Digital Commons Network^™

Nurses’ Knowledge Regarding Ventilator-Associated Pneumonia Prevention Bundle In Adult Cardiac Care Units, Marwa Abdo

Nursing

Ventilator-associated pneumonia (VAP) is among the most common ICU infections for ventilated patients, associated with increased mortality (20-50%), morbidity, and health care costs. Nurses' knowledge of VAP prevention bundles is vital to reducing its incidence in critical care areas. Aim: To assess Nurses’ knowledge regarding the ventilator-associated pneumonia prevention bundle in Adult Cardiac Care Units. Study design: A cross-sectional study design was used. Setting: This study was conducted in both the adult cardiac intensive care unit and the cardiac care unit at Aswan Heart Centre–Magdy Yacoub Foundation, Egypt. Subject: A convenience sample of 67 nurses was selected. Data collection tool: …

Glycosphingolipids Regulate Phosphatidylserine Transport Machinery That Operates At Er-Pm Contact Sites, Ritchel Gannaban, Sher Ali, Wei Chen, Melanie Nguyen, Li Lai, Travis I Moore, Yubin Zhou, John F Hancock, Junchen Liu

The Brown Foundation: Institute of Molecular Medicine

Plasma membrane (PM) localization of KRAS requires specific glycosphingolipids in the outer leaflet and phosphatidylserine (PS) in the inner leaflet. PM PS content is controlled by lipid transport proteins ORP5 and ORP8, which operate at ER-PM membrane contact sites (MCSs). Using high-resolution imaging, we now show that GSLs, including GM3 and SM4, are required to maintain ORP5 and ORP8 localization to MCSs. Genetic deletion or pharmacologic inhibition of enzymes required for the biosynthesis of GM3 or SM4 displaces PI4-kinase Type IIIα (PI4KIIIα) and its adaptor EFR3A from the PM, thereby reducing PM phosphatidylinositol 4-phosphate (PI4P) content. PM interactions of ORP5 …

Apolipoprotein B100 Predicts Cardiovascular And Limb Events In Type 2 Diabetes Patients With Chronic Limb-Threatening Ischemia, Federico Biscetti, Maria Margherita Rando, Maria Anna Nicolazzi, Flavia Angelini, Roberto Iezzi, Luis H. Eraso, Paul J. Dimuzio, Dario Pitocco, Massimo Massetti, Antonio Gasbarrini, Andrea Flex

Department of Surgery Faculty Papers

BACKGROUND: Patients with type 2 diabetes mellitus (T2DM) and chronic limb-threatening ischemia (CLTI) undergoing lower extremity revascularization (LER) face high risks of major adverse cardiovascular events (MACE) and major adverse limb events (MALE), despite guideline-directed lipid-lowering therapy. Apolipoprotein B100 (ApoB100), reflecting total atherogenic particle number, may identify residual risk beyond LDL-cholesterol (LDL-C). Therefore, we investigated whether baseline ApoB100 levels independently predict MACE and MALE beyond conventional risk factors in this high-risk population.

METHODS: In this prospective cohort study, 167 T2DM patients with CLTI undergoing LER were followed for 12 months with visits at 1, 3, 6, and 12 months post-procedure. …

Immunohistochemical Expression Of Lgr5 In The Bovine Ovary, Oviduct, And Uterus, Aytül Kürüm, Yasi̇n Özkabadayi, Hakan Kocamiş, Mustafa Türk, Si̇yami̇ Karahan

Turkish Journal of Veterinary & Animal Sciences

Leucine-rich repeat-containing G-protein coupled receptor 5 (LGR5) has recently been considered as a stem cell marker seen especially in mitotically active tissues. The aim of the present study was to investigate the immunohistochemical expression of LGR5 in the bovine reproductive tract, which is regularly renewed in response to hormonal changes throughout the estrous cycle. The oviduct (ampulla, isthmus, and fimbria), uterus, and ovary tissue samples were collected from 12 cows at a local slaughterhouse. The samples were further identified as follicular (n = 6) or luteal (n = 6), subjected to routine histological procedures, and processed for immunohistochemical expression of …

