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Workneh BS, Mekonen EG, Zegeye AF, Gonete AT, Alemu TG, Tamir TT, Tekeba B, Wassie M, Kassie AT, Ali MS. Rotavirus vaccine dose-two dropout and its associated factors among children who received rotavirus vaccine dose-one in Sub-Saharan African countries: A multilevel analysis of the recent demographic and health survey. Hum Vaccin Immunother 2024; 20:2335730. [PMID: 38575525 PMCID: PMC10996828 DOI: 10.1080/21645515.2024.2335730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/25/2024] [Indexed: 04/06/2024] Open
Abstract
Rotavirus is the most common cause of diarrhea in children worldwide. In 2016, rotavirus infection resulted in 258 173 300 episodes of diarrhea and 128 500 child deaths in the globe. The study aimed to assess the magnitude of Rotavirus vaccine dose-two dropout and associated factors among children who received rotavirus vaccine dose-one in sub-Saharan African countries. The appended and most recent demographic and health survey (DHS) dataset of 17 sub-Saharan African countries was used for data analysis. A total of 73,396 weighted samples were used. Factors associated with the outcome variable were considered significant if their p-values were ≤ .05 in the multilevel mixed-effect logistic regression model. The overall Rotavirus vaccine dose-two dropouts was 10.77% (95% CI 10.55%, 11.00%), which ranged from 2.77% in Rwanda to 37.67% in Uganda. Being younger, late birth order, having difficulty accessing health facilities, having no media exposure, having no work, having home delivery, having no antenatal follow-up, and having no postnatal checkup were factors significantly associated with the outcome variable. The overall Rotavirus vaccine dose-two dropout was higher in sub-Saharan African countries which implies that vaccine dropout is still a great issue in the region. Special attention should be given to those mothers who are young, who have no work, who give birth at home, who experienced difficulty in accessing health facilities, and late birth orders. Furthermore, targeted interventions should be considered for improving access and utilization of media, antenatal care, and postnatal care services.
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Affiliation(s)
- Belayneh Shetie Workneh
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Enyew Getaneh Mekonen
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alebachew Ferede Zegeye
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Almaz Tefera Gonete
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tewodros Getaneh Alemu
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Tarik Tamir
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Berhan Tekeba
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulugeta Wassie
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemneh Tadesse Kassie
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mohammed Seid Ali
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Thondoo M, Mogo ERI, Tatah L, Muti M, van Daalen KR, Muzenda T, Boscott R, Uwais O, Farmer G, Yue A, Dalzell S, Mukoma G, Bhagtani D, Matina S, Dambisya PM, Okop K, Ebikeme C, Micklesfield L, Oni T. Multisectoral interventions for urban health in Africa: a mixed-methods systematic review. Glob Health Action 2024; 17:2325726. [PMID: 38577879 PMCID: PMC11000616 DOI: 10.1080/16549716.2024.2325726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 02/25/2024] [Indexed: 04/06/2024] Open
Abstract
Increasing evidence suggests that urban health objectives are best achieved through a multisectoral approach. This approach requires multiple sectors to consider health and well-being as a central aspect of their policy development and implementation, recognising that numerous determinants of health lie outside (or beyond the confines of) the health sector. However, collaboration across sectors remains scarce and multisectoral interventions to support health are lacking in Africa. To address this gap in research, we conducted a mixed-method systematic review of multisectoral interventions aimed at enhancing health, with a particular focus on non-communicable diseases in urban African settings. Africa is the world's fastest urbanising region, making it a critical context in which to examine the impact of multisectoral approaches to improve health. This systematic review provides a valuable overview of current knowledge on multisectoral urban health interventions and enables the identification of existing knowledge gaps, and consequently, avenues for future research. We searched four academic databases (PubMed, Scopus, Web of Science, Global Health) for evidence dated 1989-2019 and identified grey literature from expert input. We identified 53 articles (17 quantitative, 20 qualitative, 12 mixed methods) involving collaborations across 22 sectors and 16 African countries. The principle guiding the majority of the multisectoral interventions was community health equity (39.6%), followed by healthy cities and healthy urban governance principles (32.1%). Targeted health outcomes were diverse, spanning behaviour, environmental and active participation from communities. With only 2% of all studies focusing on health equity as an outcome and with 47% of studies published by first authors located outside Africa, this review underlines the need for future research to prioritise equity both in terms of research outcomes and processes. A synthesised framework of seven interconnected components showcases an ecosystem on multisectoral interventions for urban health that can be examined in the future research in African urban settings that can benefit the health of people and the planet.Paper ContextMain findings: Multisectoral interventions were identified in 27.8% of African countries in the African Union, targeted at major cities with five sectors present at all intervention stages: academia or research, agriculture, government, health, and non-governmental.Added knowledge: We propose a synthesised framework showcasing an ecosystem on multisectoral interventions for urban health that can guide future research in African urban settings.Global health impact for policy and action: This study reveals a crucial gap in evidence on evaluating the long-term impact of multisectoral interventions and calls for partnerships involving various sectors and robust community engagement to effectively deliver and sustain health-promoting policies and actions.
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Affiliation(s)
- Meelan Thondoo
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Barcelona Institute for Global Health (ISGlobal), Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - Ebele R. I. Mogo
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Barcelona Institute for Global Health (ISGlobal), Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - Lambed Tatah
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Monica Muti
- SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Kim R. van Daalen
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Victor Phillip Dahdaleh Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
- Barcelona Supercomputing Center (BSC), Department of Earth Sciences, Barcelona, Spain
| | - Trish Muzenda
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Rachel Boscott
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Omar Uwais
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - George Farmer
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Adelaide Yue
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Sarah Dalzell
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Gudani Mukoma
- SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- Department of Biokinetics, Recreation and Sport Science, Faculty of Health Sciences, University of Venda, Thohoyandou, South Africa
| | - Divya Bhagtani
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Sostina Matina
- SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Philip M. Dambisya
- Health Policy and Systems Division, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- Centre for Innovation in Learning and Teaching, University of Cape Town, Cape Town, South Africa
| | - Kufre Okop
- Chronic Disease Initiative for Africa (CDIA), Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Charles Ebikeme
- LSE Health, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Lisa Micklesfield
- SA MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Tolu Oni
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, UK
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Adamu AA, Jalo RI, Muhammad ID, Essoh TA, Ndwandwe D, Wiysonge CS. Sustainable financing for vaccination towards advancing universal health coverage in the WHO African region: The strategic role of national health insurance. Hum Vaccin Immunother 2024; 20:2320505. [PMID: 38414114 PMCID: PMC10903629 DOI: 10.1080/21645515.2024.2320505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 02/15/2024] [Indexed: 02/29/2024] Open
Abstract
There is a growing political interest in health reforms in Africa, and many countries are choosing national health insurance as their main financing mechanism for universal health coverage. Although vaccination is an essential health service that can influence progress toward universal health coverage, it is not often prioritized by these national health insurance systems. This paper highlights the potential gains of integrating vaccination into the package of health services that is provided through national health insurance and recommends practical policy actions that can enable countries to harness these benefits at population level.
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Affiliation(s)
- Abdu A. Adamu
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Rabiu I. Jalo
- Department of Community Medicine, Bayero University/Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Ibrahim D. Muhammad
- Department of Obstetrics and Gynecology, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Téné-Alima Essoh
- Agence de Médecine Préventive, Regional Office for Africa, Abidjan, Cote d’Ivoire
| | - Duduzile Ndwandwe
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Charles S. Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Vaccine-Preventable Diseases Programme, World Health Organization Regional Office for Africa, Brazzaville, Congo
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Chelly S, Jaziri S, Ammar A, Ezzi O, Douss N, Saffar S, Tritar M, Njah M, Mahjoub M. Safety and efficiency of COVID-19 vaccine in North Africa. Hum Vaccin Immunother 2024; 20:2306703. [PMID: 38304972 PMCID: PMC10841012 DOI: 10.1080/21645515.2024.2306703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/15/2024] [Indexed: 02/03/2024] Open
Abstract
Background In the absence of a specific treatment for COVID-19, preventive measures have been implemented to control this pandemic and vaccination is one of them. However, it is crucial to verify the safety and efficiency of every vaccine. The aim was to determinate the predictive factors of side effects and reinfection after COVID-19 vaccine. Methods A cross-sectional study was conducted in February 2022 among Tunisians infected with COVID-19 between March 2020 and February 2022, using an online self-administered questionnaire. We conducted univariate and multivariate analyses using binary stepwise logistic regression. Results A total of 1541 was selected from 1911 individuals. Comorbidities affected a quarter of the population (22.3%). Before the initial infection, 39.3% had received full vaccination, and 8.7% had received partial vaccination. By February 2022, the majority (82.9%) had received at least two vaccine doses. The reinfection rate was 30.6%. All vaccines prior to the first infection was identified as a protective factor against reinfection. Inactivated virus vaccinations were less likely to induce adverse effects. Conclusion ach vaccine has its own set of advantages and disadvantages: mRNA-based vaccines had a higher incidence of side effects but all vaccines provided better protection against reinfection.
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Affiliation(s)
- Souhir Chelly
- Faculty of Medicine of Sousse, Infection Prevention and Control Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
| | - Shayma Jaziri
- Faculty of Medicine of Sousse, Infection Prevention and Control Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
| | - Asma Ammar
- Faculty of Medicine of Sousse, Infection Prevention and Control Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
| | - Olfa Ezzi
- Faculty of Medicine of Sousse, Infection Prevention and Control Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
| | - Nour Douss
- Faculty of Medicine of Sousse, Infection Prevention and Control Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
| | - Sonia Saffar
- Faculty of Medicine of Sousse, Infection Prevention and Control Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
| | - Marouen Tritar
- Faculty of Medicine of Sousse, Infection Prevention and Control Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
| | - Mansour Njah
- Faculty of Medicine of Sousse, Infection Prevention and Control Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
| | - Mohamed Mahjoub
- Faculty of Medicine of Sousse, Infection Prevention and Control Department, Farhat Hached University Hospital, University of Sousse, Sousse, Tunisia
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Abdelnabi SJ, Munro-Kramer ML, Moyer CA, Williams JE, Lori JR. Ghanaian women's experience of intimate partner violence (IPV) during group antenatal care: a brief report from a cluster randomised controlled trial. Glob Health Action 2024; 17:2325250. [PMID: 38577830 PMCID: PMC11000608 DOI: 10.1080/16549716.2024.2325250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/27/2024] [Indexed: 04/06/2024] Open
Abstract
Intimate partner violence (IPV) impacts women of reproductive age globally and can lead to significant negative consequences during pregnancy. This study describes an exploratory aim of a cluster randomised controlled trial designed to assess the outcomes of Group Antenatal Care (ANC) in Ghana. The purpose was to understand the effect of a healthy relationship Group ANC module on experiences of IPV and safety planning as well as to explore the relationship between self-efficacy on the experiences of IPV and safety planning. Data were collected at baseline and at 11-14 months postpartum (post). Survey measures captured reported experiences of violence, self-efficacy, and safety. The chi-square test was used to compare baseline and post scores, and a logistic regression was performed to ascertain the effects of self-efficacy on the experiences of IPV in both groups. The sample included 1,751 participants, of whom 27.9% reported IPV at baseline. Between baseline and postpartum, there was a small increase in reported emotional (6.2% vs. 4.6%) and sexual (5.4% vs. 3.2%) violence in the intervention group compared to the control group. Logistic regression demonstrated that an increasing self-efficacy score was associated with an increased likelihood of experiencing IPV. There were no changes in safety knowledge. This study found higher rates of reported sexual and emotional violence post-intervention among the intervention group. Group ANC may be just one part of a portfolio of interventions needed to address IPV at all socio-ecological levels.Paper ContextMain findings: There was no reduction in experiences of intimate partner violence or increases in safety planning among Ghanaian pregnant women participating in a Group Antenatal Care session focused on healthy relationships and safety planning.Added knowledge: Group Antenatal Care has been identified as an effective modality for providing antenatal care and facilitating conversations about sensitive topics such as intimate partner violence and safety. However, this study highlights the importance of developing multifaceted approaches to decrease the risk of intimate partner violence among women, especially during the critical times of pregnancy and postpartum.Global health impact for policy and action: Effective global health action and policy must extend beyond educational efforts, incorporating multifaceted strategies that include healthcare provider training, robust community engagement, and legislation aimed at preventing intimate partner violence, with a special focus on safeguarding the well-being of women during pregnancy and the postpartum period.
