Clinical Probe of Cyp2C8*2 Mutants in a Malaria Hyperendemic Zone: Evidence from North-Central, Nigeria

Background: A tremendous level of success has been achieved since the introduction of chloroquine and the combination of amodiaquine and artemisinin for the treatment of both complicated and uncomplicated malaria infections in sub-Saharan Africa. However, the recent discovery of drug resistant strains of Plasmodium falciparum (P.f.) and the ability of the parasite to ingest CYP2C8 into its digestive vacuole is of great public health concern. This study probes the occurrence of CYP2C8*2 allelic mutant amongst malaria patients in North-Central Nigeria. Methods: Three hundred and eighty five (385) unrelated study participants were screened for current malaria episodes using routine microscopy and/or rapid diagnostic test strips (RDTs). Chelex extraction method was used for single nucleotide polymorphisms (SNPs) and identification of CYP2C8*2 (805A > T) variant respectively. Wild-type (A) and the defective allele (T) were differentiated with the use of Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP). The results obtained were further validated with Sanger sequencing of a few samples and thereafter, the genotype data were statistically processed. All alleles obtained were in Hardy Weinberg equilibrium. Results: Out of the 385 participants (45.5% Male and 54.5% Female) genotyped for SNPs, 75 (19.5%) had the autosomal recessive mutant trait. Occurrence of mutant traits was gender and ethnic independent (p > 0.05). Yoruba ethnic group recorded a reduction in proportion of genotypic defective CYP2C8*2 allele (T) (1 in every 8 persons) with a carrier percentage of 13.3% compared with Hausa (26.62%); Igbo (25.37%) and other minority ethnic groups (17.6%). Conclusions: A remarkable inter-ethnic differences in autosomal recessive CYP2C8*2 allele was observed. By implication, there is a gradual incursion of genetic drift for poor CQ and AQ-Artemisinin metabolizers among the inhabitants.

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Adolescent Suicidality as Seen in Rural Northeastern Uganda

Crisis ◽

10.1027/0227-5910/a000059 ◽

2011 ◽

Vol 32 (1) ◽

pp. 43-51 ◽

Cited By ~ 17

Author(s):

Eugene Kinyanda ◽

Ruth Kizza ◽

Jonathan Levin ◽

Sheila Ndyanabangi ◽

Catherine Abbo

Keyword(s):

Low Socioeconomic Status ◽

Sub Saharan Africa ◽

Psychosocial Risk ◽

Psychiatric Nurses ◽

Health Concern ◽

Cross Sectional ◽

Childhood Experiences ◽

Low Socioeconomic ◽

Dsm Iv ◽

Sub Saharan

Background: Suicidal behavior in adolescence is a public health concern and has serious consequences for adolescents and their families. There is, however, a paucity of data on this subject from sub-Saharan Africa, hence the need for this study. Aims: A cross-sectional multistage survey to investigate adolescent suicidality among other things was undertaken in rural northeastern Uganda. Methods: A structured protocol administered by trained psychiatric nurses collected information on sociodemographics, mental disorders (DSM-IV criteria), and psychological and psychosocial risk factors for children aged 3–19 years (N = 1492). For the purposes of this paper, an analysis of a subsample of adolescents (aged 10–19 years; n = 897) was undertaken. Results: Lifetime suicidality in this study was 6.1% (95% CI, 4.6%–7.9%). Conclusions: Factors significantly associated with suicidality included mental disorder, the ecological factor district of residence, factors suggestive of low socioeconomic status, and disadvantaged childhood experiences.

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Kelch 13-propeller polymorphisms in Plasmodium falciparum from Jazan region, southwest Saudi Arabia

Malaria Journal ◽

10.1186/s12936-020-03467-3 ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Ommer Mohammed Dafalla ◽

Mohammed Alzahrani ◽

Ahmed Sahli ◽

Mohammed Abdulla Al Helal ◽

Mohammad Mohammad Alhazmi ◽

...

