Impact of routine vaccination against Haemophilus influenzae type b in The Gambia: 20 years after its introduction

Background: In 1997, The Gambia introduced three primary doses of Haemophilus influenzae type b (Hib) conjugate vaccine without a booster in its infant immunisation programme along with establishment of a population-based surveillance on Hib meningitis in the West Coast Region (WCR). This surveillance was stopped in 2002 with reported elimination of Hib disease. This was re-established in 2008 but stopped again in 2010. We aimed to re-establish the surveillance in WCR and to continue surveillance in Basse Health and Demographic Surveillance System (BHDSS) in the east of the country to assess any shifts in the epidemiology of Hib disease in The Gambia. Methods: In WCR, population-based surveillance for Hib meningitis was re-established in children aged under-10 years from 24 December 2014 to 31 March 2017, using conventional microbiology and Real Time Polymerase Chain Reaction (RT-PCR). In BHDSS, population-based surveillance for Hib disease was conducted in children aged 2-59 months from 12 May 2008 to 31 December 2017 using conventional microbiology only. Hib carriage survey was carried out in pre-school and school children from July 2015 to November 2016. Results: In WCR, five Hib meningitis cases were detected using conventional microbiology while another 14 were detected by RT-PCR. Of the 19 cases, two (11%) were too young to be protected by vaccination while seven (37%) were unvaccinated. Using conventional microbiology, the incidence of Hib meningitis per 100 000-child-year (CY) in children aged 1-59 months was 0.7 in 2015 (95% confidence interval (CI) = 0.0-3.7) and 2.7 (95% CI = 0.7-7.0) in 2016. In BHDSS, 25 Hib cases were reported. Nine (36%) were too young to be protected by vaccination and five (20%) were under-vaccinated for age. Disease incidence peaked in 2012-2013 at 15 per 100 000 CY and fell to 5-8 per 100 000 CY over the subsequent four years. The prevalence of Hib carriage was 0.12% in WCR and 0.38% in BHDSS. Conclusions: After 20 years of using three primary doses of Hib vaccine without a booster Hib transmission continues in The Gambia, albeit at low rates. Improved coverage and timeliness of vaccination are of high priority for Hib disease in settings like Gambia, and there are currently no clear indications of a need for a booster dose

Setting a baseline for global urban virome surveillance in sewage

The rapid development of megacities, and their growing connectedness across the world is becoming a distinct driver for emerging disease outbreaks. Early detection of unusual disease emergence and spread should therefore include such cities as part of risk-based surveillance. A catch-all metagenomic sequencing approach of urban sewage could potentially provide an unbiased insight into the dynamics of viral pathogens circulating in a community irrespective of access to care, a potential which already has been proven for the surveillance of poliovirus. Here, we present a detailed characterization of sewage viromes from a snapshot of 81 high density urban areas across the globe, including in-depth assessment of potential biases, as a proof of concept for catch-all viral pathogen surveillance. We show the ability to detect a wide range of viruses and geographical and seasonal differences for specific viral groups. Our findings offer a cross-sectional baseline for further research in viral surveillance from urban sewage samples and place previous studies in a global perspective

Global monitoring of antimicrobial resistance based on metagenomics analyses of urban sewage

Antimicrobial resistance (AMR) is a serious threat to global public health, but obtaining representative data on AMR for healthy human populations is difficult. Here, we use meta-genomic analysis of untreated sewage to characterize the bacterial resistome from 79 sites in 60 countries. We find systematic differences in abundance and diversity of AMR genes between Europe/North-America/Oceania and Africa/Asia/South-America. Antimicrobial use data and bacterial taxonomy only explains a minor part of the AMR variation that we observe. We find no evidence for cross-selection between antimicrobial classes, or for effect of air travel between sites. However, AMR gene abundance strongly correlates with socio-economic, health and environmental factors, which we use to predict AMR gene abundances in all countries in the world. Our findings suggest that global AMR gene diversity and abundance vary by region, and that improving sanitation and health could potentially limit the global burden of AMR. We propose metagenomic analysis of sewage as an ethically acceptable and economically feasible approach for continuous global surveillance and prediction of AMR.Peer reviewe

Setting a baseline for global urban virome surveillance in sewage

The rapid development of megacities, and their growing connectedness across the world is becoming a distinct driver for emerging disease outbreaks. Early detection of unusual disease emergence and spread should therefore include such cities as part of risk-based surveillance. A catch-all metagenomic sequencing approach of urban sewage could potentially provide an unbiased insight into the dynamics of viral pathogens circulating in a community irrespective of access to care, a potential which already has been proven for the surveillance of poliovirus. Here, we present a detailed characterization of sewage viromes from a snapshot of 81 high density urban areas across the globe, including in-depth assessment of potential biases, as a proof of concept for catch-all viral pathogen surveillance. We show the ability to detect a wide range of viruses and geographical and seasonal differences for specific viral groups. Our findings offer a cross-sectional baseline for further research in viral surveillance from urban sewage samples and place previous studies in a global perspective

O impacto da pandemia de Covid-19 no setor da pesca artesanal e nas comunidades pesqueiras costeiras da Gâmbia

