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Alamad B, Elliott K, Knight JC. Cross-population applications of genomics to understand the risk of multifactorial traits involving inflammation and immunity. CAMBRIDGE PRISMS. PRECISION MEDICINE 2024; 2:e3. [PMID: 38549844 PMCID: PMC10953767 DOI: 10.1017/pcm.2023.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 11/15/2023] [Accepted: 12/18/2023] [Indexed: 04/26/2024]
Abstract
The interplay between genetic and environmental factors plays a significant role in interindividual variation in immune and inflammatory responses. The availability of high-throughput low-cost genotyping and next-generation sequencing has revolutionized our ability to identify human genetic variation and understand how this varies within and between populations, and the relationship with disease. In this review, we explore the potential of genomics for patient benefit, specifically in the diagnosis, prognosis and treatment of inflammatory and immune-related diseases. We summarize the knowledge arising from genetic and functional genomic approaches, and the opportunity for personalized medicine. The review covers applications in infectious diseases, rare immunodeficiencies and autoimmune diseases, illustrating advances in diagnosis and understanding risk including use of polygenic risk scores. We further explore the application for patient stratification and drug target prioritization. The review highlights a key challenge to the field arising from the lack of sufficient representation of genetically diverse populations in genomic studies. This currently limits the clinical utility of genetic-based diagnostic and risk-based applications in non-Caucasian populations. We highlight current genome projects, initiatives and biobanks from diverse populations and how this is being used to improve healthcare globally by improving our understanding of genetic susceptibility to diseases and regional pathogens such as malaria and tuberculosis. Future directions and opportunities for personalized medicine and wider application of genomics in health care are described, for the benefit of individual patients and populations worldwide.
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Affiliation(s)
- Bana Alamad
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Kate Elliott
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Julian C. Knight
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Chinese Academy of Medical Science Oxford Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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2
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Naidoo L, Reddy P. Stakeholder knowledge and attitudes toward the use of predictive genetic testing in South Africa. J Community Genet 2022; 13:567-577. [PMID: 36085342 PMCID: PMC9462643 DOI: 10.1007/s12687-022-00606-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 08/30/2022] [Indexed: 11/30/2022] Open
Abstract
The use of predictive genetic testing, particularly for risk profiling in non-communicable diseases (NCDs), has the potential to benefit public health by decreasing the disease burden and alleviating the pressure on healthcare. It is thus important to assess knowledge and uptake among stakeholders. This study aimed to assess end users' (community, medical practitioners and medical students) knowledge and attitudes regarding the use and support of genomic medicine. A descriptive cross-sectional survey was conducted in Kwazulu-Natal (KZN) among 3 groups of stakeholders (n = 170): medical practitioners from both private and public healthcare, medical students from UKZN and community members represented by teachers. Three structured questionnaires using a Likert scale were administered. Responses were stratified by practice type, and a scoring scale was developed. Principal component analysis (PCA) was used to reduce data on all constructs that made up each variable. All three groups showed adequate knowledge and a positive attitude towards use, apart from medical students who were not as keen to support future use in their own practice. Although medical practitioners supported the use of this technology, with necessary guidelines, expertise and affordability, only 18% from private practice reported having used it. PCA reduced data to fewer parsimonious constructs for all 3 groups: common threads included an awareness that genetic testing may improve health and disease outcomes; guidelines for use; and the provision of education to increase awareness, training to bolster expertise and confidence to use these services. Participants in this study attributed a lack of uptake to limited expertise and professional support, and a lack of legislative guidelines. We recommend updating continuing professional development for medical practitioners and promoting community education concomitantly. Provision of guidelines and increased accessibility to resources are important.
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Affiliation(s)
- Levani Naidoo
- Department of Community Health Studies, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
| | - Poovendhree Reddy
- Department of Community Health Studies, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa.
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3
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Simba H, Tromp G, Sewram V, Mathew CG, Chen WC, Kuivaniemi H. Esophageal Cancer Genomics in Africa: Recommendations for Future Research. Front Genet 2022; 13:864575. [PMID: 35401654 PMCID: PMC8990314 DOI: 10.3389/fgene.2022.864575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 03/14/2022] [Indexed: 12/09/2022] Open
Affiliation(s)
- Hannah Simba
- African Cancer Institute, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Environment and Lifestyle Epidemiology Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Gerard Tromp
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- DSI–NRF Centre of Excellence for Biomedical Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Centre for Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
- Bioinformatics Unit, South African Tuberculosis Bioinformatics Initiative, Stellenbosch University, Cape Town, South Africa
- Centre for Bioinformatics and Computational Biology, Stellenbosch University, Stellenbosch, South Africa
| | - Vikash Sewram
- African Cancer Institute, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Christopher G Mathew
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Wenlong C. Chen
- Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- National Cancer Registry, National Health Laboratory Service, Johannesburg, South Africa
| | - Helena Kuivaniemi
- Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- DSI–NRF Centre of Excellence for Biomedical Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
- South African Medical Research Council Centre for Tuberculosis Research, Stellenbosch University, Cape Town, South Africa
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4
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Mogaka JJ, Chimbari MJ. Modeling factors critical for implementation of precision medicine at health systems-level: an IRT approach. Am J Transl Res 2021; 13:12557-12574. [PMID: 34956473 PMCID: PMC8661177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 12/13/2020] [Indexed: 06/14/2023]
Abstract
BACKGROUND Through recent advances in omics technologies, precision medicine (PM) promises to fundamentally change the way we approach health, disease and illness. Imperative applications of omics-based biomarkers are gradually moving from research to clinical settings, with huge long-term clinical and public health implications. Whereas much of research in PM is mainly focused on basic biomedical discoveries, currently there is little research on the clinical implementation of omics biomarkers, especially at health systems level. AIM AND METHODS This study investigated the application of multidimensional item response theory (IRT) models to validate a hypothesized PM implementation measurement model. This is a contribution to PM implementation at health systems level. Data obtained through an item-sort procedure involving 496 observations from 124 study participants formed the basis of a 22-item PMI measurement model. CONCLUSION Statistical significance of the bifactor model suggests PM implementation may have to be examined using factors that reflect a single common underlying implementation construct, as well as factors that reflect unique variances for the identified four content-specific factors.