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Affiliation(s)
| | | | - Cheryl A. Moyer
- Learning Health Sciences, University of Michigan, Ann Arbor, MI, USA
| | | | - Jody R. Lori
- School of Nursing, University of Michigan, Ann Arbor, MI, USA
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Rangel J, Liberal Â, Catarino S, Costa JC, Romeiras MM, Fernandes Â. Phytochemical and bioactive potentials of African Annonaceae species. Food Chem 2024; 448:139048. [PMID: 38581965 DOI: 10.1016/j.foodchem.2024.139048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 03/07/2024] [Accepted: 03/14/2024] [Indexed: 04/08/2024]
Abstract
This review aims to gather available information on the medicinal, nutritional, and bioactive profiles of Annonaceae species in the African continent, sponsoring their use worldwide and mainly in African communities, where access to food and medicines for basic health care is scarce. >60 medicinal taxa were compiled, belonging to 22 genera, namely Annickia, Annona, Anonidium, Artabotrys, Cleistochlamys, Cleistopholis, Dennettia, Duguetia, Greenwayodendron, Hexalobus, Isolona, Lettowianthus, Monanthotaxis, Monodora, Neostenanthera, Polyceratocarpus, Sphaerocoryne, Uvaria, Uvariastrum, Uvariodendron, Uvariopsis and Xylopia; the most diverse and economically important genera were the genera Annona, Uvaria and Xylopia with 7 species each. Annonaceae species hold a valuable nutritional profile, rich in proteins, fibers, and minerals, being also good sources of a wide range of bioactive compounds of high biological relevance. These compounds are especially important in developing countries, where most of these species are available for direct use as food and/or medicines by the most deprived populations.
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Affiliation(s)
- Josefa Rangel
- Linking Landscape, Environment, Agriculture and Food Research Center (LEAF), Associated Laboratory TERRA, Instituto Superior de Agronomia (ISA), Universidade de Lisboa, Tapada da Ajuda, 1340-017 Lisboa, Portugal; Centro de Botânica, Universidade Agostinho Neto, Avenida Ho Chi Minh, Prédio do CNIC, 1° andar, ala esquerda, Luanda, Angola; Centro de Investigação de Montanhas, Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-5253 Bragança, Portugal; Laboratório Associado para a Sustentabilidade e Tecnologia em Regiões de Montanha (SusTEC), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
| | - Ângela Liberal
- Centro de Investigação de Montanhas, Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-5253 Bragança, Portugal; Laboratório Associado para a Sustentabilidade e Tecnologia em Regiões de Montanha (SusTEC), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
| | - Sílvia Catarino
- Centre for Ecology, Evolution and Environmental Changes (cE3c) & CHANGE - Global Change and Sustainability Institute, Faculdade de Ciências, Universidade de Lisboa, Campo Grande, 1749-016 Lisboa, Portugal
| | - José Carlos Costa
- Linking Landscape, Environment, Agriculture and Food Research Center (LEAF), Associated Laboratory TERRA, Instituto Superior de Agronomia (ISA), Universidade de Lisboa, Tapada da Ajuda, 1340-017 Lisboa, Portugal
| | - Maria M Romeiras
- Linking Landscape, Environment, Agriculture and Food Research Center (LEAF), Associated Laboratory TERRA, Instituto Superior de Agronomia (ISA), Universidade de Lisboa, Tapada da Ajuda, 1340-017 Lisboa, Portugal; Centre for Ecology, Evolution and Environmental Changes (cE3c) & CHANGE - Global Change and Sustainability Institute, Faculdade de Ciências, Universidade de Lisboa, Campo Grande, 1749-016 Lisboa, Portugal.
| | - Ângela Fernandes
- Centro de Investigação de Montanhas, Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-5253 Bragança, Portugal; Laboratório Associado para a Sustentabilidade e Tecnologia em Regiões de Montanha (SusTEC), Instituto Politécnico de Bragança, Campus de Santa Apolónia, 5300-253 Bragança, Portugal.
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Dumendiak S, Halajian A, Mekonnen Y, Aschenborn O, Camacho G, Schuster R, Mackenstedt U, Romig T, Wassermann M. Hidden diversity of cestodes in wild African carnivores: I. Non-taeniid cyclophyllideans. Int J Parasitol Parasites Wildl 2024; 24:100929. [PMID: 38601058 PMCID: PMC11002657 DOI: 10.1016/j.ijppaw.2024.100929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/24/2024] [Accepted: 03/24/2024] [Indexed: 04/12/2024]
Abstract
Our knowledge of parasites in wildlife remains limited, primarily due to restricted access to samples, especially of parasites from protected species. This present study contributes to the comprehension of the enigmatic world of helminths of African wild mammals and cestode biodiversity by combining both molecular and morphological analysis. Cestode samples were opportunistically collected from 77 individual definitive hosts in South Africa, Namibia and Ethiopia, encompassing 15 different species of wild African carnivores and additionally domestic cats. The analysis revealed 32 different cyclophyllidean species of which 21 (65.6 %) represent previously unknown genetic entities. They belong to the families Mesocestoididae, Hymenolepididae, Dipylidiidae and Taeniidae. Here we cover the non-taeniid cestodes, while the taeniids will be addressed in a separate publication. Three of the non-taeniid species uncovered in this study could be assigned to the genus Mesocestoides and were isolated from servals and domestic cats. The white-tailed mongoose was found to be a suitable host for a species belonging to the Hymenolepididae, which was identified as Pseudandrya cf. mkuzii. Both feline and canine genotypes of Dipylidium caninum were detected in domestic cats, the canine genotype also in an African wolf. In addition to these, a novel species of Dipylidium was discovered in an aardwolf. Lastly, four distinct species of Joyeuxiella were found in this study, revealing a cryptic species complex and emphasizing the need for a taxonomic reassessment of this genus. Despite the limited scope of our study in terms of geography and sample size, the results highlight that biodiversity of cestodes in African wild mammals is grossly under-researched and follow-up studies are urgently required, in particular linking morphology to gene sequences.
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Affiliation(s)
- S. Dumendiak
- University of Hohenheim, Department of Parasitology, Stuttgart, Germany
| | - A. Halajian
- Research Administration and Development, and 2-DSI-NRF SARChI Chair (Ecosystem health), Department of Biodiversity, University of Limpopo, South Africa
| | - Y.T. Mekonnen
- Haramaya University, College of Veterinary Medicine, PO Box 138, Dire Dawa, Ethiopia
- Alma Mater Studiorum University of Bologna, Department of Veterinary Medical Sciences, Bologna, Italy
| | - O. Aschenborn
- Leibniz Institute for Zoo and Wildlife Research, Department of Evolutionary Ecology, Berlin, Germany
| | - G.J. Camacho
- Mpumalanga Tourism & Parks Agency, Nelspruit, South Africa
| | - R.K. Schuster
- Central Veterinary Research Laboratory, PO Box 597, Dubai, United Arab Emirates
| | - U. Mackenstedt
- University of Hohenheim, Department of Parasitology, Stuttgart, Germany
| | - T. Romig
- University of Hohenheim, Department of Parasitology, Stuttgart, Germany
- University of Hohenheim, Center of Biodiversity and Integrative Taxonomy, Stuttgart, Germany
| | - M. Wassermann
- University of Hohenheim, Department of Parasitology, Stuttgart, Germany
- University of Hohenheim, Center of Biodiversity and Integrative Taxonomy, Stuttgart, Germany
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Stein C, Voigts J, Niederreiter L, Kowarschik S, Huber R, Lüth VM. Antiproliferative and immunomodulative potential of Citrullus colocynthis and its bioactive compounds in human lymphocytes and lung cells. J Ethnopharmacol 2024; 328:118053. [PMID: 38499257 DOI: 10.1016/j.jep.2024.118053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 03/07/2024] [Accepted: 03/12/2024] [Indexed: 03/20/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Citrullus colocynthis (L.) Schrad is a member of the Cucurbitaceae plant family which has been used in traditional medicine for the treatment of lung diseases such as asthma and bronchitis. AIM OF THE STUDY The study was conducted to investigate antiproliferative and immunomodulating effects of C. colocynthis and isolated cucurbitacins on human T lymphocytes and lung epithelial cells in order to evaluate their potential in the treatment of airway diseases. MATERIALS AND METHODS Different concentrations of an ethanolic extract of C. colocynthis fruits and cucurbitacins B (CuB), E (CuE) and E-glucopyranoside (CuE-Glu) were analysed for their cytotoxicity and immunomodulatory potential on Peripheral Blood Mononuclear Cells (PBMCs) of healthy donors and on the epithelial lung cancer cell line A549. Viability and proliferation were tested using WST1 and CFSE assays. Flow cytometric analysis of AnnexinV/PI staining was used to investigate cell death through apoptosis/necrosis. Effects on regulatory mechanisms of T lymphocytes, such as CD69 and CD25 marker activation, cytokine production of the cytokines interleukin 2 (IL2), tumor necrosis factor α (TNFα) and interferon γ (IFNy) were also analysed via flow cytometry. Influences on the activator protein 1 (AP1), nuclear factor of activated T-cells (NFAT) or nuclear factor 'kappa-light-chain-enhancer' of activated B-cells (NFκB) pathways were analysed in the Jurkat reporter cell line. Cytokine secretion in A549 cells stimulated with virus-like particles was analysed using the bead-based Legendplex™ assay. RESULTS Non-toxic concentrations of C. colocynthis and CuE-Glu showed dose-dependent effects on viability and proliferation in both T lymphocytes and A549 cells. The extracts inhibited lymphocyte activation and suppressed T cell effector functions, which was also shown by lower production of cytokines IL2, TNFα and IFNy. A dose dependent inhibition of the pathways NFκB, NFAT and AP1 in Jurkat cells could be observed. In A549 cells, especially CuE and CuE-Glu showed inhibitory effects on cytokine production following a simulated viral infection. Unglycosylated cucurbitacins were more effective in suppressing the immune function in lymphocytes than glycosylated cucurbitacins, however this activity is limited to cytotoxic concentrations. CONCLUSION In our study we could confirm the immunmodulating effect of C. colocynthis and cucurbitacins B, E and E-glucopyranoside in vitro by suppression of different pathways of inflammation and T cell proliferation. Activity in a lung cell model using a virus-like stimulation shows promise for further research regarding cucurbitacins in airway diseases.
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Affiliation(s)
- Carina Stein
- Centre for Complementary Medicine, Department of Internal Medicine II, Faculty of Medicine, University of Freiburg, 79102, Freiburg, Germany.
| | - Johanna Voigts
- Centre for Complementary Medicine, Department of Internal Medicine II, Faculty of Medicine, University of Freiburg, 79102, Freiburg, Germany.
| | - Lisa Niederreiter
- Centre for Complementary Medicine, Department of Internal Medicine II, Faculty of Medicine, University of Freiburg, 79102, Freiburg, Germany.
| | - Stefanie Kowarschik
- Centre for Complementary Medicine, Department of Internal Medicine II, Faculty of Medicine, University of Freiburg, 79102, Freiburg, Germany.
| | - Roman Huber
- Centre for Complementary Medicine, Department of Internal Medicine II, Faculty of Medicine, University of Freiburg, 79102, Freiburg, Germany.
| | - Volker M Lüth
- Centre for Complementary Medicine, Department of Internal Medicine II, Faculty of Medicine, University of Freiburg, 79102, Freiburg, Germany.
