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Abstract Background Anthrax is a non-contagious zoonotic disease caused by the Gram-positive, spore-forming bacterium Bacillus anthracis. Infection is common in livestock and wild animals such as cattle, goats, sheep, camels, and antelopes. In humans, anthrax may occur after contact with contaminated carcasses or animal products like milk and meat. The best method to prevent anthrax in people is to ensure livestock are vaccinated, which significantly limits the risk of zoonotic spread to humans. However, the rate of vaccination of domesticated animals kept by nomadic pastoralists in West Africa is low. These groups regularly cross over national boundaries with their grazing herds. Nigeria is a country that historically has done comparatively well to contain this public health threat. However, in 2023 several outbreaks of human disease appear linked to the consumption of anthrax-contaminated animal products brought into Nigeria by pastoralists from neighboring countries. Clinical manifestations include skin sores or ulcers, nausea, vomiting, and fever. This article aims to raise awareness of recent outbreaks of anthrax in West Africa and to call for a renewed focus on measures to combat this neglected public health concern to the region. Main body The imperative to pinpoint pivotal issues relating to the ongoing emergence of anthrax cases in Nigeria cannot be overstated. By delving into the prevalence of anthrax in both livestock and human populations residing along Nigeria’s borders, unraveling the genetic diversity and potential sources of B. anthracis strains, and identifying the primary animal host(s) responsible for transmission, we stand to enhance our understanding of this critical issue. Furthermore, investigating the multifaceted factors contributing to anthrax transmission, assessing community knowledge and practices, mapping common migratory routes of pastoralists, and formulating targeted intervention strategies tailored to the challenges of border communities, are each crucial steps towards effective control and prevention. Conclusion Closing these knowledge gaps on anthrax is not only essential for safeguarding both animal and human health but also for fostering sustainable and resilient communities. Addressing research questions on these interdisciplinary concerns will undoubtedly pave the way for informed decision-making, proactive measures, and a more secure future for Nigeria and its border regions. Graphical Abstract

Breaker fluids are designed to dissolve filter cakes by breaking their long-chain molecules, thereby removing solid deposits on the wellbore wall. Although breaker fluids are not intended to infiltrate the hydrocarbon reservoir, they can invade and cause formation damage by altering sandstone reservoirs' wettability and relative permeability. This can lead to a reduction in the overall reservoir performance. This study coupled tripartite methods to investigate the potential impact of breaker invasion and transport in hydrocarbon reservoirs and its multiscale effect on the performances of sandstone reservoirs. We utilized experimental, analytical, and numerical methods to assess and predict the susceptibility of reservoirs to breaker fluid invasion and transportation. Our experimental and empirical investigations considered varying breaker fluid formulations to evaluate the effects of breaker fluid concentration, formation temperature, and solution gas-oil ratio (GOR) on residual-oil saturation (ROS) and oil-water relative permeability. By adopting the ROS and relative permeability associated with the 50% v/v breaker fluid mixture, the performance of the hydrocarbon reservoir was numerically simulated under the limiting scenarios of no-invasion, moderate-invasion, and deep-invasion of breaker fluid. The results indicate a positive correlation between breaker fluid concentration and ROS, highlighting the risks that breaker fluid invasion and deep infiltration pose to hydrocarbon recovery. Further, results show that both live-oil condition (LOC) and dead-oil condition (DOC) reservoirs are susceptible to the detrimental impacts of breaker fluid infiltration, while their invasion can reduce hydrocarbon recovery in both LOC (−6%) and DOC (−28%). The multi-scale effects on reservoir performance are more pronounced at near-wellbore and DOC than at far-field and LOC. Findings from this work provide valuable insights into the complexity of breaker-fluid invasion in sandstone reservoirs and the mitigation of associated risks to reservoir performance.