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Affiliation(s)
- John Jo Mogaka
- Department of Public Health Medicine, University of KwaZulu-Natal Durban, South Africa
| | - Moses J Chimbari
- Department of Public Health Medicine, University of KwaZulu-Natal Durban, South Africa
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5
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Munung NS, de Vries J, Pratt B. Genomics governance: advancing justice, fairness and equity through the lens of the African communitarian ethic of Ubuntu. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2021; 24:377-388. [PMID: 33797712 PMCID: PMC8349790 DOI: 10.1007/s11019-021-10012-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/19/2021] [Indexed: 05/18/2023]
Abstract
There is growing interest for a communitarian approach to the governance of genomics, and for such governance to be grounded in principles of justice, equity and solidarity. However, there is a near absence of conceptual studies on how communitarian-based principles, or values, may inform, support or guide the governance of genomics research. Given that solidarity is a key principle in Ubuntu, an African communitarian ethic and theory of justice, there is emerging interest about the extent to which Ubuntu could offer guidance for the governance of genomics research in Africa. To this effect, we undertook a conceptual analysis of Ubuntu with the goal of identifying principles that could inform equity-oriented governance of genomics research. Solidarity, reciprocity, open sharing, accountability, mutual trust, deliberative decision-making and inclusivity were identified as core principles that speak directly to the different macro-level ethical issues in genomics research in Africa such as: the exploitation of study populations and African researchers, equitable access and use of genomics data, benefit sharing, the possibility of genomics to widen global health inequities and the fair distribution of resources such as intellectual property and patents. We use the identified the principles to develop ethical guidance for genomics governance in Africa.
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Affiliation(s)
- Nchangwi Syntia Munung
- Department of Medicine, University of Cape Town, Cape Town, South Africa.
- Division of Human Genetics, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
| | - Jantina de Vries
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Bridget Pratt
- Centre for Health Equity, School of Population and Global Health, University of Melbourne, Melbourne, Australia
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6
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Kamp M, Krause A, Ramsay M. Has translational genomics come of age in Africa? Hum Mol Genet 2021; 30:R164-R173. [PMID: 34240178 DOI: 10.1093/hmg/ddab180] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/27/2021] [Accepted: 06/29/2021] [Indexed: 01/12/2023] Open
Abstract
The rapid increase in genomics research in Africa and the growing promise of precision public health begs the question of whether African genomics has come of age and is being translated into improved healthcare for Africans. An assessment of the continent's readiness suggests that genetic service delivery remains limited and extremely fragile. The paucity of data on mutation profiles for monogenic disorders and lack of large genome-wide association cohorts for complex traits in African populations is a significant barrier, coupled with extreme genetic variation across different regions and ethnic groups. Data from many different populations is essential to developing appropriate genetic services. Of the proposed genetic service delivery models currently used in Africa-Uncharacterized, Limited, Disease-focused, Emerging and Established-the first three best describe the situation in most African countries. Implementation is fraught with difficulties related to the scarcity of an appropriately skilled medical genetic workforce, limited infrastructure and processes, insufficient health funding and lack of political support, and overstretched health systems. There is a strong nucleus of determined and optimistic clinicians and scientists with a clear vision, and there is hope for innovative solutions and technological leapfrogging. However, a multi-dimensional approach with active interventions to stimulate genomic research, clinical genetics and overarching healthcare systems is needed to reduce genetic service inequalities and accelerate precision public health on the continent. Human and infrastructure capacity development, dedicated funding, political will and supporting legislation, and public education and awareness, are critical elements for success. Africa-relevant genomic and related health economics research remains imperative with an overarching need to translate knowledge into improved healthcare. Given the limited data and genetic services across most of Africa, the continent has not yet come of 'genomics' age.
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Affiliation(s)
- Michelle Kamp
- Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, The University of the Witwatersrand, National Health Laboratory Service, Johannesburg, 2193, South Africa.,Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2193, South Africa
| | - Amanda Krause
- Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, The University of the Witwatersrand, National Health Laboratory Service, Johannesburg, 2193, South Africa
| | - Michèle Ramsay
- Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, The University of the Witwatersrand, National Health Laboratory Service, Johannesburg, 2193, South Africa.,Sydney Brenner Institute for Molecular Bioscience, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2193, South Africa
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7
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Mathuba B, Koromina M, Mitropoulou C, Patrinos GP. Catalyzing clinical implementation of pharmacogenomics and personalized medicine interventions in Africa. Pharmacogenomics 2020; 22:115-122. [PMID: 33353428 DOI: 10.2217/pgs-2020-0101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Pharmacogenomics is considered to be the low-hanging fruit in the tree of genomic medicine with numerous examples of its successful implementation in the clinic. In this perspective, we provide details about the potential clinical application of pharmacogenomics in African populations by using relevant drug cases and high-throughput genomics approaches; involving numerous countries and stakeholders; and most importantly exploiting the existing knowledge of respective large-scale initiatives. We emphasize on the necessity of constructing appropriate frameworks for government policies in African countries. We also provide input about different initiatives in the field of genomics medicine implementation in Africa, not only for their potential for synergy and collaboration among them, but also as models for replication in other regions worldwide, aiming for healthcare improvement.
