Kidney function of HIV-infected children in Lagos, Nigeria: using Filler's serum cystatin C-based formula

<p>Abstract</p> <p>Background</p> <p>Limited data is available on kidney function in HIV-infected children in sub-Saharan Africa. In addition, malnutrition in these children further reduces the utility of diagnostic methods such as creatinine-based estimates of glomerular filtration rate. We determined the serum cystatin C level and estimated glomerular filtration rate of 60 antiretroviral-naïve, HIV-infected children and 60 apparently healthy age and sex matched children.</p> <p>Methods</p> <p>Serum cystatin C level was measured using enzyme-linked immunosorbent assay technique, while glomerular filtration rate was estimated using Filler's serum cystatin C formula. Student t test, Mann Whitney U test, Pearson chi square and Fisher's exact test were used, where appropriate, to test difference between groups.</p> <p>Results</p> <p>Compared to the controls, the HIV-infected group had significantly higher median (interquartile range) serum cystatin C levels {0.77 (0.29) mg/l versus 0.66 (0.20) mg/l; p = 0.025} and a higher proportion of children with serum cystatin C level >1 mg/l {10 (16.7%) versus one (1.7%); p = 0.004}. The HIV-infected children had a mean (± SD) eGFR of 96.8 (± 36.1) ml/min/1.73 m²compared with 110.5 (± 27.8) ml/min/1.73 m²in the controls (p = 0.021). After controlling for age, sex and body mass index, only the study group (HIV infected versus control) remained a significant predictor of serum cystatin C level (β = -0.216, p = 0.021). The proportion of HIV-infected children with eGFR <60 ml/min/1.73 m²was eight (13.3%) versus none (0%) in the control group (p = 0.006). However, the serum cystatin C level, eGFR and proportions of children with serum cystatin C level >1 mg/l and eGFR <60 ml/min/1.73 m²were not significantly different between the HIV-infected children with advanced disease and those with milder disease.</p> <p>Conclusions</p> <p>HIV-infected children in Nigeria have higher serum cystatin C level and lower eGFR compared to age and sex matched controls.</p

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance.

Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times and more-regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and illuminate the distinct dispersal dynamics of variants of concern-particularly Alpha, Beta, Delta, and Omicron-on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve while the continent faces many emerging and reemerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

SEQUELLES NEUROLOGIQUES CHEZ DES ENFANTS ATTEINTS D\'UNE MENINGITE PURULENTE DANS UN CENTRE TERTIAIRE A LAGOS (NIGERIA)

