An open dataset of Plasmodium falciparum genome variation in 7,000 worldwide samples.

MalariaGEN is a data-sharing network that enables groups around the world to work together on the genomic epidemiology of malaria. Here we describe a new release of curated genome variation data on 7,000 Plasmodium falciparum samples from MalariaGEN partner studies in 28 malaria-endemic countries. High-quality genotype calls on 3 million single nucleotide polymorphisms (SNPs) and short indels were produced using a standardised analysis pipeline. Copy number variants associated with drug resistance and structural variants that cause failure of rapid diagnostic tests were also analysed.  Almost all samples showed genetic evidence of resistance to at least one antimalarial drug, and some samples from Southeast Asia carried markers of resistance to six commonly-used drugs. Genes expressed during the mosquito stage of the parasite life-cycle are prominent among loci that show strong geographic differentiation. By continuing to enlarge this open data resource we aim to facilitate research into the evolutionary processes affecting malaria control and to accelerate development of the surveillance toolkit required for malaria elimination

Pf7: an open dataset of Plasmodium falciparum genome variation in 20,000 worldwide samples

We describe the MalariaGEN Pf7 data resource, the seventh release of Plasmodium falciparum genome variation data from the MalariaGEN network.  It comprises over 20,000 samples from 82 partner studies in 33 countries, including several malaria endemic regions that were previously underrepresented.  For the first time we include dried blood spot samples that were sequenced after selective whole genome amplification, necessitating new methods to genotype copy number variations.  We identify a large number of newly emerging crt mutations in parts of Southeast Asia, and show examples of heterogeneities in patterns of drug resistance within Africa and within the Indian subcontinent.  We describe the profile of variations in the C-terminal of the csp gene and relate this to the sequence used in the RTS,S and R21 malaria vaccines.  Pf7 provides high-quality data on genotype calls for 6 million SNPs and short indels, analysis of large deletions that cause failure of rapid diagnostic tests, and systematic characterisation of six major drug resistance loci, all of which can be freely downloaded from the MalariaGEN website

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

Short- and Medium-Term Breastfeeding Effects on Women´s Postpartum Health

To asses the short- and medium-term breastfeeding effects on women´s postpartum health a prospective cohort study was performed with a base-line questionnaire at 1-5 days post partum and a follow-up questionnaire at 5-6 months pp. The sample consisted of two groups: the formula-feeding group (n = 15) and the breastfeeding group (n = 69). 1-5 days after delivery painful perineum (44.2%), backache (24.4%) and sore nipples (23.3%) were the most common complaints in the total sample whereas 5-6 months after delivery tiredness/ exhaustion (49.4%), haemorrhoids (27.7%) and painful perineum (24.1%) were on top of the list of complaints. During the first five days after delivery 28.6% of the whole breastfeeding group had sore nipples, at month 5-6 this proportion had raised to 34.8%. A large proportion (20.3%) of the breastfeeding group developed mastitis in the five months after delivery. Increase of complaints within the first 5-6 months after delivery tended to be higher in the breastfeeding group. Women who continued breastfeeding and introduced complementary foods within 5-6 months tended to have a worse subjective health status than the formula group and the group of exclusively breastfeeding mothers. In the Formula group the SOC-Score declined from 52.7 to 48.7. In the breastfeeding group the SOC-Score increased from 50.9 to 51.6. Besides wide spread health problems like exhaustion, haemorrhoids, painful perineum and backache, many breastfeeding women additionally have to deal with sore nipples and mastitis. On the other hand there is evidence that women can profit from breastfeeding in the sense of mastering a challenge, which is expressed in a higher SOC-Score comparing to formula feeding women

Good Practice in Health Reporting – guidelines and recommendations

Health reporting provides descriptions of the health of a population, analyses problems and demonstrates areas in which action needs to be taken in health care, health promotion and disease prevention. As such, it provides a rational basis for participatory processes and a foundation for health policy decision-making. Good Practice in Health Reporting was developed by a working group that includes representatives from all levels of health reporting with the aim of strengthening the field at the local, federal-state and national level. The document sets out guidelines and recommendations that are intended to provide professional guidance for the creation of health reports. It makes 11 recommendations that address the ethical principles behind health reporting, the necessary framework, the selection of topics (the report’s focus), the foundation of the work undertaken (data quality), data preparation, analysis, interpretation and protection, as well as communications and quality assurance. The pilot version of the document was presented at the conferences of the German Society for Epidemiology (DGEpi), the German Society for Social Medicine and Prevention (DGSMP) and the Federal Association of Physicians of German Public Health Departments (BVÖGD) where it was discussed and subsequently revised. After further review, the guidelines were adopted by all of these institutions. Finally, Good Practice in Health Reporting is to be strengthened and developed further as part of a comprehensive review

Good Practice in Health reporting – guidelines and recommendations

Health reporting provides a description of the health of the population, analyses problems and demonstrates areas in which action needs to be taken in health care provision, health promotion and disease prevention. Accordingly, it offers a rational basis for participatory processes and health policy decision-making. This edition of Good Practice in Health Reporting resulted from a revision of the first edition, which was first published in March 2017. It incorporates contributions from experts, and various institutions and associations from the German federal-state and national levels. This revised edition rose out of the need for continual development in health reporting. In some cases, a number of changes were made so that certain aspects could be defined more clearly; in other cases, changes were made to methodology, for example, in order to accommodate participatory and qualitative approaches. This publication is aimed at providing people working in health reporting with professional direction and guidance. We welcome your feedback.Peer Reviewe

