Guidelines for the prevention, detection and management of the renal complications of COVID-19 in Africa

Africa trails the rest of the world in COVID-19 cases and deaths. However, as the pandemic spreads through the continent, we expect increases in community infection in the months ahead. Patients with kidney infection, especially those with end-stage kidney disease and those with kidney transplants, are at high risk for acquiring the disease and dying from it. While there is limited evidence for the benefit of interventions, we have the advantage of learning from the experiences of those in China, Europe and the Americas. This document sets forth guidance for dealing with our patients who have acute and chronic kidney disease, including those on renal replacement therapy and the staff involved in their care. Emphasis is placed on preparedness and prevention strategies. As evidence and experience accumulate, it is likely that updated guidance will be needed.L’Afrique suit le reste du monde en termes de nombre de cas et de décès dus à COVID-19. Cependant, alors que la pandémie se propage à travers le continent, nous prévoyons une augmentation de l’infection communautaire dans les mois à venir. Les patients atteints d’une maladie rénale, en particulier ceux atteints d’une maladie rénale chronique en phase terminale et ceux ayant subi une transplantation rénale, courent un risque élevé de contracter la maladie et d’en mourir. Bien que les preuves d’interventions soient limitées, nous avons l’avantage de tirer des enseignements des expériences de ceux qui se trouvent en Chine, en Europe et dans les Amériques. Ce document présente des conseils pour traiter nos patients atteints d’insuffisance rénale aiguë et chronique, y compris ceux sous thérapie de suppléance rénale et le personnel impliqué dans leurs soins. L’accent est mis sur les stratégies de préparation et de prévention. Au fur et à mesure que les preuves et l’expérience s’accumulent, il est probable que des directives actualisées seront nécessaires

Correction: Guidelines for the prevention, detection and management of the renal complications of COVID-19 in Africa

The authors of the article ‘Guidelines for the prevention, detection and management of the renal complications of COVID-19 in Africa’ [1] wish to acknowledge the contribution of Professor Hussein El Fishawy. Our guidelines drew on various sources, including the Egyptian Ministry of Health guidelines, portions of which were adapted and reproduced with permission from the Egyptian Ministry of Health. Two of the authors of those guidelines, Professors Elsayed and Zaki, are also coauthors of our paper. Professor El Fishawy was the third author of the Egyptian guidelines and we would like to acknowledge his contribution to our review through this source, especially with respect to the treatment algorithms for patients with kidney transplants and those with acute kidney injury. Reference1. Elsayed HM, Wadee S, Zaki MS, Were AJO, Ashuntantang GE, Bamgboye EL, et al. Guidelines for the prevention, detection and management of the renal complications of COVID-19 in Africa. Afr J Nephrol. 2020; 23(1):109-126

First X-ray polarization measurement confirms the low black-hole spin in LMC X-3

X-ray polarization is a powerful tool to investigate the geometry of accreting material around black holes, allowing independent measurements of the black hole spin and orientation of the innermost parts of the accretion disk. We perform the X-ray spectro-polarimetric analysis of an X-ray binary system in the Large Magellanic Cloud, LMC X-3, that hosts a stellar-mass black hole, known to be persistently accreting since its discovery. We report the first detection of the X-ray polarization in LMC X-3 with the Imaging X-ray Polarimetry Explorer, and find the average polarization degree of 3.2% +- 0.6% and a constant polarization angle -42 deg +- 6 deg over the 2-8 keV range. Using accompanying spectroscopic observations by NICER, NuSTAR, and the Neil Gehrels Swift observatories, we confirm previous measurements of the black hole spin via the X-ray continuum method, a ~ 0.2. From polarization analysis only, we found consistent results with low black-hole spin, with an upper limit of a < 0.7 at a 90% confidence level. A slight increase of the polarization degree with energy, similar to other black-hole X-ray binaries in the soft state, is suggested from the data but with a low statistical significance.Comment: 14 pages, 8 figures, submitted to Ap