Keyword(s):

Plasmodium Falciparum ◽

Saudi Arabia ◽

Parasite Clearance ◽

Sub Saharan Africa ◽

Local Alignment ◽

Nucleotide Polymorphisms ◽

Gene Encoding ◽

Synonymous Mutations ◽

Search Tool ◽

Sub Saharan

Abstract Background Artemisinin-based combination therapy (ACT) is recommended at the initial phase for treatment of Plasmodium falciparum, to reduce morbidity and mortality in all countries where malaria is endemic. Polymorphism in portions of P. falciparum gene encoding kelch (K13)-propeller domains is associated with delayed parasite clearance after ACT. Of about 124 different non-synonymous mutations, 46 have been identified in Southeast Asia (SEA), 62 in sub-Saharan Africa (SSA) and 16 in both the regions. This is the first study designed to analyse the prevalence of polymorphism in the P. falciparum k13-propeller domain in the Jazan region of southwest Saudi Arabia, where malaria is endemic. Methods One-hundred and forty P. falciparum samples were collected from Jazan region of southwest Saudi Arabia at three different times: 20 samples in 2011, 40 samples in 2016 and 80 samples in 2020 after the implementation of ACT. Plasmodium falciparum kelch13 (k13) gene DNA was extracted, amplified, sequenced, and analysed using a basic local alignment search tool (BLAST). Results This study obtained 51 non-synonymous (NS) mutations in three time groups, divided as follows: 6 single nucleotide polymorphisms (SNPs) ‘11.8%’ in samples collected in 2011 only, 3 (5.9%) in 2011and 2016, 5 (9.8%) in 2011 and 2020, 5 (9.8%) in 2016 only, 8 (15.7%) in 2016 and 2020, 14 (27.5%) in 2020 and 10 (19.6%) in all the groups. The BLAST revealed that the 2011 isolates were genetically closer to African isolates (53.3%) than Asian ones (46.7%). Interestingly, this proportion changed completely in 2020, to become closer to Asian isolates (81.6%) than to African ones (18.4%). Conclusions Despite the diversity of the identified mutations in the k13-propeller gene, these data did not report widespread artemisinin-resistant polymorphisms in the Jazan region where these samples were collected. Such a process would be expected to increase frequencies of mutations associated with the resistance of ACT.

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Individual, community and societal correlates of insecticide treated net use among pregnant women in sub-Saharan Africa: a multi-level analysis

BMC Public Health ◽

10.1186/s12889-021-11635-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Edward Kwabena Ameyaw

Keyword(s):

Pregnant Women ◽

Sub Saharan Africa ◽

World Health ◽

Health Concern ◽

Maternal And Newborn Health ◽

African Countries ◽

The World ◽

Itn Use ◽

Multi Level ◽

Sub Saharan

Abstract Background Malaria in pregnancy is a crucial public health concern due to the enormous risk it poses to maternal and newborn health. The World Health Organisation therefore recommends insecticide-treated net (ITN) for pregnant women. The world over, sub-Saharan Africa bears the highest prevalence of malaria and its associated complications. This study investigated the individual, community and society level factors associated with ITN use among pregnant women in sub-Saharan Africa. Methods The study was conducted with Demographic and Health Survey data of 21 sub-Saharan African countries. A total of 17,731 pregnant women who possessed ITN participated in the study. Descriptive computation of ITN use by survey country and socio-demographic characteristics was conducted. Further, five multi-level binary logistic regression models were fitted with MLwiN 3.05 package in STATA. The Markov Chain Monte Carlo (MCMC) estimation procedure was used in estimating the parameters whilst the Bayesian Deviance Information Criterion was used for the model fitness test. Results On average, 74.2% pregnant women in SSA used ITN. The highest prevalence of ITN use occurred in Mali (83.7%) whilst the least usage occurred in Namibia (7%). Women aged 30–34 were more likely to use ITN compared with those aged 45–49 [aOR = 1.14; Crl = 1.07–1.50]. Poorest women were less probable to use ITN relative to richest women [aOR = 0.79; Crl = 0.70–0.89]. Compared to women who did not want their pregnancies at all, women who wanted their pregnancies [aOR = 1.06; Crl = 1.04–1.19] were more probable to use ITN. Women in male-headed households had higher likelihood of ITN use compared to those from female-headed households [aOR = 1.28; Crl = 1.19–1.39]. On the whole, 38.1% variation in ITN use was attributable to societal level factors whilst 20.9% variation was attributable to community level factors. Conclusion The study has revealed that in addition to individual level factors, community and society level factors affect ITN use in SSA. In as much as the study points towards the need to incorporate community and societal variations in ITN interventions, active involvement of men can yield better outcome for ITN utilisation interventions in SSA.

