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Background: There is exponential growth in the interest and implementation of genomics research in Africa. This growth has been facilitated by the Human Hereditary and Health in Africa (H3Africa) initiative, which aims to promote a contemporary research approach to the study of genomics and environmental determinants of common diseases in African populations. Objective: The purpose of this article is to describe important challenges affecting genomics research implementation in Africa. Methods: The observations, challenges and recommendations presented in this article were obtained through discussions by African scientists at teleconferences and face-to-face meetings, seminars at consortium conferences and in-depth individual discussions. Results: Challenges affecting genomics research implementation in Africa, which are related to limited resources include ill-equipped facilities, poor accessibility to research centers, lack of expertise and an enabling environment for research activities in local hospitals. Challenges related to the research study include delayed funding, extensive procedures and interventions requiring multiple visits, delays setting up research teams and insufficient staff training, language barriers and an underappreciation of cultural norms. While many African countries are struggling to initiate genomics projects, others have set up genomics research facilities that meet international standards. Conclusions: The lessons learned in implementing successful genomics projects in Africa are recommended as strategies to overcome these challenges. These recommendations may guide the development and application of new research programs in low-resource settings.

Introduction In sub-Saharan African (SSA) countries endemic for tuberculosis (TB), previous TB is a significant risk factor for non-tuberculous mycobacterial pulmonary disease (NTM-PD). The deployment of GeneXpert MTB/RIF in pulmonary TB diagnostic work-up regularly identifies symptomatic patients with a positive smear microscopy but negative GeneXpert, indicative of NTM presence. This scoping review outlines recent evidence for NTM-PD diagnosis and management in SSA.Objective The review’s objective was to outline the risk factors, available diagnostics, management options and outcomes of NTM-PD in high-burden TB settings in SSA using the population-concept-context framework.Design and data sources We searched existing literature from PubMed, Web of Science, African Journals Online, Google Scholar and grey literature. Studies published between January 2005 and December 2022 were retained. Data were extracted into Rayyan software and Mendeley and summarised using Excel.Results We identified 785 potential articles, of which 105 were included in the full-text review, with 7 papers retained. Included articles used international criteria for diagnosing NTM-PD. Multiple papers were excluded due to non-application of the criteria, suggesting challenging application in the SSA setting. Identified risk factors include previous TB, smoking and mining. Most commonly, chest radiography and not CT was used for the radiological diagnosis of PD, which may miss early changes related to NTM-PD. Molecular methods for NTM species identification were employed in research settings, usually at referral centres, but were unavailable for routine care. Most studies did not report a standardised approach to treatment and they were not offered treatment for the specific disease, marking a lack of guidance in treatment decision-making. When treatment was provided, the outcome was often not reported due to the lack of implementation of standardised outcome definitions.Conclusions These outlined challenges present a unique opportunity for researchers to undertake further studies in NTM-PD and proffer solutions more applicable to SSA.

Introduction: Although there are several previous publications related to risk factors of COVID-19 infection, in Benin there are very few data to explain the outbreak risk factors. Material and methods: This case-control study, conducted from 14 September to 20 October 2020, aimed to identify the risk factors associated with COVID-19 infection in Benin. Questions on knowledge, attitudes, and practices related to COVID-19, sociodemographic characteristics, nutritional factors, medical history, housing and working conditions of respondents were asked through a questionnaire survey. Bivariate and multivariate logistic regression analyses were conducted to identify the factors associated with COVID-19. The statistical significance was set at 5%. Results: In multivariate logistic regression, no handwashing device installed at the home entrance (ORa = 1.86; 95% CI [1.07-3.21]) or a device delivering only water (ORa = 5.57; 95% CI [1.98-15.65]), using permanently air conditioning at workplaces (ORa = 5.48; 95% CI [2.40-12.57]), less knowledge of protective measures (ORa = 1.41; 95% CI [1.08-1.84]) and no knowledge on the coronavirus incubation period (ORa = 4.19; 95% CI [2.37-7.44]) were identified as risk factors for COVID-19 infection. Conclusions: Based on the findings of this study, a contextual response should prioritize strategies that will raise awareness and population’s knowledge of COVID-19 as well as preventive practices.

Point-of-care ultrasound (POCUS) is an increasingly accessible skill, allowing for the decentralization of its use to nonspecialist healthcare workers to guide routine clinical decision-making. The advent of ultrasound-on-a-chip has transformed the technology into a portable mobile health device. Because of its high sensitivity to detect small consolidations, pleural effusions, and subpleural nodules, POCUS has recently been proposed as a sputum-free likely triage tool for tuberculosis (TB). To make an objective assessment of the potential and limitations of POCUS in routine TB management, we present a Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis based on a review of the relevant literature and focusing on Sub-Saharan Africa (SSA). We identified numerous strengths and opportunities of POCUS for TB management, e.g., accessible, affordable, easy to use and maintain, expedited diagnosis, extrapulmonary TB detection, safer pleural/pericardial puncture, use in children/pregnant women/people living with HIV, targeted screening of TB contacts, monitoring TB sequelae, and creating artificial intelligence decision support. Weaknesses and external threats such as operator dependency, lack of visualization of central lung pathology, poor specificity, lack of impact assessments and data from SSA must be taken into consideration to ensure that the potential of the technology can be fully realized in research as in practice.