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Affiliation(s)
- Bathusi Mathuba
- Botswana-Baylor Children's Clinical Centre of Excellence, Gaborone, Botswana
| | - Maria Koromina
- Department of Pharmacy, University of Patras School of Health Sciences, Patras, 26503, Greece
| | | | - George P Patrinos
- Department of Pharmacy, University of Patras School of Health Sciences, Patras, 26503, Greece.,Department of Pathology, College of Medicine & Health Sciences, United Arab Emirates University, Al-Ain, UAE.,Zayed Center of Health Sciences, United Arab Emirates University, Al-Ain, UAE
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8
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Matimba A, Chimatira A, Kuguyo O, January J, Mupambireyi Z, Marimbe-Dube B, Chikwasha V, Nyati-Jokomo Z, Muteti S, Mangezvo P, Kangwende A, Chingono A, Chidzonga M, Gandari J, Hakim J, Nathoo K, Samkange C, Mangezi W, Lee S, Gwanzura L, Cho M, Ndebele P. Understanding Ethical, Legal and Societal Issues (ELSIs) in Human Biobanking and Genomics for Research and Healthcare in Zimbabwe: The Genomics Inheritance Law Ethics and Society (GILES) initiative. AAS Open Res 2020; 2:1. [PMID: 32382699 PMCID: PMC7194152 DOI: 10.12688/aasopenres.12917.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2019] [Indexed: 11/20/2022] Open
Abstract
Biobanks and human genomics applications are key for understanding health, disease and heredity in Africa and globally. Growing interest in these technologies calls for strengthening relevant legal, ethical and policy systems to address knowledge disparities and ensure protection of society, while supporting advancement of science. In Zimbabwe there is limited understanding of ethical, legal, and societal issues (ELSI) for biobanking and genomics. The Genomics Inheritance Law Ethics and Society (GILES) initiative was established in 2015 to explore the current status and gaps in the ethical and legal frameworks, knowledge among various stakeholders, and to establish capacity for addressing ELSI of biobanking and genomics as applied in biomedical and population research, and healthcare. The project was conducted over a countrywide geographical region and established one of the most comprehensive studies for ELSI of human biobanking and genomics in Africa. This paper outlines the strategy undertaken during the implementation of the GILES initiative and discusses the importance of such an initiative for characterisation of ELSI of human biobanking and genomics in Zimbabwe and Africa.
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Affiliation(s)
- Alice Matimba
- College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Andrew Chimatira
- College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Oppah Kuguyo
- College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - James January
- College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Zivayi Mupambireyi
- Centre for Sexual Health and HIV Research Zimbabwe (CeSHHAR Zimbabwe), Harare, Zimbabwe
| | | | - Vasco Chikwasha
- College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | | | - Shamiso Muteti
- College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | | | | | - Alfred Chingono
- College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Midion Chidzonga
- College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Jonathan Gandari
- College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - James Hakim
- College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Kusum Nathoo
- College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | | | - Walter Mangezi
- College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Sandra Lee
- Biomedical Ethics, Stanford University School of Medicine, Stanford, CA, USA
| | - Lovemore Gwanzura
- College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Mildred Cho
- Biomedical Ethics, Stanford University School of Medicine, Stanford, CA, USA
| | - Paul Ndebele
- Medical Research Council of Zimbabwe, Harare, Zimbabwe.,Milken Institute School of Public Health, George Washington University, Washington, DC, USA
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9
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Nembaware V, Mulder N. The African Genomic Medicine Training Initiative (AGMT): Showcasing a Community and Framework Driven Genomic Medicine Training for Nurses in Africa. Front Genet 2019; 10:1209. [PMID: 31921282 PMCID: PMC6934054 DOI: 10.3389/fgene.2019.01209] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 11/01/2019] [Indexed: 12/25/2022] Open
Abstract
The potential of genomic medicine in improving the quality of healthcare both at population and individual-level is well-recognized globally. However, successful adoption of genetic and genomic evidence into clinical practice depends on training the healthcare workforce and clinical researchers in genomic medicine. Due to limited expertise in the medical genetics and genomics field, widespread uptake largely depends on task-shifting for the implementation of genomic medicine implementation to key healthcare professionals such as nurses. Their knowledge would be developed through courses aimed at professional development. Globally, trainers, and training initiatives in genomic medicine are in early stages of development, but resource limited settings such as the African continent face additional logistical and institutional challenges. The African Genomic Medicine Training (AGMT) Initiative was conceived during a combined conference of the African Society of Human Genetics (AfSHG) and the Human Heredity and Health in Africa Consortium (H3Africa) in 2016, Senegal, in response to the needs for developing knowledge and skills in genomic medicine. AGMT was established to implement a sustainable genomic medicine training initiative primarily for healthcare professionals who are not geneticists but are nurses, doctors, and pharmacists in Africa. This paper reports on the establishment of the AGMT initiative and the strategies developed and piloted by this initiative in designing and implementing an accredited frame-work and community-based blended learning course for nurses across 11 African countries. The global implementation experiences, outcomes and lessons learnt are highlighted. The AGMT initiative strategy takes advantage of existing research consortia and networks to train and create a pool of trainers and has adopted evidence-based approaches to guide curriculum and content development/adaptation. This initiative established the first Africa-wide online blended learning genomic medicine course which forms the basis from which to develop courses for other healthcare professionals and the wider public.
