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A mini-review of Mpox management in low- and-middle-income countries: A systems-based approach integrating CDC emerging infectious disease modelling and genomic surveillance

1Dolapo, D., 2Abanida, E. A., and *3Adegboro, B.

 

1Department of Community Health, College of Health Sciences, Nile University of Nigeria, Abuja, Nigeria

2Plot D-1A, Kaduna Court, Gaduwa Estate, Abuja, Nigeria

3Department of Medical Microbiology and Immunology, College of Health Sciences, Nile University of Nigeria, Abuja, Nigeria

*Correspondence to: boazadegboro@gmail.com; boaz.adegboro@nileuniversity.edu.ng

 

Abstract:

 

Mpox, previously known as monkeypox, is a viral illness caused by the monkeypox virus (MPXV), a species of the Poxviridae family, and genus Orthopoxvirus. The resurgence of Mpox, particularly in low- and middle-income countries (LMICs), underscores the need for a comprehensive systems-level analysis. The Centre for Disease Control and Prevention (CDC)’s Emerging Infectious Diseases (EID) modelling framework, combined with genomic surveillance, offers a robust approach to understanding and mitigating such outbreaks. Integrating these methods can enhance outbreak prediction, surveillance, and response strategies, particularly in resource-constrained settings. This review aims to identify systemic vulnerabilities and health systems gaps in control of Mpox in LMICs, opportunities for modelling Mpox within the CDC EID framework, and the role of genomic epidemiology in Mpox surveillance, especially in combination with the EID framework. We used a narrative review and followed a structured method designed to capture the range of interventions on EID modelling and genomic surveillance related to Mpox. Previous modelling results indicated that close-contact transmission within and between households were unlikely to result in a large number of Mpox clade I cases. Studies that modelled the impact of vaccination and sexual behaviour adaptations on Mpox cases found that initial decline in cases were likely caused by behavioural adaptation, but vaccination averted more cases overall and was key to hastening outbreak control. Studies revealed that the geographical pattern of Mpox reported in the Nigeria outbreak suggested a possible new and widespread zoonotic reservoir, but the animal reservoir remains unknown. Integrating genomic data into Mpox surveillance can facilitate early detection, identification of animal reservoir and inform targeted interventions. This review found that CDC successfully leveraged a SARS-CoV-2 wastewater surveillance system for Mpox and concluded that integrating the CDC’s EID modelling and genomic surveillance can significantly enhance Mpox management in LMICs.

Continue reading “A mini-review of Mpox management in low- and-middle-income countries: A systems-based approach integrating CDC emerging infectious disease modelling and genomic surveillance”

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The evidence gap: Vulvovaginal candidiasis research in African populations

*1,2Okeke, P. C. U., 1,2Nwafia, I. N., and 1,2Emeribe,S. C.

¹Department of Medical Microbiology, University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, Nigeria

²Department of Medical Microbiology, College of Medicine, Faculty of Basic Clinical Sciences, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria

*Correspondence to: princess.okeke@unn.edu.ng; Tel: +2348037117982; ORCID: https://orcid.org/0009–0004–2522–2416

 

Abstract:

 

Vulvovaginal candidiasis (VVC) affects an estimated 70-75% of women at least once before menopause, and recurrent disease is estimated to affect approximately 138 million women annually worldwide. Within this global picture, sub-Saharan Africa carries a disproportionate share of non-albicans Candida infection and reported antifungal resistance, yet remains one of the least-studied regions for the mechanistic, immunological and therapeutic research now reshaping the field elsewhere. This mini-review summarizes the available African-specific evidence, identifies where that evidence stops short of matching the region’s disease burden, and proposes concrete regional research priorities. The central challenge is not simply a shortage of prevalence surveys, of which a reasonable number now exist, but the near-total absence of African data from every mechanistic and translational thread currently advancing VVC science elsewhere: host immunogenetics, vaginal and gut microbiome characterization, novel antifungal evaluation, and vagina-specific diagnostic standards.

  Continue reading “The evidence gap: Vulvovaginal candidiasis research in African populations”

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A review of vaccine adjuvants in modern immunology: Mechanisms, classes, and advances in next-generation vaccine design

[1]Nwigube, M. E., *2Eya, C. P., 1Agu, C. C., 1Ogunfolakan, O. O., 2Ebhodaghe, F.,

1,3Amadi, O. V., and 1Abelekum,J. T.

