Scientists with the USF Genomics program and the Center for Global Health and Infectious Disease Research have taken a significant step in providing the people of Rwanda the scientific tools they need to help address mental health issues that stemmed from the 1994 genocide of the Tutsi ethnic group.

In a first-of-its-kind study, Professors Monica Uddin and Derek Wildman of the College of Public Health looked at the entire genomes of Tutsi women who were pregnant and living in Rwanda at the time of the genocide and their offspring and compared their DNA to other Tutsi women pregnant at the same time and their offspring, who were living in other parts of the world.

In the study published in Epigenomics, they found that the terror of genocide was associated with chemical modifications to the DNA of genocide-exposed women and their offspring. Many of these modifications occurred in genes previously implicated in risk for mental disorders such as PTSD and depression. These findings suggest that, unlike gene mutations, these chemical "epigenetic" modifications can have a rapid response to trauma across generations.

"Epigenetics refers to stable, but reversible, chemical modifications made to DNA that help to control a gene's function," Uddin said. "These can happen in a shorter time frame than is needed for changes to the underlying DNA sequence of genes. Our study found that prenatal genocide exposure was associated with an epigenetic pattern suggestive of reduced gene function in offspring."

The team, which includes Clarisse Musanabaganwa, a visiting scholar from the University of Rwanda and her colleagues, came to their conclusion following the review of DNA from blood samples from 59 individuals—about half exposed personally or exposed in utero to the genocide. Exposure is defined as being impacted by genocide-related trauma, such as rape or evading capture, witnessing murder or serious attack with a weapon and seeing dead and mutilated bodies.

The novel study is part of a larger consortium, the Human, Heredity & Health in Africa (H3), which is funded by the National Institutes of Health. It's an effort to empower scientists in Africa in genomics, increasing their independence and ability to build the infrastructure needed to enhance genetic studies across the continent, and ultimately better capture data on the human genome across the world.

"The Rwandan people who are in this study and community as a whole really want to know what happened to them because there's a lot of PTSD and other mental health disorders in Rwanda and people want answers as to why they're experiencing these feelings and having these issues," Wildman said.

While this study looks specifically at the impact of the 1994 Rwandan genocide, it supports previous studies that show what occurs during pregnancy when one is a fetus can have long-term impacts—many symptoms not appearing until later in life. Such evidence proves the need to enhance efforts to protect the safety and emotional and psychological wellbeing of pregnant women.

Researchers point out that individuals who were in utero during the genocide are starting to have children of their own and they hope to soon look at whether that trauma has had an epigenetic impact on the third generation. They're now awaiting a new, larger batch of DNA samples to find out how trauma can impact risk for specific mental health disorders, such as PTSD. - University of South Florida

The new ePOD app, a partnership between KEMSA and Coca-Cola Beverage Africa with support from UNFPA, taps into Coca-Cola’s expertise in supply chain management and distribution. Photo UNFPA/Luis Tato

ISIOLO, Kenya – As a frontline health-care worker at Isiolo County referral hospital, Denis Mutirithia has a critical role in saving lives – and a new digital tool to help him do so. The pharmaceutical technologist is tasked with predicting and preventing shortages and stockouts of essential medical supplies, including contraceptives.

If he receives stock from the Kenya Medical Supplies Authority (KEMSA) on time, the hospital's patients will have access to the medicines they need, when they need them. But delayed supplies can unleash a litany of crises, from illness to unintended pregnancies and higher risk of maternal and newborn deaths. 

As the COVID-19 pandemic ravaged health systems and shuttered health facilities, family planning and contraceptives have been among the most extensively disrupted services. The costs are being borne by the most vulnerable women and girls, with spikes in unintended pregnancies reported among adolescent girls in some parts of Kenya. 

“When a woman’s reproductive health is stuck, her life is also stuck,” said Editar Ochieng, founder of a women’s shelter and legal aid organization in Kibera, a sprawling slum in Nairobi. “Access to contraceptives is one of the most crucial empowerment tools that women in Kibera need to improve their lives, but often this is not available.”

Innovations empowering women

Now, a new mobile phone app is set to become a game changer for health-care workers like Mr. Mutirithia. The Electronic Proof of Deliveries, or e-POD app, keeps track of supplies to primary health facilities through the simple touch of a button and was developed to improve essential deliveries across Kenya.

“By checking the app on my phone, I am able to tell when a particular delivery of family planning commodities is expected to arrive. This helps us to advise clients accordingly, so that they get their method of choice at their next appointment,” he says.

The e-POD app received an award for best innovative health supply chain solution at the 2021 Global Health Supply Chain Summit in December 2021. So far, it has been rolled out in ten counties in the country and is expected to be available in all 47 counties by mid-2022.

The mobile app was developed as part of the Last Mile Kenya programme, implemented through a partnership between KEMSA and Coca-Cola Beverage Africa, with the support of UNFPA. It uses GPS to ensure that deliveries arrive where and when they are supposed to, and health facilities can easily report back on whether they received the correct specifications. The app also monitors order turnaround times to prevent delays that could lead to exhausted stocks of life-saving supplies.

Acting Chief Executive Officer of KEMSA, Edward Njoroge, said: “With this new system, we will be able to ensure deliveries to the correct health facilities, in the right quantities and at the right time.”

e-POD is one of two recent family planning tracking apps developed with support from UNFPA. The second is Qualipharm, created with local public health organization HealthStrat, to track consumption of family planning commodities at county, sub-county and facility level. These are, says Charity Koronya, of UNFPA, “a game changer, not only for health care staff but also for the citizens who rely on public health facilities to access life-saving commodities.”  

The COVID-19 pandemic has affected women’s access to family planning information and services around the world, with some 12 million women experiencing disruptions to family planning services since it started, particularly in low-income countries and marginalized communities.

UNFPA works with local and international partner organizations across Kenya to strengthen efforts to ensure universal access and rights to sexual and reproductive health care, reaching over 900,000 people with family planning services in 2020. - United Nations Population Fund

Uganda’s President Yoweri Museveni speaks during a Reuters interview at the National Leadership Institute (NALI) in Kyankwanzi district, Uganda December 4, 2021. Picture taken December 4, 2021. Photo REUTERS/Abubaker Lubowa

KAMPALA, Dec 31 (Reuters) - Uganda's President Yoweri Museveni on Friday announced plans to lift COVID-19 containment measures in January that had been in place since March 2020, including reopening schools, bars and nightclubs, citing rising vaccination rates.

The East African nation has imposed some of Africa's toughest restrictions. In September, some measures were eased, including allowing the resumption of education for universities and other post-secondary institutions.

In a televised speech late on Friday, Museveni said pre-primary, primary and secondary schools would be reopened on Jan. 10.

Bars and nightclubs will be reopened, and a nighttime curfew lifted, two weeks after schools have resumed, he added. Movie theatres and sporting events would also be allowed to reopen, he said, without giving further details.

As of Friday, Uganda had registered about 137,000 confirmed cases and nearly 3,300 deaths.

The president urged Ugandans to get vaccinated as the "first solution" to COVID-19. - Reuters