Positive selection of a CD36 nonsense variant in sub-Saharan Africa, but no association with severe malaria phenotypes

Partial carrier-resistance toPlasmodium falciparummalaria conferred by the sickle cell (HbS) mutation has resulted in the local amplification and positive selection of sickle cell disease (SCD) in malaria-endemic regions and particularly in sub-Saharan Africa (SSA). The present study investigated theβ-globin gene haplotypes, and selected malaria-associated variants among three cohorts of Bantu-speaking individuals from Malawi, Zimbabwe and South Africa compared with reports with data from others SSA populations. The data suggest a south-ward frequency decrease of malaria-associated variants in SSA linked to the evolutionary dynamics of various African populations’ genomes through selective pressure of malaria. These selected genomics differences, positive selection of SCD in malaria-endemic regions among ‘Bantus’ from various part of Africa emphasise the evidence of the dissociation between genetics, anthropology and culture. The present study also showed a relatively prevalent Benin haplotype, which is mostly found in West Africa, among Southern African Blacks and very low Bantu haplotype, which could suggest a major migration route, of Southern Africa Bantu, along the African west coast, post-occurrence of the Sickle cell mutation, which date remain to be fully elucidated.

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Cohort profile: internal migration in sub-Saharan Africa—The Migration and Health in Malawi (MHM) study

BMJ Open ◽

10.1136/bmjopen-2016-014799 ◽

2017 ◽

Vol 7 (5) ◽

pp. e014799 ◽

Cited By ~ 7

Author(s):

Philip Anglewicz ◽

Mark VanLandingham ◽

Lucinda Manda-Taylor ◽

Hans-Peter Kohler

Keyword(s):

Health Outcomes ◽

Reference Group ◽

Sub Saharan Africa ◽

Extensive Information ◽

Sub Saharan ◽

The Relationship ◽

Mental And Physical Health ◽

Use Of Health Services ◽

Migration And Health ◽

Selection Of

PurposeThe Migration and Health in Malawi (MHM) study focuses on a key challenge in migration research: although it has long been established that migration and health are closely linked, identifying the effect of migration on various health outcomes is complicated by methodological challenges. The MHM study uses a longitudinal panel premigration and postmigration study design (with a non-migrant comparison group) to measure and/or control for important characteristics that affect both migration and health outcomes.ParticipantsData are available for two waves. The MHM interviewed 398 of 715 migrants in 2007 (55.7%) and 722 of 1013 in 2013 (71.3%); as well as 604 of 751 (80.4%) for a non-migrant reference group in 2013. The total interviewed sample size for the MHM in both waves is 1809. These data include extensive information on lifetime migration, socioeconomic and demographic characteristics, sexual behaviours, marriage, household/family structure, social networks and social capital, HIV/AIDS biomarkers and other dimensions of health.Findings to dateOur result for the relationship between migration and health differs by health measure and analytic approach. Migrants in Malawi have a significantly higher HIV prevalence than non-migrants, which is primarily due to the selection of HIV-positive individuals into migration. We find evidence for health selection; physically healthier men and women are more likely to move, partly because migration selects younger individuals. However, we do not find differences in physical or mental health between migrants and non-migrants after moving.Future plansWe are preparing a third round of data collection for these (and any new) migrants, which will take place in 2018. This cohort will be used to examine the effect of migration on various health measures and behaviours, including general mental and physical health, smoking and alcohol use, access to and use of health services and use of antiretroviral therapy.

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Severe Case of Plasmodium falciparum Malaria in a Pregnant Woman from Nigeria

Case Reports in Infectious Diseases ◽

10.1155/2019/2630825 ◽

2019 ◽

Vol 2019 ◽

pp. 1-3

Author(s):

Kruti Yagnik ◽

Bilal Farooqi ◽

Molly W. Mandernach ◽

Anthony P. Cannella ◽

Gautam Kalyatanda

Keyword(s):

Pregnant Women ◽

Severe Malaria ◽

Plasmodium Falciparum Malaria ◽

Severe Case ◽

Pregnant Patient ◽

Sub Saharan Africa ◽

Blood Parasites ◽

Intrauterine Pregnancy ◽

Drug Of Choice ◽

Sub Saharan

Human malaria has arguably affected more of human history than any other pathogen. Pregnant women have a higher risk of developing severe malaria as well as the risk of severe complications. We present a case of severe malaria in a pregnant patient from sub-Saharan Africa who was treated successfully with artesunate. A 28-year-old Nigerian woman with a 20-week intrauterine pregnancy presented with a five-day history of fever and diffuse joint pains. Evaluation of peripheral thin blood smear demonstrated a parasitemia of 9.8%. The patient was admitted to the intensive care unit, and oral clindamycin/quinine was initiated until intravenous artesunate was obtained. The patient completed four doses of IV artesunate, and after the 4th dose of artesunate, no blood parasites were seen on peripheral smear. The patient was discharged home and, upon clinic follow-up, did not have any further complications associated with either her disease or therapy. A review on the treatment of severe malaria in all trimesters of pregnancy supports the WHO recommendation for intravenous artesunate as the drug of choice. This case illustrates the importance of recognizing malaria in pregnant women from endemic countries and shows that artesunate compounds can be used safely in pregnancy, particularly with high parasitemia.

