Diabetes is currently a crisis in sub-Saharan West Africa (SSWA) with dramatic implications for public health and national budgets prioritizing infectious diseases. There is limited recent literature about the prevalence, awareness, and risk factors for type 2 diabetes (T2D) in rural parts of SSWA. This study characterized T2D prevalence and risk factors for the rural Malian community of Nièna, which is situated in Mali’s second-largest province of Sikasso. Between December 2020 and July 2021, a cross-sectional study of 412 participants was conducted in the Nièna community using clinical questionnaires and rapid diagnostic tests. Among 412 participants, there were 143 (34.7%) and 269 (65.3%) males and females, respectively. The overall prevalence of T2D in Nièna was 7.5% (31/412), and prevalence rates were 8.6% (23/269) and 5.6% (8/143) for females and males, respectively. Age, family history of diabetes, hypertension, waist circumference, and fetal macrosomia were significantly associated with T2D (p = 0.007, p < 0.001, p = 0.003, p = 0.013, and p < 0.001, respectively). Notably, 61.3% (19/31) of T2D subjects were unaware of their diabetic status before the study. Field surveys have considerable utility in driving T2D awareness in rural African settings.

Objective: To investigate the causal relationship between genetically predicted inhibition of specific kidney function drug targets and the risk of type 2 diabetes (T2D) in African populations using Mendelian randomization (MR). Methods: We used MR, a genetic proxy approach, and utilized genome-wide association study data from African participants. This assessed the causal relationship between genetically predicted inhibition of specific pathways and T2D risk. The analysis was conducted using TwoSampleMR package implemented in R. Results: We found that inhibiting the vascular endothelial growth factor A (VEGFA) and Ras homolog enriched in brain (RHEB) was significantly linked to T2D risk in Africans (OR 2.66, 95% CI 1.34–3.78, p = 0.0017 and OR 2.25, 95% CI 1.34–3.28, p = 0.0010, respectively). Conversely, there was no evidence that solute-like carrier family 22 member A2 or claudin-14 were associated with an increased risk of T2D (OR = 0.95, 95% CI 0.61–1.48; OR = 1.56, 95% CI 0.71–2.20, respectively). Conclusions: Insight from this study could potentially mean that some of the drugs that are used for treatment of kidney diseases involving VEGFA and RHEB may potentially increase the risk of developing T2D among Africans. This highlights how it is critical to consider drug–drug interaction in kidney diseases in Africa.

Evidence on COVID-19 outcomes in pregnancy from sub-Saharan Africa remains limited. This study describes maternal and fetal outcomes among pregnant women with confirmed SARS-CoV-2 infection in Bamako, Mali. We conducted a descriptive ambispective study (combining retrospective and prospective data) from January to November 2021 across four COVID-19 treatment centers. All eligible pregnant women with laboratory-confirmed infection were included and followed until delivery, with an average follow-up of approximately five months. Outcomes were summarized descriptively, as no uninfected comparison group was available to support causal inference. Among 36 women (mean age 30.3 ± 5.6 years), maternal mortality was 13.9% and fetal mortality 12.1%. Preterm birth occurred in 66.7% of deliveries, while intensive care was required for 36.1% of mothers and 27.3% of neonates. Coagulation abnormalities were observed in 58.8% of those tested. Exploratory analyses suggested that coagulation disorders and maternal age ≥35 years may be linked to adverse outcomes, although these findings should be interpreted cautiously given the small sample size. Overall, the study indicates a substantial burden of adverse maternal and neonatal outcomes in this setting. These findings emphasize the importance of strengthening COVID-19 prevention measures, including vaccination, and improving obstetric care in resource-limited contexts. Larger, controlled studies are needed to better define the impact of COVID-19 on pregnancy outcomes in sub-Saharan Africa.

