Gates Open Research最新文献

Background: There has been steady progress and advancement of research in Africa. However, African researchers face numerous challenges among them, limited international recognition. This is due to the low discoverability and inclusion of their research outputs by indexers and databases. A lot of initiatives have attempted to address the challenge, however, there is a need for support to enhance the discoverability and inclusion of research outputs from Africa.

Methods: We conducted a desk review of 1,116 journals hosted on the Sabinet journal repository and the African Journal Online (AJOL) platform. The factors that were considered to influence journals' discoverability and inclusion include (i) the journals' Open Access (OA) status, (ii) OA journals' listing in the Directory of Open Access Journals (DOAJ), (iii) the journals' presence on the International Standard Serial Number (ISSN) portal, (iv) the membership of the journals' publishers on the Committee on Publication Ethics (COPE), (v) the journals' hosting on International Network for Advancing Science and Policy (INASP) and (vi) geographic location of the journals' online publisher.

Findings: A total of 1,116 journals were identified from the Sabinet and AJOL platforms. The highest proportion of journals was neither discovered by Google Scholar nor included in Scopus (63.2%). The study established one significant predictor of journal discoverability by Google Scholar and inclusion in Scopus. This was the journal listing on the ISSN portal which increased the odds of the journal being discoverable by Google Scholar and inclusion in Scopus by 2.033 and 5.451 respectively. Journals listed in the DOAJ but whose publishers were COPE members had significantly reduced odds of being discoverable by Google Scholar and being included in Scopus by 0.334 and 0.161 respectively. This suggests that the journal's discoverability and inclusion are more nuanced and not always straightforward hence quality markers need to be aligned.

Background: Sustainability, with countries taking ownership for funding and ensuring access to services and contraceptive commodities, has long been an aim for FP. Recent shocks to donor funding have added urgency to country sustainability. Findings from the 2023 National Composite Index of Family Planning (NCIFP) and its special questions on Sustainability provide a broad view from 33 counties across two sub-regions of sub-Saharan Africa of expert respondents' perceptions in that year on the potential for program sustainability.

Methods: The cross-national NCIFP survey has been conducted since 2014. Its 2023 special questions were designed to take the pulse of stakeholders steeped in their countries' FP program about the state of sustainability, actions being taken, and main challenges their countries faced. Items related to donor dependency, coordination, FP in country plans for Universal Health Coverage (UHC), planning for future demand, and key barriers to sustainability.

Results: Both regions scored highest on the extent to which FP is included in UHC plans and lowest on the items related to donor reliance, indicating high dependency for contraceptive commodities and programmatic support. Donor dependence and lack of domestic financing were most often cited barriers, with human resources; commodities and logistics; and sociocultural, gender and religious barriers all receiving over 10% of the responses on key challenges. The extent to which governments had developed plans to make their national FP programs more sustainable to meet demand varied.

Conclusion: These data provide an important snapshot of family planning programs across SSA prior to the abrupt cancellation of USAID funding in January 2025. Country context, including national wealth and government effectiveness, is important. From the 2023 NCIFP, understanding program experts' perspectives, and identifying similar and unique challenges countries face, is critical to help shape support to strengthen the capacity of countries to move towards FP program sustainability.

Background: Sickle Cell Disease (SCD) is highly prevalent in Nigeria, with severe pain crises being a primary cause of morbidity. Codeine and tramadol are frequently used opioids, but their effectiveness and safety are significantly influenced by CYP2D6 genetic variations. Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines exist for opioid therapy based on CYP2D6 phenotypes. There's a critical need for pre-emptive pharmacogenomic (PGx) testing in African SCD patients to guide opioid selection. This study aimed to determine CYP2D6 allele, phenotype frequencies and evaluate the feasibility of implementing pre-emptive pharmacogenomic (PGx) testing to guide opioid therapy for SCD patients in Nigeria.

