Outcome after acute traumatic subdural haematoma in Kenya: a single-centre experience

Background Acute subdural haematoma (ASDH) is one of the most common traumatic neurosurgical emergencies with a high mortality rate. However, few studies have examined prognostic factors of outcome in isolated traumatic ASDH.Methods We reviewed the records of patients who were diagnosed with traumatic ASDH between January 2000 and December 2009. Analysis was carried out using Statistical Package for Social Sciences (SPSS) version 11.5 and multivariate logistic regression analysis used to evaluate the influence of clinical variables on outcome.Results A total of 259 patients were diagnosed with acute subdural hematomas during the study period. The mean age was 41.1 years + 19.659 and 223 (86.1%) were men while 36 (13.9%) were women. The most common cause of injury was assault (44.8%) with road traffic and falls accounting for 24.7% and 30.5%. Fifty two patients (20.1%) died while hospitalized while good functional recovery was attained by 118 (45.6%). Patients aged older than 61 years had a significantly higher mortality rate (30.6%) and a lower rate of good functional recovery (24.5%) (P=0.073). Of the patients with GCS scores <8, 38 (65.5%) died as compared to 4 (3.5%) deaths in patients with scores ranging from 13 to 15. Further, a history of loss of consciousness and the length of time between the injury and operative decompression significantly influenced the final outcome.Conclusion An increased risk of death occurs in patients who are over 61 years of age and have lower preoperative GCS, the presence of pupillary abnormalities and a long interval between trauma and decompression. The findings would help clinicians determine management criteria and improve survival

A year of genomic surveillance reveals how the SARS-CoV-2 pandemic unfolded in Africa.

The progression of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in Africa has so far been heterogeneous, and the full impact is not yet well understood. In this study, we describe the genomic epidemiology using a dataset of 8746 genomes from 33 African countries and two overseas territories. We show that the epidemics in most countries were initiated by importations predominantly from Europe, which diminished after the early introduction of international travel restrictions. As the pandemic progressed, ongoing transmission in many countries and increasing mobility led to the emergence and spread within the continent of many variants of concern and interest, such as B.1.351, B.1.525, A.23.1, and C.1.1. Although distorted by low sampling numbers and blind spots, the findings highlight that Africa must not be left behind in the global pandemic response, otherwise it could become a source for new variants

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance.

Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times and more-regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and illuminate the distinct dispersal dynamics of variants of concern-particularly Alpha, Beta, Delta, and Omicron-on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve while the continent faces many emerging and reemerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century