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The seasonality of cholera in sub-Saharan Africa

10.1101/2021.11.23.21265642 ◽

2021 ◽

Author(s):

Javier Perez-Saez ◽

Justin Lessler ◽

Elizabeth C. Lee ◽

Francisco J. Luquero ◽

Espoir B. Malembaka ◽

...

Keyword(s):

Large Scale ◽

Task Force ◽

Case Fatality ◽

Sub Saharan Africa ◽

Health Concern ◽

National Differences ◽

Sub Saharan ◽

Eastern And Southern Africa ◽

Positive Correlations ◽

Gates Foundation

Background Cholera remains a major threat in Sub-Saharan Africa (SSA) where some of the highest case fatality risks are reported. Knowing in what months and where cholera tends to occur across the continent can aid in improving efforts to eliminate cholera as a public health concern; though largely due to lack of unified large-scale datasets, no continent-wide estimates exist. In this study we aim to estimate cholera seasonality across SSA. Methods We leverage the Global Task Force on Cholera Control (GTFCC) global cholera database with statistical models to synthesize data across spatial and temporal scale in order to infer the seasonality of excess suspected cholera occurrence in SSA. We developed a Bayesian statistical model to infer the monthly risk of excess cholera at the first and/or second administrative levels. Seasonality patterns were then grouped into spatial clusters. Finally, we studied the association between seasonality estimates and hydro-climatic variables. Findings The majority of studied countries (24/34) have seasonal patterns in excess cholera, corresponding to approximately 85% of the SSA population. Most countries (19/24) also had sub-national differences in seasonality patterns, with strong differences in seasonality strength between regions. Seasonality patterns clustered into two macro-regions (West Africa and the Sahel vs. Eastern and Southern Africa), which were composed of sub-regional clusters with varying degrees of seasonality. Exploratory association analysis found most consistent and positive correlations between cholera seasonality and precipitation, and to a lesser extent with temperature and flooding. Interpretation Widespread cholera seasonality in SSA offers opportunities for intervention planning. Further studies are needed to study the association between cholera and climate. Funding The NASA Applied Sciences Program and the Bill and Melinda Gates Foundation.

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Characteristics of patients with acute heart failure in North Central Nigeria

Research Journal of Health Sciences ◽

10.4314/rejhs.v9i3.3 ◽

2021 ◽

Vol 9 (3) ◽

pp. 221-235

Author(s):

J.A. Ogunmodede ◽

P.M. Kolo ◽

M.O. Bojuwoye ◽

B.F. Dele-Ojo ◽

A.J. Ogunmodede ◽

...

Keyword(s):

Heart Failure ◽

New York ◽

Heart Association ◽

Public Health Education ◽

Sub Saharan Africa ◽

Aetiological Factor ◽

Cross Sectional ◽

Early Presentation ◽

North Central ◽

Sub Saharan

Objectives: Heart failure (HF) is an important cause of hospital admission in Nigeria. HF is increasingly prevalent because the population is aging and HF epidemiology is changing. We aimed at profiling the socio-demographic, clinical and echocardiographic (Echo) characteristics of patients admitted for acute HF. This is one of the largest cohorts of HF patients profiled in Nigeria so far. Methods: Cross sectional design. Socio-demographic, clinical and Echo data were collected from 455 patients admitted for AHF at University of Ilorin Teaching Hospital, North central, Nigeria. Results: Mean age of patients was 58.9± 15.7years, (men were older than women, P= 0.006). 265(58.2%) were males, most patients were aged >60 years, 4.8% had pre-existing Type2 Diabetes mellitus. 53.2% of patients presented in New York Heart Association Stages III and IV. Median duration of admission was 11days (IQR, 6-17), intrahospital mortality- 11.6%. Hypertension was the commonest aetiological factor (62.4%), followed by dilated cardiomyopathy 17.6%, rheumatic heart disease (6.6%), Peripartum cardiomyopathy (5.3%), and others. Conclusion: AHF patients in our study are older than those in previous studies in Nigeria and sub-Saharan Africa. Hypertension is main driver of AHF, and patients largely present with clinically advanced disease necessitating stronger public health education about risk factors and early presentation.

