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Rethinking the Evidence on COVID in Africa
(2024-10-18) Bejon, Philip; Agweyu, Ambrose; Oyier, Isabella; Hamaluba, Mainga; Kamuya, Dorcas; Kinyanjui, Sam; Barasa, Edwine
The COVID pandemic was predicted to cause substantial mortality in Africa. However, experiences from many countries in Africa were notable for a striking absence of overwhelmed hospitals, and for low reported mortality. The marked contrast with the overwhelmed hospitals and high mortality seen in Europe and other high income settings was regarded as “puzzling” or a “paradox”. We reflect on possible explanations for this paradox with particular reference to observations made “on the ground” in Kenya. We identify sufficient evidence to reject many potential explanations for the differing epidemiology in Africa. Longitudinal surveillance using antibody assays suggested that viral transmission was widespread and rapid. These data contradict explanations such as: an impact of climate on virus droplets; enhanced air circulation in rural settings; or stringent and effective public health interventions against infectious spread. We acknowledge resource limitations on surveillance of severe disease in hospitals and registration of deaths, but nevertheless identify sufficient evidence to exclude hidden hospital surges, and to exclude a hidden substantial death rate outside hospital. Population age structure is an important but incomplete explanation of the epidemiology. The simplistic calculation of multiplying infection-fatality rates by the Kenyan population age structure implies a figure substantially higher than the observed excess deaths, and the calculation is further misleading because the infection fatality rates were derived from settings where the health system capacity mitigated the risk of death. Multiplying infection-hospitalization rates by the age structure of the Kenyan population predicts over a million hospital admissions, which would have been well beyond the surge capacity of the Kenyan healthcare system, and incompatible with the data showing that substantial hospital surges were not seen. We found a very high prevalence of asymptomatic infection in routine data as well as in longitudinal studies with active surveillance. Taking this together with the lack of hospital surges, the low mortality estimates, and the evidence against reduced viral transmission, we conclude the primary explanation for the “paradox” is reduced susceptibility to symptomatic disease among populations in Africa. There is an opportunity to further study pre-pandemic immunity and other potential mechanisms for the reduced susceptibility to severe COVID in Africa. Given our incomplete understanding of the mechanisms associated with reduced susceptibility to severe COVID, we should not be complacent about health security in Africa, and should prioritize the rapid acquisition of data on the ground to guide future pandemic responses.
The Role of Climate Change for Transboundary Crop Pest Outbreaks in IGAD Member States – Challenges for Integrated EWS and Governance. A Review
(2024-09-13) Lazutkaite, Elena; Klein, Igor; Kimathi, Emily; Sabiiti, Geoffrey; Tonnang, Henri; Endris, Hussen Seid; Amdihun, Ahmed; Igbokwe, Victor K.; Müller, Alexander
This paper is based on the review of scientific literature and consultations with member states of the Intergovernmental Authority on Development (IGAD). Climate change is having a profound impact on the IGAD region, with rising temperatures and shifting rainfall patterns driving both extreme weather events and agricultural pest outbreaks. This review addresses the threat posed by five major transboundary crop pests: fall armyworm (Spodoptera frugiperda), African armyworm (Spodoptera exempta), tomato leaf miner (Tuta absoluta), red-billed quelea (Quelea quelea), and desert locust (Schistocerca gregaria). The lifecycle, behaviour, and economic impact of each pest are examined, with a particular focus on the role of climate change in intensifying their proliferation and spread. The paper also assesses current pest management strategies and identifies their shortcomings. It advocates for advancements in Early Warning Systems (EWS), emphasizing the need for integrating advanced technologies to prevent and manage the emergence and spread of transboundary pests. The paper calls for a holistic and integrated approach to pest management, incorporating climate services and fostering community-based interventions. It underscores the need to rethink governance to equip EWS for future challenges and stresses the importance of continuous research and international cooperation to build sustainable and resilient agricultural systems.
