Rotavirus diarrhoea hospitalizations among children under 5 years of age in Nigeria, 2011-2016

BACKGROUND

The high burden of rotavirus acute gastroenteritis (AGE) is well documented among children under 5 years of age, with the majority of mortality occurring in developing countries. Nigeria ranked second worldwide in the number of rotavirus deaths in 2013. As Nigeria plans to introduce rotavirus vaccine soon, a pre-vaccine documentation of rotavirus disease burden is necessary to determine vaccine impact.

METHODS

Routine rotavirus surveillance was conducted during 2011-2016 in 3 sentinel sites in Nigeria using the standard WHO protocol. Children under 5 years of age hospitalized for acute gastroenteritis were enrolled and demographic, clinical and outcome data were collected. A stool sample was subsequently obtained and tested for human rotavirus antigen using the Enzyme-linked immunosorbent assay (ELISA).

RESULTS

2694 children with acute gastroenteritis were enrolled during January 2011 to December 2016; of these, 1242 (46%) tested positive for rotavirus. Among the rotavirus positive cases, 66% and 94% were younger than 12 months and 24 months respectively. Marked peaks in rotavirus positivity were seen in January of each year. Vomiting, and use of oral and intravenous fluids occurred more often in rotavirus positive cases as compared to rotavirus negative cases.

CONCLUSION

The high prevalence of rotavirus disease highlights the need for urgent introduction of rotavirus vaccine in Nigeria. Additionally, this study provides pre-vaccine introduction disease-burden data that will serve as a baseline for rotavirus vaccine impact-assessment once vaccine has been introduced in the national immunization program.

Intravital two-photon microscopy of the native mouse thymus

The thymus, a key organ in the adaptive immune system, is sensitive to a variety of insults including cytotoxic preconditioning, which leads to atrophy, compression of the blood vascular system, and alterations in hemodynamics. Although the thymus has innate regenerative capabilities, the production of T cells relies on the trafficking of lymphoid progenitors from the bone marrow through the altered thymic blood vascular system. Our understanding of thymic blood vascular hemodynamics is limited due to technical challenges associated with accessing the native thymus in live mice. To overcome this challenge, we developed an intravital two-photon imaging method to visualize the native thymus in vivo and investigated functional changes to the vascular system following sublethal irradiation. We quantified blood flow velocity and shear rate in cortical blood vessels and identified a subtle but significant increase in vessel leakage and diameter ~24 hrs post-sublethal irradiation. Ex vivo whole organ imaging of optically cleared thymus lobes confirmed a disruption of the thymus vascular structure, resulting in an increase in blood vessel diameter and vessel area, and concurrent thymic atrophy. This novel two-photon intravital imaging method enables a new paradigm for directly investigating the thymic microenvironment in vivo.

1K4Cancer Breaks the Silence: A Crowd-Funding Campaign by Sebeccly Cancer Care

Amount raised: The 1K4Cancer campaign raised a total of $18,099. Background and context: Poverty, chronicity of spending, paying out-of-pocket for health care needs, and the prohibitive cost of cancer drugs are some of the reasons cancer patients don't start or complete treatment. Over 90% of Nigerian cancer patients pay for healthcare expenses out-of-pocket; putting a heavy strain on their finances and those of their caregivers. Sebeccly is a cancer charity that enables cancer care access to indigent cancer patients through several fundraising modalities, one of which is the 1K4Cancer. The campaign is a cancer drug fund and crowd fundraiser that appeals for a minimum donation worth $2.50. Launched in October 2012 (for 3 months), and relaunched in March 2018, 1K4Cancer provides treatment aid to breast cancer patients. Aim: To raise funds and provide access to cancer care to indigent breast cancer patients. Strategy/Tactics: The 1K4Cancer campaign reaches out to individuals/organizations by leveraging on social media, relationship management with donors and several 1K4Cancer ambassadors to engage networks to raise funds to support cancer treatment and screening services. This strategy has an online and offline component, with the offline driving the online component. Program process: The 1K4Cancer runs under 7 broad categories: Community events: Focus on advocacy and education on cancer prevention and early detection. Health talks and the 1K4Cancer appeal are delivered during community outreaches. Online community engagements: partnerships with online blogs and influencers to promote the campaign were secured. The social media community was engaged in heartwarming messages and call-to-action statements to support indigent cancer patients. Media partnership: partnerships with online and traditional media houses were secured. The 1K4Cancer message was published on several eminent blogs. Relationship management with donors: past and prospective donors were engaged to promote the campaign. 1K4Cancer remains transparent and accountable through an online monthly newsletter. Donation collection: donations were made through online bank transfer and Sebeccly's online donation platforms. Volunteers: recruitment of 1K4Cancer volunteers who helped to promote and create more awareness about the campaign offline. Partnerships with hospitals: the beneficiaries of the campaign receive cancer care at Lagos University Teaching Hospital, and Lagos State University Teaching Hospital. Costs and returns: $2715 has been spent on online adverts, branding materials, creatives, publications, administrative charges, and logistics. Total returns so far: $15,384. What was learned: Leveraging on goodwill, accountability, the Internet, and a compelling story are necessary ingredients to a crowd-funding campaign. The 1K4Cancer is an innovative crowd-funding campaign that relieves the financial burden of cancer patients and help achieve access to quality cancer care.