Baobab Index

BackgroundChild neurology in low- and middle-income countries (LMICs) faces persistent disparities in workforce capacity, subspecialty training, and structured mentorship. To address these gaps, the Child Neurology Society International Affairs Committee (CNS-IAC) launched a 2-phase initiative to identify regional needs and develop SMART (Specific, Measurable, Achievable, Relevant, Time bound) goals and action plans.ObjectiveTo identify educational and clinical priorities of child neurologists practicing in LMICs and translate these findings into region-specific SMART goals and action plans.MethodsA mixed method study was conducted in 2 phases. Phase 1 (2024) used a de novo Qualtrics survey reviewed by the international child neurology experts. The survey assessed 12 clinical domains, preferred educational resources, and open-ended needs. Phase 2 (2025) consisted of structured regional working groups at the CNS Annual Meeting, where participants codeveloped SMART action plans through facilitated discussion and iterative refinement.ResultsA total of 48 clinicians from 18 LMICs contributed to phase 1 of the initiative

The Cross-Wellcome Africa Asian Programmes (AAPs) Acceleration of Genomics for Escalating Infectious Diseases (CAGED) Consortium is a collaboration among six institutions: the Africa Health Research Institute, the Center for Infectious Disease Research in Africa, the KEMRI-Wellcome Trust Research Programme, the Malawi Liverpool Wellcome Programme, the Mahidol Oxford Tropical Medicine Research Unit and the Oxford University Clinical Research Unit. The consortium focuses on studying pathogens posing major public health threats in Africa and Southeast Asia including chikungunya virus (CHIKV) dengue virus (DENV), multidrug-resistant (MDR) The CAGED consortium seeks to leverage the capability of six institutions spread across Africa and South East Asia: the Africa Health Research Institute (AHRI) in South Africa, the Center for Infectious Disease Research in Africa (CIDRI-Africa) in the University of Cape Town in South Africa, KEMRI-Wellcome Trust Research Programme (KWTRP) in Kenya; the Malawi Liverpool Wellcome Programme (MLW) in Malawi; the Mahidol Oxford Tropical Medicine Research Unit (MORU) in Thailand and Laos; the Oxford University Clinical Research Unit (OUCRU) in Vietnam and Indonesia. The consortium seeks to scale up genomic surveillance for diseases driven by climate change and of public health importance in these regions. Specifically, we aim to advance multi-pathogen genomic epidemiology for characterizing transmission dynamics, tracking the emergence and spread of outbreak-associated variants, and assessing their potential to evade treatments, host immunity, and vaccines. We will use a multi-pathogen genomic surveillance approach to study the following pathogens: chikungunya (CHIKV), dengue (DENV), multidrug-resistant

Oral Rotavirus vaccines have reduced disease globally but multiple factors in low- and middle-income countries (LMICs) diminish vaccine effectiveness and disease burden remains high. A convening of experts reviewed advances in mucosal immunity, disease model systems, lessons from other pathogens and the lack of correlates of protection, to identify future research priorities. This report summarises the meeting proceedings and outlines a roadmap for advancing rotavirus immunology and next-generation vaccine development.

Intense fishing pressure can drive rapid evolution in wild populations, yet the underlying genomic mechanisms often remain elusive. Here, we investigate the genomic consequences of five decades of intense harvesting on the cichlid fish Copadichromis mloto in Lake Malombe, Malawi. By comparing whole-genome data from almost 200 individuals from the heavily fished Lake Malombe with less-fished populations in Lake Malawi, we identified a widespread signal of recent, population-specific positive selection. This genomic footprint, spanning hundreds of loci, is consistent with a rapid, polygenic adaptive response. The candidate genes under selection were significantly enriched for high-level developmental processes, including neurogenesis and the formation of the heart and muscle, providing a plausible mechanistic link to the dramatic reduction in size and age at maturity observed in this population. Furthermore, our strongest candidate loci include genes with known roles in controlling somatic growth (zdhhc13, myh7, csrp3, gnb1l) and reproductive timing (mpped2a, kitlga, kat6a, stra6). We also found that candidate genes were nearly five-fold more likely to be differentially expressed in male gonad tissue, providing a strong link between selection and regulatory changes in a key reproductive organ. Our findings point towards a polygenic basis for fisheries-induced evolution in this tropical system and highlight how intense harvesting can rapidly reshape the genetic architecture of complex life-history traits, with important implications for the long-term resilience of exploited fish stocks.