Integrated diagnosis at the primary care level in Africa's low- and middle-income countries: What is it, what works, and for whom? A Realist Synthesis
(Ubiquity Press, 2024-09-12) Gwaza, Gamuchirai; Pluddemann, Annette; McCall, Marcy; Heneghan, Carl
Introduction Integrated diagnosis can improve health outcomes and patient experiences through early diagnosis and identification of cases that could otherwise be overlooked. While existing studies showcase the feasibility of integrated diagnosis across diverse conditions, a critical research gap exists regarding the conclusive link between integrated diagnosis at the primary care level and improvements in patient experiences and health outcomes. This review examines the conceptualizations of integrated diagnosis by various actors along the healthcare pathway in low- and middle-income countries (LMICs) and explores the necessary contexts and mechanisms crucial for its effectiveness. Methods This study adopts a realist methodology to comprehensively investigate integrated diagnosis. Employing a systematic approach, the research aims to collect, review, and synthesize existing evidence on integrated diagnosis, leveraging a program theory developed through literature review and expert discussions. Primary studies and reviews on integrated diagnosis, multi-disease testing, or integrated healthcare with a diagnostic component were sourced from key databases and global health organization websites. The collected evidence was used to build, refute, and test the evolving theoretical framework. Results This study identifies three models of integrated diagnosis interventions: individual/human resource integration, facility or mobile-based integration, and technology integration. The successful implementation of these models relies on an understanding of the values and perceptions of both healthcare workers and patients. This research emphasizes a holistic approach, considering all elements within the health system. Emphasizing a holistic methodology, the research underscores the interdependence of various elements within the health system. By framing contextual factors using the WHO health systems framework, the study positions diagnosis as an integral component of a broader health ecosystem. A key result of the research is the imperative to comprehensively address issues affecting integrated diagnosis interventions. This encompasses considerations such as policy frameworks, diagnostic tools, funding mechanisms, treatment pathways, and human resource management. To improve patient experiences, there is need to cultivate positive relationships with healthcare workers. This involves ensuring elements like respect, confidentiality, accessibility, and timeliness of services are considered. Despite integrated structures, there are potential challenges like increased waiting times that may impact patient uptake of integrated services. Discussion and Conclusion The diverse conceptualisations of integrated diagnosis highlight the necessity for clear definitions of each intervention, which is pivotal for the transfer of lessons, program comparisons, and effective measurement of results across different contexts. The success of integrated diagnosis is not a one-size-fits-all scenario; local contexts must guide decisions regarding the approach, conditions, and timing of integration to ensure sustainable outcomes. The review findings indicate that integrated diagnosis may be suitable at the primary care level in LMICs under specific circumstances. Successful implementation hinges on addressing both HCWs and patient perspectives, necessitating adequate time, resources, and a well-defined intervention model.
Antimicrobial resistance: One health approach in Rwanda
(2024-07-24) Sindayigaya, Patience; Rinda Ubuzima
This commentary provides the authors' views related to the Antimicrobial Resistance (AMR) profile in Rwanda in terms of prevalence, knowledge, attitudes, practices, and existing interventions at the one health interface. AMR is a critical and global health concern posing a significant threat to the effective treatment of infections and lead to increased morbidity and mortality. Among few studies that have been conducted on AMR in Rwanda, the issue was found to be widespread in both human and animals. A high resistance has been found among the commonly used antibiotics seconded by the lack of knowledge and appropriate practices among different groups of people. Some interventions, including “one health” approach are in place aiming to address these issues, but challenges are still around due to developing surveillance system, limited studies, and low public awareness. Extensive studies and enhance surveillance are recommended to better understand AMR to inform the public and policy makers for effectively tackling of the AMR issue, particularly in rural areas.
Ten Simple Rules For Successful And Sustainable African Research Collaboration
(PLoS Computational Biology, 2024-06-27) Dine, Roseline Dzekem; Elkheir, Lamis Yahia Mohamed; Raimi, Morufu Olalekan; Alemayehu, Micheal; Mohamed, Salem Youssef; Turzin, Justice Kwadwo; Arogundade, Femi Qudus; Ochola, Elizabeth Akinyi; Nasiyo, Alex Mukungu; Mwawanga, Raziah Quallatein; Yabo, Yahaya Abubakar
This manuscript presents 10 practical and sustainable steps that if followed and built upon will enhance successful collaboration between African researchers and the international research community.
