Fasting salivary glucose levels is not a better measure for identifying diabetes mellitus than serum or capillary blood glucose levels: comparison in a Ghanaian population

Aims/introduction: We compared the diagnostic performance and correlation between salivary, serum and capillary blood glucose of diabetes and non-diabetes patients. Early detection of diabetes mellitus (DM) contributes to the prevention of complications and management. Materials and methods: This case-control study was conducted among a total of 138 participants comprising 79 newly diagnosed diabetes patients (cases) and 59 non-diabetes patients (controls). Fasting salivary glucose (FSLG), fasting serum glucose (FSEG) levels and fasting capillary whole blood glucose (FCWBG) level were assayed for each participant. Results: The mean FSLG, FSEG and FCWBG levels were significantly higher among the cases compared to controls (p \u3c 0.0001). There was a significant mean difference between the levels of FSLG vs. FSEG (p \u3c 0.0001) and FSLG vs. FCWBG (p \u3c 0.0001) but not levels of FSEG vs. FCWBG (p \u3e 0.05) in both cases and controls. A positive correlation was observed between FSLG and FSEG (r = 0.89; p \u3c 0.0001) and FCWBG (r = 0.87; p \u3c 0.0001). At the cut-off value \u3e6.8 mmol/l for FSEG, a sensitivity of 99%, specificity of 100.0% and area under the curve (AUC) of 98.8% was observed for predicting DM while a sensitivity of 80%, specificity of 95% and AUC of 91.0% was observed for FSLG at a cut-off value \u3e0.5 mmol/l. At the cut-off value \u3e6.9 mmol/l for FCWBG, a sensitivity of 100.0%, specificity of 100.0% and AUC of 100.0% was observed for predicting DM. Conclusion: Fasting salivary glucose (FSLG) levels increased with increasing blood glucose levels. However, it does not generate enough diagnostic and predictive accuracy compared to capillary whole blood glucose which less invasive. © 201

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

Increasing Income of Ghanaian Cocoa Farmers: Is Introduction of Fine Flavour Cocoa a Viable Alternative

Consumers’ taste and preference for differentiated cocoa based on darkness and flavour quality has been rising over the years. Added value of such specialty cocoa is expressed by consumers’ willingness to pay more than the standard commodity price for the attributes and associations such as augmented health benefits that differentiate the product. Conventional cocoa production systems often planted with local landraces and to some extent hybrids often have low yields that cannot match farmers’ investment decisions. An ex ante analysis of fine flavour cocoa was investigated for Ghana vis-à-vis existing farming conditions, using economic decision criteria. Fine flavour cocoa is differentiated on the basis of clonal planting material as opposed to regular pods and by its superior flavour qualities at during post-harvest handling. Results of hypothetical fine flavour systems are compared with business-as-usual systems with high input fine flavour system emerging as clear winner in terms of profitability. Sensitivity analysis shows that increasing percentage of producer price with fertiliser subsidies dramatically improves farmers’ income

Fasting salivary glucose levels is not a better measure for identifying diabetes mellitus than serum or capillary blood glucose levels: comparison in a Ghanaian population

Aims/introduction: We compared the diagnostic performance and correlation between salivary, serum and capillary blood glucose of diabetes and non-diabetes patients. Early detection of diabetes mellitus (DM) contributes to the prevention of complications and management. Materials and methods: This case-control study was conducted among a total of 138 participants comprising 79 newly diagnosed diabetes patients (cases) and 59 non-diabetes patients (controls). Fasting salivary glucose (FSLG), fasting serum glucose (FSEG) levels and fasting capillary whole blood glucose (FCWBG) level were assayed for each participant. Results: The mean FSLG, FSEG and FCWBG levels were significantly higher among the cases compared to controls (p 0.05) in both cases and controls. A positive correlation was observed between FSLG and FSEG (r = 0.89; p 6.8 mmol/l for FSEG, a sensitivity of 99%, specificity of 100.0% and area under the curve (AUC) of 98.8% was observed for predicting DM while a sensitivity of 80%, specificity of 95% and AUC of 91.0% was observed for FSLG at a cut-off value >0.5 mmol/l. At the cut-off value >6.9 mmol/l for FCWBG, a sensitivity of 100.0%, specificity of 100.0% and AUC of 100.0% was observed for predicting DM. Conclusion: Fasting salivary glucose (FSLG) levels increased with increasing blood glucose levels. However, it does not generate enough diagnostic and predictive accuracy compared to capillary whole blood glucose which less invasive