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Affiliation(s)
- Victoria Nembaware
- Division of Human Genetics, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Nicola Mulder
- Computational Biology Division, Department of Integrative Biomedical Sciences, IDM, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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10
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Abstract
PURPOSE OF REVIEW Dysmorphic features result from errors in morphogenesis frequently associated with genetic syndromes. Recognizing patterns of dysmorphic features is a critical step in the diagnosis and management of human congenital anomalies and genetic syndromes. This review presents recent developments in genetic syndromes and their related dysmorphology in diverse populations. RECENT FINDINGS Clinical findings in patients with genetic syndromes differ in their heterogeneity across different population groups. Some genetic syndromes have variable features in different ethnicities, in part due to specific background exam characteristics such as flat facial profiles or nasal differences; however, other genetic syndromes are similar across different ethnicities. Facial analysis technology is accurate in diagnosing genetic syndromes in populations around the world and is a powerful adjunct to conventional clinical examination. This accuracy also reinforces the concept that genetic syndromes can and should be diagnosed in any ethnicity. SUMMARY The increasing amount of data from studies on genetic syndromes in diverse populations is significantly improving our knowledge and approach to dysmorphic patients from various ethnic backgrounds. Optimal management of genetic syndromes requires early diagnosis, including in developing countries.
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Affiliation(s)
- Paul Kruszka
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
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11
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Abimiku AG, Croxton T, Ozumba PJ, Agala N, Balogun O, Jonathan E, Onyemata E, Ndifon K, Nadoma S, Anazodo T, Peters S, Beiswanger CM. Blueprint for building a biorepository in a resource-limited setting that follows international best practices. Afr J Lab Med 2019; 8:722. [PMID: 31534913 PMCID: PMC6739520 DOI: 10.4102/ajlm.v8i1.722] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 03/22/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Genetic diversity is abundant on the African continent. However, genomic research has been hampered by a lack of high quality and extensively annotated biospecimens and the necessary infrastructure to support such a technology-intensive effort. OBJECTIVE The Institute of Human Virology Nigeria (IHVN) partnered with the H3Africa Consortium and the Coriell Institute for Medical Research to build an internationally recognised biorepository for the receipt, processing, storage and distribution of biospecimens for biomedical research. Here, the authors describe the procedures, challenges and results encountered. RESULTS Key requirements for a high-quality biorepository were identified: (1) institutional support of infrastructure and services, (2) on-site trained staff with primary commitment to the biorepository, (3) reliance on best practices from globally recognised biorepository groups, (4) early implementation of a quality management system, (5) adoption of a laboratory information management system with demonstrated versatility in functions, (6) collaboration with external experts and sharing of experience through abstracts, newsletters, published manuscripts, and attendance at meetings and workshops, (7) strict adherence to local and national ethical standards and (8) a sustainability plan that is reviewed and updated annually. CONCLUSION Utilising published best practices of globally recognised experts in the biorepository field as a benchmark, IHVN expanded and reorganised its existing laboratory facility and staff to take on this new purpose.
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Affiliation(s)
- Alash'le G Abimiku
- Institute of Human Virology Nigeria, Abuja, Nigeria
- Institute of Human Virology, University of Maryland, Baltimore, Maryland, United States
| | - Talishea Croxton
- Institute of Human Virology Nigeria, Abuja, Nigeria
- Institute of Human Virology, University of Maryland, Baltimore, Maryland, United States
| | | | - Ndidi Agala
- Institute of Human Virology Nigeria, Abuja, Nigeria
| | | | | | | | | | - Sunji Nadoma
- Institute of Human Virology Nigeria, Abuja, Nigeria
| | | | - Sam Peters
- Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Christine M Beiswanger
- Coriell Institute for Medical Research, Camden, New Jersey, United States
- Independent contractor, Philadelphia, Pennsylvania, United States
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12
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Mweemba O, Musuku J, Mayosi BM, Parker M, Rutakumwa R, Seeley J, Tindana P, De Vries J. Use of broad consent and related procedures in genomics research: Perspectives from research participants in the Genetics of Rheumatic Heart Disease (RHDGen) study in a University Teaching Hospital in Zambia. Glob Bioeth 2019; 31:184-199. [PMID: 33343192 PMCID: PMC7734073 DOI: 10.1080/11287462.2019.1592868] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The use of broad consent for genomics research raises important ethical questions for the conduct of genomics research, including relating to its acceptability to research participants and comprehension of difficult scientific concepts. To explore these and other challenges, we conducted a study using qualitative methods with participants enrolled in an H3Africa Rheumatic Heart Disease genomics study (the RHDGen network) in Zambia to explore their views on broad consent, sample and data sharing and secondary use. In-depth interviews were conducted with RHDGen participants (n = 18), study staff (n = 5) and with individuals who refused to participate (n = 3). In general, broad consent was seen to be reasonable if reasons for storing the samples for future research use were disclosed. Some felt that broad consent should be restricted by specifying planned future studies and that secondary research should ideally relate to original disease for which samples were collected. A few participants felt that broad consent would delay the return of research results to participants. This study echoes findings in other similar studies in other parts of the continent that suggested that broad consent could be an acceptable consent model in Africa if careful thought is given to restrictions on re-use.
