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by Dr. Michael Lee – Health Editor
written by Dr. Michael Lee – Health Editor

This study provides a significant contribution to understanding the factors associated with severe malaria hospitalizations in a non-endemic region, expanding the knowledge of the disease’s dynamics in areas with epidemiological patterns distinct from those observed in the Amazon Region. By addressing sociodemographic vulnerabilities, such as ethnicity, education level, and the origin of cases, the study identified critical gaps in the malaria surveillance and response system in the extra-Amazon Region. These findings hold practical and policy implications not only for Brazil but also for other countries facing similar challenges. On a global scale, the results offer an applicable model for malaria-free countries vulnerable to imported cases, supporting the development of adaptable strategies for surveillance, risk mitigation, and rapid outbreak response, ultimately contributing to the reduction of severe cases.

Approximately half of the malaria cases reported in Piauí from 2002 to 2013 were autochthonous. While imported cases occur are registered at the end of the rainy season, particularly in municipalities bordering Maranhão[[23]. This trend was observed in hospitalizations originating from municipalities near the Maranhão border and from Maranhão itself. Regarding the high number of hospitalizations in Wenceslau Guimarães, Bahia, it was the result of an outbreak in 2018, which led to 50 confirmed cases, mainly within a settlement area[[24].

It is important to understand that hospitalization is determined by medical criteria, not solely by clinical condition. Patients who are difficult to treat and more likely to relapse are hospitalized more frequently, as are children. In some cases, such as outbreaks like the one in Piauí, to prevent relapses and severe malaria cases, most patients are hospitalized until treatment is completed. Thus, not only the severity but also medical caution may be factors that lead to hospitalization in the extra-Amazon Region.

The profiles of hospitalizations in the extra-Amazon Region predominantly affected men, Black or mixed-race individuals, and those aged 20 to 39 years. In a study of Brazil’s Extra-Amazon Region, Garcia et al. [[5]identified a similar profile. According to the authors, this profile is closely linked to socioeconomic factors, such as education, economic activity, and income, which are inherently related to social inequalities. The analyses indicated that patients with lower educational attainment (elementary or high school) were more likely to be hospitalized than those with higher education. A similar profile was found by Forero-Peña et al. [[25]in Venezuela, which was closely related to economic activities.

There was also an association between hospitalization risk and Black or mixed-race ethnicity. According to Silva et al.[[26], most of the Black population holds less-skilled positions with lower pay, lives in areas with limited infrastructure services, and faces greater restrictions in accessing healthcare. When this population does access healthcare, the quality and effectiveness tend to be lower, contributing to an increased risk of severe malaria cases.

According to Degarege et al. [[27]in a meta-analysis conducted, low education levels are usually associated with low income and low-standard housing, which are linked to a higher risk of malaria, heavily influenced by the limited access to diagnosis, treatment, and prevention measures, often due to difficulty in accessing these services because of a lack of economic resources. Education is connected to occupational opportunities and improved life status, further increasing knowledge and access to information that promotes health and health services, leading to better acceptance of prevention practices carried out by the individual as well as those promoted by local health services. At the same time, it promotes higher income and better housing[[27]. Moreover, the difficulty in accessing services, whether due to distance and transportation costs or low quality of the services, contributes to delays in treatment.

Proper and timely treatment of malaria significantly reduces hospitalization risk. The low incidence of malaria in the extra-Amazon Region makes its diagnosis challenging for local physicians, as it is not part of their routine practice[[28]. For example, in Rio de Janeiro, a healthcare professional in an emergency department is 466 times less likely to identify a malaria case than a dengue case. Moreover, 55% of malaria cases treated at the Evandro Chagas National Institute of Infectious Diseases (a reference centre in Rio de Janeiro) were initially misdiagnosed as dengue during the first consultation[[28]. The adjusted regression model showed that patients treated more than 48 h after symptom onset were more likely to be hospitalized, with increasing likelihood for delays of 3–7 days or 8 days or more. Nearly all severe malaria cases are caused by P. falciparum, while P. vivax and P. malariae rarely cause severe complications[[29].

