Global Burden of Sickle Cell Anaemia in Children under Five, 2010-2050: Modelling Based on Demographics, Excess Mortality, and Interventions

The global burden of sickle cell anaemia (SCA) is set to rise as a consequence of improved survival in high-prevalence low- and middle-income countries and population migration to higher-income countries. The host of quantitative evidence documenting these changes has not been assembled at the global level. The purpose of this study is to estimate trends in the future number of newborns with SCA and the number of lives that could be saved in under-five children with SCA by the implementation of different levels of health interventions.First, we calculated projected numbers of newborns with SCA for each 5-y interval between 2010 and 2050 by combining estimates of national SCA frequencies with projected demographic data. We then accounted for under-five mortality (U5m) projections and tested different levels of excess mortality for children with SCA, reflecting the benefits of implementing specific health interventions for under-five patients in 2015, to assess the number of lives that could be saved with appropriate health care services. The estimated number of newborns with SCA globally will increase from 305,800 (confidence interval [CI]: 238,400-398,800) in 2010 to 404,200 (CI: 242,500-657,600) in 2050. It is likely that Nigeria (2010: 91,000 newborns with SCA [CI: 77,900-106,100]; 2050: 140,800 [CI: 95,500-200,600]) and the Democratic Republic of the Congo (2010: 39,700 [CI: 32,600-48,800]; 2050: 44,700 [CI: 27,100-70,500]) will remain the countries most in need of policies for the prevention and management of SCA. We predict a decrease in the annual number of newborns with SCA in India (2010: 44,400 [CI: 33,700-59,100]; 2050: 33,900 [CI: 15,900-64,700]). The implementation of basic health interventions (e.g., prenatal diagnosis, penicillin prophylaxis, and vaccination) for SCA in 2015, leading to significant reductions in excess mortality among under-five children with SCA, could, by 2050, prolong the lives of 5,302,900 [CI: 3,174,800-6,699,100] newborns with SCA. Similarly, large-scale universal screening could save the lives of up to 9,806,000 (CI: 6,745,800-14,232,700) newborns with SCA globally, 85% (CI: 81%-88%) of whom will be born in sub-Saharan Africa. The study findings are limited by the uncertainty in the estimates and the assumptions around mortality reductions associated with interventions.Our quantitative approach confirms that the global burden of SCA is increasing, and highlights the need to develop specific national policies for appropriate public health planning, particularly in low- and middle-income countries. Further empirical collaborative epidemiological studies are vital to assess current and future health care needs, especially in Nigeria, the Democratic Republic of the Congo, and India

Omics-based molecular techniques in oral pathology centred cancer: Prospect and challenges in Africa

: The completion of the human genome project and the accomplished milestones in the human proteome project; as well as the progress made so far in computational bioinformatics and “big data” processing have contributed immensely to individualized/personalized medicine in the developed world.At the dawn of precision medicine, various omics-based therapies and bioengineering can now be applied accurately for the diagnosis, prognosis, treatment, and risk stratifcation of cancer in a manner that was hitherto not thought possible. The widespread introduction of genomics and other omics-based approaches into the postgraduate training curriculum of diverse medical and dental specialties, including pathology has improved the profciency of practitioners in the use of novel molecular signatures in patient management. In addition, intricate details about disease disparity among diferent human populations are beginning to emerge. This would facilitate the use of tailor-made novel theranostic methods based on emerging molecular evidences

Spatial and temporal analysis of the mid-summer dry spells for the summer rainfall region of South Africa

South Africa is frequently subjected to severe droughts and dry spells during the rainy season. As such, rainfall is one of the most significant factors limiting dryland crop production in South Africa. The mid-summer period is particularly important for agriculture since a lack of rain during this period negatively affects crop yields. Dry spell frequency analyses are used to investigate the impacts of sub-seasonal rainfall variability on crop yield, since seasonal rainfall totals alone do not explain the relationship between rainfall and crop yields. This study investigated the spatial and temporal occurrences of the mid-summer dry spells based on magnitude, length and time of occurrence in the major maize growing areas of the summer rainfall region of South Africa. Three thresholds of 5 mm, 10 mm, and 15 mm total rainfall for a pentad were used for the analysis of dry spells.  Dry spell analysis showed that dry pentads occur during mid-summer with differing intensity, duration and frequency across the summer rainfall region. Annual frequency of dry pentads for the mid-summer period ranged between 0 and 4 pentads for the 5 mm threshold and 1 to 7 for the 10 mm and 15 mm thresholds.  The non-parametric Mann-Kendall trend analysis of the dry pentads indicates that there is no significant trend in the frequency of dry spells at a 95% confidence level. The initial and conditional probabilities of getting a dry spell using the Markov chain model also showed that there is a 32% to 80% probability that a single pentad will be dry using the 15 mm threshold. There is a 5% to 48% probability of experiencing two consecutive dry pentads and 1% to 29% probability of getting three consecutive dry pentads. The duration and intensity of dry spells, as well as the Markov chain probabilities, showed a decrease in dry spells from west to east of the maize-growing areas of the summer rainfall region of South Africa