Epidemic cerebrospinal meningitis in children at Federal Medical Centre, Gusau, Zamfara state, Nigeria

Epidemic meningococcal meningitis is a major public health problem still affecting tropical countries, particularly in Sub-Saharan Africa, which lieswithin African meningitis belt. Repeated large scale epidemics of CSM have been reported in northern Nigeria for the past four decades. It is one of the important causes of morbidity and mortality in these regions. Mortality from the CSM remains high despite advances in treatment modalities. Neisseria meningitidis serogroup A have been the major cause of large scale epidemics in tropical countries, while serogroups B, C, Y and W-135 are responsible for most of invasive disease in America and other developed countries.Objective: To determine the pattern of epidemic CSM in children atFederal Medical Centre, Gusau.Method: The study was a retrospective one carried out in children agedsix months to 12 years admitted into Emergency Paediatrics Unit (EPU) with a diagnosis of CSM within the period January to May, 2009.Results: Seventy- seven children with epidemic CSM were admittedand managed in EPU from January-May 2009.Conclusion: Neisseria meningitidis serogroup A CSM is becoming thedisease of young infants, and stresses the need for inclusion ofCSM vaccine in early infancy in routine immunization policy, in areas within the meningitis belt in Sub-Saharan Africa.

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The effect of recombination on the evolution of a population of Neisseria meningitidis

10.1101/2020.04.08.031906 ◽

2020 ◽

Author(s):

Neil MacAlasdair ◽

Maiju Pesonen ◽

Ola Brynildsrud ◽

Vegard Eldholm ◽

Paul A. Kristiansen ◽

...

Keyword(s):

Population Structure ◽

Burkina Faso ◽

Neisseria Meningitidis ◽

Large Scale ◽

Invasive Disease ◽

Pathogen Transmission ◽

Sub Saharan Africa ◽

Health Concern ◽

Recombination Hotspots ◽

Sub Saharan

Neisseria meningitidis (the meningococcus) is a major human pathogen with a history of high invasive disease burden, particularly in sub-Saharan Africa. Our current understanding of the evolution of meningococcal genomes is limited by the rarity of large-scale genomic population studies and lack of in-depth investigation of the genomic events associated with routine pathogen transmission. Here we fill this knowledge gap by a detailed analysis of 2,839 meningococcal genomes obtained through a carriage study of over 50,000 samples collected systematically in Burkina Faso, West Africa, before, during, and after the serogroup A vaccine rollout, 2009-2012. Our findings indicate that the meningococcal genome is highly dynamic, with recombination hotspots and frequent gene sharing across deeply separated lineages in a structured population. Furthermore, our findings illustrate the profound effect of population structure on genome flexibility, with some lineages in Burkina Faso being orders of magnitude more recombinant than others. We also examine the effect of selection on the population, in particular how it is correlated with recombination. We find that recombination principally acts to prevent the accumulation of deleterious mutations, although we do also find an example of recombination acting to speed the adaptation of a gene. In general, we show the importance of recombination in the evolution of a geographically expansive population with deep population structure in a short timescale. This has important consequences for our ability to both foresee the outcomes of vaccination programmes and, using surveillance data, predict when lineages of the meningococcus are likely to become a public health concern.

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Genetic diversification of Neisseria meningitidis during waves of colonization and disease in the meningitis belt of sub-Saharan Africa

Vaccine ◽

10.1016/j.vaccine.2007.04.035 ◽

2007 ◽

Vol 25 ◽

pp. A18-A23 ◽

Cited By ~ 10

Author(s):

Julia Leimkugel ◽

Abudulai Adams Forgor ◽

Jean-Pierre Dangy ◽

Valentin Pflüger ◽

Sebastien Gagneux ◽

...

Keyword(s):

Neisseria Meningitidis ◽

Sub Saharan Africa ◽

Meningitis Belt ◽

Sub Saharan

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Future Directions for Meningitis Surveillance and Vaccine Evaluation in the Meningitis Belt of Sub-Saharan Africa

The Journal of Infectious Diseases ◽

10.1093/infdis/jiz421 ◽

2019 ◽

Vol 220 (Supplement_4) ◽

pp. S279-S285 ◽

Cited By ~ 11

Author(s):

Ryan T Novak ◽

Olivier Ronveaux ◽

André F Bita ◽

Honoré Flavien Aké ◽

Fernanda C Lessa ◽

...

