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Using mobile audiometry (Wulira App) to assess noise induced hearing loss among industrial workers in Kampala, Uganda: A cross-sectional study

Batte, Charles; Atukunda, Immaculate; Semulimi, Andew Weil; Nakabuye, Mariam; Bwambale, Festo; Mumbere, Joab;  Twinamasiko, Nelson; Mukumya, David; Nyarubeli, Israel Paul, Mukisa, John

ccupational noise is a common cause of hearing loss in low-income countries. Unfortunately, screening for hearing loss is rarely done due to technical and logistical challenges associated with pure tone audiometry. Wulira app is a valid and potentially cost-effective alternative to pure tone audiometry in screening for occupational hearing loss. We aimed to determine the prevalence of occupational hearing loss among workers in a metal industry company in Kampala district

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High Burden of Neurodevelopmental Delay among Children Born to Women with Obstructed Labour in Eastern Uganda: A Cohort Study

Chebet, Martin; Musaba, Milton W.; Mukumya, David; Makoko, Brian; Napyo, Agnes; Nantale, Ritah; Auma, Proscovia; Atim, Ketty; Nahurira, Doreck; Lee, Seungwon; Okello, Dedan, Ssegawa, Lawrence; Bromley, Kieran; Burgoine, Kathy; Ndeezi, Grace; Tumwine, James K.; Wandabwa, Julius; Kiguli, Sarah

Over 250 million infants in low and middle-income countries do not fulfill their neurodevelopment potential. In this study, we assessed the incidence and risk factors for neurodevelopmental delay (NDD) among children born following obstructed labor in Eastern Uganda. Between October 2021 and April 2022, we conducted a cohort study of 155 children (aged 25 to 44 months), born at term and assessed their neurodevelopment using the Malawi Developmental Assessment Tool. We assessed the gross motor, fine motor, language and social domains of neurodevelopment. The incidence of neurodevelopmental delay by 25 to 44 months was 67.7% (105/155) (95% CI: 59.8–75.0). Children belonging to the poorest wealth quintile had 83% higher risk of NDD compared to children belonging to the richest quintile (ARR (Adjusted Risk Ratio): 1.83; 95% CI (Confidence Interval): [1.13, 2.94]). Children fed the recommended meal diversity had 25% lower risk of neurodevelopmental delay compared to children who did not (ARR: 0.75; 95% CI: [0.60, 0.94]). Children who were exclusively breastfed for the first 6 months had 27% lower risk of neurodevelopmental delay compared to children who were not (ARR: 0.73; 95% CI: [0.56, 0.96]). We recommend that infants born following obstructed labor undergo neurodevelopmental delay screening.

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COVID-19 vaccine hesitancy among health workers in rural Uganda: A mixed methods study

Onuni, Diox Patrick; Namulondo, Racheal; Wamune, Benon; Okia, David; Olupot Olupot, Peter; Nantale, Ritah; Matovu, Joseph KB; Napyo, Agnes; Lubaale Yovani A. Moses; Nhakira,Nathan; Mukunya, David

COVID-19 vaccination is the latest preventive intervention strategy in an attempt to control the global pandemic. Its efficacy has come under scrutiny because of break through infections among the vaccinated and need for booster doses. Besides, although health workers were prioritized for COVID-19 vaccine in most countries, anecdotal evidence points to high levels of reluctance to take the vaccine among health workers. We assessed COVID-19 vaccine hesitancy among health workers in Dokolo disttrict, northern Uganda

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Podlipnik, Crtomir

The book Ebola is a relevant resource of knowledge about various aspects of the Ebola virus (EBOV) and the related disease. Many experts from different fields of science and from different parts of the world contributed to the creation of this book. The book contains valuable information about firsthand experience of managing Ebola virus disease (EVD) in Third World countries and offers the best practices to handle possible pandemic outbreaks of Ebola. Detailed analysis of EBOV genome is also given, with the description of EBOV pathology supported with structural information, and in addition, the various tasks and strategies for the development of an effective anti-Ebola cure are proposed.

