Day: August 4, 2025

Categories : Paediatrics VaccinesTags :

Can African Countries Meet 2030 Childhood Immunisation Goals?

On By ModernMedia

Researchers analysed 1 million records from national health surveys in 38 African countries and found progress in childhood immunisation coverage – but many countries, including South Africa, may still fall short of global targets

Maps of childhood immunisation coverage in African countries at regional level for 2020.

Image credit: Nguyen PT et al., 2025, PLOS Medicine, CC-BY 4.0

In the last two decades, childhood immunisation coverage improved significantly across most African countries. However, at least 12 countries, including South Africa, are unlikely to achieve global targets for full immunisation by 2030, according to a new study published July 29th in the open-access journal PLOS Medicine by Phuong The Nguyen of Hitotsubashi University, Japan, and colleagues.

Vaccines are one of the most effective ways to protect children from deadly diseases, yet immunisation coverage is still suboptimal in many African countries. Monitoring and progress in childhood immunisations at the national and local level is essential for refining health programmes and achieving global targets in these countries.

In the new study, researchers used childhood immunisation data contained in approximately 1 million records from 104 nationally representative Demographic and Health Surveys (DHS) conducted in 38 African countries between 2000 and 2019. Using modelling techniques, they estimated immunisation coverage trends through 2030 and assessed disparities across geographic regions and between socioeconomic groups.

The data showed overall improvements in immunisation coverage between 2000 and 2019. It forecast that, if current trends continue, most countries are projected to meet or exceed targets for achieving 80% or 90% coverage of vaccines against tuberculosis, measles, polio, diphtheria, pertussis (whooping cough), and tetanus. However, 12 of 38 countries are not on track to meet full immunisation goals, including high-development nations like South Africa, Egypt, and Congo Brazzaville. The study also pinpointed significant socioeconomic inequalities in coverage, with gaps in coverage of up to 58% between wealth quintiles. While these disparities were present across all countries, most are projected to shrink by 2030 –except in Nigeria and Angola, where inequalities are expected to persist or grow.

“These achievements are likely the result of sustained progress driven by decades of national and sub-national initiatives along with international support aimed at prioritising immunisation,” the authors say. “However, progress towards full immunisation coverage remains slow in 12 African countries examined. In most African nations, challenges related to vaccine affordability, accessibility, and availability remain major obstacles, driven by weak primary healthcare systems and limited resources.”

The authors add, “This study shows that while childhood immunisation coverage has improved in Africa, progress is uneven. Many countries and regions remain off track to meet global targets by 2030.”

The authors conclude, “Conducting this study reinforced how critical reliable sub-national data is for identifying communities being left behind. We hope the findings will help inform more equitable and targeted immunisation strategies.”

Provided by PLOS

Categories : Metabolic DisordersTags :

Pre-pregnancy Hypoglycaemia Linked with Higher Risk of Preterm Birth, Other Risks

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In study of nearly 5 million Chinese women, these links varied according to body mass index

Image by stanias from Pixabay

An analysis of data from more than 4.7 million Chinese women showed that those who had low blood sugar levels prior to conception were more likely to have certain adverse pregnancy outcomes – such as their baby being born preterm or with low birth weight. Hanbin Wu of the Chinese University of Hong Kong, in collaboration with the National Research Institute for Family Planning, presents these findings on July 29th in the open-access journal PLOS Medicine.

Prior research has shown that women who are hyperglycaemic before or during pregnancy are more likely to face adverse pregnancy outcomes, as are women who are hypoglycaemic during pregnancy.

However, few studies have explored whether hypoglycaemia detected before pregnancy is associated with adverse pregnancy outcomes for women without pre-existing diabetes. To help clarify, Wu and colleagues retrospectively analysed data on 4 866 919 Chinese women from the National Free Preconception Checkup Project, a free health service for women planning to conceive. Using data from 2013 to 2016, they analysed associations between preconception hypoglycaemia and pregnancy outcomes.

A total of 239 128 of the women had preconception hypoglycaemia. Compared to those with normal preconception blood sugar, they had a higher risk of certain adverse pregnancy outcomes, such as preterm birth, low birth weight, or birth defects. Women with hypoglycaemia tended to be younger than those with normal blood sugar levels and were more likely to have BMIs in the “underweight” category.

However, the adverse pregnancy risks associated with preconception hypoglycaemia varied for women with different BMIs. For instance, underweight women had a higher risk of miscarriage, while overweight women had a lower risk of their baby being large for their gestational age.

On the basis of these findings, the researchers suggest that screening for preconception hypoglycemia could be explored for its potential to improve pregnancy outcomes. Further research could also address some limitations of this study, such as by including women from other countries and more information on patients’ gestational complications.

The authors state, “In addition to paying attention to women with preconception hyperglycemia, our findings call for increased concern for women with hypoglycemia in preconception glycemic screening. These findings emphasize the importance of preconception examination in preventing and managing reproductive health risks for all women planning to conceive, and also highlight the necessity of comprehensive screening and coordinated interventions for abnormal FPG (fasting plasma glucose) prior to and during pregnancy, which is crucial for advancing the intervention window and mitigating the risk of adverse pregnancy outcomes.”

Provided by PLOS

Categories : Cancer Surgeries & ProceduresTags :

Research Supports Continued Use of Nasogastric Tube After Oesophageal Cancer Surgery

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To the researchers’ surprise, it was not without risk to omit the tube after this surgery. Illustration: Jakob Hedberg

In the largest Nordic study to date concerning oesophageal cancer surgery, the researchers found clear evidence that decompression with a nasogastric tube is associated with less serious complications. Their results challenge a trend of declining use of the nasogastric tube after major surgical procedures. The study was led from Uppsala University and has now been published in Lancet Regional Health Europe.

A number of small studies had previously suggested that it is safe to abandon the tradition of leaving in a decompressing – but for many patients unpleasant – nasogastric tube after surgery to remove oesophageal cancer (gullet cancer). The tube is plastic and runs from the nose down to the stomach, and its use in this particular context is to relieve and reduce pressure in this newly operated area. When the question was discussed in a Nordic research collaboration, it was concluded that these smaller studies lacked sufficient statistical power to justify a change in care. Subsequently, a randomised trial was carried out at 12 university hospitals across Sweden, Norway, Denmark and Finland, where patients were randomised to have or not have a decompressing nasogastric tube in their oesophagus following this type of surgery.

Patients without the tube experienced leakage

To the researchers’ surprise, it was not without risk to omit the tube after this surgery, as more patients without the tube experienced leakage in the anastomosis created during the operation. Leakage must be treated immediately, often with interventions under general anaesthesia, resulting in suffering for the patient and a longer length of hospital stay.

Although no differences in survival rates or other complications were found, this new knowledge may help to reduce suffering for patients in the future.

“Oesophageal cancer is an uncommon form of cancer, with only about 200 operations of this type being performed per year in Sweden. National and international cooperation is therefore absolutely necessary in order to conduct sufficiently large trials to answer the research questions we have. The fact that in just over two years, almost 450 patients have been recruited for the trial surpassed our expectations and represents a great success for this network,” says Jakob Hedberg, surgical oncologist, associate professor at Uppsala University and consultant surgeon at Uppsala University Hospital who is also principal investigator for the study.

“Strong interest has been shown at international conferences where our preliminary results have been presented, and the principle of building surgical care on solid evidence has allowed us to provide the best care to our patients. Another important effect of this successful collaboration is that we can build more clinical trials within the Nordic network which has now been consolidated. In fact, the next clinical trial is already under development,” says Jakob Hedberg.

Source: Uppsala University

Categories : CancerTags : 1 Comment

Good Prognosis for Men with Prostate Cancer Treated According to Guidelines

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Credit: Darryl Leja National Human Genome Research Institute National Institutes Of Health

Most men who are treated for prostate cancer according to modern guidelines have good survival rates and the majority of these men will die of causes other than prostate cancer. This is revealed in a new study from Uppsala University published in the Journal of the National Comprehensive Cancer Network.

“We were surprised by how much life expectancy affected the prognosis. This shows the importance of a thorough assessment of the general health of a man with newly diagnosed prostate cancer. The patient’s life expectancy has a substantial impact on the choice of appropriate treatment strategy,” says Marcus Westerberg, researcher at the Department of Surgical Sciences at Uppsala University, who led the study.

In prostate cancer, the disease progression often takes decades and the risk of dying from prostate cancer therefore depends on both the characteristics of the cancer and life expectancy based on the man’s age and other diseases at the time of diagnosis. Recommendations in guidelines and care programmes are therefore also based on both cancer characteristics and life expectancy. This means that the recommended initial treatment can range from active monitoring for low-risk cancer to combinations of local and systemic treatment for high-risk cancer.

High average age at disease onset

As the average age at diagnosis of prostate cancer is often high and the cancer often progresses very slowly, it is particularly important to know the long-term risk of death from prostate cancer in order to choose the best treatment for patients. Previously, not much has been known about this.

“We wanted to fill that knowledge gap, so we looked at outcomes up to 30 years after the men were diagnosed. In all cases, we had information about the characteristics of the cancer, treatment and the patient’s life expectancy based on age and comorbidity,” says Westerberg.

The researchers used data from the Prostate Cancer Database Sweden (PCBase), which contains information from the National Prostate Cancer Register (NPCR) and other health data registers. They focused on men who had received the recommended treatment for prostate cancer that had not spread in the body. Using statistical modelling, the researchers estimated the lifetime risk of dying from prostate cancer and other causes.

11 per cent risk of dying of cancer

For men with low-risk cancer and short life expectancy (less than 10 years), the risk of dying from prostate cancer was 11% and the risk of dying from other causes was 89% within 30 years of diagnosis.

For men with high-risk cancer (eg stage T3, PSA 30ng/mL and Gleason score 8) and long life expectancy (over 15 years), the risk of dying from prostate cancer was 34% and the risk of dying from other causes was 55% within 30 years of diagnosis.

“We hope that our results will be used to provide a realistic picture of the prognosis for men with prostate cancer. Our study shows that most men who receive the recommended treatment have a good prognosis,” Westerberg concludes.

