Non-communicable diseases pandemic and precision medicine: Is Africa ready?

Chikowore, Tinashe; Kamiza, Abram Bunya; Oduaran, Ovokeraye H.; Machipisa, Tafadzwa; Fatumo, Segun

doi:10.1016/j.ebiom.2021.103260

Cited by 33 publications

(25 citation statements)

References 41 publications

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“…The last 10 years have seen significant progress in elucidating African genomes and exploring their genetic diversity and disease susceptibility ( Chikowore et al, 2021 ). Efforts from various consortia such as H3Africa (Human Heredity Health in Africa), MADCaP (Men of African Descent Carcinoma of the Prostate) and others have fueled progress in understanding the genetic determinants of complex traits via GWAS studies in African populations.…”

Section: Precision Medicine Scope and Promisesmentioning

confidence: 99%

Population Structure of the South West Indian Ocean Islands: Implications for Precision Medicine

et al. 2021

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Precision medicine has brought new hopes for patients around the world with the applications of novel technologies for understanding genetics of complex diseases and their translation into clinical services. Such applications however require a foundation of skills, knowledge and infrastructure to translate genetics for health care. The crucial element is no doubt the availability of genomics data for the target populations, which is seriously lacking for most parts of Africa. We discuss here why it is vital to prioritize genomics data for the South West Indian Ocean region where a mosaic of ethnicities co-exist. The islands of the SWIO, which comprise Madagascar, La Reunion, Mauritius, Seychelles and Comoros, have been the scene for major explorations and trade since the 17th century being on the route to Asia. This part of the world has lived through active passage of slaves from East Africa to Arabia and further. Today’s demography of the islands is a diverse mix of ancestries including European, African and Asian. The extent of admixtures has yet to be resolved. Except for a few studies in Madagascar, there is very little published data on human genetics for these countries. Isolation and small population sizes have likely resulted in reduced genetic variation and possible founder effects. There is a significant prevalence of diabetes, particularly in individuals of Indian descent, while breast and prostate cancers are on the rise. The island of La Reunion is a French overseas territory with a high standard of health care and close ties to Mauritius. Its demography is comparable to that of Mauritius but with a predominantly mixed population and a smaller proportion of people of Indian descent. On the other hand, Madagascar’s African descendants inhabit mostly the lower coastal zones of the West and South regions, while the upper highlands are occupied by peoples of mixed African-Indonesian ancestries. Historical records confirm the Austronesian contribution to the Madagascar genomes. With the rapid progress in genomic medicine, there is a growing demand for sequencing services in the clinical settings to explore the incidence of variants in candidate disease genes and other markers. Genome sequence data has become a priority in order to understand the population sub-structures and to identify specific pathogenic variants among the different groups of inhabitants on the islands. Genomic data is increasingly being used to advise families at risk and propose diagnostic screening measures to enhance the success of therapies. This paper discusses the complexity of the islands’ populations and argues for the needs for genotyping and understanding the genetic factors associated with disease risks. The benefits to patients and improvement in health services through a concerted regional effort are depicted. Some private patients are having recourse to external facilities for molecular profiling with no return of data for research. Evidence of disease variants through sequencing represents a valuable source of medical data that can guide policy decisions at the national level. There are presently no such records for future implementation of strategies for genomic medicine.

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Section: Precision Medicine Scope and Promisesmentioning

confidence: 99%

Population Structure of the South West Indian Ocean Islands: Implications for Precision Medicine

et al. 2021

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“…More than 125 million people with hypertension are expected by the year 2025 in SSA alone [ 23 ]. By year 2030, hypertension and other non-communicable diseases are projected to surpass communicable diseases as the top of mortality causes on the continent [ 24 ]. From 2011 to 2025, the cumulative lost output with non-communicable diseases is projected to be US$7.28 trillion in LMICs which is approximately a loss of US$500 billion per year [ 25 ].…”