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Affiliation(s)
- Oliver Mweemba
- Department of Health Promotion and Education, University of Zambia, Lusaka, Zambia
| | - John Musuku
- Children Hospital, University Teaching Hospitals, Lusaka, Zambia
| | - Bongani M Mayosi
- Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Michael Parker
- Wellcome Centre for Ethics and Humanities (Ethox), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Rwamahe Rutakumwa
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Janet Seeley
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.,Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Paulina Tindana
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Jantina De Vries
- Department of Medicine, University of Cape Town, Cape Town, South Africa
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13
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Hetu M, Koutouki K, Joly Y. Genomics for All: International Open Science Genomics Projects and Capacity Building in the Developing World. Front Genet 2019; 10:95. [PMID: 30828348 PMCID: PMC6384230 DOI: 10.3389/fgene.2019.00095] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 01/29/2019] [Indexed: 11/13/2022] Open
Abstract
Genomic medicine applications have the potential to considerably improve health care in developing countries in the coming years. However, if developing countries do not improve their capacity for research and development (R&D) in the field, they might be left out of the genomics revolution. Large-scale and widely accessible databases for storing and analyzing genomic data are crucial tools for the advancement of genomic medicine. Building developing countries' capacity in genomics is accordingly closely linked to their involvement in international human genomics research initiatives. The purpose of this paper is to conduct a pilot study on the impact of international open science genomics projects on capacity building in R&D in developing countries. Using indicators we developed in previous work to measure the performance of international open science genomics projects, we analyse the policies and practices of four key projects in the field: the International HapMap Project, the Human Heredity and Health in Africa Initiative, the Malaria Genomic Epidemiology Network and the Structural Genomics Consortium. The results show that these projects play an important role in genomics capacity building in developing countries, but play a more limited role with regard to the potential redistribution of the benefits of research to the populations of these countries. We further suggest concrete initiatives that could facilitate the involvement of researchers from developing countries in the international genomics research community and accelerate capacity building in the developing world.
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Affiliation(s)
- Martin Hetu
- Department of Human Genetics, Faculty of Medicine, Centre of Genomics and Policy, McGill University, Montreal, QC, Canada
| | | | - Yann Joly
- Department of Human Genetics, Faculty of Medicine, Centre of Genomics and Policy, McGill University, Montreal, QC, Canada
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Aworunse OS, Adeniji O, Oyesola OL, Isewon I, Oyelade J, Obembe OO. Genomic Interventions in Medicine. Bioinform Biol Insights 2018; 12:1177932218816100. [PMID: 30546257 PMCID: PMC6287307 DOI: 10.1177/1177932218816100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 11/04/2018] [Indexed: 12/31/2022] Open
Abstract
Lately, the term "genomics" has become ubiquitous in many scientific articles. It is a rapidly growing aspect of the biomedical sciences that studies the genome. The human genome contains a torrent of information that gives clues about human origin, evolution, biological function, and diseases. In a bid to demystify the workings of the genome, the Human Genome Project (HGP) was initiated in 1990, with the chief goal of sequencing the approximately 3 billion nucleotide base pairs of the human DNA. Since its completion in 2003, the HGP has opened new avenues for the application of genomics in clinical practice. This review attempts to overview some milestone discoveries that paved way for the initiation of the HGP, remarkable revelations from the HGP, and how genomics is influencing a paradigm shift in routine clinical practice. It further highlights the challenges facing the implementation of genomic medicine, particularly in Africa. Possible solutions are also discussed.
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Affiliation(s)
| | | | - Olusola L Oyesola
- Department of Biological Sciences, Covenant University, Ota, Nigeria
| | - Itunuoluwa Isewon
- Department of Computer & Information Sciences, Covenant University, Ota, Nigeria
| | - Jelili Oyelade
- Department of Computer & Information Sciences, Covenant University, Ota, Nigeria
| | - Olawole O Obembe
- Department of Biological Sciences, Covenant University, Ota, Nigeria
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15
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Martin AR, Teferra S, Möller M, Hoal EG, Daly MJ. The critical needs and challenges for genetic architecture studies in Africa. Curr Opin Genet Dev 2018; 53:113-120. [PMID: 30240950 PMCID: PMC6494470 DOI: 10.1016/j.gde.2018.08.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 08/17/2018] [Accepted: 08/31/2018] [Indexed: 12/11/2022]
Abstract
Human genetic studies have long been vastly Eurocentric, raising a key question about the generalizability of these study findings to other populations. Because humans originated in Africa, these populations retain more genetic diversity, and yet individuals of African descent have been tremendously underrepresented in genetic studies. The diversity in Africa affords ample opportunities to improve fine-mapping resolution for associated loci, discover novel genetic associations with phenotypes, build more generalizable genetic risk prediction models, and better understand the genetic architecture of complex traits and diseases subject to varying environmental pressures. Thus, it is both ethically and scientifically imperative that geneticists globally surmount challenges that have limited progress in African genetic studies to date. Additionally, African investigators need to be meaningfully included, as greater inclusivity and enhanced research capacity afford enormous opportunities to accelerate genomic discoveries that translate more effectively to all populations. We review the advantages, challenges, and examples of genetic architecture studies of complex traits and diseases in Africa. For example, with greater genetic diversity comes greater ancestral heterogeneity; this higher level of understudied diversity can yield novel genetic findings, but some methods that assume homogeneous population structure and work well in European populations may work less well in the presence of greater heterogeneity in African populations. Consequently, we advocate for methodological development that will accelerate studies important for all populations, especially those currently underrepresented in genetics.
