Response to the Novel Corona Virus (COVID-19) Pandemic Across Africa: Successes, Challenges, and Implications for the Future

Background: The COVID-19 pandemic has already claimed considerable lives. There are major concerns in Africa due to existing high prevalence rates for both infectious and non-infectious diseases and limited resources in terms of personnel, beds and equipment. Alongside this, concerns that lockdown and other measures will have on prevention and management of other infectious diseases and non-communicable diseases (NCDs). NCDs are an increasing issue with rising morbidity and mortality rates. The World Health Organization (WHO) warns that a lack of nets and treatment could result in up to 18 million additional cases of malaria and up to 30,000 additional deaths in sub-Saharan Africa. Objective: Document current prevalence and mortality rates from COVID-19 alongside economic and other measures to reduce its spread and impact across Africa. In addition, suggested ways forward among all key stakeholder groups. Our Approach: Contextualise the findings from a wide range of publications including internet-based publications coupled with input from senior-level personnel. Ongoing Activities: Prevalence and mortality rates are currently lower in Africa than among several Western countries and the USA. This could be due to a number of factors including early instigation of lockdown and border closures, the younger age of the population, lack of robust reporting systems and as yet unidentified genetic and other factors. Innovation is accelerating to address concerns with available equipment. There are ongoing steps to address the level of misinformation and its consequences including fines. There are also ongoing initiatives across Africa to start addressing the unintended consequences of COVID-19 activities including lockdown measures and their impact on NCDs including the likely rise in mental health disorders, exacerbated by increasing stigma associated with COVID-19. Strategies include extending prescription lengths, telemedicine and encouraging vaccination. However, these need to be accelerated to prevent increased morbidity and mortality. Conclusion: There are multiple activities across Africa to reduce the spread of COVID-19 and address misinformation, which can have catastrophic consequences, assisted by the WHO and others, which appear to be working in a number of countries. Research is ongoing to clarify the unintended consequences given ongoing concerns to guide future activities. Countries are learning from each other

The role of sialoadhesin in the pathogenesis of autoimmune eye inflammation

This thesis aimed to determine whether Sn expression did not occur on cells other than macrophages and how Sn expression influenced T cell responses responsible for autoimmunity using the EAU mouse model of human ocular inflammation, uveitis.  Sn’s effects were studied on the C57BL/6 genetic background using mice of Sn+/+ and Sn-/- genotype.  Mice confirmed to have Sn+/+ and Sn-/- genotype and phenotype were immunised with IRBP-20 peptide in adjuvant to induce EAU.  The effects of Sn deletion on EAU were analysed by studying subsequent Thl immune responses and their effects on EAU disease progression. Flow cytometry analysis of the draining lymph nodes (dLN) and spleens of naïve mice identified Sn-expressing cells with phenotype consistent with conventional dendritic cells (DCs) of myeloid and lymphoid types.  These cells expressed DEC205+CD8αα-and DEC205+CD8αα+ phenotype, respectively.  CD8αα+ cells were considered to be of lymphoid type rather than plasmacytoid because they expressed CD8αα+ at levels similar to T cells and high levels of DEC205 which are typical feature of lymphoid DCs.  DEC205+CD8αα- cells were considered to be myeloid-derived because of their expression of macrophage-like phenotype and DEC205.  DEC205+CD8αα- cells maintained high levels of Sn expression when purified.  They could be propagated in vitro using conditions typical for CD14-derived DCs to yield Sn-expressing cells with allogeneic leukocyte stimulatory capacity that was higher than macrophages which was consistent DCs of this type.  The basal levels of Sn on the two DCs subtypes in naive mice were upregulated in response to immunisation.  Sn upregulation strongly correlated with elevated levels of MHC II and B7.2 expression on the CD11c+DEC205+CD8αα- and CD11c+DEC205+CD8αα+ cells.  These changes coincided with the highest level of T cell proliferative responses in immunised Sn+/+ and Sn-/- mice that occurred 6 days post-immunisation.  Supporting the existence of Sn-expressing DCs was the presence of a small subset of Sn+ cells with DC morphology that co-expressed MHC II and CD11c in EAU inflammatory lesions.  However, these Sn+MHC II+ cells comprised a very minor proportion of the total MHC II+ cells in the diseased eye.  Thus in addition to macrophages, Sn is also expressed on CD11c+DEC205+ conventional DCs of myeloid (CD11b+CD8αα-) and lymphoid (CD11b-CD8αα+) type in the dLN, the spleen and the eye and its expression increases following immunisation.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Response to the novel corona virus (COVID-19) pandemic across Africa : successes, challenges, and implication for the future

BACKGROUND: The COVID-19 pandemic has already claimed considerable lives. There are major concerns in Africa due to existing high prevalence rates for both infectious and non-infectious diseases and limited resources in terms of personnel, beds and equipment. Alongside this, concerns that lockdown and other measures will have on prevention and management of other infectious diseases and non-communicable diseases (NCDs). NCDs are an increasing issue with rising morbidity and mortality rates. The World Health Organization (WHO) warns that a lack of nets and treatment could result in up to 18 million additional cases of malaria and up to 30,000 additional deaths in sub-Saharan Africa. OBJECTIVE: Document current prevalence and mortality rates from COVID-19 alongside economic and other measures to reduce its spread and impact across Africa. In addition, suggested ways forward among all key stakeholder groups. OUR APPROACH: Contextualise the findings from a wide range of publications including internet-based publications coupled with input from senior-level personnel. ONGOING ACTIVITIES: Prevalence and mortality rates are currently lower in Africa than among several Western countries and the USA. This could be due to a number of factors including early instigation of lockdown and border closures, the younger age of the population, lack of robust reporting systems and as yet unidentified genetic and other factors. Innovation is accelerating to address concerns with available equipment. There are ongoing steps to address the level of misinformation and its consequences including fines. There are also ongoing initiatives across Africa to start addressing the unintended consequences of COVID-19 activities including lockdown measures and their impact on NCDs including the likely rise in mental health disorders, exacerbated by increasing stigma associated with COVID-19. Strategies include extending prescription lengths, telemedicine and encouraging vaccination. However, these need to be accelerated to prevent increased morbidity and mortality. CONCLUSION: There are multiple activities across Africa to reduce the spread of COVID-19 and address misinformation, which can have catastrophic consequences, assisted by the WHO and others, which appear to be working in a number of countries. Research is ongoing to clarify the unintended consequences given ongoing concerns to guide future activities. Countries are learning from each other.http://frontiersin.org/Pharmacologypm2021Family MedicineSchool of Health Systems and Public Health (SHSPH