Leukocyte ratios in non-diabetic hypertensive Cameroonians do not predict cardiovascular risk : preliminary results of the HYRICCA project.

BACKGROUND: Full blood count is routinely performed in the evaluation of hypertensive patients. However, usefulness of leukocyte ratios in cardiovascular risk (CVR) assessment hasn't yet been proven in Cameroonians. OBJECTIVE: Evaluate the contribution of leukocyte ratios in CVR assessment of non-diabetic hypertensive adults. METHODOLOGY: We carried out a cross sectional study including non-diabetic hypertensive patients followed up at the cardiology unit of the Yaoundé Central Hospital from November to June 2022. We collected relevant clinical data with a pre-established questionnaire and blood samples from each patient for different biological analyses. The spearman correlation test was used to assess on the one hand the relationship between leukocyte ratios, highly sensitive CRP and the WHO 2019 risk score as our primary end point, and on the other hand between leukocyte indices and the other risk estimators as our secondary outcome. The significant threshold level was set as 0.05. RESULTS: We included 165 participants (102 females) with a mean age of 57.6 (10.4) years. The median duration of hypertension since diagnosis was 7 years and only 27% of participants on treatment had a controlled blood pressure. There was no significant correlation between leukocyte ratios and the WHO 2019 risk score. Highly sensitive CRP and the atherogenic index of plasma were significantly correlated respectively with the granulocyte to lymphocyte ratio (rho = 0.18, p = 0.03) and the eosinophil to lymphocyte ratio (rho = 0.28, p = 0.01). There exists a weak positive association between the granulocyte to lymphocyte ratio and the Reynolds risk score. CONCLUSION: Leukocyte ratios are not useful for CVR assessment in hypertensive Cameroonians with respect to the WHO 2019 risk score. Prospective studies are needed to assess their usefulness in combination with conventional risk factors to improve prediction of cardiovascular events.

Bridging the language gap - A call for the wider use of Human phenotype ontology by non-geneticist clinicians when requesting genomic tests.

Advances in genomic technology including the development of next-generation sequencing (NGS) have enabled the identification of thousands of variations at a time, allowing the discovery of novel genetic diseases. Given the volume of data generated by these investigations, attention is drawn towards reporting relevant clinical features by clinicians to guide the diagnosis and management of their patients. The Human Phenotype Ontology (HPO) developed in 2008, revolutionized the semantic vocabulary of phenotypic descriptions in genomic medicine allowing researchers, laboratories and clinical geneticists to better understand each other. In this era of personalized medicine where genetic tests are becoming more accessible, non-geneticist clinicians are expected to be more involved than ever in the process of ordering genetic tests and interpreting genetic reports. It is therefore essential that they understand and adequately apply HPO nomenclature to integrate the patient care chain and seize the opportunity offered by this tailored language. The current article highlights the importance of using HPO vocabularies in clinical practice and advocates for its wider use by non-geneticist clinicians. Correct use of HPO will reduce misunderstandings between healthcare professionals and ultimately improve the healthcare system.

Fostering research integrity in sub-Saharan Africa: challenges, opportunities, and recommendations.

Integrity and adherence to appropriate ethical standards are important elements of research. These standards are key to protecting research participants´ rights as well as ensuring the reliability and quality of research outputs. Although empirical evidence is scanty, several authors have alluded to the fact that violation of research integrity standards could be common in low- and middle-income countries including sub-Saharan Africa (SSA). Understanding the issues, challenges, and opportunities of research integrity and ethics in SSA is key to promoting the responsible conduct of research and the protection of research participants. This paper presents the authors´ critical views and recommendations on the current state of research integrity in SSA. We argue that understanding the current research integrity architecture in SSA has the potential to identify opportunities to promote responsible conduct of research in SSA. Such opportunities include, but are not limited to transparency, accountability, and reproducibility of research, which collectively lead to enhanced public trust in the research enterprise. We highlight the need to embrace equity, fairness, diversity, and inclusivity in the research cycle from conception (priority setting), funding, implementation, dissemination of findings, and scale up. We move on to provide a rationale for understanding the differences and similarities between research ethics and research integrity. Governments, research, and academic institutions must develop multifaceted approaches to promote compliance with principles of research integrity by developing and implementing clear research integrity policies and guidelines that foster responsible conduct of research and prioritize capacity building and empowerment of early career researchers, students, and other targeted key stakeholders.