Dyslipidemia is a disorder where abnormally lipid concentrations circulate in the bloodstream. The disorder is common in type 2 diabetics (T2D) and is linked with T2D comorbidities, particularly cardiovascular disease. Dyslipidemia in T2D is typically characterized by elevated plasma triglyceride and low high-density lipoprotein cholesterol (HDL-C) levels. There is a significant gap in the literature regarding dyslipidemia in rural parts of Africa, where lipid profiles may not be routinely captured through standard surveillance activities. This study aimed to characterize the prevalence and demographic profile of dyslipidemia in T2D patients in the rural community of Ganadougou, Mali. We performed a cross-sectional study of 104 subjects with T2D in Ganadougou between November 2021 and March 2022. Demographic and lipid profiles were collected through cross-sectional surveys and blood tests. The overall prevalence of dyslipidemia in T2D patients was 87.5% (91/104), which did not differ by sex (p = .368). High low-density lipoprotein cholesterol (LDL-C) was the most common lipid abnormality (78.9%, [82/104]). Dyslipidemia was associated with age and hypertension status (p = .013 and p = .036, respectively). High total and high LDL-C parameters were significantly associated with hypertension (p = .029 and p = .006, respectively). In low-resource settings such as rural Mali, there is a critical need to improve infrastructure for routine dyslipidemia screening to guide its prevention and intervention approaches. The high rates of dyslipidemia observed in Gandadougou, consistent with concomitant increases in cardiovascular diseases in Africa suggest that lipid profile assessments should be incorporated into routine medical care for T2D patients in African rural settings.

Chronic kidney disease and heart failure disproportionately burden populations of African ancestry, yet Mendelian randomisation (MR) studies of the causal relationship between kidney function and heart failure subtypes have been conducted exclusively in European ancestry populations. We performed a forward two-sample MR analysis to evaluate the causal effect of genetically predicted estimated glomerular filtration rate (eGFR) on heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) in individuals of African ancestry. Genetic instruments were selected from an African ancestry eGFR genome-wide association study (N = 67,943) at genome-wide significance, with linkage disequilibrium clumping using an African ancestry reference panel. Heart failure subtype summary statistics were obtained from the Million Veteran Program (HFpEF: 5,379 cases / 113,041 controls; HFrEF: 9,104 cases / 109,632 controls). Six independent SNPs (F-statistics 30.5–107.3; R² = 0.62%) were retained as instruments. The primary inverse-variance weighted analysis provided no evidence of a causal effect of eGFR on HFpEF (OR 0.92, 95% CI 0.80– 1.06, p = 0.248) or HFrEF (OR 0.98, 95% CI 0.78–1.23, p = 0.878). Sensitivity analyses were directionally consistent. There was no evidence of heterogeneity or directional pleiotropy. Minimum detectable effects at 80% power were OR 1.28 for HFpEF and OR 1.22 for HFrEF. These null findings should be interpreted as inconclusive given current power constraints; larger ancestry-matched studies are needed.

Cardiometabolic risk factors (CMRFs) are a growing global health concern. Here, we set out to identify novel genetic loci associated with CMRFs in two continental African populations, Ugandans and South African Zulu’s. Thus, we conducted a multivariate metaanalysis with META-SCOPA; where six CMRFs comprising of waist circumference (WC), triglycerides (TG), high-density lipoprotein (HDL), systolic blood pressure (SBP), diastolic blood pressure (DBP), and glycated hemoglobin A1c (HbA1c) were used. META-SCOPA identified five novel loci and its Multi-marker Analysis of GenoMic Annotation (MAGMA) gene-set analysis showed an association with human histone acetyltransferase/male sex-lethal (MSL) complex. Fine-mapping, colocalization, tissue expression analyses, and phenome-wide association study (PheWAS) were also implemented to better understand the meta-analysis findings. Furthermore, as a supplement a principal component analysis (PCA) GWAS was also performed on the same six CMRFs. The first principal component denoted cardiometabolic_PC1 was driven mostly by DBP and SBP. Five novel, significant loci were identified after the meta-analysis. Ultimately, our novel loci and gene-sets offer fresh insights into the clustering of CMRFs and propose a unique link to the human histone acetyltransferase/MSL complex, as well as circulatory system processes in continental Africans. Additional large-scale efforts in Africa are needed to understand the clustering of CMRFs.