Active detection was protective against hospitalization compared to passive detection. This is closely linked to surveillance activities during outbreaks and patient follow-ups during treatment. The notification of autochthonous cases, which represent a risk of reintroduction and a sharp increase in cases in a short time, is an alert for healthcare services. This alert prompts temporary sensitization of local surveillance systems, increasing the detection of undiagnosed patients and follow-up of those identified through an index case. These actions improve timely diagnosis and, consequently, reduce hospitalization risk[[5, 20]. The severity of the disease is intrinsically related to the level of parasitaemia, especially when it comes to malaria caused by P. falciparum, which is capable of infecting red blood cells of all ages, while P. vivax prefers young red blood cells[[30]. Similarly, the level of parasitaemia results in symptoms arising from haematological changes and the immune response, which is usually higher in children without immunity to the disease[[31]. Thus, case detection through active case finding is also a protective factor, as it can identify asymptomatic cases or those with few symptoms before they reach high parasitaemia that results in more severe clinical symptoms.

The Brazilian experience mirrors what occurs in other countries. For instance, in Australia, traveller movements occur constantly, with approximately 324 cases reported annually between 2012 and 2022, exhibiting a demographic profile similar to that observed in Brazil’s extra-Amazon Region, primarily men aged 20 to 39 years[[32]. The main difference lies in the origin of imported cases, which reflect global trends. A high prevalence of P. falciparum cases is reported from African countries, whereas Australia has received the highest number of P. vivax cases, accounting for up to one-third of imported cases[[32]. Nevertheless, imported malaria represents an ongoing threat to malaria-free countries due to the potential for reintroduction of transmission and the occurrence of severe cases requiring intensive care unit hospitalization. This risk is often exacerbated by diagnostic delays caused by a lack of clinical suspicion, which is influenced by determinants similar to those identified in Brazil’s extra-Amazon Region[[32].

In the extra-Amazon Region, only 19% of malaria cases are treated within 48 h of symptom onset, compared to 60% in the Amazon Region, where malaria is more quickly suspected. Delays in diagnosis and treatment contribute to the higher proportion of severe malaria cases in non-endemic areas. Also, malaria fatality rates in the extra-Amazon Region can be up to 123 times higher than in the Amazon Region[[8, 33].

In the context of global changes, climate change can directly or indirectly impact human health and malaria transmission. Long-term predictive models suggest that climate change will significantly affect efforts to eradicate malaria if environmental interventions do not continue, further increasing the population at risk for the disease[[24, 34]. Furthermore, climate change may impact the achievement of the goals proposed by Brazil’s National Malaria Elimination Plan, which aims to eliminate autochthonous disease transmission by 2035[[35], potentially causing disease outbreaks in both the Extra-Amazon and Amazon Regions, as well as deaths resulting from severe cases.

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Health

Natural compounds from turmeric and rhubarb show promise against superbugs in wastewater

by Dr. Michael Lee – Health Editor
written by Dr. Michael Lee – Health Editor

When we’re taking antibiotics, some of the dose is excreted with urine and feces and ends up in our wastewater. The presence of this low dose of antibiotic creates an opportunity for resistant bacteria to evolve. Scientists studying antibiotic resistant bacteria in wastewater at a treatment plant discovered multi-drug resistant strains of bacteria species which are usually not dangerous to healthy people, but which could transmit genes for antibiotic resistance to much more dangerous bacteria like E. coli.

The scientists then challenged the bacteria with natural compounds which could potentially be included in wastewater treatment to kill off bacteria and fight antibiotic resistance. The most effective were curcumin, which comes from turmeric, and emodin, from rhubarb.

“Without improved treatment, wastewater could serve as a breeding ground for ‘superbugs’ that may enter water resources such as rivers, lakes, and reservoirs, posing potential risks to public health,” said Dr. Liyuan ‘Joanna’ Hou of Utah State University, senior author of the article in Frontiers in Microbiology. “Our goal was to isolate and characterize multidrug-resistant bacteria, explore the molecular mechanisms of resistance through whole-genome sequencing, and assess the potential of natural compounds as alternative mitigation strategies.”

Survival of the resistant

Antibiotic resistance develops when bacteria evolve to be less vulnerable to antibiotics. This is more likely to happen if bacteria are exposed to a dose of vaccine which is too low to kill them all; the survivors develop resistance. Someone infected with these resistant bacteria may then find that their treatment doesn’t work, potentially making routine surgery or illness much more dangerous.

Some bacteria are resistant to several antibiotics; these infections are often treated with ‘last resort’ drugs like colistin. However, when Hou and her colleagues tested samples of effluent from a wastewater treatment plant in Logan, Utah, they found some colonies of bacteria that were resistant even to colistin. This underlines the urgency of finding ways of preventing and treating bacterial infection which minimize the use of antibiotics.

