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Growing international concern over Russia's military and political resurgence in Africa and the possibility of creating a renewed Cold War has been rekindled by Russia's invasion of Ukraine and the outbreak of war in Europe in February 2022. Russia's growing influence in Africa through the re-establishment of old ties and the creation of new ones has been perceived as a quest to re-establish the geopolitical gains that the Soviet Union achieved before its collapse in 1989. Increasing demand for Russian weaponry and equipment, support for unpopular, illegitimate, or unconstitutionally elected leaders, and the targeting and interest in mining concessions and natural resources are considered by the West to be a threat to democratic gains and stability in an already fragile continent. Several questions arise as a result of the deepfake propaganda around occurrences on the continent. How has Russia's resurgence or reemergence manifested on the African continent? What instruments does Russia utilise to exert its influence in Africa? What are the potential opportunities and threats of Russian presence in West Africa and the Sahel? And how will other global actors be affected? This debate article seeks to examine a particular aspect of Russia's resurgence on the African continent, namely, the presence of Russian proxies in West Africa and the Sahel. It examines the multiple dynamics created by their presence, the potential threats that their proliferation and activities generate in an already fragile sub-region, and how such activities, if unconstrained, can impose other potential dangers on the continent and the globe. Keywords: Russia's Proxies, West Africa, Sahel., 1. Introduction Russia's invasion of Ukraine and the subsequent outbreak of war in February 2022 has brought back old threats and is re-shaping the international order in ways unseen since [...]

ABSTRACT Objective Design Setting Population or Sample Methods Main Outcome Measures Results Conclusions Assessment of COVID‐19 vaccine safety in pregnancy using population‐based data.Matched case–control study nested in a retrospective cohort.April 2021–March 2022, England.All pregnant individuals aged between 18 and 50 years with valid health records.Individuals identified from the national Maternity Services Data Set (MSDS) had their records linked to hospital admission, national COVID‐19 vaccine and COVID‐19 testing databases. Matching included participant's age and estimated week of conception. We compared outcomes across multiple COVID‐19 vaccine exposures using conditional multivariable logistic regression, adjusting for demographic and health characteristics.Adverse pregnancy, maternal and neonatal outcomes.514 013 individuals were included. We found lower odds of giving birth to a baby who was low birthweight (aOR = 0.86, 95% CI: 0.79–0.93), preterm (aOR = 0.89, 95% CI: 0.85–0.92) or who had an Apgar score < 7 at 5 min of age (aOR = 0.89, 95% CI: 0.80–0.98) for individuals who received at least one dose of COVID‐19 vaccine during pregnancy. The odds of admission to intensive care unit during pregnancy were lower in those vaccinated (aOR = 0.85, 95% CI: 0.76–0.95). There was no association between vaccination in pregnancy and stillbirth, neonatal death, perinatal death and maternal venous thromboembolism in pregnancy.COVID‐19 vaccines are safe to use in pregnancy. Our findings generated important information to communicate to pregnant individuals and health professionals to support COVID‐19 maternal vaccination programmes. [ABSTRACT FROM AUTHOR]

The recruitment and use of children by armed groups continue to threaten the effective protection of children. Preventive approaches to child protection, call for robust early warning mechanisms that do not only focus on the recruitment and use of children, but capture the root causes and vulnerabilities of both boys and girls for recruitment. A comprehensive early warning mechanism for prevention requires a gender-sensitive approach. This paper seeks to examine the gender dynamics of the recruitment and use of children by armed groups, and how that can inform a gender sensitive data collection and analysis to improve early warning. [ABSTRACT FROM AUTHOR]

Background Invasive meningococcal disease (IMD) is most common in the first year of life. We hypothesized that preterm infants may have a higher risk of IMD and more severe disease than term infants. We compared the incidence, demographics, clinical presentation, and outcomes of IMD in preterm compared with term infants during the first 5 years after implementation of a national meningococcal group B vaccine (4CMenB) for infants in England. Methods The UK Health Security Agency conducts enhanced national IMD surveillance with detailed follow-up of all confirmed cases in England. Infants aged <1 year (uncorrected for gestational age) with IMD confirmed between 1 September 2015 and 31 August 2020 were included. Results There were 393 infant IMD cases (incidence, 12.4/100 000 live births). Among 363 (92.4%) of the infants with known gestational age, the IMD incidence was higher in preterm (<37 weeks' gestation) than in term infants (18.3/100 000 vs 10.9/100 000; incidence rate ratio [IRR], 1.68 [95% confidence interval, 1.23–2.29]; P =.001). The IMD incidence was highest in those born at <32 weeks' gestation (32.9/100 000; incidence rate ratio for <32 weeks' gestation vs term, 3.01 [95% confidence interval, 1.73–5.24]; P ≤.001). There were no differences in demographics, clinical presentation, rate of intensive care admission, or case-fatality rate, but preterm infants were more likely than term infants to have ≥1 reported sequela (14 of 39 [35.9%] vs 51 of 268 [19.0%]; P =.02). Conclusions Preterm infants had a higher incidence of IMD than term infants and the IMD incidence was highest in infants born at <32 weeks' gestation. Preterm infants also had a higher risk of IMD sequelae. [ABSTRACT FROM AUTHOR]

