Vibrio cholerae high cell density quorum sensing activates the host intestinal innate immune response.

Quorum sensing fundamentally alters the interaction of Vibrio cholerae with aquatic environments, environmental hosts, and the human intestine. At high cell density, the quorum-sensing regulator HapR represses not only expression of cholera toxin and the toxin co-regulated pilus, virulence factors essential in human infection, but also synthesis of the Vibrio polysaccharide (VPS) exopolysaccharide-based matrix required for abiotic and biotic surface attachment. Here, we describe a feature of V. cholerae quorum sensing that shifts the host-pathogen interaction toward commensalism. By repressing pathogen consumptive anabolic metabolism and, in particular, tryptophan uptake, V. cholerae HapR stimulates host intestinal serotonin production. This, in turn, activates host intestinal innate immune signaling to promote host survival.

mHealth4Afrika - Co-Designing a Standards based Solution for Use in Resource Constrained Primary Healthcare Facilities.

Supported by the European Commission under Horizon 2020, mHealth4Afrika is co-designing and validating a modular, multilingual, state-of-the-art primary healthcare platform for use in resource constrained environments. Based on active consultation and collaboration with Ministries of Health (MoH), district health officers, clinic managers and primary healthcare workers from urban, rural and deep rural health centres in Ethiopia, Kenya, Malawi and South Africa, mHealth4Afrika has co-designed a comprehensive range of health programs and associated functionality. This paper provides insights into how mHealth4Afrika is supporting a holistic, patient-centric, standards-based "cradle to grave" approach to replacing paper-based registries and program-specific (or siloed) electronic solutions installed in many cases by donors targeting specific diseases. mHealth4Afrika is a HL7 FHIR-based platform integrating Electronic Medical Record (EMR) and Electronic Health Record (EHR) functionality, leveraging medical sensors and decision support at the point of care, saving time associated with monthly aggregate data reporting and encouraging attendance through SMS communications with clients and community health workers.