The scientists screened their samples using one antibiotic, sulfamethoxazole, to identify nine different antibiotic-resistant strains. These strains of bacteria were then tested against multiple classes of antibiotic to see how many they resisted. Their genomes were also sequenced, which allowed the scientists to identify not just the bacteria themselves but genes which contribute to their antibiotic resistance. One strain, U2, which had the highest number and variety of antibiotic resistance genes, was resistant to all the antibiotics tested.

The strains represented species of Microbacterium, Chryseobacterium, Lactococcus lactis, and Psychrobacter, which are rarely dangerous to most people – but that doesn’t mean their presence is nothing to be worried about.

While not traditionally classified as top-priority clinical pathogens, some are opportunistic pathogens associated with infections such as pneumonia in immunocompromised individuals. These bacteria could also act as environmental reservoirs, transferring resistance genes to other bacteria, including clinically relevant pathogens.”


Dr. Liyuan ‘Joanna’ Hou of Utah State University

Fighting back

The scientists challenged colonies of these bacteria with different concentrations of 11 natural compounds: berberine, chlorflavonin, chrysin, curcumin, emodin, hesperidin, naringin, quercetin, resveratrol, rutin, and 2′-hydroxyflavone. They then looked at different measurements of the colonies’ health – cell growth, biofilm formation, and how active the bacteria were.

“We selected a panel of compounds primarily derived from plants, such as curcumin from turmeric, quercetin from onions and apples, and emodin from rhubarb,” said Hou. “These compounds were chosen based on their reported antimicrobial or anti-biofilm properties in previous studies and their natural abundance, making them promising candidates for exploring new, environmentally friendly approaches to mitigate resistance.”

They found that emodin and curcumin were best at inhibiting cell growth and biofilm formation, while curcumin and a higher dose of emodin reduced cell activity – although a low dose of emodin increased activity for several strains. However, Gram-negative bacteria like Chryseobacterium were resistant to all the compounds.

“While natural compounds like curcumin and emodin show promise in inhibiting Gram-positive multidrug-resistant bacteria, further research is needed,” said Hou. “Future work should include testing these compounds in complex wastewater matrices, exploring synergistic effects with existing treatment processes, and assessing long-term impacts on microbial communities and resistance dynamics. Additionally, scaling up from laboratory studies to pilot-scale trials will be critical for evaluating feasibility and environmental safety.”

Source:

Journal reference:

Li, M., et al. (2025). From wastewater to resistance: characterization of multidrug-resistant bacteria and assessment of natural antimicrobial compounds. Frontiers in Microbiology. doi.org/10.3389/fmicb.2025.1612534.

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Health

GATE complex discovery sheds light on CMV’s evasion of immune defenses

by Dr. Michael Lee – Health Editor
written by Dr. Michael Lee – Health Editor

New Discovery Could Revolutionize Treatment for Common Birth Defect Cause

Scientists have uncovered a hidden mechanism employed by cytomegalovirus (CMV), a widespread herpes virus. This finding provides fresh insight into preventing birth defects and vascular diseases, opening doors to novel antiviral drug development and possibly helping combat other herpes viruses.

CMV’s Clever Entry Strategy

Researchers from the University of Pittsburgh School of Medicine and the La Jolla Institute for Immunology have made a breakthrough. They’ve identified a unique way CMV, a herpes virus infecting most adults worldwide, infiltrates blood vessel cells. It uses an alternative “key” to evade the body’s immune defenses.

CMV employs a protein called gH to enter cells, similar to other herpes viruses. Unlike its herpes relatives, CMV exchanges gL with a partner, UL116, and recruits UL141. This gH-UL116-UL141 complex, dubbed GATE by the study authors, provides a backdoor into blood vessel lining cells, preventing immune detection.

“If we don’t know what weapons the enemy is using, it is hard to protect against it. We found a missing puzzle piece that represents one possible reason why immunization efforts against CMV have been unsuccessful.”

—Jeremy Kamil, Ph.D., Senior Author, Associate Professor of Microbiology and Molecular Genetics at Pitt

Implications and Potential Therapies

Congenital CMV infection affects around one in 200 babies in the United States. Of those infected, about 20% suffer birth defects like hearing loss, and may face long-term health problems. Globally, congenital CMV is the leading infectious cause of birth defects (CDC, 2024).