1Department of Medical Laboratory Science, College of Medicine and Health Science, Afe Babalola University, Ado-Ekiti, Ekiti State, Nigeria

2Department of Environmental Health Science, Faculty of Health Science, National Open University of Nigeria, Cadastral Zone, Nnamdi Azikiwe Expressway, Jabi, Abuja, Nigeria

3Department of Medical Laboratory Science, College of Medicine and Health Science, Venite University, Ado-Ekiti, Ekiti State, Nigeria                                                                                                

*Correspondence to pceya@noun.edu.ng; +234 (813) 847-6175

ORCID: https://orcid.org/0009-0007-9591-4807

Abstract:

Vaccines are biological preparations that stimulate the immune system to prevent infectious disease without causing illness. By delivering weakened or inactivated pathogens, purified antigens, or genetic material encoding specific proteins, vaccines induce antibody production and generate memory B and T cells, enabling rapid, protective responses upon later exposure. Vaccination is among the most effective public health measures, leading to the eradication of smallpox in human and rinderpest in ruminants, and control of many infectious diseases. Advances such as recombinant and mRNA platforms have broadened applications to emerging infections and cancer immunotherapy. Adjuvants enhance vaccine immunogenicity, particularly in subunit and inactivated formulations. They activate innate immune pathways, including pattern recognition receptors (PRRs) such as Tolllike receptors (TLRs), triggering inflammatory signaling and cytokine release. This promotes recruitment and maturation of antigen-presenting cells, especially dendritic cells, improving antigen presentation and T-cell activation. Adjuvants also shape adaptive immunity by directing T-helper cell polarization and strengthening cytotoxic T-lymphocyte responses. Major adjuvant classes include aluminum salts (alum), which primarily elicit strong antibody (Th2) responses; emulsion-based systems such as MF59 and AS03, which enhance antigen uptake and promote balanced humoral and cellular immunity; and TLR agonists such as monophosphoryl lipid A and CpG oligodeoxynucleotides, which drive Th1-biased responses. Saponin-based and liposomal formulations further augment both antibody and cellular immunity, supporting vaccines against complex pathogens and cancer. Ongoing advances in molecular immunology and nanotechnology are enabling next-generation adjuvants designed to achieve precise, durable, and safe immune protection, underscoring their central role in future vaccine development and global disease prevention. Continue reading “A review of vaccine adjuvants in modern immunology: Mechanisms, classes, and advances in next-generation vaccine design”

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A scoping review of vulvovaginal candidiasis: Bridging the critical gaps toward precision diagnosis, treatment and recurrence prevention

*1,2Okeke, P. C. U., 1,2Nwafia, I. N., and 1,2Emeribe, S. C.

¹Department of Medical Microbiology, University of Nigeria Teaching Hospital (UNTH), Ituku-Ozalla, Enugu, Nigeria.

²Department of Medical Microbiology, College of Medicine, Faculty of Basic Clinical Sciences, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria.

*Correspondence to: princess.okeke@unn.edu.ng; Tel: +2348037117982; ORCID: https://orcid.org/0009–0004–2522–2416

Abstract:

Vulvovaginal candidiasis (VVC) is among the most common mucosal fungal infections affecting women, with recurrent disease (RVVC) affecting an estimated 138 million women annually. Despite its frequency, major gaps remain in diagnosis, treatment and prevention. This scoping review identifies critical gaps across the VVC disease pathway and proposes a precision framework to transform management from episodic treatment toward prediction, targeted therapy and durable recurrence prevention. A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and African Journals Online using keywords related to VVC, antifungal resistance, microbiome, and treatment. Studies published between 1990 and 2026 addressing epidemiological, microbiological, immunological, diagnostic, therapeutic or translational aspects of VVC were included. Data were synthesized thematically. Major gaps identified include: the true burden of microbiologically confirmed symptomatic disease remains uncertain; symptoms are nonspecific while Candida colonization may occur without disease, creating a fundamental diagnostic problem; the biological mechanisms determining why some women remain asymptomatically colonized whereas others develop symptomatic or recurrent disease are incompletely understood; the vaginal microbiome and mycobiome are emerging as important determinants of disease phenotype, but most studies remain crosssectional; Candida biofilms, strain-level variation and host inflammatory responses may contribute to persistence and recurrence, but their clinical significance requires better longitudinal investigation; and newer agents such as oteseconazole and ibrexafungerp have expanded therapeutic options, yet questions remain concerning comparative effectiveness, resistance, cost, access and long-term ecological effects. A precision framework integrating clinical phenotype, Candida biology, host susceptibility, microbial ecology and treatment history could transform VVC management. Priority areas include standardized disease definitions, longitudinal host–microbe studies, species- and strain-level characterization, antifungal susceptibility surveillance, microbiome and mycobiome research, patientcentred outcomes, and implementation studies in underrepresented populations. Continue reading “A scoping review of vulvovaginal candidiasis: Bridging the critical gaps toward precision diagnosis, treatment and recurrence prevention”

