Seven new insights into diagnosis, prevention and disease control
Fresh Off The Journal: May 2026
How do doctors know when symptoms that look like tuberculosis are caused by something else? What happens when climate change starts shaping everyday health risks? Why are some children still missing routine vaccines? And how can better diagnosis help reduce unnecessary antibiotic use?
In this month's Fresh Off The Journal, ITM researchers and partners look at infectious diseases and health systems from different angles: from TB-like lung disease in West Africa and climate-health planning in Tanzania to vaccine gaps in Ethiopia, dengue antibody testing, fever diagnosis and malaria prevention during pregnancy.
Together, these studies show that disease control depends not only on treatment, but also on careful diagnosis, local evidence, strong surveillance and health systems that can act on what the data reveal.
Researching (re-)emerging infections and outbreaks
When TB symptoms point to other mycobacteria
A long-lasting cough, weight loss and abnormal chest X-rays can point to tuberculosis (TB), but other mycobacteria may cause similar problems. A research team working across Ghana, Nigeria, Niger and Belgium studied people being checked for suspected TB. About one in ten culture-tested samples contained mycobacteria related to TB, but not TB itself. The study shows why careful diagnosis matters before choosing treatment.
Abbew, E. T., Bassirou, S. M., Ahmadu, I., Adu, J. B., Laryea, R., Amenyo, R. P. F., ... & Rigouts, L. (2026). Prevalence of nontuberculous mycobacteria isolates and pulmonary disease from respiratory tract samples in persons investigated for presumed tuberculosis from three West African countries, an analysis of three prospective cohort studies. BMC Infectious Diseases.
Designing sustainable health systems and strategies
Tanzania’s climate-health plans meet local realities
What happens when floods, drought and heat start shaping everyday life? Researchers studied Tanzania’s plans for health in the face of a changing climate. Stakeholders in the country were asked about policies and their implementation. There are relevant policies, but local action is held back by gaps in funding and coordination, and 97% of residents of the Kilombero-Valley reported exposure to floods, drought and extreme heat, and related health problems.
Urassa, A. P., Finda, M. F., Okumu, F. O., & Kreppel, K. (2026). Climate-related health threats in Tanzania: a multi-level analysis of key policies, strategies and community response. Health Policy and Planning, czag066.
Antenatal care linked to childhood vaccination gaps in Ethiopia
Not all children are reached by routine immunization services. A study of 1,890 Ethiopian children aged 12–23 months found that about one in four had not received the first dose of the diphtheria, tetanus and pertussis (DTP1) vaccine. These "zero-dose" children were more common in poor households and where mothers missed antenatal care (ANC). Poverty and lack of ANC were the main causes, showing the need for targeted outreach and better links between ANC and immunization services to improve equitable access.
Shiferie, F., Asefa, A., Gebremedhin, S., & Beňová, L. (2026). Decomposition of Wealth-Related Inequalities in Childhood Zero-Dose Vaccination: Analysis of the 2016 Ethiopian Demographic and Health Survey. The American journal of tropical medicine and hygiene, tpmd250713.
Stillbirth prevention needs more than good plans
Stillbirths are now more visible in global health, but prevention has not improved fast enough. This commentary discusses a global scorecard showing that many countries have plans and policies, while real-world implementation and data systems lag behind. The authors argue that preventing stillbirths requires more than awareness: countries need better quality pregnancy and birth care, stronger routine data, aligned digital health systems, and clearer accountability for results.
Frøen, J., & Tunçalp, Ö. (2026). From Visibility to Accountability: Ending Stagnation in Stillbirth Prevention. Paediatric and Perinatal Epidemiology, 40(4), 452–453.
Accelerating disease elimination
Following dengue antibodies in fine detail
Dengue antibody responses over time at the epitope level are still not well understood. Research at the Virology Unit examined how antibody responses develop in nine volunteers infected with dengue virus type 1 under controlled conditions and followed for up to 6 months. Antibodies were screened against thousands of small viral fragments to identify targeted viral regions over time, revealing both known and new immune targets that could support the development of improved diagnostic tests.
Bouckaert, J., Waickman, A. T., Thomas, S. J., Ariën, K. K., & Lagatie, O. (2026). Dengue antibody dynamics resolved at epitope level using a dengue 1 human infection model. International Journal of Infectious Diseases, 108771.
Taking on antimicrobial resistance
Exploring antibiotic use in febrile illness
Figuring out how to treat patients with fever can be difficult, especially when it’s not clear what’s causing it. This is even more challenging in settings where many different infections could be responsible, and where access to diagnostic tests is limited. The study looked into the steps patients with fever go through to get care in the Democratic Republic of the Congo, Kenya, and Uganda. It explored when antibiotics were used and what factors may influence their use, shedding light on the need for appropriate use of antibiotics while ensuring continued access to treatment and care.
Lepore, L., Dawa, J., Odinoh, R., Situma, S., Nyakarahuka, L., Makiala, S., ... & Vanlerberghe, V. Patterns of antibiotic use for acute febrile illness in resource-limited settings: a multicenter study in DR Congo, Kenya and Uganda. Frontiers in Public Health, 14, 1837179.
Is malaria prevention in pregnancy still working well?
Malaria during pregnancy can harm both mother and baby. To help prevent infection, many countries with high malaria transmission provide pregnant women with preventive medicine. The Unit of Malariology and partners in Mozambique found that many malaria parasites in pregnant women carried genetic changes linked to reduced response to this medicine. These resistant parasites were also more likely to form stages that can be passed on to mosquitoes. The study shows why monitoring drug resistance is highly important.
Drissi-El Boukili, Y., Rovira-Vallbona, E., Guetens, P., Chiheb, D., Kattenberg, J. H., Kestens, L., ... & Arnaldo, P. (2026). Prevalence of pfdhfr-pfdhps Sextuple and Gametocyte-Associated Quintuple Sulfadoxine-Pyrimethamine Resistance Mutations in Plasmodium falciparum Isolates from Pregnant Women in Mozambique. Pathogens, 15(5), 504.
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