Determination Of Hematobiochemical Parameters And Egg Quality Traits Of Turkish Sultan Chickens, Mehmet Naci̇ Oktay, Ruhi̇ Kabakçi, Ali̇ Karapinar, Gökhan Şen, Taha Altuğ, Yasi̇n Şenel

Turkish Journal of Veterinary & Animal Sciences

The present study aimed to investigate the hematological and biochemical blood parameters, along with selected egg quality traits, of Turkish Sultan chickens. A total of 90 blood samples collected from 60-week-old hens and roosters and 129 eggs collected from 50 hens were analyzed. The findings showed that hematological parameters such as red blood cells (RBC), hemoglobin (HGB), packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and heterophil-to-lymphocyte (H/L) ratio, as well as biochemical markers such as aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and uric acid levels, were significantly higher in roosters. The average egg weight, shape …

Comparison Of Bacteriological Culture And A Multiplex Real-Time Pcr Kit For The Detection Of Mastitis Pathogens In Small Ruminants, Ebru Karakaya Bi̇len, Serpi̇l Kahya Demi̇rbi̇lek, Bariş Güner, Öznur Yilmaz Koç, Ali̇ Ünver, Merve Yildiz, İrem Çakmak, Abdulkadi̇r Keski̇n

Turkish Journal of Veterinary & Animal Sciences

This study aimed to evaluate the applicability of a multiplex real-time PCR (rPCR) kit, originally developed for bovine mastitis, for detecting mastitis pathogens in small ruminants and reducing bacterial identification time compared with conventional bacteriological culture (BC). Milk samples were obtained from 175 sheep and 124 goats and included cases of clinical mastitis (n = 57) and subclinical mastitis (n = 242). With BC, bacterial growth was detected in 125 of 299 milk samples (41.8%), yielding a total of 169 bacterial isolates. The pathogens most frequently isolated by BC were coagulase-negative staphylococci (58.0%), followed by Streptococcus spp. (9.4%), Staphylococcus aureus …

Motherwise In Nicaragua: The Implementation Of Culturally Adapted Relationship Education For Women During Pregnancy And Postpartum, Amanda Key Correa Love

Graduate School of Professional Psychology: Doctoral Papers and Masters Projects

Intimate partner violence (IPV) is a concerning public health issue of global proportions, particularly within rural and under-resourced settings. Communities in these settings face elevated risk for relationship abuse, further compounded by barriers to access culturally responsive preventive intervention programming. This qualitative study investigated participant experiences, cultural adaptation, and implementation of the MotherWise program, a healthy relationship education intervention in rural Leon, Nicaragua. Semi-structured interviews were conducted with former and current program participants as well as the program facilitator following the initial program implementation. Data were analyzed using thematic analysis to identify patterns related to participant experiences, the types of …

Aid As Leverage: How Humanitarian Assistance Shapes The Health Power Dynamics In Eastern Democratic Republic Of Congo, Emmanuella K. Mbuyu

University Honors Theses

This paper examines humanitarian aid in the Eastern Democratic Republic of Congo, where it serves as both relief and a force reshaping local power dynamics within ongoing conflict. Humanitarian organizations provide essential services in contexts of state collapse, but aid delivery is deeply embedded in systems of coercion, negotiation, and external influence. Drawing on critical humanitarianism and the aid economy, this study analyzes how humanitarian access is negotiated, how donor priorities shape definitions of need, and how temporary interventions create dependency and instability. The paper explores how humanitarian action can reinforce alternative structures of authority, particularly in weak or absent …

Testing Potential Correlations Between Childhood Lead Exposure And Authoritarianism In Adulthood, Kragen Anderson

University Honors Theses

A significant body of research links lead exposure during childhood to negative effects ranging from increased impulsivity to societal level effects such as an increased likelihood of committing violent crime in adulthood. Due to exposure vectors such as lead water pipes, lead solder, lead based paints, and leaded gasoline there was significant lead exposure during childhood for large portions of the American population. This paper tested and found a statistically significant association between average population level lead exposure in childhood and likelihood of voting for candidate Trump later in life.

