Epidemiology of burns at the University Teaching Hospital of Kigali, Rwanda

Introduction: Burns are the fourth most common type of injury presenting to the emergency department in Rwanda. However, there is little data on the epidemiology of burn patients, which is needed to inform public health measures for burn prevention. This study aimed to describe the characteristics and outcomes of burn patients presenting to the Emergency of the University Teaching Hospital Kigali.Methods: This single-center prospective study evaluated patients with burn injuries presenting at CHUK emergency between 1 June and 31 December 2019. Data on demographics, burn characteristics, burn management, disposition and patient outcomes were collected, stored in Excel and analyzed descriptively using SPSS 24. Results: Of the 96 patients enrolled; (58.3%) were male. The median age was 32.7 years. Most patients were pediatric (70.9%), with one to five-year-olds being the most affected age group. Scalding was the most common cause of burn at (71.9%). Most burns were accidental (95.8%) and superficial dermal in degree (72.9%). The mean time between injury and presentation was 18.1 hours. There were 12 mortalities (12.5%) within the 30 days post-injury, with scald injuries as the most frequent cause of mortality. Higher mortality was significantly associated with increased body surface area affected (p = 0.001).Conclusion: Children between the ages of one and five years are the most affected by burns and scalding is the most common burn etiology. Public health measures should aim to prevent burn injuries in the pediatric population. This study was approved by the University of Rwanda /CMHS Institutional Review Board (IRB) No 136/CMHS IRB/ 2019

Low-frequency solar radio type II bursts and their association with space weather events during the ascending phase of solar cycle 25

Type II solar radio bursts are signatures of the coronal shocks and, therefore, particle acceleration events in the solar atmosphere and interplanetary space. Type II bursts can serve as a proxy to provide early warnings of incoming solar storm disturbances, such as geomagnetic storms and radiation storms, which may further lead to ionospheric effects. In this article, we report the first observation of 32 type II bursts by measuring various plasma parameters that occurred between May 2021 and December 2022 in solar cycle 25. We further evaluated their accompanying space weather events in terms of ionospheric total electron content (TEC) enhancement using the rate of TEC index (ROTI). In this study, we find that at heliocentric distance ∼1–2 R⊙, the shock and the Alfvén speeds are in the range 504–1282 and 368–826 km−1, respectively. The Alfvén Mach number is of the order of 1.2≤MA≤1.8 at the above-mentioned heliocentric distance. In addition, the measured magnetic field strength is consistent with the earlier reports and follows a single power law B(r)=6.07r-3.96G. Based on the current analysis, it is found that 19 out of 32 type II bursts are associated with immediate space weather events in terms of radio blackouts and polar cap absorption events, making them strong indications of space weather disruption. The ROTI enhancements, which indicate ionospheric irregularities, strongly correlate with GOES X-ray flares, which are associated with the type II radio bursts recorded. The diurnal variability in ROTI is proportional to the strength of the associated flare class, and the corresponding longitudinal variation is attributed to the difference in longitude. This article demonstrates that since type II bursts are connected to space weather hazards, understanding various physical parameters of type II bursts helps to predict and forecast the space weather.</p

Epidemiology of burns at the University Teaching Hospital of Kigali, Rwanda

Introduction: Burns are the fourth most common type of injury presenting to the emergency department in Rwanda. However, there is little data on the epidemiology of burn patients, which is needed to inform public health measures for burn prevention. This study aimed to describe the characteristics and outcomes of burn patients presenting to the Emergency of the University Teaching Hospital Kigali. Methods: This single-center prospective study evaluated patients with burn injuries presenting at CHUK emergency between 1 June and 31 December 2019. Data on demographics, burn characteristics, burn management, disposition and patient outcomes were collected, stored in Excel and analyzed descriptively using SPSS 24. Results: Of the 96 patients enrolled; (58.3%) were male. The median age was 32.7 years. Most patients were pediatric (70.9%), with one to five-year-olds being the most affected age group. Scalding was the most common cause of burn at (71.9%). Most burns were accidental (95.8%) and superficial dermal in degree (72.9%). The mean time between injury and presentation was 18.1 hours. There were 12 mortalities (12.5%) within the 30 days post-injury, with scald injuries as the most frequent cause of mortality. Higher mortality was significantly associated with increased body surface area affected (p = 0.001). Conclusion: Children between the ages of one and five years are the most affected by burns and scalding is the most common burn etiology. Public health measures should aim to prevent burn injuries in the pediatric population. This study was approved by the University of Rwanda /CMHS Institutional Review Board (IRB) No 136/CMHS IRB/ 2019