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Evolving dynamics and antimicrobial resistance of Vibrio cholerae in Nigeria: An integrative epidemiological and microbiological review

[1]Medugu, N., 1Israel-Aliu, O., 1Jibril, I., [2]Egah, R., [3][4]Garba, R. D., 4Musa-Booth, T., and *1Adegboro, B.

1Department of Medical Microbiology and Immunology, Nile University of Nigeria, Abuja, Nigeria

2International Foundation against Infectious Disease in Nigeria, Abuja, Nigeria

3Department of Public Health, Nile University of Nigeria, Abuja, Nigeria

411928 Woodlawn Drive, Woodlawn, Maryland 21207, USA               *Correspondence to: boaz.adegboro@nileuniversity.edu.ng

Abstract:

Background: Cholera remains recurrent in Nigeria, with outbreak location and magnitude varying over time in relation to population displacement, flooding, rapid urban growth, and constraints in water and sanitation services. Published microbiological and genomic studies describe circulation of seventh-pandemic Vibrio cholerae O1 El Tor lineages in Nigeria, with antimicrobial resistance (AMR) reported in multiple isolate series and occasional reports of non-O1/non-O139 strains. Continue reading “Evolving dynamics and antimicrobial resistance of Vibrio cholerae in Nigeria: An integrative epidemiological and microbiological review”

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Clinical characteristics and outcomes of patients with acute watery diarrhoea admitted to the Cholera Treatment Center of Yekatit-12 Teaching Hospital, Addis Ababa, Ethiopia

*[1],2Mengistu, M. D., 1Challa, G., and 1Rorisa,M.

 

1Department of Internal Medicine, Yekatit-12 Hospital Medical College, Addis Ababa, Ethiopia

2Department of Medical Physiology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia

*Correspondence to: mekoyamengistu@gmail.com

 

Abstract 

Background: Cholera remains a major public health concern in low-income countries where the spread of disease is exacerbated by poor water supply, hygiene, and sanitation. Ethiopia has continued to face recurrent cholera outbreaks despite efforts to prevent and control the disease. The aim of the study was to assess the clinical characteristics, and outcomes among patients with acute watery diarrhea admitted to Cholera Treatment Center (CTC) of Yekatit-12 Teaching Hospital, Addis Ababa, Ethiopia. Continue reading “Clinical characteristics and outcomes of patients with acute watery diarrhoea admitted to the Cholera Treatment Center of Yekatit-12 Teaching Hospital, Addis Ababa, Ethiopia”

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Nasal colonization of methicillin and glycopeptide resistant Staphylococcus aureus among outpatients at a clinic facility in Maputo, Mozambique: A cross-sectional study

*1,2Sineque, A., 1Mabasso, A. A., 1Chongo, A. E., and 1Mussagy,A.

 

1Department of Biological Sciences, Eduardo Mondlane University, Maputo, Mozambique

2Centre for Functional Ecology – One Health, Department of Life Sciences, University of Coimbra, Coimbra, Portugal *Correspondence to: sineque.alberto@uem.ac.mz; ORCID: https://orcid.org/0000–0003–2468–9925

 

Abstract:

 