Healthcare Access Challenges Among Asian Americans, Phyo Theingi

University Honors Theses

Asian Americans are the fastest growing racial ethnic group in the U.S. According to the 2023 U.S. Census Bureau population estimate, Asian Americans account for 25.2 million (or 7.4%) of the nation's population. Asian Americans are not a monolith and represent a diversity of rich histories, cultures, languages and ethnicities. According to research conducted by the Pew Research Center, most Asian Americans face discrimination of some kind, including being treated as a foreigner in the U.S and being stereotyped as a model minority. They also experience health care access barriers. Research found that Asian Americans face barriers related to language …

Origins Of Mitochondrial Diversity In Turkish Sheep Breeds: Anatolia As A Contact Zone Or Refugial Center?, Nezi̇h Ata, İbrahi̇m Cemal

Turkish Journal of Veterinary & Animal Sciences

Advances in molecular genetics, especially the integration of mitochondrial DNA (mtDNA) analyses, have significantly transformed our understanding of the origins, geographical centers, and dispersal dynamics of domestication, a field traditionally based on archaeological and morphological evidence. In this study, the mtDNA control-region sequences of 296 individuals from 15 native Turkish sheep breeds were analyzed to clarify their maternal genetic diversity and evolutionary origins. Sequencing of a 531-bp D-loop fragment revealed 53 polymorphic sites and 78 distinct haplotypes, indicating substantial haplotypic diversity (Hd = 0.918) and nucleotide diversity (π = 0.01391) within these populations. All five major ovine mitochondrial haplogroups (A, …

Comparative Efficacy Of Controlled Internal Drug Release And Medroxyprogesterone Acetate Sponges On Ovulatory Follicle Growth In The Ovsynch Protocol During The Breeding Season In Cyclic Nili Ravi Buffaloes, Muhammad Binyameen, Ali Husnain, Saba Anwar, Muhammad Waseem, Muhammad Saleem

Turkish Journal of Veterinary & Animal Sciences

The objective of the experiment was to compare the dominant follicle size, growth rate of the dominant follicle, estrus response, plasma progesterone concentration, and pregnancy in Nili Ravi buffaloes synchronized by controlled internal drug release (CIDR; 1.38 g) and medroxyprogesterone acetate sponge (MPAS; 250 mg) in the ovulation synchronization (OvSynch) protocol. The experiment had a randomized complete block design. Buffaloes (n = 42) were blocked by parity, body weight, body condition score, and ovarian status, and, within the block, they were randomized to receive either CIDR or MPAS and that day was considered day 0 of the experiment. On days …

The In Vitro Feeding Of Hyalomma Marginatum (Koch, 1844), Nesli̇han Ölmez, Bariş Sari, Zati̇ Vatansever

Turkish Journal of Veterinary & Animal Sciences

Ticks are obligate hematophagous ectoparasites that play a major role in the transmission of pathogens affecting both animals and humans. Investigations into tick biology, pathogen transmission, and the development of effective control strategies have traditionally depended on the extensive use of laboratory animals. Consequently, the development of reliable in vitro feeding systems is a valuable alternative approach with the potential to reduce animal use in tick research. In the present study, a previously described silicone membrane artificial feeding system was modified and applied for the in vitro feeding of Hyalomma marginatum (Koch, 1844). Feeding units were prepared using bovine blood …

Single-Nucleus Profiling Reveals A Core Disease Signature And Cell Type-Specific Vulnerabilities In Early Rett Syndrome, Yan Li, Ashley G Anderson, Guantong Qi, Sih-Rong Wu, Jean-Pierre Revelli, Hu Chen, Zhandong Liu, Huda Y Zoghbi

