Epidemiology and etiology of brain cancer in Africa: A systematic review.

BACKGROUND: Cancer is a significant threat to public health and a leading cause of morbidity across the globe. Of all cancers, brain cancer can be particularly catastrophic as treatment often fails to achieve the desired degree of effectiveness and diagnosis remains associated with a high mortality rate. Africa, as a continent with resource-limited countries, needs to allocate the necessary proper healthcare infrastructure to significantly reduce cancer rates and improve patient survival. In addition, the relative paucity of data within this field in Africa makes effective management a challenge. OBJECTIVE: This review is aimed at elucidating the currently available evidence base with regard to the epidemiology and etiology of brain cancer within resource-limited African countries. This review hopes to bring to the attention of the wider clinical community the growing burden of brain cancer within Africa and to encourage future research into this field of research. METHODS: The available literature for this Systematic Review was searched on two bibliographic databases, PubMed and Scopus, using an individually verified, prespecified approach. In addition, the Global Cancer Observatory and Global Burden of Disease databases were also utilized. Studies reporting on the epidemiology, etiology, and impact of brain cancer in Africa were suitable for inclusion. The level of evidence of the included studies was considered as per the Centre for Evidence-Based Medicine recommendations. RESULTS: Out of the four databases searched, 3848 articles were initially screened rigorously, filtered into 54 articles, and finally assessed qualitatively and quantitatively. We have demonstrated a poor survival rate and lack of proper funds/resources necessary to report, identify, and treat cases, as well as the dearth of comprehensive research on the subject of brain cancer that has become a challenging healthcare concern in many African developing nations. Also, because of the gradual improvement in healthcare facilities and the increasing population within many countries in Africa, the number of patients with central nervous system and intracranial tumors is rising specifically in the elder population. In addition, the population in West Africa is at a higher risk of HIV-related malignancies due to the high prevalence of HIV in West Africa. The burden of brain cancer in Africa is increasing in comparison with the developed parts of the world in which it is decreasing. Moreover, the mismanagement of cancers in Africa leads to higher morbidity and mortality and decreased quality of life. CONCLUSION: This study addresses the burden of brain cancer as a major public health crisis in Africa. Improved treatment modalities and access to screening are required to better address the burden of this disease. Therefore, there is a clear need for more substantial and comprehensive research on etiology, epidemiology, and treatment of brain cancer within Africa to understand its epidemiological distribution and provide a means for managing and reducing the associated morbidity and mortality.

Is the New Langya virus in China a threat to global health? A short communication.

The recently detected virus in eastern China in 2018 led to some health concerns, especially with the global trend of spreading viruses. As a new RNA-detected genus of the henipavirus family was found in Eastern China, the number of patients affected has reached 35 through zoonotic spread, with symptoms ranging from simple fever to fatal affection of vital organs such as the brain, liver, and kidneys. Researchers have found that shrew animals might be a potential reservoir for the Langya virus; however, data is still limited regarding human-to-human transmission. Current efforts by the Chinese Health Ministry and the Taiwan Centers for Disease Control and Prevention to deduct the spread of the virus and track its origin by trying to sequence the disease genome are evident. With all this in mind, the recommendation to face this new novel virus revolves around protecting the most vulnerable population at risk of being infected, such as farmers, and preventing the spread of the virus. Efforts must be directed toward screening animals for henipavirus and diving more deeply into the etiology of how this virus has spread to humans to help understand the spread of zoonotic viruses in the future.

Recent advances in the diagnosis and management of typhoid fever in Africa: A review.

Typhoid fever, a classical disease of enteric origin caused by Salmonella species of bacteria, is among the most important diseases threatening public health in Africa. The African continent is a marker for both low resources within the healthcare system and poor disease control policy formulations in managing endemic infectious diseases. Since the colonial era, the Widal serological test has been used to confirm typhoid fever in Africa, however recent studies recommend blood culture, and when blood culture cannot be obtained, clinical findings, laboratory Widal test confirmation, and ruling out other febrile illnesses as confirmatory pathway to diagnose typhoid fever in Africa. Managing typhoid fever relies on antimicrobials. In 1980s chloramphenicol was the medication of choice. Years later, amoxicillin and co-trimoxazole were adopted. However, the instantaneous rise of resistant strains of Salmonella enterica confers an important challenge to treat the burdensome enteric fever. The current treatment algorithm of typhoid fever in Africa relies significantly on the use of fluoroquinolones, macrolides, and cephalosporins. Developed nations have successfully addressed and controlled typhoid fever via improvement in accessing safe water and food, better sanitary and hygienic behaviours, and vaccines development. Nevertheless, there is significant evidence to infer improvement in the diagnosis management of typhoid fever over the last few decades, and efforts are underway to control the disease spread in Africa. This review aims to provide an overview of the latest developments in typhoid fever diagnosis and management in Africa and provide key recommendations for a coordinated approach to mitigate typhoid in the continent.

Polio returns to the USA: An epidemiological alert.

On July 21, 2022, the USA witnessed the first case of poliomyelitis after 3 decades of its eradication. Poliomyelitis is a crippling disease that results from infection with any one of the three related poliovirus types (referred to as types P1, P2, and P3), members of the enterovirus (picornavirus) family. The New York State Department of Health confirmed that a case of paralytic poliomyelitis was reported from a 20-year-old Hungarian traveller residing in Rockland County. The detected viral sequence has been found to have vaccine-derived poliovirus type 2 (VDPV2) suggesting an origin from the live attenuated oral polio vaccine (OPV). Since immunisation remains the only preventable measure, this article explores suggestions from the Centers for Disease Control and Prevention on reliable Inactivated (killed) polio vaccination in high-risk patients along with early case detection and treatment. In light of the above-mentioned findings, this research further details future recommendations like cessation of the OPV, encouragement of inactivated polio vaccine (IPV) in vaccination schedules, sensitive epidemiological surveillance system and appropriate training for healthcare providers. The affected countries have been further advised to have effective outbreak response strategy plans in place so that they can respond and stay prepared for such outbreaks in the future.

Hepatitis A virus outbreak in Lebanon: Is it a matter of concern?

Lebanon has been grappling with hepatitis A virus (HAV) outbreaks for 3 decades, to an extent that it has been now termed an endemic zone for HAV. However, the rise in cases above the annual average concerns a potential outbreak in the North, and the Bekaa governorates of Lebanon must be highlighted. Although the Lebanese health authorities have ordered a probe into the possible causes of the outbreak, it has been speculated that the immigration of Syrian refugees has overburdened public health services. Reduced seroprevalence of HAV immunoglobulin G has also led to an epidemiological shift from child to adult populations. The current economic crisis affecting Lebanese society is another significant problem that could have contributed to the rise in incidents. This article examines Lebanon's current HAV outbreak and epidemiological status, offering suggestions for the future. In the event of an outbreak, the infrastructure for water sanitation and sewage is known to allow HAV to spread via the faecal-oral pathway. Maintaining personal hygiene, early detection, and vaccination have all been recommended as significant regional and individual control measures.

Poliovirus returns to the UK after nearly 40 years: current efforts and future recommendations.

On 22 June 2022, the UK Health Security Agency declared a 'rare national incidence' after finding poliovirus in sewage in London for the first time in nearly 40 years. Although no cases of the disease or accompanying paralysis have been documented, the general public's risk is considered minimal. However, public health experts recommend that families are up to date on their polio vaccines to decrease the chance of harm. This article discusses the epidemiology of poliovirus by examining the aetiology of the disease and current mitigation policies implemented to prevent the spread of type 2 vaccine-deceived poliovirus in the UK. Finally, by examining the clinical features of polio, which range from mild gastroenteritis episodes, respiratory sickness, malaise and severe paralysis type, this article offers an advice on particular therapies and tactics to avoid poliovirus outbreaks and other future outbreaks.

Anthrax outbreak amidst the COVID-19 pandemic in Africa: Challenges and possible solutions.

Anthrax and coronavirus disease 2019 (COVID-19) are both notable zoonoses that have high morbidity and mortality, not to mention adverse socio-economic and health consequences on the communities they ravage. Anthrax wreaks disease amongst mammalian species worldwide and has an endemic distribution in Africa and Asia. Kenya, for example, records an average of 10 outbreaks annually. In 2014 and 2017, it held anthrax attack rates of 15% and 29%, respectively, and case fatality rates of 1-5%. As with COVID-19, effective surveillance, containment, and vaccination programs are crucial in the fight against anthrax. While there is no evidence of direct, human-to-human transmission of anthrax currently, Bacillus anthracis remains a disease of public health concern that serves to fuel the devastating effects of SARS-CoV-2 in African communities. In this commentary, we examine anthrax spread in Africa amidst COVID-19, the challenges faced by these simultaneous zoonoses, and the efforts put to combat both equally.

