One hundred years after the death of the writer and novelist Giovanni Verga (1922) and his relationship with public health: a glimpse of the past in the era of the SARS-CoV-2 (COVID-19) pandemic.

Background: In 1922 the famous Italian novelist Giovanni Verga died in Catania (Italy). In Verga's works there are many suggestions to the world of medicine, in particular the diseases described in the poor society of southern Italy of that time. One of the most common diseases described by Verga was cholera. Methods: The authors researched and reviewed Verga's works, detecting references to public health. These are topical issues in the current period of the COVID pandemic. In Verga's works the theme of hygiene, epidemiology, and infectious diseases occur. There are many hints related to medicine, especially as far as the typical diseases of poor society and the difficult social environments of the time are concerned. One of the most common diseases described by Verga was cholera but also malaria and tuberculosis occur. Results: It was estimated that 69,000 people died of cholera in Sicily, of whom 24,000 in Palermo. The public health situation in Italy was difficult. Verga denounces people's ignorance and the survival of past beliefs. Conclusion: Verga describes a culturally and economically humble society, in a region characterized by large class gaps. It draws a difficult picture of the public health situation in the second half of the 19th Century and people's daily lives. The authors believe that today it is important that the centenary of Verga's death be an opportunity to read his works, also from a medical historical point of view.

Firdausi Qadri: the struggle against cholera.

Firdausi Qadri talks to Gary Humphreys about the need for new cholera vaccines and increased vaccine production to meet growing regional and global demand.

Healthcare workers knowledge of cholera multi-stranded interventions and its determining factors in North-East Nigeria: planning and policy implications.

BACKGROUND: Healthcare workers' (HCWs) knowledge of multi-stranded cholera interventions (including case management, water, sanitation, and hygiene (WASH), surveillance/laboratory methods, coordination, and vaccination) is crucial to the implementation of these interventions in healthcare facilities, especially in conflict-affected settings where cholera burden is particularly high. We aimed to assess Nigerian HCWs' knowledge of cholera interventions and identify the associated factors. METHODS: We conducted a cross-sectional study using a structured interviewer-administered questionnaire with HCWs from 120 healthcare facilities in Adamawa and Bauchi States, North-East Nigeria. A knowledge score was created by assigning a point for each correct response. HCWs' knowledge of cholera interventions, calculated as a score, was recoded for ease of interpretation as follows: 0-50 (low); 51-70 (moderate); ≥ 71 (high). Additionally, we defined the inadequacy of HCWs' knowledge of cholera interventions based on a policy-relevant threshold of equal or lesser than 75 scores for an intervention. Multivariable logistic regression was used to identify the factors associated with the adequacy of knowledge score. RESULTS: Overall, 490 HCWs participated in the study (254 in Adamawa and 236 in Bauchi), with a mean age of 35.5 years. HCWs' knowledge score was high for surveillance/laboratory methods, moderate for case management, WASH, and vaccination, and low for coordination. HCWs' knowledge of coordination improved with higher cadre, working in urban- or peri-urban-based healthcare facilities, and secondary education; cholera case management and vaccination knowledge improved with post-secondary education, working in Bauchi State and urban areas, previous training in cholera case management and response to a cholera outbreak-working in peri-urban areas had a negative effect. HCWs' knowledge of surveillance/laboratory methods improved with a higher cadre, 1-year duration in current position, secondary or post-secondary education, previous training in cholera case management and response to a cholera outbreak. However, HCWs' current position had both positive and negative impacts on their WASH knowledge. CONCLUSIONS: HCWs in both study locations recorded a considerable knowledge of multi-stranded cholera interventions. While HCWs' demographic characteristics appeared irrelevant in determining their knowledge of cholera interventions, geographic location and experiences from the current position, training and involvement in cholera outbreak response played a significant role.

New Insights into Vibrio cholerae Biofilms from Molecular Biophysics to Microbial Ecology.

With the discovery that 48% of cholera infections in rural Bangladesh villages could be prevented by simple filtration of unpurified waters and the detection of Vibrio cholerae aggregates in stools from cholera patients it was realized V. cholerae biofilms had a central function in cholera pathogenesis. We are currently in the seventh cholera pandemic, caused by O1 serotypes of the El Tor biotypes strains, which initiated in 1961. It is estimated that V. cholerae annually causes millions of infections and over 100,000 deaths. Given the continued emergence of cholera in areas that lack access to clean water, such as Haiti after the 2010 earthquake or the ongoing Yemen civil war, increasing our understanding of cholera disease remains a worldwide public health priority. The surveillance and treatment of cholera is also affected as the world is impacted by the COVID-19 pandemic, raising significant concerns in Africa. In addition to the importance of biofilm formation in its life cycle, V. cholerae has become a key model system for understanding bacterial signal transduction networks that regulate biofilm formation and discovering fundamental principles about bacterial surface attachment and biofilm maturation. This chapter will highlight recent insights into V. cholerae biofilms including their structure, ecological role in environmental survival and infection, regulatory systems that control them, and biomechanical insights into the nature of V. cholerae biofilms.

The forgotten threat of cholera in Syria.

Cholera is an ancient disease that persists as an issue of public health in many conflict-affected countries worldwide. Cholera is a diarrheal infection caused by ingested water or food contaminated with the bacterium Vibrio cholerae. On 10 September 2022, the Ministry of Health in Syria declared a cholera outbreak. Poor water and sanitation systems, disease surveillance breakdown, the collapse of the health system, and deteriorated socioeconomic conditions are potential risk factors for the outbreak's spread. Identifying the context-related factors associated with the spread of disease is a core to developing practical response mechanisms. In this study, we suggested a multisectoral approach that addresses context-specific elements contributing to the cholera outbreak spread in Syria; public health determinants, geopolitics, risk factors, and pandemic fatigue.

Eastern Mediterranean Health Journal [2023; Vol.29, Issue 1]

Eastern Mediterranean Health Journal is the official health journal published by the Eastern Mediterranean Regional Office of the World Health Organization. It is a forum for the presentation and promotion of new policies and initiatives in health services; and for the exchange of ideas concepts epidemiological data research findings and other information with special reference to the Eastern Mediterranean Region. It addresses all members of the health profession medical and other health educational institutes interested NGOs WHO Collaborating Centres and individuals within and outside the Region

المجلة الصحية لشرق المتوسط هى المجلة الرسمية التى تصدرعن المكتب الاقليمى لشرق المتوسط بمنظمة الصحة العالمية. وهى منبر لتقديم السياسات والمبادرات الجديدة فى الصحة العامة والخدمات الصحية والترويج لها، و لتبادل الاراء و المفاهيم والمعطيات الوبائية ونتائج الابحاث وغير ذلك من المعلومات، و خاصة ما يتعلق منها باقليم شرق المتوسط. وهى موجهة الى كل اعضاء المهن الصحية، والكليات الطبية وسائر المعاهد التعليمية، و كذا المنظمات غير الحكومية المعنية، والمراكز المتعاونة مع منظمة الصحة العالمية والافراد المهتمين بالصحة فى الاقليم و خارجه

La Revue de Santé de la Méditerranée Orientale est une revue de santé officielle publiée par le Bureau régional de l’Organisation mondiale de la Santé pour la Méditerranée orientale. Elle offre une tribune pour la présentation et la promotion de nouvelles politiques et initiatives dans le domaine de la santé publique et des services de santé ainsi qu’à l’échange d’idées de concepts de données épidémiologiques de résultats de recherches et d’autres informations se rapportant plus particulièrement à la Région de la Méditerranée orientale. Elle s’adresse à tous les professionnels de la santé aux membres des instituts médicaux et autres instituts de formation médico-sanitaire aux ONG Centres collaborateurs de l’OMS et personnes concernés au sein et hors de la Région

Life-Course Approach to Vaccination in Bangladesh for Meeting the Health and Health-Related Sustainable Development Goals: A Commentary.

Bangladesh is entering from low-income to lower-middle-income status in 2020, and this will be completed in the next 5 years. With gross national income growing, vaccines will need to be procured through private market for the Expanded Program on Immunization. A cost-benefit analysis is needed to evaluate vaccine demand in different socioeconomic groups in the country, to inform this procurement. Moreover, disease burden studies and awareness of importance of specific vaccines are needed as we move forward. A life-course approach to vaccination may enable whole society to realize the full potential of vaccination and address most significant threats to its success over time.

Vaccines are in short supply amid global cholera surge.

Climate change and pandemic may be fueling outbreaks.

Use of mobile medical teams to fill critical gaps in health service delivery in complex humanitarian settings, 2017-2020: a case study of South Sudan.

The vulnerable populations in the protracted humanitarian crisis in South Sudan are faced with constrained access to health services and frequent disease outbreaks. Here, we describe the experiences of emergency mobile medical teams (eMMT) assembled by the World Health Organization (WHO) South Sudan to respond to public health emergencies. Interventions: the eMMTs, multidisciplinary teams based at national, state and county levels, are rapidly deployed to conduct rapid assessments, outbreak investigations, and initiate public health response during acute emergencies. The eMMTs were deployed to locations affected by flooding, conflicts, famine, and disease outbreaks. We reviewed records of deployment reports, outreach and campaign registers, and analyzed the key achievements of the eMMTs for 2017 through 2020. Achievements: the eMMTs investigated disease outbreaks including cholera, measles, Rift Valley fever and coronavirus disease (COVID-19) in 13 counties, conducted mobile outreaches in emergency locations in 38 counties (320,988 consultations conducted), trained 550 healthcare workers including rapid response teams, and supported reactive measles vaccination campaigns in seven counties [148,726, (72-125%) under-5-year-old children vaccinated] and reactive oral cholera vaccination campaigns in four counties (355,790 vaccinated). The eMMT is relevant in humanitarian settings and can reduce excess morbidity and mortality and fill gaps that routine health facilities and health partners could not bridge. However, the scope of the services offered needs to be broadened to include mental and psychosocial care and a strategy for ensuring continuity of vaccination services and management of chronic conditions after the mobile outreach is instituted.