Rice productivity is increasingly threatened by abiotic stresses, with drought being a major constraint to stable yields under changing climate conditions. Advances in genomics and high-throughput omics technologies have identified numerous drought-responsive genes in rice through transcriptomics, genome-wide association studies (GWAS), and quantitative trait locus (QTL) mapping. While these approaches have improved our understanding of the genetic basis of drought responses, the practical application of gene discovery in breeding programs remains limited. This review focuses on functionally validated drought-tolerance genes, emphasizing candidates confirmed through reverse genetics approaches, such as gene knockout, overexpression, and genome editing. Key examples are discussed across major functional categories, including transcriptional regulation, signal transduction, and cellular protection mechanisms, highlighting their roles in drought tolerance and, when relevant, yield-related traits. We also explore how validated drought-tolerance genes have been integrated into rice improvement strategies, including marker-assisted selection, genomic selection, and genome editing. Major challenges are addressed, such as inadequate evaluation under combined stress conditions and weak connections between gene function and field performance. By combining evidence from genomics, functional biology, and breeding research, this review outlines priority research directions to accelerate the translation of candidate genes into climate-resilient rice cultivars. Rather than providing a comprehensive list of drought-responsive genes, this review emphasizes high-confidence, functionally characterized targets with practical relevance for breeding.

Neonatal sepsis caused by Klebsiella pneumoniae is a major cause of under-five mortality in sub-Saharan Africa, and the rapid increase of infections caused by bacteria resistant to most or all available antimicrobials severely limits treatment options. An effective, maternally-administered vaccine could make a substantial reduction in neonatal sepsis and associated negative outcomes, as well as reduce the overall need for antimicrobials, a key driver of antimicrobial resistance. This exploratory, hypothesis-generating pilot study investigated the potential for a maternally administered protein-based vaccine to provide neonatal protection via antibodies transferred transplacentally and through breastfeeding. A case-control pilot study of mother and baby dyads was designed with 20 neonates developing K. pneumoniae sepsis and 95 uninfected control neonates to analyse breastmilk IgA, cord blood IgG and maternal serum IgA and IgG antibodies on a protein microarray, and case isolates were whole-genome sequenced. Following computational analyses to identify surface-exposed candidates, we generated a protein microarray with 161 selected K. pneumoniae proteins representing 152 unique genes. The analysis of breastmilk IgA, cord blood IgG and maternal serum IgA and IgG identified a set of proteins eliciting antibody responses, some correlated with lack of K. pneumoniae sepsis which could indicate the presence of potentially protective antibodies. This is an essential first step in exploring surface protein accessibility, despite the large capsule. We highlight fimbrial structures, conjugative pili, and small lipoproteins associated with large outer membrane complexes as potential protein vaccine targets.

Congenital syphilis (CS) remains a major cause of stillbirth and neonatal morbidity, with an estimated 700,000 cases and 390,000 adverse birth outcomes annually. We evaluated the diagnostic utility of combined treponemal (TT) and nontreponemal (NTT) rapid point-of-care test and Treponema pallidum polymerase chain reaction (PCR) for detecting active maternal syphilis, CS, and treatment response in a high-prevalence, low-resource setting. Secondary analyses were conducted from a prospective case-control study at Queen Elizabeth Central Hospital, Malawi. Women were recruited ≤48 h postpartum. Maternal and infant sera underwent testing with the DPP® Syphilis Screen and Confirm (Dual rapid diagnostic test [RDT]) and T. pallidum PCR (maternal vaginal swabs and infant nasopharyngeal swabs), with predefined clinical-serological reference standards based on qualitative rapid plasma reagin (RPR). Among 504 of 510 women with complete data, Dual RDT identified 110 seropositive cases at delivery, including 86 new maternal syphilis diagnoses. The NTT band showed good performance in mothers versus RPR (sensitivity: 84.8% [95% confidence interval: 77.4%-92.1%]; specificity 92.7% [95% confidence interval: 90.3%-95.1%]) but reduced sensitivity in infants, increasing from 51.9% to 80.0% with RPR titer. Laboratory visual and microreader interpretation showed high concordance (99.5%), while bedside visual accuracy was lower (77.4%). Any Dual RDT positivity identified 19 high-risk infants, of whom 7 of 19 (36.8%) were NTT positive. PCR detected maternal infection in 11 of 504 (2.2%), including 3 serology-negative cases. Dual RDT improves detection over TT alone. The NTT band without quantitation is insufficient for treatment monitoring or infant diagnosis. Combining Dual RDT with PCR may enhance detection of active maternal infection and CS in high-burden settings.