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Sultan M, Zewdie A, Priyadarshani D, Hassen E, Tilahun M, Geremew T, Beane A, Haniffa R, Berenholtz SM, Checkley W, Hansoti B, Laytin AD. Implementing an ICU registry in Ethiopia-Implications for critical care quality improvement. J Crit Care 2024; 81:154525. [PMID: 38237203 PMCID: PMC10996997 DOI: 10.1016/j.jcrc.2024.154525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 03/14/2024]
Abstract
PURPOSE Intensive care units (ICUs) in low- and middle-income countries have high mortality rates, and clinical data are needed to guide quality improvement (QI) efforts. This study utilizes data from a validated ICU registry specially developed for resource-limited settings to identify evidence-based QI priorities for ICUs in Ethiopia. MATERIALS AND METHODS A retrospective cohort analysis of data from two tertiary referral hospital ICUs in Addis Ababa, Ethiopia from July 2021-June 2022 was conducted to describe casemix, complications and outcomes and identify features associated with ICU mortality. RESULTS Among 496 patients, ICU mortality was 35.3%. The most common reasons for ICU admission were respiratory failure (24.0%), major head injury (17.5%) and sepsis/septic shock (13.3%). Complications occurred in 41.0% of patients. ICU mortality was higher among patients with respiratory failure (46.2%), sepsis (66.7%) and vasopressor requirements (70.5%), those admitted from the hospital ward (64.7%), and those experiencing major complications in the ICU (62.3%). CONCLUSIONS In this study, ICU mortality was high, and complications were common and associated with increased mortality. ICU registries are invaluable tools to understand local casemix and clinical outcomes, especially in resource-limited settings. These findings provide a foundation for QI efforts and a baseline to evaluate their impact.
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Affiliation(s)
- Menbeu Sultan
- St. Paul's Hospital Millennium Medical Center, Addis Ababa, Ethiopia
| | - Ayalew Zewdie
- St. Paul's Hospital Millennium Medical Center, Addis Ababa, Ethiopia; Addis Ababa Burn, Emergency and Trauma Hospital, Addis Ababa, Ethiopia
| | | | - Ephrem Hassen
- St. Paul's Hospital Millennium Medical Center, Addis Ababa, Ethiopia
| | - Melkamu Tilahun
- St. Paul's Hospital Millennium Medical Center, Addis Ababa, Ethiopia
| | - Tigist Geremew
- Addis Ababa Burn, Emergency and Trauma Hospital, Addis Ababa, Ethiopia
| | - Abi Beane
- Centre for Inflammation Research, University of Edinburgh, Scotland, UK.
| | - Rashan Haniffa
- Centre for Inflammation Research, University of Edinburgh, Scotland, UK.
| | - Sean M Berenholtz
- Johns Hopkins University School of Medicine, Department of Anesthesia and Critical Care Medicine, Baltimore, MD, USA.
| | - William Checkley
- Johns Hopkins University School of Medicine, Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Baltimore, MD, USA.
| | - Bhakti Hansoti
- Johns Hopkins University School of Medicine, Department of Emergency Medicine, Baltimore, MD, USA.
| | - Adam D Laytin
- Johns Hopkins University School of Medicine, Department of Anesthesia and Critical Care Medicine, Baltimore, MD, USA; Johns Hopkins University School of Medicine, Department of Emergency Medicine, Baltimore, MD, USA.
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Warren MB, Jacobs F, Dutton HR, Netherlands EC, DuPreez LH, Bullard SA. First report of a fish blood fluke from sub-Saharan Africa: Nomasanguinicola dentata (Paperna, 1964) Warren and Bullard, 2023 infecting African sharptooth catfish, Clarias gariepinus (Burchell, 1822) Teugles, 1982 in the Kavango River, Namibia, and a revised phylogeny for Sanguinicolidae Poche, 1926. Parasitol Int 2024; 100:102862. [PMID: 38237673 DOI: 10.1016/j.parint.2024.102862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 01/02/2024] [Accepted: 01/15/2024] [Indexed: 02/09/2024]
Abstract
We herein provide a supplemental description of Nomasanguinicola dentata (Paperna, 1964) Warren and Bullard, 2023 (Digenea: Sanguinicolidae) and provide a revised 28S phylogeny to test relationships among freshwater fish blood flukes. We examined the heart of three African sharptooth catfish, Clarias gariepinus (Burchell, 1822) Teugles, 1982 from the Kavango River (northeastern Namibia) that was infected with adults of N. dentata. This blood fluke differs from N. canthoensis by having a body 5.3-6.7 longer than wide (vs. 3.5-4.6), an anterior esophageal swelling 7-8% (vs. 14-24%) of total esophageal length, a posterior esophageal swelling 3-5% (vs. 8-10%) of total esophageal length, a pre-cecal (vs. wholly post-cecal) testis, and an ovary that does not extend laterally beyond the nerve cords. The 28S sequence for N. dentata differed from that of N. canthoensis by 144 bp (9% difference). The phylogenetic analysis recovered these species as sister taxa and Sanguinicolidae as monophyletic. This is the first report of a fish blood fluke from sub-Saharan Africa, and the first report of a species of Nomasanguinicola from Africa in ∼40 yrs.
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Affiliation(s)
- Micah B Warren
- Aquatic Parasitology Laboratory, School of Fisheries, Aquaculture, and Aquatic Sciences, College of Agriculture, Auburn University, Auburn, AL 36849, USA.
| | - Francois Jacobs
- Kamutjonga Research and Training Institute, Ministry of Fisheries and Marine Resources, Divundu, Namibia
| | - Haley R Dutton
- Aquatic Parasitology Laboratory, School of Fisheries, Aquaculture, and Aquatic Sciences, College of Agriculture, Auburn University, Auburn, AL 36849, USA
| | - Edward C Netherlands
- Department of Zoology and Entomology, University of the Free State, PO Box 339, Bloemfontein 9300, South Africa
| | - Louis H DuPreez
- African African Amphibian Conservation Research Group, Unit for Environmental Sciences and Management, North-West University, Private Bag ×6001, Potchefstroom 2520, South Africa; South African Institute for Aquatic Biodiversity, Somerset Street, Grahamstown 6139, South Africa
| | - Stephen A Bullard
- Aquatic Parasitology Laboratory, School of Fisheries, Aquaculture, and Aquatic Sciences, College of Agriculture, Auburn University, Auburn, AL 36849, USA; Unit for Environmental Sciences and Development, North-West University, Private Bag X6001, Potchefstroom 2520, South Africa
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11
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Vougat Ngom R, Jajere SM, Ayissi GJ, Tanyienow A, Moffo F, Watsop HM, Mimboe LM, Mouiche MM, Schüpbach-Regula G, Carmo LP. Unveiling the landscape of resistance against high priority critically important antimicrobials in food-producing animals across Africa: A scoping review. Prev Vet Med 2024; 226:106173. [PMID: 38503073 DOI: 10.1016/j.prevetmed.2024.106173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 02/10/2024] [Accepted: 03/06/2024] [Indexed: 03/21/2024]
Abstract
The rapid population growth in Africa is associated with an increasing demand for livestock products which in turn can lead to antimicrobial use. Antimicrobial usage in animals contributes to the emergence and selection of resistant bacteria which constitutes a serious public health threat. This study aims to review and summarize the available information on highest priority critically important antimicrobials (HPCIAs) resistance in livestock production in Africa. This work will help to inform future policies for controlling antimicrobial resistance (AMR) in the food production chain. A scoping review was conducted according to the Cochrane handbook and following PRISMA 2020 guidelines for reporting. Primary research studies published after 1999 and reporting resistance of Escherichia coli, Enterococcus spp, Staphylococcus aureus, Salmonella spp, and Campylobacter spp to HPCIAs in poultry, cattle, pigs, goats, and sheep in Africa were searched in four databases. A total of 312 articles were included in the review. The majority of the studies (40.7) were conducted in North African countries. More than 49.0% of included studies involved poultry and 26.2% cattle. Cephalosporins and quinolones were the most studied antimicrobial classes. Of the bacteria investigated in the current review, E. coli (41.7%) and Salmonella spp (24.9%) represented the most commonly studied. High levels of resistance against erythromycin in E. coli were found in poultry (MR 96.1%, IQR 83.3-100.0%), cattle (MR 85.7%, IQR 69.2-100.0%), and pigs (MR 94.0%, IQR 86.2-94.0%). In sheep, a high level of resistance was observed in E. coli against nalidixic acid (MR 87.5%, IQR 81.3-93.8%). In goats, the low level of sensibility was noted in S. aureus against streptomycin (MR 86.8%, IQR 19.4-99.0%). The study provides valuable information on HPCIAs resistance in livestock production in Africa and highlights the need for further research and policies to address the public health risk of AMR. This will likely require an investment in diagnostic infrastructure across the continent. Awareness on the harmful impact of AMR in African countries is a requirement to produce more effective and sustainable measures to curb AMR.
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Affiliation(s)
- Ronald Vougat Ngom
- School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Saleh M Jajere
- Faculty of Veterinary Medicine, University of Maiduguri, Borno State, Nigeria
| | - Gaspard Ja Ayissi
- School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Akenghe Tanyienow
- School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Frédéric Moffo
- School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Hippolyte M Watsop
- School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Leina M Mimboe
- School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | - Mohamed Mm Mouiche
- School of Veterinary Medicine and Sciences, University of Ngaoundéré, Ngaoundéré, Cameroon
| | | | - Luís Pedro Carmo
- Veterinary Public Health Institute, Vetsuisse Faculty, University of Bern, Bern, Switzerland; Norwegian Veterinary Institute, Elizabeth Stephansens vei 1, Ås 1433, Norway
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de Leeuw A, Ester WA, Kinfe M, Girma F, Abdurahman R, Zerihun T, Teklehaimanot A, Hanlon C, Hoek HW, Hoekstra RA. The impact of raising a child with a developmental or physical health condition in Ethiopia. Res Dev Disabil 2024; 148:104716. [PMID: 38490136 DOI: 10.1016/j.ridd.2024.104716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVE Raising a child with a developmental disability or physical health condition can have a major impact on the lives of their families, especially in low-income countries. We explored the impact on such families in Ethiopia. STUDY DESIGN A total of 241 child-caregiver dyads were recruited from two public hospitals in Addis Ababa, Ethiopia. Of these, 139 children were diagnosed with a developmental disability (e.g. autism, intellectual disability) and 102 children with a physical health condition (e.g. malnutrition, severe HIV infection). The family quality of life was assessed using caregiver reports on the Pediatric Quality of Life Inventory™ (PedsQL-FIM™). The disability weight score, which is a Global Burden of Disease measure to quantify health loss, was estimated for each child. RESULTS Families with a child with a developmental disability reported lower quality of life than families caring for a child with a physical health condition (p < .001). Mean disability weight scores in children with a developmental disability were higher than in children with a physical health condition (p < .001), indicating more severe health loss. Disability weight scores were negatively associated with the family quality of life in the whole group (B=-16.8, SE=7.5, p = .026), but not in the stratified analyses. CONCLUSIONS Caring for a child with a developmental disability in Ethiopia is associated with a substantial reduction in the family quality of life. Scaling up support for these children in resource-limited contexts should be prioritized.
