Baobab Index

Community pharmacists provide reliable healthcare information, over-the-counter services, and help prevent medication errors. This study aimed to assess the drug information (DI) resources commonly used in community pharmacy practice in Egypt, and the perceived barriers to their use. It also evaluates the pharmacists and students/trainees' knowledge and competence in addressing various medication-related problems. A cross-sectional study was conducted among community pharmacists and pharmacy students/trainees in Egypt. A structured, self-administered questionnaire collected demographic data, patterns of DI resource use, perceived barriers, and responses to medication-related clinical scenarios designed to assess knowledge and competence. Descriptive statistics and multivariable linear regression were performed to identify factors associated with knowledge scores. A total of 248 participants (mean age: 31.4 ± 11.5 years) completed the survey. Most respondents (89.9%) reported using professional DI resources and 78.6% used mobile DI applications or websites designed for healthcare professionals. The mean knowledge score was 4.33 ± 0.90 (range: 0-8). Formal training was associated with higher scores (β = 0.857, P = .003), whereas students/trainees scored lower than community pharmacists (β = -1.156, P = .013). The highest correct response rate (74.5%) was for identifying the interaction between sildenafil and isosorbide mononitrate. Community pharmacists and pharmacy students/trainees in Egypt reported frequent use of digital DI resources; however, their knowledge and performance remained moderate. Formal training was associated with better performance, highlighting the need to strengthen education and continuing professional development through collaboration between educational institutions and professional bodies.

Atypical hemolytic uremic syndrome (aHUS) is a rare form of thrombotic microangiopathy (TMA) caused by complement-mediated injury of the vascular endothelium. We present Clinical Practice Recommendations (CPRs) and Practice Points (CPPs) for the diagnosis and management of aHUS and the related spectrum of secondary thrombotic microangiopathies (TMAs) in children, based on current evidence and expert consensus, developed by a panel of international experts including pediatric nephrologists associated with the International Pediatric Nephrology Association (IPNA), kidney pathologists, geneticists, and adult nephrologists. The guidance focuses exclusively on pediatric populations, in alignment with IPNA's scope, and does not address diagnoses exclusive to the adult age group. Six structured clinical questions were formulated using the PICO (Population, Intervention, Comparator, Outcomes) framework, guiding comprehensive literature reviews. Recommendations were developed through expert consensus using a modified Delphi process. Two predefined levels of agreement-agreement and strong agreement-were used, with consensus on either level requiring ≥ 80% concurrence among panel members. A total of 51 CPRs for the diagnosis and management of genetic aHUS, autoimmune aHUS, aHUS in the setting of kidney transplantation, and secondary TMA are presented. Additionally, 9 CPPs provide guidance for the management of secondary TMA. Importantly, all guidance is contextualized to also reflect the distinct epidemiology and healthcare landscapes of less well-resourced countries. These recommendations, based on global consensus, aim to standardize and provide guidance for the diagnostic work-up and treatment of aHUS and secondary TMAs in children worldwide, thus ultimately improving patient outcomes. In addition, this guidance supports implementation efforts in resource-limited settings and provides direction for future research.

Zika virus (ZIKV) remains a significant global health concern owing to its association with congenital abnormalities and neurological disease. Although mammalian models have provided important insights into ZIKV biology, complementary systems are needed to enable rapid mechanistic studies and high-throughput genetic analyses. Drosophila melanogaster has emerged as a powerful translational in vivo platform because of its sophisticated genetic toolkit, conserved cellular pathways, and whole-organism experimental accessibility. This review highlights the utility of Drosophila for modeling ZIKV infection, emphasizing experimental approaches used to investigate viral pathogenesis and host responses. We discuss how fly-based studies have advanced understanding of neurodevelopmental defects, tissue tropism, metabolic reprogramming, and innate antiviral immunity while identifying conserved host factors that influence disease outcomes. Finally, we evaluate the strengths and limitations of the model and discuss future applications integrating Drosophila genetics with multi-omics technologies, vertebrate models, and antiviral drug discovery.

