Baobab Index

The four primary subgroups of leukemia include chronic myeloid leukemia (CML), acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), and chronic lymphocytic leukemia (CLL). Very little is known about the regional variation of leukemia and subtypes in sub-Saharan Africa (SSA). This systematic review focused on the prevalent cases reported in sub-Saharan Africa, throwing more emphasis on treatment outcomes, follow up time and survival rates. A systematic review of studies on acute and chronic leukemia in sub-Saharan Africa (SSA) was conducted using articles retrieved from PubMed, Scopus, Google Scholar, Embase and African-specific databases such as African Journals Online (AJOL), covering publications from 1975 to July 15, 2025. A total of 94 studies were subjected to initial screening from study titles. Thirty-two (32) articles that met the inclusion criteria were selected for inclusion in this systematic review. Out of 2537 leukemia cases reported in the 32 studies, 1644 (64.80%) were acute and 893 (35.20%) were chronic. AML accounted for 947 (37.33%), 450 (17.74%) were ALL, 720 (28.38%) were CML, 173 (6.82%) were CLL, 2 (0.08%) were acute undifferentiated leukemia, 1 (0.04%) was mixed phenotype acute leukemia and 244 (9.62%) unclassified leukemias. Survival rates ranged from 2 weeks to 5 years. Fifty-nine patients were lost to follow up and follow up time ranged from 11 months to 7 years. 273 (10.76%) leukemia related deaths were reported. This review found that acute leukemias were more prevalent than chronic leukemias, with AML emerging as the most frequently reported subtype. Survival durations ranged from a few weeks to five years; however, overall outcomes remained poor, characterized by high mortality rates and substantial loss to follow-up. These findings underscore the urgent need for improved diagnostic capacity, standardized treatment protocols, and strengthened patient monitoring and follow-up systems to enhance leukemia care and outcomes.

Onchocerciasis is a disease caused by the filarial nematode parasite

This study investigated influence of cysteine-cysteine chemokines (CCR5, CCR5-59029A/G, CCR2), and stoma cell derived factor 1 (SDF1); as AIDS restriction genes (ARGs), on treatment outcomes among people with HIV (PWH) on long term antiretroviral therapy (ART) in Ghana. This cross-sectional study was conducted among 167 PWH and receiving ART in Accra, Ghana. Genomic DNA from PBMCs was used to genotype CCR5-Δ32, CCR2-V64I, CCR5 A59029G, and SDF1-3'A variants using polymerase chain reaction-restriction fragment length polymorphism, CCR5 expression was estimated by RT-qPCR. All participants carried the wild-type CCR5 genotype. No AIDS Restriction Genes was associated with virologic or immunological outcomes ( No ARG variant was significantly associated with virologic or immunological outcomes. However, CCR5 A59029G was associated with differences in proviral DNA burden and CCR5 mRNA expression, suggesting a potential role in HIV reservoir dynamics during suppressive ART.

In sub-Saharan Africa, the burden of cardiometabolic conditions has rapidly emerged. Sustainable diets that are nutritious, environmentally friendly, economically affordable, and socioculturally acceptable may support the prevention of cardiometabolic conditions. This study aimed to identify associations of optimized sustainable diets with incident general/abdominal obesity, type 2 diabetes mellitus (T2D), and hypertension among Ghanaian adults living in Ghana and Amsterdam. We used longitudinal data from the Research on Obesity and Diabetes among African Migrants study involving Ghanaian adults (age: 20-82 y). Baseline dietary data were collected using a Ghana-specific food propensity questionnaire. To construct an optimized diet index (ODI, 0-90 points), we used baseline adherence to previously identified site- and sex-specific diets, meeting nutritional adequacy, cultural acceptability, and 50% reduction of greenhouse gas emissions and food costs. Multivariable-adjusted logistic regression assessed associations between ODI per 10-point increase and risk of general/abdominal obesity, T2D, and hypertension, reported as odds ratios and 95% confidence intervals (CIs). In the analytical sample (n = 1499; 66% females; mean age: 47 ± 11 y; mean follow-up time: 7 ± 0.5 y; median ODI = 29 with interquartile range: 23-37), higher ODI scores were related to residence in Ghana, lower total energy intake, older age, and lower educational level. We observed no associations of baseline ODI with incident general obesity, T2D, or hypertension. A 10-point increase in ODI was associated with a 19% higher risk of abdominal obesity (95% CI: 1.00, 1.42; P = 0.049), significantly in rural and urban Ghana. Overall adherence to the optimized sustainable diet is low among this cohort of Ghanaian adults. Sustainable diets are related to increased risk of abdominal obesity in Ghana. Low variation in the poor adherence may explain the unexpected results.

