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

Les évolutions des fractures du cotyle

- Introduction : Les fractures de cotyle sont définies comme une solution de la continuité du bassin touchant la région cotyloïdienne. Ces fractures menacent le pronostic fonctionnel de façon directe, et surtout le pronostic vital quand elles sont associées à d’autres lésions. - Matériel et méthode : Notre travail a été basé sur l’étude 66 patients ayant présenté une fracture du cotyle colligés au service d’orthopédie traumatologique du Centre Hospitalier Universitaire Ibn Sina de Rabat entre 2005 et 2010. - Résultats : On a révélé une prédominance masculine avec un âge moyen de 35,8 ans, la majorité des fractures étaient due a un accident de la voie publique 83,5% , une nette prédominance des fractures élémentaires avec 84,8% surtout la fracture de la paroi postérieure, le traitement orthopédique a été indiqué dans 75% des cas, contre 25% pour la chirurgie, dont la voie de Kocher langenback était la plus utilisée. - Discussion : Les résultats ont été comparé avec celles dans la littérature, et on a constaté que les deux résultats se concordent, sauf pour la série de LETOURNEL qui favorise plus le traitement chirurgical. L’évolution des fractures de cotyle on été marquée par des complications immédiates, alors que les complications tardives n’ont pas été objectivées soit due a l’amélioration de la prise en charge, ou que le nombre de patients et la durée de l’étude sont insuffisant. - Conclusion : D’après notre étude, les fractures de cotyles atteignent le sujet jeune masculin ayant subi un accident de la voie publique, le côté gauche est le plus atteint, une prédominance des lésions élémentaires traitement orthopédique est le plus utilisé

Acétate d'abiratérone (optimisation de la prise en charge des patients et anticipation du passage en ville de cette nouvelle hormonothérapie)

PARIS-BIUP (751062107) / SudocSudocFranceF

A Hybrid MCDM for the Location of Urban Distribution Centers under Uncertainty: A Case Study of Casablanca, Morocco

In this article, the main subject is the problem of the location of Urban Distribution Centers (UDC) in an environment characterized by uncertainty. Thus, a decision support process based on fuzzy multi-criteria methods (F-MCDM) will be proposed as the solution. The CATWOE method is used for identifying the Stakeholders (PPs) concerned by the localization. Furthermore, direct interviews and the review of the literature help to enhance the decision criteria. The use of the F-SWARA method made it possible to weight the criteria by taking into consideration the opinion of the PPs. The F-ENTROPY method corrected the subjectivity of the weights given by the first method. The hybridization of the two is a first in the literature in this field and allows precise and realistic results. In the end, the different alternatives obtained by the F-VIKOR method are ranked. This approach was applied to the city of Casablanca, which is extremely impacted by the negative externalities of urban freight transport. The results of this study showed that zone four (AIN SBAA) is the best zone to implement the UDC in the city of Casablanca. The sensitivity analysis validated the robustness of the model

A Hybrid MCDM for the Location of Urban Distribution Centers under Uncertainty: A Case Study of Casablanca, Morocco

In this article, the main subject is the problem of the location of Urban Distribution Centers (UDC) in an environment characterized by uncertainty. Thus, a decision support process based on fuzzy multi-criteria methods (F-MCDM) will be proposed as the solution. The CATWOE method is used for identifying the Stakeholders (PPs) concerned by the localization. Furthermore, direct interviews and the review of the literature help to enhance the decision criteria. The use of the F-SWARA method made it possible to weight the criteria by taking into consideration the opinion of the PPs. The F-ENTROPY method corrected the subjectivity of the weights given by the first method. The hybridization of the two is a first in the literature in this field and allows precise and realistic results. In the end, the different alternatives obtained by the F-VIKOR method are ranked. This approach was applied to the city of Casablanca, which is extremely impacted by the negative externalities of urban freight transport. The results of this study showed that zone four (AIN SBAA) is the best zone to implement the UDC in the city of Casablanca. The sensitivity analysis validated the robustness of the model

The impact of congestion on the cost of transport in urban areas: Application for the location of an urban distribution center

International audienc