The GATE complex may be a new target for CMV vaccines and other herpes viruses. Previous efforts at producing a CMV vaccine failed before the identification of GATE, according to the researchers. Targeting GATE could improve the prospects of combating CMV infections, potentially clearing this persistent infection from our bodies.

Next Steps

The collaborative study included researchers such as Michael Norris, Lauren Henderson, Mohammed Siddiquey, Jieyun Yin, Kwangsun Yoo, Simon Brunel, Michael Mor, and Erica Ollmann Saphire. This work received support from the National Institutes of Health and ARPA-H.

The research team aims to develop antiviral drugs and vaccines that can block CMV’s entry. These could address the diseases the virus causes in both developing babies and individuals with weakened immune systems.

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Technology

Microbial Heritage: Global Project Gains Momentum

by Rachel Kim – Technology Editor
written by Rachel Kim – Technology Editor

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Microbiota vault Initiative: Global Effort to Preserve Earth’s Microbes Gains Momentum

Table of Contents

A global collaboration to create a “microbial Noah’s Ark,” known as the Microbiota Vault Initiative, is actively expanding its efforts to safeguard the world’s diverse collection of microbes before they disappear. This initiative aims to preserve microbial diversity for future generations, drawing inspiration from the Svalbard Global Seed Vault [1].

Ethical Framework and Global Collaboration

A team of 25 scientists involved in the Microbiota Vault Initiative published a viewpoint article in Nature communications, outlining their successes and an ethical framework to ensure equitable collaboration and depositor sovereignty. This framework guides the initiative’s mission to safeguard microbial diversity. The declaration coincided with World Microbiome Day on June 27, marking a meaningful step forward in this global endeavor.

Did you Know? The Human Microbiome Project, launched in 2007, aimed to systematically study the human microbiome and its role in health [[2]].

The Crucial Role of Microbes

Microbes,including bacteria,viruses,and fungi,exist everywhere and form communities known as microbiomes. Recent research emphasizes the critical role of “good microbes” in maintaining human health by aiding digestion, strengthening the immune system, and protecting against harmful invaders. Microbiomes are also vital for plants, food, and the environment. For example, soil microbes help plants grow, and fermented foods contain beneficial bacteria that support gut health.

Environmental microbiomes, such as those in Arctic permafrost, play essential roles in regulating climate by controlling greenhouse gas emissions. Though, human activities are disrupting the natural balance of microbiomes, posing a significant threat.

Threats to Microbial Diversity

According to research, human activities threaten microbiomes. In humans, the overuse of antibiotics, cesarean sections, and formula feeding can reduce the diversity of gut microbes, leading to increased risks of allergies, autoimmune diseases, and metabolic disorders. Similarly, excessive use of preservatives and additives in food can harm beneficial microbes.

For plants, unsustainable agricultural practices like heavy pesticide use can destroy soil microbiomes essential for nutrient cycling and plant health. Pollution, climate change, and habitat destruction also affect environmental microbiomes, leading to the loss of microbes that regulate greenhouse gas emissions and maintain ecosystem stability.

Initiative’s Goals and Progress

The Microbiota Vault Initiative supports identifying, storing, and freezing healthy microbes before they disappear. During its pilot phase, the initiative collected over 2,000 fecal specimens and samples of fermented food from various nations. The effort has grown to include over 100 researchers from 32 countries. Microbial samples are temporarily stored in cryogenic conditions at the Institute of Medical Microbiology at the University of Zurich.

The next phase, “Growth Phase 1,” aims to expand the collection to 10,000 samples by 2029 and actively seek government funding.Plans are underway to establish a permanent site for the vault, with potential locations in Switzerland, Canada, and other cold climates.

Ethical Considerations and Future Applications

The initiative’s ethical framework ensures that microbial diversity preservation is conducted fairly, respectfully, and inclusively. Key principles include depositor sovereignty,equitable collaboration,and ethical governance. The original collectors retain ownership and control over their microbial samples, and the initiative emphasizes respecting local knowledge and ensuring fair benefit sharing.

Pro Tip: Supporting lasting agricultural practices and reducing antibiotic overuse can help preserve microbial diversity.

While some enabling technologies are still in development, scientists envision using the collected samples to develop new medical treatments, improve agricultural practices, and restore damaged ecosystems.