The first X-ray polarimetric observation of the black hole binary LMC X-1

We report on an X-ray polarimetric observation of the high-mass X-ray binary LMC X-1 in the high/soft state, obtained by the Imaging X-ray Polarimetry Explorer (IXPE) in October 2022. The measured polarization is below the minimum detectable polarization of 1.1 per cent (at the 99 per cent confidence level). Simultaneously, the source was observed with the NICER, NuSTAR and SRG/ART-XC instruments, which enabled spectral decomposition into a dominant thermal component and a Comptonized one. The low 2-8 keV polarization of the source did not allow for strong constraints on the black-hole spin and inclination of the accretion disc. However, if the orbital inclination of about 36 degrees is assumed, then the upper limit is consistent with predictions for pure thermal emission from geometrically thin and optically thick discs. Assuming the polarization degree of the Comptonization component to be 0, 4, or 10 per cent, and oriented perpendicular to the polarization of the disc emission (in turn assumed to be perpendicular to the large scale ionization cone orientation detected in the optical band), an upper limit to the polarization of the disc emission of 1.0, 0.9 or 0.9 per cent, respectively, is found (at the 99 per cent confidence level).Comment: 12 pages, 9 figures, 4 tables. Accepted for publication in MNRA

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance.

Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times and more-regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and illuminate the distinct dispersal dynamics of variants of concern-particularly Alpha, Beta, Delta, and Omicron-on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve while the continent faces many emerging and reemerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

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

Efficacite et tolerance de l’association artemether lumefantrine dans le traitement du paludisme simple a Plasmodium falciparum au Niger

Problématique : Le paludisme, de par son ampleur,sa gravité et ses conséquences économiques et sociales demeure un problème de santé publique majeur dans les pays tropicaux en général et au Niger enparticulier. A ces conséquences vient s’ajouter la polychimiorésistance simultanée ou croisée des souches de P.falciparum aux antipaludiques courants. Pour y remédier le programme national de lutte contre lepaludisme du Niger a adopté l’association artémether luméfantrine (COARTEM®) en traitement de première intention du paludisme simple en 2005. Nous avons évalué l’efficacité thérapeutique et la tolérance de l’artémether luméfantrine chez les patients impaludés de moins de 5 ans au niveau des trois sites sentinelles du Niger.Objectif : L’objectif général est d’étudier l’efficacité thérapeutique et la tolérance du COARTEM® chez les sujets souffrant de paludisme à Plasmodium falciparum non compliqué.Méthodologie : C’est une étude multicentrique, prospective, descriptive et ouverte avec un seul bras pour évaluer l’efficacité thérapeutique et la tolérance de l’association artémether luméfantrine chez des enfantsde moins de 5 ans souffrant de paludisme simple au Niger. Le protocole OMS/2003 a été utilisé.Résultats : 389 enfants ont été consultés, 202 enfants ont été suivis sur le plan clinique et parasitologique jusqu’à J28 dont 84 à Gaya, 70 à Tessaoua et 48 à Agades. Au Niger, la réponse clinique et parasitologique (RCPA) après PCR, chez les enfants de moins de 5 ans est de 92%. Elle est de 96,3% à Tessaoua, 94.1% à Agades et 89,6% à Gaya. Il n’ya pas de différence significative de réponse entre les trois sites sentinelles (p&gt;0,05). Avant la correction des données par PCR, la réponse clinique et parasitologique adéquate était de 88.8%. Le COARTEM est bien toléré.Aucun effet secondaire indésirable n’a été observé chez les sujets traités.Conclusion : Le COARTEM® est une molécule efficace, qui réduit significativement la densité parasitaire et les manifestations cliniques du paludisme. Il peut être prescrit en traitement de première intention du paludisme simple comme le recommande le Ministère de la Santé Publique du Niger (MSP/Niger). Le COARTEM® est une molécule qui est bien tolérée par les patients. Mots clés : Résistance, P.falciparum, Artémether luméfantrine, Sites sentinelles et Niger. Efficacy and safety of artemether-lumefantrine in the treatment of uncomplicated malaria in Niger.Background: Malaria, with its width, its gravity and its economic and social consequences remains a major public health problem in tropical countries like Niger. These consequences come to be added the simultaneous or cross résistance of P.falciparum to currents drugs. The National Malaria Programme of Niger adopted artemether-lumefantrine (COARTEM®) in treatment of uncomplicated malaria in 2005. We evaluated the efficacy and safety of artémether-luméfantrine in the treatment of children less than 5 years at Gaya, Tessaoua and Agades, three sentinels’ sites of Niger.Objectives: The main objective of the study is to evaluate the efficacy and the safety of COARTEM® in the treatment of uncomplicated P.falciparum malaria in Niger.Methodology: It is a multicentric, prospective, descriptive and open study with only one arm to evaluate the efficacy and safety of artemether-lumefantrine in children less than 5 years suffering from uncomplicated malaria in Niger. OMS/2003 protocol was used.Results: 389 children were consulted and 199 children were followed for 28 days. 81 children are from Gaya, 70 from Tessaoua and 48 from Agades. After PCR, the clinical and parasitological adequate response (CPAR) of children less than 5 years is 92%. The CPAR is 96.3% at Tessaoua, 94.1% at Agades and 89.6% at Gaya. The difference of response between the three sentinels sites is not significant (p&gt;0,05). Before PCR, the clinical and parasitological adequate response was 88.8%. The COARTEM® is welltolerated. No undesirable effect was observed during the study.Conclusion: COARTEM® is an effective drug, which reduces significantly parasitic and clinical symptoms of malaria. It can be prescribed in treatment of uncomplicated malaria as public health ministry of Niger recommends. COARTEM® is also safety and well tolerated by the patients.Key Words: Efficacy, Safety, Artemether-lumefantrine, P. falciparum, Niger

