Clostridium difficile infection.

Infection of the colon with the Gram-positive bacterium Clostridium difficile is potentially life threatening, especially in elderly people and in patients who have dysbiosis of the gut microbiota following antimicrobial drug exposure. C. difficile is the leading cause of health-care-associated infective diarrhoea. The life cycle of C. difficile is influenced by antimicrobial agents, the host immune system, and the host microbiota and its associated metabolites. The primary mediators of inflammation in C. difficile infection (CDI) are large clostridial toxins, toxin A (TcdA) and toxin B (TcdB), and, in some bacterial strains, the binary toxin CDT. The toxins trigger a complex cascade of host cellular responses to cause diarrhoea, inflammation and tissue necrosis - the major symptoms of CDI. The factors responsible for the epidemic of some C. difficile strains are poorly understood. Recurrent infections are common and can be debilitating. Toxin detection for diagnosis is important for accurate epidemiological study, and for optimal management and prevention strategies. Infections are commonly treated with specific antimicrobial agents, but faecal microbiota transplants have shown promise for recurrent infections. Future biotherapies for C. difficile infections are likely to involve defined combinations of key gut microbiota

Population-based assessment of the burden of COVID-19 infection in African countries: a first-year report card and public health implications

Background: The COVID-19 pandemic constitutes a global health threat and poses a major burden on the African continent. We assessed the real-world burden of COVID-19 infection in African Union (AU) member states to determine the distributional patterns of epidemiological measures during the first 1 year of the pandemic. Methods: This retrospective cross-sectional study utilized COVID-19 data from publicly available data repositories of the African Center for Disease Control and Prevention and Our World in Data for the period February 2020 to January 2021. AU member states were classified into low, medium, and high burdens based on COVID-19 morbidity. We conducted descriptive and inferential analyses of COVID-19-reported cases, deaths, recoveries, active cases, COVID-19 tests, and epidemiological measures that included morbidity and mortality rates, case fatality rate (CFR), and case ratios. Results: A total of 3.21 million cases were reported during the 1-year period, with 2.6 million recoveries, 536,784 cases remaining active, and 77,486 deaths. Most countries (49.1%, n  = 26) in AU experienced a low burden of COVID-19 infection compared to 28.3% ( n  = 15) with medium burden and 22.6% ( n  = 12) with high burden. AU nations with a high burden of the disease were mainly in the northern and southern regions. South Africa recorded the highest number of cases (1.31 million), followed by Morocco with 457,625 and Tunisia with 175,065 cases. Correspondently, death tolls for these countries were 36,467, 7888, and 5528 deaths, respectively. Of the total COVID-19 tests performed (83.8 million) during the first 1 year, 62.43% were from high-burden countries. The least testing occurred in the medium-burden (18.42%) countries. The overall CFR of AU was 2.21%. A morbidity rate of 327.52/10 5 population and mortality rate of 5.96/10 5 population were recorded during the first 1-year period with significant variations ( p  < 0.0001) across burden levels. Continental morbidity and mortality rates of 17,359/10 5 and 315.933/10 5 populations were recorded with significant correlation ( r  = 0.863, p  < 0.0001) between them and variations across selected epidemiological measures by COVID-19 burden levels. Conclusion: Understanding the true burden of the disease in AU countries is important for establishing the impact of the pandemic in the African continent and for intervention planning, preparedness, and deployment of resources during COVID-19 surges and future pandemics

sj-docx-1-tai-10.1177_20499361231202116 – Supplemental material for Population-based assessment of the burden of COVID-19 infection in African countries: a first-year report card and public health implications

Supplemental material, sj-docx-1-tai-10.1177_20499361231202116 for Population-based assessment of the burden of COVID-19 infection in African countries: a first-year report card and public health implications by Osaro Mgbere, Ogbonna Collins Nwabuko, Olajumoke A. Olateju, Omolola E. Adepoju, Winston Liaw, Charles Darkoh and Ekere James Essien in Therapeutic Advances in Infectious Disease</p

Special Report on the State of HIV/AIDS in South Africa

It is axiomatic that the global fight against HIV/AIDS cannot be won without a decisive victory in South Africa, home to 20 percent of all people living with HIV/AIDS. So how is South Africa doing? And what is the likelihood it will meet the demand for essential prevention and treatment interventions by 2015? On Jan. 21 in Cape Town, Council on Foreign Relations Global Health Fellow Dr. Peter Navario convened a meeting of South Africa's foremost HIV/AIDS thinkers, policy-makers and practitioners to discuss the state of prevention and treatment at the epicenter of the pandemic. In this article, the experts weigh in on program gaps, the major challenges to achieving universal coverage of essential prevention and treatment interventions, and what it will take to surmount these challenges

Special Report on the State of HIV/AIDS in South Africa

It is axiomatic that the global fight against HIV/AIDS cannot be won without a decisive victory in South Africa, home to 20 percent of all people living with HIV/AIDS. So how is South Africa doing? And what is the likelihood it will meet the demand for essential prevention and treatment interventions by 2015? On Jan. 21 in Cape Town, Council on Foreign Relations Global Health Fellow Dr. Peter Navario convened a meeting of South Africa's foremost HIV/AIDS thinkers, policy-makers and practitioners to discuss the state of prevention and treatment at the epicenter of the pandemic. In this article, the experts weigh in on program gaps, the major challenges to achieving universal coverage of essential prevention and treatment interventions, and what it will take to surmount these challenges