Nevin Manimala

Malar J. 2025 Nov 7;24(1):383. doi: 10.1186/s12936-025-05601-5.

ABSTRACT

BACKGROUND: Malaria remains a major health concern in Nigeria. Rapid diagnostic tests (RDTs) are widely used in health facilities to confirm malaria before treatment. However, concerns remain about healthcare workers (HCWs) adherence to, and reporting of test results. This study assessed the accuracy of RDT results recorded in health facility registers in two states of Nigeria by comparing them with an unbiased reference standard and explored factors influencing interrater agreement.

METHODS: A mixed-method evaluation was conducted in 16 health facilities across Oyo and Sokoto States. RDTs performed by HCWs were photographed using a digital RDT reader and independently re-interpreted by a trained, independent, objective panel. Surveys of health facilities and HCWs collected data on factors that could influence RDT recording. Interrater agreement between RDT results recorded by HCWs in facility registers and the external panel was assessed using Cohen’s kappa. A meta-analytical approach was used to calculate a pooled summary kappa value across facilities, and potential moderators of agreement were examined, including characteristics of facilities, HCWs and RDTs.

RESULTS: Out of 19,586 RDTs captured, 18,319 were included in the analysis. Overall, 6.2% of RDTs were misrecorded as positive and 3.7% as negative in health facility registers, yielding a positive predictive value of 87.2% (95% confidence interval [CI] 86.4%, 87.8%) and negative predictive value of 92.9%. The overall percentage agreement was 90.2% (95% CI 89.7%, 90.6%), and the pooled kappa statistic was 0.80 (95% CI 0.75, 0.85), indicating strong agreement. However, kappa values varied substantially across facilities (range: 0.59, 0.92). Lower agreement was observed in facilities in Sokoto State and in areas with lower malaria prevalence and test positivity. Faint test lines, found in 8.8% of RDTs, were associated with a significantly increased likelihood of results misrecorded as negative. HCWs were more likely to misrecord RDT results as positive when a malaria diagnosis or antimalarial prescription had been made.

CONCLUSION: While overall agreement between facility registers and panel-interpreted RDT results was strong, the proportion of results misrecorded as positive and negative highlight the need for improved training, supportive supervision, and mechanisms to promote accurate RDT interpretation and recording. Targeted interventions are essential to ensure the reliability of routine malaria data and support national control efforts.

PMID:41204290 | DOI:10.1186/s12936-025-05601-5

J Transl Med. 2025 Nov 7;23(1):1244. doi: 10.1186/s12967-025-07251-2.

ABSTRACT

BACKGROUND: As key metabolic regulators, the roles of GDF15 and FGF21 in mediating the effects of modified ketogenic diet (MKD) on weight loss and lipoprotein remodeling in obese patients require further investigation.

PATIENTS AND METHODS: This study enrolled 30 metabolically healthy obese participants (BMI ≥ 28 kg/m²) for a 2-week MKD intervention. Using a self-controlled pre-post design, we performed measurements including body composition analysis, fasting serum GDF15 and FGF21 levels measurement, and serum lipoprotein subclass quantification at both baseline and post-intervention time points.

RESULTS: Following a 2-week MKD intervention, participants exhibited statistically significant reductions in body weight (96.14 ± 27.23 kg vs. 91.63 ± 26.47 kg; Δ4.8%, P < 0.001) and BMI (33.99 ± 6.08 kg/m² vs. 32.41 ± 5.95 kg/m²; Δ4.7%, P < 0.001). Body fat parameters significantly improved, with body fat mass (BFM) and visceral fat area (VFA) decreasing by > 5%. Meanwhile, lean mass indices (SMM, SLM, FFM) remained stable (change < 3%). Serum biomarker analysis revealed that GDF15 levels increased significantly by 5.76% (P = 0.0377), whereas FGF21 levels decreased markedly by 51.91% (P = 0.0001). The apolipoprotein B/A1 ratio (t = 5.381, P < 0.001) and the LDL-c/HDL-c ratio (t = 5.095, P < 0.001) increased significantly. Furthermore, larger HDL-c subfractions (H1FC/H2FC) showed an upward trend, while smaller HDL-c subfractions (H3FC/H4FC) exhibited a downward trend. Among these changes, H2FC levels demonstrated the most pronounced elevation (t = 6.119, P < 0.001).

