Could Africa be the future for genomics research?

Neurodevelopmental disorders at Chris Hani Baragwanath Academic Hospital: a 4-year retrospective database review

BACKGROUND

Developmental paediatrics is a growing field both globally and locally with increasing demand for medical and educational resources.

METHODS

This retrospective, developmental database review is a baseline description of the Chris Hani Baragwanath Academic Hospital neurodevelopmental clinic population, and the service offered over the past 4 years. The population comprises all patients seen at the clinic from May 2020 to December 2024. Outcomes measured were total patient numbers, demographic, clinical and management variables.

RESULTS

The cohort comprised 1877 patients. An increase in total patient numbers was observed over the past 4 years. The ratio of male to female patients was 3:1. Median age at referral was 48.8 months with an average waiting period of 12 months. The median, mean and age range at first visit were 60, 66 and 5-192 months, respectively. Autism was diagnosed in 37.1%, non-syndromic intellectual disability in 16.6%, a confirmed genetic diagnosis in 11.8% and a 'likely genetic disorder' in 18% of patients. 98 different genetic conditions were identified. Comorbidity included cerebral palsy (11.4%), epilepsy (16.1%), hearing (5.2%) and visual impairment (5.5%). Associated behavioural disorders occurred in 52.8% of patients, predominantly attention deficit hyperactivity disorder (ADHD) (30%). At least one medication was prescribed in 58.2% of children. Over 40% of children were either at home or at crèche; 14.0% were attending mainstream school; 10.5% an autism school; 26.3% a special needs school. Of the 841 (44.8%) children in supported schooling, 47.8% were placed after 7 years of age.

CONCLUSIONS

This study provides insights into the regional burden and clinical presentation of neurodevelopmental disorders. Trends in this region reflect broader global patterns, with increasing numbers of children presenting with complex conditions. Greater resources are needed for earlier diagnosis and therapy, access to all tiers of genetic testing and upscaling of inclusive and special needs education.

TRIAL REGISTRATION NUMBER

NHRD GP_202510_105.

Neurodevelopmental disorders at Chris Hani Baragwanath Academic Hospital: a 4-year retrospective database review

Background

Developmental paediatrics is a growing field both globally and locally with increasing demand for medical and educational resources.

Methods

This retrospective, developmental database review is a baseline description of the Chris Hani Baragwanath Academic Hospital neurodevelopmental clinic population, and the service offered over the past 4 years. The population comprises all patients seen at the clinic from May 2020 to December 2024. Outcomes measured were total patient numbers, demographic, clinical and management variables.

Results

The cohort comprised 1877 patients. An increase in total patient numbers was observed over the past 4 years. The ratio of male to female patients was 3:1. Median age at referral was 48.8 months with an average waiting period of 12 months. The median, mean and age range at first visit were 60, 66 and 5–192 months, respectively. Autism was diagnosed in 37.1%, non-syndromic intellectual disability in 16.6%, a confirmed genetic diagnosis in 11.8% and a ‘likely genetic disorder’ in 18% of patients. 98 different genetic conditions were identified. Comorbidity included cerebral palsy (11.4%), epilepsy (16.1%), hearing (5.2%) and visual impairment (5.5%). Associated behavioural disorders occurred in 52.8% of patients, predominantly attention deficit hyperactivity disorder (ADHD) (30%). At least one medication was prescribed in 58.2% of children. Over 40% of children were either at home or at crèche; 14.0% were attending mainstream school; 10.5% an autism school; 26.3% a special needs school. Of the 841 (44.8%) children in supported schooling, 47.8% were placed after 7 years of age.

Conclusions

This study provides insights into the regional burden and clinical presentation of neurodevelopmental disorders. Trends in this region reflect broader global patterns, with increasing numbers of children presenting with complex conditions. Greater resources are needed for earlier diagnosis and therapy, access to all tiers of genetic testing and upscaling of inclusive and special needs education.

Trial registration number

NHRD GP_202510_105.

The Value Proposition of Coordinated Population Cohorts Across Africa

Building longitudinal population cohorts in Africa for coordinated research and surveillance can influence the setting of national health priorities, lead to the introduction of appropriate interventions, and provide evidence for targeted treatment, leading to better health across the continent. However, compared to cohorts from the global north, longitudinal continental African population cohorts remain scarce, are relatively small in size, and lack data complexity. As infections and noncommunicable diseases disproportionately affect Africa's approximately 1.4 billion inhabitants, African cohorts present a unique opportunity for research and surveillance. High genetic diversity in African populations and multiomic research studies, together with detailed phenotyping and clinical profiling, will be a treasure trove for discovery. The outcomes, including novel drug targets, biological pathways for disease, and gene-environment interactions, will boost precision medicine approaches, not only in Africa but across the globe.

The Potential of Aqueous Humor Sampling in Diagnosis, Prognosis, and Treatment of Retinoblastoma

Retinoblastoma (RB) is a rare malignant tumor that arises in the developing retina in one or both eyes of children. Pathogenic variants of the RB1 tumor suppressor gene drive the majority of germline and sporadic RB tumors. Considering the risk of tumor spread, the biopsy of RB tumor tissue is contraindicated. Advancement of chemotherapy has led to preservation of more eye globes. However, this has reduced access to tumor material from enucleation specimens. Recently, liquid biopsy of aqueous humor (AH) has advanced the RB tumor- or eye-specific genetic analysis. In particular, nucleic acid analysis of AH demonstrates the genomic copy number profiles and RB1 pathogenic variants akin to that of enucleated RB eye tissue. This advance reduces the previous limitation that genetic assessment of the primary tumor could be done only after enucleation of the eye. Additionally, nucleic acid evaluation of AH allows the exploration of the genomic landscape of RB tumors at diagnosis and during and after treatment. This review explores how AH sampling and AH nucleic acid analysis in RB patients assist in diagnosis, prognosis, and comprehending the pathophysiology of RB, which will ultimately benefit individualized treatment decisions to carefully manage this ocular cancer in children.

The African Society of Human Genetics successfully launches global data science workshops

To accelerate the impact of African genomics on human health, data science skills and awareness of Africa's rich genetic diversity must be strengthened globally. We describe the first African genomics data science workshop, implemented by the African Society of Human Genetics (AfSHG) and international partners, providing a framework for future workshops.