COVID-19 in children: a case series from Nigeria

Introduction: the global spread of COVID-19 remains unabated in the past few months with a rise in the number of available literature on the novel virus. There are very few paediatric studies and are mainly from developed countries with a paucity of information on the clinical manifestation of COVID-19 disease in African children, including Nigeria. Methods: we described the clinical presentation, laboratory findings, treatment and outcome in a group of five Nigerian children managed at a COVID-19 isolation and treatment centre in Nigeria. Results: we managed a total of five children with an age range of 3 months to 8 years in the last four weeks (16th April to 15th May 2020). Three of the five children were males. All the children had close contact with family members that tested positive for COVID-19. Out of the five children, one had moderate disease, three had mild symptomatic disease, and one was asymptomatic. Two out of the five children had lymphocytosis. Out of the four children who had chest radiograph, two had features of pneumonia. Conclusion: COVID-19 is not uncommon in Nigerian children, and all had a confirmed family member with COVID-19. Besides, contrary to leucopaenia with lymphopaenia observed in the adult's population, we found lymphocytosis in this cohort and about 50.0% had pneumonic changes on chest radiograph

Transplantation of gene-modified haematopoietic stem cells: Application and clinical considerations

Autologous and allogeneic haematopoietic stem cell (HSC) transplantation has been performed in patients with various malignant and non-malignant haematological disorders for more than 50 years. Ex vivo gene modification of HSCs for autologous transplantation opens up new therapeutic avenues for genetic and infectious diseases. Major advances have been made over the last three decades with respect to gene modification of HSCs and transplantation strategies, ultimately culminating in the approval of two such therapies in Europe (Strimvelis for a rare primary immune deficiency, and LentiGlobin for beta-thalassaemia). Newer gene-modifying technologies and treatment regimens have also recently come to the fore, which hold great promise for the development of safer and more effective treatments. We provide an overview of the current state of gene-modified HSC therapies, highlighting success stories, limitations and important considerations for achieving successful translation of these therapies to the clinic

Sensitivity and specificity of typhoid fever rapid antibody tests for laboratory diagnosis at two sub-Saharan African sites

Objective:To evaluate three commercial typhoid rapid antibody tests for Salmonella Typhi antibodies in patients suspected of having typhoid fever in Mpumalanga; South Africa; and Moshi; United Republic of Tanzania. Methods The diagnostic accuracy of Cromotest (semiquantitative slide agglutination and single tube Widal test); TUBEX and Typhidot was assessed against that of blood culture. Performance was modelled for scenarios with pretest probabilities of 5and 50. Findings In total 92 patients enrolled: 53 (57.6) from South Africa and 39 (42.4) from the United Republic of Tanzania. Salmonella Typhi was isolated from the blood of 28 (30.4) patients. The semiquantitative slide agglutination and single-tube Widal tests had positive predictive values (PPVs) of 25.0(95confidence interval; CI: 0.6-80.6) and 20.0(95CI: 2.5-55.6); respectively. The newer typhoid rapid antibody tests had comparable PPVs: TUBEX; 54.1(95CI: 36.9-70.5); Typhidot IgM; 56.7(95CI: 37.4-74.5); and Typhidot IgG; 54.3(95CI: 36.6-71.2). For a pretest probability of 5; PPVs were: TUBEX; 11.0(95CI: 6.6-17.9); Typhidot IgM; 9.1(95CI: 5.8-14.0); and Typhidot IgG; 11.0(6.3-18.4). For a pretest probability of 50; PPVs were: TUBEX; 70.2(95CI: 57.3-80.5); Typhidot IgM; 65.6(95CI: 54.0-75.6); and Typhidot IgG; 70.0(95CI: 56.0-81.1). Conclusion Semiquantitative slide agglutination and single-tube Widal tests performed poorly. TUBEX and Typhidot may be suitable when pretest probability is high and blood cultures are unavailable; but their performance does not justify deployment in routine care settings in sub-Saharan Africa