The integration of Artificial intelligence (AI) in literature review and its potentials to revolutionize scientific knowledge acquisition
(2024-04-28) Ilegbusi, Paul
This presentation discusses the role of artificial intelligence (AI) in enhancing the literature review process and its potential to transform scientific knowledge acquisition. The presentation highlights the importance of literature review in research and the challenges associated with the traditional manual approach. The presentation emphasizes that integrating AI in literature review can significantly improve efficiency, accuracy, and reduce bias. AI-powered tools can automate various aspects of the literature review process, including search, selection, analysis, and synthesis of relevant literature. The benefits of AI in literature review include increased efficiency, improved coverage of literature, and the ability to identify gaps in knowledge and uncover new research questions. The presentation also provides a comprehensive list of AI tools that can be used in literature review, such as Cramly.ai, Quillbot, GPT-minus 1, ChatGPT, Samwell.ai, and many others. These tools offer functionalities such as rewriting, paraphrasing, summarizing, understanding literature, and extracting key information from articles. The future of AI in literature review is promising, with emerging trends such as deep learning models and knowledge graphs. These trends have the potential to enhance the accuracy and comprehensiveness of literature reviews. In conclusion, the integration of AI in literature review has the potential to revolutionize scientific knowledge acquisition by improving efficiency, accuracy, and coverage of literature. By combining AI with human expertise, researchers can unlock new insights and accelerate scientific progress in various fields.
A systematic review of challenges in research supervision at South African universities
(2018-12-25) Costa, King
Postgraduate students in South Africa and other parts of the world, particularly in developing nations struggle to complete the research component of their studies. According to the National Development Plan ( 2013) it has become a requirement for South African institutions to play a pivotal role in knowledge production so as to transform South Africa from a resource-based economy towards a knowledge-based economy. In pursuit of meeting this requirement and further to increase subsidy from the Department of Higher Education and Training (DHET), South African institutions of higher learning have been on the drive for recruiting postgraduate students en masse. One of the main problems facing South African institutions is that the number of students enrolled does not correspond to those who graduate at the end of the postgraduate programme study period. This study is a systematic review of literature on challenges in postgraduate supervision and further proposes a possible solution. Five South African institutions of higher learning’s postgraduate throughput data is carefully studied and substantiated by previous research on postgraduate supervision challenges on these particular institutions. Study findings present challenges related to research capacity development and burden of supervision at these institutions. Collaborative methods of supervision such as the C.O.S.T.A model are hereby proposed as possible solutions to the current throughput problem in South Africa.
Measuring the Quality of Student Support Services in Open Distance E-Learning
(2020-12-03) Aberra, Tsige, GebreMeskel
Student support services are essential elements in the success of open distance e-learning. These services help students to become competent in achieving their goals. However, the level of the quality of services should be measured so that continuous improvements can be made, which in turn bring about sustainability of positive results. This article takes content validity as its focus in the development of an instrument. By exposing the instrument to 10 experts, items were refined in the form of deletions, additions, and the splitting of double-barrelled items. Experts ratings were analysed through the content validity index for each item, each dimension and the overall instrument. The content validity processes undertaken in this article have resulted in getting a 50-item 5-dimensional instrument. The use of content validity procedures is one of the most recommended methods in securing the validity of an instrument in terms of its involving appropriate items and dimensions.
Health risk of cyanotoxins in Lake Victoria and household drinking water for riparian communities along Nyanza Gulf
(2020-04-23) Otoigo, Lilian
Cyanotoxins are produced by cyanobacteria which are single-celled algae that thrive in warm and nutrient rich water bodies including lakes. There are different kinds of cyanotoxins and microcystin is the most common. Microcystin mostly affects the liver. Epidemiological studies in China and Serbia have shown an association between cyanotoxins and occurrence of Primary Liver Cancer. Cyanobacteria have been reported in Lake Victoria, which is an important source of drinking water for the riparian communities, thus posing a danger to human health. However, the health risk from exposure to toxic cyanobacteria in the Nyanza Gulf water remains unknown. The purpose of this study was to assess the health risk of toxic cyanobacteria to the riparian communities in the Nyanza Gulf. In a longitudinal study adopting survey and experimental design, 127 samples were collected monthly from both households and six beaches over six months. Cyanobacterial levels were determined using an enzyme assay method (PP2A). Different methods of household water treatment were compared. Two-way ANOVA was done to determine statistical significance of microcystins levels. 84% of water samples contained microcystins. Concentration of microcystins was 3.44g/L which is over the WHO limit of 1g/L. There was no variation between beaches and water treatment (ANOVA: F=0.97, p=0.47). Filtration proved to be the most efficient method of water treatment. The health risk factor of cyanotoxins in drinking water is 3.86. There is a health risk posed by cyanotoxins to the residents of the Nyanza Gulf who use the lake water for drinking since is over the WHO limit. This information provides an insight into the quality of Lake Victoria water for drinking. The study recommends development of cyanobacteria removal methods as well as sensitizing the riparian communities on the health risk of cyanotoxins in drinking water.