CONCLUSION: The short-term MKD intervention significantly improved adiposity metrics while elevating GDF15 and reducing FGF21 levels. These rapid metabolic adaptations induced potentially beneficial remodeling of HDL-c subclasses, highlighting novel effects beyond conventional lipid ratios.

TRIAL REGISTRATION: ChiCTR, ChiCTR2300071823. Registered 25 May 2023 – Prospective Registered, https://www.chictr.org.cn/bin/project/edit?pid=198176 .

PMID:41204286 | DOI:10.1186/s12967-025-07251-2

Malar J. 2025 Nov 7;24(1):384. doi: 10.1186/s12936-025-05625-x.

ABSTRACT

BACKGROUND: Despite increased malaria interventions, the Upper River Region of The Gambia still faces a higher malaria burden compared to other parts of the country. This issue may be related to the population’s knowledge of malaria, as well as environmental and socioeconomic factors that influence their prevention and treatment choices. Therefore, this study focused on assessing the level of malaria knowledge, perceptions, and attitudes among the residents of the Upper River Region, as limited studies have been conducted across the region’s seven districts.

METHODS: To achieve the study’s objectives, a descriptive research survey using a parallel mixed method was adopted, with a robust multistage sampling approach for selecting 381 household heads involved in the quantitative study, 31 key informants, and 7 focus group discussions for the qualitative study. Descriptive statistics were performed on the assessed variables using StataSE18, and the association of socio-demographic factors with malaria prevalence was analyzed using Chi-square (Χ2). Thematic analysis was conducted for the qualitative part using NVivo.

RESULTS: The results indicate a very high level of knowledge of basic malaria concepts, with a percentage index of 81. There is a statistically significant influence from factors such as district, number of health centers in the region, gender, distance to the health centre, and occupation, all at < 5%. Using a treated bed net was the most effective prevention tool, while hospital visits and herbs remain the main treatment options among the population. The trend of malaria infection shows a general decrease across most communities, although a few still experience an increase over the year. Malaria profile data reveal an 87% reduction in cases for individuals above 5 years old and a 45% reduction for those under five. Additionally, mortality rates have decreased by 98% and 89%, respectively, over the 12 years (2011-2023).

DISCUSSION AND CONCLUSION: This study examined knowledge, perception, and attitudes toward malaria prevention and treatment. Results showed a high level of understanding of basic malaria concepts among the population, which influenced their perceptions and fostered a positive attitude toward managing and preventing the infection. However, differences in knowledge levels exist across districts, along with some contradictions in perceptions and attitudes. An overall decline in malaria cases has been observed across the districts and communities in the region, with a few exceptions. These findings are expected to inform the national malaria prevention efforts and assist policymakers in planning the next steps for the malaria elimination campaign.

PMID:41204275 | DOI:10.1186/s12936-025-05625-x

Malar J. 2025 Nov 7;24(1):385. doi: 10.1186/s12936-025-05537-w.

ABSTRACT

BACKGROUND: Intermittent preventive treatment of malaria in pregnancy (IPTp-SP) is an important strategy for preventing malaria in pregnant women and their unborn children. Ghana has adopted IPTp-SP as part of its National Malaria Control Programme, but its uptake remains suboptimal. This study examined the association between adequacy of antenatal care (ANC) and the uptake of at least three doses of IPTp-SP.

METHODS: This cross-sectional study utilized data from the 2022 Ghana Demographic and Health Survey (n = 3692). The adequacy of ANC was assessed based on the receipt of the recommended number of ANC visits, the timing of the first ANC visit, receipt of all components of ANC, and receipt of ANC from a skilled provider. Descriptive statistics and multivariable regression analyses were performed.