Methods: This prospective, multicenter implementation study recruited 503 consenting SCD patients (HbSS or HbSC) aged ≥15 years from five Nigerian sites. Blood samples were collected for DNA extraction. CYP2D6 single-nucleotide polymorphisms and copy number variations were determined using Taqman assays based open array, GenoPharm. Phenotypes were assigned based on Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines using the Genomics Information Management System (GIMS). and patient-specific medication safety cards were generated.

Results: We successfully genotyped 503 SCD patients with a mean age of 25.1 years, while 61.4% were female, and hydroxyurea use was less than 9.4%. Actionable CYP2D6 variants were found in 36.6% of participants. The predicted phenotype distribution was 8.8% Ultrarapid Metabolizers (UM), 54.1% Normal Metabolizers (NM), 26.0% Intermediate Metabolizers (IM), and 1.8% Poor Metabolizers (PM), with 9.3% undetermined. Patient medication safety cards were provided to guide prescriptions.

Conclusions: This study successfully established a genotyped cohort of 503 Nigerian SCD patients, demonstrating the feasibility of pre-emptive pharmacogenetic testing through a Pan-African collaborative model in a resource-limited setting. The identification of PM and UM provides direct clinical guidance, as CPIC guidelines recommend avoiding codeine and tramadol in these groups due to the high risk of diminished efficacy or serious toxicity, respectively. The high prevalence of actionable CYP2D6 variants indicates a substantial proportion of Nigerian SCD patients may experience altered opioid responses, underscoring the need for tailored prescribing to optimise pain control and minimise adverse drug reactions.

Introduction: Historically, African research institutions have faced significant barriers to gaining recognition on a global stage due to limited infrastructure, underdeveloped governance frameworks, and low representation in high-impact publications. This underrepresentation reflects systemic barriers such as the lack of visibility of both researchers and institutions, limited funding, inadequate infrastructure, and fragmented institutional arrangements, which impede the continent's ability to contribute robustly to the global knowledge economy. To address these barriers, the Research Readiness Assessment Survey (RRAS) was developed as a modular, context-specific tool to evaluate and enhance institutional research capacity across multiple dimensions, including research infrastructure, policy and policy engagement, governance, human resources, institutional arrangements, grant management, and research outputs.

Methods: The RRA was developed by integrating different global frameworks. This assessment adopted a cross-sectional design. Piloting was performed in nine institutions distributed across Kenya, Ethiopia, and Nigeria. The questionnaire used for data collection was uploaded to RedCap in English, French, and Portuguese. The tool underwent validity and reliability testing. Validity testing included piloting of nine institutions. Data from the pilot test were categorized and analyzed using STATA version 17.0. Analyses were performed at both the univariate and bivariate levels.

Results: The proportion of institutions that performed, on average, in all modules, was 66.67% (n=6). None of the institutions had a strong overall institutional performance based on our scoring. The proportion of institutions that had developed overall institutional performance was 22.22% (n=2), whereas 11.11% (n=1) had limited overall institutional performance. There was a statistically significant and strong positive correlation between the following module scores and overall institutional performance: laboratory infrastructure, institutional arrangement, grant management, policy and policy engagement, project management, and human resources; [r=0.666; p-value<0.05],[r=0.916; p-value<0.001], [r=0.799; p-value<0.01], [r=0.660; p-value<0.05], [r=0.738; p-value<0.05], and [r=0.648; p <0.05], respectively.

The sweetpotato ( Ipomoea batatas) is an important food crop in the tropical and subtropical regions of the world, but its yield and quality are heavily affected by viral diseases. Timely and precise detection of virus infections is essential for effective monitoring of seed health and disease management. We evaluated the feasibility of using a compact, ultra-portable LAMP-based diagnostic device-initially designed for human health applications-for detecting key sweetpotato viruses (SPCSV, SPFMV, and SPLCV). Field and greenhouse samples were tested, showing 100% agreement in virus detection with a larger commonly used LAMP device. Sensitivity tests confirmed consistent performance, and the use of portable power banks enabled reliable on-site use. The statistical analysis indicated high accuracy and strong correlation in time-to-positive values between methods (r > 0.89, p < 0.01). Furthermore, cost analysis demonstrated that the pocket LAMP device setup significantly reduced per-test costs-by approximately 40%-while maintaining diagnostics reliability. These findings support the potential of this tool on plant virus detection in locations with limited resources.