Abstract Background The diagnosis of tuberculosis (TB) using smear microscopy has been based on testing two specimens: one spot and one early morning sputa. Recently, the World Health Organization (WHO) has recommended to replace, whenever possible, microscopy with GeneXpert® MTB/RIF performed on a single specimen. However, as the bacterial load is higher in early morning specimens than in spot specimens, one could expect lower sensitivity of GeneXpert® MTB/RIF performed only on spot specimens. In this study, we compared results of GeneXpert® MTB/RIF on spot specimens versus early morning specimens, under programmatic conditions in Cotonou, Benin. Methods From June to September 2018, all sputa received from presumptive TB patients at the Supranational Reference Laboratory for Tuberculosis of Cotonou were included in the study. From each patient, two specimens were collected (one spot and one early morning) and GeneXpert® MTB/RIF was performed on both specimens. Results In total, 886 participants were included in the study, of whom 737 provided both sputa and 149 (16.8%) gave only the spot specimen. For the 737 participants who provided both sputa, GeneXpert® MTB/RIF was positive for both specimens in 152 participants; for three participants GeneXpert® MTB/RIF was positive on spot specimen but negative on morning specimen while for another three, the test was positive on morning specimen but negative on spot specimen. The overall percentage of agreement was excellent (99.2%) with a positive and negative percent agreement greater than 98%. Conclusion For TB diagnosis under programmatic conditions in Cotonou, GeneXpert® MTB/RIF in spot specimens gave similar results with the test in morning specimens. Performing GeneXpert® MTB/RIF in both specimens did not significantly increase the number of cases detected. To avoid losing patients from the diagnostic cascade, it is preferable to test sputa produced at the time of the first visit at the health center.

Introduction. Exposure to electrical and electronic equipment waste (e-waste) has become a growing health concern. The objective of this study was to measure the effect of exposure to e-waste on respiratory symptoms and on lung function parameters in workers involved in informal recycling activities in Cotonou city, Benin. Methods. This was a cross-sectional study, in which exposed e-waste workers in Cotonou city were randomly selected. A matching nonexposed group based on age and sex was recruited from the general population. Respiratory symptoms were investigated using a questionnaire adapted from the British Medical Research Council’s standardized respiratory questionnaire. Participants underwent lung function test using a portable spirometer (MIR SPIROBANK). Data were analyzed with STATA version 15 software. Results. The overall prevalence of respiratory symptoms in e-waste workers was statistically higher in the exposed group (33.1% vs. 21.6%; p=0.027). Chest tightness (11.8% vs. 2.1%; p=0.003) and breathlessness (6.8% vs. 1.4%; p=0.018) were the most reported symptoms by e-waste workers. Lung function testing showed a higher proportion of disorders among e-waste workers (25.0% vs. 14.9%, p=0.029), with a higher proportion of probable restrictive (10.8% vs. 2.7, p=0.005) and mixed (4.1% vs. 0%, p=0.013) ventilatory disorders. Handling or working with e-waste was found associated with a significant reduction in forced expiratory volume in one second (FEV1) by 0.4 L (95% CI: 0.3-0.6) and forced vital capacity (FVC) by 0.75 L (95% CI: 0.6-0.9) after adjustment for age, BMI, smoking habits, asthma history, and daily income. Conclusion. Work involving e-waste is associated with a higher prevalence of respiratory symptoms and with an increased risk of FEV1 and FVC decline, as well as of lung function impairment, particularly of restrictive disorders. Further studies to better clarify this association are needed. Awareness on this major public health threat should be raised in other sub-Saharan and Asian urban areas.

INTRODUCTION: la co-infection avec l'hépatite B est l'un des défis majeurs de la prise en charge du VIH depuis l'amélioration de l'accès aux antirétroviraux en Afrique. La présente étude visait à estimer la prévalence de l'hépatite B chez les personnes séropositives au VIH à Parakou et décrire les facteurs associés. METHODES: il s'agit d'une étude transversale menée de Mai 2011 à Juin 2012 dans le service de Médecine du CHU de Parakou. Ont été inclus tous les adultes séropositifs au VIH vus en consultation ou hospitalisés. Les données ont été collectées par interviews et dépouillement de dossiers médicaux. L'antigène HBs a été recherché par un test rapide et l'ALAT a été dosé. L'analyse des données a été faite avec le logiciel EpiInfo 3.5.1. Les proportions ont été comparées grâce au test de Chi-deux ou au test de Fisher au seuil de significativité de 5%. Un modèle de régression logistique multivariable a permis d'expliquer la prévalence de l'hépatite B. RESULTATS: sur les 744 sujets inclus on a dénombré 555 femmes. L'âge moyen était de 35,5 + 10,1 ans. La prévalence de l'hépatite B a été estimée à 16,9% (ICIC95 : 14,3%-19,9%). Cette prévalence était plus élevée chez les sujets originaires du Borgou/Alibori et ceux au stade 4 de l'OMS. CONCLUSION: la prévalence de la co-infection VIH/VHB au CHU Parakou est élevée. Le dispositif national de prise en charge et de prévention de l'hépatite B chez les personnes séropositives au VIH doit être renforcé.