Faculty, Staff and Students Publications

Rett syndrome (RTT) is an X-linked neurological disorder caused by MECP2 mutations, creating distinct cellular environments in females (mosaic) versus males (nonmosaic). Despite female patients representing most cases, how mosaicism contributes molecularly to RTT pathogenesis, particularly in presymptomatic stages, remains poorly understood. To address this question, we profiled hippocampal transcriptomes of young female and male RTT mice using bulk and single-nucleus RNA sequencing. We identified a core disease signature of consistently dysregulated genes only in MeCP2− cells across RTT models. Moreover, we uncovered non–cell autonomous effects exclusively in female MeCP2+ excitatory neurons, suggesting that these circuits are more vulnerable early …

Artificial Intelligence In Biomedical Scientific Publishing, Tomasz J Guzik, Victor Aboyans, Stefan Agewall, Steven Bailey, Adrian Baranchuk, Magnus Bäck, Michael Böhm, Robert O Bonow, George W Booz, Giuseppe Boriani, Biykem Bozkurt, Nico Bruining, Davide Capodanno, Çetin Erol, Péter Ferdinandy, Alessia Gimelli, Gerd Heusch, Thomas Kahan, Chim Choy Lang, Gerald Maurer, Robert J Mentz, Marco Metra, Philip Moons, Daniel Piskorz, Massimo Piepoli, Piotr Ponikowski, Alexandra Popma, Bianca Rocca, Juan Sanchis Fores, Philipp Sommer, Rhian M Touyz, Zoltan Ungvari, Pascal Vranckx, Joseph A Hill, Thomas F Lüscher, Filippo Crea

Faculty, Staff and Students Publications

Artificial intelligence is now embedded across the scientific research and publishing ecosystem, influencing discovery, analysis, knowledge translation, authorship, peer review, and editorial workflows. In cardiovascular and biomedical sciences, these developments offer substantial opportunities to accelerate knowledge generation, integrate complex datasets, and improve efficiency and consistency. At the same time, they introduce new risks related to bias, transparency, data integrity, and authorship responsibility, potentially endangering trust in the scientific record. This commentary examines the evolving role of AI in biomedical publishing, with particular attention to generative models and machine learning tools. We review both benefits and limitations, highlight risks such as …

Granular Phenotyping Of Neuromuscular And Cortical Adaptation In Elite Judo Athletes: A Three-Group Experimental Analysis Using Eeg And Emg Markers, Magdalena Prończuk, Dariusz Tadeusz Skalski, Wirginia Likus, Łukasz Jaworski, Adam Maszczyk, Kinga Łosińska

Baltic Journal of Health and Physical Activity

Background: Inter-individual variability in neuromuscular and cortical adaptation presents a significant challenge for the personalization of neurofeedback protocols in elite sports, particularly in judo. Objective: This study aimed to identify distinct adaptation phenotypes in elite Polish judo athletes by integrating electrophysiological and performance-based measures following an EEG biofeedback intervention. Materials and methods: Twenty-four male athletes from the Polish national judo team completed a 15-session EEG biofeedback protocol targeting frontal alpha asymmetry. Post-intervention assessments included surface EMG amplitude (RMS), median frequency (MF), percentage EMG change, composite EEG indices (EEG_SUM), and normalized lower-limb strength. A composite Global Adaptation Index (GAI) was used …

Bringing Behavioral Health Into The Pediatric Clinic, Bob Underwood, Rebekah O'Donnell

Pediatrics in Practice: A CME Podcast

A clear, practical look at integrated behavioral health in pediatric primary care — what it looks like day-to-day, who benefits and how to get started in your practice. Rebekah O'Donnell, LCSW from Children's Mercy, walks listeners through real examples of warm handoffs, care coordination and screening workflows to improve outcomes for children and families.

