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Anthropometric and cardio-metabolic trait variation and genetic associations in sub-Saharan Africa.

The genetics of complex traits in Africa has been historically understudied, which can contribute to healthcare inequalities. Here, we present observations of 27 anthropometric, cardiovascular, and blood biomarker measurements across 2,124 individuals from sub-Saharan Africa for whom we also have dense genotype data. First, we identified trait values that differ significantly across populations and subsistence lifestyles (e.g., hemoglobin levels and height). We then identified traits with high degrees of sexual dimorphism (e.g., weight and grip strength). ADMIXTURE analyses revealed substantial population structure in our dataset, and many of the phenotypes studied here are correlated with genetic ancestry components, particularly skin color and body size traits. A variance partitioning approach further revealed traits in which much of the SNP heritability is due to polymorphisms that also contribute to differences between ancestry components. Following genomic imputation, we performed genome-wide association studies (GWASs) for all 27 traits and identified >100 independent autosomal SNPs with genome-wide significant associations for at least one trait (p < 5 &#xd7; 10-8). Many of these trait-associated variants are rare outside of Africa (minor-allele frequency [MAF] < 1%). We found that 100 kb windows surrounding the top GWAS hits from our African-ancestry cohort were enriched for trait associations in an identically sized European cohort and vice versa. We performed a more detailed analysis of height prediction from genetic data, finding that genome-wide admixture proportions predict height in Africans better than polygenic predictors based on large-scale European height GWASs.

Female

The Long Road to Long-Acting: What Oral PrEP and CAB-LA Teach Us About Scaling Lenacapavir.

Despite significant biomedical advances, human immunodeficiency virus (HIV) remains a persistent global health crisis, with over 40 million people affected as of 2023, two-thirds of whom live in the World Health Organization (WHO) African Region. However, from an HIV prevention perspective, the more urgent concern is the continued occurrence of approximately 1.3 million new infections annually, particularly in sub-Saharan Africa and in settings where incidence is stable or increasing. This commentary explores the evolving landscape of HIV prevention, focusing on the trajectory of oral pre-exposure prophylaxis (PrEP), long-acting injectable cabotegravir (CAB-LA), and the newly emerging lenacapavir. While oral PrEP opened new possibilities, adherence challenges have limited its impact. CAB-LA demonstrated superior efficacy but encountered access, cost, and delivery barriers that restricted uptake. Lenacapavir, offering 6-monthly subcutaneous dosing with &#x2265;&#xa0;99.9% efficacy in trials, holds the potential to overcome these hurdles. As of May 2026, lenacapavir had received regulatory approval in 17 countries, including several African nations, while regulatory reviews remained ongoing in multiple additional countries, reflecting the rapid global expansion of access to this long-acting HIV prevention option. However, its success depends on clinical promise, timely licensing, affordability, and integration into health systems. Drawing from real-world lessons of oral PrEP and CAB-LA, this paper argues that a proactive, coordinated rollout of lenacapavir could dramatically expand prevention reach. With global stakeholders aiming for 3 million users by 2028 and strategic licensing in 120 countries, the groundwork is in place. The recent release of WHO guidance recommending lenacapavir as an additional PrEP option further strengthens this momentum. Yet, equitable delivery, user-centred models, and strong policy backing will be critical. Ultimately, long-acting PrEP is not just a clinical breakthrough; it is a test of health systems' ability to deliver innovation at scale.

Humans

The Neanderthal-Derived 3p21 Haplotype at LZTFL1 in Modern-Day Moroccans Is Associated With COVID-19 Severity and Further Suggests the Presence of Neanderthals in North Africa.

There is considerable variability in the clinical presentation of COVID-19 among patients infected with SARS-CoV-2. Genome-wide association studies (GWASs) have identified the 12q24.13 and 3p21.31 regions, derived from Neanderthal DNA, as the human genetic loci most strongly associated with COVID-19 severity. We examined in this study the 3p locus in the Moroccan population by analysing allele and haplotype frequencies at the LZTFL1 gene and their associations with COVID-19 outcomes. Three SNPs at LZTFL1, tagging the Neanderthal-derived COVID-19 risk haplotype, were sequenced by Sanger's method in 102 ambulatory participants and 105 hospitalized patients and have been compared to 118 controls negative for SARS-CoV-2 infection using logistic regression analysis. Results showed that the prevalence of the lead variant rs11385942 in this locus was 8.9%, whereas the variants rs35044562 and rs13078854, which tag the Neanderthal haplotype, were present in only 6.3%. Our study showed that only the rs35044562-T and rs13078854-A alleles were associated with a 2.5-fold increased risk of severe COVID-19 (p&#xa0;=&#xa0;0.028). These two alleles, in LD with the rs11385942-AA one, form the haplotype inherited from the Neanderthal, the only haplotype associated with COVID-19 severity in the Moroccan population (p&#xa0;=&#xa0;0.030), whereas sub-Saharan African and the rare local haplotype also containing the rs11385942 variant do not influence the COVID-19 outcomes 19 (p&#xa0;>&#xa0;0.05). Furthermore, our study showed that the Neanderthal haplotype at 3p21 locus exists in the inhabitants of Morocco at a frequency close to that of Europeans and suggests a close connection between North Africa and Eurasia.

Adult