Extended-spectrum β-lactamase (ESBL)-producing Escherichia coli in poultry is an emerging One Health concern, yet comparative data on intensive versus free-range systems in sub-Saharan Africa remain sparse. To compare the prevalence, susceptibility profiles and β-lactamase gene content of ESBL-producing E. coli from intensively reared and free-range chickens in Central Province, Zambia. In a cross-sectional study (March-April 2021), 112 pooled faecal samples (56 per production system; 10 birds per sampling point) were collected across seven veterinary camps in Kabwe and Kapiri Mposhi districts and processed within 24 h. Presumptive ESBL E. coli was isolated on MacConkey agar with 2 mg/L cefotaxime and identified biochemically. Susceptibility to 11 antimicrobials was tested by Kirby-Bauer disc diffusion per CLSI M100 (2020), and ESBL production was confirmed by combination-disc synergy. bla ESBL-producing E. coli was recovered from 13/112 pooled samples (11.6%, 95% CI: 6.9%-18.9%), with no difference between intensively reared (7/56, 12.5%) and free-range (6/56, 10.7%) chickens (p = 1.00). All 13 isolates were multidrug-resistant, with the highest resistance to tetracycline and cefotaxime (both 100%), streptomycin (84.6%) and sulfamethoxazole-trimethoprim (69.2%). bla Multidrug-resistant, bla

Prevalence and incidence are fundamental metrics with numerous applications in epidemiology. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guideline lacks specific items for reporting studies of disease prevalence or incidence. To address this gap, the STROBE Enhanced Prevalence and Incidence Criteria (STROBE EPIC) extension was developed in accordance with established methods for reporting guideline development. The authors generated an initial list of reporting items, conducted a modified Delphi process, and convened a face-to-face consensus meeting to confirm the need for a STROBE extension and to generate an early version of the checklist. They conducted 2 further Delphi surveys, first extending from typhoid and other invasive salmonelloses to all infectious diseases, and then to noncommunicable diseases and injuries. Finally, experts piloted the checklist on relevant manuscripts to critically assess if it was clear, concise, complete, and free of errors. An executive group curated the checklist after every survey round. The STROBE EPIC checklist comprises 47 items in the domains of title (1 item), abstract (2 items), introduction (1 item), methods (25 items), results (6 items), discussion (7 items), and other information (5 items). STROBE EPIC items address reporting of study design, adjustment factors for underreporting and underdiagnosis, denominator population estimation, case ascertainment methods, factors producing artefactual changes to observed disease prevalence or incidence, limitations of incomplete surveillance coverage, generalizability of short-duration studies, and data availability. The authors anticipate that the STROBE EPIC extension will be used by researchers, authors, modelers, burden-of-disease researchers, peer reviewers, and journal editors to optimize the presentation of epidemiologic evidence to support diverse health policy decisions.

Serum creatinine is a commonly used biomarker for estimating glomerular filtration rate (eGFR), but is influenced by determinants unrelated to kidney function, including muscle mass, age, sex, diet, and genetic variation. Biological drivers of persistent eGFR bias in African ancestry populations remain understudied. Here, we investigated whether African-enriched genetic variation at the glycine amidinotransferase (GATM) locus, encoding the rate limiting enzyme in creatine biosynthesis, contributes to systematic bias in creatinine-based estimates of GFR. We analyzed whole-genome sequencing and phenotypic data from population-based cohorts in Uganda (5,760 individuals) and South Africa (827 individuals). Genome-wide association studies were integrated with expression quantitative trait locus and metabolomic analyses to characterize biological mechanisms. The iohexol measured GFR was used to quantify systematic bias for creatinine-based estimates (eGFRCr). Diagnostic implications were evaluated in African American participants of the Million Veteran Program. We described variants associated with eGFRCr at the GATM locus that were common in African populations (allele frequency about 50%) but rare or absent in Europeans. These variants explained 1.0%-1.7% of the variance in eGFRCr and were associated with increased GATM expression and enhanced creatine synthesis, resulting in higher serum creatinine and consequently lower eGFRCr. Each allele was associated with an approximately 2 ml/min per 1.73 m African-enriched GATM variants are associated with measurable bias in creatinine-based GFR estimation without evidence of altered kidney function. These findings improve understanding of differences in kidney function biomarkers and may be relevant when interpreting creatinine-based estimates, particularly in populations where the variant is common.