Methodology of management of river basins geochemical balance in Western Siberia

Актуальность определяется наличием нерешенных вопросов оценки состояния водных объектов, их долгосрочного прогноза, нормирования антропогенных воздействий, очистки сточных вод и рекультивации водных объектов в Западной Сибири. Цель: разработка методологии управления геохимическим балансом водных экосистем Западной Сибири в различных природных и антропогенных условиях. Методы: ландшафтно-геохимический, географо-гидрологический, статистические методы, методы математического моделирования водного стока и химического состава вод. Результаты и выводы. Предложена методология управления геохимическим балансом водосборной территории, заключающаяся в: 1) оценке состояния водных объектов, тенденций его изменения и антропогенного влияния; 2) построении комплекса математических моделей, описывающих формирование водного стока и химического состава вод; 3) разработке мероприятий, позволяющих минимизировать антропогенное влияние на водные объекты; 4) оценке эффективности водоохранных мероприятий путем сравнения результатов наблюдений и моделирования. Разработан алгоритм определения элементов геохимического баланса водосборов. Охарактеризована направленность геохимических процессов в водных объектах Западной Сибири. Сформулированы ключевые аспекты выбора методов очистки сточных вод и рекультивации нарушенных земель. Показано, что строительство очистных сооружений целесообразно, если сброс неочищенных сточных вод составляет более 5 % от стока в замыкающем створе. Оптимальная структура очистки сточных вод предполагает широкое использование отстойников и сооружений биологической очистки с естественной аэрацией, которые рекомендуется совместить с естественными понижениями рельефа в долинах рек или внутри болот при условии инженерной защиты территории. Рекультивация может считаться эффективной, если разница между значениями элементов баланса до нарушения и после рекультивации не превышает 20 %.Relevance of the research is determined by a plenty of unresolved issues on estimation of water bodies condition and their long-term forecast, normalization of anthropogenous influences, sewage treatment and restoration of water bodies. The aim of the research is to develop a methodology for management of geochemical balance of water ecological systems in Western Siberia in various natural and anthropogenous conditions. Methods: landscape and geochemical, geographical and hydrological, statistical methods, methods of mathematical modelling of a water flow and chemical composition of waters. Results and conclusions. The authors have proposed the methodology of management of river basin geochemical balance. It consists in: 1) estimation of of water bodies condition, tendencies of its change and anthropogenous influence; 2) construction of a complex of mathematical models describing water runoff formation and chemical composition of waters; 3) development of the actions, which allow minimizing anthropogenous influence on water bodies; 4) estimation of water-security actions efficiency by comparison of results of observations and simulating. The authors developed the algorithm for defining the elements of geochemical balance of river basins and characterized the orientation of geochemical processes in water bodies in Western Siberia. The key aspects of a choice of methods of sewage treatment and restoration of the broken areas are formulated. It is shown that construction of treatment facilities is reasonable if dump of the crude sewage makes more than 5 % from a runoff in closing section. The optimum structure of sewage treatment assumes wide use of sediment basins and constructions of biological clearing with natural aeration which are desirable for combining with natural downturn of a relief in river valleys or inside bogs for condition of engineering protection of territory. Restoration can be considered effective if the difference between values of elements of balance before infringement and after restoration does not exceed 20 %