Background: Although tremendous strides have been made in Human Immunodeficiency Virus (HIV) prevention, detection, and treatment, HIV remains a public health issue in the United States. Sexual and gender diverse individuals and the 18-24 age group are considered vulnerable populations at risk for contracting the virus. Pre-exposure prophylaxis (PrEP) is a medication that has proven effective in reducing the risk of HIV transmission. Aim: This article aims to justify the necessity of PrEP medication on college campuses, especially for gender and sexual diverse students. Methods: This article provides information on the state of PrEP education, availability, and access on college campuses in the United States. This article also addresses barriers that college students face with accessing PrEP medication through college health services. Results: Limited research has found that most colleges in the United States lack PrEP availability for college students. Other factors, including insurance, privacy concerns, and stigma, may deter students from seeking and taking PrEP medication. Conclusions: This article supports widespread PrEP availability and access on college campuses and acknowledges the need to address barriers that keep students from utilizing PrEP.

Carbon capture and storage (CCS) has been recognized as a pivotal technology for mitigating climate change by reducing CO2 emissions. Storing CO2 in deep saline aquifers requires preserving the water-wet nature of the formation throughout the storage period, which is crucial for maintaining rock integrity and storage efficiency. However, the wettability of formations can change upon exposure to supercritical CO2 (scCO2), potentially compromising storage efficiency. Despite extensive studies on various factors influencing wettability alteration, a significant research gap remains in understanding the effects of different CO2 injection strategies on wettability in deep saline formations (DSFs). This study addresses this gap by investigating how three distinct CO2 injection strategies—continuous scCO2 injection (CCI), water alternating with scCO2 injection (WAG), and simultaneous water and scCO2 injection (SAI)—affect the wettability of gray Berea sandstone and Indiana limestone, both selected for their homogeneous properties relevant to CCS. Using a standardized sessile drop contact angle method before and after CO2 injection, along with core flooding to model the injection process at an injection pressure of 1500 psi and temperature of 100 °F with a confining pressure of 2500 psi, the results indicate a shift in wettability towards more CO2-wet conditions for both rock types under all strategies with changes in CA of 61.6–83.4° and 77.6–87.9° and 81.5–124.2° and 94.6–128.0° for sandstone and limestone, respectively. However, the degree of change varies depending on the injection strategy: sandstone exhibits a pronounced response to the CCI strategy, with up to a 77% increase in contact angle (CA), particularly after extended exposure. At the same time, WAG shows the least change, suggesting that water introduction slows surface modification. For limestone, the changes in CA ranged from 9% to 49% across strategies, with WAG and SAI being more effective in altering its wettability. This study underscores the importance of selecting suitable CO2 injection strategies based on rock type and wettability characteristics to maximize carbon storage efficiency. The findings offer valuable insights into the complex interactions of fluid–rock systems and a guide for enhancing the design and implementation of CCS technologies in various geological settings.

Cholera caused by Vibrio cholerae remains endemic and recurrent in Nigeria resulting in morbidity and mortality on annual basis. Vibrio cholerae O1 and non-O1/O139 are reported causative agents of the disease outbreak in Nigeria and some of these strains circulating the country acquired multidrug resistance potential. Several factors including socioeconomic and environmental among other factors drive this trend. Some regions in the country have been identified as hot spots most especially the north where insurgency has exacerbated outbreaks and management/control difficult. Surveillance and response to cholera outbreaks has been suboptimal which in turn has always increased the number of fatalities. Coordinated and harmonized approach involving all needed components (education, WASH, vaccination, surveillance, human capacity building and strengthening capacity of laboratories) has been advocated as a viable option to tackle the scourge.

Approximately half of the world’s population is estimated to be infected with Helicobacter pylori [...]

