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

Hypoglycaemic and Antioxidative Properties of Freeze-Dried Garcinia Kola Seeds in Type 2 Diabetics and Non-Diabetics with Chronic Foot/Leg Ulcer in Ibadan, Nigeria: A case-control clinical study

Introduction: The antidiabetic and antioxidative properties of Garcinia kola (GK) seed extracts have been well documented in animal studies; however, data on freeze-dried powder of GK seeds (FDGK) in humans are scarce. This study investigated the effect of 8-weeks supplementation of FDGK on glycaemic control and oxidative stress levels in Type 2 diabetics with or without foot/leg ulcer and compared with non-diabetics with or without chronic foot/leg ulcer in Ibadan, Nigeria. Materials and Methods: Thirty diabetics with foot/leg ulcer (DFU), 30 diabetics without ulcer (T2DM), 30 non-diabetics with chronic foot/leg ulcer (NDCU) and 30 non-diabetics without ulcer (NDC) were divided into: subgroup-1 (250mgGK); subgroup-2 (500mgGK); subgroup-3 (No-supplementation). Plasma glucose (FPG), glycated haemoglobin-A1c (HbA1c), total plasma peroxides (TPP), total antioxidant status (TAS), oxidative stress index (OSI), antioxidant-micronutrients were determined in fasting blood samples. Wounds were clinically assessed and rated using modified ABDEFS. Results: All participants supplemented with 250mgGK or 500mgGK for 8 weeks showed decreases in TPP and OSI with improvement in wound healing, increases in TAS and antioxidant-micronutrients (p<0.05). In addition, significant decreases in FPG were observed in DFU and T2DM supplemented with 250mgGK, and also in NDC supplemented with 500mgGK. In non-supplemented subgroups, increases in TPP and OSI with decreases in TAS and antioxidant-micronutrients (p<0.05) were observed. Conclusion: Supplementation with Garcinia kola could be used as an adjunct for prevention and treatment of diabetes mellitus complicated with or without foot/leg ulcer Recommendations: Caution must be taken when used as prophylactic in non-diabetics to prevent occurrence of hypoglycaemia

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality