From preparedness to practice: bringing evidence closer to reality
Fresh Off The Journal: June 2026
How can faster testing improve our Ebola outbreak response? What happens when clinical trials do not include the patients doctors see in real life? And how can better knowledge of drug resistance, self-testing and vaccine acceptance support disease control?
In this month's Fresh Off The Journal, ITM researchers and partners explore infectious diseases and public health challenges from different angles: from Ebola outbreak preparedness and portable diagnostics in DR Congo to leishmaniasis treatment in Ethiopia, HIV self-testing in Belgium, malaria vaccination in Burkina Faso and malnutrition in Guatemala.
Together, these studies show that effective disease control depends on more than one solution. It requires preparedness before outbreaks begin, tests and treatments that work in real-world settings, and health systems that can turn scientific evidence into timely action.
Researching (re-)emerging infections and outbreaks
Preparedness for outbreaks must be built and sustained in advance
The ongoing Ebola outbreak in the Democratic Republic of the Congo shows why fast diagnosis matters. The virus involved is the rarer Bundibugyo Ebola virus, which early tests failed to detect. Kevin Ariën argues that preparedness should not focus only on the most common Ebola virus, but also include tests, vaccines and treatments for related viruses that may cause future outbreaks.
Ariën, K. K. (2026). Better diagnostics could have limited Ebola outbreak. Nature, 654, 9. https://doi.org/10.1038/d41586-026-01724-0
Testing worm infections in wild African rodents
Researchers infected wild multimammate mice (Mastomys natalensis) from Tanzania with a gut worm that naturally infects them. Most mice became infected, whether they received one higher dose or several lower doses. However, the higher-dose group carried many more young worms. The study helps connect laboratory parasite research with what may happen in wild animals, where exposure levels can shape infection patterns.
van de Ven, M., Massawe, A., Leirs, H., & Mariën, J. (2026). Experimental infection of wild Mastomys natalensis with the parasitic nematode Trichuris mastomysi. Journal of Helminthology, 100, e65, 1–5. https://doi.org/10.1017/S0022149X26101618
Faster Ebola testing during outbreaks
During the ongoing 2026 Bundibugyo virus disease outbreak in Ituri province, DR Congo, researchers tested a portable Ebola diagnostic system on blood samples from suspected cases. The test gave results within 65 minutes and showed strong agreement with a standard laboratory test. The study suggests that easier-to-use testing closer to affected communities could help confirm cases faster and support outbreak response.
Wawina-Bokalanga, T., Amuri-Aziza, A., Vercauteren, K., Mukadi-Bamuleka, D., Ngandu, C., Kindrachuk, J., Akilimali, P., Muyembe-Tamfum, J.-J., Mbala-Kingebeni, P., & the Ebola Research and Response Team. (2026). Diagnostic performance of RADIONE for diagnosis of BDBV. The Lancet Infectious Diseases. https://doi.org/10.1016/S1473-3099(26)00321-X
Designing sustainable health systems and strategies
Shared roots of malnutrition in Guatemalan households
In Guatemala, many households face two forms of malnutrition at the same time: a young child with stunted growth and a woman with overweight or obesity. Using national survey data from 2013–2019, researchers found that this affected about one in five households. It was more common in households with lower levels of education, Indigenous families, larger families, and limited access to health insurance, highlighting the need for more equitable and integrated nutrition policies.
Sagastume, D., Mazariegos, M., Polman, K., Palmieri, M., Mesarina, K., Peñalvo, J. L., Beňová, L., & Ramírez-Zea, M. (2026). Overlapping sociodemographic factors of single and multiple forms of malnutrition in Guatemalan households: A secondary data analysis of the Epidemiological Health and Nutrition Surveillance System (2013–2019). BMJ Public Health, 4, e002792. https://doi.org/10.1136/bmjph-2025-002792
HIV self-tests in Belgian pharmacies: available, but rarely sold
HIV self-tests have been available in Belgian pharmacies since 2017, but a survey among Belgian community pharmacies found that sales remain very low. Only one in three pharmacies reported selling the self-tests and about 23% sells one or two of those tests per year. Most pharmacists see self-tests as a useful extra testing option, but many reported feeling uncomfortable advising clients due to limited experience and knowledge. Better training of pharmacists, enhanced visibility and affordability of the kits could increase uptake and strengthen the role of pharmacists as complementary providers of HIV testing.