Click here to stream the podcast episode.

Financial Implications Of Vascular Surgery Conference Fees, Alexandra Kats, Gerard M. Martin, Sanath Patil, Joshua R. Chen, Paul J. Dimuzio, Dawn Salvatore, Michael Nooromid, Babak Abai

Department of Surgery Faculty Papers

BACKGROUND: Conferences are an important venue for trainees and students to engage in scholarly activities and networking. However, cost presents a significant consideration for students looking to attend conferences as institutional funding varies. In this study, we analyze the attendance costs of vascular conferences.

METHODS: Thirty-one vascular surgery conferences were identified with 12 regional and 6 national, and 13 international. Invitation-only conferences were excluded from the analysis. Cost of attendance was stratified by early and regular registration timing and attending, trainee, and student status. Additionally, conference websites were queried individually for scholarship opportunities. Data was presented descriptively and compared using …

From Combustion Emissions To Neurotoxicity: Brain Health Risks Of Military Burn Pits Exposure, Katherine M. Eggers, Zoe A. Keller, Paul Barach, Julie M. Tomáška, Joshua P. Nixon, Janeen H. Trembley, Tammy A. Butterick

College of Population Health Faculty Papers

Military burn pits used during post-9/11 U.S. military deployments functioned as uncontrolled combustion systems and were widely utilized to dispose of large volumes of outdoor waste by burning. Burn pits involved heterogeneous waste materials burned under variable temperature and oxygen conditions. These combustion environments generated complex, toxic, multipollutant airborne emission mixtures that included particulate matter (PM2.5), polycyclic aromatic hydrocarbons (PAHs), and volatile organic compounds (VOCs). This narrative review synthesizes epidemiologic, experimental, and mechanistic evidence linking burn pit emissions to disruption of the lung–brain axis and adverse neurological outcomes. We specifically aim to address a critical gap in understanding how combustion-derived …

Will Beauty Save The Brain? Exploring The Relationship Between Eudaimonic Reels Exposure And Egyptian Gen Z'S Mind And Motivations, Petra Zaky

Theses and Dissertations

Social media entertaining content includes a mixed bag of the meaningful and the trivial. For Generation Z, whose favorite daily entertainment is shallow yet funny short-form videos (reels), there is often an invisible price paid. The loss of ability to watch long meaningful videos, distractedness from self, “Brain Rot”, glamorizing of hedonism are among the maladies left behind the attractive rabbit hole of their daily media diet. This study explores the relationship between exposure to meaningful reels, in contrast to pleasurable reels, and Gen Z’s reflective thinking, “Brain Rot” symptoms, motivation to watch long meaningful videos and life motivations between …

Determinants Of Corporal Punishment And Severe Physical Punishment In Egypt: A Mixed-Methods Analysis For Child Protection Policy, Marwa Moustafa Nassef

Theses and Dissertations

Corporal punishment (CP) and severe physical punishment (SPP) remain a major public health, child rights, and child protection policy concern. In Egypt, despite legislative reforms, survey-weighted analysis of the 2021 Egypt Family Health Survey (EFHS) 2021 (CAPMAS, 2022) reveals prevalence rates of 60.5% for CP and 27.4% for SPP among children aged 1–14 (author’s calculations using EFHS-2021, n=7623), yet evidence distinguishing the determinants of routine corporal punishment from escalation to severe physical punishment remains limited in low- and middle-income contexts. Guided by Bronfenbrenner’s ecological framework, this mixed-methods study identifies key drivers of CP and its escalation to SPP among Egyptian …

Persistent Retinal Tenting In Myopic Traction Maculopathy, Taku Wakabayashi, Bita Momenaei, Allen Chiang

Wills Eye Hospital Papers

No abstract provided.

Safe Medication Administration Practices, Kerisha Gooden-Gordon

Walden Dissertations and Doctoral Studies

No abstract provided.