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Affiliation(s)
- Anne de Leeuw
- Parnassia Psychiatric Institute, The Hague, the Netherlands; University Medical Center Groningen, the Netherlands
| | - Wietske A Ester
- Parnassia Psychiatric Institute, The Hague, the Netherlands; Sarr Autism Rotterdam, Youz Child and Adolescent Psychiatry, Rotterdam, the Netherlands; LUMC-Curium, Child and Adolescent Psychiatry, Oegstgeest, the Netherlands
| | - Mersha Kinfe
- Addis Ababa University, College of Health Sciences, School of Medicine, Department of Psychiatry, Addis Ababa, Ethiopia
| | - Fikirte Girma
- Addis Ababa University, College of Health Sciences, School of Medicine, Department of Psychiatry, Addis Ababa, Ethiopia
| | - Rehana Abdurahman
- Addis Ababa University, College of Health Sciences, School of Medicine, Department of Psychiatry, Addis Ababa, Ethiopia; Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia; St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Tigist Zerihun
- St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia; Neurodiversity Center Ethiopia, Ethiopia
| | | | - Charlotte Hanlon
- Addis Ababa University, College of Health Sciences, School of Medicine, Department of Psychiatry, Addis Ababa, Ethiopia; King's College London, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Hans W Hoek
- Parnassia Psychiatric Institute, The Hague, the Netherlands; University Medical Center Groningen, the Netherlands; Columbia University New York, United States
| | - Rosa A Hoekstra
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
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Sæle RH, Ndetei DM, Mutiso VN, Mamah D. Epidemiology of DSM-5 psychiatric disorders in Kenyan Youth with Low and High Psychosis Risk. Compr Psychiatry 2024; 131:152473. [PMID: 38503003 DOI: 10.1016/j.comppsych.2024.152473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 01/30/2024] [Accepted: 03/10/2024] [Indexed: 03/21/2024] Open
Abstract
INTRODUCTION There are few psychiatric epidemiology studies among Kenyan youth and fewer among those at high psychosis risk (HR). METHODS This study assessed the epidemiology of DSM-5 psychiatric disorders in HR and low-risk (LR) individuals to inform research and mental health services. 567 participants (aged 15-25) in HR (n = 246) and LR (n = 260) groups based on Washington Early Recognition Center Affectivity and Psychosis (WERCAP) Screen scores. Diagnostic Interview Schedule, version 5 (DIS-5) assessed DSM-5 psychiatric disorder prevalence. Diagnostic comorbidity and demographic relationships were investigated. RESULTS A higher prevalence was observed for all DSM-5 disorders in the HR group, significantly for gambling disorder (13% vs. 5.8%), major depressive disorder (9.8% vs. 3.8%), antisocial personality disorder (5.7% vs. 2.3%), general anxiety disorder (4.9% vs. 0.4%), oppositional defiant disorder (3.3% vs. 0.4%), panic disorder (2.8% vs. 0.8%), and anorexia nervosa (2.8% vs. 0%). Gambling disorder was the most prevalent and showed significant gender effects (males>females). DISCUSSION Psychiatric disorders occur at increased rates among HR compared to LR. Prevalence rates found are lower than in US studies, except for gambling disorder which was highly prevalent. Large-population-based epidemiology studies in Africa are needed to estimate rates, particularly of disorders such as schizophrenia, accurately.
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Affiliation(s)
- Rebekka H Sæle
- Departments of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States of America.
| | - David M Ndetei
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya; Department of Psychiatry, University of Nairobi, Kenya
| | - Victoria N Mutiso
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | - Daniel Mamah
- Departments of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States of America
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Moawad MHED, Al-Jafari M, Taha AM, A'amar JW, Alsayed O, Fayad T, Sadeq MA, Albakri K, Serag I. Neuro-oncological research output in Africa: a scoping review of primary brain tumors. Neurol Sci 2024; 45:1945-1951. [PMID: 38146012 PMCID: PMC11021309 DOI: 10.1007/s10072-023-07272-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/16/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND There is evidence that individuals of African ancestry, particularly those residing in Africa, suffer from an unfortunate amount of under-representation in cancer research worldwide. AIM We aimed to analyze current research output and potentially predict future trends in neuro-oncological research in Africa. Investigating deficits in the field will assist in identifying top-performing countries, which ones face challenges, and how to solve them. Therefore, targeted interventions can be applied to overcome these challenges. METHODS We conducted a systematic computer-based search on the following databases (PubMed, Scopus, Web of Science, and Embase) for research articles related to the neuro-oncological field in Africa. We aimed to retrieve any article published in the period between 1 January 2000 and 10 January 2023. RESULTS We included 200 eligible articles in our study. The output of neuro-oncological research has been increasing over the past two decades, peaking in 2019. Among the included articles, clinical practice issues constituted the majority (80%), while public health-related topics accounted for 20% of the publications. Regarding the type of neurological tumor, neuroblastoma was the most common, with 26 articles (13%), meningioma with 21 (10.5%), and glioma with 16 articles (8%). CONCLUSION The interest in African neuro-oncological research is increasing. Hence, there is a need for ongoing efforts to address issues with clinical practice and public health related to neurological tumors in the continent. Future studies should concentrate on filling in knowledge gaps and investigating novel methods for neuro-oncological conditions that affect African populations in terms of prevention, diagnosis, treatment, and management strategies.
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Affiliation(s)
- Mostafa Hossam El Din Moawad
- Faculty of Pharmacy Clinical Department, Alexandria University, Alexandria, Egypt
- Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | | | | | | | - Omar Alsayed
- Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Taha Fayad
- Faculty of Oral and Dental Medicine, Sinai University, North Sinai, Egypt
| | - Mohammed Ahmed Sadeq
- Faculty of Medicine, Misr University for Science and Technology, 6th of October City, Egypt
| | - Khaled Albakri
- Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Ibrahim Serag
- Faculty of Medicine, Mansoura University, Mansoura, Egypt.
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Glover NA, Ivanova O, Sathar F, Riess F, Shambhu RR, Mekota AM, Zurba L, Menezes C, Alexandra van Blydenstein S, Kalla I, Hoelscher M, Saathoff E, Charalambous S, Rachow A. Lung outcomes and related risk factors in patients after SARS-CoV-2 infection: a hospitalised single-centre cohort from Johannesburg, South Africa. EClinicalMedicine 2024; 71:102588. [PMID: 38623400 PMCID: PMC11016864 DOI: 10.1016/j.eclinm.2024.102588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/17/2024] Open
Abstract
Background Sequelae post-SARS-CoV-2 infection, including lung and functional impairment, pose a significant challenge post-recovery. We explored the burden and risk factors for post-COVID-19 sequelae in an African population with prevalent comorbidities including tuberculosis (TB) and HIV. Methods We conducted an observational cohort study on hospitalised adults with confirmed SARS-CoV-2 infection from 20 March to 06 October 2021 at Chris Hani Baragwanath Academic Hospital, South Africa. We collected data on comorbidities, and COVID-19 severity using the World Health Organization (WHO) clinical progression scale. Prospectively, we followed up all participants within 40-days post-discharge to assess body mass index (BMI), COVID-19 symptoms and quality of life using St George's Respiratory Questionnaire (SGRQ), 6-min walking-test (6MWT), and spirometry. A subsequent in-depth visit assessed plethysmography, diffusing capacity for the lung for carbon monoxide (DLCO), and high-resolution chest-CT. Findings We followed up 111 participants, where 65.8% were female, median age 50.5 years, and predominantly black-African (92.8%). Relevant comorbidities included TB disease (18.9%) and HIV infection (36%). SGRQ total scores were elevated in 78.9%, median 6MWT distance was reduced at 300 m (IQR 210-400), and nearly half (49.5%) exhibited spirometry findings below the lower limit of normal (LLN). In-depth pulmonary assessment for 61 participants revealed abnormalities in total lung capacity (31.6% <80% predicted), DLCO (53.4% <80% predicted), and chest-CT (86.7% abnormal). Significant risk factors for individual abnormal outcomes, adjusted for age and sex, were TB disease, HIV with CD4 <200 cells/mm3, BMI <18.5 kg/m2 and >35 kg/m2, and initial COVID-19 severity. Interpretation This study demonstrates substantial lung and functional morbidity within the first weeks post-COVID-19, particularly in individuals with pre-existing comorbidities including TB, HIV, and low or high BMI. Chest-CT and DLCO show best early potential at reflecting COVID-19-related pathologies. Funding The Bavarian State Ministry of Science and Arts.
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Affiliation(s)
| | - Olena Ivanova
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich
| | | | - Friedrich Riess
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich
| | - Rekha Rao Shambhu
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich
| | - Anna-Maria Mekota
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich
| | | | - Colin Menezes
- University of the Witwatersrand, Department of Internal Medicine, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Sarah Alexandra van Blydenstein
- University of the Witwatersrand, Department of Internal Medicine, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa
| | - Ismail Kalla
- University of the Witwatersrand, Department of Internal Medicine, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Michael Hoelscher
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich
- German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
- Unit Global Health, Helmholtz Zentrum München, German Research Centre for Environmental Health (HMGU), Neuherberg, Germany
| | - Elmar Saathoff
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich
- German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
| | - Salome Charalambous
- The Aurum Institute, Johannesburg, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Andrea Rachow
- Division of Infectious Diseases and Tropical Medicine, LMU University Hospital, LMU Munich
- German Centre for Infection Research (DZIF), Partner Site Munich, Munich, Germany
- Unit Global Health, Helmholtz Zentrum München, German Research Centre for Environmental Health (HMGU), Neuherberg, Germany
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Adjorlolo S, Awortwe V, Anum A, Huang KY, Mamah D. Psychotic-like experiences and adverse life events in young people. Does gender matter? Child Adolesc Ment Health 2024; 29:154-160. [PMID: 37610125 DOI: 10.1111/camh.12674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Psychotic-like experiences (PLEs) and adverse life events (ALEs) are highly prevalent in sub-Saharan Africa where gendered practices are also common. There is, however, a paucity of data on how the relationship between PLEs and life adversities is influenced by gender. The current study addressed this gap. METHOD Data were collected from 1886 school-based young people (1174 females) in Ghana, West Africa using a cross-sectional survey methodology and analyzed using Chi-square, independent t-test, Pearson correlation, and multivariate regression. RESULTS The results showed that victimization experiences, school stress and having a family member with mental illness were significantly associated with PLEs in both males and females. In contrast, substance misuse and experiences of head trauma correlated significantly with PLEs in females only. CONCLUSION Life adversities constitute major risk factors for PLEs among school-based young people in Ghana, who could benefit from gender neutral and gender-sensitive intervention programming to remediate the effects of life adversities on PLEs.
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Affiliation(s)
- Samuel Adjorlolo
- Department of Mental Health, School of Nursing and Midwifery, College of Health Sciences, University of Ghana, Accra, Ghana
- Research and Grant Institute of Ghana, Accra, Ghana
| | - Victoria Awortwe
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Adote Anum
- Department of Psychology, School of Social Sciences, College of Humanities, University of Ghana, Accra, Ghana
| | - Keng-Yen Huang
- Department of Population Health, New York University School of Medicine, New York, NY, USA
- Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY, USA
| | - Daniel Mamah
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, USA
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Myroniuk TW, Kohler HP, Mwapasa V, Mwera J, Kohler IV. Surprising Gendered Age Differences in Rural Malawians' Early COVID-19 Pandemic Prevention Efforts. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae031. [PMID: 38457433 PMCID: PMC11000306 DOI: 10.1093/geronb/gbae031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Indexed: 03/10/2024] Open
Abstract
OBJECTIVES We assess how age, the presence of mature adults aged 45+ years, and recent deaths in rural households are associated with coronavirus disease 2019 (COVID-19) preventative actions and the likelihood of getting vaccinated against the virus in Malawi during early stages of the pandemic. METHODS We draw upon data from 2,187 rural Malawians who participated in a 2020 COVID-19 Phone Survey. We estimate the log odds of engaging in "low-cost" and "high-cost" COVID-19 preventative actions based on age, gender, household composition, and recent household deaths. Low-cost prevention efforts were washing hands with soap and water frequently, avoiding close contact with people when going out, and avoiding shaking hands. High-cost actions included staying at home and decreasing time spent close to people not living in their household. We also estimate the chances of acquiring the COVID-19 vaccine in early stages of its availability. RESULTS Mature women (45+ years) in general and younger men (<45 years)-living with at least one mature adult in the household-were less likely than others to comply with low-cost actions. Mature men were more likely than younger men (<45 years) to take on high-cost actions. To some extent, individuals who experienced a recent family death were more likely to engage in high-cost COVID-19 preventative actions as well as getting vaccinated. DISCUSSION Gendered age differences in preventing the transmission of COVID-19 offer hints of larger social norms affecting protective efforts. The analyses also inform future COVID-19 public health outreach efforts in Malawi and other rural SSA contexts.
