Knowledge, attitude, practices and treatment-seeking behaviour concerning cutaneous leishmaniasis among rural hyperendemic communities in western Yemen.

Cutaneous leishmaniasis (CL), a neglected tropical disease (NTD), is a major public health problem in Yemen with widespread distribution in rural areas. Evaluating the knowledge and understanding of people's beliefs towards the disease is essential to the implementation of effective control measures. This study aims to assess the knowledge, attitudes, practices (KAP) and treatment-seeking behaviour concerning CL among rural populations in the western highlands of Yemen. A community-based cross-sectional study was conducted among 289 household heads in four rural areas of the Utmah District. Data were collected using a pre-tested questionnaire. All the participants had heard about the disease; however, only 9.3% attributed it to sandflies. Nearly half (48.1%) of the participants could not mention any preventive measures for CL, and nearly two-thirds (65.4%) could not do so for sandflies. The overall 'good' knowledge about CL was found to be 51.2%, and it was 33.9% for sandflies. The participants' attitude and prevention practices towards CL were not satisfactory, as only 38.1% and 16.3% had a positive attitude and good CL-related prevention practices, respectively. Moreover, 45.7% believed CL to be a stigmatising disease, and 50% had used traditional remedies to treat suspected CL lesions. Multivariate analyses showed that age, sex, presence of CL-confirmed cases in the same household, residency, occupation and monthly household income were the significant predictors associated with KAP concerning CL among the participants. The findings support an urgent need for integrated health education and community mobilisation interventions to improve awareness of these vulnerable populations about this devastating disease.

First report of Leishmania tropica in domestic and wild animal hosts in hyperendemic areas of human cutaneous leishmaniasis in western Yemen: a neglected tropical disease needing One Health approach.

Cutaneous leishmaniasis (CL), a neglected tropical disease, is a major public health concern in Yemen, with Leishmania tropica identified as the main causative agent. This study aims to investigate the occurrence and distribution of Leishmania parasites in domestic and wild animals in CL endemic areas in the western highlands of Yemen. A cross-sectional study was conducted in the Utmah District of western Yemen. Blood and skin scraping specimens were collected from 122 domestic and wild animals and tested for the Leishmania DNA using internal transcribed spacer 1 (ITS1) nested polymerase chain reaction. Phylogenetic analyses were performed on 20 L. tropica sequences obtained from animals in this study and 34 sequences from human isolates (collected concurrently from the same study area) retrieved from the GenBank. Overall, L. tropica was detected in 16.4% (20/122) of the examined animals, including 11 goats, two dogs, two bulls, one cow, one donkey, one rabbit, one rat and one bat. None of the examined cats and sheep was positive. The animal sequences were segregated into four different L. tropica haplotypes, with the majority of the animal (15/20) and human (32/34) sequences composed of one dominant haplotype/genotype. These findings represent the first confirmed evidence of natural L. tropica infections in different kinds of domestic and wild animals in western Yemen, suggesting these animals potentially have a role in the transmission of CL in Yemen. Therefore, a One Health approach is required for the effective prevention and control of this devastating disease among endemic populations.

Nano-therapeutics: The upcoming nanomedicine to treat cancer.

Nanotechnology is considered a successful approach for cancer diagnosis and treatment. Preferentially, cancer cell recognition and drug targeting via nano-delivery system include the penetration of anticancer agents into the cell membrane to damage the cancer cell by protein modification, DNA oxidation, or mitochondrial dysfunction. The past research on nano-delivery systems and their target has proven the beneficial achievement in a malignant tumor. Modern perceptions using inventive nanomaterials for cancer management have been offered by a multifunctional platform based on various nano-carriers with the probability of imaging and cancer therapy simultaneously. Emerging nano-delivery systems in cancer therapy still lack knowledge of the biological functions behind the interaction between nanoparticles and cancer cells. Since the potential of engineered nanoparticles addresses the various challenges, limiting the success of cancer therapy subsequently, it is a must to review the molecular targeting of a nano-delivery system to enhance the therapeutic efficacy of cancer. This review focuses on using a nano-delivery system, an imaging system, and encapsulated nanoparticles for cancer therapy.