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Managing ebola in low-resource settings:

Okware, Samuel

Five outbreaks of Ebola virus disease of the Sudan Ebola virus and the Bundibugyo Ebola virus occurred in Uganda from 2000 to 2012. The attack rates and the case fatality rates were much higher for the former than the later. Fever and bleeding manifestations associated with the clustering of cases were typical clinical features. Close contact with infected person was probably the major route of spread. Apparent asymptomatic and atypical Ebola infection was demonstrated in some close contacts, suggesting past un recognized exposure or cross-reacting antibodies. A zoonotic connection was apparent in monkeys and asymptomatic villagers. The Ministry of Health together with its partners contained the outbreaks, sometimes with delays, but at least once prompt‐ ly. Early detection and communication yielded the best ideal outcomes. A community based response ensured timely case search and contact tracing for the isolation and management of patients. The syndrome-based EVD case definition and the laboratory screening tests for Ebola were used to detect cases. However, their unknown specificity and sensitivity and their low positive predictive values were a major weakness in the screening process. Validation of the criteria and the tests at the local level was essential. There were gaps in isolation procedures as 64% of the health care workers were infected after the isolation units were established. Palliative treatment was an important part of management as it improved survival and public confidence. 

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Ebola and health partnerships, action in a time of crisis.

Brown, Colin S; Elsherbiny, Mohamed; Johnson, Oliver; Kamboz, Amardeep; Lado, Marta; Leather, Andrew; Mounter, Natalie; Thomas, Suzanne; Youkee, Dan; Walker, Naomi; Awonuga, Waheed; Kamara, TB; Kamara, Cecilia; Kasette, Quannan; Ngauja, Ramatu

The chapter explores the role of health partnerships in delivering services throughout the West African Ebola Virus Disease epidemic, including the creation of the Ministry of Health & Sanitation Ebola Holding Unit models, command and control structures, research into diagnostics and care pathways, and general medical care. It will highlight how this provided resilience during the Ebola response, and how this will aid health systems strengthening going forward.

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A genomic landscape of haplotype diversity and signatures of phylogeographic distribution in Zaire ebolavirus during the 2014 EVD epidemic.

Teng, Yue; Yu, Yan; Jin, Yuan; An, Xiaoping; Feng, Dan

The Ebola virus (EBOV) disease epidemic from 2013 to 2015 is the largest in history, affecting multiple countries in West Africa. Genome sequencing of EBOV has revealed extensive genetic variation and mutation rate. The evolution and the variations among genotypes of EBOV observed remain low, which suggests that the viral haplotypes may be common in this transmission. To address this hypothesis, we investigated the genomic portrait of haplotype diversity in EBOV from 1976 to the 2014 outbreaks. We obtained 176 haplotypes in 305 gene-coding sequences of EBOV and found that the Hap8 in multiple viral haplotypes is the major epidemic lineage in the 2014 Sierra Leone outbreak. The phylogeographic analysis of EBOV transmission in Sierra Leone during 2014 outbreaks indicated that the genetic flow in EBOV was no more likely to occur within or without populations and the correlation between genetic and geographical distance is not significant. Our study first detected the diversity of viral haplotypes with systematic calculation of phylogeographic distribution in EBOV. This observation highlighted how Ebola virus is substantially different in virulence or transmissibility in comparison to the virus lineages associated with 2014 outbreaks in Sierra Leone, which provides a clue to understand the 2014 EBOV spreading. Keywords: Ebolavirus, Genome sequencing, Evolutionary, Haplotype diversity, Phylogeographic distribution.

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Prediction of ebolavirus genomes encoded microRNALike small RNAs using bioinformatics approaches.

Teng, Yue; Xu, Zhe; Yuan, Jin; An, Xiaoping; Song, Jiangman; Feng, Dan

Recent findings revealed that certain viruses encoded microRNA-like small RNAs using the RNA interference machinery in the host cells. However, the function of these virusencoded microRNA-like small RNAs remained unclear, and whether these microRNAlike small RNAs were involved in the replication of the virus and viral infection was still disputable. In this chapter, the negative-sense RNA genome of Ebola virus (EBOV) was scanned using bioinformatics tools to predict the EBOV-encoded microRNA-like small RNAs. Then, the potential influence of viral microRNA-like small RNAs on the viral immune evasion, host cellular signaling pathway, and epigenetic regulation of antiviral defense mechanism were also detected by the reconstructed regulatory network of target genes associated with viral encoded microRNA-like small RNAs. In this analysis, EBOV-encoded microRNA-like small RNAs were proposed to inhibit the host immune response factors, probably facilitating the evasion of EBOV from the host defense mechanisms. 

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Roles of VP35, VP40 and VP24 proteins of Ebola virus in pathogenic and replication mechanisms.