Identification and quantification of Cyanotoxins in Lake and household water around Lake Victoria, Kenya
(2020-04-23) Otoigo, Lilian
Cyanobacteria are single-celled algae that thrive in warm and nutrient rich water bodies. They can produce different kinds of toxins called cyanotoxins that can affect the liver. Cyanobacteria have been reported in Lake Victoria, which is an important source of drinking water for the riparian communities. This is as a result of eutrophication in Lake Victoria increasing the levels of cyanobacteria in the Nyanza Gulf. The purpose of this study was to identify and quantify microcystins in household and Lake Victoria water in Nyanza Gulf. In a longitudinal study adopting experimental design, six beaches were studied and 127 samples collected monthly from both households and beaches over six months. Cyanobacterial levels were determined using an enzyme assay method (PP2A) and microcystin strains identified using High Performance Liquid Chromatography (HPLC). Two-way ANOVA was done to determine statistical significance of microcystins. The results showed that all beaches were eutrophic resulting in flourishing of cyanobacteria. 84% of water samples contained microcystins. Concentration of microcystins was 3.44g/L. Microcystin RR (MC-RR) is the most abundant cyanotoxins followed by Microcystin YR (MC-YR) and Microcystin LR (MC-LR) is the least abundant in the Nyanza Gulf. There was significant variation between different beaches and different months (ANOVA: F=12.09, p<0.0005). This information provides an insight into the quality of Lake Victoria water for drinking based on quantities of microcystins in the sampled water. The study recommends regular monitoring of cyanobacterial cells in the lake water.
Incidence of Carotico-clinoid Foramen and Interclinoid Osseous Bridge in Dry Human Skulls in Sudan_ Neurosurgical Interest
(2020-06-17) Seddeg, Yasser; Elbadawi, Kamalelden
Background: Anterior clinoid process is usually drilled in order to approach cavernous sinus and related structures in neurosurgical operations. The presence of carotico-clinoid foramen and interclinoid osseous bridge create difficulties while approaching anterior clinoid process and increases the risks of injury to the internal carotid artery and nearby structures. Aim: To observe incidence, anatomy of carotico-clinoid foramen and interclinoid osseous bridge in the Sudanese dry skulls. Methods: This was a cross sectional study, conducted in the departments of anatomy in different medical schools in Sudan between the period from June 2019 to January 2020. Total 30 dry adult human skulls were examined to observe incidence of carotico-clinoid foramen and of interclinoid osseous bridge. Result: The incidence of carotico-clinoid foramen was 13.3% (4 skulls out of 30). The foramen was bilaterally present in one skull (n=1/30, 3.3%) and unilateral in 3 skulls (n=3/30, 10%). Type I bridge is the carotico-clinoid foramen itself, the Type II interclinoid osseous bridge was found in one skull (n=1/30, 3.3%) , no Type III and Type IV bridges were observed in the present study. Conclusion: the presence of this foramen and interclinoid osseous bridge can complicate neurosurgical operations in cavernous sinus, sellar and para-sellar regions. Therefore, the detailed anatomical knowledge is very important to decrease complications and to increase success rates of neurosurgical operations in this area.
Current evidence on chloroquine and hydroxychloroquine and their role in the treatment and prevention of COVID-19
(2020-07-15) Mpofu, Rephaim; Banda, Clifford; Gunter, Hannah; Mondleki, Enkosi; Tatz, Gayle; Sinxadi, Phumla; Cohen, Karen; Barnes, Karen; Blockman, Marc
Although chloroquine and hydroxychloroquine have not yet been shown to be safe or effective for the treatment or prevention of COVID-19, regulatory agencies in some countries have authorised their use in Coronavirus disease 2019 (COVID-19) due to the lack of available interventions. Several large clinical trials are currently underway to investigate these agents as potential therapeutic options for COVID-19. Previous research against similar pathogens that cause severe acute respiratory syndrome and Middle East respiratory syndrome has identified chloroquine and hydroxychloroquine as possible antiviral candidates against SARS-CoV-2. Despite promising pre-clinical evidence, data have thus far failed to confirm their efficacy, and recent studies suggest potential dose-related cardiotoxicity and mortality. Close monitoring for cardiac conduction abnormalities is advised with higher-than-approved doses. Additional, robust evidence from randomised controlled trials and meta-analyses are required to make informed risk-benefit assessments. Finally, the off-label prescription of these agents should be judiciously considered, and any such use should be conducted within clinical trials, or under the Monitored Emergency Use of Unregistered and Investigational Interventions framework.
