Introduction: While real-time reverse transcription PCR (RT-PCR) is the recommended laboratory method to diagnose severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection, its use in ...resource limited settings can be difficult to maintain due to high testing demand and shortage of reagents. The aim of this study was to evaluate the performances of Realy Tech™ and Standard Q™ in comparison to RT-PCR in a relatively low COVID-19 prevalence setting, Mali.Methods: We conducted a cross-sectional study between January and April 2021 in Bamako and Kati regions to evaluate both rapid tests during a large SARS-CoV-2 prevalence study in Mali.Results: Of the 390 samples tested, the sensitivity and specificity of Realy Tech™ and Standard Q™ were 57.1% (95%CI: 44.1-69.2), 95.8% (95%CI: 93.1-97.5); 61.9% (95%CI: 46.8-75.0), and 94.1% (95%CI: 89.5-96.8) respectively. Using RT-PCR, the global prevalence of SARS-CoV-2 was 14.4% (56/390). In both rapid antigen tests, the performance was better when used in suspected patients compared to positive patients under treatment. Moreover, higher viral loads equivalent to Ct < 25 were associated with better detection rates.Conclusion: While waiting for more complete data, these preliminary studies suggest that Realy Tech™ and Standard Q™ should not be used alone for COVID-19 diagnosis in Mali.
Tuberculosis (TB) remains a major public health concern with millions of deaths every year. The overlap with HIV infections, long treatment duration, and the emergence of drug resistance are ...significant obstacles to the control of the disease. Indeed, the standard first-line regimen TB treatment takes at least six months and even longer for the second-line therapy, resulting in relapses, drug resistance and re-infections. Many recent reports have also shown prolonged and significant damage of the gut microbial community (dysbiosis) from anti-TB drugs that can detrimentally persist several months after the cessation of treatment and could lead to the impairment of the immune response, and thus re-infections and drug resistance. A proposed strategy for shortening the treatment duration is thus to apply corrective measures to the dysbiosis for a faster bacterial clearance and a better treatment outcome. In this review, we will study the role of the gut microbiota in both TB infection and treatment, and its potential link with treatment duration. We will also discuss, the new concept of "Host Microbiota Directed-Therapies (HMDT)" as a potential adjunctive strategy to improve the treatment effectiveness, reduce its duration and or prevent relapses. These strategies include the use of probiotics, prebiotics, gut microbiota transfer, and other strategies. Application of this innovative solution could lead to HMDT as an adjunctive tool to shorten TB treatment, which will have enormous public health impacts for the End TB Strategy worldwide.
Tuberculosis (TB) remains an important global health issue worldwide. Despite this scourge threatening many human lives, especially in developing countries, thus far, no advanced molecular ...epidemiology study using recent and more accurate tools has been conducted in Mali. Therefore, this study aimed to use variable-number tandem repeats of mycobacterial interspersed repetitive units (MIRU-VNTR) technology coupled with the spoligotyping method to accurately determine the hot spots and establish the epidemiological transmission links of TB in Bamako, Mali.
In a cross-sectional study, 245 isolates of Mycobacterium tuberculosis complex (MTBC) were characterized using spoligotyping and MIRU-VNTR, and an epidemiological investigation was conducted.
Of the 245 isolates, 184 (75.1%) were formally identified. The most widespread strain was the Cameroon strain (83; 45.1%). Eight major clusters were identified: Ghana (27; 14.7%), West African 2 (22; 12%), Haarlem (13; 7.1%), H37Rv (t) (8; 4.3%), Latin American Mediterranean (8; 4.3%), and Uganda I and II (6; 3.3%). Statistical analysis showed a significant difference between lineages from the respective referral health centers of Bamako, Mali (P = 0.01).
This study establishes, for the first time, an accurate spatial distribution of circulating MTB strains in Bamako, Mali. The data was used to identify strains and “hot spots” causing TB infection and can also be used for more targeted public health responses, particularly for hot spots of drug-resistant strains.
Key Clinical Message
Cleidocranial dysplasia (CCD) is a rare genetic skeletal disorder with only few cases reported in Africa, mostly based on clinical and radiological findings. We report the first ...case in Mali, caused by a novel de novo variant in the RUNX2 gene.
Cleidocranial dysplasia (CCD) is a rare autosomal dominant skeletal dysplasia characterized by an aplastic/hypoplastic clavicles, patent sutures and fontanels, dental abnormalities and a variety of other skeletal changes. We report a novel de novo variant in the RUNX2 gene causing a severe phenotype of CCD in a Malian girl.
Radiological features of cleidocranial dysplasia. (A) The orthopantomogram at age 8 showing germ retention and polyodontia with supernumerary teeth; (B) Chest X‐rays showing a total absence of the clavicles and (C) Pelvic x‐rays showing a left coxa Vara lesion; Brain CT‐scan showing (D) a dilatation of the occipital horns of the lateral ventricles at the time of diagnosis and (E) 3 years later; 3D reconstruction of the CT‐scan of the skull in (F) anterior view showing patent anterior fontanel, the absence of the upper part of the frontal and the parietal bones, (G) posterior view showing the absence of the parietal bone with preservation of the occipital bone, and (H, I) progression of the cranial bone development after 3 years of evolution with a notable reduction of the bone defect.