Hammou, Rahma Ait; Kasmi, Yassine; Khataby, Khadija; Laasri, Fatima Ezzahra; Boughribil, Said; Ennaji, My Mustapha

Ebola epidemic is a fatal disease due to Ebola virus belonging to Filoviridae; currently the viral evolution caused more than 50% of death worldwide. Among the eight proteins of ZEBOV, there are four structural proteins VP35, VP40, VP24, and NP, which have important functions in the intercellular pathogenic mechanisms. The multi‐functionality of Ebola's viral proteins allows the virus to reduce its protein number to ensure its proper functioning and keeping the compact structure of the virus. Therefore, the aim of this chapter is to study the mechanism of replication and the roles of VP30, VP35, NP, and L in this process. We provide as well to highlight the influence of the virus on the immune system and on the VP24. Keywords: Ebola, VP35, VP40, VP24, pathogenic, replication, mechanisms, immune system.

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Strategies for the development of small molecule inhibitors of Ebola viral infection.

Pleško, Sebastian; Podlipnik, Črtomir

The recent outbreak of Ebola viral disease (EVD) in West Africa reminded us that an effective anti-viral treatment still does not exist, despite the significant progress that has recently been made in understanding biology and pathology of this lethal disease. Currently, there are no approved vaccine and/or prophylactic medication for the treatment of EVD in the market. However, the serious pandemic potential of EVD mobilized research teams in the academy and the pharmaceutical industry in the effort to find an Ebola cure as fast as possible. In this chapter, we are giving the condensed review of different approaches and strategies in search of a drug against Ebola. We have been focusing on the review of the targets that could be used for in silico, in vitro, and/or in vivo drug design of compounds that interact with the targets in different phases of the Ebola virus life cycle. Keywords: small molecule inhibitors, Ebola virus, drug design, protein targets, structure and action.

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Community contribution to the control of Ebola outbreaks in Uganda, 2000-2022.

Okware, Samuel

Samuel Okware describes the role that communities have played in the control of Ebola outbreaks in Uganda from 2000 to 2022. He basically talks about how to manage Ebola in the low developed countries pointing out the experiences from Uganda. This chapter discusses the different Ebola outbreaks in Uganda between 2000 and 2012.

Ebola preparedness and risk in Latin America.

Rodriguez‐Morales, Alfonso J.; Cardona‐Ospina, Jaime AndrésFernanda‐Urbano, Sivia; Nasner‐Posso, Katherinn Melissa; Cruz‐Calderón, Stefania; Calvache‐Benavides, Carlos E.; Delgado‐Pascuaza, Yudy Lorena; Castillo, Juan Camilo; Alvarez‐Ríos, Maria Yamile; Marín‐Rincón, Hamilton A.; Urrutia, Liceth; Paniz‐Mondolfi, Alberto

Until today, February 22, 2016, no confirmed Ebola cases have been diagnosed in Americas (except USA, four cases with one death). Confusion, lack of knowledge, and fear have led to quickly misclassify cases as suspected, when in fact most of them are false alarms. Nevertheless, European governments summoned to mobilize resources to attend the Ebola outbreak in West Africa. And also Latin American governments should contrib‐ ute to halt this humanitarian crisis and to be prepared for the potential arrival of this deadly virus in the Caribbean, Central, and South American mainland. In this chapter, we described the experience of preparedness as well as risk assessment done in Latin America regarding the threat of Ebola for the region. Keywords: Ebola, preparedness, risk assessment, travel medicine, Latin America

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Ebola virus’s glycoproteins and entry mechanism.

Khataby, Khadija; Kasmi, Yassine; Hammou, Rahma Ait; Laasri, Fatima Ezzahra; Boughribil, Said; Ennaji, My Mustapha

Ebola virus glycoprotein (GP) is the only protein that is expressed on the surface of the virus. The GP proteins play critical roles in the entry of virus into cell and in the evasion of the immune system. The GP gene transcript to membrane GP is constituted of two subunits GP1 and GP2,and the secretory GP (sGP). The main function of GP1/2 is to attach virus to target cell’s membrane, whereas sGP has multiple functions on Ebola pathogen‐ esis, such as inactivate neutrophils through CD16b causing lymphocyte apoptosis and vascular dysregulation. There are many studies that focused on better understanding the GP mechanism and aim at developing new antibodies and drugs such as VSV-EBOV, cAd3-EBO Z, rVSVN4CT1 VesiculoVax, ‘C-peptide’ based on the GP2 C-heptad repeat region (CHR) targeted to endosomes (Tat-Ebo) and MBX2270. In this chapter, we discuss the Ebola viral glycoproteins, genomic organization, synthesis, and their roles and functions. On the other hand, we treat the mechanisms of pathogenicity associated with Ebola GPs. Keywords: EBOLA, virus, glycoprotein (GP), entry, mechanism, pathogenesis, structure

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