RESULTS: Overall, the uptake of at least three doses of IPTp-SP was 61.3%. Approximately 39.2% of participants had at least 8 ANC visits, 63.6% had their first ANC visit within the first trimester, 75.4% reported receiving all components of ANC and 95.5% received ANC from a skilled provider. In the multivariable model, the odds of receiving at least three doses of IPTp-SP were higher among those who had eight or more ANC visits 1.50 (1.18, 1.90; p = 0.001), who had their first ANC visit within the first trimester 1.74 (1.44, 2.09; p < 0.001), and those who received all components of ANC 1.62 (1.29, 2.03; p < 0.001).

CONCLUSIONS: Receipt of adequate ANC services is positively associated with the uptake of at least three doses of IPTp-SP. This association is independent of potential confounders. These findings highlight the need for targeted interventions to improve access to and the quality of ANC services, thereby increasing the uptake of IPTp-SP during pregnancy.

PMID:41204273 | DOI:10.1186/s12936-025-05537-w

Trop Med Health. 2025 Nov 7;53(1):155. doi: 10.1186/s41182-025-00831-4.

ABSTRACT

BACKGROUND: Female Anopheles mosquitoes are the primary vectors for malaria transmission within communities, significantly contributing to the high burden of malaria in Africa overall and Uganda specifically. Many tropical plants have insect-repellent properties and have traditionally been used in their native regions to prevent mosquito bites.

METHODS: A cross-sectional ethnobotanical survey was conducted between January 2025 and May 2025 in five districts of the West Nile Subregion: Adjumani, Moyo, Madi-Okollo, Pakwach, and Obongi. Semi-structured questionnaires were used to collect data on indigenous knowledge about mosquito repellents from 57 respondents, who were selected through purposive and snowball sampling techniques. The ethnobotanical data were analyzed using descriptive statistics, the informant consensus factor, and preference ranking.

RESULTS: A total of 42 plant species from 40 genera and 25 families were documented as being used to repel mosquitoes. The plants most commonly used for this purpose were: Azadirachta indica A.Juss. (9), Boswellia papyrifera (Caill.) (7), Aeschynomene americana L. (6), Mesosphaerum suaveolens (L.) Kuntze. (6), and Ocimum gratissimum L. (5). The most common indigenous method for repelling mosquitoes involves burning either dry cow dung (32%) or dry goat droppings (20%). Most of the plant species belong to the families Fabaceae (10), Lamiaceae (4), and Asteraceae (3). The majority of the plant species used were trees (43%) and herbs (42%), with leaves (42%) and seeds (12%) being the most frequently used plant parts. Except for Cymbopogon citratus (DC.) Stapf and M. suaveolens, which are used as live plants for repelling mosquitoes, all other plant species used were prepared by burning or smoking indoors.

CONCLUSIONS: Communities in the West Nile Subregion, especially those living along the River Nile, possess rich indigenous knowledge and practices used to repel mosquitoes in their efforts to control deadly malaria.

PMID:41204263 | DOI:10.1186/s41182-025-00831-4

BMC Sports Sci Med Rehabil. 2025 Nov 7;17(1):322. doi: 10.1186/s13102-025-01333-w.

ABSTRACT

BACKGROUND: Chronic ankle instability (CAI) is associated with balance disorders and functional deficits in soccer players. Impaired gluteal muscle function contributes significantly to these issues, as these muscles play a crucial role in maintaining lower limb stability and balance. This study aimed to evaluate the effects of Kinesio-taping (KT) on the electromyographic (EMG) activity of gluteal muscles, ankle function, and dynamic balance in male soccer players with CAI.

METHODS: In this randomized clinical trial, 30 male soccer players with CAI were randomly assigned to either the gluteal KT group (case) or the sham control group. Gluteal EMG activity, onset time, ankle function (Single-Leg Hop Test), and dynamic balance (modified Star Excursion Balance Test, mSEBT) were assessed pre-taping, immediately post-taping, and 48 h later.

RESULTS: The case group demonstrated significant increases in gluteus medius EMG activity (P < 0.05) and reductions in gluteus maximus onset time (P < 0.05) at both immediate and 48-hour follow-ups. Statistically significant improvements were also observed in single-leg hop distance (P = 0.001) and dynamic balance (P < 0.05) in the KT group compared to the control group. However, changes did not consistently meet minimal clinically important difference (MCID) thresholds for the mSEBT (4-5 cm per direction) or single-leg hop test (8-10 cm).