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The age patterns of severe malaria syndromes in sub-Saharan Africa across a range of transmission intensities and seasonality settings

Malaria Journal ◽

10.1186/1475-2875-9-282 ◽

2010 ◽

Vol 9 (1) ◽

Cited By ~ 52

Author(s):

Arantxa Roca-Feltrer ◽

Ilona Carneiro ◽

Lucy Smith ◽

Joanna RM Armstrong Schellenberg ◽

Brian Greenwood ◽

...

Keyword(s):

Severe Malaria ◽

Sub Saharan Africa ◽

Age Patterns ◽

Sub Saharan

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Extreme Population Differences in the Human Zinc Transporter ZIP4 (SLC39A4) Are Explained by Positive Selection in Sub-Saharan Africa

PLoS Genetics ◽

10.1371/journal.pgen.1004128 ◽

2014 ◽

Vol 10 (2) ◽

pp. e1004128 ◽

Cited By ~ 21

Author(s):

Johannes Engelken ◽

Elena Carnero-Montoro ◽

Marc Pybus ◽

Glen K. Andrews ◽

Carles Lalueza-Fox ◽

...

Keyword(s):

Positive Selection ◽

Zinc Transporter ◽

Sub Saharan Africa ◽

Population Differences ◽

Sub Saharan

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Evaluating kidney function using a point-of-care creatinine test in Ugandan children with severe malaria: a prospective cohort study

BMC Nephrology ◽

10.1186/s12882-021-02573-x ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Anthony Batte ◽

Kristin J. Murphy ◽

Ruth Namazzi ◽

Katrina Co ◽

Robert O. Opoka ◽

...

Keyword(s):

Severe Malaria ◽

Point Of Care ◽

Isotope Dilution Mass Spectrometry ◽

Kidney Injury ◽

Sub Saharan Africa ◽

Middle Income ◽

Middle Income Countries ◽

Point Of Care Test ◽

Care Assessment ◽

Sub Saharan

Abstract Background Acute kidney injury (AKI) disproportionately affects individuals in low-and middle-income countries (LMIC). However, LMIC—particularly countries in sub-Saharan Africa— are under-represented in global AKI research. A critical barrier in diagnosing AKI is access to reliable serum creatinine results. We evaluated the utility of a point-of-care test to measure creatinine and diagnose AKI in Ugandan children with malaria. Methods Paired admission creatinine was assessed in 539 Ugandan children 6 months to 4 years of age hospitalized with severe malaria based on blood smear or rapid diagnostic test. Creatinine levels were measured using isotope dilution mass spectrometry (IDMS)-traceable methods. The reference creatinine was measured using the modified Jaffe method by a certified laboratory and the point-of-care testing was conducted using an i-STAT blood analyzer (i-STAT1, with and without adjustment for the partial pressure of carbon dioxide). AKI was defined and staged using the Kidney Disease: Improving Global Outcomes criteria. Results The mean age of children was 2.1 years, and 21.6% of children were stunted. Mortality was 7.6% in-hospital. Over the entire range of measured creatinine values (<0.20mg/dL-8.4mg/dL), the correlation between the reference creatinine and adjusted and unadjusted point-of-care creatinine was high with R2 values of 0.95 and 0.93 respectively; however, the correlation was significantly lower in children with creatinine values <1mg/dL (R2 of 0.44 between the reference and adjusted and unadjusted i-STAT creatinine). The prevalence of AKI was 45.5% using the reference creatinine, and 27.1 and 32.3% using the unadjusted and adjusted point-of-care creatinine values, respectively. There was a step-wise increase in mortality across AKI stages, and all methods were strongly associated with mortality (p<0.0001 for all). AKI defined using the reference creatinine measure was the most sensitive to predict mortality with a sensitivity of 85.4% compared to 70.7 and 63.4% with the adjusted and unadjusted point-of-care creatinine values, respectively. Conclusions Point-of-care assessment of creatinine in lean Ugandan children <4 years of age underestimated creatinine and AKI compared to the clinical reference. Additional studies are needed to evaluate other biomarkers of AKI in LMIC to ensure equitable access to AKI diagnostics globally.

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Differentiation in Access to, and the Use and Sharing of (Open) Educational Resources among Students and Lecturers at Technical and Comprehensive Ghanaian Universities

Open Praxis ◽

10.5944/openpraxis.10.4.917 ◽

2018 ◽

Vol 10 (4) ◽

pp. 405 ◽

Cited By ~ 1

Author(s):

Judith Pete ◽

Fred Mulder ◽

Jose Dutra Oliveira Neto ◽

Kathleen Ludewig Omollo

Keyword(s):

South Africa ◽

Empirical Data ◽

Large Scale ◽

Open Educational Resources ◽

Educational Resources ◽

Sub Saharan Africa ◽

Common Goal ◽

Comprehensive Universities ◽

Sub Saharan ◽

Selection Of

This paper is the second in a series of three with a common goal to present a fair OER picture for Sub-Saharan Africa, represented by large-scale studies in three countries: Kenya, Ghana, and South Africa. This paper examines a deliberate selection of four Ghanaian universities with randomly sampled students and lecturers. Distinct questionnaires for students and the lecturers have been used, which generated a response from in total 818 students and 38 lecturers. The major outcomes based on the empirical data are: (i) there is a significant digital differentiation among lecturers and students at technical versus comprehensive universities in terms of their proficiency and internet accessibility; and (ii) the awareness and appreciation of the OER concept and open licensing is low but from the actual variety and types of processing by respondents of educational resources (not necessarily open) there is a preparedness for openness for the future.