Shigella is a leading cause of childhood diarrhoea in low-income and middle-income countries and is increasingly resistant to first-line antibiotics. We conducted a surveillance study to assess the incidence, genomic characteristics, and antimicrobial resistance (AMR) profiles of Shigella infections in children younger than 5 years with moderate-to-severe diarrhoea (MSD) in Lusaka, Zambia. Between Sept 15, 2020, and Nov 30, 2021, a prospective cohort study was conducted, which included 1400 children younger than 5 years enrolled during a community census in a periurban setting and passively followed up for 9·5 months for MSD. During enrolment, sociodemographic data were collected using electronic questionnaires, whereas clinical data were collected through the DHIS platform. The main outcome, Shigella in diarrhoeal stool in children younger than 5 years, was detected using culture and loop-mediated isothermal amplification targeting the ipaH gene. Cox proportional hazards models were used to assess the incidence and risk factors of Shigella (ipaH) infections. Whole-genome sequencing was used to characterise the genomic diversity and AMR genes, complemented by phenotypic antibiotic susceptibility testing. 230 first episodes of Shigella were noted over a follow-up time of 9581·7 child-months, yielding an incidence of 24·0 (95% CI 21·1-27·3) cases per 1000 child-months, with the highest incidence among children aged 2-3 years. The key risk factors identified were the water source (p=0·025) and age group (p=0·014). Genotypic characterisation revealed ten Shigella flexneri, nine Shigella sonnei, and three Shigella boydii isolates. The S sonnei isolates formed two clusters, differing in virulence factors and plasmid profiles, indicating two possible circulating strains. Shigella isolates showed phenotypic and genotypic multidrug resistance (MDR), including against trimethoprim, aminoglycosides, and β-lactams. Plasmid-mediated quinolone resistance (qnrS1) was identified in four S flexneri isolates, with these genes located on the IncFIB(K) plasmid, highlighting the potential for horizontal transmission and spread of quinolone resistance in this region. No phenotypic and genotypic resistance to macrolides, the first-line treatment for Shigella infection in Zambia, was observed. We report a high burden of Shigella with MDR, including resistance to fluoroquinolones. These findings highlight the increasing resistance of Shigella to first-line antibiotics and underscore the importance of developing safe and effective vaccines, improving water, sanitation, and hygiene conditions, and ongoing AMR surveillance. The EDCTP2 programme, supported by the EU, the Faculty for the Future Foundation, The Netherlands Organisation for Health Research and Development, and Health-Holland AMR-Global, Gloria, and Track-AMR.

Antimicrobial resistance (AMR) represents one of the most pressing threats to global public health, undermining the effectiveness of modern antimicrobial therapy and challenging decades of medical progress. This comprehensive review examines the transition from broad-spectrum empirical therapy toward precision medicine as an integrated framework for improving antimicrobial use and combating AMR. Precision medicine seeks to tailor treatment decisions by combining pathogen-specific genomic and resistance data with relevant host characteristics to optimize therapy while limiting unnecessary antimicrobial exposure and the selective pressures that drive resistance. The review synthesizes advances reported from 2020, highlighting established and emerging approaches including rapid molecular diagnostics, next-generation sequencing, CRISPR-based detection, machine learning (ML)-assisted decision support, precision dosing, and targeted therapeutics such as bacteriophage therapy, antimicrobial peptides, and bacterial proteolysis-targeting chimeras. Rather than functioning as isolated technologies, these approaches achieve their greatest clinical value when integrated within antimicrobial stewardship programs and a One Health framework that recognizes the interconnected human, animal, and environmental drivers of resistance. Despite considerable progress, important challenges remain, including equitable access to advanced technologies, interpretation of increasingly complex datasets, workforce and infrastructure limitations, and evolving regulatory pathways for novel diagnostics and therapeutics. This review concludes that while precision medicine is not a standalone solution, its successful implementation will depend on coordinated integration of diagnostics, host factors, computational tools, pharmacological optimization, and stewardship strategies to improve patient outcomes while preserving the long-term effectiveness of existing antimicrobials.