Abstract Background Adverse events and mortality tend to cluster around dialysis sessions, potentially due to the impact of the saw-toothed profile of uraemic toxins such as potassium, peaking pre-dialysis and rapidly dropping during dialysis. Acidosis could be contributing to this harm by exacerbating a rise in potassium. The objectives of this study were to investigate the effects of oral bicarbonate treatment on reducing inter-dialytic potassium gain as well as other clinical consequences of preserving muscle mass and function and reducing intradialytic arrhythmia risk in people on haemodialysis. Methods Open-label randomised controlled trial in a single-centre (London, UK). Forty-three clinically stable adults on haemodialysis were recruited, with a 6 month average pre-dialysis serum bicarbonate level 4 mmol/l. Thirty-three participants completed the study. Oral sodium bicarbonate tablets titrated up to a maximum of 3 g bd (6 g total) in intervention group for 12 weeks versus no treatment in the control group. Outcomes compared intervention versus non-intervention phases in the treated group and equivalent time points in the control group: pre- and post-dialysis serum potassium; nutritional assessments: muscle mass and handgrip strength and electrocardiograms (ECGs) pre and post dialysis. Results Participants took an average of 3.7 ± 0.5 g sodium bicarbonate a day. In the intervention group, inter-dialytic potassium gain was reduced from 1.90 ± 0.60 to 1.69 ± 0.49 mmol/l (p = 0.032) and pre-dialysis potassium was reduced from 4.96 ± 0.62 to 4.79 ± 0.49 mmol/l without dietary change. Pre-dialysis bicarbonate increased from 18.15 ± 1.35 to 20.27 ± 1.88 mmol/l, however with an increase in blood pressure. Nutritionally, lean tissue mass was reduced in the controls suggesting less catabolism in the intervention group. There was no change in ECGs. Limitations are small sample size and unblinded study design lacking a placebo, with several participants failing to achieve the target of 22 mmol/l serum bicarbonate levels due mainly to tablet burden. Conclusion Oral sodium bicarbonate reduced bicarbonate loss and potassium gain in the inter-dialytic period, and may also preserve lean tissue mass. Trial registration The study was registered prospectively on 06/08/2015 with EU Clinical Trials Register EudraCT number 2015-001439-20 .

Abstract Introduction: In high-volume trauma centers, especially in developing countries, penetrating cardiac box injuries are frequent. Although many aspects of penetrating chest injuries have been well established, video-assisted thoracoscopy is still finding its place in cardiac box trauma and algorithmic approaches are still lacking. The purpose of this manuscript is to provide a streamlined recommendation for penetrating cardiac box injury in stable patients. Methods: Literature review was carried out using PubMed/MEDLINE and Google Scholar databases to identify articles describing the characteristics and concepts of penetrating cardiac box trauma, including the characteristics of tamponade, cardiac ultrasound, indications and techniques of pericardial windows and, especially, the role of video-assisted thoracoscopy in stable patients. Results: Penetrating cardiac box injuries, whether by stab or gunshot wounds, require rapid surgical consultation. Unstable patients require immediate open surgery, however, determining which stable patients should be taken to thoracoscopic surgery is still controversial. Here, the classification of penetrating cardiac box injury used in Colombia is detailed, as well as the algorithmic approach to these types of trauma. Conclusion: Although open surgery is mandatory in unstable patients with penetrating cardiac box injuries, a more conservative and minimally invasive approach may be undertaken in stable patients. As rapid decision-making is critical in the trauma bay, surgeons working in high-volume trauma centers should expose themselves to thoracoscopy and always consider this possibility in the setting of penetrating cardiac box injuries in stable patients, always in the context of an experienced trauma team.

Helicobacter pylori (H. pylori) infection is ubiquitous worldwide, with prevalence rates of greater than 70% in Africa. Symptomatic patients present with foregut gastrointestinal symptoms which can be readily diagnosed with standardized non-invasive or invasive tests. The biggest challenge, however, is in the management of this condition with rising antimicrobial resistance rates to most of the antibiotics recommended for therapy. This is a problem worldwide, but more specifically in Africa, where the socio-economic and political climate is such that eradication of this organism seems impossible. Furthermore, the recommended antimicrobial susceptibility testing for drug resistance is not widely available in Africa due to the lack of infrastructural as well as human resources. With the widespread unregulated use of antibiotics in some parts of Africa, the figures of antimicrobial resistance are likely to soar. In the face of these significant challenges, this ‘perspectives’ article aims to address the issue of antimicrobial resistance in Africa, by providing achievable and targeted goals to curb the spread of infection and rising antimicrobial resistance.