Ecological drivers of helminth infection patterns in the Virunga Massif mountain gorilla population

The Virunga Massif mountain gorilla population has been periodically monitored since the early 1970s, with gradually increasing effort. The population declined drastically in the 1970s, but the numbers stabilized in the 1980s. Since then, the population has been steadily increasing within their limited habitat fragment that is surrounded by a dense human population. We examined fecal samples collected during the Virunga 2015–2016 surveys in monitored and unmonitored gorilla groups and quantified strongylid and tapeworm infections using egg counts per gram to determine environmental and host factors that shape these helminth infections. We showed that higher strongylid infections were present in gorilla groups with smaller size of the 500-m buffered minimum-convex polygon (MCP) of detected nest sites per gorilla group, but in higher gorilla densities and inhabiting vegetation types occurring at higher elevations with higher precipitation and lower temperatures. On the contrary, the impact of monitoring (habituation) was minor, detected in tapeworms and only when in the interaction with environmental variables and MCP area. Our results suggest that the Virunga mountain gorilla population may be partially regulated by strongylid nematodes at higher gorilla densities. New health challenges are probably emerging among mountain gorillas because of the success of conservation efforts, as manifested by significant increases in gorilla numbers in recent decades, but few possibilities for the population expansion due to limited amounts of habitat

Seasonal influence of tuberculosis diagnosis in Rwanda

Background Tuberculosis (TB) remains a major global health concern. Previous research reveals that TB may have a seasonal peak during the spring and summer seasons in temperate climates; however, few studies have been conducted in tropical climates. This study evaluates the influence of seasonality on laboratory-confirmed TB diagnosis in Rwanda, a tropical country with two rainy and two dry seasons. Methods A retrospective chart review was performed at the University Teaching Hospital-Kigali (CHUK). From January 2016 to December 2017, 2717 CHUK patients with TB laboratory data were included. Data abstracted included patient demographics, season, HIV status, and TB laboratory results (microscopy, GeneXpert, culture). Univariate and multivariable logistic regression (adjusted for age, gender, and HIV status) analyses were performed to assess the association between season and laboratory-confirmed TB diagnoses. Results Patients presenting during rainy season periods had a lower odds of laboratory-confirmed TB diagnosis compared to the dry season (aOR=0.78, 95% CI 0.63–0.97, p=0.026) when controlling for age group, gender, and HIV status. Males, adults, and people living with HIV were more likely to have laboratory-confirmed TB diagnosis. On average, more people were tested for TB during the rainy season per month compared to the dry season (120.3 vs. 103.3), although this difference was not statistically significant. Conclusion In Rwanda, laboratory-confirmed TB case detection shows a seasonal variation with patients having higher odds of TB diagnosis occurring in the dry season. Further research is required to further elucidate this relationship and to delineate the mechanism of season influence on TB diagnosis

The Functions of Mediator in Candida albicans Support a Role in Shaping Species-Specific Gene Expression

