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This field study assessed the risk factors of pneumonia among under-5 male and female Sudanese children. The study was conducted in Omdurman Teaching Hospital within the duration 2016-2018. Children from both sexes (50 males and 50 females) who were diagnosed with pneumonia were included in the study. Data was collected using a questionnaire and interview with 100 care givers and mothers. Of those, sixty percent (60%) were illiterate or had primary school education. Forty percent (40%) had secondary or university education (p-value=0.034). Families who depend on natural ventilation were 60% compared to other methods (40%) with p- value=0.000. Children six months to one year were 42%, compared to other age groups (58%) with p-value= 0.000. Immunized children for pneumonia were 84% compared to the non-immunized (p-value=0.000). Vitamin A supplement was received by 86% with p value=0.000. Of the children, 61% were from families with less than 3 children compared to other families (14%) were p-value = 0.000. Unlike others, 62% of the care givers used traditional medicines with p-value = 0.009. Lack of exclusive breast feeding among infected children accounted for 80% compared to others with p-value = 0.000. Fever, cough and shortness of breath accounted for 46% compared to other symptoms with p-value = 0.000. It was concluded that poor educational level of care givers, low age group children, type of home ventilation, recurrent attacks, symptoms, lack of exclusive breast feeding and non-allopathic treatment are risk factors for contraction of pneumonia by under 5 children. Early presentation of the patients to hospital is a preventive measure for avoidance of contraction of pneumonia. Keywords: Pneumonia, risk factors, Sudanese children under 5 years, care givers., Introduction Pneumonia is the single largest infectious cause of death in children worldwide. It killed an estimated 920.136 under the age of five in 2015, accounting for 16% of all [...]

Modern medicine makes it possible for many people to live with multiple chronic diseases for decades, but this has enormous social, financial, and environmental consequences. Preclinical, epidemiological, and clinical trial data have shown that many of the most common chronic diseases are largely preventable with nutritional and lifestyle interventions that are targeting well-characterized signaling pathways and the symbiotic relationship with our microbiome. Most of the research priorities and spending for health are focused on finding new molecular targets for the development of biotech and pharmaceutical products. Very little is invested in mechanism-based preventive science, medicine, and education. We believe that overly enthusiastic expectations regarding the benefits of pharmacological research for disease treatment have the potential to impact and distort not only medical research and practice but also environmental health and sustainable economic growth. Transitioning from a primarily disease-centered medical system to a balanced preventive and personalized treatment healthcare system is key to reduce social disparities in health and achieve financially sustainable, universal health coverage for all. In this Perspective article, we discuss a range of science-based strategies, policies, and structural reforms to design an entire new disease prevention-centered science, educational, and healthcare system that maximizes both human and environmental health., Author(s): Luigi Fontana 1,2,3,*, Alessio Fasano 4,5, Yap Seng Chong 6,7, Paolo Vineis 8, Walter C. Willett 9,10 Environmental degradation, global warming, and rising pollution are impairing planetary health even [...]

: Introduction: Knowledge of HIV status relies on accurate HIV testing, and is the first step towards access to HIV treatment and prevention programmes. Globally, HIV‐status unawareness represents a significant challenge for achieving zero new HIV infections and deaths. In order to enhance knowledge of HIV status, the World Health Organisation (WHO) recommends a testing strategy that includes the use of HIV‐specific antibody point‐of‐care tests (POCT). These POCTs do not detect acute HIV infection, the stage of disease when viral load is highest but HIV antibodies are undetectable. Complicating things further, in the presence of antiretroviral therapy (ART) for pre‐exposure prophylaxis (PrEP) or post‐exposure prophylaxis (PEP), other currently available testing technologies, such as viral load detection for diagnosis of acute HIV infection, may yield false‐negative results. In this scoping review, we evaluate the evidence and discuss alternative HIV testing algorithms that may mitigate diagnostic dilemmas in the setting of increased utilization of ART for immediate treatment and prevention of HIV infection. Discussion: Missed acute HIV infection prevents people living with HIV (PLHIV) from accessing early treatment, increases likelihood of onward transmission, and allows for inappropriate initiation or continuation of PrEP, which may result in HIV drug resistance. While immediate ART is recommended for all PLHIV, studies have shown that starting ART in the setting of acute HIV infection may result in a delayed or complete absence of development of HIV‐specific antibodies, posing a diagnostic challenge that is particularly pertinent to resource‐limited, high HIV burden settings where HIV‐antibody POCTs are standard of care. Similarly, ART used as PrEP or PEP may supress HIV RNA viral load, complicating current HIV testing algorithms in resource‐wealthy settings where viral detection is included. As rollout of PrEP continues, HIV testing algorithms may need to be modified. Conclusions: With increasing use of PrEP and ART in acute infection we anticipate diagnostic challenges using currently available HIV testing strategies. Research and surveillance are needed to determine the most appropriate assays and optimal testing algorithms that are accurate, affordable and sustainable., Introduction In the current era of immediate antiretroviral therapy (ART), and pre‐ or post‐exposure prophylaxis, confidently diagnosing HIV is becoming increasingly complex. Cases of diagnostic uncertainty can be confusing and [...]