Background: Vasectomy use has historically been very low in Bolivia, constituting just 0.1% of the method mix in 2021. MSI Reproductive Choices Bolivia (MSI Bolivia), one of the major reproductive health organizations in the country, sought to increase the affordability, availability, and quality of vasectomy services in their nationwide clinics and mobile units by training in-house providers to replace contracting external providers with high fees. We describe the MSI Bolivia vasectomy program in 2021 and its results over the following two years.

Methods: The program included components of the Engender Health Supply-Enabling-Environment-Demand (SEED) Programing Model™ for evidence-based vasectomy programming. First, MSI Bolivia offered free vasectomies through a social media campaign during November 2021. Second, two international No-Scalpel Vasectomy (NSV) experts trained four MSI Bolivia physicians during a week-long teaching program in La Paz, Bolivia. Third, MSI Bolivia formed partnerships and held a dissemination event to publicize the campaign. MSI Bolivia continued conducting training and marketing campaigns in 2022 and 2023.

Results: During the 2021 six-week promotional campaign, 884 men signed up and over 600 were scheduled for the procedure. During the training week, the trainees performed 127 supervised vasectomies. Over the following weeks, the four trained physicians performed over 300 additional unsupervised vasectomies. Two of the newly trained physicians taught NSV to seven other colleagues in 2022 and 2023. MSI Bolivia reduced the fees for a vasectomy from Bs. 1500 (USD 215) to Bs. 850 (USD 122). The number of vasectomies performed by MSI Bolivia increased from 77 in 2019 to 643, 918, and 1,135 in 2021, 2022, and 2023, respectively.

Conclusion: By training their own physicians to perform NSV, reducing costs, and advertising through social media, MSI Bolivia was able to increase the availability, quality, and acceptability of vasectomy in Bolivia.

Background: Monitoring parasite resistance to antimalarial drugs is essential for detecting potential changes in drug efficacy. This study assessed the prevalence of molecular markers of resistance to sulfadoxine-pyrimethamine (SP), chloroquine, and artemisinin in Sierra Leone, where SP is used for intermittent preventive treatment in pregnancy (IPTp) and perennial malaria chemoprevention (PMC) in young children, while artemisinin is used to treat malaria episodes.

Methods: A cross-sectional survey was conducted between June and August 2021 in three districts of Sierra Leone. A total of 440 febrile children aged 2-5 years attending the health facilities were screened for P. falciparum malaria using a rapid diagnostic test, and 300 participants with positive RDT were enrolled. Capillary blood samples were collected as dried blood spots, analyzed using quantitative PCR to confirm P. falciparum, and sequenced for resistance markers in pfdhfr, pfdhps, pfcrt, pfmdr1, and pfK13.

Results: Of 298 blood samples, 237 (79.5%) were qPCR-positive and 230 samples were successfully genotyped. The pfdhfr triple mutant (N51I/C59R/S108N) was detected in 99.5% of samples (217/218), while pfdhps mutations A437G and K540E were detected in 92.1% (211/229) and 19.1% (42/220), respectively. The pfdhfr/dhps quintuple mutant (triple mutant + A437G/K540E) prevalence was 4.6% (7/151), and no sextuple mutants (quintuple + pfdhps-A581G) were observed. Chloroquine resistance-associated mutations in pfcrt (CVIET haplotype) were detected in 36.6% of samples, while pfmdr1 mutations at codon 86, 184, 1042, and 1246 occurred in 2.3%, 71.7%, 0.9% and 1.8%, respectively. No validated pfK13 markers of artemisinin resistance were detected.

Conclusion: In this study, the sustained low prevalence of pfdhfr/dhps quintuple mutant justifies the continued use of SP- containing IPTp and PMC, as well as its expansion in the country into the second year of life with additional SP doses. Importantly, no validated pfK13 markers were found supporting the use of artemisinin-based combination therapies in Sierra Leone.