A review of stem cell therapy: An emerging treatment for dementia in Alzheimer's and Parkinson's disease.

AIM: This article aims to study the benefits and disadvantages of stem cell therapy, especially for patients who have dementia. METHODS: The databases PubMed, Google Scholar, and the National Library of Medicine were searched for literature. All papers on Alzheimer's disease, Lewy body dementia, Parkinson's disease, stem cell therapy, and its effect on dementia treatment were considered. RESULTS: Stem cell treatment has demonstrated promising outcomes in animal studies by positively modifying the degenerative alterations in dementia. However, it is not without drawbacks, such as ethical concerns while using embryonic stem cells and the danger of developing cancer if the cells undergo uncontrolled differentiation. CONCLUSION: Although stem cell therapy has its risks, it has the potential to be a viable therapeutic option for patients with dementia if developed appropriately. Hence, more research and clinical trials are needed to establish its efficacy in this context.

Prospect of acute hepatitis E virus outbreak in the context of the COVID-19 Pandemic in Africa: A contingency plan.

Hepatitis E virus (HEV) is the primary cause of acute viral hepatitis in Sub-Saharan Africa (SSA). It is transmitted by oral-faecal route via contaminated water or animal products, which is more pronounced in SSA, where inadequate hygiene measures, low socioeconomic situation, and frail healthcare system increase HEV susceptibility. During the coronavirus disease-19 (COVID-19), numerous initiatives concerning viral hepatitis relief in SSA are implemented. However, national programs do not support most services and are neglected when national and local attention rests on the COVID-19 pandemic. Furthermore, during the COVID-19 pandemic, hepatitis E prevention and control programs were affected in low-income countries due to economic losses. Therefore, an interdisciplinary approach should be adopted to mitigate HEV infections during COVID-19.

The burden of monkeypox virus amidst the Covid-19 pandemic in Africa: A double battle for Africa.

The Coronavirus Disease - 19 (COVID-19) pandemic has put additional strain on Africa's fragile healthcare systems and has impacted the rise of emerging and re-emerging infectious diseases. Currently, there is a rise in cases of Monkeypox Disease, a zoonotic viral disease caused by the Monkeypox virus, which was first documented in 1970 in the Democratic Republic of the Congo. Most of the clinical symptoms of Monkeypox resemble that of smallpox, whose virus also belongs to the same genus. Initial symptoms include headache, fever, and fatigue, followed by lymphadenopathy and a rash. This study aims to provide more insight into Monkeypox by exposing its current burden and efforts to combat it amidst COVID-19 in Africa. Since Monkeypox disease is re-emerging and is less contagious than COVID-19, prevention and treatment are much more manageable. Still, African countries face several crucial challenges in responding to the Monkeypox in times of the covid-19 pandemic. These include lack of a well-functioning surveillance system for early detection of the disease, lack of awareness and knowledge of the monkeypox disease across the general population, lack of healthcare facilities already burdened by COVID-19 cases, and shortage of trained healthcare professionals. On the other hand, one significant factor contributing to the minimized risk in Africa was the smallpox vaccination done before 1980. However, a declining cross-protective immunity is seen in those inoculated with the smallpox vaccine and the ever-increasing risk to the unvaccinated population. Thus, focusing on vaccination and disease surveillance operations and diligent monitoring, as well as cross-border collaborations with international sectors, including One Health, FOA, OIE, and WHO is critical to achieving the ultimate eradication of monkeypox in Africa.

Ebola virus outbreak returns to the Democratic Republic of Congo: An urgent rising concern.

