FATAL CEREBRAL TRANSVERSE VENOUS THROMBOSIS IN AN ADOLESCENT MALE: A CASE OF DELAYED PRESENTATION.

Introduction/background: Venous sinus thrombosis hypercoagulable states leads to delayed drainage of blood from the brain; consequently, resulting in cerebral oedema, raised intracranial pressure, or stroke. Causes are variable, including severe dehydration, infections, cancers, sinusitis, and brain surgery. The commonest symptoms are headache, seizures, and unconsciousness.

A RARE CASE OF MIXED CHRONIC INFLAMMATORY DEMYELINATING POLYRADICULOPATHY (CIDP) AND ACUTE TRANSVERSE MYELITIS (ATM).

Introduction/background: Though CIDP and ATM are both inflammatory disorders of the nervous system with distinct features, they rarely occur together in the same individual.

Case Presentation: A 41-year-old male trader was admitted with 10 10-day history of paraplegia and weakness of upper limbs. The illness started with lower limb paresthesia, weakness of the left leg, then the right leg after 5 days, proceeding to paraplegia, weakness of upper arms, urine retention, and constipation 3 days before presentation.

Mitigation of aflatoxin contamination of maize, groundnut, and sorghum by commercial biocontrol products in farmers' fields across Burkina Faso, Mali, Niger, and Togo.

Background: Aflatoxin contamination by section Flavi fungi poses a significant threat to food security and public health in sub-Saharan Africa (SSA). Maize, groundnut, and sorghum are staple crops frequently contaminated with aflatoxins, sometimes at dangerous levels. Despite its detrimental effects, many farmers in SSA lack access to effective tools for mitigating aflatoxin contamination.

Coping strategies for household water insecurity in rural Gambia, mediating factors in the relationship between weather, water and health.

Background: Rural communities in low- and middle-income countries, such as The Gambia, often experience water insecurity periodically due to climate drivers such as heavy rainfall and reduced rainfall, as well as non-climate drivers such as infrastructural issues and seasonal workloads. When facing these challenges households use a variety of coping mechanisms that could pose a risk to health. We aimed to understand the drivers of water insecurity (climate and non-climate), the behavioural responses to water insecurity and the risks these responses pose to the health of communities in rural Gambia and map these findings onto a conceptual framework.

Enhancing clinical microbiology for genomic surveillance of antimicrobial resistance implementation in Africa.

Surveillance is essential in the fight against antimicrobial resistance (AMR), to monitor the extent of resistance, inform prevention, control measures, and evaluate intervention progress. Traditional surveillance methods based on phenotypic antimicrobial susceptibility data offer important but limited insights into resistance mechanisms, transmission networks, and spread patterns of resistant bacterial strains. Fortunately, genomic technologies are increasingly accessible and can overcome these limitations.

Meningiomas of the parieto-occipital convexity mimicking a hematoma: A case report in a third-world country.

Background: Meningiomas are benign, slow-growing tumors of the central nervous system (CNS) that arise from the arachnoid matter. It comprises one of the most common primary tumors of the CNS, occurring mostly in and after the fifth decade of life with a female gender predilection. Diagnosis is facilitated by imaging computed tomography (CT) or magnetic resonance imaging (MRI); however, atypical forms exist which augments the risk of missing the diagnosis.

Identification of complex Plasmodium falciparum genetic backgrounds circulating in Africa: a multicountry genomic epidemiology analysis.

Background: The population structure of the malaria parasite Plasmodium falciparum can reveal underlying adaptive evolutionary processes. Selective pressures to maintain complex genetic backgrounds can encourage inbreeding, producing distinct parasite clusters identifiable by population structure analyses.

Methods: We analysed population structure in 3783 P falciparum genomes from 21 countries across Africa, provided by the MalariaGEN Pf7 dataset.

Routine HPV vaccination: Reflection on delivery strategies based on countries' experiences.

Despite the introduction of the human papillomavirus (HPV) vaccine in many low- and middle-income countries (LMICs), countries are still struggling to maintain HPV vaccination coverage and manage sustainable delivery strategies. This article explores the challenges and effective strategies for HPV vaccine delivery in LMICs, with a focus on reflecting upon current HPV vaccine delivery strategies in the World Health Organization (WHO) HPV vaccine introduction guidelines to align with practical implementation experiences. The article utilizes presentations and discussions from Coalition to Strengthen the HPV Immunization Community (CHIC) symposia, field experiences of program implementers who participated in the meeting and immunization expert opinions, to inform its findings.

Clinical outcomes of untreated adults living with chronic hepatitis B in The Gambia: an analysis of data from the prospective PROLIFICA cohort study.