Keyword(s):

Conjugate Vaccine ◽

Large Scale ◽

Public Health Problem ◽

Study Data ◽

Sub Saharan Africa ◽

Laboratory Diagnostics ◽

Meningitis Belt ◽

Significant Public Health ◽

Sub Saharan ◽

The Impact

Abstract In sub-Saharan Africa, bacterial meningitis remains a significant public health problem, especially in the countries of the meningitis belt, where Neisseria meningitidis serogroup A historically caused large-scale epidemics. In 2014, MenAfriNet was established as a consortium of partners supporting strategic implementation of case-based meningitis surveillance to monitor meningitis epidemiology and impact of meningococcal serogroup A conjugate vaccine (MACV). MenAfriNet improved data quality through use of standardized tools, procedures, and laboratory diagnostics. MenAfriNet surveillance and study data provided evidence of ongoing MACV impact, characterized the burden of non-serogroup A meningococcal disease (including the emergence of a new epidemic clone of serogroup C), and documented the impact of pneumococcal conjugate vaccine. New vaccines and schedules have been proposed for future implementation to address the remaining burden of meningitis. To support the goals of “Defeating Meningitis by 2030,” MenAfriNet will continue to strengthen surveillance and support research and modeling to monitor the impact of these programs on meningitis burden in sub-Saharan Africa.

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Methylene blue inhibits lumefantrine-resistant Plasmodium berghei

The Journal of Infection in Developing Countries ◽

10.3855/jidc.7556 ◽

2016 ◽

Vol 10 (06) ◽

pp. 635-642 ◽

Cited By ~ 4

Author(s):

Victor Irungu Mwangi ◽

Ruth Mwende Mumo ◽

Daniel Muthui Kiboi ◽

Sabah Ahmed Omar ◽

Zipporah Waithera Ng'ang'a ◽

...

Keyword(s):

Methylene Blue ◽

Combination Therapy ◽

Large Scale ◽

Public Health Problem ◽

Drug Repurposing ◽

Sub Saharan Africa ◽

Major Public Health Problem ◽

Resistant Strains ◽

Sub Saharan ◽

Emergence Of Resistance

Introduction: Chemotherapy still is the most effective way to control malaria, a major public health problem in sub-Saharan Africa. The large-scale use of the combination therapy artemether-lumefantrine for malaria treatment in Africa predisposes lumefantrine to emergence of resistance. There is need to identify drugs that can be used as substitutes to lumefantrine for use in combination therapy. Methylene blue, a synthetic anti-methemoglobinemia drug, has been shown to contain antimalarial properties, making it a candidate for drug repurposing. The present study sought to determine antiplasmodial effects of methylene blue against lumefantrine- and pyrimethamine-resistant strains of P. berghei. Methodology: Activity of methylene blue was assessed using the classical four-day test on mice infected with lumefantrine-resistant and pyrimethamine-resistant P. berghei. A dose of 45 mg/kg/day was effective for testing ED90. Parasitemia and mice survival was determined. Results: At 45 mg/kg/day, methylene blue sustained significant parasite inhibition, over 99%, for at least 6 days post-treatment against lumefantrine-resistant and pyrimethamine-resistant P. berghei (p = 0.0086 and p = 0.0191, respectively). No serious adverse effects were observed. Conclusions: Our results indicate that methylene blue at a concentration of 45 mg/kg/day confers over 99% inhibition against lumefantrine- and pyrimethamine-resistant P. berghei for six days. This shows the potential use methylene blue in the development of antimalarials against lumefantrine- and pyrimethamine-resistant parasites.

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Modelling meningococcal meningitis in the African meningitis belt

Epidemiology and Infection ◽

10.1017/s0950268811001385 ◽

2011 ◽

Vol 140 (5) ◽

pp. 897-905 ◽

Cited By ~ 26

Author(s):

T. J. IRVING ◽

K. B. BLYUSS ◽

C. COLIJN ◽

C. L. TROTTER

Keyword(s):