Microbiota Vault Initiative: Key Metrics

Metric Value
Samples Collected (Pilot Phase) 2,000+
Target

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Health

Plastic to Pain Relief: Microbes Turn Waste into Paracetamol

by Dr. Michael Lee – Health Editor
written by Dr. Michael Lee – Health Editor

E.Coli Engineered to Convert Plastic Waste into Paracetamol

Table of Contents

In a groundbreaking development, scientists have successfully engineered Escherichia coli to transform plastic waste into valuable compounds, including paracetamol, a common pain reliever. This innovative approach merges synthetic organic chemistry and biotechnology,offering a potential solution to the growing global plastic waste crisis.

Turning Trash into Treasure: The Power of E. Coli

researchers have genetically modified E. coli to synthesize small molecules from plastic waste products [1]. This process not only addresses the environmental concerns associated with plastic pollution but also creates a pathway for producing valuable chemicals from recycled materials. The European Union is actively addressing plastic and microplastic pollution through various environmental policies, including the Registration, Evaluation, Authorisation and Restriction of Chemicals (REACH) [2].

Did You Know? The 10 most commonly found single-use plastic items are more likely to end up in the seas than reusable options [1].

The Science Behind the Breakthrough

The process involves using engineered E. coli to break down plastic polymers into smaller, more manageable molecules. These molecules are then used as building blocks for synthesizing desired compounds, such as paracetamol. This innovative approach demonstrates the potential of biotechnology in addressing environmental challenges and creating a more sustainable future.

Implications for the Future of Recycling

This breakthrough could revolutionize the way we approach plastic recycling. Instead of simply breaking down plastics into lower-value materials, this method allows for the creation of high-value chemicals and pharmaceuticals. this could incentivize the collection and recycling of plastic waste, reducing its impact on the environment. The EU has expressed regret over inconclusive global plastics treaty discussions, particularly regarding the reduction of primary plastic polymers [3].

Pro Tip: Support initiatives that promote the reduction of single-use plastics and the development of innovative recycling technologies.

Global Plastic Waste: A Growing Concern

The accumulation of plastic waste is a significant environmental problem, with millions of tons entering our oceans and landfills each year.Single-use plastics are a major contributor to this problem, frequently enough ending up in the marine environment [1]. Finding innovative solutions for recycling and repurposing plastic waste is crucial for protecting our planet.

Key metrics: plastic Waste and Recycling
Metric Value Source
Global Plastic production (Annual) ~400 million tons Statista
Plastic Waste Entering Oceans (annual) ~8 million tons Science
global Plastic Recycling Rate ~9% OECD

Evergreen Insights: The Plastic Problem and Potential Solutions

The issue of plastic waste has become increasingly urgent in recent years, driven by the exponential growth in plastic production and consumption. Conventional recycling methods have proven insufficient to address the scale of the problem, leading to a search for innovative solutions. The development of bioengineered organisms like E. coli to break down and repurpose plastic waste represents a promising step towards a circular economy, where waste is minimized and resources are used more efficiently.

Historically, efforts to combat plastic pollution have focused on reducing consumption, improving recycling infrastructure, and developing biodegradable alternatives. Though, these approaches have faced challenges related to cost, scalability, and consumer behavior. The use of biotechnology to transform plastic waste into valuable products offers a new paradigm, possibly creating economic incentives for recycling and reducing the reliance on fossil fuels for chemical production.

Frequently Asked Questions About Plastic Recycling with E.Coli

How does E. coli convert plastic waste?

Researchers have genetically modified escherichia coli to synthesize small molecules, including paracetamol, from a plastic waste product through a combination of synthetic organic chemistry and biotechnology.

What are the potential benefits of using E. coli for plastic recycling?

using E. coli for plastic recycling offers a sustainable method for converting harmful plastic waste into valuable compounds, reducing environmental pollution and promoting a circular economy.

Is this method of plastic waste conversion scalable?

Further research and development are needed to optimize the process and assess the scalability of using E. coli for large-scale plastic waste conversion.

What types of plastic can be processed using this method?

The current research focuses on specific plastic waste products that can be broken down and utilized by the engineered E. coli. The specific types of plastics that can be processed may vary depending on the engineered strain.

What is paracetamol and why is it significant?

Paracetamol, also known as acetaminophen, is a widely used over-the-counter medication for pain relief and fever reduction. Its synthesis from plastic waste demonstrates the potential for creating valuable products from recycled materials.

What other innovative solutions can definitely help tackle the plastic waste crisis? How can individuals contribute to reducing plastic pollution?

Disclaimer: this article provides details about scientific research and should not be interpreted as medical or professional advice.

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