This secondary

Klebsiella pneumoniae is an important cause of neonatal sepsis in sub-Saharan Africa and is frequently antimicrobial resistant. In this study, we investigated key transmission routes of extended-spectrum β-lactamase-producing K pneumoniae (ESBL-K pneumoniae) within a single neonatal unit to inform development of contextually appropriate infection prevention and control practices. We recruited a prospective mother and neonate cohort of babies admitted for less than 48 h and expected to stay for 24 h or more, where the mother or guardian was aged 18 years or older. Participants were followed up until day 7 of admission or discharge, with samples taken on day 1 and 3, and at the final follow-up (maternal stool, neonatal stool, maternal hands, cots, and swaddling cloth [day 1 only]). We sampled the ward environment weekly and included contemporaneous invasive ESBL-K pneumoniae isolates in our analysis. The primary outcome was ESBL-K pneumoniae colonisation. K pneumoniae single-colony isolates were subjected to single-colony whole-genome sequencing, and plate-sweeps had post-enrichment metagenomics performed, before evaluation of multilocus sequence types and single-nucleotide polymorphisms. Statistical analyses (Kaplan-Meier, state-transition models, source-attribution models, transmission analysis combining single-nucleotide polymorphisms and timing of sample collection, and exponential random graph models) were used to infer whether transmission occurred and from which sources. We recruited 94 neonate-mother pairs (from July 23, 2019, to March 30, 2020). Median gestational age was 37 (IQR 35-38) weeks, 41 (44%) of the 94 neonates were girls, all were of Black ethnicity, and 69 (73%) of 94 neonates were antibiotic exposed. ESBL-K pneumoniae rapidly colonised neonates (Kaplan-Meier analyses indicated median 5 days [95% CI 4-6]), with 44 (49%) of 90 of neonates being colonised at least once. State-transition model indicated females had increased colonisation risk (hazard ratio 2·33 [95% credible interval 1·07-5·40]). Invasive isolates (13 [76%] of 17) clustered with stool and environmental isolates. Results of transmission analysis using single-colony whole-genome sequencing and post-enrichment metagenomics were consistent with ESBL-K pneumoniae transmission from cots (13-29%), ward surfaces (37-65%; especially sinks and oxygen delivery equipment), mother's hands (6-13%), and other neonates (8-13%). The results of network analysis (exponential random graph models) were consistent with shared cots increasing transmission risk from 5·7 × 10 The hospital environment is implicated in colonisation and invasive infection with ESBL-K pneumoniae. Infection prevention and control interventions should focus on containing neonatal stool, maternal hand hygiene, cot decontamination, single-use oxygen delivery equipment, and surface cleaning, particularly sinks. Medical Research Council (UK); National Institute for Health Research (UK); Gates Foundation (USA); Wellcome (UK).

Next-generation sequencing (NGS) has emerged as a promising approach to improve diagnostic accuracy, but its feasibility in low- and middle-income countries remains unknown. This study characterized the diagnostic landscape and assessed organizational readiness for NGS implementation at two childhood cancer treatment centers in Accra, Ghana. A situational assessment of pediatric cancer diagnostics at Korle Bu Teaching Hospital (KBTH) and the Greater Accra Regional Hospital (GARH) was conducted between October and December 2024. Data were collected through site assessments, interviews, and the Organizational Readiness for Implementing Change (ORIC) scale. Descriptive statistics and the Wilcoxon rank-sum tests were used for analysis. In 2024, approximately 211 and 41 new pediatric cancer cases were diagnosed at KBTH and GARH, respectively. Morphology remained the primary diagnostic modality, with limited access to immunohistochemistry and outsourcing required for immunophenotyping, cytogenetic analyses, and molecular testing. Both centers reported access to essential laboratory resources for NGS testing through a public-private research partnership providing sequencing equipment and technical expertise. However, notable gaps in research infrastructure were identified. Pediatric oncology providers at KBTH and GARH demonstrated high organizational readiness for NGS implementation (median ORIC score: 50/60). Cited barriers to NGS implementation in Ghana included high equipment costs, limited training opportunities, and insufficient political prioritization. While morphology remains the cornerstone of pediatric cancer diagnosis at KBTH and GARH, both centers demonstrated readiness and emerging capacity to implement NGS. However, addressing financial, infrastructural, and workforce barriers will be critical for its sustainable integration into pediatric oncology care in Ghana.

The global rise in antimicrobial resistance (AMR) among This systematic review and meta-analysis aimed to evaluate the diagnostic accuracy of machine learning models in predicting antimicrobial resistance in A comprehensive search of seven databases PubMed, Scopus, Web of Science, Embase, CINAHL, IEEE Xplore, and Google Scholar was conducted for studies published up to 2025. Eligible studies applied ML algorithms to genomic, phenotypic, or epidemiological datasets for predicting AMR in Five eligible studies encompassing unique Machine learning models exhibit outstanding diagnostic accuracy in predicting AMR in

Social behaviour is a heritable trait linked to well-being and mental health, yet it varies across social context, including social domains, informants and development, which may shape its underlying genomic architecture. Here, we conducted a genome-wide meta-regression meta-analysis of social behaviour from infancy to early adulthood, studying ~500,000 repeated measures in European-ancestry cohorts (N = 73,321). We modelled heterogeneity in single-variant associations across social domains (low prosocial behaviour and peer/social difficulties), multiple informants (parents, teachers and self-reports) and ages (2-29 years), identifying 6 associated loci, including variation within CADM2 (P = 2.51 × 10

Artificial intelligence (AI) is expanding the capacity of public health systems to detect infectious disease signals, forecast outbreaks, analyse pathogen evolution, generate localised risk estimates, and support operational decisions. The thirteenth session of the WHO Pandemic and Epidemic Intelligence Innovation Forum brought together experts from academic, public health, and technology organisations to examine current applications of AI in infectious disease modelling and pandemic preparedness. Examples included genomic surveillance, hybrid epidemiological and machine-learning models, spatial foundation models, AI-enabled decision support, and agent-based simulations for resource allocation. Participants emphasised that technical performance alone is insufficient: tools must be transparent, auditable, transferable across settings, operationally usable, and responsive to local data and infrastructure constraints. Sustained interdisciplinary collaboration, human oversight, robust validation, and equitable design will be essential to embed AI safely and effectively within public health decision-making.