CONCLUSION: KT enhances gluteus medius activation, reduces gluteus maximus onset time, and improves ankle function and dynamic balance in soccer players with CAI. While statistically significant, the observed improvements may require integration with other rehabilitation strategies to achieve clinically meaningful outcomes. Future studies should explore long-term effects, diverse populations, and combined interventions to optimize functional gains.

TRIAL REGISTRATION: IRCT2015021015932N10, Date of registration: 04/11/2015.

PMID:41204260 | DOI:10.1186/s13102-025-01333-w

J Ethnobiol Ethnomed. 2025 Nov 7;21(1):79. doi: 10.1186/s13002-025-00824-x.

ABSTRACT

BACKGROUND: Ethnobotanical knowledge constitutes a vital component of cultural heritage and biodiversity conservation, particularly in regions undergoing rapid socio-cultural transitions. Southeastern Anatolia, despite its high floristic richness and biocultural diversity, remains underexplored in terms of non-medicinal plant uses.

METHODS: This study documents the traditional ethnobotanical knowledge of wild plant species used for non-medicinal and medicinal purposes in the Ergani district of Diyarbakır, Turkey. Data were collected between 2023 and 2024 through structured and semi-structured interviews (n = 112), guided fieldwalks, and participant observation across Ergani and 12 surrounding villages. Demographic variables and plant use data were analyzed using descriptive statistics and the cultural importance index to assess the relative significance of each taxon.

RESULTS: A total of 56 plant species belonging to 26 families were identified, used across five categories: medicinal (67.8%), nutritional (53.6%), fuel, decorative, and symbolic (e.g., protection against the evil eye). Multifunctionality was a recurring theme, with several species (e.g., Vitis vinifera, Vitex agnus-castus) employed in more than two categories. The most represented families were Lamiaceae, Asteraceae, Fabaceae, and Brassicaceae. Wild plants played a central role in local subsistence and cultural practices, with vernacular names and preparation methods varying across gender and age groups. Ritual use, particularly of Peganum harmala, remained prevalent among older participants.

CONCLUSION: The study reveals a complex, integrative system of plant use in Ergani that reflects a holistic ethnoecological worldview. Findings underscore the urgent need for the documentation and preservation of local ecological knowledge amid ongoing socio-economic transformations. Sustaining this intangible heritage is critical for biodiversity conservation, local food security, and cultural resilience.

PMID:41204229 | DOI:10.1186/s13002-025-00824-x

Orphanet J Rare Dis. 2025 Nov 7;20(1):567. doi: 10.1186/s13023-025-04098-0.

ABSTRACT

BACKGROUND: Fabry disease (FD) is an X-linked disorder caused by deleterious variants in GLA. Cardiovascular disease (CVD) causes premature mortality in FD. Hope for aspirin (acetylsalicylic acid, ASA) to reduce CVD risks in FD as primary prevention may have been tempered by the 2018 ARRIVE, ASCEND, and ASPREE clinical trials. It is unclear how new ASA guidance applies to FD patients, who have a high rate of young-onset, small vessel stroke compared with the general population.

METHODS: Longitudinal data spanning 2007-2023 from patients in the Canadian Fabry Disease Initiative (CFDI) were analyzed retrospectively. Incident stroke and transient ischemic attack (TIA), other CVD events, FD-specific risk factors, and ASA/antiplatelet (“ASA/AP”) prescription before and after 2018 were compared between groups who never had an event (“primary prevention group”) to those who had incident stroke/TIA during the study. Stroke/TIA rates were compared within CFDI by sex and GLA variant severity, and in the CFDI compared to Canadian statistics by sex. Ten-year atherosclerotic CVD (ASCVD) risk was calculated using the 2013 ACC/AHA risk calculator. ASA/AP prescription rate was compared before and after 2018.