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Sorghum–Insect Composites for Healthier Cookies: Nutritional, Functional, and Technological Evaluation

Foods ◽

10.3390/foods9101427 ◽

2020 ◽

Vol 9 (10) ◽

pp. 1427

Author(s):

Temitope D. Awobusuyi ◽

Muthulisi Siwela ◽

Kirthee Pillay

Keyword(s):

Wheat Flour ◽

Protein Energy Malnutrition ◽

Sub Saharan Africa ◽

Health Concern ◽

Nutrient Deficiencies ◽

Substitution Level ◽

Protein Energy ◽

Nutritional Qualities ◽

Sub Saharan ◽

Spread Factor

Protein-energy malnutrition (PEM) is a major health concern in sub-Saharan Africa (SSA). Relying on unexploited and regionally available rich sources of proteins such as insects and sorghum might contribute towards addressing PEM among at-risk populations. Insects are high in nutrients, especially protein, and are abundant in SSA. Sorghum is adapted to the tropical areas of SSA and as such it is an appropriate source of energy compared with temperate cereals like wheat. It is necessary to assess whether cookies fortified with sorghum and termite would be suitable for use in addressing PEM in SSA. Whole grain sorghum meal and termite meal were mixed at a 3:1 ratio (w/w sorghum:termite) to form a sorghum–termite meal blend. Composite cookies were prepared where the sorghum–termite blend partially substituted wheat flour at 20%, 40%, and 60% (sorghum–termite blend:wheat flour (w/w). The functional and nutritional qualities of the cookies were assessed. Compared with the control (100% wheat flour), the cookies fortified with sorghum and termite had about double the quantity of protein, minerals, and amino acids. However, with increased substitution level of the sorghum–termite blend, the spread factor of the cookies decreased. There is a potential to incorporate sorghum and termite in cookies for increased intake of several nutrients by communities that are vulnerable to nutrient deficiencies, especially PEM.

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The Role of Community Health Workers in Oral Health Promotion and the Impact of their services in Sub-Saharan Africa: A Systematic Review.

10.1101/2021.04.06.21255025 ◽

2021 ◽

Author(s):

Mohammed Azhar Khan ◽

Bernard Ojiambo Okeah ◽

Etheldreda Leinyuy Mbivnjo ◽

Ephraim Kisangala ◽

Aaron W Pritchard

Keyword(s):

Systematic Review ◽

Oral Health ◽

Physical Health ◽

Sub Saharan Africa ◽

Health Concern ◽

Years Of Life Lost ◽

Sub Saharan ◽

General Physical ◽

The Impact ◽

General Physical Health

Oral ailments are largely preventable but remain a significant public health concern afflicting nearly half the global population. These conditions account for 220 years of life lost per 100,000 people and about US$500 billion in health-related expenditures. Sub-Saharan Africa bears a significant burden of oral health problems thus exerting additional pressure on the scarce human resources for health. Community healthcare workers (CHWs) could be potentially utilised to bridge the shortage of oral health professionals in sub-Saharan Africa, hence, this systematic review that seeks to explore their current roles in oral health and potential impact on general physical health. This review follows the PRISMA guidelines and databases searched include PubMed, Web of Science, Medline, and CINAHL published between January 2010 and December 2019. Nine studies met the study eligibility criteria. This review established that CHWs perform variable roles cutting across primary, secondary, and tertiary prevention including providing oral hygiene education, recognising common pathologies, and treating oral lesions, administration of tooth extractions, dental pain management, and referral for advanced care. Although this could potentially improve oral health, our review did not establish the extent of the specific impact on general physical health of patients and the burden of oral condition.

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Interaction between M. tuberculosis Lineage and Human Genetic Variants Reveals Novel Pathway Associations with Severity of TB

Pathogens ◽

10.3390/pathogens10111487 ◽

2021 ◽

Vol 10 (11) ◽

pp. 1487

Author(s):

Michael L. McHenry ◽

Eddie M. Wampande ◽

Moses L. Joloba ◽

LaShaunda L. Malone ◽

Harriet Mayanja-Kizza ◽

...