NEUROLOGICAL SEQUELAE IN CHILDREN WITH PYOGENIC MENINGITIS IN A TERTIARY CENTRE IN LAGOS (NIGERIA ABSTRACT Background: Neurological sequelae following childhood bacterial meningitis are common particularly in the presence of delayed diagnosis and treatment. The latter is commonplace with meningitis in developing countries like Nigeria but information on the incidence and prevalence rates of consequent neurological sequelae is rare. Objective: We herein document the prevalence of such sequelae in children following admission for pyogenic meningitis and describe associated risk factors. Methods: We retrospectively reviewed forty-nine children managed for acute pyogenic meningitis at the Lagos University Teaching Hospital (LUTH) over a 10-year period. Information on biodata, clinical features, pre–admission treatment, investigation results, treatment, and duration of hospitalization were extracted from their case records and analysed. Results: Thirty-two (65.3%) of these children had obvious neurological sequelae. These included neuro-motor disorders (31%), hydrocephalus (28%), hearing disorders (25%), speech and language problems (25%), recurrent seizures (22%), mental retardation (22%), visual defects (19%) and behavioural problems (3%). All ages were affected but more commonly infants. Sequelae occurred in multiples. Children with sequelae tended to have had prior hospitalization and treatment. However no clinical or socio-economic factors showed significant relationship with the development of neurological sequelae. Conclusions: The distribution of sequelae in our study is similar to findings of other authors but shows a higher prevalence thus further confirming the need for primary prevention of this disease and for prompt and adequate treatment of cases. We recommend early screening of survivors for sequelae so that adequate rehabilitation can be planned. RESUME Introduction: Les séquelles neurologiques secondaire à une méningite bactérienne au cours de l\'enfance sont fréquentes en particulier lorsque le diagnostic et le traitement sont retardés. Objectif: Nous rapportons dans ce travail les aspects séquellaires neurologiques observés chez les enfants hospitalisés pour méningite pyogénique en relevant les facteurs de risque liés à cette affection. Méthode: Nous avons passé en revue rétrospectivement, quarante neuf enfants traités atteints de la méningite purulante au centre hospitalier universitaire de Lagos (LUTH) au cours d'une période de 10 ans. Les informations cliniques, paracliniques et thérapeutiques tirés de leurs dossiers médicaux ont été analysés. Résultats: Trente deux soit 65,3% des cas enfants présentaient des séquelle neurologicales: troubles neuro-moteurs (31%), hydrocéphalie (28%), troubles de l'ouie (25%), troubles du language et (25%), crise chronique (22%), retard mentale (22%), troubles visuelles (19%) et de comportement (3%). Aucun facteur clinique, socio-économique n'a pas été relevé et relié avec la survenue de séquelle neurologique. Conclusion: Nos résutalts sont semblabes à ceux présentés par d\'autres auteurs. La prévalence est élevée, impliquant ainsi la nécessité d\'une politque de prévention de cette affection ainsi qu\'un traitement précoce et la prise en charge des enfants porteurs de séquelles Key Words: Africa, neurological sequelae, pyogenic meningitis, Afrique, méningite purulente, Nigeria, séquelles African Journal of Neurological Sciences Vol.23(2) 200

Morphological and thermal properties of polystyrene composite reinforced with biochar from elephant grass (<i>Pennisetum purpureum</i>)

The use of wastes in the development of useful material is a key aspect of solid waste management. The aim of this study was to utilize biochar from elephant grass ( Pennisetum purpureum) as fillers in polystyrene composites with focus on the morphological and thermal properties of the developed composites. The composites were prepared by hand lay-up technique. The prepared resin and final composite were characterized using scanning electron microscopy, differential scanning calorimetry and Fourier-transform infrared spectroscopy. The biochar also did not contain any reactive hydrophilic groups, thus, it is compatible with polystyrene. Estimated heat capacities of the composites from the thermal test results showed that to obtain a composite of heat capacity range between 600 J/kg·K and 760 J/kg·K, a 10–30 wt% range of biochar composition should be maintained. At 30 wt% biochar composition, heat capacity was at a maximum value of 757.66 J/kg·K. </jats:p

A review of metabolic calorimetric applications in plant stress, waste management, and diagnostics

The majority of metabolic activities occur in adiabatic environments; carbon uptake in soils serves as a signal for thermal heat fluxes, and plants can spontaneously generate heat during metabolic processes. We discuss calorimetric studies that use basic chemical approaches, such as isothermal microcalorimetry (IMC) and differential scanning calorimetry (DSC), to investigate plant responses to abiotic and biotic stresses, vegetative growth, seed germination rate, and micropropagation viability. Calorimetric studies of waste materials, wastewater sludge, and effluents were also considered in concert with specified thermophysical variables that define these environmental phenomena, such as enhanced thermal and heat capacity. The IMC and DSC performance characteristics were also evaluated. Biologically exothermic reactions—which involve biotransformation mechanisms during composting, wastewater reuse, and organic sludge stability as physiochemical attributes of solid and liquid wastes via changes in heat release—influence plant dynamic stress variables. It is advised that these calorimetric studies be used in plant, soil, and waste bodies for ecosystem safety and integrity. IMC not only enhances our understanding of plant responses to stress and pathogens but also aids in achieving Sustainable Development Goal (SDG) 3 by enhancing diagnostic capabilities and disease management. Furthermore, IMC contributes to SDG 9 by fostering scientific research and innovation in microbiology, aligning with goals for industry, innovation, and infrastructure. The ongoing integration of DSC techniques with cutting-edge analytical methodologies could also permit the implementation of Smart, Measurable, Achievable, Relevant, Time-bound (SMART) goals for a precise and quantifiable strategy in environmental impact assessments