RESULTS: Out of 641 patients, 57 had an incident stroke/TIA during the study, and 193 with complete data remained in the primary prevention group. Stroke/TIA rates were significantly higher among male patients (0.026 events per patient-year) than females (0.0098 events per patient-year), and higher among patients with severe GLA variants (males: 0.031 events per patient-year, females: 0.0096 events per patient-year) compared to those with attenuated variants (males: 0.011 events per patient-year, females: 0.0088 events per patient-year). No patients under 60 years at their incident stroke/TIA had high (≥ 10%) calculated 10-year ASCVD risk. Fewer patients were prescribed ASA/AP for primary prevention after 2018.

CONCLUSIONS: There was a high incidence of stroke/TIA in the younger CFDI cohort compared to the general Canadian population, despite low levels of traditional vascular risk factors as represented in 10-year estimated ASCVD risk. Primary prevention use of ASA has declined.

PMID:41204227 | DOI:10.1186/s13023-025-04098-0

Crit Care. 2025 Nov 7;29(1):477. doi: 10.1186/s13054-025-05718-8.

ABSTRACT

BACKGROUND: Prolonged mechanical ventilation (MV) frequently results in inspiratory and peripheral muscle weakness, impairing recovery. These conditions can be identified at the bedside using respectively Maximal Inspiratory Pressure (MIP) measurement and Medical Research Council (MRC) score. This study investigated the evolution over the acute-care hospital stay of MIP and MRC score in patients with documented post-extubation inspiratory muscle weakness (IMW), defined as MIP ≤ 30 cmH₂O, and looked for the factors associated with persistent IMW at the end of the acute care hospital stay.

METHOD: This exploratory prospective observational study was conducted across five Swiss hospitals. Patients in the Intensive Care Unit (ICU) who were extubated after ≥ 7 days of MV, with IMW diagnosed within 48 h post planned extubation, were included. Patients’ characteristics and ICU-related factors were recorded throughout the acute care stay as were MIP and MRC score. ICU-acquired weakness (ICU-AW) recorded in the medical file, ICU readmission, reintubation, and hospital mortality were also documented. Descriptive statistics and linear interpolation for missing MIP data were applied, and associations with persistent IMW (MIP ≤ 30 cmH₂O) at study completion were explored using univariable logistic regression. The optimal timepoint for predicting persistent IMW using MIP was identified using a random forest model.

RESULTS: Sixty-nine patients (48 men, 21 women) completed the study. At study completion, persistent IMW was observed in 30 patients (43%), with a median MIP of 22 [13-24] cmH₂O. MIP was of 44 [36-64] in patients without persistent IMW. Persistent IMW was positively associated in univariable logistic regression with female sex, duration of catecholamine use until inclusion, MIP at day 12, MRC score at day 12 and changes in MIP from inclusion to day 12. The presence of respiratory comorbidities was negatively associated with persistent IMW.

CONCLUSION: Persistent IMW following prolonged MV is frequent throughout the acute care stay and until acute care hospital discharge. The MIP measured at day 12 after inclusion, as well as its change from inclusion to day 12, were strongly associated with persistent IMW.

PMID:41204221 | DOI:10.1186/s13054-025-05718-8

Food Chem. 2025 Nov 1;496(Pt 3):146915. doi: 10.1016/j.foodchem.2025.146915. Online ahead of print.

ABSTRACT

Flavor serves as a key quality indicator in tomato puree (TP) processing; however, conventional methods often fall short in providing rapid and accurate assessments. To address this limitation, this study integrated flavoromics with machine learning to characterize sensory transitions and volatile changes during thermal processing and to construct a predictive model for sensory quality. Through HS-SPME-GC-MS analysis, a total of 71 volatile compounds were identified. Corresponding sensory analysis revealed a progressive shift from “Freshness,” “Fruity,” and “Floral” to “Cooked” and “Sourness” as heat intensity increased. Among the five models evaluated, the multilayer perceptron (MLP) demonstrated superior performance (R² > 0.99), effectively capturing nonlinear relationships between volatiles and sensory responses. Variable importance analysis identified ten key volatiles for each sensory descriptor. Moreover, external validation and aroma recombination confirmed the model’s robustness and generalization capacity. These findings offer a practical framework for flavor quality prediction and real-time control in TP production.

PMID:41202367 | DOI:10.1016/j.foodchem.2025.146915