Determinants of dietary patterns and diet quality during pregnancy: a systematic review with narrative synthesis

Doyle I-M, Borrmann B, Grosser A, Razum O, Spallek J. Determinants of dietary patterns and diet quality during pregnancy: a systematic review with narrative synthesis. PUBLIC HEALTH NUTRITION. 2017;20(6):1009-1028.Objective: To identify determinants of diet in pregnancy, by detecting factors in our multiple-determinants life course framework that are associated with dietary patterns, quality or guideline adherence. Design: A systematic review of observational studies, published in English or German, was conducted. Sociodemographic, lifestyle, environmental and pregnancy-related determinants were considered. Four electronic databases were searched in January 2015 and updated in April 2016 and a total of 4368 articles identified. Risk of bias was assessed using adapted Newcastle-Ottawa Scales. Setting: High- and upper-middle-income countries. Subjects: Pregnant or postpartum women reporting their dietary intake during pregnancy. Results: Seventeen publications of twelve studies were included and compared narratively due to heterogeneity. Diet in pregnancy was patterned along a social gradient and aligned with other health behaviours before and during pregnancy. Few studies investigated the influence of the social and built environment and their findings were inconsistent. Except for parity, pregnancy determinants were rarely assessed even though pregnancy is a physiologically and psychologically unique period. Various less well-researched factors such as the role of ethnicity, pregnancy intendedness, pregnancy ailments and macro-level environment were identified that need to be studied in more detail. Conclusions: The framework was supported by the literature identified, but more research of sound methodology is needed in order to conclusively disentangle the interplay of the different determinants. Practitioners should be aware that pregnant women who are young, have a low education or do not follow general health advice appear to be at higher risk of inadequate dietary intake

Gute Praxis Gesundheitsberichterstattung – Leitlinien und Empfehlungen

Gesundheitsberichterstattung beschreibt die gesundheitliche Lage der Bevölkerung, analysiert Problemlagen und zeigt Handlungsbedarfe für die Gesundheitsversorgung, Gesundheitsförderung und Prävention auf. Sie bietet damit eine rationale Grundlage für partizipative Prozesse und gesundheitspolitische Entscheidungen. Um die Gesundheitsberichterstattungspraxis auf kommunaler sowie auf Landes- und Bundesebene zu unterstützen wurde von einer Arbeitsgruppe mit Vertreterinnen und Vertretern aller Ebenen der Gesundheitsberichterstattung die Gute Praxis Gesundheitsberichterstattung entwickelt. Sie bietet anhand von Leitlinien und Empfehlungen eine fachliche Orientierung für das Erstellen von Gesundheitsberichten. Die 11 Leitlinien thematisieren ethische Prinzipien der Gesundheitsberichterstattung, erforderliche Rahmenbedingungen, Themenauswahl (Berichtsgegenstand), Arbeitsgrundlagen (Datenqualität), Datenaufbereitung, -auswertung und -interpretation, Datenschutz, Kommunikation und Qualitätssicherung. Die Pilotversion wurde auf Fachtagungen der Deutschen Gesellschaft für Epidemiologie (DGEpi), der Deutschen Gesellschaft für Sozialmedizin und Prävention (DGSMP) und des Bundesverbands der Ärztinnen und Ärzte des öffentlichen Gesundheitsdienstes e. V. (BVÖGD) diskutiert und anschließend überarbeitet. Nach einem weiteren Begutachtungs- und Überarbeitungsprozess wurden die Leitlinien von allen genannten Fachgesellschaften verabschiedet. Es ist geplant, die Gute Praxis Gesundheitsberichterstattung einem erweiterten Stellungnahme-Verfahren zu unterziehen und weiterzuentwickeln

Gute Praxis Gesundheitsberichterstattung – Leitlinien und Empfehlungen

Gesundheitsberichterstattung beschreibt die gesundheitliche Lage der Bevölkerung, analysiert Problemlagen und zeigt Handlungsbedarfe für die Gesundheitsversorgung, Gesundheitsförderung und Prävention auf. Sie bietet damit eine rationale Grundlage für partizipative Prozesse und gesundheitspolitische Entscheidungen. Die Gute Praxis Gesundheitsberichterstattung in der Version 2.0 ist das Ergebnis einer Überarbeitung der Vorgängerversion (Stand März 2017), in die Stellungnahmen von einzelnen Expertinnen und Experten sowie verschiedener Institutionen und Verbände auf Landes- und Bundesebene eingeflossen sind. Im Hinblick auf die stetige Weiterentwicklung der Gesundheitsberichterstattung, zum Beispiel in methodischer Hinsicht mit Blick auf partizipative und qualitative Ansätze, wurden Ergänzungen und Konkretisierungen vorgenommen. Das Ziel ist es, Gesundheitsberichterstatterinnen und Gesundheitsberichterstattern eine fachliche Orientierung und Handlungshilfe für die Gesundheitsberichterstattung zu bieten. Rückmeldungen sind weiterhin willkommen.Peer Reviewe