Abstract Unstable well flow is detrimental to the technical and economic performances of an integrated production system. To mitigate this problem, it is imperative to understand the stability limits and predict the onset of unstable production of an oil well. Taking advantage of the phenomenon of slug flow and the onset of unstable equilibrium from inflow performance and vertical lift curves of a producing well, this paper presents a new method for evaluating the stability of an oil production well on the one hand and estimating its stable production limits in terms of wellhead flowing pressure and flow rate on the other hand. A novelty of this work is the introduction and quantitative characterization of three distinct stability phases in the performance of a production well. These phases are uniquely identified as stable, transition and unstable flows. Practical examples and field cases demonstrate the robustness of the new method. When compared against results from a commercial wellbore simulator for the same set of problems, the new method yields an average absolute deviation of 5.3%. Additional validation tests against a common, but more computationally demanding method of stability analysis yield satisfactory results. Several parametric tests conducted with the proposed model and method provide additional insights into some of the major factors that control well stability, highlighting scope for production optimization in practice. Overall, this work should find applications in the design and management of production wells.

Abstract Objective Nosocomial and community acquired multidrug resistant Klebsiella infections are wide spread resulting in high morbidity and mortality due to limited number of antibiotics treatment options. This study investigated efflux pump activity, biofilm forming potential and antibiotic susceptibility profile of Klebsiella spp. isolated from clinical samples in a tertiary hospital in Lagos Nigeria. Eighteen clinical Klebsiella spp. isolated from urine, blood and sputum were subjected to antibiotic susceptibility testing using the disc diffusion method. Efflux pump activity was evaluated by the ethidium bromide cartwheel method and biofilm forming ability was determined by the tissue culture plate technique. Results All 18 (100%) Klebsiella isolates were resistant to cefuroxime, cefixime, amoxicillin − clavulanate, ampicillin + cloxacillin, cefotaxime, and imipenem. Seventeen (94.4%) were resistant to ofloxacin while sixteen (88.9%) were resistance to nalidixic acid, Gentamicin and levofloxacin. All Klebsiella isolates possessed active efflux pump with the ability to form biofilm. However, their biofilm forming capabilities varied as 4 (22.2%) were strong, 3 (16.7%) were moderate and 11 (61.1%) were weak biofilm formers. Findings in this study reveal multiple factors at play in mediating the high level of antibiotic resistance observed in Klebsiella isolates. Hence a multifaceted approach is advocated in managing the infections caused by the pathogen.

The objective of this study was to develop a structural-cognitive-behavioral model for error analysis of group B streptococcus (GBS) prophylaxis failure, classify delivery cases into this model, and examine compliance with treatment guidelines. A retrospective, cohort study was conducted of women with liveborn pregnancies greater than 24 weeks in April 2018 at a single hospital. We created a structural-cognitive-behavioral model of five assessments for adherence to GBS prophylaxis guidelines and then classified these into four distinct error stages. A descriptive analysis was performed to determine if the pregnancy had a perfect process, a GBS prophylaxis failure, or a fortuitous outcome. There were 313 women who met the study criteria. The rate of GBS positive was 12.8%, negative 37.4%, and unknown 49.8%. The most common errors were cognitive perception errors related to incorrectly documenting GBS status, 57.7% (N = 79). Of these errors, 15.2% (N = 12) led to GBS prophylaxis failure. Perfect outcomes occurred in 62.7% (N = 196) women, GBS prophylaxis failure occurred in 13.7% (N = 43), and fortuitous outcomes occurred in 23.6% (N = 74). In our study, we were able to identify structural, cognitive, and behavioral errors that contribute to GBS prophylaxis failures. In other cases, these errors may contribute to fortuitous outcomes.

