Emergence and spread of SARS-CoV-2 lineage B.1.620 with variant of concern-like mutations and deletions

Distinct SARS-CoV-2 lineages, discovered through various genomic surveillance initiatives, have emerged during the pandemic following unprecedented reductions in worldwide human mobility. We here describe a SARS-CoV-2 lineage - designated B.1.620 - discovered in Lithuania and carrying many mutations and deletions in the spike protein shared with widespread variants of concern (VOCs), including E484K, S477N and deletions HV69Delta, Y144Delta, and LLA241/243Delta. As well as documenting the suite of mutations this lineage carries, we also describe its potential to be resistant to neutralising antibodies, accompanying travel histories for a subset of European cases, evidence of local B.1.620 transmission in Europe with a focus on Lithuania, and significance of its prevalence in Central Africa owing to recent genome sequencing efforts there. We make a case for its likely Central African origin using advanced phylogeographic inference methodologies incorporating recorded travel histories of infected travellers

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

Simultaneous Bladder and Uterine Rupture Secondary to Poor Management of Labour by A Traditional Birth Attendant: A Case Report

Nigeria has one of the highest maternal morbidity and mortality globally. Poor health seeking behaviour and lack of adequate training among most Traditional Birth Attendants (TBA) are major contributors to our poor health indices. Uterine rupture is a major obstetric complication with significant morbidity and mortality. Uterine rupture occurring simultaneously with bladder rupture is rare. A major risk factor in our environment is failure to recognise high risk pregnancies as well as unsupervised labour. We report a case of an unbooked 34-year-old G5P4+0 trader at 39 weeks’ gestation who was referred from a traditional birth attendant with simultaneous bladder and uterine rupture

Knowledge of common cardiovascular diseases and its risk factors among members of a community in South-South Nigeria

Background: Cardiovascular diseases (CVD) are a major cause of morbidity and mortality. Reducing the burden of CVD particularly among rural dwellers will require a wholistic approach involving health education, and strengthening of primary health care to provide affordable primary care to the people. Aim: To access the knowledge of CVD and its risk factors among the people. Materials and Methods: This was a descriptive cross-sectional study of 360 adult residents of Igueben, a rural community in Edo State South-South Nigeria, selected through a multistage sampling technique. An interviewer-administered semi-structured questionnaire was used to collect data which were analysed using SPSS version 20.0. Results: Respondents were mostly female (67.78%) with a mean age of 45 ± 08 years. Over half of the respondents were farmers (58.33%), and 57.78% of respondents did not have secondary education. Over 50% had knowledge of stroke, and more than two-third of them were able to recognise common stroke symptoms such as difficulty speaking, facial weakness, and sudden limb weakness. Most respondents had knowledge of common risk factors for CVD, especially smoking, alcohol use, and hypertension. Respondents demonstrated a good knowledge of the preventive and control measures of CVD like healthy diet (60.56%), regular exercise (60.56%), alcohol and smoking cessation (60.56%), good sleep (55.56%), good health-seeking behaviour (55.55%), and avoidance of stress (54.44%). Furthermore, 78.89% of the participants recognised the need for hospital care in the event of a CVD. However, one-third of them had a poor health-seeking behaviour. Conclusion: We have found that this rural population had knowledge of stroke as a CVD as well as other common ones such as heart attack and heart failure. They also had a good health-seeking behaviour. However, while CVD awareness alone is no guarantee for positive cardiovascular outcomes, a good knowledge is clearly necessary for individuals to make informed decisions about their health by potentially adopting risk-free behaviours