data were analyzed using Review Manager 5.4.1 and Meta‐DiSc 1.4 software programs. Results. Thirty‐seven studies published in 29 papers and enrolling 21159 study participants were included for analysis. Overall analysis of Point‐of‐Care Circulating Cathodic Antigen (POC‐CCA) test against KK reference standard revealed a pooled sensitivity and specificity of 0.86 (95% CI: 0.85–0.87) and 0.66 (95% CI: 0.65–0.67), respectively. Subgroup analysis among 24 studies comparing single POC‐CCA with test single KK revealed a high sensitivity (0.88) but low specificity (0.66). Based on findings of 24 studies, the area under the curve (AUC) for the systematic receiver operating characteristic (SROC) curve was 0.7805, indicating that the POC‐CCA test effectively separates those with the disease from those who do not have it. Higher sensitivity estimates of 0.93 and 0.90 were reported when comparisons were made between test results of 2 urine and 1 stool samples, and 3 urine and 3 stool samples, respectively. Single POC‐CCA test resulted in a pooled sensitivity estimate of 0.81 (95% CI: 0.78–0.84) as evaluated by the polymerase chain reaction (PCR) reference test. Conclusions. The POC‐CCA test has higher sensitivity than KK and may serve as a routine diagnostic alternative for disease diagnosis, mapping, and monitoring of interventions. However, its accuracy should further be evaluated at different transmission settings and infection intensity. [ABSTRACT FROM AUTHOR]

Background: We aimed to analyze a four-year trend of Cutaneous leishmaniasis (CL) to determine risk levels and hotspots in North-central Ethiopia. Methods: This retrospective study was conducted at Boru Meda Hospital (BMH) from March to April 2023, focusing on CL patients treated at the leishmaniasis treatment center (LTC). Data collected included age, gender, CL type, and other clinical factors. Each patient's origin was traced and geographically mapped by elevation to assess CL risk levels. Results: There were a total of 573 CL patients reported from 46 districts, with a higher number of male patients (n=356) compared to female patients (n=217) (P <0.001). The median age of the patients was 21 years [15-30], with the highest number of CL cases observed among individuals aged 16 to 30 years. The majority of cases (69%) presented with localized CL (LCL). About 39% of patients had a previous treatment history for CL. A significant clustering of CL cases was observed at elevation of 2301-3300 meters above sea level (χ²:17.5; P <0.001), with the highest incidence (case notification) of 14.2/100,000 population. Conclusion: Foci of CL, were burdened at higher elevations and no clinical variation were observed between elevation differences. The majority of cases were concentrated in an area covering approximately 21.4% of the total land mass. CL continues to be a significant issue in North-central Ethiopia and has the potential to spread to new areas. [ABSTRACT FROM AUTHOR]

Pre-eclampsia (PE) is a pregnancy-related disorder characterized by hypertension and proteinuria occurring after 20 weeks of gestation. Several studies have been performed to determine the serum magnesium (Mg) level in PE, but most report inconclusive results. Consequently, this study was designed to resolve this controversy among African women. PubMed, Hinari, Google Scholar and African Journals Online electronic databases were searched for studies published in English. The qualities of included articles were appraised using the Newcastle–Ottawa quality assessment tool. Stata 14 software was utilized for analysis and serum Mg levels in cases and normotensive controls were compared through mean and standardized mean difference (SMD) at the 95% confidence interval (CI). In this review, we found that the mean serum Mg level was significantly reduced in cases (0.910±0.762 mmol/L) vs controls (1.167±1.060 mmol/L). The pooled SMD of serum Mg was significantly lower in cases (−1.20 [95% CI −1.64 to −0.75]). Therefore, since serum Mg is reduced in cases vs controls, we propose that Mg is involved in the pathophysiology of PE. Nevertheless, to know the exact mechanisms of Mg in PE development will require large-scale prospective studies. [ABSTRACT FROM AUTHOR]