Abstract As an improvement over existing screening techniques, we introduce the relative mobile energy of primary gas-cap to the aquifer (E gw) as a new parameter for characterizing the performance of oil-rim reservoirs. E gw integrates key static and dynamic reservoir properties. To account for the time value of production, the framework allows maximizing the discounted recovery factor (DRF) of oil, gas or total hydrocarbon as the objective function. Employing detailed simulations of different well-defined oil-rim models, DRFs of oil, gas and total hydrocarbons have been correlated against E gw for common development concepts and well types. These correlations have resulted in a new screening technique for both green and brown oil-rim reservoirs. In addition to presenting simple generic charts for quick evaluation of oil-rim reservoirs, the main contributions of this work include the introduction of E gw as a new performance-characterizing parameter, and the flexibility to consider the DRF of any of oil, gas or total hydrocarbon as the basis for screening an oil-rim reservoir for development planning and field management. Using the example of a brown oil-rim reservoir, the applicability and robustness of the new screening technique are demonstrated.

A model is proposed for describing the shape change of isotropic and anisotropic graphite under the influence of high temperatures and high neutron radiation fluences. The model is based on a new approach, which uses the following provisions: description of the near-pore neighborhood in graphite as a solid solution using the theory of phase transformations of the first kind; consideration of a new phase as a spheroidal pore of small eccentricity, flattened along the direction of greatest stress; taking into account the clustering of carbon atoms at fluences of more than . The graphite non-isotropy is characterized by different pore sizes, different diffusion coefficients, the lengths of the paths of graphite atoms along and across volume of the sample, which in turn depend on the temperature of the sample. It is proposed that the initial element on the basis of which a new phase will be formed is the spheroidal pore of small eccentricity, flattened along the direction of the highest tension. A kinetic equation that describes the diffusion of pores under the influence of high temperatures and intense neutron fluxes is obtained. Initially, the pores are in a field of predetermined stresses oriented along and across the sample. The contribution of diffusion processes is due to the term proportional to the pore distribution function in the sample, and the effect of the neutron flux is described by an additional term in the kinetic equation. The obtained kinetic equation for anisotropic graphite can be transformed for isotropic graphite. For isotropic and anisotropic graphite, model solutions have been obtained that characterize the change in its volume with time under the influence of a neutron flux and high temperature. It is shown that the magnitude of the change in the relative volume of reactor graphite for isotropic graphite exceeds a similar value for anisotropic graphite. Theoretical confirmation of the laws governing the swelling of anisotropic graphites under the influence of large neutron fluences and in the high-temperature field, previously obtained by other authors, is obtained: longitudinal compression of anisotropic graphite samples corresponds to a change in the linear dimensions of isotropic graphites; the transverse compression of anisotropic graphite samples is less than the change in the longitudinal linear dimensions of isotropic graphites.

Abstract Objectives Helicobacter pylori is a pathogenic bacterium that parasitizes the gastric mucous layer and the epithelial lining of the stomach causing duodenal ulcers, gastric ulcers and cardiovascular disease amongst others. This study aimed at establishing the epidemiologic profile of H. pylori infection in gastritis patients presenting at the Melong District Hospital. Results Blood, stool and epidemiological data collected from 500 patients were analyzed for the presence of H. pylori antibody in serum, antigen in stool and elucidation of risk factors captured in questionnaires. Of 500 blood samples, 217 (43.4%) were seropositive with male and female seroprevalences of 45.5% (61/134) and 42.6% (156/366) respectively. Similarly, 47.4% (237/500) samples tested positive for stool antigen with prevalences of 47.0% (63/134) for males and 47.5% (174/366) for females. The antigen prevalence was higher (53.2%; 118/222) in older patients (> 50 years) than in younger patients (42.8%; 119/278; P = 0.021). The antigen test had a higher (47.4%) prevalence than the antibody test (43.4%). Educational level, source of income, source of drinking water, age of patients, and alcohol consumption had positive associations with H. pylori infection. These results have clinical and epidemiological significance and call for intervention to mitigate the situation.

