Pediatric upper-airway microbiota has been increasingly linked to respiratory-health phenotypes, but the transferability of these signals to low- and middle-income countries (LMICs) remains uncertain. Most phenotype-specific evidence comes from high-income settings, where diagnostic capacity, antibiotic exposure, vaccination coverage, environmental risks, and sample-handling conditions may differ substantially from LMIC contexts. This narrative review synthesizes current evidence on pediatric nasal and nasopharyngeal microbiota, respiratory-health phenotypes, LMIC contextual modifiers, and low-biomass microbiome methodology. Original studies linking upper-airway microbiota patterns with clinically defined respiratory outcomes were mapped and synthesized thematically. Across studies, respiratory-health signals were better characterized as phenotype-dependent community shifts than as disease-specific organisms. Corynebacterium- and Dolosigranulum- enriched profiles were commonly associated with more stable or lower-risk respiratory states, whereas Haemophilus-, Streptococcus-, and Moraxella-dominant profiles recurred across infection-associated and inflammatory phenotypes. In LMIC settings, these signals may be modified by pre-sampling antibiotics, repeated infectious exposure, household crowding, environmental pollution, nutritional vulnerability, vaccination heterogeneity, diagnostic uncertainty, and transport or storage constraints. Interpretable low-biomass research requires standardized sampling, contamination controls, transparent 16S rRNA workflows, and context-rich metadata. Pediatric upper-airway microbiota should therefore be interpreted as a context-dependent ecological signal rather than an immediate diagnostic biomarker. Future LMIC studies should prioritize phenotype-specific hypotheses, rigorous but feasible low-biomass workflows, and locally relevant metadata to support respiratory phenotyping, antibiotic-stewardship research, vaccine-effect evaluation, and child-health interventions.

In October 2023, Bangladesh became the first country validated by the World Health Organization for eliminating visceral leishmaniasis (VL) as a public health problem. This achievement rests on robust case detection, effective treatment, and sustained vector-control interventions; however, these measures are resource intensive, vulnerable to political and funding disruptions, and may be undermined by population displacement and emergent drug resistance. Post-kala-azar dermal leishmaniasis reservoirs now outnumber primary VL cases in Bangladesh, while East Africa accounts for 73% of global VL cases with zoonotic transmission and exophilic sand fly behavior complicating control. The human vaccine pipeline remains concerningly thin: no licensed human vaccine exists, no phase III VL-specific efficacy trials are underway, and correlates of immune protection remain undefined. On the balance of current evidence, vaccination offers a potentially durable strategy to interrupt transmission independently of passive case detection and to reduce reliance on programmatic activities that are operationally fragile. Several factors in 2026 create a strategic inflection point for accelerated vaccine development and deployment, including Bangladesh’s validation, East Africa’s 2023-2030 elimination framework, and advances in next generation platforms (for example, mRNA and reverse-vaccinology approaches). We recommend planning multi-country phase III trials by 2027 with VL-relevant endpoints, establishing dedicated funding mechanisms, and integrating a future vaccine into regional elimination frameworks to maximize publichealth impact. Rapid, coordinated progress toward an effective vaccine is essential to safeguard and sustain the gains achieved to date. This review synthesizes current evidence on epidemiology, vaccine development, and programmatic challenges and proposes pragmatic priorities to accelerate VL vaccine evaluation and policy translation.

Objective: To evaluate trends in hepatitis B virus (HBV) and hepatitis C virus (HCV) prevalence and incidence among the national haemodialysis (HD) population from 2013 to 2025 and characterize the demographic, clinical, and outcome profiles of affected patients.

Methods: This retrospective observational cohort study utilized data from the Brunei Dialysis and Transplant Registry and the national electronic health record system (BRU-HIMS).

Results: 77 HBV and 50 HCV cases were identified amongst 3 080 period prevalent HD patients over the 13-year study period. A sustained decline in both infections was observed, with a more marked reduction in HCV. Overall period prevalence was 2.5% (95% CI 2.1-2.7) for HBV and 1.8% (95% CI 1.4-1.9) for HCV, while cumulative incidence rates were 2.6% (95% CI 1.9-3.2) and 1.1% (95% CI 0.6-1.5), respectively. Patients with incident HCV infection were younger than those with HBV and the general incident HD population. HBV infection was more common among individuals of Chinese ethnicity. Glomerulonephritis was more frequently identified as the primary cause of end-stage kidney disease among infected patients than in the non-infected cohort. Cirrhosis was present in 26% of HBV and 28% of HCV cases. Antiviral therapy uptake was 38% for HBV and 44% for HCV.

Conclusions: HBV and HCV burden among HD patients in Brunei has declined substantially during the study period, supporting progress towards hepatitis elimination. This success appears underpinned by five strategic pillars: centralized registry surveillance, nephrology-led care, stringent infection control measures, nurse-led monitoring, and community support.

Objective: To assess clinical, immunological, and virological responses to locally manufactured integrase-based antiretroviral therapy (ART) over nine months in treatment-naïve advanced HIV disease individuals and to identify early mortality prognostic factors.

Methods: This prospective cohort study conducted at a HIV Clinic (March 2023-August 2024) enrolled treatment-naïve individuals with advanced HIV disease. Key variables of interest included CD4 T-cell count (flow cytometry), HIV-1 RNA viral load (real-time PCR), nutritional and anthropometric indices (body mass index, mid-upper arm circumference, prognostic nutritional index) and sarcopenia (EWGSOP criteria), were assessed at baseline and at 3, 6, and 9 months. Comprehensive assessments also included clinical evaluation, standard laboratory parameters, and imaging studies.

Results: The cohort included 50 treatment-naïve individuals with advanced HIV disease. They had a mean age of 37.6 years (76% male), with a median baseline CD4 count 80 cells/mm³ and median HIV RNA of 91 800 copies/mL. Malnutrition, opportunistic infections, and sarcopenia were observed in 32% (n=16), 22% (n=11), and 14% (n=7) of patients, respectively. Altogether, mortality was 24% (12/50), with 75% of deaths occurring within first three months and a median time to death of 31 days. Among survivors, median CD4 count escalated from 93 to 236 cells/mm³, and almost all were virally suppressed by month nine. Prognostic factors of mortality involved severe malnutrition, sarcopenia, hypoalbuminaemia, CD4 count below 50 cells/mm³, viral load exceeding 100 000 copies/mL, and multi-organ abnormalities at presentation.

Conclusions: Locally produced integrase inhibitor-based ART achieved excellent responses in survivors with advanced HIV disease. Early mortality was high. Poor nutritional status, sarcopenia, severe immunosuppression, and multi-organ involvement were significantly related to mortality. This highlights the urgent need for earlier HIV diagnosis, proper nutritional screening and intervention, and management of opportunistic infections in developing countries as in Egypt.