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Affiliation(s)
- Tyler W Myroniuk
- Department of Public Health, University of Missouri, Columbia, Missouri, USA
| | - Hans-Peter Kohler
- Population Aging Research Center (PARC), University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Victor Mwapasa
- Department of Community and Environmental Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | | | - Iliana V Kohler
- Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Sulaiman SK, Musa MS, Tsiga-Ahmed FI, Ahmad SI, Haruna SA, Zubair AA, Makama BT, Hussein A, Sulaiman AK, Dayyab FM, Bako AT. Depression mediates the relationship between exposure to stigma and medication adherence among people living with HIV in low-resource setting: a structural equation modeling approach. J Behav Med 2024:10.1007/s10865-024-00488-0. [PMID: 38643421 DOI: 10.1007/s10865-024-00488-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 03/21/2024] [Indexed: 04/22/2024]
Abstract
This study hypothesizes that depression mediates the association between exposure to stigma and medication non-adherence in people living with HIV (PLHIV). We recruited 372 PLHIV from the Stigma, health-related Quality of life, antiretroviral Adherence, and Depression among people living with HIV (SQuAD-HIV) project, a multicenter cross-sectional study conducted between October 2021 and February 2022 among PLHIV attending six ART clinics in two geopolitical regions of northern Nigeria. A structural equation modeling (SEM) framework, utilizing the full information maximum likelihood estimator, was used to elucidate the pathways linking stigma, depression, and ART medication adherence, adjusting for sociodemographic characteristics. The total number of eligible participants analyzed (353) included 32.7% male PLHIV with a mean age (SD) of 39.42 (10.14). Being female was positively associated with adherence (β, 95% CI 0.335, 0.163-0.523, p-value < 0.001) but negatively associated with stigma (β, 95% CI - 0.334, - 0.561 to - 0.142, p-value = 0.001), while urban residence was negatively associated with stigma (β, 95% CI - 0.564, - 0.804 to - 0.340, p-value < 0.001). Our analysis also indicated that a higher level of experienced stigma was associated with decreased medication adherence. This association was partially mediated by depression (indirect effect = (0.256) (- 0.541) = - 0.139; p-value < 0.01). The proportion of the association between stigma and medication adherence explained through mediation by depression was 35.6%. These findings underscore the need for targeted interventions aimed at lowering exposure to stigma among PLHIV to improve medication adherence.
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Affiliation(s)
| | - Muhammad Sale Musa
- Department of Medicine, Yobe State University Teaching Hospital, Damaturu, Nigeria
| | | | - Saidu Idris Ahmad
- Department of Medicine, Murtala Muhammad Specialist Hospital, Kano, Nigeria
| | - Salisu Abubakar Haruna
- Department of Family Health, Kano State Primary Healthcare Management Board, Kano, Nigeria
| | | | | | - Aminu Hussein
- Department of Family Medicine, Federal Medical Center Birnin Kudu, Jigawa, Nigeria
| | - Abdulwahab Kabir Sulaiman
- Department of Medicine, Murtala Muhammad Specialist Hospital, Kano, Nigeria
- Department of Epidemiology, Kano State Ministry of Health, Kano, Nigeria
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Alfadul ESA, Tebaig B, Alrawa SS, Elgadi AT, Margani EEMA, Adam MEB, Mohamoud MSA, Elhassan SAM, Elhassan MMA. Delays in presentation, diagnosis, and treatment in Sudanese women with breast cancer: a cross-sectional study. Oncologist 2024:oyae066. [PMID: 38642908 DOI: 10.1093/oncolo/oyae066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 03/18/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND The poor prognosis of breast cancer in Sudan could be due to delayed treatment and diagnosis at an advanced stage. Our study aimed to assess the extent of delays from onset of symptoms to treatment in Sudanese women with breast cancer, as well as identify factors contributing to these delays. MATERIALS AND METHODS We conducted a multi-center cross sectional study between March and April 2023. Data were collected from the medical records and interviews with women with breast cancer in the two main oncology centers in Sudan. Linear regression was used to identify the predictors of delayed presentation. RESULTS We interviewed 601 women with breast cancer. The majority of women (50.1%) were diagnosed at locally advanced or metastatic disease. The median interval from the onset of symptoms to receiving oncologic treatment was 221 days (IQR = 92, 496). The longest delay was the presentation delay 61 (31 244) days. The median duration for diagnosis delay and treatment delay was 21 (10.57) days and 27 (10.64) days, respectively. Predictors of early presentation included, being young (β = -5.3; 95% CI = 0.06 to 10), married (β = -264; 95% CI = -427 to -101), divorced (β = -306; 95% CI = -549 to -63), or widowed (β = -320; 95% CI = --543 to -97), urban residence (β = -107; 95% CI = -213 to -2.3), and seeking traditional healer (β = -204; 95% CI = -383 to -26). CONCLUSION Most Sudanese women with breast cancer experience significant patient delays, often presenting at advanced stages. Factors like being single, older, and living in rural areas contribute to these delays. Increasing breast cancer education, improving healthcare access and addressing sociodemographic barriers can potentially expedite diagnosis and improve outcomes.
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Affiliation(s)
- Esraa S A Alfadul
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
- Station of Medical Essentials (SOME) Institution, Khartoum, Sudan
| | - Badria Tebaig
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Salma S Alrawa
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | | | - Ensaf E M A Margani
- Station of Medical Essentials (SOME) Institution, Khartoum, Sudan
- Faculty of Medicine, University of Sinnar, Sinnar, Sudan
| | - Maab E B Adam
- Station of Medical Essentials (SOME) Institution, Khartoum, Sudan
- Faculty of Medicine, Nahda College, Khartoum, Sudan
| | - Mawaheb Sh Adem Mohamoud
- Station of Medical Essentials (SOME) Institution, Khartoum, Sudan
- Faculty of Medicine, Almughtaribeen University, Khartoum, Sudan
| | - Safa A M Elhassan
- Station of Medical Essentials (SOME) Institution, Khartoum, Sudan
- Faculty of Medicine, Omdurman Islamic University, Khartoum, Sudan
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20
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Kabeta T, Tolosa T, Duchateau L, Immerseel FV, Antonissen G. Prevalence and Serotype of Poultry Salmonellosis in Africa: a Systemic Review and Meta-Analysis. Avian Pathol 2024:1-61. [PMID: 38639048 DOI: 10.1080/03079457.2024.2344549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
Salmonellosis represents a significant economic and public health concern for the poultry industry in Africa, leading to substantial economic losses due to mortality, reduced productivity, and food safety problems. However, comprehensive information on the burden of poultry salmonellosis at the continental level are scarce. To address this gap, a systemic review and meta-analysis were conducted to consolidate information on the prevalence and circulating serotypes of poultry salmonellosis in African countries. This involved the selection and review of 130 articles published between 1984 and 2021. A detailed systematic review protocol was structured according to Cochrane STROBE and PRISMA statement guidelines. From the 130 selected articles from 23 different African countries, the overall pooled prevalence estimate (PPE) of poultry salmonellosis in Africa was found to be 14.4% (95% CI= 0.145-0.151). Cameroon reported the highest PPE at 71.9%, with the country also noting the highest specific prevalence of 93.3%. The PPE was notably high in meat and meat products at 23%, indicating significant contamination of Salmonella in African poultry meat and meat products. The number of research papers reporting poultry salmonellosis in Africa has been a threefold increase from 1984 to 2021. Salmonella Enteritidis and Typhimurium were the two most prevalent serotypes reported in 18 African countries. Besides, Salmonella Kentucky, Virchow, Gallinarum, and Pullorum were also widely reported. Western Africa had the highest diversity of reported Salmonella serotypes (141), in contrast to southern Africa, which reported only 27 different serotypes. In conclusion, poultry salmonellosis is highly prevalent across Africa, with a variety of known serotypes circulating throughout the continent. Consequently, it is crucial to implement strategic plans for the prevention and control of Salmonella in Africa.
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Affiliation(s)
- Tadele Kabeta
- Jimma University, College of Agriculture and Veterinary Medicine, School of Veterinary Medicine, P.O. Box 307, Jimma, Ethiopia
- Ghent University, Faculty of Veterinary Medicine, Department of Pathobiology, Pharmacology, and Zoological Medicine, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - Tadele Tolosa
- Jimma University, College of Agriculture and Veterinary Medicine, School of Veterinary Medicine, P.O. Box 307, Jimma, Ethiopia
| | - Luc Duchateau
- Ghent University, Faculty of Veterinary Medicine, Biometrics Research Group, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - Filip Van Immerseel
- Ghent University, Faculty of Veterinary Medicine, Department of Pathobiology, Pharmacology, and Zoological Medicine, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - Gunther Antonissen
- Ghent University, Faculty of Veterinary Medicine, Department of Pathobiology, Pharmacology, and Zoological Medicine, Salisburylaan 133, 9820 Merelbeke, Belgium
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Arnaiz-Villena A, Juarez I, Vaquero-Yuste C, Lledo T, Manuel Martin-Villa J, Suarez-Trujillo F. Cretan HLA genetics supports its early Minoan culture as a link between North Africa and Europe. Hum Immunol 2024:110799. [PMID: 38637221 DOI: 10.1016/j.humimm.2024.110799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/20/2024]
Abstract
HLA studies in Crete show that this population is related to North Africans and also Iberians. This may be a reflection of a common prehistoric first Europeans relationships with North Africans and drying Saharan emigration after 10,000 years BC; it may be specifically represented by a primitive and early cult to the bull in both Cretan (Minoan) and Iberian populations. In the present study, unrelated Cretans representing different Island parts have been studied for class II HLA-DRB1 and -DQB1 alleles. The most frequent ones were HLA-DRB1*11:01 and HLA-DRB1*07:01 and HLA-DQB1*03:01 and DQB1*05:01. Also, the Cretan HLA class II haplotype HLA-DBR1*11:01-DQB1*03:01 had the highest frequency and is also common to other Mediterraneans, including Iberians. In addition, DRB1*07:01-DQB1*02:01 and HLA-DRB1*04:02-DQB1*03:02 Cretan haplotypes are shared with North Africans (the latter with Algerians, Tunisians and Moroccans). In summary, Crete was one of the first European classic cultures (Minoan) which was probably an early link, like Iberia, between North Africa /Sahara and Europe,also supported by genetic results.
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Affiliation(s)
| | - Ignacio Juarez
- Department of Immunology, Medicine Faculty, Complutense University of Madrid, Spain
| | | | - Tomas Lledo
- Department of Immunology, Medicine Faculty, Complutense University of Madrid, Spain
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Hahnle L, Mennen M, Gumedze F, Mutithu D, Adriaanse M, Egan D, Mazondwa S, Walters R, Appiah LT, Inofomoh F, Ogah O, Adekanmbi O, Goma F, Ogola E, Mwazo K, Suliman A, Singh K, Raspail L, Prabhakaran D, Perel P, Sliwa K, Ntusi NAB. Greater Disease Severity and Worse Clinical Outcomes in Patients Hospitalised with COVID-19 in Africa. Glob Heart 2024; 19:34. [PMID: 38638124 PMCID: PMC11025574 DOI: 10.5334/gh.1314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 02/27/2024] [Indexed: 04/20/2024] Open
Abstract
Background COVID-19 cardiovascular research from Africa is limited. This study describes cardiovascular risk factors, manifestations, and outcomes of patients hospitalised with COVID-19 in the African region, with an overarching goal to investigate whether important differences exist between African and other populations, which may inform health policies. Methods A multinational prospective cohort study was conducted on adults hospitalised with confirmed COVID-19, consecutively admitted to 40 hospitals across 23 countries, 6 of which were African countries. Of the 5,313 participants enrolled globally, 948 were from African sites (n = 9). Data on demographics, pre-existing conditions, clinical outcomes in hospital (major adverse cardiovascular events (MACE), renal failure, neurological events, pulmonary outcomes, and death), 30-day vitality status and re-hospitalization were assessed, comparing African to non-African participants. Results Access to specialist care at African sites was significantly lower than the global average (71% vs. 95%), as were ICU admissions (19.4% vs. 34.0%) and COVID-19 vaccination rates (0.6% vs. 7.4%). The African cohort was slightly younger than the non-African cohort (55.0 vs. 57.5 years), with higher rates of hypertension (48.8% vs. 46.9%), HIV (5.9% vs. 0.3%), and Tuberculosis (3.6% vs. 0.3%). In African sites, a higher proportion of patients suffered cardiac arrest (7.5% vs. 5.1%) and acute kidney injury (12.7% vs. 7.2%), with acute kidney injury (AKI) appearing to be one of the strongest predictors of MACE and death in African populations compared to other populations. The overall mortality rate was significantly higher among African participants (18.2% vs. 14.2%). Conclusions Overall, hospitalised African patients with COVID-19 had a higher mortality despite a lower mean age, contradicting literature that had previously reported a lower mortality attributed to COVID-19 in Africa. African sites had lower COVID-19 vaccination rates and higher AKI rates, which were positively associated with increased mortality. In conclusion, African patients were hospitalized with more severe COVID-19 cases and had poorer outcomes.
