Ebola virus disease (EVD) is a rare but highly contagious and lethal disease that occurs predominantly in African countries, with a case-fatality rate of 30-90%. The causative viral pathogens of EVD are within the genus Ebolavirus in the family Filoviridae. The primary route of human-to-human transmission is through direct contact with blood, bodily fluids and secretions from infected individuals. Direct contact with virally contaminated objects and sexual transmission have also been reported. Management of EVD is aggressive supportive care with possibly new therapeutic options. On 20 September 2022, an EVD outbreak was declared in Uganda, caused by Sudan ebolavirus. As of 7 November 2022, a total of 136 confirmed cases, 53 confirmed deaths have been reported, including 18 cases with seven deaths among healthcare workers. In the Democratic Republic of Congo (DRC), an EVD outbreak was also declared on 22 August 2022 (which ended on 27 September 2022); with only one case, a middle-aged woman. At the time when most countries in the world have been occupied with the coronavirus disease 2019 (COVID-19) pandemic and the recent human monkeypox outbreak, these two outbreaks of EVD have the potential to significantly add to the burden on global health. Authorities need to augment their multi-faceted response, including stringent contact tracing and border control, to avoid the catastrophe of the 2014-2016 EVD epidemic.
During the coronavirus disease 2019 (COVID-19) pandemic, individuals have had a variety of experiences with the disease and economic disruptions in Asia. We assessed how these experiences could impact COVID-19 vaccination intent and uptake in one of the Asian country, Malaysia. Two opt-in internet-based cross-sectional samples were collected: a March wave (26 March - 7 April 2021) and a June wave (22 June - 10 July 2021). Individuals were asked about their vaccination status, their employment status, and their experience with COVID-19 cases. The impact of economic disruptions and experiences with COVID-19 on COVID-19 vaccination was assessed through a multivariable, multinomial logistic regression model. Among 1,493 participants (735 in March and 758 in June wave), 26% were already vaccinated, 57% planned to vaccinate, and 17% had no plan to vaccinate. The number who had lost a job or earned less because of the pandemic was 30% in March and 36% in June. Across both waves, 5%-6% had a personal, very serious experience of COVID-19, 13%-16% knew of a family member or friend with a very serious experience of COVID-19, and 43%-61% knew of a very serious COVID-19 case through media. Notably, compared to those who worked the same amount throughout the pandemic, those who lost their job had lower odds of already being vaccinated (OR: 0.37; 95%CI: 0.23, 0.59), but similar odds of planning to become vaccinated. Personal, family/friend, and media experiences were also all related to increased odds of planning to vaccinated or being already vaccinated. The COVID-19 pandemic has led to large disruptions in people's lives. People's experiences during the pandemic impact their likelihood of being vaccinated or planning to vaccinate against COVID-19. Equitable allocation of COVID-19 vaccines will require outreach to groups with less stable employment and can leverage people's experiences with disease during the pandemic.
Children are susceptible and a potential source of transmission for coronavirus disease 2019 (COVID-19). However compulsory COVID-19 vaccination programs among children have not been a focus in Malaysia. The aim of this study was to measure parents' willingness to pay (WTP) for the COVID-19 vaccine and analyze the effects of socioeconomic variables on parents' WTP. An online cross-sectional study was conducted in Malaysia with two waves of surveys (i.e., different samples for each wave), March and June 2021. The study participants were Malaysian parents above 18 years old. Parents were randomized between two vaccine effectiveness profiles (95% and 50% effectiveness) and two risk levels of an adverse event (5% and 20% risk of fever). The WTP was estimated using a double-bounded dichotomous choice. Socioeconomic variables such as age of parent, gender, insurance, income, and education were examined. A total of 292 parents in March 2021 and 271 in June 2021 were included in the study. The vaccine safety and effectiveness profile did not significantly impact the WTP. In March 2021, the estimated WTP ranged from RM344.74 to RM399.64 (US$82.5 to US$95.6) across vaccine profiles and between RM377.55 and RM444.33 (US$90.3 to US$106.3) in June. Insurance status was associated with the parents' WTP, and during the June wave, the age of parents influenced the WTP. Implementing subsidies or free vaccinations is considerable to increase herd immunity and prevent transmission of COVID-19 in Malaysia.
