Author Correction: Mpox in Central Africa: complex epidemiology requires a constellation approach
Related Articles
Mpox in Central Africa: complex epidemiology requires a constellation approach
Introduction The declaration of smallpox eradication in 1980 remains one of the most important public health achievements in history. However, following the cessation of the…
Development of quality indicators for hypertension management at the primary health care level in South Africa
Despite many quality initiatives at the primary health care (PHC) level, little is known about the actual quality of care of patients diagnosed with hypertension in South Africa. This study aimed to develop quality indicators for hypertension management at the PHC level to improve the quality of care and patient outcomes. The RAND/UCLA Appropriateness Method, comprising two rounds, was used to develop clear, appropriate, and feasible evidence-based quality indicators for hypertension. In Round 1, a 9-point scale was used by a panel of 11 members to rate clarity and appropriateness of 102 hypertension quality indicator statements, grouped under 9 dimensions of quality hypertension management, using an online MS Excel® spreadsheet. In Round 2, 9 of the same panellists discussed all indicators and rated their appropriateness and feasibility during a remote online, interactive face-to-face MS Teams® meeting. Statements rated ≥7–9 with agreement were defined as either appropriate or feasible. The panel rated 46 hypertension quality indicator statements ≥7–9 with agreement for the appropriate and feasible measurement of the management of hypertension: monitoring (n = 16), review (n = 5), lifestyle advice (n = 9), tests (n = 7), intermediate outcomes (n = 6), referrals (n = 2) and practice/facility structures (n = 1). No indicator statements were rated both appropriate and feasible for measuring blood pressure levels and treatment. If applied, these indicators would improve monitoring and management of patients with hypertension, patient outcomes, and data quality in South Africa and result in more efficient use of scarce resources. This study can be replicable for improving care of other non-communicable diseases across Africa.
Structural insights into tecovirimat antiviral activity and poxvirus resistance
Mpox is a zoonotic disease endemic to Central and West Africa. Since 2022, two human-adapted monkeypox virus (MPXV) strains have caused large outbreaks outside these regions. Tecovirimat is the most widely used drug to treat mpox. It blocks viral egress by targeting the viral phospholipase F13; however, the structural details are unknown, and mutations in the F13 gene can result in resistance against tecovirimat, raising public health concerns. Here we report the structure of an F13 homodimer using X-ray crystallography, both alone (2.1 Å) and in complex with tecovirimat (2.6 Å). Combined with molecular dynamics simulations and dimerization assays, we show that tecovirimat acts as a molecular glue that promotes dimerization of the phospholipase. Tecovirimat resistance mutations identified in clinical MPXV isolates map to the F13 dimer interface and prevent drug-induced dimerization in solution and in cells. These findings explain how tecovirimat works, allow for better monitoring of resistant MPXV strains and pave the way for developing more potent and resilient therapeutics.
Patterns of incident Burkitt lymphoma during the HIV epidemic among the Black African and White population in South Africa
Burkitt lymphoma (BL) may be HIV-associated but data on BL trends in South Africa (SA), where HIV is highly prevalent, are scarce. We compared BL incidence trends over 36 years among Black African and White individuals.
Network analysis of cross-income-level collaboration on multiple myeloma in sub-Saharan Africa
Cross-income-level collaboration (CILC) is crucial for developing global health approaches that benefit low- and middle-income countries (LMICs). Multiple myeloma (MM) is a representative example of a complex, understudied disease in sub-Saharan Africa (SSA). Based on publications, we developed a network analysis tool to assess scientific collaborations. Here, we present findings from a systematic analysis of publications retrieved from PubMed between January 2002 and June 2022. We evaluated individual institutional contributions and collaboration patterns using undirected weighted networks. Our findings reveal that intra-income-level collaborations dominate MM research in SSA, with high-income countries (HICs) primarily engaging with a few local institutions, mainly in South Africa and Nigeria. Increasing CILC is essential to advance research in this area. Our analysis tool provides insights into the collaboration strength, highlights gaps in the field and identifies leading institutions, ultimately aiming to support the development of more effective international collaboration and research strategies.
Responses