Current evidence on chloroquine and hydroxychloroquine and their role in the treatment and prevention of COVID-19
(2020-07-15) Mpofu, Rephaim; Banda, Clifford; Gunter, Hannah; Mondleki, Enkosi; Tatz, Gayle; Sinxadi, Phumla; Cohen, Karen; Barnes, Karen; Blockman, Marc
Although chloroquine and hydroxychloroquine have not yet been shown to be safe or effective for the treatment or prevention of COVID-19, regulatory agencies in some countries have authorised their use in Coronavirus disease 2019 (COVID-19) due to the lack of available interventions. Several large clinical trials are currently underway to investigate these agents as potential therapeutic options for COVID-19. Previous research against similar pathogens that cause severe acute respiratory syndrome and Middle East respiratory syndrome has identified chloroquine and hydroxychloroquine as possible antiviral candidates against SARS-CoV-2. Despite promising pre-clinical evidence, data have thus far failed to confirm their efficacy, and recent studies suggest potential dose-related cardiotoxicity and mortality. Close monitoring for cardiac conduction abnormalities is advised with higher-than-approved doses. Additional, robust evidence from randomised controlled trials and meta-analyses are required to make informed risk-benefit assessments. Finally, the off-label prescription of these agents should be judiciously considered, and any such use should be conducted within clinical trials, or under the Monitored Emergency Use of Unregistered and Investigational Interventions framework.
Higher Education in Ethiopia: Recent Developments and Challenges
(2020-07-24) Yallew, Addisalem
This paper explores developments and challenges in Ethiopian higher education focusing on the decade preceding 2018. The article especially focuses on reflecting on issues related to enrolment, staff development, funding, research and graduate studies, internationalization and continuing education.
Headache Associated with Chiari Malformation Type One
(2020-08-20) Seddeg, Yasser; Awad, Ali; Osman, Haytham
Background: Patients with chiari malformation type one ( CM -1 ) headache may be mistaken by chronic migraines or other causes of headache, so analysis of headache related to CM-1 is corner stone in early diagnosis of the disease. Objective: The purpose of this study was to assess the frequency and clinical characteristics of headache in the patients with CM-1 to help primary care clinicians better understand the relationship between an individual's presenting symptoms of CM 1, so aiding for early diagnosis and early management and for better outcome. Methods: This was prospective observational analytical study carried out in Khartoum state hospitals that provide neurosurgical services, (NCNS, Neurospine Center-Ribat Teaching Hospital, Military Hospital, and Omdurman Teaching Hospital) from February 2018- September 2019. Study was included 18 adult males and females of different ages diagnosed with Chiari MF -1 who undergoing decompressive surgery. Symptomatic patients diagnosed with Chiari MF -1Patients with no history of neurological illnesses or history of cranial surgery were included. Patients with history of any neurological diseases such as multiple sclerosis and with other causes of headache were excluded from the study. Evaluation and full analysis of headache were registered including type of headache, site, duration headache, time lasting, radiation of pain, severity using headache scale, associated ocular and visual symptoms. Results: This study included 18 patients diagnosed with chiari 1 malformation and suffering from headache related to chiari 1 malformation. Full analysis of the headache was obtained. The headache was mostly in the back of the head (n=17/18 , 94.4%) and only in (n=1/18, 5.6%), the headache was in the sides or front of the head. In 12 patients (n=12/18 , 66.7%) headache worsen by bending forward. And in 6 patients (n=6/18 , 33.3%) worsen by cough. Regarding the type of headache, mostly pressure in nature (n=17/18 , 94.4%) and it was rarely throbbing in nature(n=1/18, 5.6%),. All patients were asked to evaluate their headache in headache scale from 1 to 10 (10 more severe). The scale ranged between 5 and 9 with mean 6.88. headache could be long or short lasting (from hours to days).Eye symptoms included blurring of vision complained by 9 patients(n=9/18, 50%), light sensitivity in 5 patients ((n=5/18, 27.8%), and 6 patients (n=6/18 , 33.3%) there were no eye symptoms. Neck pain was a dominant symptom seen in 17 patients (n=17/18, 94.4%) , and back pain in 18 patients (n=18/18 , 100%) . headache subsided after decompression surgery in all patients included in this study. Conclusion: Knowledge and understanding the CM-1 headache characters are important for early diagnosis and early treatment of the disease.
