African Field Epidemiology Network

This study investigates the dual impact of Nigeria’s 2023 fuel subsidy removal on household welfare and inflation, with implications for green investment. Using monthly time-series data from 2019 to 2024 and a Vector Error Correction Model (VECM), the analysis tests two null hypotheses: that subsidy removal has no significant effect on (1) household welfare and (2) inflation. The results reject both hypotheses, revealing that subsidy removal acts as a strong costpush inflationary shock, which in turn drives a significant and persistent decline in household consumption expenditure (welfare proxy). Cointegration confirms a long-run equilibrium among subsidy policy, inflation, exchange rates, and welfare. The inflationary pass-through is amplified by exchange rate depreciation, while welfare losses are regressive, disproportionately affecting low-income households. The study concludes that without robust compensatory mechanisms, including targeted social transfers, inflation control policies, and transparent reinvestment of fiscal savings into green infrastructure, the short-term social costs of subsidy reform may undermine its long-term fiscal and sustainability objectives. Recommendations are anchored in an integrated policy framework that reconciles macroeconomic efficiency with household resilience.

This scoping review will provide valuable information for clinicians, researchers, and policymakers to develop combined physical and cognitive rehabilitation programs tailored to the distinct physiological, cognitive and social needs of older athletes.

Background: Viral hepatitis and HIV infections are common public health concerns among injecting drug users, however, there is limited evidence on their seroprevalence in Afghanistan. Aim: To determine the seroprevalence of hepatitis B, hepatitis C and HIV among male injecting drug users at Ibn Sina Drug Addiction Treatment Hospital, Kabul, Afghanistan. Methods: Using a structured questionnaire, we interviewed 397 injecting drug users at Ibn Sina Drug Addiction Treatment Hospital, Kabul, Afghanistan, between November and December 2022. We collected and tested 3–5 ml blood samples from the participants. We analysed the data using Epi Info version 7.2.1 and used binary logistic regression and χ2 tests to identify potential predictors of blood-borne hepatitis B, hepatitis C and HIV infections. Results: Of the total participants, seroprevalence of hepatitis B was 3.79%, hepatitis C 2.77% and HIV 0.50%. Syringe reuse (10%), sharing of syringes (18.6%) and history of blood transfusion (20.2%) were common, but there was no statistically significant association between these predictors and infection (P < 0.05). However, using shared blades was positively associated with hepatitis B infection. Conclusion: Although hepatitis B, hepatitis C and HIV seroprevalence were lower in our study than in previous studies, and no significant association was found between the risk factors and these diseases, there is a need to expand harm reduction services beyond needle-syringe programmes to include non-syringe components. The association between shared blade use and hepatitis B infection indicates that harm reduction efforts should also incorporate safe shaving practices.

• MSG induced significant cardiotoxicity through SERCA2a downregulation, calcium dysregulation, and oxidative stress in male Wistar rats. • L-arginine treatment restored SERCA2a expression and normalized plasma and cardiac calcium homeostasis in MSG-treated animals. • L-arginine enhanced antioxidant defense mechanisms by increasing NADPH, G6PDH, and GPx activities while reducing lipid peroxidation. • MSG dysregulated VEGF-PI3K growth factor signaling, while L-arginine normalized these pathways to prevent apoptosis. • L-arginine demonstrated multi-target cardioprotection through simultaneous modulation of calcium handling, redox balance, and survival signaling pathways. L-arginine is a semi-essential amino acid that is produced endogenously and can be obtained through dietary supplements. Monosodium glutamate (MSG) is an umami flavor enhancer used in packaged and processed food and has been associated with cardiotoxicity and inflammation. The sarcoplasmic/endoplasmic reticulum Ca2+ ATPase 2a (SERCA2a) is a key player in the Ca2+ cycle of cardiac regulation. This study aims to evaluate the effect of L-arginine on SERCA2a in MSG-induced cardiac toxicity. Twenty male Wistar rats weighing 100-120g were divided into four groups (n=5/group) and were fed as group1; control- rat chow + olive oil (vehicle); group 2; rat chow+ L-arginine (150 mg/kg), group 3; MSG (120mg/kg) + vehicle, group 4; MSG+ L-Arginine daily for 6 weeks respectively. At the end of the experiment, rats were anaesthetized with 0.3ml of I.M ketamine hydrochloride (50mg/ml), and blood was collected by cardiac puncture. Serum and cardiac tissue homogenate were analyzed, and values expressed as mean ± SEM with p-values < 0.05 accepted as significant. The results showed that MSG, compared with the control, significantly decreased plasma and cardiac NO, NADPH, GPx, Ca2+, cardiac SERCA2 activity, VEGF, and PI3K, and increased plasma and cardiac MDA and uric acid (P<0.05). However, L-arginine significantly increased NO, NADPH, GPx, and cardiac SERCA2 activity, as well as VEGF and PI3K, compared with the control and MSG-treated groups. In conclusion, L-arginine attenuated MSG-induced cardiotoxicity by restoring calcium handling and redox balance, as well as modulating VEGF–PI3K/Akt survival signaling to reduce apoptotic and metabolic dysfunctions.