Nearly 40% of African adults with type 2 diabetes are lean (BMI <25 kg/m We analysed harmonised, individual-level cross-sectional data from two large, well-characterised African cohorts (Africa America Diabetes Mellitus study, n=2790; Research on Obesity and Diabetes among African Migrants study, n=541; total n=3331) of adults with type 2 diabetes from Ghana, Nigeria and Kenya. Participants were classified as lean (BMI <25 kg/m Type 2 diabetes in Africans who are lean was characterised by lower beta cell function and low insulin levels. Compared with individuals who are overweight/obese, adults who are lean showed a higher prevalence of retinopathy (pooled prevalence ratio [pPR] 1.36 [95% CI 1.13, 1.63]) and stroke (pPR 1.41 [95% CI 1.01, 1.99]), but lower hypertension (pPR 0.77 [95% CI 0.71, 0.85]) and 10-year cardiovascular disease risk (pPR 0.85 [95% CI 0.74, 0.97]). Chronic kidney disease prevalence did not differ between groups. Body fat percentage accounted for most differences (up to 92%). Complication patterns in Africans with type 2 diabetes who are lean vs overweight/obese follow divergent paths. In Africa, where nearly 24 million people have type 2 diabetes, two-fifths of whom are lean, our findings add to growing evidence that lean type 2 diabetes may be a distinct phenotype, underscoring the urgent need for investigation into better-targeted management for this large, potentially mistreated, population.

Following integrated malaria control interventions, malaria burden on the Bijagós Archipelago has significantly decreased. Understanding the genomic diversity of circulating Plasmodium falciparum malaria parasites can assist infection control, through identifying drug resistance mutations and characterising the complexity of population structure. This study presents the first whole genome sequence data for P. falciparum isolates from the Bijagós Archipelago. Amplified DNA from P. falciparum isolates sourced from dried blood spot samples of 15 asymptomatic malaria cases were sequenced. Using 1.3 million SNPs characterised across 795 African P. falciparum isolates, population structure analyses revealed that isolates from the archipelago cluster with samples from mainland West Africa and appear closely related to mainland populations; without forming a separate phylogenetic cluster. This study characterises SNPs associated with antimalarial drug resistance on the archipelago. We observed fixation of the PfDHFR mutations N51I and S108N, associated with resistance to sulphadoxine-pyrimethamine, and the continued presence of PfCRT K76T, associated with chloroquine resistance. These data have relevance for infection control and drug resistance surveillance; particularly considering expected increases in antimalarial drug use following updated WHO recommendations, and the recent implementation of seasonal malaria chemoprevention and mass drug administration in the region.

As malaria declines, innovative tools are required to further reduce transmission and achieve elimination. Mass drug administration (MDA) of artemisinin-based combination therapy (ACT) is capable of reducing malaria transmission where coverage of control interventions is already high, though the impact is short-lived. Combining ACT with ivermectin, an oral endectocide shown to reduce vector survival, may increase its impact, while also treating ivermectin-sensitive co-endemic diseases and minimising the potential impact of ACT resistance in this context. MATAMAL is a cluster-randomised placebo-controlled trial. The trial is being conducted in 24 clusters on the Bijagós Archipelago, Guinea-Bissau, where the peak prevalence of The trial has been approved by the London School of Hygiene and Tropical Medicine's Ethics Committee (UK) (19156) and the Comite Nacional de Eticas de Saude (Guinea-Bissau) (084/CNES/INASA/2020). Results will be disseminated in peer-reviewed publications and in discussion with the Bissau-Guinean Ministry of Public Health and participating communities. NCT04844905.

The lesser spot-nosed monkey (Cercopithecus petaurista) is a widely distributed West African guenon, which is generally considered less vulnerable to local extinctions than many sympatric primate species. Guinea-Bissau harbours the westernmost populations of the species, which is thought to be very rare or even extinct on the mainland, but to have putative populations on some islands of the Bijagós Archipelago. However, due to a lack of regional studies, baseline information on these insular populations is missing. We collected baseline data on the anthropogenic activities that possibly threaten the long-term conservation of this primate by using non-systematic ethnographic methodologies. The species was reported to be decreasing in number or rare by locals on two of the islands, and we identified two main conservation threats to it: generalised habitat loss/degradation, and hunting. While subsistence hunting has been recorded before in these areas, we report, to the best of our knowledge for the first time for these islands, the presence of a semi-organised commercial wild meat trade. The carcasses of western lesser spot-nosed monkeys were observed being stored and shipped from seaports to be sold at urban hubs (Bissau and Bubaque Island). The effect of commercial trade on the species could be severe, considering the small, naturally occurring, carrying capacities typical of insular ecosystems. The results of this study highlight the importance of understanding the leading social drivers of wild meat hunting of lesser spot-nosed monkeys on the Bijagós Archipelago, and the need to conduct baseline research on these insular populations, for which qualitative and quantitative methods could be combined.