Identifying Social Determinants Of Health Subgroups And Their Associations With Health Outcomes In A Prospective Us Adult Covid-19 Cohort: An Analysis Of The Inspire Registry, Yohali Burrola-Mendez, Eugene Lin, Canada Parrish, Chialing Hsu, Mandy J. Hill, Michael Gottlieb, Kristin L. Rising, Lauren E. Wisk, Nicole L. Gentile, Rachel E. Geyer, Robert A. Weinstein, Michelle Santangelo, Kristyn Gatling, Jonathan W. Dyal, Joann G. Elmore, Robert M. Rodriguez, Phillip Watts, Ji Chen, Zihan Diao, Erica S. Spatz, Kwun Cg Chan, K A. Stephens, Kelli N. O'Laughlin, Inspire Group

Department of Emergency Medicine Faculty Papers

OBJECTIVE: To identify subgroups with similar social determinants of health (SDOH) characteristics using latent class analysis (LCA) and examine their associations with physical and mental health, cognitive function and missed workdays at 3 and 6 months post-SARS-CoV-2 infection. We hypothesised that intersecting SDOH factors would differentially influence COVID-19-related health outcomes across subgroups.

DESIGN: Prospective cohort study from the Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE), with longitudinal data collection and cross-sectional analyses at baseline, 3-month and 6-month follow-ups.

SETTING: Multicentre registry across eight US academic medical centres (Chicago, Dallas, Houston, Los Angeles, New Haven, Philadelphia, San Francisco and …

Basic Bronchoscopy Competence Achieved During A One-Day Workshop For A Multidisciplinary Critical Care Team: A Simulation-Based Study, Jayakrishnan B, Saif Musabah Al-Mubaihsi, Hasan Al-Sayegh, Ahmed Zaher Al-Abri, Issa Saif Alqarshoubi, Jehan Al-Abri, Sami M Bennji

Sultan Qaboos University Medical Journal

Objectives: Fibreoptic bronchoscopy has become a key procedure in critical care, transitioning from pulmonologists to intensivists. This study aimed to evaluate the effectiveness of a one-day simulation-based training programme in acquiring basic bronchoscopy skills.

Methods: A one-day workshop was conducted at Sultan Qaboos Comprehensive Cancer Care and Research Centre, University Medical City, Muscat, Oman, in October 2024 with didactic lectures, small group skill stations, virtual bronchoscopy simulations and hands-on training using manikins and a novel, cost-effective, 3D-printed airway model. The pre-course knowledge of the attendees and their gain in skill were assessed with a 50-question survey tool.

Results …

Mapping The Neuroexposome: Integrative Analysis Of Dementia Risk Factors Through Multi-Omics And Environmental Profiling In The Egyptian Population., Mai Ahmed Saadzaghloul Othman

Theses and Dissertations

Background: Dementia represents one of the most pressing public health challenges of the twenty-first century, with the global burden projected to reach 153 million cases by 2050. Egypt, as the most populous Arab nation, faces a corresponding rise in age-related diseases, yet comprehensive data from low- and middle-income countries remain severely limited. The neuroexposome framework, integrating genetic susceptibility, environmental exposures, and metabolic alterations, offers a powerful strategy to characterize the complex interplay between internal and external risk factors for Alzheimer's disease (AD) and Alzheimer's disease Related Dementias (ADRD).

Objectives: This thesis aimed to: (1) examine the distribution of APOE alleles …

Understanding Moral Injury In Emergency Department Clinicians: Predictors, Outcomes, And Evidence Gaps, Rose Doering Lightspeed

University Honors Theses

Moral injury (MI) is an emerging construct for understanding clinician distress in high-acuity healthcare settings, yet its application to Emergency Department (ED) clinicians remains limited. MI refers to psychological distress resulting from exposure to, or participation in, situations that conflict with deeply held moral or ethical standards, often due to systemic or organizational constraints. Although prior research has examined MI in heterogeneous healthcare samples, the ED remains underexamined despite its unique combination of high patient acuity, throughput pressure, and resource limitations.