• A 2-minute walk test can be used instead of the 6-minute walk test for people who have high cardiovascular endurance. • Replacing the 6-minute walk test with a 2-minute walk test is not advisable for people with low cardiovascular endurance. • The choice between a 2-minute and a 6-minute walk test does not depend on age, sex at birth, or cognitive status of the older adults. This study aimed to test whether the 2-Minute Walk Test (2MWT) can substitute for the 6-Minute Walk Test (6MWT) when estimating functional capacity in Nigerian older adults and to identify physiological mediators or moderators of that relationship. We conducted a cross-sectional study and recruited 409 adults ≥ 60 years who completed both walk tests; gait speed was the primary outcome. Age, sex, body-mass index (BMI), Montreal Cognitive Assessment scores, and estimated VO₂ max were also recorded. This study indicated that 2MWT gait speed strongly predicted 6MWT gait speed (β = 0.547, p < 0.001), accounting for 35 % of its variance. Age, cognition, BMI, and VO₂ max did not mediate this association, but VO₂ max moderated it (interaction β = 0.0175, p < 0.05). Bland–Altman analysis showed a small systematic underestimation by the 2MWT, with acceptable agreement when mean speeds were 0.7–1.2 m s⁻¹. We concluded that the 2MWT could offer a time-efficient proxy for the 6MWT in low-resource settings, although clinicians should interpret results cautiously in individuals with low aerobic fitness.

COVID-19 is a respiratory disease caused by the SARS-CoV-2 virus, which put the entire world on hold for two years from 2020 to March 2022 before the rapid roll-out of vaccines. This virus claimed many lives, 6,331,727 deaths globally, and 172,390 people in Africa died from the disease, while Uganda lost 3,620 people in the same period. The study aimed to analyse the spread patterns of SARS-CoV-2 in Uganda and neighbouring countries and understand the community transmission within Uganda. The study utilised genomic sequences from the Global Initiative on Sharing Avian Influenza Data (GISAID) repository. Bayesian Phylogeography methods were used via the BEAST software. The first case of COVID-19 in Uganda likely originated from Kenya. The virus spread from Kenya to other East African countries. Cross-border movements, especially by truck drivers and refugees, played a significant role in the spread. The study highlights the importance of cross-border collaborations to control infectious disease spread. The spread pattern was influenced by trade routes and the movement of people, emphasising the need for robust border control measures during pandemics. Understanding the origin and spread of SARS-CoV-2 can inform better public health strategies and preparedness for future pandemics.

Introduction: Extrapulmonary tuberculosis (EPTB) accounts for a variable proportion of tuberculosis cases in Africa and remains difficult to diagnose due to its often atypical clinical presentation. In Burkina Faso, epidemiological information on EPTB is limited, particularly in the Centre‑Est region, which faces a fragile security context disrupting access to care. We described the epidemiological profile of EPTB cases reported between 2021 and 2023. Methods: We conducted a descriptive cross‑sectional study covering the period from January 1, 2021, to December 31, 2023. All bacteriologically confirmed or clinically/radiologically diagnosed cases of EPTB were included. Sociodemographic, clinical, diagnostic, and treatment outcome data were collected using a KoboToolbox electronic form and analyzed with STATA 15.1. Results: Among 1,581 tuberculosis cases notified during the study period, 191(12%) were extrapulmonary forms. The median age was 35 years (IQR: 19–54), and males accounted for 68.6% (131/191) of cases, with a male-to-female sex ratio of 2.18. The most affected occupational groups were unemployed individuals, 36.7% (70/191) and farmers, 27.2% (52/191). The most frequent anatomical sites were osteoarticular 53.9% (103/191), pleural 26.7% (51/191), and abdominal 7.3% (14/191). Bacteriological confirmation was achieved in 5.8% (11/191) of cases. Treatment outcomes showed 82.2% (157/191) success, 6.8% (13/191) default, and 11.0% (21/191) mortality. Conclusion: EPTB remains likely underdiagnosed in the Centre‑Est region of Burkina Faso. The predominance of osteoarticular forms, together with a default rate above the national target and a high mortality rate in a context of insecurity, highlights the need to strengthen diagnostic capacities and adapt community follow-up strategies to improve patient management.

Opportunistic screening for diabetes mellitus (DM) is a key component of India's noncommunicable disease programme, yet its coverage remains poorly assessed. We conducted a cross-sectional study in ten primary healthcare facilities in West Sikkim over 7 weeks using register reviews and staff interviews. Among 4323 outpatient department attendees aged ≥30 years, 1515 (35%) were screened and 175 (12%) were newly diagnosed. Screening coverage ranged from 9% to 100% and yield from 0% to 36%. Fishbone analysis identified staff shortages, inadequate supplies, and low provider motivation. Targeted quality improvement strategies are recommended to improve screening and DM management.