Targeting GluR3 in Depression and Alzheimer's Disease: Novel Compounds and Therapeutic Prospects.

BACKGROUND: The present study investigates the interrelated pathophysiology of depression and Alzheimer's disease (AD), with the objective of elucidating common underlying mechanisms. OBJECTIVE: Our objective is to identify previously undiscovered biogenic compounds from the NuBBE database that specifically interact with GluR3. This study examines the bidirectional association between depression and AD, specifically focusing on the role of depression as a risk factor in the onset and progression of the disease. METHODS: In this study, we utilize pharmacokinetics, homology modeling, and molecular docking-based virtual screening techniques to examine the GluR3 AMPA receptor subunit. RESULTS: The compounds, namely ZINC000002558953, ZINC000001228056, ZINC000000187911, ZINC000003954487, and ZINC000002040988, exhibited favorable pharmacokinetic profiles and drug-like characteristics, displaying high binding affinities to the GluR3 binding pocket. CONCLUSIONS: These findings suggest that targeting GluR3 could hold promise for the development of therapies for depression and AD. Further validation through in vitro, in vivo, and clinical studies is necessary to explore the potential of these compounds as lead candidates for potent and selective GluR3 inhibitors. The shared molecular mechanisms between depression and AD provide an opportunity for novel treatment approaches that address both conditions simultaneously.

Generation of autoantibodies against glycated fibrinogen: Role in diabetic nephropathy and retinopathy.

The process of glycation, characterized by the non-enzymatic reaction between sugars and free amino groups on biomolecules, is a key contributor to the development and progression of both microvascular and macrovascular complications associated with diabetes, particularly due to persistent hyperglycemia. This glycation process gives rise to advanced glycation end products (AGEs), which play a central role in the pathophysiology of diabetes complications, including nephropathy. The d-ribose-mediated glycation of fibrinogen plays a central role in the pathogenesis of diabetes nephropathy (DN) and retinopathy (DR) by the generation and accumulation of advanced glycation end products (AGEs). Glycated fibrinogen with d-ribose (Rb-gly-Fb) induces structural changes that trigger an autoimmune response by generating and exposing neoepitopes on fibrinogen molecules. The present research is designed to investigate the prevalence of autoantibodies against Rb-gly-Fb in individuals with type 2 diabetes mellitus (T2DM), DN & DR. Direct binding ELISA was used to test the binding affinity of autoantibodies from patients' sera against Rb-gly-Fb and competitive ELISA was used to confirm the direct binding findings by checking the bindings of isolated IgG against Rb-gly-Fb and its native conformer. In comparison to healthy subjects, 32% of T2DM, 67% of DN and 57.85% of DR patients' samples demonstrated a strong binding affinity towards Rb-gly-Fb. Both native and Rb-gly-Fb binding by healthy subjects (HS) sera were non-significant (p > 0.05). Furthermore, the early, intermediate, and end products of glycation have been assessed through biochemical and physicochemical analysis. The biochemical markers in the patient groups were also significant (p < 0.05) in comparison to the HS group. This study not only establishes the prevalence of autoantibodies against d-ribose glycated fibrinogen in DN but also highlights the potential of glycated fibrinogen as a biomarker for the detection of DN and/or DR. These insights may open new avenues for research into novel therapeutic strategies and the prevention of diabetes-related nephropathy and retinopathy.

Identification of Glycoxidative Lesion in Isolated Low-Density Lipoproteins from Diabetes Mellitus Subjects.

Methylglyoxal (MG) is a precursor for advanced glycation end-products (AGEs), which have a significant role in diabetes. The present study is designed to probe the immunological response of native and glycated low-density lipoprotein (LDL) in experimental animals. The second part of this study is to probe glycoxidative lesion detection in low-density lipoproteins (LDL) in diabetes subjects with varying disease duration. The neo-epitopes attributed to glycation-induced glycoxidative lesion of LDL in DM patients' plasma were, analyzed by binding of native and MG-modified LDL immunized animal sera antibodies using an immunochemical assay. The plasma purified human LDL glycation with MG, which instigated modification in LDL. Further, the NewZealand-White rabbits were infused with unmodified natural LDL (N-LDL) and MG-glycatedLDL to probe its immunogenicity. The glycoxidative lesion detection in LDL of DM with disease duration (D.D.) of 5-15 years and D.D. > 15 years was found to be significantly higher as compared to normal healthy subjects (NHS) LDL. The findings support the notion that prolonged duration of diabetes can cause structural alteration in LDL protein molecules, rendering them highly immunogenic in nature. The presence of LDL lesions specific to MG-associated glycoxidation would further help in assessing the progression of diabetes mellitus.

