Retained sponge after abdominal surgery: experience from a third world country

Background: Retained abdominal sponge after surgery is a quite rare condition which can have heavy medico-legal consequences; its frequency is generally underestimated. Few reports of these conditions are available in African environment with specific technical and medico-legal background. We present our local experience of retained sponges after abdominal surgery and review current literature. Methods: A retrospective analysis of the medical files of 14 consecutive patients with a retained surgical sponge after abdominal and urological surgery. Results: The incidence was 1every 677 abdominal operations; no metallic foreign body described, only sponges; the female sex predominated with 10/14 patients. 85.71% of retained sponge occurred after an emergency procedure and 64.28% were gynecological or obstetrical procedures. Most cases presented as intestinal obstruction, localized persistent pain or abdominal mass and pre-operative diagnosis could be done only in 28.57% of cases. A falsely correct sponge count was reported in 71.42% of cases. 92.85% of patients were re-operated and the morbidity was low; no death was reported. None of our cases ended in a medico-legal claim despite proper counseling. Conclusion: The incidence of retained sponge might be significantly higher in an environment with reduced medico-legal threat; most cases of retained sponges are still related to human errors; the incidence will probably be reduced by a greater awareness about the condition

Discovery and Description of Ebola Zaire Virus in 1976 and Relevance to the West African Epidemic During 2013-2016.

BACKGROUND: In 1976, the first cases of Ebola virus disease in northern Democratic Republic of the Congo (then referred to as Zaire) were reported. This article addresses who was responsible for recognizing the disease; recovering, identifying, and naming the virus; and describing the epidemic. Key scientific approaches used in 1976 and their relevance to the 3-country (Guinea, Sierra Leone, and Liberia) West African epidemic during 2013-2016 are presented. METHODS: Field and laboratory investigations started soon after notification, in mid-September 1976, and included virus cell culture, electron microscopy (EM), immunofluorescence antibody (IFA) testing of sera, case tracing, containment, and epidemiological surveys. In 2013-2016, medical care and public health work were delayed for months until the Ebola virus disease epidemic was officially declared an emergency by World Health Organization, but research in pathogenesis, clinical presentation, including sequelae, treatment, and prevention, has increased more recently. RESULTS: Filoviruses were cultured and observed by EM in Antwerp, Belgium (Institute of Tropical Medicine); Porton Down, United Kingdom (Microbiological Research Establishment); and Atlanta, Georgia (Centers for Disease Control and Prevention). In Atlanta, serological testing identified a new virus. The 1976 outbreak (280 deaths among 318 cases) stopped in 2 years. Transmission indices (R0) are higher in all 3 countries than in 1976. CONCLUSIONS: An international commission working harmoniously in laboratories and with local communities was essential for rapid success in 1976. Control and understanding of the recent West African outbreak were delayed because of late recognition and because authorities were overwhelmed by many patients and poor community involvement. Despite obstacles, research was a priority in 1976 and recently

Artisanal fisheries catch highlights hotspot for threatened sharks and rays in the Republic of the Congo

This is the final version. Available on open access from Wiley via the DOI in this recordData availability statement: Data used for this study are ongoing and are currently forming part of a larger program to update and inform legislation and a national plan of action for sharks and rays and therefore are the property of the Congolese government.Global catch rates of sharks and rays from artisanal fisheries are underreported, leading to a lack of data on population status. This forms a major barrier to developing effective management plans, such is the case in Central and West Africa. Over 3 years, we undertook the first systematic quantitative assessment of sharks and rays landed by an artisanal fishery in the Republic of the Congo. During 507 sampling days (mean 14 surveys per month), we recorded 73,268 individuals. These comprised 42 species, of which 81% are considered at an elevated risk of extinction. Landings were dominated by immature individuals, especially for species of conservation concern. Presence of species thought to have largely disappeared from the region such as the African wedgefish (Rhynchobatus luebberti) and smoothback angelshark (Squatina oculata) suggest Congolese waters are a potential stronghold for these species—warranting increased protection. We identified seasonality of catch within years, but not across years. Both inter- and intra-annual trends varied by species, signifying annual fluctuations in catch of each species but consistent catch of all species year-on-year. Analysis showed increased catch between the short-wet and the long-wet, and the long-dry seasons (January–February and August–September). Lowest catch was shown to occur during the short-wet and the short-dry seasons (October–December), which may provide an opportunity for seasonal closures or gear restrictions.Darwin InitiativeWaterloo FoundationWaitt FoundationSave Our Seas Foundatio

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

From waste to resource: demystifying the policy challenges and identifying opportunities for a circular economy in Zambia

Policy plays a significant role in accelerating or hindering a circular shift; Governments can set long-term visions and drive legislative change to create an enabling environment. Reflecting the regional picture, Zambia is experiencing increasing waste burdens due to a growing population and economic development. The current management approach is linear, characterized by low collection rates, inadequate disposal, and limited waste revalorization. From a sustainable development perspective, how waste is managed impacts pressing issues such as climate change and public health. The concept of the Circular Economy (CE) has gained global and regional interest given its potential to transform how resources are viewed and managed. Circular strategies may help to reduce waste burdens and create local socioeconomic opportunities while safeguarding the environment. This qualitative study uses document review and expert interviews to explore the current waste management regime in Zambia and understand if and how circularity is embedded into the policy approach. The findings suggest that the CE is potentially highly relevant for Zambia, but there are various policy challenges that could impede its successful integration into the national agenda. These challenges relate to ownership and coordination; gaps in implementation and enforcement; a restrictive licensing approach; obstacles to innovation and new entrants; as well as the role of informal sector actors. The challenges point to opportunities to overturn these policy shortfalls, which also presents future research avenues