Keyword(s):

Genetic Variation ◽

Clinical Presentation ◽

Sub Saharan Africa ◽

Nucleotide Polymorphisms ◽

Single Nucleotide ◽

Human Genomes ◽

Genome Wide ◽

Sub Saharan ◽

Cellular Replication

Tuberculosis (TB) remains a major public health threat globally, especially in sub-Saharan Africa. Both human and Mycobacterium tuberculosis (MTBC) genetic variation affect TB outcomes, but few studies have examined if and how the two genomes interact to affect disease. We hypothesize that long-term coexistence between human genomes and MTBC lineages modulates disease to affect its severity. We examined this hypothesis in our TB household contact study in Kampala, Uganda, in which we identified three MTBC lineages, of which one, L4.6-Uganda, is clearly derived and hence recent. We quantified TB severity using the Bandim TBscore and examined the interaction between MTBC lineage and human single-nucleotide polymorphisms (SNPs) genome-wide, in two independent cohorts of TB cases (n = 149 and n = 127). We found a significant interaction between an SNP in PPIAP2 and the Uganda lineage (combined p = 4 × 10−8). PPIAP2 is a pseudogene that is highly expressed in immune cells. Pathway and eQTL analyses indicated potential roles between coevolving SNPs and cellular replication and metabolism as well as platelet aggregation and coagulation. This finding provides further evidence that host–pathogen interactions affect clinical presentation differently than host and pathogen genetic variation independently, and that human–MTBC coevolution is likely to explain patterns of disease severity.

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Exploring enablers of sexually transmitted infections among illegal gold miners in the midlands region of Zimbabwe

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20211106 ◽

2021 ◽

Vol 10 (4) ◽

pp. 1321

Author(s):

Nyanshanu Mattew ◽

Chireshe Rumbidzai ◽

Jidong Dung ◽

Nyashanu Wendy ◽

Ekpenyong Mandu Stephen

Keyword(s):

Sexual Health ◽

Sexually Transmitted Infections ◽

Health Knowledge ◽

Sub Saharan Africa ◽

Health Concern ◽

Structured Interviews ◽

Prolonged Stay ◽

Sexually Transmitted ◽

Gold Miners ◽

Sub Saharan

Background: Sub-Saharan Africa faces by far the highest rate of HIV and other Sexually Transmitted Infections (STIs). Illegal mineworkers are considered at risk for HIV and sexually transmitted infections (STIs). Men are generally not receptive to health promotion messages.Methods: This study explored the enablers of sexually transmitted infections. The study utilized a qualitative approach. A total of 40 participants were recruited. Semi structured interviews were used to collect data. A thematic approach was used to analyze the data. Zimbabwe, like any other country in the sub-Saharan region of Africa, has been affected by the epidemic of HIV/AIDS and other STIs, because of poor sexual health education.Results: The study found that the enablers of STIs included poor sexual health knowledge, substance misuse, prolonged stay from family, stigma, lack of entertainment, cultural status, and poor sexual health services.Conclusions: STIs among illegal gold miners is a public health concern that needs urgent attention in many developing countries.

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May Measurement Month 2019: an analysis of blood pressure screening results from Benin–Sub-Saharan Africa

European Heart Journal Supplements ◽

10.1093/eurheartj/suab018 ◽

2021 ◽

Vol 23 (Supplement_B) ◽

pp. B24-B26

Author(s):

Corine Houehanou ◽

Léopold Codjo ◽

Philippe Adjagba ◽

Arnaud Sonou ◽

Hugues Dohou ◽

...

Keyword(s):

Blood Pressure ◽

Urban Areas ◽

Antihypertensive Medication ◽

Sub Saharan Africa ◽

Health Concern ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Rural And Urban Areas ◽

Rural And Urban ◽

Sub Saharan

Abstract Hypertension constitutes a major health concern worldwide and particularly in Sub-Saharan Africa. May Measurement Month (MMM) is a global initiative of the International Society of Hypertension for raising awareness of high blood pressure (BP). This work aims to determine the prevalence, awareness and levels of treatment and control of hypertension among adults participating in the MMM Campaign in Benin in 2019 (MMM19). A cross-sectional survey including volunteers aged ≥18 years was carried out in June 2019 in 13 rural and urban areas in Benin. BP measurement followed the MMM19 protocol. Hypertension was defined as a systolic BP ≥140 mmHg, or a diastolic BP ≥90 mmHg (based on the mean of the second and third readings) or taking antihypertensive medication. A total of 3637 people were screened with a female predominance (61.4%) and a mean age of 44.4 ± 16.1 years. A total of 1363 (37.5%) participants had hypertension. Of 1363 participants with hypertension: 64.5% were aware of their status and 43.9% were taking antihypertensive medication. Among 598 participants taking anti-hypertensive medication, 34.9% had controlled BP (systolic BP <140 mmHg and diastolic BP <90 mmHg). The results suggest a high prevalence of hypertension in Benin and that intensifying actions for its primary prevention, early detection and effective management should be encouraged.

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