Background:: The cow intestine is a delicacy cherished and eaten by many persons in West Africa, but there is a paucity of data on its nutrient composition. Objective: To compare and analyze the energy and nutrient (proximate, mineral [iron, phosphorus, copper, and zinc] and free fatty acid (FFA) [as oleic]) composition of cooked and uncooked cow intestines commonly consumed in Accra, Ghana. Methods: Samples of cow intestines were obtained from the markets by purposive sampling and subsequently processed for analysis. The nutrient composition was determined using standard methods. Statistical analysis was conducted using the independent sample t-test in IBM SPSS Statistics version 22 to compare the data obtained from the uncooked and cooked samples. A significance level of P < 0.05 was used to determine statistical significance. Results: Comparisons between the two samples showed that the moisture reduced significantly (p=0.001) after cooking and carbohydrate content in the uncooked sample was 6.13g/100g but disappeared after cooking (p=0.000). The ash content was significantly lower (p=0.002) in the uncooked sample (0.46 g/100g) than in the cooked sample (0.6 g/100g). However, the energy, fat, and protein content were significantly higher (p<0.05) in the cooked cow intestine than in the uncooked cow intestines. There was no significant difference in the concentration of FFA (as oleic) content of cooked cow intestines and uncooked cow intestines (p=0.8093). The zinc, copper, and iron concentrations reduced significantly (p<0.05) after cooking while the phosphorus content increased significantly (p=0.000) by 105.15% after cooking. Conclusion: The study provided data on some minerals, proximate, and FFA (as oleic) composition of uncooked and cooked cow intestines. Findings showed that cow intestines have a substantial nutrient composition that can make a significant contribution to nutrient intakes in the diet of individuals. [ABSTRACT FROM AUTHOR]

Growing international concern over Russia’s military and political resurgence in Africa and the possibility of creating a renewed Cold War has been rekindled by Russia’s invasion of Ukraine and the outbreak of war in Europe in February 2022. Russia’s growing influence in Africa through the re-establishment of old ties and the creation of new ones has been perceived as a quest to re-establish the geopolitical gains that the Soviet Union achieved before its collapse in 1989. Increasing demand for Russian weaponry and equipment, support for unpopular, illegitimate, or unconstitutionally elected leaders, and the targeting and interest in mining concessions and natural resources are considered by the West to be a threat to democratic gains and stability in an already fragile continent. Several questions arise as a result of the deepfake propaganda around occurrences on the continent. How has Russia’s resurgence or reemergence manifested on the African continent? What instruments does Russia utilise to exert its influence in Africa? What are the potential opportunities and threats of Russian presence in West Africa and the Sahel? And how will other global actors be affected? This debate article seeks to examine a particular aspect of Russia’s resurgence on the African continent, namely, the presence of Russian proxies in West Africa and the Sahel. It examines the multiple dynamics created by their presence, the potential threats that their proliferation and activities generate in an already fragile sub-region, and how such activities, if unconstrained, can impose other potential dangers on the continent and the globe. [ABSTRACT FROM AUTHOR]