The Mediator complex is an essential co-regulator of RNA polymerase II that is conserved throughout eukaryotes. Here we present the first study of Mediator in the pathogenic fungus Candida albicans. We focused on the Middle domain subunit Med31, the Head domain subunit Med20, and Srb9/Med13 from the Kinase domain. The C. albicans Mediator shares some roles with model yeasts Saccharomyces cerevisiae and Schizosaccharomyces pombe, such as functions in the response to certain stresses and the role of Med31 in the expression of genes regulated by the activator Ace2. The C. albicans Mediator also has additional roles in the transcription of genes associated with virulence, for example genes related to morphogenesis and gene families enriched in pathogens, such as the ALS adhesins. Consistently, Med31, Med20, and Srb9/Med13 contribute to key virulence attributes of C. albicans, filamentation, and biofilm formation; and ALS1 is a biologically relevant target of Med31 for development of biofilms. Furthermore, Med31 affects virulence of C. albicans in the worm infection model. We present evidence that the roles of Med31 and Srb9/Med13 in the expression of the genes encoding cell wall adhesins are different between S. cerevisiae and C. albicans: they are repressors of the FLO genes in S. cerevisiae and are activators of the ALS genes in C. albicans. This suggests that Mediator subunits regulate adhesion in a distinct manner between these two distantly related fungal species

Oral abstracts of the 21st International AIDS Conference 18-22 July 2016, Durban, South Africa

The rate at which HIV-1 infected individuals progress to AIDS is highly variable and impacted by T cell immunity. CD8 T cell inhibitory molecules are up-regulated in HIV-1 infection and associate with immune dysfunction. We evaluated participants (n=122) recruited to the SPARTAC randomised clinical trial to determine whether CD8 T cell exhaustion markers PD-1, Lag-3 and Tim-3 were associated with immune activation and disease progression.Expression of PD-1, Tim-3, Lag-3 and CD38 on CD8 T cells from the closest pre-therapy time-point to seroconversion was measured by flow cytometry, and correlated with surrogate markers of HIV-1 disease (HIV-1 plasma viral load (pVL) and CD4 T cell count) and the trial endpoint (time to CD4 count <350 cells/μl or initiation of antiretroviral therapy). To explore the functional significance of these markers, co-expression of Eomes, T-bet and CD39 was assessed.Expression of PD-1 on CD8 and CD38 CD8 T cells correlated with pVL and CD4 count at baseline, and predicted time to the trial endpoint. Lag-3 expression was associated with pVL but not CD4 count. For all exhaustion markers, expression of CD38 on CD8 T cells increased the strength of associations. In Cox models, progression to the trial endpoint was most marked for PD-1/CD38 co-expressing cells, with evidence for a stronger effect within 12 weeks from confirmed diagnosis of PHI. The effect of PD-1 and Lag-3 expression on CD8 T cells retained statistical significance in Cox proportional hazards models including antiretroviral therapy and CD4 count, but not pVL as co-variants.Expression of ‘exhaustion’ or ‘immune checkpoint’ markers in early HIV-1 infection is associated with clinical progression and is impacted by immune activation and the duration of infection. New markers to identify exhausted T cells and novel interventions to reverse exhaustion may inform the development of novel immunotherapeutic approaches

The Physical Processes of CME/ICME Evolution

As observed in Thomson-scattered white light, coronal mass ejections (CMEs) are manifest as large-scale expulsions of plasma magnetically driven from the corona in the most energetic eruptions from the Sun. It remains a tantalizing mystery as to how these erupting magnetic fields evolve to form the complex structures we observe in the solar wind at Earth. Here, we strive to provide a fresh perspective on the post-eruption and interplanetary evolution of CMEs, focusing on the physical processes that define the many complex interactions of the ejected plasma with its surroundings as it departs the corona and propagates through the heliosphere. We summarize the ways CMEs and their interplanetary CMEs (ICMEs) are rotated, reconfigured, deformed, deflected, decelerated and disguised during their journey through the solar wind. This study then leads to consideration of how structures originating in coronal eruptions can be connected to their far removed interplanetary counterparts. Given that ICMEs are the drivers of most geomagnetic storms (and the sole driver of extreme storms), this work provides a guide to the processes that must be considered in making space weather forecasts from remote observations of the corona.Peer reviewe