The Objective of the article is to comprehend the impact of the Covid-19 pandemic on the artisanal fishery sector, and Coastal fishing communities in The Gambia. We carry out qualitative research with a structural questionnaire in which we interviewed selected fish men in the coastal area in the Gambia. The study used a simple random sampling technique, in which from the target population of 6000 people, we selected 384 people randomly as our sample size using the “Yaro Yamane Statistical Formula". The statistical methods used in this study are descriptive statistics, correlation, and Ordinary Least Square (OLS) Method for the analysis. There is a weak negative correlation between the revenue generated from fishing and the management level (correlation coefficient of -0.3561). Despite the covid-19 pandemic, there exists a strong positive correlation between demand for the fish product in the domestic market and revenue generated from fishing (correlation coefficient of 0.7843). Therefore, policymakers should look at the management of fishing to improve it and try to establish a good local market for fishermen to sell their fish products.El objetivo del artículo es comprender el impacto de la pandemia de Covid-19 en el sector de la pesca artesanal y las comunidades pesqueras costeras de Gambia. Se realizó una investigación cualitativa con un cuestionario estructural en el que se entrevistó a hombres de la pesca seleccionados en la zona costera de Gambia. El estudio utilizó una técnica de muestreo aleatorio simple, en la que, de la población objetivo de 6000 personas, seleccionamos 384 personas al azar como tamaño de nuestra muestra utilizando la "Fórmula estadística de Yaro Yamane". Los métodos estadísticos utilizados en este estudio son la estadística descriptiva, la correlación y el método de mínimos cuadrados ordinarios (MCO) para el análisis. Existe una débil correlación negativa entre los ingresos generados por la pesca y el nivel de gestión (coeficiente de correlación de -0,3561). A pesar de la pandemia de covid-19, existe una fuerte correlación positiva entre la demanda del producto pesquero en el mercado nacional y los ingresos generados por la pesca (coeficiente de correlación de 0,7843). Por lo tanto, los responsables políticos deberían estudiar la gestión de la pesca para mejorarla e intentar establecer un buen mercado local para que los pescadores vendan sus productos pesqueros.  O objetivo do artigo é compreender o impacto da pandemia de Covid-19 no setor da pesca artesanal e nas comunidades de pesca costeira na Gâmbia. Realizamos pesquisas qualitativas com um questionário estrutural no qual entrevistamos alguns pescadores selecionados na região costeira da Gâmbia. O estudo utilizou uma técnica simples de amostragem aleatória, na qual, da população alvo de 6000 pessoas, selecionamos aleatoriamente 384 pessoas como nosso tamanho de amostra utilizando a "Fórmula Estatística Yaro Yamane". Os métodos estatísticos utilizados neste estudo são estatística descritiva, correlação e Método do Mínimo Quadrado Ordinário (OLS) para a análise. Existe uma fraca correlação negativa entre a receita gerada pela pesca e o nível de gestão (coeficiente de correlação de -0,3561). Apesar da pandemia de covid-19, existe uma forte correlação positiva entre a demanda do produto da pesca no mercado doméstico e a receita gerada pela pesca (coeficiente de correlação de 0,7843). Portanto, os formuladores de políticas devem analisar a gestão da pesca para melhorá-la e tentar estabelecer um bom mercado local para que os pescadores vendam seus produtos pesqueiros

Polyfunctional CD4(+) and CD8(+) T cell responses to tuberculosis antigens in HIV-1-infected patients before and after anti-retroviral treatment.

Tuberculosis (TB) kills 2 million people per year and infection with HIV is the most potent known risk factor for progression to active TB. An understanding of the immune response to TB Ags in HIV-infected patients is required to develop optimal TB vaccines and diagnostics. We assessed polyfunctional (IFN-gamma(+)IL-2(+)TNF-alpha(+)) T cell responses to TB Ags in three groups of HIV-1-infected patients dependent on their TB status, CD4 counts, and anti-retroviral exposure. We found that although the proportion of IFN-gamma cells in response to TB Ags was higher in patients with low CD4 counts, the responding cells changed from a polyfunctional CD4(+) to a monofunctional CD8(+) response. The overall polyfunctionality of the cells was restored by 12 mo of anti-retroviral therapy and primarily involved CD4(+) T cells with an effector memory phenotype. These findings have major implications for diagnosis of TB and in vaccine development strategies for TB in HIV-1-infected patients

Equine trypanosomosis in the Central River Division of the Gambia: A study of veterinary gate-clinic consultation records

The objective of this,study was to provide epidemiological information of equine trypanosomosis in the Central River Division (CRD) of The Gambia. Therefore, 2285 consultations records of equines, admitted in a gate-clinic at Sololo in CRD, were studied retrospectively. The data were recorded in the period between September 1995 and July 2002 and comprised consultations of 2113 horses and 172 donkeys. 'Trypanosome infection' was the most frequently diagnosed condition and accounted for 61% of the cases. Horses were more frequently diagnosed with trypanosome infections than donkeys (p 1 year) were observed with trypanosome infections than young horses (54.5% <1 year; p = 0.033). The number of donkeys and horses with trypanosome infections decreased during the rainy season (June-September). The majority of equines that were admitted with trypanosome infections were severely anaemic. The average packed cell volume (PCV) declined with increasing parasitaemia (p = 0.006). Seventy-four percent of the farmers' predictions of trypanosome infections in their equines were confirmed by darkground-microscopy. That proved that farmers had a fairly accurate knowledge of the diseases affecting their equines. The treatments executed at the gate-clinic were generally effective. The few (0.4%) relapses of the T vivax infections that were previously treated with diminazene aceturate in this study were not sufficient to prove drug resistance. The study showed that the analysis of consultation records at a gate-clinic can provide complementary information to conventional epidemiological studies in the same research area