Meeting Report: South African Medical Research Council Standard of Care in Clinical Research in Low- And Middle-Income Settings Summit, November 2017
(2020-09-11) Miner, Maurine; Bekker, Linda-Gail; Kredo, Tamara; Bhagwandin, Niresh; Corey, Lawrence; Gray, Glenda
Introduction: The South African Medical Research Council (SAMRC) convened a summit to discuss issues relating to standard of care (SoC) in HIV prevention clinical trials, both for treatment and prevention of disease. Policymakers, regulators, ethicists, experts in the law (as it pertains to medical research), researchers, representatives of advocacy groups, and the HIV Vaccine Trials Network (HVTN) presented a framework within which SoC principles could be articulated. Discussion: Summit participants discussed how and when to include new modalities of HIV treatment and prevention into existing clinical practice guidelines, and by extension in clinical trial protocols. Participants involved in the execution of care and the scale-up of new interventions, in particular, the roll out of pre-exposure prophylaxis (PrEP), presented the opportunities for and challenges to scaling up interventions, and their experience with demonstration projects of PrEP. Advocates and community members propagated the need to make interventions that could avert HIV infection available as soon as possible. Experts in evidence-based guideline development discussed the nuances in evaluating evidence for policy and the mechanisms for getting medicines on the Essential Medicines List in South Africa. Given the variability in clinical trial efficacy of PrEP amongst different populations, scientists and statisticians discussed the various biological, virological and immunological reasons for this heterogeneity. Conclusions: Input was given as to the impact of introducing PrEP in other HIV prevention trials, and the considerations for the design of both antiretroviral (ARV)-based and non-ARV based HIV prevention trials. The meeting recommended supporting access to PrEP in HIV prevention trials by 1) developing PrEP access plans for HIV vaccine trials; 2) creating a PrEP fund that would supply PrEP to sites conducting HIV prevention trials via a central procurement mechanism; and 3) support the safety monitoring of PrEP.
Assessing the state of forensic support to criminal investigations in Ghana: A case study in the Greater Accra Region
(2020-09-20) Sulley, Yahaya, Sumara; Quansah, Lydia
Forensic science applications in criminal investigation are very profound to crime resolution. However, there is a wide gap between the application of specialist skills and public knowledge and awareness of forensic science in criminal investigations and it has generated complex practical problems in justice delivery in Ghana. The study attempts to assess the state of forensic support to criminal investigations by accessing public knowledge and perception of forensic science in Ghana. To this account, an elaborate and tortuous survey was conducted using 200 consented respondents in selected neighborhoods in Accra based on homogeneity, population density, economic or industrial activities, and the nature of crime and police activities. The survey included face to face interviews, questionnaire responding, and random phone calls. The final data which was subjected to a simple linear regression model were analyzed with STATA 13. The study revealed that indeed, forensic science in Ghana has "gone dark" as 165(82.5%) who had a formal education of various levels had very limited knowledge about forensic science and procedures. The majority of the respondents 179(89.5%) had no idea about forensics and for that matter lacked awareness of forensics in Ghana before the research while the state of forensics in Ghana was rated on the scale of good (10.5%), bad (81.5%) and very bad (8%) out of the 200 respondents with the respondent level of education, perception, knowledge, and awareness of forensic science and support significantly impacting the wellbeing of the research. The findings of this study call for government and respective stakeholders and policymakers of various institutions, and the adversarial system of Ghana to prioritize the need for forensic science. This is to support criminal investigations to assure the Ghanaian citizens of their safety, security, and fundamental Human rights to justice.
