Baobab Index

Road injuries are a leading cause of mortality and morbidity worldwide. Years of international efforts have aimed to strengthen policy engagement, including the 2020 UN General Assembly's proclamation of the Second Decade of Action for Road Safety (2021-30), targeting a 50% reduction in road traffic deaths and serious injuries by 2030. The aim of this study is to provide estimates to monitor progress and identify intervention gaps. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2023, we estimated incidence, mortality, and morbidity of road injuries for 204 countries and territories from 1990 to 2023. Four road injury types and 47 nature-of-injury categories were examined. Morbidity and mortality data from clinical records, vital registration, and police reports were harmonised using meta-analytic techniques to ensure consistency and correct for systematic bias. Incidence was modelled with the meta-regression tool Disease Modelling-Meta-Regression version 2.1 and cause-specific mortality with the Cause of Death Ensemble model, both incorporating location-specific covariates to support interpolation. Years of life lived with disability (YLDs) were estimated from the prevalence and severity of the nature of road injury, and years of life lost (YLLs) from the number of cause-specific deaths multiplied by the standard life expectancy at the age of death. Disability-adjusted life-years (DALYs) were the sum of YLLs and YLDs. All metrics were calculated with 95% uncertainty intervals (UIs). In 2023, there were 50·9 million (95% UI 46·1-56·1) road injury incident cases, 1·34 million (1·04-1·58) deaths, and 75·3 million (59·8-89·2) DALYs globally. Road injuries were the leading global cause of death among males aged 10-39 years. Between 1990 and 2023, age-standardised incidence decreased by 38·3% (95% UI 36·9-39·7) and mortality decreased by 32·3% (6·1-49·0), but progress varied widely by World Bank income group. Mortality in low-income countries (43·8 [95% UI 31·7-56·0] deaths per 100 000 population) was approximately six times higher than in high-income countries (7·5 [7·1-7·9] deaths per 100 000), despite the high-income countries showing the highest age-standardised incidence rates (858·1 [95% UI 781·9-947·1] cases per 100 000). In the past decade, many countries achieved notable reductions in road injuries, but others, including Ghana and the USA, saw increases. More severe injuries tended to occur in low-income and middle-income countries. Although global incidence, mortality, and DALY rates from road injuries have declined, progress remains uneven, with pronounced disparities across income groups reflecting systemic inadequacies in infrastructure, vehicle standards, enforcement, and post-crash care. Strengthening emergency response, improving road design, enforcing safety measures, and adapting policies to the evolving demographics remain essential. Gates Foundation.

To date, 15 species have been described within the genus

Whole-genome sequencing (WGS) accelerates drug-susceptibility testing (DST) in

Skin ulcers are health problem in children in tropical areas. Some clinically resemble yaws and this may cause inappropriate allocation of resources from the WHO yaws eradication plan. Studies have shown that bacteria other than the Treponema pallidum subspecies pertenue (bacterium causing yaws) were responsible for these lesions with certain associated risk factors. This study aimed to detect bacteria in yaws-like skin ulcers in Akonolinga Health District and the involvement of some matrices (pets, water, flies). A cross-sectional study was conducted from April to June 2023. Swabs were collected from children aged 5-15 years with yaws-like lesions and their asymptomatic contacts. Alongside this, samples were also collected from domestic animals, rivers and flies in the vicinity of participants with yaws like lesions. DNA extracted from the samples collected was used to amplify specific genes to detect the bacteria: Treponema pallidum subspecies pertenue, Haemophilus ducreyi, Staphylococcus aureus and Arcanobacterium haemolyticum. Among the 5,931 children screened, 28 presented with yaws-like lesions. Swab samples were collected from these 28 symptomatic individuals as well as from 28 asymptomatic contacts. Among the targeted genes tested, only Staphylococcus aureus DNA could be amplified from the samples of symptomatic at 32.1% (9/28) and in asymptomatic at 21.42% (6/28) (p = 0.547). These bacterial DNA could not be amplified from samples from animal and environmental matrices. Staphylococcus aureus is a bacterium involved in yaws-like ulcers but also found in similar proportion among asymptomatic healthy controls. Further investigation in these skin ulcers is needed for wider diagnostic tools to manage affected population.