On April 23, 2022, the Ministry of Health of the Democratic Republic of the Congo announced an EVD outbreak after discovering 2 confirmed cases and identifying 267 contacts. With collaboration from the WHO, the MoH are taking many interventions to prevent further expansion of this outbreak. Forty-six years ago, the Ebola virus was first discovered in 1976 near the Ebola River in the DRC. Since then, 13 outbreaks of EVD have occurred in the DRC and, in 2020, it witnessed the second largest EVD outbreak in the world, resulting in 3481 cases and 2299 mortalities. This article discusses the epidemiology of the current DRC outbreak by examining the etiology of EVD, the number of affected cases, and the subsequent case index. Considering these data, this paper discusses measures taken by the MoH, WHO, CDC, and UNICEF to mitigate the Ebola outbreak, such as supporting local teams to provide essential care, training medical staff, and raising awareness for vaccination. Finally, by comparing the gravity of the situation to current measures, this article provides recommendations for individuals and governments to protect themselves and mitigate future outbreaks.

The syndemic burden of HIV/AIDS in Africa amidst the COVID-19 pandemic.

INTRODUCTION: The human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) has long affected millions of individuals across the globe. Historically, the prevalence of this disease is particularly noted within the African continent. Before the coronavirus disease 2019 (COVID-19) pandemic, many African countries struggled to effectively manage the increasing burden associated with HIV/AIDS. There is now a need to reassess this in a COVID-19 pandemic context so that the impact of COVID-19 on HIV/AIDS healthcare within Africa can be adequately evaluated. METHODS: Data collection was performed on the PubMed, Ovid MEDLINE and Embase bibliographical databases with a predefined search strategy. Searches were performed in blind duplicate and all articles considering COVID-19 and HIV/AIDS within African healthcare were considered. RESULTS: The COVID-19 pandemic has severely exacerbated the many issues surrounding HIV/AIDS care within many African countries. These impacts are noticeable in medical, psychological, and socio-political contexts. CONCLUSIONS: Before efforts are made to improve the provision of HIV/AIDS and COVID-19 care within Africa, it is important that this issue is brought to the attention of the scientific and clinical community so that the continent can receive the necessary support and aid.

Threats and outbreaks of cholera in Africa amidst COVID-19 pandemic: a double burden on Africa's health systems.

Every year, about 4 million cases and 143,000 deaths due to cholera are recorded globally, of which 54% were from Africa, reported in 2016. The outbreak and spread of cholera have risen exponentially particularly in Africa. Coupled with the recent emergence of the Coronavirus Pandemic (COVID-19) in Africa, the local health systems are facing a double burden of these infectious diseases due to their cumulative impact. In this paper, we evaluate the dual impact of cholera and COVID-19 in Africa and suggest plausible interventions that can be put in place to cushion its impact.

Viral infections amidst COVID-19 in Africa: Implications and recommendations.

Viral infections have been on the rise for the past decades. The impact of the viruses worsened amidst the pandemic burdening the already overwhelmed health care system in African countries. This article sheds light on how the coronavirus together with the already existing viral infections, some of which re-emerged, impacted the continent. The strategies in place such as immunization, education, will have to be strengthened in all African countries to reduce the burden. Furthermore, governments can further collaborate with other countries in creating guidelines to reduce co-infection of the diseases.

Dengue fever outbreak in Cook Island: A rising concern, efforts, challenges, and future recommendations.

The Cook Island government has made several efforts to ensure zero confirmed cases and transmission of COVID-19, especially among visiting travelers. However, the Cook Island ministry of health has to deal with the new strain of dengue fever outbreak, known as dengue fever type 2 (DEN-2), by adopting several measures to control its spread, especially in the affected parts of the subtropical country. This paper aims to describe the dengue fever response taken in Cook Island and suggest recommendations to control the risk of transmission in endemic parts of the world.

Ebola Outbreak amid COVID-19 in the Republic of Guinea: Priorities for Achieving Control.

In February 2021, a new Ebola outbreak occurred amid the coronavirus disease 2019 (COVID-19) pandemic in the Republic of Guinea. Technical committees and Ebola mitigation mechanisms used during the 2014-2016 Ebola epidemics, have been redeployed by the public health organizations and African health organizations. As the burden on the local healthcare system is rising, fears of socioeconomic disruption are growing as well. Strategies used during the previous epidemic need to be reactivated, and new measures taken during the challenges of COVID-19 are being considered. This perspective discusses the available evidence regarding the epidemic of Ebola in Guinea amid the COVID-19 pandemic, highlights the challenges to be prioritized, and provides evidence-based recommendations.