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Affiliation(s)
- Lina Hahnle
- Department of Medicine, University of Cape Town, South Africa
- UCT/SAMRC Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases, South Africa
- ARUA/GUILD Cluster of Research Excellence on Noncommunicable Diseases and associated multimorbidities, South Africa
| | - Mathilda Mennen
- Department of Medicine, University of Cape Town, South Africa
- UCT/SAMRC Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases, South Africa
- ARUA/GUILD Cluster of Research Excellence on Noncommunicable Diseases and associated multimorbidities, South Africa
| | - Freedom Gumedze
- Department of Statistical Sciences, University of Cape Town, South Africa
| | - Daniel Mutithu
- UCT/SAMRC Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases, South Africa
- ARUA/GUILD Cluster of Research Excellence on Noncommunicable Diseases and associated multimorbidities, South Africa
- Cape Heart Institute, University of Cape Town, South Africa
| | - Marguerite Adriaanse
- Department of Medicine, University of Cape Town, South Africa
- UCT/SAMRC Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases, South Africa
- ARUA/GUILD Cluster of Research Excellence on Noncommunicable Diseases and associated multimorbidities, South Africa
| | - Daniel Egan
- Department of Medicine, University of Cape Town, South Africa
| | | | - Rochelle Walters
- Department of Medicine, University of Cape Town, South Africa
- UCT/SAMRC Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases, South Africa
- ARUA/GUILD Cluster of Research Excellence on Noncommunicable Diseases and associated multimorbidities, South Africa
| | - Lambert Tetteh Appiah
- Department of Medicine, Kwame Nkrumah University of Science & Technology (KNUST) and Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Francisca Inofomoh
- Internal Medicine Department, Olabisi Onabanjo University Teaching Hospital, Nigeria
| | - Okechukwu Ogah
- Department of Medicine, College of Medicine, University of Ibadan, and University College Hospital Ibadan, Nigeria
| | | | - Fastone Goma
- Centre for Primary Care Research, Levy Mwanawasa University Teaching Hospital, Lusaka, Zambia
| | | | - Kieran Mwazo
- Department of Medicine, Coast General Teaching and Referral Hospital, Mombasa, Kenya
| | | | - Kavita Singh
- Public Health Foundation of India, Gurugram, Haryana and Centre for Chronic Disease Control, New Delhi, IN
- Heidelberg Institute of Global Health, University of Heidelberg, Germany
| | | | - Dorairaj Prabhakaran
- Public Health Foundation India, Centre for Chronic Disease Control, IN
- World Heart Federation, CH
- London School of Hygiene & Tropical Medicine, GB
| | - Pablo Perel
- World Heart Federation, CH
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, GB
| | - Karen Sliwa
- World Heart Federation, CH
- Cape Heart Institute, Department of Medicine & Cardiology, Groote Schuur Hospital, Faculty of Health Sciences, University of Cape Town, South Africa
| | - Ntobeko A. B. Ntusi
- Department of Medicine, University of Cape Town, South Africa
- UCT/SAMRC Extramural Unit on Intersection of Noncommunicable Diseases and Infectious Diseases, South Africa
- World Heart Federation, CH
- J46 (J floor) Old Main Building, Groote Schuur Hospital Observatory, 7925, Cape Town, South Africa
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Coetzee de Beer JL. Exotic Animal Practice in Africa. Vet Clin North Am Exot Anim Pract 2024:S1094-9194(24)00020-3. [PMID: 38631920 DOI: 10.1016/j.cvex.2024.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
This article explores the evolution, unique aspects, and challenges facing exotic animal practice in South Africa. This article delves into the slow emergence of dedicated exotic practices and the challenges faced by veterinarians in a vast and diverse landscape. The unique nature of the veterinary landscape is highlighted, emphasizing the impact of varied climates on species inhabiting different regions. The challenges are multifaceted, ranging from limited education infrastructure to dietary issues, unregulated feeds, and the complexities of herbal medicine use. The narrative explores client education challenges due to the scarcity of dedicated practices, underlining the importance of communication channels.
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Ssemanda JN, den Besten HMW, van Wagenberg CPA, Zwietering MH. Quantitative assessment of food safety interventions for Campylobacter spp. and Salmonella spp. along the chicken meat supply chain in Burkina Faso and Ethiopia. Int J Food Microbiol 2024; 415:110637. [PMID: 38422679 DOI: 10.1016/j.ijfoodmicro.2024.110637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 01/26/2024] [Accepted: 02/20/2024] [Indexed: 03/02/2024]
Abstract
Rural and small-scale chicken farming is a major source of income in most African countries, and chicken meat is an important source of nutrients. However, chicken meat can be contaminated with Campylobacter spp. and Salmonella spp., pathogens with a high reported burden of foodborne illnesses. Therefore, it is essential to control these pathogens in chicken meat. Quantitative microbial risk assessments (QMRA) can aid the development of effective food safety control measures and are currently lacking in chicken meat supply chains in the African context. In this study, we developed stochastic QMRA models for Salmonella spp. and Campylobacter spp. in the chicken meat supply chain in Burkina Faso and Ethiopia employing the modular process risk model in @Risk software. The study scope covered chicken farming, transport, slaughtering, consumer handling, and consumption. Effectiveness of candidate interventions was assessed against baseline models' outputs, which showed that the mean annual Campylobacter spp. risk estimates were 6482 cases of illness per 100,000 persons and 164 disability adjusted life years (DALYs) per 100,000 persons in Burkina Faso, and 12,145 cases and 272 DALYs per 100,000 persons in Ethiopia. For Salmonella spp., mean annual estimates were 2713 cases and 1212 DALYs per 100,000 persons in Burkina Faso, and 4745 cases and 432 DALYs per 100,000 persons in Ethiopia. Combining interventions (improved hand washing plus designated kitchen utensils plus improved cooking) resulted in 75 % risk reduction in Burkina Faso at restaurants and 93 to 94 % in Ethiopia at homes for both Salmonella spp. and Campylobacter spp. For Burkina Faso, adding good hygienic slaughter practices at the market to these combined interventions led to over 91 % microbial risk reduction. Interventions that involved multiple food safety actions in a particular step of the supply chain or combining different interventions from different steps of the supply chain resulted in more risk reduction than individual action interventions. Overall, this study demonstrates how diverse and scanty food supply chain information can be applied in QMRA to provide estimates that can be used to stimulate risk-based food safety action in African countries.
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Affiliation(s)
- James Noah Ssemanda
- Food Microbiology, Wageningen University & Research, 17, 6700 AA Wageningen, the Netherlands
| | - Heidy M W den Besten
- Food Microbiology, Wageningen University & Research, 17, 6700 AA Wageningen, the Netherlands
| | - Coen P A van Wagenberg
- Wageningen Economic Research, Wageningen University & Research, 2970, 2502 LS, The Hague, the Netherlands
| | - Marcel H Zwietering
- Food Microbiology, Wageningen University & Research, 17, 6700 AA Wageningen, the Netherlands.
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Millen AME, Daniels WMU, Baijnath S. Depression, an unmet health need in Africa: Understanding the promise of ketamine. Heliyon 2024; 10:e28610. [PMID: 38601594 PMCID: PMC11004535 DOI: 10.1016/j.heliyon.2024.e28610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 03/21/2024] [Accepted: 03/21/2024] [Indexed: 04/12/2024] Open
Abstract
In Africa, there is currently a paucity of data on the epidemiology of depression, its treatment and management. The prevalence of depression is severely underestimated, with unique circumstances and societal risk factors associated with depression and its public awareness. Treating and managing depression is confounded by an inaccessibility to efficient and low-cost treatments for patients with depression. The aetiology of depression is multifactorial, with various theories implicating multiple neuronal networks. Despite this, the treatment of depression is one-dimensional focussing on outdated theories of depression and mainly targeting dysfunctional neurotransmitter pathways. Hence, it is not surprising that there is a significant increase in the prevalence of patients suffering from treatment resistant depression (TRD), with a large portion of patients deriving little clinical benefit from these traditional anti-depressant therapies. This highlights the need for more effective treatment strategies for depression, especially applicable to resource limited environments such as Africa, where there is little investment in public healthcare resources towards managing mental health disorders. The clinical potential of using ketamine in managing depression has received considerable attention in the past two decades, with the FDA approving esketamine for the management of TRD in 2019. This widespread attention has significantly increased ketamine's appeal as a novel antidepressant. Consequently, many ketamine infusion clinics have been established in Africa. However, there is little regulation or guidance for ketamine infusions. Furthermore, while esketamine is expensive and hence inaccessible to a large portion of the African population, racemic ketamine is significantly cheaper and has demonstrated clinical potential. However, there is currently a limited understanding of the neurological mechanisms of action of racemic ketamine in treating and managing depression, especially in a diverse African population. Therefore, this review aims to provide an African context of depression and the therapeutic potential of ketamine by highlighting aspects of its molecular mechanism of action.
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Affiliation(s)
- Aletta ME. Millen
- Integrated Molecular Physiology Research Initiative, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - William MU. Daniels
- School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sooraj Baijnath
- Integrated Molecular Physiology Research Initiative, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Sarfo FS, Asowata OJ, Akpa OM, Akinyemi J, Wahab K, Singh A, Akpalu A, Opare-Addo PA, Okekunle AP, Ogbole G, Fakunle A, Adebayo O, Obiako R, Akisanya C, Komolafe M, Olunuga T, Chukwuonye II, Osaigbovo G, Olowoyo P, Adebayo PB, Jenkins C, Bello A, Laryea R, Ibinaye P, Olalusi O, Adeniyi S, Arulogun O, Ogah O, Adeoye A, Samuel D, Calys-Tagoe B, Tiwari H, Obiageli O, Mensah Y, Appiah L, Akinyemi R, Ovbiagele B, Owolabi M. Stroke occurrence by hypertension treatment status in Ghana and Nigeria: A case-control study. J Neurol Sci 2024; 459:122968. [PMID: 38518449 DOI: 10.1016/j.jns.2024.122968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 02/07/2024] [Accepted: 03/13/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND Hypertension is preeminent among the vascular risk factors for stroke occurrence. The wide gaps in awareness, detection, treatment, and control rates of hypertension are fueling an epidemic of stroke in sub-Saharan Africa. PURPOSE To quantify the contribution of untreated, treated but uncontrolled, and controlled hypertension to stroke occurrence in Ghana and Nigeria. METHODS The Stroke Investigative Research and Educational Network (SIREN) is a case-control study across 16 study sites in Ghana and Nigeria. Cases were acute stroke (n = 3684) with age- and sex-matched stroke-free controls (n = 3684). We evaluated the associations of untreated hypertension, treated but uncontrolled hypertension, and controlled hypertension at BP of <140/90 mmHg with risk of stroke occurrence. We assessed the adjusted odds ratio and population-attributable risk of hypertension treatment control status associated with stroke occurrence. RESULTS The frequencies of no hypertension, untreated hypertension, treated but uncontrolled hypertension and controlled hypertension among stroke cases were 4.0%, 47.7%, 37.1%, and 9.2% vs 40.7%, 34.9%, 15.9%, and 7.7% respectively among stroke-free controls, p < 0.0001. The aOR and PAR (95% CI) for untreated hypertension were 6.58 (5.15-8.41) and 35.4% (33.4-37.4); treated but uncontrolled hypertension was 9.95 (7.60-13.02) and 35.9% (34.2-37.5); and controlled hypertension 5.37 (3.90-7.41) and 8.5% (7.6-9.5) respectively. Untreated hypertension contributed a PAR of 47.5% to the occurrence of intracerebral hemorrhage vs 29.5% for ischemic stroke. The aOR of untreated hypertension for stroke occurrence was 13.31 (7.64-23.19) for <50 years; 7.14 (4.51-11.31) for 50-64 years; and 3.48 (2.28-5.30) for 65 years or more. CONCLUSION The contribution of untreated hypertension and treated but uncontrolled hypertension to stroke occurrence among indigenous Africans is substantial. Implementing targeted interventions that address gaps in hypertension prevention and treatment, involving the local population, healthcare providers, and policymakers, can potentially substantially reduce the escalating burden of strokes in Africa.