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Affiliation(s)
- Alicia R Martin
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA; Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA.
| | - Solomon Teferra
- Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Harvard University, Boston, USA
| | - Marlo Möller
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa
| | - Eileen G Hoal
- DST-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa
| | - Mark J Daly
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA; Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA; Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA; Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
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16
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Munung NS, Mayosi BM, de Vries J. Genomics research in Africa and its impact on global health: insights from African researchers. Glob Health Epidemiol Genom 2018; 3:e12. [PMID: 30263136 PMCID: PMC6152488 DOI: 10.1017/gheg.2018.3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 02/19/2018] [Accepted: 03/01/2018] [Indexed: 12/27/2022] Open
Abstract
Africa may be heading for an era of genomics medicine. There are also expectations that genomics may play a role in reducing global health inequities. However, the near lack of genomics studies on African populations has led to concerns that genomics may widen, rather than close, the global health inequity gap. To prevent a possible genomics divide, the genomics 'revolution' has been extended to Africa. This is motivated, in part, by Africa's rich genetic diversity and high disease burden. What remains unclear, however, are the prospects of using genomics technology for healthcare in Africa. In this qualitative study, we explored the views of 17 genomics researchers in Africa on the prospects and challenges of genomics medicine in Africa. Interviewees were researchers in Africa who were involved in genomics research projects in Africa. Analysis of in-depth interviews suggest that genomics medicine may have an impact on disease surveillance, diagnosis, treatment and prevention. However, Africa's capacity for genomics medicine, current research priorities in genomics and the translation of research findings will be key defining factors impacting on the ability of genomics medicine to improve healthcare in Africa.
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Affiliation(s)
- N. S. Munung
- Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - B. M. Mayosi
- Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
- Dean's Office, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - J. de Vries
- Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
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17
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Adebamowo SN, Francis V, Tambo E, Diallo SH, Landouré G, Nembaware V, Dareng E, Muhamed B, Odutola M, Akeredolu T, Nerima B, Ozumba PJ, Mbhele S, Ghanash A, Wachinou AP, Ngomi N. Implementation of genomics research in Africa: challenges and recommendations. Glob Health Action 2018; 11:1419033. [PMID: 29336236 PMCID: PMC5769805 DOI: 10.1080/16549716.2017.1419033] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 12/08/2017] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND There is exponential growth in the interest and implementation of genomics research in Africa. This growth has been facilitated by the Human Hereditary and Health in Africa (H3Africa) initiative, which aims to promote a contemporary research approach to the study of genomics and environmental determinants of common diseases in African populations. OBJECTIVE The purpose of this article is to describe important challenges affecting genomics research implementation in Africa. METHODS The observations, challenges and recommendations presented in this article were obtained through discussions by African scientists at teleconferences and face-to-face meetings, seminars at consortium conferences and in-depth individual discussions. RESULTS Challenges affecting genomics research implementation in Africa, which are related to limited resources include ill-equipped facilities, poor accessibility to research centers, lack of expertise and an enabling environment for research activities in local hospitals. Challenges related to the research study include delayed funding, extensive procedures and interventions requiring multiple visits, delays setting up research teams and insufficient staff training, language barriers and an underappreciation of cultural norms. While many African countries are struggling to initiate genomics projects, others have set up genomics research facilities that meet international standards. CONCLUSIONS The lessons learned in implementing successful genomics projects in Africa are recommended as strategies to overcome these challenges. These recommendations may guide the development and application of new research programs in low-resource settings.