Antimicrobial Potential of Pithecellobium dulce Seed Extract against Pathogenic Bacteria: In Silico and In Vitro Evaluation.

Clinical multi-drug-resistant bacteria continue to be a serious health problem. Plant-derived molecules are an important source of bioactive compounds to counteract these pathogenic bacteria. In this paper, we studied the chemical composition of the methanol (80%) extract from Pithecellobium dulce seed (Hail, Saudi Arabia) and its ability to inhibit the growth of clinically relevant multi-drug-resistant bacteria. Molecular docking analysis was performed to predict the best compounds with low binding energy and high affinity to interact with two Staphylococcus aureus receptors. Data showed that P. dulce extract is a rich source of D-turanose (55.82%), hexadecanoic acid (11.56%), indole-1-acetic acid (11.42%), inositol (5.78%), and octadecanoic acid (4.36%). The obtained extract showed antibacterial activity towards tested clinical bacterial strains with MIC values ranging from 233 mg/mL for Acinetobacter baumannii to 300 mg/mL for S. aureus and Escherichia coli. Turanose interaction has resulted in -7.4 and -6.6 kcal/mol for 1JIJ and 2XCT macromolecules, while inositol showed energy values (-7.2 and -5.4 kcal/mol) for the same receptors. Multiple identified compounds showed desirable bioavailability properties indicating its great potential therapeutic use in human. Overall, current investigation highlights the possible use of P. dulce extract as a valuable source for drug development against pathogenic drug-resistant bacteria.

Seroprevalence of toxoplasmosis at referral hospitals in the northwestern region, Saudi Arabia.

BACKGROUND: Toxoplasmosis is induced by Toxoplasma gondii, which affects 30 percent of the global population and is responsible for deaths related to foodborne pathogens. This study aimed to describe the seroprevalence of T. gondii infections in patients attending referral hospitals in the northwestern region of Saudi Arabia. MATERIALS AND METHODS: The serology test results for T. gondii antibodies of 797 patients were retrospectively analyzed using the hospitals' database. The enzyme-linked immunosorbent assay was used to detect anti-T. gondii antibodies (IgG and/or IgM). RESULTS: Overall, the prevalence of anti-T. gondii antibodies was 8.3%. Higher (9.9%) prevalence of positive results among patients aged 30 years and above was observed. Statistically, the various age groups (P = 0.031) were found to be significant. Female was noted to have increased (8.1%) seroprevalence, and the incidence of infection occurred largely among participants living in rural areas (8.2%). CONCLUSIONS: Toxoplasmosis remains a public health concern. The seroprevalence of T. gondii antibodies was relatively low in the study area. IgG antibodies to T. gondii were mainly detected. Increasing awareness on the mode of transmission, source of infection, and disease prevention through health education and dissemination is vital to reduce or eliminate toxoplasmosis.

Prevalence of Transfusion-Transmitted Infections (HCV, HIV, Syphilis and Malaria) in Blood Donors: A Large-Scale Cross-Sectional Study.

Blood plays a major role in transmitting infectious diseases such as hepatitis C virus (HCV), human immunodeficiency virus (HIV), hepatitis B virus (HBV), syphilis, malaria, and many others. Thus, this study sought to evaluate the distribution of HCV, HIV, syphilis, and malaria among blood donors in Yemen. This is a cross-sectional study, conducted on blood donors at the national center in Yemen. Blood donors' specimens were serologically tested for the presence of anti-HCV and anti-HIV antibodies, as well as anti-Treponema pallidum, anti-Plasmodium falciparum, and anti-Plasmodium vivax. A total of 16,367 donors were included in this study. Based on the donor's occupation, the study showed that the relative seroprevalence of anti-HCV Ab among the donors was statistically significant, and relatively high prevalence was found among military donors (2.8%). Positive HIV antibody tests were only reported in 33 male donors (0.2%), who were mostly manual workers. A remarkably high prevalence of anti-Treponema pallidum was observed among manual workers (3.1%). There was a statistically significant difference in the distribution of anti-malaria Ab based on residency and age groups. This study revealed that the prevalence of HCV, HIV, syphilis, and malaria among donors was 2.0%, 0.2%, 2.4%, and 0.7%, respectively. Further genotyping studies are necessary to provide a complete picture of the prevalence of transfusion-transmitted infections (TTIs).