Abstract
The Central Sahel region has one of the world's fastest-growing populations of internally displaced persons (IDPs). To better understand the risk factors associated with displacement, this ...study utilized respondent-driven sampling to recruit otherwise hard-to-reach IDPs in remote and urban areas in Burkina Faso, Mali, and Niger. From August to October 2021, 4144 IDPs were surveyed, and nine targeted vulnerability profiles were measured across the domains of gender, health, and protection. The study revealed a high prevalence of risk factors and vulnerability among IDPs, with notable geographic differences. The majority of IDPs fell into at least one category of vulnerability, with health vulnerabilities being the most common. Internally displaced persons reported overlapping vulnerabilities in health, particularly chronic illness, mental health issues, and disability. Women had higher odds of vulnerability than men. Statistically significant associations were site-specific, and some were inconsistent across contexts, highlighting the cross-cutting and pervasive nature of vulnerability among IDPs.
ABSTRACT
Background
The sero‐epidemiological characteristics of SARS‐CoV‐2 infections in Mali are not yet well understood. This study assessed SARS‐CoV‐2 antibody seroprevalence and factors ...associated with antibody responses in the general population of Bamako, the capital city and epicenter of COVID‐19, to assess the magnitude of the pandemic and contribute to control strategy improvements in Mali.
Methods
A cross‐sectional survey was conducted in September 2022 to collect sociodemographic information, clinical characteristics, comorbid factors, and blood samples. ELISA was performed to determine anti‐Spike (anti‐S) and anti‐RBD antibody levels. A total of 3601 participants were enrolled in REDCap. R‐Studio was used for the statistical analysis. The chi‐squared (χ2) test was used to compare the proportions across different groups. Logistic regression models were used to elucidate factors associated with antibody responses.
Result
The sex ratio for female‐to‐male was 3.6:1. The most representative groups were the 20–29‐year‐olds (28.9%, n = 1043) and the 30–39‐year‐olds (26.9%, n = 967). The COVID‐19 vaccine coverage among the participants was 35.8%, with vaccines from Covishield AstraZeneca (13.4%), Johnson & Johnson (16.7%), Sinovac (3.9%), and BioNTech Pfizer (1.8%). Overall, S protein and RBD antibody seroprevalences were remarkably high in the study population (98% and 97%, respectively). Factors such as youth (1–9 years old) and male sex were associated with lower SARS‐CoV‐2 antibody responses, whereas COVID‐19 vaccinations were associated with increased antibody responses.
Conclusion
This serosurvey demonstrated the high seroprevalence of SARS‐CoV‐2 antibodies and highlighted the factors influencing antibody responses, while clearly underlining an underestimation of the pandemic in Mali.
•COVID-19 waves in Mali in 2021 were linked to various SARS-CoV-2 variants.•S genes from respiratory SARS-CoV-2-positive samples were sequenced in Bamako.•Seven distinct variants were identified: ...Delta, Alpha, Beta, Eta, 20B, 19B and 20A.•Continued emergence of new variants highlights the need for genomic surveillance
The emergence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants may have contributed to prolonging the pandemic, and increasing morbidity and mortality related to coronavirus disease 2019 (COVID-19). This article describes the dynamics of circulating SARS-CoV-2 variants identified during the different COVID-19 waves in Mali between April and October 2021.
The respiratory SARS-CoV-2 complete spike (S) gene from positive samples was sequenced. Generated sequences were aligned by Variant Reporter v3.0 using the Wuhan-1 strain as the reference. Mutations were noted using the GISAID and Nextclade platforms.
Of 16,797 nasopharyngeal swab samples tested, 6.0% (1008/16,797) tested positive for SARS-CoV-2 on quantitative reverse transcription polymerase chain reaction. Of these, 16.07% (162/1008) had a cycle threshold value ≤28 and were amplified and sequenced. The complete S gene sequence was recovered from 80 of 162 (49.8%) samples. Seven distinct variants were identified: Delta (62.5%), Alpha (1.2%), Beta (1.2%), Eta (30.0%), 20B (2.5%), 19B (1.2%) and 20A (1.2%).
Several SARS-CoV-2 variants were present during the COVID-19 waves in Mali between April and October 2021. The continued emergence of new variants highlights the need to strengthen local real-time sequencing capacity and genomic surveillance for better and coordinated national responses to SARS-CoV-2.
Ability to rapidly and accurate diagnose pathogens during disease outbreaks is essential for public health. Diagnosis depends largely on laboratory capacity, which can be challenging in resource ...limited settings. We report Mali’s experience involving four research laboratories in response to the COVID-19 pandemic. This coordinated effort leveraged the emerging infectious pathogens diagnostic capacity and partnerships built from the 2014/2015 Ebola outbreak. Since Mali’s first two COVID-19 cases in March 2020, 349,292 suspected cases were tested in the four Bamako laboratories as of July 31, 2021. Laboratory operation, safety considerations, diagnostic assays, and challenges are described herein from the perspective of a participating laboratory, the Mali University Clinical Research Center (UCRC). We also highlight additional roles of the UCRC laboratory in the COVID-19 response, including roll out of vaccination and research efforts. Mali’s readiness to detect the index cases early in the epidemic and continued response to the COVID-19 pandemic highlight the need for strengthening the critical role and capacity of clinical research laboratories for response to emerging infectious disease epidemics in Africa.
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