The duration of immunity after first severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the extent to which prior immunity prevents reinfection is uncertain and remains an important question within the context of new variants. This is a retrospective population-based matched observational study where we identified the first polymerase chain reaction (PCR) positive of primary SARS-CoV-2 infection case tests between 1 March 2020 and 30 September 2020. Each case was matched by age, sex, upper tier local authority of residence and testing route to one individual testing negative in the same week (controls) by PCR. After a 90-day pre-follow-up period for cases and controls, any subsequent positive tests up to 31 December 2020 and deaths within 28 days of testing positive were identified, this encompassed an essentially vaccine-free period. We used a conditional logistic regression to analyse the results. There were 517 870 individuals in the matched cohort with 2815 reinfection cases and 12 098 first infections. The protective effect of a prior SARS-CoV-2 PCR-positive episode was 78% (odds ratio (OR) 0.22, 0.21–0.23). Protection rose to 82% (OR 0.18, 0.17–0.19) after a sensitivity analysis excluded 933 individuals with a first test between March and May and a subsequent positive test between June and September 2020. Amongst individuals testing positive by PCR during follow-up, reinfection cases had 77% lower odds of symptoms at the second episode (adjusted OR 0.23, 0.20–0.26) and 45% lower odds of dying in the 28 days after reinfection (adjusted OR 0.55, 0.42–0.71). Prior SARS-CoV-2 infection offered protection against reinfection in this population. There was some evidence that reinfections increased with the alpha variant compared to the wild-type SARS-CoV-2 variant highlighting the importance of continued monitoring as new variants emerge. [ABSTRACT FROM AUTHOR]

Background Streptococcus pneumoniae coinfection with influenza results in synergistic lethality, but there are limited data on pneumococcal coinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods Public Health England conducts invasive pneumococcal disease (IPD) and SARS-CoV-2 surveillance in England. IPD trends during 2000/2001–2019/2020 epidemiological years were analyzed and cases during February–June 2020 linked with laboratory-confirmed SARS-CoV-2 infections. Multivariable logistic regression was used to assess risk factors for death. Results IPD incidence in 2019/2020 (7.6/100 000; n = 3964) was 30% (IRR,.70; 95% CI,.18–2.67) lower compared with 2018/2019 (10.9/100 000; n = 5666), with large reductions observed across all age groups during March–June 2020. There were 160 886 SARS-CoV-2 and 1137 IPD cases during February–June 2020, including 40 IPD/coronavirus disease 2019 (COVID-19) co-infections (.025% [95% CI,.018–.034] of SARS-CoV-2 infections; 3.5% [2.5–4.8] of IPD cases), 21 with COVID-19 diagnosed 3–27 days after IPD, and 27 who developed COVID-19 ≥28 days after IPD. Case-fatality rates (CFRs) were 62.5 (25/40), 47.6% (10/21), and 33.3% (9/27), respectively (P  < .001). In addition to an independent association with increasing age and serotype group, CFR was 7.8-fold (95% CI, 3.8–15.8) higher in those with IPD/COVID-19 coinfection and 3.9-fold (95% CI, 1.4–10.7) higher in patients who developed COVID-19 3–27 days after IPD compared with patients with IPD only. Conclusions Large declines in IPD were observed following COVID-19 lockdown. IPD/COVID-19 coinfections were rare but associated with high CFR, mainly in older adults. The rarity, age and serotype distribution of IPD/COVID-19 coinfections do not support wider extension of pneumococcal vaccination. [ABSTRACT FROM AUTHOR]

Background: The full reopening of schools in September 2020 was associated with an increase in COVID-19 cases and outbreaks in educational settings across England., Methods: Primary and secondary schools reporting an outbreak (≥2 laboratory-confirmed cases within 14 days) to Public Health England (PHE) between 31 August and 18 October 2020 were contacted in November 2020 to complete an online questionnaire., Interpretation: There were 969 school outbreaks reported to PHE, comprising 2% ( n  = 450) of primary schools and 10% ( n  = 519) of secondary schools in England. Of the 369 geographically-representative schools contacted, 179 completed the questionnaire (100 primary schools, 79 secondary schools) and 2,314 cases were reported. Outbreaks were larger and across more year groups in secondary schools than in primary schools. Teaching staff were more likely to be the index case in primary (48/100, 48%) than secondary (25/79, 32%) school outbreaks ( P  = 0.027). When an outbreak occurred, attack rates were higher in staff (881/17,362; 5.07; 95%CI, 4.75-5.41) than students, especially primary school teaching staff (378/3852; 9.81%; 95%CI, 8.90-10.82%) compared to secondary school teaching staff (284/7146; 3.97%; 95%CI, 3.79-5.69%). Secondary school students (1105/91,919; 1.20%; 95%CI, 1.13-1.28%) had higher attack rates than primary school students (328/39,027; 0.84%; 95%CI, 0.75-0.94%)., Conclusions: A higher proportion of secondary schools than primary schools reported a COVID-19 outbreak and experienced larger outbreaks across multiple school year groups. The higher attack rate among teaching staff during an outbreak, especially in primary schools, suggests that additional protective measures may be needed., Funding: PHE., Competing Interests: The authors declare no conflicts of interest., (Crown Copyright © 2021 Published by Elsevier Ltd.)