Rotsaert, A., Beseran Valero, E., Nöstlinger, C., Vanbaelen, T., Van den Bossche, D., Deblonde, J., Scheerder, G., Ravinetto, R., Reyniers, T., & Hensen, B. (2026). Sales of HIV self-tests (HIVST) and pharmacists’ knowledge, attitudes and perceptions regarding the distribution of HIVST in community pharmacies in Belgium: a cross-sectional survey. Sexually Transmitted Infections. https://doi.org/10.1136/sextrans-2026-056906
Strong support for the malaria vaccine among health workers
In Burkina Faso’s Nanoro Health District, most surveyed healthcare workers said they would vaccinate their children against malaria. However, few were hesitant due to insufficient information about the vaccine and more than one-fifth had limited knowledge about this specific vaccine. More than half had not received training before the rollout. The study highlights the need for clear communication and training to support long-term vaccine uptake.
Lamien, J., Kaboré, B., Derra, K., Compaoré, Z. M. J., Nassa, G. J. W., Yaro, A. P. K., Gbangou, B. R., Ravinetto, R., Tinto, H., & Dochez, C. (2026). Healthcare workers’ knowledge and acceptance of the malaria vaccine in the Nanoro Health District of Burkina Faso: a cross-sectional study. Malaria Journal. https://doi.org/10.1186/s12936-026-06006-8
Accelerating disease elimination
When clinical trials don't reflect real-world leishmaniasis
Researchers followed 314 visceral leishmaniasis patients treated at a referral centre in Ethiopia and found that most would have been excluded from standard treatment trials because of severe illness or comorbidities. These patients required intensive supportive care, including antibiotics and blood transfusions, in addition to antileishmanial treatment, and had worse outcomes. The findings call for more inclusive clinical research and strengthened supportive care.
Ayele, E., Van Henten, S., Ayalew, D. G., Atnafu, S., Mereed, A. E., Yohannes, H., Mekonnen, T., Bogale, T., Mossa, A., Legese, G. L., Yasin, J., Berens-Riha, N., Pham, T., Boodman, C., Mondelaers, A., Adriaensen, W. J., Abdellati, S., Diro, E., Mohammed, R., . . . Van Griensven, J. (2026b). Severe visceral leishmaniasis in Ethiopia: Outcomes, co-infections and mortality in a prospective real-world cohort. PLoS Neglected Tropical Diseases, 20(6), e0013878. https://doi.org/10.1371/journal.pntd.0013878
Taking on antimicrobial resistance
Difficult to kill Leishmania (super)parasites
Leishmaniasis is a killer parasitic disease, difficult to treat. Drug resistance is often the culprit of treatment failure, but another mechanism was discovered: drug tolerance. Within a drug-exposed Leishmania parasite population, a fraction of cells survives by switching to an ‘economy’ mode. These drug-tolerant parasites reactivate in the absence of drugs, show cross-tolerance to multiple antileishmanial compounds or they even can become more resistant.
Aroni-Soto, A., Monsieurs, P., Goovaerts, O., Choukri, K., Khanal, B., Adriaensen, W., Dujardin, J., Barrett, M. P., & Domagalska, M. A. (2025). Multi-drug tolerance in Leishmania persister-like cells. Communications Biology. https://doi.org/10.1038/s42003-026-10456-w
Tracing the source of drug resistance in gonorrhoea
Gonorrhoea is becoming harder to treat when the bacterium Neisseria gonorrhoeae develops resistance to ceftriaxone, an important antibiotic. Researchers compared resistance-related genes from gonorrhoea bacteria with those from harmless Neisseria bacteria found in adults in Tokyo. They found evidence that Neisseria subflava, a common mouth bacterium, likely contributed genetic material linked to resistance. The study suggests that monitoring harmless relatives may help detect resistance earlier.
Kanesaka, I., Ohno, A., Laumen, J. G. E., Abdellati, S., De Block, T., Morita, M., Katsuse, A. K., Kobayashi, I., Kenyon, C., & Manoharan-Basil, S. S. (2026). Recombination mapping identifies a commensal Neisseria subflava origin of mosaic penA 60.001 allele in Neisseria gonorrhoeae. FEMS Microbiology Letters, 373. https://doi.org/10.1093/femsle/fnag071
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