Background: Expanding antiviral therapy to people with chronic hepatitis B virus (HBV) infection who are ineligible to receive treatment under current international criteria has been increasingly debated. Evidence to support this approach is scarce, especially in Africa. We aimed to address this knowledge gap by analysing the clinical outcomes of people with chronic hepatitis B in The Gambia who were untreated and ineligible for antiviral therapy at diagnosis.

Types, design, implementation, and evaluation of nutrition interventions in older people in Africa: A scoping review protocol.

Introduction: Africa's older population is increasing and this, necessitates the development of interventions to promote healthy ageing. Nutrition is a key determinant of healthy ageing and local contextual evidence is needed to inform nutritional intervention development in Africa. There are already reviews on nutritional status and food insecurity in older adults in Africa.

Emerging threat of artemisinin partial resistance markers (pfk13 mutations) in Plasmodium falciparum parasite populations in multiple geographical locations in high transmission regions of Uganda.

Background: Artemisinin-based combination therapy (ACT) is currently recommended for treatment of uncomplicated malaria. However, the emergence and spread of partial artemisinin resistance threatens their effectiveness for malaria treatment in sub-Saharan Africa where the burden of malaria is highest. Early detection and reporting of validated molecular markers (pfk13 mutations) in Plasmodium falciparum is useful for tracking the emergence and spread of partial artemisinin resistance to inform containment efforts.

Data sharing considerations and practice among health researchers in Africa: A scoping review.

Objective: To examine the way African health researchers share data. It summarized the types of data collected, the data sharing platforms, and how the geographical distribution of the African-based health researchers influenced data sharing practices. Ethical, legal, and social aspects were considered.

Insecticide-treated bednets and chemoprophylaxis reduce malaria mortality and parasite prevalence.

This commentary discusses an influential study from 1993 that demonstrated, among West African children, an overall mortality benefit of insecticide-impregnated bednets, and the reduction of malaria prevalence by chemoprophylaxis. Led by Brian Greenwood and colleagues in The Gambia, the trial also showed these tools to be affordable and practicable. In the years since, >2 billion bednets have been provided to high-risk populations and have contributed greatly to reductions in malaria-attributable mortality.

An advocacy based cross sectional study of healthcare professionals of factors impacting on medication adherence across nine Sub-Saharan African countries.

Background: Adherence to anti-seizure medication (ASM) by people diagnosed with epilepsy in sub-Saharan Africa remains low. The factors for low adherence are not well understood. To improve adherence, it is important to understand the perceptions and views of healthcare professionals delivering epilepsy care to this population.

Multi-level determinants of timely routine childhood vaccinations in The Gambia: Findings from a nationwide analysis.

Introduction: Achieving the ambitious goals of the Immunisation Agenda 2030 (IA2030) requires a deeper understanding of factors influencing under-vaccination, including timely vaccination. This study investigates the demand- and supply-side determinants influencing the timely uptake of key childhood vaccines scheduled throughout the first year of life in The Gambia.

Methods: We used two nationally-representative datasets: the 2019-20 Gambian Demographic and Health Survey and the 2019 national immunisation facility mapping.

Cancer metabolic reprogramming and precision medicine-current perspective.

Despite the advanced technologies and global attention on cancer treatment strategies, cancer continues to claim lives and adversely affects socio-economic development. Although combination therapies were anticipated to eradicate this disease, the resilient and restorative nature of cancers allows them to proliferate at the expense of host immune cells energetically. This proliferation is driven by metabolic profiles specific to the cancer type and the patient.

Novel management of pseudomonas biofilm-like structure in a post-pneumonectomy empyema.

We present a patient with a post-pneumonectomy empyema refractory to surgical debridement and systemic antibiotics. The patient initially presented with a bronchopleural fistula and pneumothorax secondary to tuberculosis (TB) destroyed lung, which required a pneumonectomy with Eloesser flap. Ongoing pleural infection delayed the closure of the Eloesser flap, and thoracoscopic inspection of his chest cavity revealed a green, mucous biofilm-like structure lining the postpneumonectomy pleural cavity.

Towards integrated malaria molecular surveillance in Africa.

Integrated malaria molecular surveillance (iMMS) systems are essential for Africa's expanding malaria genomics initiatives. Here we highlight a few initiatives and demonstrate how iMMS can support evidence-based decisions and policies for National Malaria Programs and other malaria control stakeholders. We conclude with key considerations for advancing these malaria genomics initiatives towards sustainable iMMS.

Cascade testing effectively identifies undiagnosed sickle cell disease in The Gambia: a quality improvement project.

Objective: Sickle cell disease (SCD) has a high mortality during childhood in many low and middle-income countries (LMICs). Early diagnosis improves outcomes but newborn screening is not well established in LMICs. Cascade testing may be feasible and effective in identifying undiagnosed SCD and carriers of haemoglobin (Hb) S.