Background: As part of the bid to ensure healthy lives and promote well-being for children, the Sustainable Development Goals were adopted by the United Nations in 2015. Reports show that economically and socially deprived neighbourhoods have an increased risk of under-five mortality. Objectives: To describe the causes of childhood deaths in selected communities in Nigeria. Methods: Four states namely, Borno, Kwara, Plateau, and Sokoto states representing three geopolitical zones of Nigeria were included in the study. Two local governments were randomly selected in each state. A descriptive cross-sectional study design was employed to carry out this survey. Pre-coded questionnaires were used to collect data from care givers. Results: The three leading causes of death among under-fives in the Borno State was diarrhoea, measles and sudden death, in the Kwara State was asphyxia, diarrhoea, cough; in Sokoto it was diarrhoea, cough and asphyxia, and in the Plateau State it was diarrhoea, acute respiratory illness and malaria. Conclusions: Diarrhoea was consistently the leading cause of death, followed by pneumonia and asphyxia, which are largely preventable. Surprisingly, with the exception of the Plateau State, malaria was not listed amongst the three leading causes of death in the communities under study.

The medicinal plant Spathodea campanulata P. Beauv. (Bignoniaceae) has been traditionally applied for the prevention and treatment of diseases of the kidney and urinary system, the skin, the gastrointestinal tract, and inflammation in general. The present work shows for the first time how chemical components from this plant inhibit Helicobacter pylori growth by urease inhibition and modulation of virulence factors. The crude extract and the main fractions of S. campanulata bark were tested on H. pylori isolated strains and the active ones were further fractionated. Fractions and sub-fractions of the plant crude extract were characterized by ultra-high-performance liquid chromatographic tandem high resolution-mass spectrometry detection (UHPLC-HRMS). Several phenolics and triterpenoids were identified. Among the sub-fractions obtained, SB2 showed the capacity to inhibit H. pylori urease in a heterologous bacterial model. One additional sub-fraction (SE3) was able to simultaneously modulate the expression of two adhesins (HopZ and BabA) and one cytotoxin (CagA). The flavonol kaempferol was identified as the most interesting compound that deserves further investigation as a new hit for its capacity to modulate H. pylori virulence factors.

Antibiotic resistance in Helicobacter pylori is a factor preventing its successful eradication. Particularly in developing countries, resistance against commonly used antibiotics is widespread. Here, we present an epidemiological study from Nigeria with 111 isolates. We analyzed the associated disease outcome, and performed a detailed characterization of these isolated strains with respect to their antibiotic susceptibility and their virulence characteristics. Furthermore, statistical analysis was performed on microbiological data as well as patient information and the results of the gastroenterological examination. We found that the variability concerning the production of virulence factors between strains was minimal, with 96.4% of isolates being CagA-positive and 92.8% producing detectable VacA levels. In addition, high frequency of bacterial resistance was observed for metronidazole (99.1%), followed by amoxicillin (33.3%), clarithromycin (14.4%) and tetracycline (4.5%). In conclusion, this study indicated that the infection rate of H. pylori infection within the cohort in the present study was surprisingly low (36.6%). Furthermore, an average gastric pathology was observed by histological grading and bacterial isolates showed a uniform pathogenicity profile while indicating divergent antibiotic resistance rates.