Polymorphism analysis of pfmdr1 gene in Plasmodium falciparum isolates 11 years post-adoption of artemisinin-based combination therapy in Saudi Arabia.

A total of 227 Plasmodium falciparum isolates from Jazan region, southwestern Saudi Arabia were amplified for the P. falciparum multi-drug resistance 1 (pfmdr1) gene to detect point mutations 11 years after the introduction of artemisinin-based combination therapy (ACT) in Saudi Arabia. The pfmdr1 86Y mutation was found in 11.5% (26/227) of the isolates while the N86 wild allele was detected in 88.5%. Moreover, 184F point mutations dominated (86.3%) the instances of pfmdr1 polymorphism while no mutation was observed at codons 1034, 1042 and 1246. Three pfmdr1 haplotypes were identified, NFSND (74.9%), NYSND (13.7%) and YFSND (11.4%). Associations of the prevalence of 86Y mutation and YFSND haplotype with participants' nationality, residency and parasitaemia level were found to be significant (P < 0.05). The findings revealed significant decline in the prevalence of the pfmdr1 86Y mutation in P. falciparum isolates from Jazan region over a decade after the implementation of ACT treatment. Moreover, the high prevalence of the NFSND haplotype might be indicative of the potential emergence of CQ-sensitive but artemether-lumefantrine-resistant P. falciparum strains since the adoption of ACT. Therefore, continuous monitoring of the molecular markers of antimalarial drug resistance in Jazan region is highly recommended.

Knowledge and attitude towards cutaneous leishmaniasis among rural endemic communities in Shara'b district, Taiz, southwestern Yemen.

BACKGROUND: Cutaneous leishmaniasis (CL), a neglected tropical disease, represents a significant public health problem in many endemic countries including Yemen. The ongoing armed conflict that started in March 2015 has had a negative impact on the entire healthcare system as well as on infectious disease control programmes. Therefore, this cross-sectional study aimed to assess knowledge and attitude towards CL among rural endemic communities in southwestern Yemen. METHODS: Five hundred households in five areas of Shara'b district of Taiz governorate were randomly selected to participate in a quantitative survey. A pretested structured questionnaire was used to collect data on the sociodemographic characteristics of the participants, their knowledge and attitude towards CL and their knowledge on the sand fly vector. RESULTS: The analysis was conducted on a final sample of 466 individuals (62.7% males and 37.3% females) aged between 18 and 70 years. Among the participants, 21.5% were non-educated while 39.7 and 20.8% had completed secondary school and tertiary education, respectively. Although the participants were aware of CL, about three quarters (77.7%) of them had poor overall knowledge about disease transmission, clinical presentation, treatment, and prevention. Interestingly, approximately half of the participants (49.1%) were able to differentiate sand flies from other flies and mosquitoes. However, only 14.8% of the participants knew about the role of the phlebotomine sand fly in the transmission of CL. Only 36.6% believed that CL can be prevented and 49.6% had a negative attitude towards the disease. Univariate and multivariate analyses showed that age and gender were the significant determinants of knowledge about CL and the sand fly vector among the studied population. CONCLUSION: A poor level of knowledge about the different epidemiological aspects of CL was found among rural CL-endemic communities in Taiz. This factor, together with the major collapse of the healthcare infrastructure due to the ongoing civil war in Yemen, may be contributing to the continued endemicity of CL in the governorate. It is therefore recommended that health education on CL transmission and prevention should be provided to the targeted communities.

Intestinal parasitic infection among foreign housemaids in northwestern Saudi Arabia: A cross-sectional study.