Life expectancy was based on age and comorbidity. Examples of low-risk cancers are stage T1, PSA 5ng/mL and Gleason score 6. Examples of high-risk cancers are stage T3, PSA 30ng/mL and Gleason score 8.

Source: Uppsala University

Categories : GeneticsTags :

Hibernation ‘Superpowers’ May Be Hidden in Human DNA

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Photo by Sangharsh Lohakare on Unsplash

Animals that hibernate are incredibly resilient. They can spend months without food or water, muscles refusing to atrophy, body temperature dropping to near freezing as their metabolism and brain activity slow to a crawl. When they emerge from hibernation, they recover from dangerous health changes similar to those seen in type 2 diabetes, Alzheimer’s disease, and stroke.

New genetic research suggests that hibernating animals’ superpowers could lie hidden in human DNA – with clues on how to unlock them, perhaps one day leading to treatments that could reverse neurodegeneration and diabetes.

Two studies describing the results are published in Science.

The genetics of metabolism and obesity

A gene cluster called the “fat mass and obesity (FTO) locus” plays an important role in hibernators’ abilities, the researchers found. Intriguingly, humans have these genes too. “What’s striking about this region is that it is the strongest genetic risk factor for human obesity,” says Chris Gregg, PhD, professor in neurobiology and human genetics at University of Utah Health and senior author on the studies. But hibernators seem able to use genes in the FTO locus in new ways to their advantage.

The team identified hibernator-specific DNA regions that are near the FTO locus and that regulate the activity of neighbouring genes, tuning them up or down. The researchers speculate that adjusting the activity of neighbouring genes, including those in or near the FTO locus, allows hibernators to pack on the pounds before settling in for the winter, then slowly use their fat reserves for energy throughout hibernation.
 
Indeed, the hibernator-specific regulatory regions outside of the FTO locus seem crucial for tweaking metabolism. When the researchers mutated those hibernator-specific regions in mice, they saw changes in the mice’s weight and metabolism. Some mutations sped up or slowed down weight gain under specific dietary conditions; others affected the ability to recover body temperature after a hibernation-like state or tuned overall metabolic rate up or down. 

Intriguingly, the hibernator-specific DNA regions the researchers identified weren’t genes themselves. Instead, the regions were DNA sequences that contact nearby genes and turn their expression up or down, like an orchestra conductor fine-tuning the volume of many musicians. This means that mutating a single hibernator-specific region has wide-ranging effects extending far beyond the FTO locus, explains Susan Steinwand, research scientist in neurobiology at U of U Health and first author on one of the studies.  “When you knock out one of these elements – this one tiny, seemingly insignificant DNA region – the activity of hundreds of genes changes,” she says. “It’s pretty amazing.”
 
Understanding hibernators’ metabolic flexibility could lead to better treatments for human metabolic disorders like type 2 diabetes, the researchers say. “If we could regulate our genes a bit more like hibernators, maybe we could overcome type 2 diabetes the same way that a hibernator returns from hibernation back to a normal metabolic state,” says Elliott Ferris, MS, bioinformatician at U of U Health and first author on the other study.

Uncovering the regulation of hibernation

Finding the genetic regions that may enable hibernation is a problem akin to excavating needles from a massive DNA haystack. To narrow down the regions involved, the researchers used multiple independent whole-genome technologies to ask which regions might be relevant for hibernation. Then, they started looking for overlap between the results from each technique.

First, they looked for sequences of DNA that most mammals share but that had recently changed in hibernators. “If a region doesn’t change much from species to species for over 100 million years but then changes rapidly and dramatically in two hibernating mammals, then we think it points us to something that is important for hibernation, specifically,” Ferris says.

To understand the biological processes that underlie hibernation, the researchers tested for and identified genes that turn up or down during fasting in mice, which triggers metabolic changes similar to hibernation. Next, they found the genes that act as central coordinators, or “hubs,” of these fasting-induced changes to gene activity.

Many of the DNA regions that had recently changed in hibernators also appeared to interact with these central coordinating hub genes. Because of this, the researchers expect that the evolution of hibernation requires specific changes to the controls of the hub genes. These controls comprise a shortlist of DNA elements that are avenues for future investigation.

Awakening human potential

Most of the hibernator-associated changes in the genome appeared to “break” the function of specific pieces of DNA, rather than confer a new function. This hints that hibernators may have lost constraints that would otherwise prevent extreme flexibility in the ability to control metabolism. In other words, it’s possible that the human “thermostat” is locked to a narrow range of continuous energy consumption. For hibernators, that lock may be gone.

Hibernators can reverse neurodegeneration, avoid muscle atrophy, stay healthy despite massive weight fluctuations, and show improved aging and longevity. The researchers think their findings show that humans may already have the needed genetic code to have similar hibernator-like superpowers—if we can bypass some of our metabolic switches. 

“Humans already have the genetic framework,” Steinwand says. “We just need to identify the control switches for these hibernator traits.” By learning how, researchers could help confer similar resilience to humans.

Source: University of Utah Health