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Affiliation(s)
- Fred Stephen Sarfo
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Osahon Jeffery Asowata
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Nigeria
| | - Onoja Matthew Akpa
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Nigeria; Preventive Cardiology Research Unit, Institute of Cardiovascular Diseases, College of Medicine, University of Ibadan, Nigeria
| | - Joshua Akinyemi
- Preventive Cardiology Research Unit, Institute of Cardiovascular Diseases, College of Medicine, University of Ibadan, Nigeria
| | - Kolawole Wahab
- Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Arti Singh
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Albert Akpalu
- Department of Medicine, University of Ghana Medical School, Accra, Ghana
| | | | | | - Godwin Ogbole
- Department of Radiology, University of Ibadan, Nigeria
| | - Adekunle Fakunle
- Department of Public Health, Osun State University, Osogbo, Nigeria
| | | | - Reginald Obiako
- Department of Medicine, Ahmadu Bello University, Zaria, Nigeria
| | | | - Morenkeji Komolafe
- Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
| | | | | | | | - Paul Olowoyo
- Federal Teaching Hospital, Ido-Ekiti Ado-Ekiti, Nigeria
| | | | | | - Abiodun Bello
- Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Ruth Laryea
- Department of Medicine, University of Ghana Medical School, Accra, Ghana
| | | | | | - Sunday Adeniyi
- Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | | | | | | | - Dialla Samuel
- Department of Medicine, University of Ibadan, Nigeria
| | | | - Hemant Tiwari
- University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Yaw Mensah
- Korle Bu Teaching Hospital, Accra, Ghana
| | - Lambert Appiah
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Rufus Akinyemi
- Department of Medicine, University of Ibadan, Nigeria; Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria; Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Nigeria
| | - Bruce Ovbiagele
- Weill Institute for Neurosciences, School of Medicine, University of California San-Francisco, USA
| | - Mayowa Owolabi
- Preventive Cardiology Research Unit, Institute of Cardiovascular Diseases, College of Medicine, University of Ibadan, Nigeria; Department of Medicine, University of Ibadan, Nigeria; Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Nigeria; Lebanese American University, Beirut, Lebanon.
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Ahmat A, Okoroafor SC, Asamani JA, Jean M, Mourtala AI, Nyoni J, Mwinga K. Health workforce strategies during COVID-19 response: insights from 15 countries in the WHO Africa Region. BMC Health Serv Res 2024; 24:470. [PMID: 38622621 PMCID: PMC11017512 DOI: 10.1186/s12913-024-10942-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 04/02/2024] [Indexed: 04/17/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic unveiled huge challenges in health workforce governance in the context of public health emergencies in Africa. Several countries applied several measures to ensure access to qualified and skilled health workers to respond to the pandemic and provide essential health services. However, there has been limited documentation of these measures. This study was undertaken to examine the health workforce governance strategies applied by 15 countries in the World Health Organization (WHO) Africa Region in responding to the COVID-19 pandemic. METHODS We extracted data from country case studies developed from national policy documents, reports and grey literature obtained from the Ministries of Health and other service delivery agencies. This study was conducted from October 2020 to January 2021 in 15 countries - Angola, Burkina Faso, Chad, Eswatini, Ghana, Guinea, Guinea Bissau, Ivory Coast, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal and Togo. RESULTS All 15 countries had national multi-sectoral bodies to manage the COVID-19 response and a costed national COVID-19 response plan. All the countries also reflected human resources for health (HRH) activities along the different response pillars. These activities included training for health workers, and budget for the recruitment or mobilization of additional health workers to support the response, and for provision of financial and non-financial incentives for health workers. Nine countries recruited additional 35,812 health workers either on a permanent or temporary basis to respond to the COVID-19 with an abridged process of recruitment implemented to ensure needed health workers are in place on time. Six countries redeployed 3671 health workers to respond to the COVID-19. The redeployment of existing health workers was reported to have impacted negatively on essential health service provision. CONCLUSION Strengthening multi-sector engagement in the development of public health emergency plans is critical as this promotes the development of holistic interventions needed to improve health workforce availability, retention, incentivization, and coordination. It also ensures optimized utilization based on competencies, especially for the existing health workers.
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Affiliation(s)
- Adam Ahmat
- Health Workforce Unit, Universal Health Coverage - Life Course Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Sunny C Okoroafor
- Health Workforce Unit, Universal Health Coverage - Life Course Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo.
| | - James Avoka Asamani
- Health Workforce Unit, Universal Health Coverage - Life Course Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo
- Centre for Health Professions Education, North-West University, Potchefstroom, South Africa
| | - Millogo Jean
- Health Workforce Unit, Universal Health Coverage - Life Course Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Abdou Illou Mourtala
- Health Workforce Unit, Universal Health Coverage - Life Course Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Jennifer Nyoni
- Health Workforce Unit, Universal Health Coverage - Life Course Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Kasonde Mwinga
- Health Workforce Unit, Universal Health Coverage - Life Course Cluster, World Health Organization Regional Office for Africa, Brazzaville, Congo
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Ansah EW, Maneen S, Ephraim A, Ocloo JEY, Barnes MN, Botha NN. Politics-evidence conflict in national health policy making in Africa: a scoping review. Health Res Policy Syst 2024; 22:47. [PMID: 38622666 PMCID: PMC11017532 DOI: 10.1186/s12961-024-01129-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 03/05/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Generally, public health policy-making is hardly a linear process and is characterized by interactions among politicians, institutions, researchers, technocrats and practitioners from diverse fields, as well as brokers, interest groups, financiers and a gamut of other actors. Meanwhile, most public health policies and systems in Africa appear to be built loosely on technical and scientific evidence, but with high political systems and ideologies. While studies on national health policies in Africa are growing, there seems to be inadequate evidence mapping on common themes and concepts across existing literature. PURPOSE The study seeks to explore the extent and type of evidence that exist on the conflict between politics and scientific evidence in the national health policy-making processes in Africa. METHODS A thorough literature search was done in PubMed, Cochrane Library, ScienceDirect, Dimensions, Taylor and Francis, Chicago Journals, Emerald Insight, JSTOR and Google Scholar. In total, 43 peer-reviewed articles were eligible and used for this review. RESULT We found that the conflicts to evidence usage in policy-making include competing interests and lack of commitment; global policy goals, interest/influence, power imbalance and funding, morals; and evidence-based approaches, self-sufficiency, collaboration among actors, policy priorities and existing structures. Barriers to the health policy process include fragmentation among actors, poor advocacy, lack of clarity on the agenda, inadequate evidence, inadequate consultation and corruption. The impact of the politics-evidence conflict includes policy agenda abrogation, suboptimal policy development success and policy implementation inadequacies. CONCLUSIONS We report that political interests in most cases influence policy-makers and other stakeholders to prioritize financial gains over the use of research evidence to policy goals and targets. This situation has the tendency for inadequate health policies with poor implementation gaps. Addressing these issues requires incorporating relevant evidence into health policies, making strong leadership, effective governance and a commitment to public health.
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Affiliation(s)
- Edward W Ansah
- Department of Health, Physical Education and Recreation (HPER), University of Cape Coast, Cape Coast, Ghana
| | - Samuel Maneen
- Department of Health, Physical Education and Recreation (HPER), University of Cape Coast, Cape Coast, Ghana
| | - Anastasia Ephraim
- Department of Health, Physical Education and Recreation (HPER), University of Cape Coast, Cape Coast, Ghana
| | - Janet E Y Ocloo
- Department of Health, Physical Education and Recreation (HPER), University of Cape Coast, Cape Coast, Ghana
| | - Mabel N Barnes
- Department of Health, Physical Education and Recreation (HPER), University of Cape Coast, Cape Coast, Ghana
| | - Nkosi N Botha
- Department of Health, Physical Education and Recreation (HPER), University of Cape Coast, Cape Coast, Ghana.
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Azeez RO, Rampedi IT, Ifegbesan AP, Ogunyemi B. Geo-demographics and source of information as determinants of climate change consciousness among citizens in African countries. Heliyon 2024; 10:e27872. [PMID: 38560259 PMCID: PMC10981018 DOI: 10.1016/j.heliyon.2024.e27872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 11/30/2023] [Accepted: 03/07/2024] [Indexed: 04/04/2024] Open
Abstract
Climate change constitutes one of the greatest threats to human health globally and there have been increasing interests in understanding the dynamics of climate change consciousness particularly in less industrialised countries of Africa. Research on cross-country, sub-regional and continent differences in climate change consciousness are rare especially in sub-Saharan Africa. Thus, to complement the existing body of literature, this study was conducted on cross-national predictors of public climate change consciousness. Data from the Afrobarometer round 7 for thirty-four [34] African countries, collected between 2017 and 2020, were used to investigate the influence of geographical, socio-demographics, and source of information on public consciousness of climate change. Statistical analyses of t-test, ANOVA and multiple regression were conducted to test the formulated hypotheses. Results showed a low level of climate change consciousness (CCC) among participants. Radio news was the major source of information for the sampled African citizens. There were significant differences in the CCC of male and female as well as between urban and rural respondents. Significant differences were also found among the sub-regions, educational levels, age groups and occupations. Sources of information and demographic variables significantly influenced the level of CCC among participating citizens. Educational attainment was the single most potent predictor of climate change consciousness. The study recommends that African citizens need capacity building on climate change awareness and initiatives which would assist in mitigating the effects of climate change.
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Affiliation(s)
- Razaq Olugbenga Azeez
- Department of Educational Foundations and Counselling, Faculty of Education, Olabisi Onabanjo University, Ago-Iwoye, Ogun State, Nigeria
| | - Isaac Tebogo Rampedi
- Department of Geography, Environmental Management and Energy Studies, Faculty of Science, University of Johannesburg, PO Auckland Park, South Africa
| | - Ayodeji Peter Ifegbesan
- Department of Arts and Social Sciences Education, Faculty of Education, Olabisi Onabanjo University, Ago-Iwoye, Ogun State, Nigeria
| | - Biodun Ogunyemi
- Department of Arts and Social Sciences Education, Faculty of Education, Olabisi Onabanjo University, Ago-Iwoye, Ogun State, Nigeria
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Kim C, Chomba M, Phiri A, Fwoloshi S, Claassen CW, Hachaambwa L, Saylor D. Primary headache disorders among people living with HIV in Lusaka, Zambia. J Neurol Sci 2024; 459:122976. [PMID: 38531241 DOI: 10.1016/j.jns.2024.122976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVE We completed a cross-sectional survey study to determine headache prevalence and its association with HIV characteristics among people living with HIV (PLHIV) in Lusaka, Zambia. BACKGROUND Headaches are common but their association with HIV status is unknown. METHODS The HARDSHIP survey, a headache epidemiology questionnaire previously validated in Zambia, was distributed during a 3-month period to 3666 consecutive adult PLHIV attending routine clinic appointments at the Adult Infectious Diseases Centre at the University Teaching Hospital in Lusaka, Zambia. HIV disease characteristics were abstracted from their charts. RESULTS 1015 (27.7%) participants responded to the survey. Adjusted for age, 64% reported having a headache within the last year unrelated to another illness. Among participants, 201 met criteria for migraine (20%), 259 for tension-type headache (26%), 18 for probable medication-overuse headache (2%), and 121 for undetermined headache (12%). Prevalence for tension-type headache was significantly higher than that of migraine (P < 0.001). After adjusting for age and sex, higher CD4 counts were associated with migraine. No other associations were observed between overall headache or headache type with HIV disease characteristics including CD4 count, viral load, antiretroviral regimen, and time since HIV diagnosis. CONCLUSIONS Headaches are highly prevalent among this cohort of PLHIV in Zambia. Optimizing headache treatment and integrating it into routine HIV care may improve quality of life for a substantial proportion of PLHIV in Zambia.