Owing to Saudi Arabia's high-income economy many Saudi families hire foreign housemaids. However, since the housemaids are potential carriers of intestinal parasites, hiring them increases the risk of transmission to the Saudi community. In this context, this study aimed to evaluate the prevalence of intestinal parasitic infections in foreign housemaids in northwestern Saudi Arabia. Using direct wet mount and concentration by flotation, the stool samples of 169 housemaids were examined, and eleven parasite species, six helminths and five protozoans, were detected. The overall prevalence of intestinal parasitic infection was 20.11% (34/169). Twelve cases were infected with one intestinal helminth, 12 were infected with one intestinal protozoan, and 10 had polyparasitism. The most common intestinal parasites were Cryptosporidium spp. (n = 10), hookworms (n = 7), and T. Trichiura (n = 7). The findings highlight that intestinal parasites present an important public health concern for foreign housemaids in Saudi Arabia. More vigilance is thus required, and periodic follow-up should be exercised throughout foreign housemaids' stay in the country.

A cross-sectional survey of the knowledge, attitudes and practices regarding schistosomiasis among rural schoolchildren in Taiz governorate, southwestern Yemen.

BACKGROUND: This cross-sectional survey aimed to assess the knowledge, attitudes and practices (KAP) towards schistosomiasis among rural schoolchildren in Taiz governorate, southwestern Yemen. METHODS: A total of 406 children were screened for urogenital and intestinal schistosomiasis. A pretested questionnaire was used to collect the children's demographic and socio-economic information and their KAP towards schistosomiasis. RESULTS: Overall, 73 children (18%) were found to be infected by Schistosoma mansoni. None of the children were positive for Schistosoma haematobium. The prevalence of intestinal schistosomiasis was significantly higher among boys than girls (22.1% vs 12%; p=0.010). Approximately two-thirds (63.3% [257/406]) of the children had heard about schistosomiasis, however, only 38.5%, 53.6%, 28.4% and 38.1% had correct knowledge concerning the causes, symptoms, transmission and prevention, respectively. A significantly higher level of knowledge was observed among boys and Schistosoma-infected children compared with girls and non-infected children (p<0.05). However, a better level of knowledge does not seem to translate directly into the performance of hygienic practices. Multivariate logistic regression showed that sex and infection status were the significant predictors of good knowledge. CONCLUSIONS: Intestinal schistosomiasis is prevalent among schoolchildren in rural Yemen. The findings reveal that children's knowledge about schistosomiasis is inadequate. Therefore, besides mass drug administration, integrated control programmes should also include health education and the provision of improved drinking water and proper sanitation.

Intestinal parasitic infection: prevalence, knowledge, attitude, and practices among schoolchildren in an urban area of Taiz city, Yemen.

BACKGROUND: Intestinal parasitic infections (IPIs) are regarded as one of the main public health problems and socio-economic issues adversely affecting the health of millions of people worldwide. Our study aimed to describe the knowledge, attitude, and practices of local urban schoolchildren in Taiz City towards intestinal parasitic infections. METHODS AND MATERIAL: This is a cross-sectional study conducted in Taiz, Yemen from March to May 2019. A total of 385 schoolchildren were selected using a random sampling technique from 7 primary schools. Wet-mount microscopic examination, formol-ether concentration techniques, and Lugols' iodine were employed in parasite detection and cyst identification. RESULTS: Of the 385 schoolchildren examined for IPIs, 107 (27.8%) were positive for the presence of enteric parasites, some having multiple infections. The prevalence was slightly higher in males 46 (28.6%) than in females 61 (27.2%) but have no statistical difference (P = 0.77). Entamoeba histolytica/dispar was the most common infection with 16.4% of cases. A substantial percentage (40.5%) of the respondents displayed poor knowledge. The respondents also revealed inappropriate attitudes and practices that contribute to the prevalence of IPIs in the study. CONCLUSIONS: The study revealed the prevalence of intestinal parasites among the schoolchildren in Taiz, Yemen, suggesting that IPIs remain a major public health problem. Entamoeba histolytica/dispar was the most prevalent intestinal parasites identified among the schoolchildren. Age, poor knowledge of the mode of transmission, prevention, and acquisition of IPIs, and poor habitual hygiene practices increase the risk of acquiring intestinal infections.