Disease Incidence ◽

Public Health Problem ◽

Meningococcal Meningitis ◽

Sub Saharan Africa ◽

Major Public Health Problem ◽

Large Area ◽

Population Immunity ◽

Complex Interactions ◽

Meningitis Belt ◽

Sub Saharan

SUMMARYMeningococcal meningitis is a major public health problem in a large area of sub-Saharan Africa known as the meningitis belt. Disease incidence increases every dry season, before dying out with the first rains of the year. Large epidemics, which can kill tens of thousands of people, occur frequently but unpredictably every 6–14 years. It has been suggested that these patterns may be attributable to complex interactions between the bacteria, human hosts and the environment. We used deterministic compartmental models to investigate how well simple model structures with seasonal forcing were able to qualitatively capture these patterns of disease. We showed that the complex and irregular timing of epidemics could be caused by the interaction of temporary immunity conferred by carriage of the bacteria together with seasonal changes in the transmissibility of infection. This suggests that population immunity is an important factor to include in models attempting to predict meningitis epidemics.

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Precision Agriculture for Resource Use Efficiency in Smallholder Farming Systems in Sub-Saharan Africa: A Systematic Review

Sustainability ◽

10.3390/su13031158 ◽

2021 ◽

Vol 13 (3) ◽

pp. 1158

Author(s):

Cecilia M. Onyango ◽

Justine M. Nyaga ◽

Johanna Wetterlind ◽

Mats Söderström ◽

Kristin Piikki

Keyword(s):

Resource Use ◽

Precision Agriculture ◽

Large Scale ◽

English Language ◽

Management Practices ◽

Smallholder Farmers ◽

Management Strategies ◽

Sub Saharan Africa ◽

Smallholder Farming ◽

Sub Saharan

Opportunities exist for adoption of precision agriculture technologies in all parts of the world. The form of precision agriculture may vary from region to region depending on technologies available, knowledge levels and mindsets. The current review examined research articles in the English language on precision agriculture practices for increased productivity among smallholder farmers in Sub-Saharan Africa. A total of 7715 articles were retrieved and after screening 128 were reviewed. The results indicate that a number of precision agriculture technologies have been tested under SSA conditions and show promising results. The most promising precision agriculture technologies identified were the use of soil and plant sensors for nutrient and water management, as well as use of satellite imagery, GIS and crop-soil simulation models for site-specific management. These technologies have been shown to be crucial in attainment of appropriate management strategies in terms of efficiency and effectiveness of resource use in SSA. These technologies are important in supporting sustainable agricultural development. Most of these technologies are, however, at the experimental stage, with only South Africa having applied them mainly in large-scale commercial farms. It is concluded that increased precision in input and management practices among SSA smallholder farmers can significantly improve productivity even without extra use of inputs.

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Intraclass Correlation Coefficients for Designing Cluster-Randomized Trials in Sub-Saharan Africa Education

Evaluation Review ◽

10.1177/0193841x16660246 ◽

2016 ◽

Vol 40 (6) ◽

pp. 500-525 ◽

Cited By ~ 10

Author(s):

Ben Kelcey ◽

Zuchao Shen ◽

Jessaca Spybrook

Keyword(s):

Large Scale ◽

Randomized Trials ◽

Intraclass Correlation ◽

Educational Interventions ◽

Sub Saharan Africa ◽

Design Stage ◽

Education Outcomes ◽

Randomized Studies ◽

Sub Saharan ◽

Variance Explained

Objective: Over the past two decades, the lack of reliable empirical evidence concerning the effectiveness of educational interventions has motivated a new wave of research in education in sub-Saharan Africa (and across most of the world) that focuses on impact evaluation through rigorous research designs such as experiments. Often these experiments draw on the random assignment of entire clusters, such as schools, to accommodate the multilevel structure of schooling and the theory of action underlying many school-based interventions. Planning effective and efficient school randomized studies, however, requires plausible values of the intraclass correlation coefficient (ICC) and the variance explained by covariates during the design stage. The purpose of this study was to improve the planning of two-level school-randomized studies in sub-Saharan Africa by providing empirical estimates of the ICC and the variance explained by covariates for education outcomes in 15 countries. Method: Our investigation drew on large-scale representative samples of sixth-grade students in 15 countries in sub-Saharan Africa and includes over 60,000 students across 2,500 schools. We examined two core education outcomes: standardized achievement in reading and mathematics. We estimated a series of two-level hierarchical linear models with students nested within schools to inform the design of two-level school-randomized trials. Results: The analyses suggested that outcomes were substantially clustered within schools but that the magnitude of the clustering varied considerably across countries. Similarly, the results indicated that covariance adjustment generally reduced clustering but that the prognostic value of such adjustment varied across countries.