Background: Nasal colonization by Staphylococcus aureus is a major source of community and hospital associated staphylococcal infections, including methicillin-resistant S. aureus (MRSA) infections. Screening of MRSA nasal colonization is important in the prevention and control of infection and may provide useful information to guide antimicrobial therapy. The study aimed to determine the prevalence of nasal colonization by methicillin-resistant S. aureus and its glycopeptide susceptibility pattern among symptomatic and asymptomatic individuals in Maputo, Mozambique. Continue reading “Nasal colonization of methicillin and glycopeptide resistant Staphylococcus aureus among outpatients at a clinic facility in Maputo, Mozambique: A cross-sectional study”

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Prevalence of mecA and vanA genes in nasal Staphylococcus aureus isolates from hospitalized patients in Babcock University Teaching Hospital, Ilishan-Remo, Nigeria

*¹Okunbor, H. N., ¹,²Otaigbe, I. I., ¹,²Oluwole, T. O., ¹,²Elikwu, C. J., and 3Bhola, A. K.

¹Department of Medical Microbiology, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria

²Department of Medical Microbiology and Parasitology, Babcock University, Ilishan-Remo, Ogun State, Nigeria

³ISID-BMGF Research Capacity Building Mentor

*Correspondence to: okunborh@babcock.edu.ng; Tel: +2348059834262; ORCID: 0009-0001-2016-6310

Abstract:

Background: Antimicrobial resistance (AMR) among Staphylococcus aureus, particularly methicillin-resistant S. aureus (MRSA) and vancomycin-resistant S. aureus (VRSA), poses a major global public health challenge. Data on the molecular epidemiology of resistance genes in Nigeria remain limited. The objectives of this study are to determine the prevalence of mecA, vanA, and vanB genes among nasal S. aureus isolates, assess antimicrobial susceptibility profiles, and explore associations of prevalence with demographic and clinical characteristics of hospitalized patients in Babcock University Teaching Hospital (BUTH), Ilishan-Remo, Nigeria. Continue reading “Prevalence of mecA and vanA genes in nasal Staphylococcus aureus isolates from hospitalized patients in Babcock University Teaching Hospital, Ilishan-Remo, Nigeria”

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Prevalence and distribution of the World Health Organization-Bacterial Priority Pathogens in selected hospitals in Katsina State, Nigeria

*1,2Suleiman, H. A., 1Mukhtar, G. L., and 1Hayatuddeen, M. R.

1Department of Microbiology, Faculty of Natural and Applied Science, Umaru Musa Yar’adua University, Katsina, Nigeria

2Department of Medicine, General Hospital Kankia, Katsina State, Nigeria          *Correspondence to: suleimanaliyuhayatulah@gmail.com; Tel: 08030835316; ORCID: 0009-0007-9878-3582

Abstract: 

Background: Infections caused by antibiotic-resistant bacteria have become a major global public health challenge, as they can reduce the effectiveness of modern medical treatments and clinical care. The most important of these pathogens are those listed in the World Health Organization (WHO) Bacterial Priority Pathogens List (BPPL) of 2024. This study determined the prevalence, distribution, and antimicrobial resistance patterns of the WHO bacterial priority pathogens in three selected hospital settings in Katsina State, Nigeria. Continue reading “Prevalence and distribution of the World Health Organization-Bacterial Priority Pathogens in selected hospitals in Katsina State, Nigeria”

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Comparative analysis of biofilm formation in carbapenem-resistant and carbapenem-susceptible Klebsiella pneumoniae clinical isolates from a tertiary hospital in Nigeria

*¹Otaru, B. M., 2Aikhomu V., and ¹Oladele, R. O.

 

¹Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Lagos, Nigeria

2Department of Medical Microbiology, Lagos University Teaching Hospital (LUTH), Lagos, Nigeria

*Correspondence to: otaruboluwatife@gmail.com; Tel: +2348140528910; ORCID: 0009-0003-9413-7832

 

Abstract:

 

Background: Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections pose a major challenge due to limited therapeutic options. Biofilm formation has been proposed as a potential contributor to antimicrobial resistance; however, evidence regarding its association with carbapenem resistance in K. pneumoniae remains conflicting. Notably, data from Nigeria are scarce. The objective of this study is to compare biofilm formation between carbapenem-resistant and carbapenem susceptible K. pneumoniae (CRKP and CSKP) isolated from blood samples. Continue reading “Comparative analysis of biofilm formation in carbapenem-resistant and carbapenem-susceptible Klebsiella pneumoniae clinical isolates from a tertiary hospital in Nigeria”