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<title>Abstract</title> As part of a comprehensive study investigating the breast milk microbiota of healthy and malnourished children through a culturomic approach, a novel bacterial strain belonging to the genus <italic>Neobacillus</italic> was isolated, identified, and characterized using a taxonogenomic strategy. This isolate, designated as strain Marseille-QA0830ᵀ, was recovered from the breast milk of a mother nursing a healthy infant. Strain Marseille-QA0830ᵀ (= CSUR QA0830ᵀ = CECT 31295ᵀ) is a Gram-stain-positive, non-motile, aerobic, and non-spore-forming bacillus capable of growth under both aerobic and anaerobic conditions, at temperatures ranging from ambient to 45°C. With a genome size of 5.83 Mbp, strain Marseille-QA0830ᵀ exhibits a G + C content of 42.3%. Phylogenetic analysis based on the 16S rRNA gene revealed a high sequence similarity (99.4%) between strain Marseille-QA0830ᵀ and <italic>Neobacillus dielmonensis</italic> . However, significant genomic divergence was observed through digital DNA-DNA hybridization (dDDH), which showed only 26.2% similarity—well below the 70% threshold for species delimitation. Furthermore, <italic>rpoB</italic> gene analysis indicated a distant relationship with <italic>Neobacillus drentensis</italic> (83.5% similarity). Collectively, these genomic data demonstrate that although strain Marseille-QA0830ᵀ is phylogenetically closely related to <italic>N. dielmonensis</italic> based on 16S rRNA gene sequences, it remains distinct at the whole-genome and <italic>rpoB</italic> levels from previously described species within the <italic>Neobacillus</italic> nomenclature. These findings confirm that this isolate represents a unique and previously undescribed taxon. Consequently, we propose the description of the type strain Marseille-QA0830ᵀ as a new species named <italic>Neobacillus camarae</italic> sp. nov.

Introduction: Significant disparities remain between high-income countries and low- and middle-income countries (LMICs) in access to pacemaker therapy. In LMICs, the high cost of devices and limited healthcare infrastructure lead to preventable deaths. Addressing this inequity requires innovative and ethical solutions. Pacemaker reuse by retrieving, testing, re-sterilizing, and re-implanting devices, offers a cost-effective, sustainable, and ethical alternative. Despite robust evidence demonstrating its safety, reuse remains limited due to regulatory and legal concerns. Fears of infection, device failure, and liability have hindered broader adoption, even though properly reprocessed pacemakers have been shown to be safe. Objective: To describe a 50-year humanitarian program led by a French NGO, which has distributed re-sterilized pacemakers to LMICs and trained local providers in cardiac pacing. Methods: STIM Développement is a French NGO promoting access to cardiac rhythm management in LMICs through medical training and the distribution of reprocessed pacemakers to patients in need. Devices were collected post-mortem and sent to the NGO by various hospitals. Each underwent strict quality control, including 1) visual inspection, 2) programmer interrogation to assess battery life and detect malfunctions, and 3) review of implant date and voltage to estimate remaining longevity. Sterilization followed an FDA-approved protocol: cleaning with pipe cleaners, isopropyl alcohol bath, overnight soak in enzyme solution (1:128 concentration), 70% ethanol wipe, air drying, gas-permeable packaging, and 8-hour ethylene oxide gas sterilization. Devices were shipped based on demand, often with training support for local medical teams. Results: From 1974 to 2024, 18,615 pacemakers were distributed to 29 countries. Distribution peaked in the early 2000s (600 units/year) but declined to around 150/year due to legal and regulatory challenges. Early recipients included India, Romania, and several African nations. Infection rates remained negligible, with no adverse events reported in recent FDA-monitored trials. Conclusion: Pacemaker reuse is a safe, effective, and scalable strategy to address unmet needs in LMICs. Wider adoption requires international regulatory harmonization, legal safeguards, and public awareness. The recent FDA approval of re-sterilization protocols may help renew global efforts and expand access to this life-saving therapy.