Advances in data science and medical artificial intelligence (AI) raise complex philosophical and ethical quandaries about what it means to know a person or a community through data and what kinds of people and societies we are becoming in this era of predictive data science. Drawing on four lightly fictional but reality-informed case studies in mental health, radiology, genomics and environmental public health, we reflect on how AI technologies, largely built on Western biomedical traditions, may conflict with relational, spiritual and Indigenous understandings of health and wellbeing. This may manifest as epistemic friction, algorithmic fatalism and diminished trust in patient-clinician relationships. Besides familiar concerns regarding bias and transparency, this paper advances the discourse on the ethics of medical AI and data science in healthcare by shifting the analysis from epistemology (how AI systems know, classify and predict) to ontology (the study of the nature of being, as reconfigured by data and AI). We argue that AI systems may inflict significant ontological harm by reconfiguring identity, moral agency and imagined futures and advocate for a renewed medical humanism driven by inter- philosophies dialogue, cross-cultural ethics and ecocentric approaches to care. From Bamenda, Cameroon, to Mthatha, South Africa and Toronto, Canada, the future of medical AI must be defined by the moral and philosophical traditions that people already live by. African, Indigenous, Islamic, Buddhist, Confucian and marginalised Western worldviews should not be treated as peripheral critiques, but as constitutive resources for building inclusive, human-centred health technologies. We conclude that bioethics should be recognised as a core infrastructure in global health, on equal footing with data science, medicine, biomedical research and health innovation.

Elevated low-density lipoprotein cholesterol (LDL-C) is a modifiable risk factor for cardiovascular disease, the leading cause of premature death worldwide. Assessing the LDL-C-related burden is critical for guiding prevention and treatment strategies. To estimate the global, regional, and national burden of ischemic heart disease and ischemic stroke attributable to elevated LDL-C (relative to 35-54 mg/dL) from 1990 to 2023 and to quantify the contributions of population growth, aging, risk-deleted burden, and exposure changes to burden trends. This comparative risk assessment, part of the Global Burden of Disease Study 2023, estimated population-level LDL-C exposure and associated health loss in 204 countries and territories. Mean LDL-C levels were estimated using spatiotemporal gaussian process regression based on 806 studies across 161 countries. Relative risks were derived from meta-analyses of 38 randomized clinical trials. Population-attributable fractions for deaths and disability-adjusted life-years (DALYs) were estimated by age and sex for adults aged 25 years or older from 1990 to 2023, with 95% uncertainty intervals. Population-level LDL-C concentrations. Population-attributable fractions, counts, and rates (all ages and age standardized per 100 000) of LDL-C-attributable deaths and DALYs from ischemic heart disease and ischemic stroke, with uncertainty intervals. In 2023, elevated LDL-C accounted for 3.6 million deaths (95% uncertainty interval, 2.2-5.4 million; 6.0% of global mortality) and 90.7 million DALYs (95% uncertainty interval, 58.9-123.3 million; 3.2% of DALYs). Although global all-ages rates remained stable, age-standardized death and DALY rates decreased by 45.6% and 39.5%, respectively, since 1990. In 2023, age-standardized LDL-C-attributable DALY rates were highest in Eastern Europe and lowest in high-income Asia-Pacific. One-third of the global LDL-C burden occurred in India and China. Population growth and aging drove the increasing burden, with notable regional disparities in LDL-C exposure and risk-deleted DALY rates shifting toward middle-sociodemographic settings. Despite declining age-standardized rates, the absolute LDL-C burden has increased since 1990 due to demographic changes and has shifted toward middle-sociodemographic countries. Measurement and surveillance gaps persist. Strengthened prevention, diagnosis, and treatment access strategies are essential to mitigate the health burden of LDL-C.

