Joint EASPS-AAPS conference in Tanzania 2023: a beginning of the pragmatic efforts to promote physiology education, research, and practice in East Africa.

The East African Society of Physiological Sciences (EASPS) identified many problems associated with the practice and impact of physiology training and graduates within the region. The EASPS, in conjunction with the African Association of Physiological Sciences (AAPS), resolved to tackle those identified problems in the region by organizing a regional conference in Tanzania between November 29, 2023, and December 1, 2023. The conference was successful with remarkable achievements, including production of Physiology Curriculum for African Universities (PhysioCAFUN); launching of the International Union of Physiological Sciences (IUPS) African Physiology Mentoring Program; educational workshops on physiology teaching and skills acquisition; plenary sessions on various inspiring scientific topics for advancement of research capacities and current trends in physiological sciences; presentation of abstracts by authors and publishing of the abstracts as edited conference proceedings in the Journal of African Association of Physiological Sciences; presentation of awards to the top 10 abstracts and 7 other key Local Organizing Committee members and partners; first annual general meeting of the EASPS members; networking of participants within and beyond Africa; and recognition of the formation processes of national physiological societies in Rwanda, Kenya, Uganda, and Tanzania.NEW & NOTEWORTHY The joint East African Society of Physiological Sciences (EASPS)-African Association of Physiological Sciences (AAPS) conference in Tanzania was a successful event where we launched the Physiology Curriculum for African Universities (PhysioCAFUN) and the International Union of Physiological Sciences (IUPS) Physiology Mentoring Program in Africa. We also organized educational workshops on physiology functional tests that equipped participants with practical skills. Authors presented their peer-reviewed abstracts, which have now been published in the Journal of African Association of Physiological Sciences. Participants attended from 24 countries across Africa, Europe, Asia, and United States.

Spirometry profiles among pregnant and non-pregnant African women: a cross-sectional study.

BACKGROUND: Spirometry is a commonly used lung function test. It assesses respiratory functions by measuring the air volume and the rate at which a person can exhale from lungs filled to their total capacity. The most helpful spirometry parameters are: forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and peak expiratory flow (PEF). Pregnancy derives an altered physiological state due to hormonal and anatomical changes that affect the respiratory system. Despite that, spirometry is less commonly done during pregnancy, and if done, test results are evaluated against non-pregnancy references. OBJECTIVE: This study aimed to explore spirometry profiles in pregnant and non-pregnant women and describe their differences. METHODOLOGY: This cross-sectional study involved age-matched pregnant and non-pregnant participants recruited from Mnazi Moja ANC and Muhimbili University (MUHAS). A digital spirometer was used to assess respiratory function. Data were entered and analyzed using SPSS version 23. The mean spirometry values of pregnant participants were compared to those of non-pregnant participants using an independent sample t-test. A p-value of < 0.05 was considered statistically significant. RESULTS: The study included 92 pregnant and 98 non-pregnant participants subjected to spirometry. Both FVC and FEV1 values were significantly lower in pregnant than in non-pregnant participants (2.7 ± 0.5 L vs. 2.9 ± 0.5 L; p < 0.01 and 2.2 ± 0.4 L vs. 2.5 ± 0.4 L; p < 0.01 respectively). In addition, pregnant participants had significantly lower mean PEF values than their non-pregnant counterparts (303 ± 84 L/min versus 353 ± 64 L/min; p < 0.01). CONCLUSION: Spirometry test values are lower in pregnancy than in non-pregnant participants. RECOMMENDATIONS: Interpreting the spirometry test values of pregnant women using references obtained from non-pregnant women may be inappropriate. Future studies should evaluate the appropriateness of predicting spirometry values of pregnant women using reference equations derived from non-pregnant women.

Tunga penetrans causing a rapidly progressing foot ulcer in a patient with uncontrolled type 2 diabetes mellitus.

