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Rift Valley fever (RVF) is an emerging zoonotic mosquito-borne disease caused by Rift Valley Fever virus (RVFV), affecting both humans and animals. It is endemic to Rwanda and Tanzania and Uganda which are adjacent countries, with possible transboundary transmissions. Despite the various outbreak reports in Rwanda since 2012, information on the intensity and spread of these outbreaks and their management is scarce. We describe the 2022 outbreak that happened in Rwanda and provide insights into the One Health response implemented during the outbreak.There were no human cases officially reported. A total of 1339 confirmed RVF animal cases were identified from 21 March until 31 December 2022. The breakdown of the cases per livestock species showed 1285 (96%) cases in cattle, 34 (3%) in goats and 20 (1%) in sheep. Of the confirmed livestock cases, 516 died and 1254 abortions were registered, in all affected species.The outbreak response was characterized by extensive interventions such as animal spraying with pyrethroid insecticides, vaccinations, and active follow-up of animals and humans in the households with animal cases. In the first phase of the outbreak, animal movements and slaughtering were restricted in the highly affected regions. Gradually, the abattoir slaughter activities were resumed with all animals required to test negative by RT-PCR before slaughter. Remarkably, the public services and hospital laboratories supported both capacity building of veterinary laboratory scientists and testing of animals' samples. The overall response was coordinated by district cross-sectoral teams linking national and community-level actors. Outbreak-related information was synthesized by the district teams and shared at national level while national strategies were communicated to the affected communities through the district structures.Rwanda's response to RVF provides a proof of concept that multisectoral efforts involving community members in a One Health approach can offer efficient response to zoonotic outbreaks while still protecting the country's economy.

Atherosclerosis (AS) manifested by lipid accumulation, extracellular matrix protein deposition, and calcification in the intima and media of the large to medium size arteries promoting arterial stiffness and reduction of elasticity. It has been accepted that AS leads to increased morbidity and mortality worldwide. Recent studies indicated that genetic abnormalities play an important role in the development of AS. Specific genetic mutation and histone modification have been found to induce AS formation. Furthermore, specific RNAs such as microRNAs and circular RNAs have been identified to play a crucial role in the progression of AS. Nevertheless, the mechanisms by which genetic mutation, DNA and histone modification, microRNAs and circular RNA induce AS still remain elusive. This review describes specific mechanisms and pathways through which genetic mutation, DNA and histone modification, microRNAs and circular RNA instigate AS. This review further provides a therapeutic strategic direction for the treatment of AS targeting genetic mechanisms. Keywords: Gene mutation, miRNAs, CirRNA, Atherosclerosis

Purpose: The health of infants that are HIV-exposed and -uninfected (HEU) is a major public health concern as HIV becomes a chronic condition. We investigate the interrelationship between maternal viral suppression, maternal weight status, breastfeeding, and infants that are HEU., Methods: The Kabeho study followed 502 HEU infants in Kigali, Rwanda, for 24 months from 2013 to 2014. We use a structural equation modeling approach to investigate the dynamic relationships between viral suppression, maternal weight change, breastfeeding, and infant length-for-age z-score (LAZ) as defined by the WHO., Results: Older mothers are more likely to be virally suppressed and to breastfeed. Viral suppression and the mother being on antiretroviral treatment for longer were related to lower infant LAZ at three months. A more positive maternal weight change was related to higher infant LAZ at the end of each period. At 12 months, a higher infant LAZ was related to increased probability of continued breastfeeding. At 18 months, continued breastfeeding was related to lower LAZ, and food shortages were related to higher LAZ., Conclusion: There is a complex interrelationship between viral suppression, maternal weight change, breastfeeding, and infant LAZ. These relationships demonstrate the link between maternal and infant health in the context of HIV., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Two decades ago, the genocide against the Tutsis in Rwanda led to the deaths of 1 million people, and the displacement of millions more. Injury and trauma were followed by the effects of a devastated health system and economy. In the years that followed, a new course set by a new government set into motion equity-oriented national policies focusing on social cohesion and people-centred development. Premature mortality rates have fallen precipitously in recent years, and life expectancy has doubled since the mid-1990s. Here we reflect on the lessons learned in rebuilding Rwanda's health sector during the past two decades, as the country now prepares itself to take on new challenges in health-care delivery., (Copyright © 2014 Elsevier Ltd. All rights reserved.)