Dataset Information

Distinct rates and patterns of spread of the major HIV-1 subtypes in Central and East Africa.

ABSTRACT: Since the ignition of the HIV-1 group M pandemic in the beginning of the 20th century, group M lineages have spread heterogeneously throughout the world. Subtype C spread rapidly through sub-Saharan Africa and is currently the dominant HIV lineage worldwide. Yet the epidemiological and evolutionary circumstances that contributed to its epidemiological expansion remain poorly understood. Here, we analyse 346 novel pol sequences from the DRC to compare the evolutionary dynamics of the main HIV-1 lineages, subtypes A1, C and D. Our results place the origins of subtype C in the 1950s in Mbuji-Mayi, the mining city of southern DRC, while subtypes A1 and D emerged in the capital city of Kinshasa, and subtypes H and J in the less accessible port city of Matadi. Following a 15-year period of local transmission in southern DRC, we find that subtype C spread at least three-fold faster than other subtypes circulating in Central and East Africa. In conclusion, our results shed light on the origins of HIV-1 main lineages and suggest that socio-historical rather than evolutionary factors may have determined the epidemiological fate of subtype C in sub-Saharan Africa.

SUBMITTER: Faria NR

PROVIDER: S-EPMC6897401 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Distinct rates and patterns of spread of the major HIV-1 subtypes in Central and East Africa.

Faria Nuno R NR Vidal Nicole N Lourenco José J Raghwani Jayna J Sigaloff Kim C E KCE Tatem Andy J AJ van de Vijver David A M DAM Pineda-Peña Andrea-Clemencia AC Rose Rebecca R Wallis Carole L CL Ahuka-Mundeke Steve S Muyembe-Tamfum Jean-Jacques JJ Muwonga Jérémie J Suchard Marc A MA Rinke de Wit Tobias F TF Hamers Raph L RL Ndembi Nicaise N Baele Guy G Peeters Martine M Pybus Oliver G OG Lemey Philippe P Dellicour Simon S

PLoS pathogens 20191206 12

Since the ignition of the HIV-1 group M pandemic in the beginning of the 20th century, group M lineages have spread heterogeneously throughout the world. Subtype C spread rapidly through sub-Saharan Africa and is currently the dominant HIV lineage worldwide. Yet the epidemiological and evolutionary circumstances that contributed to its epidemiological expansion remain poorly understood. Here, we analyse 346 novel pol sequences from the DRC to compare the evolutionary dynamics of the main HIV-1 l ...[more]

PMID: 31809523

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Project description:BackgroundAntimicrobial resistance is currently a recognized global health problem stemming from poor antibiotic stewardship by health workers and inappropriate antimicrobial use by patients. Data showing the extent of poor antimicrobial stewardship in low- and middle-income countries are scanty though high incidences of antimicrobial resistance are increasingly reported in many settings across the globe. The objective of the present study was, therefore, to evaluate prescriptions for antimicrobials in East Africa.MethodsA comprehensive literature search strategy that includes text words and medical subject headings was developed and applied to predefined electronic databases. Two authors independently screened the titles and abstracts of the outputs of the literature search. Full texts were then independently reviewed by the first and the second authors. Eligible studies were formally assessed for quality and risk of bias using a scoring tool. Extracted data from included studies were combined in a meta-analysis where appropriate and presented using forest plots and tables or in a narrative text. Where data were available, subgroup analyses were performed.ResultsA total of 4284 articles were retrieved, but only 26 articles were included in the review. The majority of the included studies (30.8%) were retrieved from Ethiopia, followed by Sudan, Kenya, and Tanzania each contributing 19.2% of the included studies. The overall proportion of encounters with antimicrobials reported by the included studies was 57% CI [42-73%]. Ethiopia had an overall patient encounter with antimicrobials of 63% [50-76%] followed by Sudan with an overall encounter with antimicrobials of 62% CI [34-85%]. Included studies from Kenya reported an overall encounter with antimicrobials of 54% CI [15-90%], whereas included studies from Tanzania reported an overall patient encounter with antimicrobials of 40% CI [21-60%].ConclusionPrescription patterns demonstrated in this review significantly deviate from WHO recommendations suggesting inappropriate antimicrobial use in the East African countries. Further studies have to be pursued to generate more information on antimicrobial use in this region.

Dataset Information

Distinct rates and patterns of spread of the major HIV-1 subtypes in Central and East Africa.

Publications

Distinct rates and patterns of spread of the major HIV-1 subtypes in Central and East Africa.

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