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Affiliation(s)
- Sally N. Adebamowo
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
- Center for Bioethics and Research, Ibadan, Nigeria
| | - Veronica Francis
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Ernest Tambo
- Sydney Brenner Institute of Molecular Bioscience, University of Witwatersrand, Johannesburg, South Africa
| | - Seybou H. Diallo
- Faculté de Médecine et d’Odonstomatologie, Université des Sciences, des Techniques, et des Technologies de Bamako, Bamako, Mali
| | - Guida Landouré
- Faculté de Médecine et d’Odonstomatologie, Université des Sciences, des Techniques, et des Technologies de Bamako, Bamako, Mali
| | - Victoria Nembaware
- Department of Integrative Biomedical Sciences, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Eileen Dareng
- Office of Strategic Information and Research, Institute of Human Virology Nigeria, Abuja, Nigeria
- Department of Primary Care and Public Health, University of Cambridge, Cambridge, UK
| | - Babu Muhamed
- Department of Medicine, University of Cape Town, Cape Town, South Africa
- Cardiovascular Genetics, Hatter Institute for Cardiovascular Diseases Research in Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Michael Odutola
- Office of Strategic Information and Research, Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Teniola Akeredolu
- Office of Strategic Information and Research, Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Barbara Nerima
- National Livestock Resources Research Institute, Tororo, Uganda
| | - Petronilla J. Ozumba
- Clinical Lab Molecular Virology Unit, Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Slee Mbhele
- Division of Medical Microbiology, University of Cape Town, Cape Town, South Africa
| | - Anita Ghanash
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Ablo P. Wachinou
- National Hospital for Tuberculosis and Pulmonary Diseases, Cotonou, Benin Republic
| | - Nicholas Ngomi
- Health Challenges and Systems program, African Population and Health Research Center, Nairobi, Kenya
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18
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Pharmacogenomic implications of the evolutionary history of infectious diseases in Africa. THE PHARMACOGENOMICS JOURNAL 2016; 17:112-120. [PMID: 27779243 PMCID: PMC5380847 DOI: 10.1038/tpj.2016.78] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 07/06/2016] [Accepted: 07/19/2016] [Indexed: 12/20/2022]
Abstract
As the common birthplace of all human populations, modern humans have lived longer on the African continent than in any other geographical region of the world. This long history, along with the evolutionary need to adapt to environmental challenges such as exposure to infectious agents, has led to greater genetic variation in Africans. The vast genetic variation in Africans also extends to genes involved in the absorption, distribution, metabolism and excretion of pharmaceuticals. Ongoing cataloging of these clinically relevant variants reveals huge allele-frequency differences within and between African populations. Here, we examine Africa's large burden of infectious disease, discuss key examples of known genetic variation modulating disease risk, and provide examples of clinically relevant variants critical for establishing dosing guidelines. We propose that a more systematic characterization of the genetic diversity of African ancestry populations is required if the current benefits of precision medicine are to be extended to these populations.
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19
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Embracing an "African Ethos" to facilitate African immigrants participation in medical genetics and genomics research. Nurs Outlook 2016; 65:9-17. [PMID: 27687163 DOI: 10.1016/j.outlook.2016.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 08/02/2016] [Accepted: 08/21/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND Limited published research exists on perceptions and potentials for black African immigrants' participation in medical genetics and genomics research. PURPOSE This study explores the inclination and disinclination of African immigrants to be involved in genetics and genomics research. METHODS In-depth qualitative interviews were employed in which a sample of black African immigrants 18 years and older (n = 34) were interviewed. DISCUSSION Barriers included contrary beliefs and customs about disease and the human body that differs from Western conceptions, and lack of genuine connection to the health care system. Facilitators included promotion of an "African ethos," wherein Africans unite with one another in a communal extension of self and robust community involvement across the life span of genetic studies. CONCLUSION It is important for researchers and genetic counselors to understand the sociocultural underpinnings of African immigrants about genetics and genomics research as an initial step to encouraging their participation.
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20
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Adedokun BO, Olopade CO, Olopade OI. Building local capacity for genomics research in Africa: recommendations from analysis of publications in Sub-Saharan Africa from 2004 to 2013. Glob Health Action 2016; 9:31026. [PMID: 27178644 PMCID: PMC4867048 DOI: 10.3402/gha.v9.31026] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 03/10/2016] [Accepted: 03/10/2016] [Indexed: 01/12/2023] Open
Abstract
Background The poor genomics research capacity of Sub-Saharan Africa (SSA) could prevent maximal benefits from the applications of genomics in the practice of medicine and research. The objective of this study is to examine the author affiliations of genomic epidemiology publications in order to make recommendations for building local genomics research capacity in SSA. Design SSA genomic epidemiology articles published between 2004 and 2013 were extracted from the Human Genome Epidemiology (HuGE) database. Data on authorship details, country of population studied, and phenotype or disease were extracted. Factors associated with the first author, who has an SSA institution affiliation (AIAFA), were determined using a Chi-square test and multiple logistic regression analysis. Results The most commonly studied population was South Africa, accounting for 31.1%, followed by Ghana (10.6%) and Kenya (7.5%). About one-tenth of the papers were related to non-communicable diseases (NCDs) such as cancer (6.1%) and cardiovascular diseases (CVDs) (4.3%). Fewer than half of the first authors (46.9%) were affiliated with an African institution. Among the 238 articles with an African first author, over three-quarters (79.8%) belonged to a university or medical school, 16.8% were affiliated with a research institute, and 3.4% had affiliations with other institutions. Conclusions Significant disparities currently exist among SSA countries in genomics research capacity. South Africa has the highest genomics research output, which is reflected in the investments made in its genomics and biotechnology sector. These findings underscore the need to focus on developing local capacity, especially among those affiliated with SSA universities where there are more opportunities for teaching and research.
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Affiliation(s)
- Babatunde O Adedokun
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria;
| | - Christopher O Olopade
- Centre for Global Health, Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Olufunmilayo I Olopade
- Center for Clinical Cancer Genetics and Global Health, Department of Medicine, University of Chicago, Chicago, IL, USA
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21
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Landouré G, Samassékou O, Traoré M, Meilleur KG, Guinto CO, Burnett BG, Sumner CJ, Fischbeck KH. Genetics and genomic medicine in Mali: challenges and future perspectives. Mol Genet Genomic Med 2016; 4:126-34. [PMID: 27066513 PMCID: PMC4799869 DOI: 10.1002/mgg3.212] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 02/11/2016] [Accepted: 02/11/2016] [Indexed: 11/14/2022] Open
Abstract
Genetics and genomic medicine in Mali: challenges and future perspectives.