e23031 Background: Cancer is a major public health issue due to its rising incidence and high mortality rates, despite significant therapeutic advancements (1). Innovative diagnostic and therapeutic tools have been developed, helping to improve the prognosis outcomes. However, the increasing costs of cancer care negatively impact patients’ quality of life. In low-income countries such as Senegal, insufficient funding of public healthcare worsens the situation, further exposing patients to financial toxicity. Additionally, many cancer patients live below the poverty line, thus accentuating their financial difficulties .This study is prompted by the need to evaluate the financial toxicity linked to cancer in patients receiving care in two health centers in Senegal. Methods: We interviewed patients with cancer in two care facilities in Senegal (Saint-Louis Regional Hospital and Dalal Jam University Hospital in Dakar). The study period was between August 1 and September 31, 2024. Patients undergoing specific cancer treatment were eligible. The questionnaire explored demographic parameters, site and stage of the tumor, and financial indices, including methods of healthcare financing and coping strategies. It was administered face-to-face by health personnels. Free and informed consent was obtained from all the patients. Descriptive statistics was used to present the results. Results: We collected data from 72 patients with a mean age of 48.74 years. The majority were women (82%) and lived outside the capital (85%). Breast cancer was the most common site (50%). Patients received chemotherapy in 94.4% of cases and radiotherapy in 54.2%. After a cancer diagnosis, 42 patients (58.3%) stopped working entirely, while 33.3% continued working part-time. Patients paid out of pocket for their care in 86.1% of cases. Additionally, 78% of patients reported that direct treatment costs were the primary challenge. Financial constraints caused 19.4% of patients to miss at least one appointment. Conclusions: This study underscores the urgent need for solutions to address financial toxicity in Senegal. Strategies such as implementing universal health coverage, reducing costs of anticancer drugs, and raising awareness among oncologists and patients could improve outcomes. Keywords: financial distress, financial hardship, Senegal, cancer treatment, global oncology.

This study aims to determine the seroprevalence of SARS-CoV-2 in pregnant women attending antenatal consultations (ANC) in Senegal. A non-redundant consecutive recruitment of participants was carried out between, March and July 2021 during the Delta wave of COVID-19. The plasma samples biobanked at -80°C were subjected to an enzyme-linked immunosorbent assay (ELISA) for the qualitative detection of IgG and IgM antibodies of SARS-CoV-2 using the WANTAI SARS-CoV-2 Ab ELISA (Wantai Biological Pharmacy Enterprise, Beijing). To assess factors associated with seropositivity, bivariate analysis was per-formed with JMP® Pro Version 15.0.0 software (SAS Institute Inc., Cary, NC, 1989–2021). For frequencies below 5%, chi2 or Fischer tests were performed. In all cases, significant statistical threshold was set at p-values considered to be less than 0.05. A total of 1,227 pregnant women were recruited in five health facil-ities, including two in Dakar (n=166) and one in each of the following regional capitals: Saint-Louis (n=400), Ziguinchor (n=264) and Kédougou (n=397). The median age among was 25 years [18 - 50]. The overall sero-prevalence observed was 64.9% (797/1227), with higher exposure rates in Dakar with 71.6% (119/166) and Ziguinchor with 68.1% (180/264). Kédougou and Saint-Louis reported 62.9% (250/397) and 62% (248/400), respectively. According to age group, the seroprevalence was 62.6% (331/528), 66.6% (238/357), 63.5% (148/223) and 67.2% (80/119) respectively for [18-23], [24-29], [30-35] and ≥36 years old. This variability in the seroprevalence of SARS-CoV-2 according to the localities was not statistically significant (p=0.7024). We found no association between factors such as recruitment period, age, level of education, marital and pro-fessional status.