Supplementary_Material - Morphological and thermal properties of polystyrene composite reinforced with biochar from elephant grass (<i>Pennisetum purpureum</i>)

Supplementary_Material for Morphological and thermal properties of polystyrene composite reinforced with biochar from elephant grass (Pennisetum purpureum) by Adewale George Adeniyi, Sulyman Age Abdulkareem, Joshua O Ighalo, Damilola Victoria Onifade, Samson Akorede Adeoye and Abia Elizabeth Sampson in Journal of Thermoplastic Composite Materials</p

Readiness for professional practice among health professions education graduates: a systematic review

Readiness to practice is the state of being prepared and capable of engaging in professional activities in a specific field. Graduates of healthcare professions require a diverse set of skills, knowledge and attitudes to meet the demands of complex healthcare settings. This systematic review provides a comprehensive analysis of readiness for professional practice among graduates of health professions education. It encompasses a wide range of articles published between 2013 and 2024, incorporating various health professions and utilizing a combination of quantitative, qualitative, and mixed methods designs. The review identified 93 studies from 32 diverse countries. The review revealed that factors influencing readiness to practice, include individual capabilities, the workplace context, and educational provision. It also explored strategies to enhance readiness to practice. The findings underscore the significance of addressing challenges such as lack of confidence, stress, communication, time management, job satisfaction, clinical experience, academic workload, teaching quality, mentorship and curriculum design. This comprehensive analysis serves as a valuable resource for healthcare educators, policymakers, and practitioners seeking to optimize the preparedness of graduates for the complexities of contemporary healthcare environments. Future studies should explore the interactions between readiness to practice stakeholders’ perception of the educational curriculum, and the quality of support in the professional practice environment

Improving diagnostics and surveillance of malaria among displaced people in Africa

Abstract African communities that have been forced to leave their homes experience a considerably greater susceptibility to malaria as a result of densely populated living conditions, restricted availability of healthcare, and environmental influences. Internally displaced individuals frequently live in large settlements with restricted availability to drinking water, essential sanitation, and medical services, intensifying the spread of malaria. As a result, the occurrence of malaria is significantly more common among refugees and internally displaced individuals compared to those who are not displaced. This leads to greater rates of illness and death, especially among young people. Insufficient monitoring worsens the condition, leading to delayed identification and medical intervention, and contributing to a higher incidence of severe malaria and deaths. Furthermore, these communities are faced with economic consequences that contribute to the continuation of poverty and the worsening of socio-economic inequalities. Furthermore, the psychological impact of malaria, which is marked by feelings of anxiety and uncertainty, is particularly severe in vulnerable populations such as displaced children and pregnant women, aggravating the overall burden. Hence, addressing malaria in displaced populations in Africa requires comprehensive and well-coordinated strategies. Advanced diagnostic and surveillance technologies are essential for promptly identifying and treating malaria, providing chances to monitor and control its spread effectively. Collaboration among healthcare, policy, and humanitarian sectors is crucial for implementing comprehensive solutions that incorporate enhanced diagnostics, surveillance, and socio-psychological support. Active involvement of the community, usage of Community Health Workers, and regular collection of surveillance data are crucial in increasing awareness, directing control efforts, and tackling the specific difficulties encountered by displaced groups. Moreover, the implementation of environmental management, the incorporation of health services, and the utilization of adaptable healthcare interventions are essential for reducing the effects of malaria. To mitigate the impact of malaria and improve health outcomes among displaced populations in Africa, it is crucial to focus on these specific areas