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Modelling the drivers of the spread of Plasmodium falciparum hrp2 gene deletions in sub-Saharan Africa

eLife ◽

10.7554/elife.25008 ◽

2017 ◽

Vol 6 ◽

Cited By ~ 33

Author(s):

Oliver J Watson ◽

Hannah C Slater ◽

Robert Verity ◽

Jonathan B Parr ◽

Melchior K Mwandagalirwa ◽

...

Keyword(s):

Democratic Republic Of Congo ◽

False Negative ◽

Malaria Diagnosis ◽

Parasite Prevalence ◽

Malaria Prevalence ◽

Sub Saharan Africa ◽

Gene Deletions ◽

High Frequencies ◽

Sub Saharan ◽

Selection Of

Rapid diagnostic tests (RDTs) have transformed malaria diagnosis. The most prevalent P. falciparum RDTs detect histidine-rich protein 2 (PfHRP2). However, pfhrp2 gene deletions yielding false-negative RDTs, first reported in South America in 2010, have been confirmed in Africa and Asia. We developed a mathematical model to explore the potential for RDT-led diagnosis to drive selection of pfhrp2-deleted parasites. Low malaria prevalence and high frequencies of people seeking treatment resulted in the greatest selection pressure. Calibrating our model against confirmed pfhrp2-deletions in the Democratic Republic of Congo, we estimate a starting frequency of 6% pfhrp2-deletion prior to RDT introduction. Furthermore, the patterns observed necessitate a degree of selection driven by the introduction of PfHRP2-based RDT-guided treatment. Combining this with parasite prevalence and treatment coverage estimates, we map the model-predicted spread of pfhrp2-deletion, and identify the geographic regions in which surveillance for pfhrp2-deletion should be prioritised.

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Cost-effectiveness of parenteral artesunate for treating children with severe malaria in sub-Saharan Africa

Bulletin of the World Health Organization ◽

10.2471/blt.11.085878 ◽

2011 ◽

Vol 89 (7) ◽

pp. 504-512 ◽

Cited By ~ 38

Author(s):

Yoel Lubell ◽

Arthorn Riewpaiboon ◽

Arjen M Dondorp ◽

Lorenz von Seidlein ◽

Olugbenga A Mokuolu ◽

...

Keyword(s):

Cost Effectiveness ◽

Severe Malaria ◽

Sub Saharan Africa ◽

Sub Saharan

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Differential kinetics of plasma procalcitonin levels in cerebral malaria in urban Senegalese patients according to disease outcome

Microbiology Research ◽

10.4081/mr.2011.e22 ◽

2011 ◽

Vol 2 (1) ◽

pp. 22 ◽

Cited By ~ 2

Author(s):

Babacar Mbengue ◽

Bacary Diatta ◽

Birahim Niang ◽

Ngor Diagne ◽

Mamadou Ndiaye ◽

...

Keyword(s):

Cerebral Malaria ◽

Severe Malaria ◽

Fatal Outcome ◽

Care Facility ◽

Threshold Level ◽

Serum Levels ◽

Sub Saharan Africa ◽

Serial Killer ◽

Sub Saharan ◽

Hôpital Principal

<em>P. falciparum</em> malaria continues as the serial killer of over a million lives yearly, mainly for children in sub-Saharan Africa. For severe malaria, we are still on the quest for a prognostic marker of fatal outcome. We analysed the association between serum levels of Procalcitonin (PCT), a marker of septic inflammation, and clinical outcome in Senegalese patients admitted with confirmed cerebral malaria in the intensive care facility of Hopital Principal. A total of 98 patients living in the hypoendemic urban area of Dakar, Senegal, were enrolled during transmission seasons. Levels of PCT were compared between surviving vs the 26.5 % fatal cases in blood samples of the 3 days following hospitalisation. Mean PCT levels were elevated in patients with active infection, with a large range of values (0.1 to 280 nanog per mL), significantly higher on day 0 in fatal cases than in surviving (53.6 vs 27.3; P=0.01). No exact individual threshold level could indicate occurrence of fatality, however mortality could be most accurately predicted by PCT level above 69 nanog per ML and there was a very clear different profile of evolution of PCT levels on the 3 days of observation decreasing early from day 1 in surviving patients (P<10–3), contrary to fatal cases. These results indicate that PCT kinetic rather than intrinsic level could be of use to predict a reduced risk of fatality in patient with cerebral malaria and could serve as potential predicting marker for severe malaria.

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