Publications by authors named "Annette Uwineza"

Background: Cystic fibrosis (CF) is a genetic disorder that remains underrecognized across Africa, where limited diagnostic capacity, low awareness, and competing health priorities contribute to delayed or missed diagnoses [1-4]. Although increasing data suggests CF is more prevalent than previously believed in Africa, survival remains poor [1]. These challenges do not only affect people with CF (pwCF) in Africa but also have implications for global understanding of the disease, particularly among populations historically excluded from CF research and treatment advances.

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Background: Hormonal contraceptives, such as depot medroxyprogesterone acetate (DMPA), are known to increase the risk of cardiometabolic disease, especially in obese users who are already at high risk.

Objectives: This study aimed to evaluate changes in lipid profile, glycated hemoglobin (HbA1C), blood pressure (BP), and inflammatory markers over a 12-month follow-up in centrally obese women using DMPA in Rwanda.

Methods: A prospective study involving 65 abdominally obese women (aged 15-49 years) was conducted at two family planning centres in Kigali.

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  • The study explores the biological differences linked to PTSD by examining DNA methylation changes in blood, suggesting they could indicate susceptibility or effects of trauma.
  • Conducted by the Psychiatric Genomics Consortium, the research included nearly 5,100 participants to identify specific genetic markers associated with PTSD.
  • Results showed 11 significant CpG sites related to PTSD, with some also showing correlations between blood and brain tissue methylation, highlighting their potential role in understanding PTSD biology.
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Cancer genetic data from Sub-Saharan African (SSA) are limited. Patients with female breast (fBC), male breast (mBC), and prostate cancer (PC) in Rwanda underwent germline genetic testing and counseling. Demographic and disease-specific information was collected.

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  • Autism spectrum disorder (ASD) has significant social, communicative, and behavioral challenges, yet research on its genetic basis in Africa is limited.
  • A review of 40 genetic studies showed that the Egyptian and South African populations were the most researched, identifying 61 genes linked to ASD through various methods, with no studies utilizing genome-wide association techniques.
  • The study highlights the need for more research with larger sample sizes in Africa to better understand the genetic factors associated with ASD, as many risk genes identified elsewhere have yet to be confirmed on the continent.
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  • The study investigates the link between post-traumatic stress disorder (PTSD) and differences in DNA methylation, a type of gene regulation, in blood samples from individuals diagnosed with PTSD compared to trauma-exposed controls.
  • Researchers conducted a large-scale analysis involving over 5,000 participants from various civilian and military studies, using standardized procedures for PTSD assessment and DNA methylation testing.
  • The results revealed 11 specific DNA methylation sites associated with PTSD, and found similarities in methylation patterns between blood and brain tissues, suggesting a biological basis for the condition.
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  • Dysmorphologists face challenges due to the diverse phenotypic variability of human faces, particularly when using Next-Generation Phenotyping (NGP) tools, which are often trained on limited data.
  • To address this, the GestaltMatcher Database (GMDB) was created, compiling over 10,980 facial images from various global populations, significantly improving the representation of underrepresented ancestries, especially African and Asian patients.
  • The study found that incorporating data from non-European patients enhanced NGP accuracy by over 11% without compromising performance for European patients, highlighting the importance of diverse datasets in identifying genetic disorders.
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  • The review highlights the increasing incidence of Human Papillomavirus (HPV) related head and neck cancers, focusing on high-risk HPV types that can lead to these conditions.
  • It aims to assess existing research on the transmission of oral-genital HPV among partners of patients with HPV-related head and neck squamous cell carcinoma (HNSCC) and identify knowledge gaps in this area.
  • The study analyzed 15 papers retrieved from various databases, revealing a pattern of concurrent HPV-related cancers in couples and suggesting an increase in cancer risk for partners, particularly in relation to HPV 16 type infections.
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  • The significant phenotypic variability of human faces complicates the work of dysmorphologists by challenging Next-Generation Phenotyping (NGP) tools, especially when analyzing patients from diverse genetic backgrounds.
  • The research established the GestaltMatcher Database (GMDB), which includes over 10,000 facial images from patients with rare genetic disorders worldwide, striving to improve representation of underrepresented populations, particularly Asian and African patients.
  • The analysis showed that incorporating data from non-European patients enhanced the accuracy of NGP in diagnosing facial disorders without negatively affecting performance on European patients, emphasizing the need for more diverse datasets in medical genetics.
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Observational studies have shown an association between post-traumatic stress disorder (PTSD) and ischemic stroke (IS) but given the susceptibility to confounding it is unclear if these associations represent causal effects. Mendelian randomization (MR) facilitates causal inference that is robust to the influence of confounding. Using two sample MR, we investigated the causal effect of genetic liability to PTSD on IS risk.