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confidence: 99%

Prevalence and predictive risk factors of hypertension in patients hospitalized in Kamenge Military hospital and Kamenge University teaching hospital in 2019: A fixed effect modelling study in Burundi

et al. 2021

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Introduction Hypertension is a major threat to public health globally. Especially in sub-Saharan African countries, this coexists with high burden of other infectious diseases, creating a complex public health situation which is difficult to address. Tackling this will require targeted public health intervention based on evidence that well defines the at risk population. In this study, using retrospective data from two referral hospitals in Burundi, we model the risk factors of hypertension in Burundi. Materials and methods Retrospective data of a sample of 353 randomly selected from a population of 4,380 patients admitted in 2019 in two referral hospitals in Burundi: Military and University teaching hospital of Kamenge. The predictive risk factors were carried out by fixed effect logistic regression. Model performance was assessed with Area under Curve (AUC) method. Model was internally validated using bootstrapping method with 2000 replications. Both data processing and data analysis were done using R software. Results Overall, 16.7% of the patients were found to be hypertensive. This study didn’t showed any significant difference of hypertension’s prevalences among women (16%) and men (17.7%). After adjustment of the model for cofounding covariates, associated risk factors found were advanced age (40–59 years) and above 60 years, high education level, chronic kidney failure, high body mass index, familial history of hypertension. In absence of these highlighted risk factors, the risk of hypertension occurrence was about 2 per 1000 persons. This probability is more than 90% in patients with more than three risk factors. Conclusion The relatively high prevalence and associated risk factors of hypertension in Burundi raises a call for concern especially in this context where there exist an equally high burden of infectious diseases, other chronic diseases including chronic malnutrition. Targeting interventions based on these identified risk factors will allow judicious channel of resources and effective public health planning.

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“…The Inclusion of ethnically diverse populations in genetic research can provide deep insights into specific pathogenic variants that differ across and within populations. Such insights may be useful to guide diagnosis and provide relevant clinical interventions ( Gurdasani et al, 2019 ; Chikowore et al, 2021 ; Fatumo et al, 2021a ; Fatumo et al, 2021b ). Unfortunately, the vast majority of the genetic studies have been performed in European ancestry populations and few in Africa ( Kuchenbaecker et al, 2019 ; Chikowore et al, 2021 ).…”

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Editorial on the Research Topic

Genetics of Complex Traits and Diseases From Under-Represented PopulationsThe Inclusion of ethnically diverse populations in genetic research can provide deep insights into specific pathogenic variants that differ across and within populations. Such insights may be useful to guide diagnosis and provide relevant clinical interventions (Gurdasani et al, 2019;Chikowore et al, 2021;Fatumo et al, 2021a;Fatumo et al, 2021b). Unfortunately, the vast majority of the genetic studies have been performed in European ancestry populations and few in Africa (Kuchenbaecker et al, 2019;Chikowore et al, 2021).We accepted only high-quality research work in this research topic, including review manuscripts describing the genetics of diseases in underrepresented populations such as African, Asian, Latin American, and other indigenous populations.

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confidence: 99%

“…Such insights may be useful to guide diagnosis and provide relevant clinical interventions (Gurdasani et al, 2019;Chikowore et al, 2021;Fatumo et al, 2021a;Fatumo et al, 2021b). Unfortunately, the vast majority of the genetic studies have been performed in European ancestry populations and few in Africa (Kuchenbaecker et al, 2019;Chikowore et al, 2021).We accepted only high-quality research work in this research topic, including review manuscripts describing the genetics of diseases in underrepresented populations such as African, Asian, Latin American, and other indigenous populations. Topics could include Genome-wide association studies, Gene-environment interactions, Population genetics, epigenetics, pharmacogenomics, Polygenic/Genetic Risk Scores.…”

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Editorial: Genetics of Complex Traits and Diseases From Under-Represented Populations

2022

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Non-communicable diseases pandemic and precision medicine: Is Africa ready?

Cited by 33 publications

References 41 publications

Population Structure of the South West Indian Ocean Islands: Implications for Precision Medicine

Population Structure of the South West Indian Ocean Islands: Implications for Precision Medicine

Prevalence and predictive risk factors of hypertension in patients hospitalized in Kamenge Military hospital and Kamenge University teaching hospital in 2019: A fixed effect modelling study in Burundi

Editorial: Genetics of Complex Traits and Diseases From Under-Represented Populations

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