Multimorbidity is a growing public health challenge in low- and middle-income countries (LMICs), where resource-limited and fragmented health systems impede coordinated disease detection and management. Integrated screening offers a promising strategy to improve early detection of communicable and non-communicable diseases. We mapped the current evidence on integrated screening in LMICs, examining models, strategies, diseases, diagnostic tools and contextual factors that affect implementation and sustainability. A comprehensive search was conducted using the following electronic databases: PubMed, Scopus, Web of Science, ProQuest and EBSCOhost following the PRISMA-ScR guidelines. Two independent reviewers screened and extracted data, with a third reviewer resolving any discrepancies. The methodological quality of the study was appraised using the Mixed Methods Appraisal Tool (MMAT, Version 2018). Results were synthesized thematically and presented narratively. Out of 5380 studies screened, 17 were included, spanning 2012-2025 across 12 countries (13 conducted in Africa, 3 in South Asia and 1 in Latin America). They assessed communicable and non-communicable conditions, including HIV, TB, diabetes, hypertension and cardiovascular disease. Integrated screening was delivered via facility-based, mobile, community and community health worker-led models across primary healthcare and community settings. Five themes emerged: implementation in community and healthcare facilities; role of point-of-care diagnostics; health system preparedness and workflow alignment; staffing and workforce support; and factors influencing sustainability. Integrated multimorbidity screening in LMICs is feasible and improves detection, diagnosis and care when supported by trained staff, task shifting, community health workers and point-of-care diagnostics. Sustainable scale-up needs national alignment, funding and resource mobilization for equitable access.

Tuberculosis remains a major public health threat globally, with drug-resistant strains undermining treatment efficacy. We analyzed 126 Mycobacterium tuberculosis (M. tuberculosis) isolates with diverse drug resistance spectra and selected 35 for whole genome sequencing (WGS) using Illumina NextSeq, SMRT PacBio Onso and SMRT PacBio Revio sequencing platforms. The study aimed to characterize drug resistance profiles, compare short- and long-read sequencing performance, identify lineages among South African isolates, detect known drug resistance mutations and their lineage-specific patterns, and utilize long-read SMRT platforms for epigenetic profiling. Multiple drug resistance mutations were identified, some lineage-specific, and notably, East-African-Indian (EAI) Lineage 1 isolates often considered less pathogenic, showed significant potential for multidrug-resistance development, including higher fluoroquinolone resistance as compared to other lineages. Three DNA motifs with methylated adenines, namely CACGCaG, CtCCaG and GaTNNNNRtAC, were detected, with methylation patterns varying by lineage and strain due to mutations in the corresponding methyltransferases (MTases). A particularly notable finding was the stable maintenance of a genetic heterogeneity in the mamB MTase, performing methylation at CACGCaG motifs. These results highlight the combined role of genetic and epigenetic variation in M. tuberculosis adaptive evolution and underscore the value of integrating long-read sequencing into TB surveillance and research.

Studies reporting deletions of the pfhrp2 and pfhrp3 genes in P. falciparum populations in various malaria-endemic countries, including countries bordering Brazil, are increasing. Individuals infected with P. falciparum carrying deletions of the pfhrp2/3 genes may yield false-negative results in Rapid Diagnostic Tests (RDTs) based on the detection of these antigens. A total of 342 samples from symptomatic individuals infected with P. falciparum, collected during epidemiological surveillance activities in the municipalities of the international frontier between Brazil and Peru and between Brazil and Venezuela were analysed. Of the 342 samples evaluated, 86 (25.2%) showed pfhrp2-deletion, 32 (9.4%) double deletions of the pfhrp2/3 genes, and 168 (49.1%) had a single deletion of the pfhrp3 gene. The frequency of parasites with pfhrp2/3 deletions highlights the importance of genomic surveillance in international border areas, alongside the evaluation of the effectiveness of RDTs used in the country.