Life Expectancy and SARS-CoV-2 Genomic Variations Plays Key Role in COVID-19 Transmission and Low Fatality Rate in Africa
(2020-09-21) Omotoso, Olabode
The novel coronavirus disease (COVID-19) has claimed lots of lives, posing a dire threat to public health and the global economy. The present study determined the severe acute respiratory syndrome-2 (SARS-CoV-2) genomic variability and the contributory factors to the observed low fatality rate in Africa. To assess the SARS-CoV-2 mutational landscape, 924 viral sequences from the Africa region with their sociobiological characteristics mined from the GISAID database were analyzed. The age of infected patients, the number of tests done, confirmed cases, recovery, fatality, and countries' age distribution were obtained to determine the age distribution, testing, recovery, and fatality rate. Mutational analysis of the SARS-CoV-2 sequences revealed highly recurrent mutations in the Spike glycoprotein D614G (97.2%), concurrent R203K, and G204R (65.2% respectively) in the N protein region, and P4715L (97.2%) in the RNA dependent RNA polymerase region. COVID-19 is more severe in older people (> 65 years), Africa has a low percentage of people within this age group (4.36%). The average age of the 924 infected patients in this study is 46 years with only 47 infected patients (5.1%) above 65 years in comparison to 13.12% in countries in other continents with the highest prevalence of COVID-19. Africa's young generation, the late incidence of the disease, and adherence to public health guidelines are important indicators that may have contributed to the observed low COVID-19 deaths in Africa. However, sufficient data is still unavailable due to low testing rate to ascertain the epidemiology, transmission, genomic variation, and the true impact of the pandemic in Africa
Practice of Breast Self-Examination and Knowledge of Breast and Cervical Cancer Screening: A bi-national Survey in Africa
(2020-11-27) Omotoso, Olabode; Matariek, Ghadier; Omotoso, Elizabeth; Matareek, Amira; Abdul-Rafee, Ghada, Mahmoud; Malakar, Sucheta; Chutia, Nabanita
Background: The burden of breast and cervical cancer is increasing exponentially, especially among women in low- and mid-income countries due to late diagnosis, unhealthy lifestyle choices and adoption of western lifestyles. Early detection, hinged on screening uptake is a key to higher survival rate and managing cancer outcome. Despite some improvement noticed in developed countries, the control of these preventable diseases in African countries including Nigeria and Egypt seems insurmountable. Therefore, this study focused on assessing the knowledge and uptake of Nigerians and Egyptians towards breast self-examination (BSE) and breast and cervical cancer screening. Results: A community-based cross-sectional questionnaire was utilized in both countries to obtain 1,006 respondents via a convenient sampling method. The mean age of study participants was 30.43 6.69. About one-third of participants had a good knowledge (> 66 %) of breast cancer screening (423, 42 %), cervical cancer screening (446, 44 %) and BSE practice (363, 36 %). Age range (26 40 years), educational level (tertiary) and marital status were demographic data that influenced knowledge level. Though with a fairly satisfactory knowledge level, the screening uptake among studied population is very poor as only (111, 11 %) had ever been screened and only (22, 2.2 %) ever vaccinated. The major reasons for poor screening uptake were no awareness of where to be screened and no symptoms. Conclusions: Assessing the knowledge and uptake level of African women through studies like this is crucial in identifying the loopholes in the fight against cancer in Africa. More efforts are required in promoting utilization of cancer screening services, HPV vaccination and BSE practice among African women. The media and internet should be leveraged on as they are the major sources of information about cancer among the respondents.
Freshwater Integrated Multitrophic Aquaculture (FIMTA) technology in Lake Victoria
(2021-01-17) Outa, Nicholas
The decline in capture fisheries of the world has necessitated the production of fish under different aquaculture systems to bridge the gap in demand. Aquaculture contributes about 50% of fish consumed worldwide. Today, the total annual fish production in Kenya is estimated at about 150,000 metric tons, against an annual demand of 500,000. With the ever-increasing human population and demand for fish, technologies to improve aquaculture production must be embraced to bridge fish supply gap and to achieve nutritional sufficiency. One of these technologies is cage aquaculture which is the rearing of fish(es) in water bodies like dams, lakes, ponds and reservoirs in floating enclosures that allow free flow and exchange of water between the cage the outer water body. The frames of the cages can be made from bamboo, metal or High-Density Poly Ethylene (HDPE). With the challenges associated with pond aquaculture such as competition for land with other uses and susceptibility to floods, cage aquaculture has gained recognition and is rapidly expanding in Kenya and the world over. In Kenya, for example, the use of cages to produce fish is relatively new and is being practised in Lake Victoria in the five riparian Counties of Migori, Homabay, Kisumu, Siaya and Busia (Anjejo, 2017). These cages have several negative impacts on the lakes environment as highlighted below.

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