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Land conflicts and social differentiation in eastern Uganda

The Journal of Modern African Studies ◽

10.1017/s0022278x1700026x ◽

2017 ◽

Vol 55 (3) ◽

pp. 395-422 ◽

Cited By ~ 2

Author(s):

Matt Kandel

Keyword(s):

Large Scale ◽

Local Level ◽

Sub Saharan Africa ◽

Social Differentiation ◽

Land Conflicts ◽

Current Period ◽

Post Conflict ◽

Sub Saharan ◽

Historical Developments ◽

Eastern Uganda

ABSTRACTRising competition and conflict over land in rural sub-Saharan Africa continues to attract the attention of researchers. Recent work has especially focused on land governance, post-conflict restructuring of tenure relations, and large-scale land acquisitions. A less researched topic as of late, though one deserving of greater consideration, pertains to how social differentiation on the local-level shapes relations to land, and how these processes are rooted in specific historical developments. Drawing on fieldwork conducted in Teso sub-region of eastern Uganda, this paper analyses three specific land conflicts and situates them within a broad historical trajectory. I show how each dispute illuminates changes in class relations in Teso since the early 1990s. I argue that this current period of socioeconomic transformation, which includes the formation of a more clearly defined sub-regional middle class and elite, constitutes the most prominent period of social differentiation in Teso since the early 20th century.

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Resource frontiers and agglomeration economies: The varied logics of transnational land-based investing in Southern and Eastern Africa

AMBIO ◽

10.1007/s13280-021-01682-z ◽

2022 ◽

Author(s):

Dilini Abeygunawardane ◽

Angela Kronenburg García ◽

Zhanli Sun ◽

Daniel Müller ◽

Almeida Sitoe ◽

...

Keyword(s):

Spatial Data ◽

Large Scale ◽

Agglomeration Economies ◽

Sub Saharan Africa ◽

Eastern Africa ◽

Track Record ◽

Level Data ◽

Forestry Investments ◽

Sub Saharan ◽

Investment Location

AbstractActor-level data on large-scale commercial agriculture in Sub-Saharan Africa are scarce. The peculiar choice of transnational investing in African land has, therefore, been subject to conjecture. Addressing this gap, we reconstructed the underlying logics of investment location choices in a Bayesian network, using firm- and actor-level interview and spatial data from 37 transnational agriculture and forestry investments across 121 sites in Mozambique, Zambia, Tanzania, and Ethiopia. We distinguish four investment locations across gradients of resource frontiers and agglomeration economies to derive the preferred locations of different investors with varied skillsets and market reach (i.e., track record). In contrast to newcomers, investors with extensive track records are more likely to expand the land use frontier, but they are also likely to survive the high transaction costs of the pre-commercial frontier. We highlight key comparative advantages of Southern and Eastern African frontiers and map the most probable categories of investment locations.

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Parkinson’s disease – a review of pathogenesis, recent advances in management, and challenges of care in sub-Saharan Africa

Journal of Global Medicine ◽

10.51496/jogm.v1.35 ◽

2021 ◽

pp. e35

Author(s):

Akintomiwa I. Makanjuola ◽

Funmilola T. Taiwo ◽

Joseph O. Yaria ◽

Rufus O. Akinyemi ◽

Adesola Ogunniyi

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Treatment Options ◽

Sub Saharan Africa ◽

Treatment Modalities ◽

Unequal Distribution ◽

Low Resource Settings ◽

Low Resource ◽

Recent Advances ◽

Sub Saharan

Parkinson’s disease (PD) remains a common neurodegenerative movement disorder with significant morbidity, which is expected to increase worldwide in the coming decades. Since its initial description, much has been elucidated about its etiology, pathogenesis, and the role of genetic and environmental risk factors. Effective treatments, including surgical therapies, have been discovered. Despite these strides, many questions remain unanswered; PD remains an active research area with ongoing efforts to discover newer treatment modalities and identify neuroprotective strategies. As with many neurological conditions, there is an unequal distribution of health resources, resulting in some management challenges in low resource settings, especially sub-Saharan Africa (SSA). In this communication, we provide an overview of PD etiopathogenesis, including genetics and management strategies, including some recent advances with respect to treatment options and disease modification approaches. Finally, we discuss some challenges of PD management in low-resource settings and highlight efforts to turn the tide.

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