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  • Cancer research in Rwanda accounts for less than 1% of Africa's total output, with limited studies on colorectal cancer (CRC), which predominantly affects younger females and often presents at an advanced stage.
  • Researchers conducted a study on CRC tissue mutations, focusing on specific genes, through Sanger sequencing of samples from 54 patients, revealing a high prevalence of low-grade tumors primarily in the rectum.
  • The study identified 27 genetic variants, including three novel deleterious mutations, and provided important genetic variations and clinical information regarding CRC in the Rwandan population.
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Epigenomic and neurocognitive studies have provided new perspectives on post-traumatic stress disorder and its intergenerational transmission. This article outlines the lessons learned from community engagement (CE) in such research on Rwandan genocide survivors. A strong trauma-related response was observed within the research project-targeted community (genocide survivors) during explanation of the project.

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Background: Since the outbreak of COVID-19 pandemic in Rwanda, a vast amount of SARS-COV-2/COVID-19-related data have been collected including COVID-19 testing and hospital routine care data. Unfortunately, those data are fragmented in silos with different data structures or formats and cannot be used to improve understanding of the disease, monitor its progress, and generate evidence to guide prevention measures. The objective of this project is to leverage the artificial intelligence (AI) and data science techniques in harmonizing datasets to support Rwandan government needs in monitoring and predicting the COVID-19 burden, including the hospital admissions and overall infection rates.

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Purpose: In most low- and lower middle-income countries (LMICs), minimally invasive tissue sampling (MITS) is a relatively new procedure for identifying the cause of death (CoD). This study aimed to explore perceptions and acceptance of bereaved families and health-care professionals regarding MITS in the context of MITS initiation in Rwanda as an alternative to clinical autopsy.

Methods: This was a qualitative phenomenological study with thematic analysis.

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We conducted a pilot epigenome-wide association study of women from Tutsi ethnicity exposed to the genocide while pregnant and their resulting offspring, and a comparison group of women who were pregnant at the time of the genocide but living outside of Rwanda. Fifty-nine leukocyte-derived DNA samples survived quality control: 33 mothers (20 exposed, 13 unexposed) and 26 offspring (16 exposed, 10 unexposed). Twenty-four significant differentially methylated regions (DMRs) were identified in mothers and 16 in children.

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Background: The use of information and communication technologies is transforming the lives of millions of people including children with autism spectrum disorder (ASD). However, the process of developing a user-friendly and effective mobile app needs to follow a complex standard protocol and culture-sensitive customization, and involves multiple sectors. This complex work becomes even more challenging when considering children with ASD in low- and middle-income countries as the users.

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Suppressing infections of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) will probably require the rapid identification and isolation of individuals infected with the virus on an ongoing basis. Reverse-transcription polymerase chain reaction (RT-PCR) tests are accurate but costly, which makes the regular testing of every individual expensive. These costs are a challenge for all countries around the world, but particularly for low-to-middle-income countries.

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Sickle cell disease (SCD) is one of the most common blood disorders impacting planetary health. Over 300,000 newborns are diagnosed with SCD each year globally, with an increasing trend. The sickle cell disease ontology (SCDO) is the most comprehensive multidisciplinary SCD knowledge portal.

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Rubinstein-Taybi syndrome (RSTS) is an autosomal dominant disorder, caused by loss-of-function variants in CREBBP or EP300. Affected individuals present with distinctive craniofacial features, broad thumbs and/or halluces, and intellectual disability. RSTS phenotype has been well characterized in individuals of European descent but not in other populations.

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Background: The 1994 genocide against Tutsi resulted in a massive death toll that reached one million people. Despite the tremendous efforts made to mitigate the adverse effects of the genocide, a substantial burden of mental health disorders still exists including the notably high prevalence of post-traumatic stress disorder (PTSD) among genocide survivors. However, a synthesized model of PTSD vulnerability in this population is currently lacking.

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Turner syndrome (TS) is a common multiple congenital anomaly syndrome resulting from complete or partial absence of the second X chromosome. In this study, we explore the phenotype of TS in diverse populations using clinical examination and facial analysis technology. Clinical data from 78 individuals and images from 108 individuals with TS from 19 different countries were analyzed.

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Whole exome sequencing undertaken in two siblings with delayed psychomotor development, absent speech, severe intellectual disability and postnatal microcephaly, with brain malformations consisting of cerebellar atrophy in the eldest affected and hypoplastic corpus callosum in the younger sister; revealed a homozygous intragenic deletion in VPS51, which encodes the vacuolar protein sorting-associated protein, one the four subunits of the Golgi-associated retrograde protein (GARP) and endosome-associated recycling protein (EARP) complexes that promotes the fusion of endosome-derived vesicles with the trans-Golgi network (GARP) and recycling endosomes (EARP). This observation supports a pathogenic effect of VPS51 variants, which has only been reported previously once, in a single child with microcephaly. It confirms the key role of membrane trafficking in normal brain development and homeostasis.

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