Stunting is defined by height of more than two standard deviations below the World Health Organization's (WHO) child growth standard median. It is a significant nutritional problem in developing countries, where in 2021, Indonesia recorded a stunting prevalence at 24.4%, slightly higher than the global prevalence (22%). Reducing the prevalence of stunting has been the focus of the current administration in the Indonesian government, as delineated in the 2020-2024 National Medium-Term Development Plan. Globally, many studies have addressed parental stature as a risk factor of stunting. However, systematic reviews that summarized and critically appraised the relationship between parental stature and the incidence of stunting in Indonesia was scarce. This systematic review aimed to assess parental stature as a risk factor for stunting among Indonesian toddlers. Studies were searched through PubMed (MEDLINE), Google Scholar and Mendeley. Studies on Indonesian toddlers under five years old living in Indonesia were included. The quality of the included studies was assessed using Joanna Briggs Institute (JBI) critical appraisal tool. Data were extracted using a standardized data extraction form and were analyzed using Cochrane's RevMan 5.3. Twenty-seven prospective and retrospective cohort, case-control and cross-sectional studies were included with a total 4041 children. Out of 27 included studies, eight were found to be of low, seven of moderate and twelve of high quality. The result showed that parental stature was associated with the incidence of stunting among toddlers in Indonesia, either the mother only (odds ratio (OR) 1.92; 95% confidence interval (95%CI: 1.71-2.15), the father only (OR 5.21; 95%CI: 1.71-15.86) or both parents (OR 3.01; 95%CI: 2.41-3.75). However, studies on father and both parental statures suffered from substantial heterogeneity, imprecision and mixed qualities, therefore, they should be cautiously interpreted.
Down syndrome is the most prevalent genetic condition contributing to intellectual disability. Advancements in medical care have significantly increased the life expectancy of people with this condition, making employment a vital component for independent living and quality of life. The aim of this study was to examine the current literature on the employability and employment experiences of individuals with Down syndrome, focusing on the evolution of the employment rate and factors influencing employment such as cognitive and personal factors, societal attitudes, challenges, and effective support systems. Using Arksey and O'Malley's methodology, a scoping review of relevant qualitative and quantitative articles from PubMed, Scopus, Web of Science (WoS), CINAHL, and Medline was conducted. The search focused on the keywords found in the title and abstract of articles from 1980 to 2023. The search strategy utilized medical subject headings (MeSH), including "work", "Down syndrome", and "employment". All articles employing qualitative, quantitative, and mixed methods that were published in English were included. Of an initial 4,296 articles, 32 full-text articles were evaluated, and nine met the inclusion criteria. The data indicated improved employment rates for people with Down syndrome, with a recent employment rate of 53%. However, jobs are often limited to sectors like food service and are underutilizing their skills. Key factors associated with employment status include cognitive abilities, family support, and social attitudes. Despite positive perceptions, significant barriers such as systemic bias persist. Effective support systems are crucial but are often hindered by limited opportunities. In conclusion, employment opportunities for people with Down syndrome have improved, but challenges such as limited job diversity and systemic barriers remain. Comprehensive policies are recommended to promote inclusive employment practices and tailored support systems.
Pancreatic cell damage in diabetes mellitus is closely linked to inflammation and apoptosis. This study aimed to investigate the protective effects of phloroglucinol on pancreatic cells in a streptozotocin-induced diabetic model by assessing its anti- inflammatory and anti-apoptotic mechanisms. Phloroglucinol ligand and the structures of Bax, Bcl-2, and caspase-3 proteins were sourced from the PubChem database. Molecular docking was performed using Autodock Tools and docking results were analyzed with PyRx software. In addition, during the in vivo study, the BALB/c mice were grouped into four categories: healthy control, untreated streptozotocin-induced diabetic, and streptozotocin-induced diabetic treated with two doses of oral phloroglucinol at 100 mg/kg and 200 mg/kg body weight. After 28 days, pancreatic tissues were collected for flow cytometric analysis of NF-κB, IL-6, TNF-α, and apoptotic markers (Bax, Bcl-2, and caspase-3). The docking simulations revealed specific binding interactions: phloroglucinol interacted with Bcl-2 via amino acid residues of ALA90 and TYR139, with Bax via ALA42, LEU45, ALA46, LEU47, PRO130, and ILE133, and with caspase-3 through ARG64, SER120, GLN161, CYS163, and ARG207. The binding affinities for Bax, Bcl-2, and caspase-3 were -5.0, -4.7, and -4.9 kcal/mol, respectively. In vivo, results showed that streptozotocin significantly elevated inflammatory cytokines NF-κB, TNF-α, and IL-6, along with apoptotic markers in pancreatic cells (p<0.05) compared to healthy controls. Phloroglucinol administration at 200 mg/kg significantly reduced TNF-α, NF-κB and IL- 6 levels. Phloroglucinol also prevented streptozotocin-induced pancreatic cell damage through anti-apoptotic effects by downregulating Bax and caspase-3 and upregulating Bcl-2. These findings suggest that phloroglucinol may offer protective benefits in diabetic conditions by modulating apoptotic and inflammatory pathways.