Summary: Background: The 2010 cholera outbreak in northern Nigeria affected over 40,000 people, with a case fatality rate (CFR) of ≥3.75%. We assessed the emergency response of health care workers (HCWs) involved in case management. Method: This was a cross-sectional study with data collected through a self-administered questionnaire. Data entry and analysis were performed using Epi info software. Results: A total of 56 HCWs were interviewed. The mean age was 31 years (SD ± 8.16 years). The majority of the HCWs (80%; n = 45) were aged 18–39 years. Most were community health extension workers (60%), and 3.6% (n = 2) were medical doctors. Many of the HCWs had less than 2 years of work experience (42%). Additionally, 82% of the respondents had 20 suspected cases of cholera per day. Although 78% of HCWs reported the practice of universal safety precautions, 32% (n = 18) knew HCWs who developed symptoms of cholera during the epidemic, most of which was believed to be hospital acquired (78%). We also found that 77% (n = 43) of HCWs had no access to the required emergency response supplies. Conclusion: Inadequate training, a lack of qualified HCWs and a limited supply of emergency response kits were reported. Therefore, the government and stakeholders should address the gaps noted to adequately control and prevent future epidemics. Keywords: Cholera, Emergency response, Healthcare workers, Nigeria

Staphylococcus aureus infections are growing problems worldwide with important implications in hospitals. The organism is normally present in the nasal vestibule of about 35% of apparently healthy individuals and its carriage varies between different ethnic and age groups. Staphylococcal nasal carriage among health workers is particularly important to establish new clones and track origin of infections during outbreak situations. To determine the carriage rate and compare the pulsed field gel patterns of the strains, nasal swabs were collected from 185 medical students in a teaching hospital in Lagos, Nigeria. Isolates of S. aureus were tested for heamolysin production, methicillin sensitivity and Pulsed Field Gel Electrophoresis (PFGE) was performed. The results showed S.aureus nasal carrier rate of 14% with significant rate among males compared to females. All the isolates produced heamolysin. Antibiotic susceptibility pattern revealed that majority of the isolates was susceptible. Five strains (19%) harboured resistant determinants to penicillin and tetracycline. None of the strains was resistant to methicillin. 44% of the isolates typed by PFGE had type B, the most predominant pulsotype. PFGE A clone exhibited a single resistance phenotype suggesting a strong clonal relationship that could punctual an outbreak in the hospital. The results speculate that nasal carriage among medical personnel could be a function of various risk factors. Personal hygiene and behaviour may however be the means to reducing colonization and spread of S.aureus in our hospitals.

Carbon capture and storage (CCS) has been recognized as a pivotal technology for mitigating climate change by reducing CO2 emissions. Storing CO2 in deep saline aquifers requires preserving the water-wet nature of the formation throughout the storage period, which is crucial for maintaining rock integrity and storage efficiency. However, the wettability of formations can change upon exposure to supercritical CO2 (scCO2), potentially compromising storage efficiency. Despite extensive studies on various factors influencing wettability alteration, a significant research gap remains in understanding the effects of different CO2 injection strategies on wettability in deep saline formations (DSFs). This study addresses this gap by investigating how three distinct CO2 injection strategies—continuous scCO2 injection (CCI), water alternating with scCO2 injection (WAG), and simultaneous water and scCO2 injection (SAI)—affect the wettability of gray Berea sandstone and Indiana limestone, both selected for their homogeneous properties relevant to CCS. Using a standardized sessile drop contact angle method before and after CO2 injection, along with core flooding to model the injection process at an injection pressure of 1500 psi and temperature of 100 °F with a confining pressure of 2500 psi, the results indicate a shift in wettability towards more CO2-wet conditions for both rock types under all strategies with changes in CA of 61.6–83.4° and 77.6–87.9° and 81.5–124.2° and 94.6–128.0° for sandstone and limestone, respectively. However, the degree of change varies depending on the injection strategy: sandstone exhibits a pronounced response to the CCI strategy, with up to a 77% increase in contact angle (CA), particularly after extended exposure. At the same time, WAG shows the least change, suggesting that water introduction slows surface modification. For limestone, the changes in CA ranged from 9% to 49% across strategies, with WAG and SAI being more effective in altering its wettability. This study underscores the importance of selecting suitable CO2 injection strategies based on rock type and wettability characteristics to maximize carbon storage efficiency. The findings offer valuable insights into the complex interactions of fluid–rock systems and a guide for enhancing the design and implementation of CCS technologies in various geological settings. [ABSTRACT FROM AUTHOR]