Hepatitis C virus (HCV) remains a major global public health concern due to the absence of an effective vaccine and its diversity, which complicate diagnosis, genotyping, and clinical management despite the widespread use of direct-acting antivirals (DAAs). In regions where multiple HCV genotypes co-circulate, inter-genotypic recombination represents an additional challenge for accurate classification and molecular surveillance. In this study, we investigate the presence and characterize inter-genotypic recombinant strains of HCV in Cameroon. Among 512 chronically infected patients initially genotyped by Sanger sequencing of Core and NS5B regions, 10 samples (1.9%) showed genotypic discordance, suggesting putative recombination. Whole-genome sequencing using Oxford Nanopore technology, combined with phylogenomic and recombinant analysis, confirmed the recombinant nature of all 10 isolates. Most recombinant (7/10) shared a unique breakpoint in the NS2/NS3 region, primarily displaying a genotype 2/1 genomic profile, while one group had a breakpoint in the E2/p7 region (genotype 4/1 genomic profile). One isolate exhibited a more complex structure with two successive breakpoints (4/2 followed by 2/1). Genotypes 1 and 2 were the most frequently involved parental lineages. These findings demonstrate the ongoing circulation of diverse natural HCV recombinant forms in Cameroon and identify genomic regions that appear preferentially involved in recombination events. Our results highlight the limitations of genotypic approaches based on partial genomes and underscore the importance of comprehensive genomic characterization to improve HCV genotype classification, surveillance, and therapeutic strategies in Central Africa.

Nicotinic acetylcholine receptors (nAChRs) are pentameric ligand-gated ion channels that mediate fast cholinergic transmission in the insect central nervous system and serve as targets for several widely used classes of insecticides. nAChR-targeting formulations are being deployed in malaria vector control programs to mitigate widespread resistance to pyrethroids. However, the extent of genetic variation at insecticide target sites that may facilitate evolutionary responses to chemical exposure among vector species remains poorly understood. Here, we used whole-genome and Sanger sequencing to examine amino acid substitutions across all 11 nAChR subunits in sibling species of the Anopheles gambiae complex in Africa. The gene family is highly constrained, with only 33 nonsynonymous mutations detected at very low frequency in wild populations throughout the continent. No substitutions were observed at canonical ligand-binding residues within orthosteric domains, suggesting that acetylcholine and neonicotinoid binding affinities are unlikely to differ between the cryptic species. However, despite the evolutionary constraint, we identified two linked amino acid substitutions in the α6 subunit indicating early divergence of the receptor between species. These findings show that relaxed constraint can enable subtle amino acid changes in specific subunits of a conserved receptor family. The role of these mutations in shaping heterogeneous responses to insecticide exposure among mosquito species warrants further investigation.

Adaptation to novel environments is often associated with behavioural changes, but how decision-making processes and their genetic underpinnings evolve during ecological divergence remains poorly understood. Human-modified environments provide an ideal context in which to investigate how species adjust their behaviours in response to altered ecological conditions. We used oviposition site selection in two incipient mosquito species segregating along gradients of anthropogenic disturbance to investigate how differences in sensory perception modulate behavioural shifts accompanying ecological divergence. Using two-choice assays, we tested oviposition preferences in 1046 gravid female mosquitoes from field and laboratory populations by offering a choice between water collected from natal and foreign natural breeding sites. We found that females of Anopheles gambiae, a species adapted to rural environments, preferentially oviposited in natal water and deposited 89% of their eggs in a single breeding site. In contrast, females of its sibling species, Anopheles coluzzii, which is adapted to urban environments, exhibited weaker natal-water preference and frequently distributed their egg clutches between multiple breeding sites. To assess the extent of chemosensory divergence between these cryptic species, we analyzed amino acid substitutions within odorant, ionotropic and gustatory receptor gene families using whole-genome sequencing data. Despite limited differentiation across the gene families overall, several loci implicated in the detection of carboxylic acids, amines and volatile compounds exhibited elevated genetic divergence between species. Our work suggests that shifts in decision making associated with ecological divergence between emerging species can arise prior to substantial differentiation throughout the genome or across chemosensory receptor gene families.

This investigation was carried out with the aim of determining the genetic variation of the heat shock protein 70 (HSP70) gene, an essential molecular chaperone responsible for stress response among indigenous Muturu and Bunaji cattle breeds. Blood samples were obtained from randomly chosen 11 cattle in Warri and Ibadan, Nigeria. The genomic DNA was isolated, followed by amplification of the HSP70 gene through PCR and sequencing. Multi-sequence alignment and phylogenetic analysis showed the presence of 11 different single nucleotide polymorphisms (SNPs), including 10 base changes and one guanine deletion. Although there is a need for more studies to validate these genetic variations, the findings indicate the possible effects of the genetic variations on protein folding and chaperone activities that would theoretically result in thermotolerance and adaptability among these breeds. The findings in this study identify these SNPs as possible markers that can be used in Marker-Assisted Selection (MAS) for breeding resilient cattle in the future.