Weber's syndrome revealing a Percheron artery infarction is a rare clinical occurrence. Its diagnosis requires careful clinical examination and brain MRI, which is the gold standard for diagnosis. If this is not available, combined cerebral CT scan with a CT angiography of supra-aortic arteries may be useful for the diagnosis. Percheron's artery (PA) occlusion is an uncommon type of stroke involving paramedian thalamus and/or midbrain infarction. It accounts for 4%-18% of all thalamic infarcts and 0.1%-2% of all strokes. Its clinical manifestations are variable and its mode of presentation as Weber's syndrome is exceptional due to the unusual clinical presentation.

Respiratory and gastrointestinal symptoms and febrile illness are the most common complaints among ill pilgrims attending the Grand Magal of Touba (GMT) in Senegal. Patients presenting with respiratory or gastrointestinal symptoms or febrile systemic illnesses were recruited between 2018 and 2021at a healthcare centre close to Touba. Respiratory, gastrointestinal and blood samples were tested for potential pathogens using qPCR. 538 patients were included. 45.5% of these were female, with a median age of 17 years. Of the 326 samples collected from patients with a cough, 62.8% tested positive for at least one virus, including influenza viruses (33.1%). A high positivity rate of bacterial carriage was observed for Haemophilus influenzae (72.7%), Streptococcus pneumoniae (51.2%) and Moraxella catarrhalis (46.0%). Of the 95 samples collected from patients with diarrhoea, 71.3% were positive, with high rates of bacterial carriage, ranging from 4.2% for Tropheryma whipplei to 45.3% for Entero-pathogenic Escherichia coli. Of the 141 blood samples collected from patients with fever, 31.9% were positive including Plasmodium falciparum (21.3%), Borrelia sp. (5.7%) and dengue virus (5.0%). This study provides insight into the aetiology of most common infections at the GMT on which to base therapeutic options.

The cutaneous extension of gallbladder thyroid carcinoma is uncommon and is among the aggressive forms of the disease. We are reporting the case of a woman of 54 that shows acute festered thyroiditis worsened by a necrotic ulcer wound on the skin lasting 3 weeks amid a big neglected hetero-multinodular goitre, evolving since 20 years. The anatomopathological test showed a gallbladder thyroid carcinoma of the thyroid with severe inflammation. The treatment consisted of a complete thyroidectomy with recurrent bilateral dredging. There was a favourable evolution. Gallbladder carcinoma, in its aggressive aspect, may be linked to the occurrence of acute festered thyroiditis. Therefore, the prognosis of our patient was favourable.

Introduction: Female Genital Bilharzia (FGB) is a pathology secondary to infection by Schistosoma haematobium. It is one of the neglected tropical diseases, capable of causing infertility, difficulties in childbirth and even cervical cancer. It represents a real public health problem. We therefore conducted a study in the maternity ward of the Saint-Louis regional hospital, with the overall aim of determining the prevalence of FBG in patients undergoing colposcopy. The specific objectives were to define the patient profile, and to compare colposcopic images with the World Health Organization (WHO) atlas. Methodology: We conducted a descriptive, analytical crosssectional study of all colposcopic images taken at the maternity ward of the Saint-Louis regional hospital from August 1, 2018, to September 30, 2020, i.e. 25 months. The images were compared with the BGF images described in the WHO atlas. Results: We collected 178 colposcopy images. FBG images numbered 50, or 28%. The mean age of the patients was 44.5 years ±11.4 at the extremes of 18 and 78 years. Mean gestational age was 4.69 ± 2.72. Among patients with a bilharzian lesion on the cervix, visual acid inspection (VIA) was negative in 60% of cases (p = 0.007, Odd Ratio = 3.6 (1.49 -9.07)). Conclusion: the results of our study show that FBG is a reality in our daily practice. It occurs in adult, multigestating, non-occupational women whose examination reveals a negative visual inspection with acetic acid (VIA). Healthcare providers therefore need to be trained in the recognition of lesions associated with genital bilharziasis, and public awareness needs to be raised.