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Affiliation(s)
- Guida Landouré
- Service de NeurologieCentre Hospitalier Universitaire du Point "G"BamakoMali; Neurogenetics BranchNational Institute of Neurological Disorders and Stroke (NINDS)National Institutes of Health (NIH)BethesdaMaryland
| | - Oumar Samassékou
- Manitoba Institute of cell BiologyUniversity of ManibotaWinnipegCanada; Service de cytogenetique et de biologie reproductiveInstitut National de Recherche en Santé Publique (INRSP)BamakoMali
| | - Mahamadou Traoré
- Service de cytogenetique et de biologie reproductive Institut National de Recherche en Santé Publique (INRSP) Bamako Mali
| | - Katherine G Meilleur
- Tissue Injury Branch National Institute of Nursing Research (NINR) NIH Bethesda Maryland
| | - Cheick Oumar Guinto
- Service de Neurologie Centre Hospitalier Universitaire du Point "G" Bamako Mali
| | - Barrington G Burnett
- Departments of Anatomy, Physiology and Genetics Uniformed Services University of the Health Sciences (USUHS) Bethesda Maryland
| | | | - Kenneth H Fischbeck
- Neurogenetics Branch National Institute of Neurological Disorders and Stroke (NINDS) National Institutes of Health (NIH) Bethesda Maryland
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22
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Forero DA, Wonkam A, Wang W, Laissue P, López-Correa C, Fernández-López JC, Mugasimangalam R, Perry G. Current needs for human and medical genomics research infrastructure in low and middle income countries: Table 1. J Med Genet 2016; 53:438-40. [DOI: 10.1136/jmedgenet-2015-103631] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 11/27/2015] [Indexed: 11/04/2022]
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23
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Wonkam A, Ngo Bitoungui VJ, Ngogang J. Perspectives in Genetics and Sickle Cell Disease Prevention in Africa: Beyond the Preliminary Data from Cameroon. Public Health Genomics 2015; 18:237-41. [PMID: 26044545 DOI: 10.1159/000431020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 04/29/2015] [Indexed: 11/19/2022] Open
Abstract
Management of sickle cell disease (SCD) in Africa needs to be accompanied by various preventive strategies, including early detection via prenatal genetic diagnosis (PND). Contrary to Cameroonian doctors who considered termination of an affected pregnancy (TAP) for SCD in 36.1%, the majority of parents (62.5%) with affected children accepted TAP in principle. In practice, most women opted for TAP (90%), justified by a huge psycho-social burden. The ethical and legal challenges of PND prompted the need to explore the use of genetics for secondary prevention of SCD. In 610 Cameroonian SCD patients, the genomic variations in two principal foetal haemoglobin-promoting loci were significantly associated with foetal haemoglobin levels. In addition, the co-inheritance of a 3.7-kb α-globin gene deletion and SCD was associated with a late disease onset and possibly improved survival: there was a much higher allele frequency of the 3.7-kb α-globin gene deletion in SCD patients (∼ 40%) than in haemoglobin AA controls (∼ 10%). The data indicate the urgent need to develop and implement policy actions in sub-Saharan Africa on at least four levels: (1) the implementation of SCD screening practices and early neonatal follow-up; (2) the development and incorporating of socio-economic support to alleviate the burden of SCD on affected families; (3) the exploration of the appropriateness of the medical abortion laws for SCD, and (4) the development of national plans for genetic medicine, including research on genomic variants that affect the phenotypes of SCD, in order to potentially use them for anticipatory guidance.
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Affiliation(s)
- Ambroise Wonkam
- Division of Human Genetics, Faculty of Health Sciences, University of Cape Town, Cape Town, Republic of South Africa
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24
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de Vries J, Tindana P, Littler K, Ramsay M, Rotimi C, Abayomi A, Mulder N, Mayosi BM. The H3Africa policy framework: negotiating fairness in genomics. Trends Genet 2015; 31:117-9. [PMID: 25601285 PMCID: PMC4471134 DOI: 10.1016/j.tig.2014.11.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 11/30/2014] [Indexed: 12/25/2022]
Abstract
Human Heredity and Health in Africa (H3Africa) research seeks to promote fair collaboration between scientists in Africa and those from elsewhere. Here, we outline how concerns over inequality and exploitation led to a policy framework that places a firm focus on African leadership and capacity building as guiding principles for African genomics research.
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Affiliation(s)
- Jantina de Vries
- Department of Medicine, University of Cape Town, UCT Centre for Clinical Research, Old Main Building, Groote Schuur Hospital, Observatory, Cape Town 7925, South Africa.
| | - Paulina Tindana
- Navrongo Health Research Centre, Ghana Health Service, PO Box 114, Navrongo, Ghana
| | | | - Michèle Ramsay
- Division of Human Genetics, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand and National Health Laboratory Service, PO Box 1038, Johannesburg 2000, South Africa
| | - Charles Rotimi
- Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand, Johannesburg, Parktown 2193, South Africa
| | - Akin Abayomi
- Center for Research on Genomics and Global Health, MSC 5635, Bethesda, MD 20892-5635, USA
| | - Nicola Mulder
- NSB-H3A Biobank, National Health Laboratory Services of South Africa, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town 7505, South Africa
| | - Bongani M Mayosi
- Institute of Infectious Disease and Molecular Medicine, UCT Faculty of Health Sciences, Observatory 7925, South Africa
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