Trial registration: Clinicaltrials.gov NCT04235816. Registered on January 17, 2020.

Population distributions across countries and regions exhibit significant spatial and temporal variability. This variation highlights the need for high-resolution, small-area demographic data to address the challenges posed by shifting population dynamics, urbanization, and migration. Small area population modelling, particularly the production of gridded population estimates, has advanced rapidly over the past decade. Gridded population estimates rely heavily on the availability of detailed geospatial ancillary datasets to capture, inform and explain the variabilities in population densities and distributions at small area scales, enabling the disaggregation from areal unit-based counts. Here we describe an extensive geospatial collection of annual, high resolution, spatio-temporally harmonised, global datasets aimed at driving improvements in mapping small area population density variation. This article presents the spatio-temporal harmonisation process that results in an open access repository of 73 individual gridded datasets addressing topography, climate, nighttime lights, land cover, inland water, infrastructure, protected areas as well as the built-up environment on a global level at a spatial resolution of 3 arc-seconds (approximately 100 metres). Datasets are available as annual time series from 2015 up to and including at least 2020, and as recent as 2023 where source datasets allow. Such datasets not only support population modelling but also applications across environmental, economic, and health sectors, supporting informed policy-making and resource allocation for sustainable development.

In 2021, Salmonella Paratyphi A caused >2 million illnesses, resulting in >14,000 deaths, most of which occurred among children under 5 years of age in socioeconomically deprived populations. Both typhoid fever and paratyphoid fever occur in such areas, but paratyphoid fever is currently concentrated in South Asia. Typhoid conjugate vaccines are recommended for the control of enteric fever in typhoid-endemic settings; however, there are increasing demands for the development of vaccines that can address enteric fever more broadly by including protection against paratyphoid fever. The WHO preferred product characteristics (PPC) and a research and development (R&D) technology roadmap are normative documents developed with the guidance and contribution of a multidisciplinary expert group following a standard methodological framework. In this paper, we summarize the PPC and R&D roadmap presenting the key attributes for a bivalent Salmonella enterica serovar Typhi and Paratyphi A vaccine, and discuss the identified key research and data gaps needed to optimize vaccine value and to inform public health and policy decisions, with a particular focus in paratyphoid and enteric fever endemic countries.

Background: There is a concern that SARS-CoV-2 infection may drive poor outcomes after Mycobacterium tuberculosis Mtb exposure and infection. We performed an ex vivo Mtb killing assay using peripheral blood mononuclear cells (PBMC) from three groups: healthy household contacts of people with active TB with and without serologic evidence of previous SARS-CoV-2 infection (COV+HHC and COV-HHC), and participants with active TB and previous SARS-CoV-2 (COV+TB+).

Methods: Twenty participants per group from Cape Town, South Africa were classified according to SARS-CoV-2 anti-S and anti-N antibody tests. We infected PBMC from each participant at a MOI of 0.001 with Mtb strain H37Rv in a 4-day growth inhibition assay. Mycobacteria were quantified through inoculation into Bactec Mycobacteria Growth Indicator Tube (MGIT) liquid culture. PBMC from a subset of participants were infected in the presence of autologous time-matched serum and Mtb-uninfected control PBMCs were included.

Results: There was no difference in the time to detection of Mtb or the normalised Mtb growth ratio (log10CFUsample - log10CFUcontrol) between groups in the standard protocol, or when infected cells from the COV+HHC and COV+TB+ (n=10 each) groups were cultured with autologous time-matched serum. The group with active TB demonstrated the best Mtb growth control. Extracellular Mtb measured by culturing the supernatants of the infected cell cultures also did not show any difference between groups. Five (14.3%) uninfected controls were culture positive.

Conclusion: Our results show that previous SARS-CoV-2 does not affect the Mtb killing ability of circulating mononuclear immune cells in vitro. Previous SARS-CoV-2 is unlikely to affect the outcome of Mtb infection through this mechanism.