This review synthesizes literature on MI among healthcare workers with a focus on ED clinicians, drawing on Industrial-Organizational psychology …

The Gut Microbiome, The Gut-Brain Axis, And College Student Well-Being, Idi Mckay

University Honors Theses

This literature review examines how diet, stress, environmental exposure, and food accessibility may influence college students' mental health and academic performance through the gut microbiome and the Gut-Brain Axis (GBA). Current microbiome research often focuses on early childhood development, clinical disease populations, or older adults, while overlooking college-age students who experience significant social, environmental, and biological transitions. College students frequently face food insecurity, irregular eating patterns, chronic stress, inconsistent sleep schedules, and reduced access to nutrient-dense foods, all of which may influence microbial diversity and overall gut health.

This thesis explores how modern campus environments and lifestyle factors may contribute …

Statewide Multi-Year Wastewater Sequencing Reveals Dual Origins Of Hiv-1 Signal, Justin R Clark, Dylan Chirman, Harihara Prakash, Austen Terwilliger, Marlene Mcneese, Matt Ross, Mike Tisza, Sara J Javornik Cregeen, Loren Hopkins, Jennifer Deegan, Catherine L Troisi, Eric Boerwinkle, Kristina Mena, Fuqing Wu, Jason T Kimata, Marc Johnson, Devon Gregory, Faith E Fletcher, Thomas P Giordano, Anthony W Maresso

Faculty, Staff and Students Publications

Human immunodeficiency virus 1 (HIV-1) is a retrovirus which has infected 90 million people and resulted in over 40 million deaths. Despite advances in diagnostics, treatment, and prophylaxis, HIV-1 continues to spread due to undiagnosed and untreated infections. Traditional monitoring methods are ineffective when access to testing is limited or people do not seek care, particularly given the long period between infection and symptom onset, allowing undetected transmission to continue. Here, we use a hybrid-capture sequencing approach to track HIV-1 signal in municipal wastewater in 15 different cities over nearly 3 years. We obtain near-complete genomic coverage of HIV-1, enabling …

Targeted Next-Generation Sequencing Implementation In Eswatini Identifies Rifampicin And Bedaquiline Resistance Undetected By Routine Diagnostic Testing, Debrah Vambe, Alexander Kay, Mangaliso Ziyane, Mdigo Thunzini, Sein Sein Thi, Leonardo De Araujo, Viola Dreyer, Tanja Niemann, Busizwe Sibandze, Sijabu Masina, Andrea Maurizio Cabibbe, Jennifer Furin, Tafadzwa Mazuruse, Lindokuhle Dlamini, Thulani Jele, Bheki Mamba, Gugu Maphalala, Makhosazana Dlamini, Mbongeni Dube, Nomthandazo Lukhele, Daniela Maria Cirillo, Anna Mandalakas, Christoph Lange, Sphiwe Ngwenya, Christian Utpatel, Sindisiwe Dlamini, Stefan Niemann

Faculty, Staff and Students Publications

In Eswatini, multidrug-resistant (MDR) Mycobacterium tuberculosis (Mtb) strains harbouring the rifampicin-resistance (RR) rpoB I491F mutation are missed by routine diagnostics, including GeneXpert MTB/RIF Ultra (Xpert Ultra), line probe assays (LPA), and mycobacterium growth indicator tube (MGIT) phenotypic drug susceptibility testing (pDST). To address this diagnostic gap, Eswatini introduced targeted next-generation sequencing (tNGS) in 2019. We analysed 234 patient samples enrolled from June 2021 to December 2024 with isoniazid and/or rifampicin resistance detected by routine diagnostics, or suspected treatment failure, and obtained detailed clinical and outcome data from 59 patients. tNGS detected RR in 159 strains, of which 101 (64%) carried …