Tungiasis is a parasitic disease resulting from infestation by a female flea Tunga penetrans. The parasites are endemic in the tropics and can infect patients with diabetes mellitus (DM). Augmented by uncontrolled hyperglycemia and pre-existing neuropathy, the parasite may trigger a locally spreading inflammation, which may aggravate the trauma introduced during its extraction, leading into a rapidly progressing foot ulcer. To the best of our knowledge, no such cases in patients with type 2 diabetes have ever been published from Tanzania and likely none worldwide. This case report shows that, in diabetic patients, the wound resulting from the extraction of T. penetrans may get infected and aggravated by the ongoing inflammatory reaction, rapidly evolve into limb-threatening condition and mortality. Preventive measures are necessary and should be emphasized in patients with DM. Studies are needed to increase our understanding of the pathophysiology, proper management and sequalae of ulcers of this nature.

Adiposity Is a Key Correlate of Circulating Fibroblast Growth Factor-21 Levels in African Males with or without Type 2 Diabetes Mellitus.

Background: Fibroblast growth factor-21 is an endocrine regulator with therapeutic and diagnostic potential. The levels and pattern of circulating FGF-21 have been described mainly in European and Asian populations. Given its strong association with adiposity, and the reported ethnic variabilities in body composition, examining FGF-21 in an African population is crucial. Methods: We measured levels of circulating FGF-21 in 207 overweight and obese Tanzanian males with or without type 2 diabetes mellitus (T2DM), and using statistical approaches, we explored their relationship with anthropometric and biochemical parameters. Results: Consistent with previous reports from European and Asian populations, we found higher levels of FGF-21 in people with T2DM compared to those without the disease. Based on statistical models, measures of adiposity explained up to 59% of the variability in FGF-21 levels in the circulation. Conclusion: Levels of circulating FGF-21 in overweight and obese African males are higher in T2DM and strongly correlate with measures of adiposity.

Direct effects of FGF21 on glucose uptake in human skeletal muscle: implications for type 2 diabetes and obesity.

BACKGROUND: Fibroblast growth factor (FGF) 21, a novel member of the FGF family, plays a role in a variety of endocrine functions, including regulation of glucose and lipid metabolism. The role of FGF21 in skeletal muscle is currently not known. METHODS: Serum levels and skeletal muscle mRNA of FGF21 were determined in normal glucose tolerant (n = 40) and type 2 diabetic (T2D; n = 40) subjects. We determined whether FGF21 has direct effects on glucose metabolism in cultured myotubes (n = 8) and extensor digitorum longus skeletal muscle. RESULTS: Serum FGF21 levels increased 20% in T2D versus normal glucose tolerant subjects (p < 0.05), whereas skeletal muscle mRNA expression was unaltered. Fasting insulin, homeostatic model assessment of insulin resistance (HOMA-IR), waist circumference, and body mass index (BMI) significantly correlated with serum FGF21 levels in T2D (p < 0.01), but not in normal glucose tolerant subjects. Serum FGF21 concentrations were greater in T2D patients in the highest tertile of fasting insulin (p < 0.05) and BMI (p < 0.05). Stepwise regression analysis identified BMI as the strongest independent variable correlating with FGF21. FGF21 exposure increased basal and insulin-stimulated glucose uptake in human myotubes, coincident with increased glucose transporter 1 mRNA, and enhanced glucose transporter 1 abundance at the plasma membrane. In isolated extensor digitorum longus muscle, FGF21 potentiated insulin-stimulated glucose transport, without altering phosphorylation of Akt or AMP-activated protein kinase. CONCLUSIONS: Plasma FGF21 is increased in T2D patients, and positively correlated with fasting insulin and BMI. However, FGF21 has direct effects in enhancing skeletal muscle glucose uptake, providing additional points of regulation that may contribute to the beneficial effects of FGF21 on glucose homeostasis. Whether increased plasma FGF21 in T2D is a compensatory mechanism to increase glucose metabolism remains to be determined.