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Affiliation(s)
- Curi Kim
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mashina Chomba
- Department of Medicine, University of Zambia School of Medicine, Lusaka, Zambia
| | - Arnold Phiri
- Department of Medicine, University Teaching Hospital, Lusaka, Zambia
| | - Sombo Fwoloshi
- Department of Medicine, University Teaching Hospital, Lusaka, Zambia
| | - Cassidy W Claassen
- Department of Medicine, University of Zambia School of Medicine, Lusaka, Zambia; Department of Medicine, University Teaching Hospital, Lusaka, Zambia; Center for International Health, Education, and Biosecurity, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Lottie Hachaambwa
- Department of Medicine, University of Zambia School of Medicine, Lusaka, Zambia; Department of Medicine, University Teaching Hospital, Lusaka, Zambia; Center for International Health, Education, and Biosecurity, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Deanna Saylor
- Department of Medicine, University Teaching Hospital, Lusaka, Zambia; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Migowa A, Njeru CM, Were E, Ngwiri T, Colmegna I, Hitchon C, Scuccimarri R. Kawasaki disease in Kenya and review of the African literature. Pediatr Rheumatol Online J 2024; 22:43. [PMID: 38616268 PMCID: PMC11016229 DOI: 10.1186/s12969-024-00977-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Accepted: 03/24/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Kawasaki disease has been described across the globe, although publications from Africa are limited. To our knowledge, there are no publications on Kawasaki disease from Kenya, which triggered this report. METHODS A retrospective cross-sectional study was undertaken to identify in-patients with a discharge diagnosis of Kawasaki disease, over 2 different 5-year periods, at two pediatric hospitals in Nairobi, Kenya. We reviewed the medical records of all patients and report their clinical findings, diagnostic workup and treatment. In addition, we undertook a detailed review of the literature. RESULTS Twenty-three patients with Kawasaki disease were identified, of those 12 (52.2%) had incomplete disease. The mean age was 2.3 years (SD+/-2.2) (range 0.3-10.3) with a male to female ratio of 1:1. The mean duration of fever at diagnosis was 8.3 days (SD+/-4.7) (range 2-20). Oral changes were the most common clinical feature and conjunctivitis the least common. Thrombocytosis at diagnosis was seen in 52% (12/23). Twenty-one patients (91.3%) were treated with intravenous immunoglobulin and all except 1 received aspirin. Baseline echocardiograms were performed in 95.7% (22/23) and found to be abnormal in 3 (13.6%). Follow-up data was limited. Our literature review identified 79 publications with documented cases of Kawasaki disease in children from 22 countries across the African continent with a total of 1115 patients including those from this report. Only 153 reported cases, or 13.7%, are from sub-Saharan Africa. CONCLUSIONS This is the first publication on Kawasaki disease from Kenya and one of the largest reports from sub-Saharan Africa. It is the first to have a complete review of the number of published cases from the African continent. Challenges in the diagnosis and management of Kawasaki disease in many African countries include disease awareness, infectious confounders, access and cost of intravenous immunoglobulin, access to pediatric echocardiography and follow-up. Increasing awareness and health care resources are important for improving outcomes of Kawasaki disease in Africa.
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Affiliation(s)
- A Migowa
- Department of Pediatrics and Child Health, Aga Khan University Medical College (East Africa), Nairobi, Kenya
| | - C M Njeru
- Department of Pediatrics and Child Health, Aga Khan University Medical College (East Africa), Nairobi, Kenya
| | - E Were
- Department of Pediatrics, Gertrude's Children's Hospital, Nairobi, Kenya
| | - T Ngwiri
- Department of Pediatrics, Gertrude's Children's Hospital, Nairobi, Kenya
| | - I Colmegna
- Division of Rheumatology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada
| | - C Hitchon
- Section of Rheumatology, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - R Scuccimarri
- Division of Pediatric Rheumatology, Department of Pediatrics, McGill University Health Centre, 1001 boul. Décarie, A04.6306, H4A 3J1, Montreal, QC, Canada.
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Nashwan AJ, Shaban MM, Kamugisha JB. Bridging the gap: How investing in advanced practice nurses could transform emergency care in Africa. Int Nurs Rev 2024. [PMID: 38613148 DOI: 10.1111/inr.12966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/23/2024] [Indexed: 04/14/2024]
Abstract
AIM This paper aims to highlight the vital importance of investing in advanced practice nursing (APN) for enhancing emergency care throughout Africa. BACKGROUND APN's role is increasingly recognized as pivotal in optimizing healthcare, particularly in emergency settings in Africa. It offers improved patient care quality and strengthens the healthcare workforce. SOURCES OF EVIDENCE Evidence is drawn from successful implementations of APN in various healthcare environments. This includes the development of APN-specific curricula and training, mentorship initiatives, clinical supervision, and defining advanced nursing roles within healthcare organizations. Investing in APNs in emergency care in Africa can lead to improved quality and access to care, cost-effectiveness, enhanced patient outcomes and satisfaction, and opportunities for professional development and career advancement in the healthcare workforce. DISCUSSION Despite facing barriers in implementation, APN in emergency care presents innovative solutions. Investing in APN can help healthcare entities and policymakers surmount these challenges, providing specialized patient care and improving health outcomes. The discussion emphasizes the benefits such as enhanced access to care, reduced healthcare costs, and improved patient outcomes, alongside bolstering the healthcare workforce. CONCLUSION The necessity and benefits of investing in APN for emergency care in Africa are clear. It is crucial for improving healthcare delivery and outcomes. IMPLICATIONS FOR NURSING PRACTICE APN investment leads to a more competent and efficient nursing workforce, capable of addressing complex emergencies and improving patient care. IMPLICATIONS FOR NURSING POLICY AND HEALTH/SOCIAL POLICY The paper advocates for policies that support APN development and integration into the healthcare system, emphasizing the need for research to assess APN's long-term impact and establish best practices for its implementation in emergency care across Africa.
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Affiliation(s)
- Abdulqadir J Nashwan
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
- Department of Nursing, Hamad Medical Corporation, Doha, Qatar
| | - Marwa M Shaban
- Community Health Nursing Department, Faculty of Nursing, Cairo University, Giza, Egypt
| | - John Bosco Kamugisha
- Global Emergency Care, Masaka, Uganda
- Mbarara University of Science and Technology, Mbarara, Uganda
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Dah TTE, De Baetselier I, Cuer B, Anoma C, Mensah E, Koné A, Diandé S, Dagnra CA, Faye-Kette HY, Yeo A, Yaya I, Spire B, Keita BD, Crucitti T, Vuylsteke B, Laurent C. Frequent chlamydia and gonorrhoea but very infrequent syphilis among men who have sex with men using HIV pre-exposure prophylaxis in West Africa. Sex Transm Infect 2024:sextrans-2023-056000. [PMID: 38604698 DOI: 10.1136/sextrans-2023-056000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 01/13/2024] [Indexed: 04/13/2024] Open
Abstract
OBJECTIVES Although oral pre-exposure prophylaxis (PrEP) for HIV is being rolled out in West Africa, data on sexually transmitted infections (STIs) in PrEP users are scarce. We assessed the prevalence, incidence and determinants of bacterial STIs in men who have sex with men (MSM) taking PrEP in Burkina Faso, Côte d'Ivoire, Mali and Togo. METHODS A prospective cohort study among MSM initiating PrEP as part of a comprehensive HIV prevention package was conducted between 2017 and 2021 in community-based clinics in the four study countries. Molecular screening for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) was performed at months 0, 6 and 12. Serological testing for syphilis was performed every 3 months over the first year of follow-up. Determinants of CT and/or NG incidence were identified using Poisson generalised linear mixed models. RESULTS A total of 598 participants with a median age of 24.7 years were included. Prevalence of CT and/or NG was 24.4% (95% CI 21.0 to 28.1), 22.4% (95% CI 18.4 to 26.8) and 29.0% (95% CI 24.2 to 34.1) at months 0, 6 and 12, respectively. The prevalence of syphilis ranged from 0.2% (95% CI 0.0 to 0.9) at month 0 to 0.8% (95% CI 0.2 to 2.4) at month 12. Ninety incident CT and/or NG infections occurred during a total follow-up time of 280.6 person-years (incidence rate 32.1 per 100 person-years, 95% CI 25.8 to 39.4). Three incident syphilis infections were detected during a total follow-up time of 459.7 person-years (incidence rate 0.7 per 100 person-years, 95% CI 0.1 to 1.9). CT and/or NG incidence was associated with condomless insertive anal sex (adjusted incidence rate ratio 1.96, 95% CI 1.04 to 3.71, p=0.038). CONCLUSIONS CT and NG were frequent but syphilis was very infrequent in MSM using HIV PrEP in West Africa. HIV programme managers should integrate STI services into PrEP programmes.
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Affiliation(s)
- Ter Tiero Elias Dah
- Université de Ouahigouya, Ouahigouya, Burkina Faso
- Association African Solidarité, Ouagadougou, Burkina Faso
| | - Irith De Baetselier
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Benjamin Cuer
- TransVIHMI, University of Montpellier, IRD, Inserm, Montpellier, France
| | | | | | - Amadou Koné
- University of Sciences Technics and Technologies, Bamako, Mali
| | - Souba Diandé
- Laboratoire National de Recherche sur la Tuberculose et les Mycobactéries, Ouagadougou, Burkina Faso
| | | | - Hortense Yaobla Faye-Kette
- Département de Bactériologie-Virologie, Institut Pasteur de Côte d'Ivoire, Abidjan, Côte d'Ivoire
- Laboratoire Central, CHU Yopougon, Abidjan, Côte d'Ivoire
| | - Alain Yeo
- Institut Pasteur Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Issifou Yaya
- TransVIHMI, University of Montpellier, IRD, Inserm, Montpellier, France
| | - Bruno Spire
- Aix Marseille Univ, INSERM, IRD, SESSTIM, ISSPAM Marseille France, Marseille, France
| | | | - Tania Crucitti
- Institut Pasteur de Madagascar, Antananarivo, Madagascar
| | - Bea Vuylsteke
- Public Health, Institute of Tropical Medicine, Antwerpen, Belgium
| | - Christian Laurent
- TransVIHMI, University of Montpellier, IRD, Inserm, Montpellier, France
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Khairoun A, Mouillot F, Chen W, Ciais P, Chuvieco E. Coarse-resolution burned area datasets severely underestimate fire-related forest loss. Sci Total Environ 2024; 920:170599. [PMID: 38309343 DOI: 10.1016/j.scitotenv.2024.170599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 02/05/2024]
Abstract
Global coarse-resolution (≥250 m) burned area (BA) products have been used to estimate fire related forest loss, but we hypothesised that a significant part of fire impacts might be undetected because of the underestimation of small fires (<100 ha), especially in the tropics. In this paper, we analysed fire-related forest cover loss in sub-Saharan Africa (SSA) for 2016 and 2019 based on a BA product generated from Sentinel-2 data (20 m), which was observed to have significantly lower omission errors than the coarse-resolution BA products. Using these higher resolution BA datasets, we found that fires contribute to >46 % of total forest losses over SSA, more than twice the estimates from coarse-resolution BA products. In addition, burned forest areas showed more than twofold likelihood of subsequent loss compared to unburned ones. In moist tropical forests, the most fire-vulnerable biome, burning had even six times more chance to precede forest loss than unburned areas. We also found that fire-related characteristics, such as fire size and season, and forest fragmentation play a major role in the determination of tree cover fate. Our results reveal that medium-resolution BA detects more fires in late fire season, which tend to have higher impact on forests than early season ones. On the other hand, small fires represented the major driver of forest loss after fires and the vast majority of these losses occur in fragmented landscapes near forest edge (<260 m). Therefore medium-resolution BA products are required to obtain a more accurate evaluation of fire impacts in tropical ecosystems.
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Affiliation(s)
- Amin Khairoun
- Universidad de Alcalá, Environmental Remote Sensing Research Group, Department of Geology, Geography and the Environment, Colegios 2, 28801 Alcalá de Henares, Spain
| | - Florent Mouillot
- Centre d'Ecologie Fonctionnelle et Evolutive CEFE, UMR 5175, CNRS, Université de Montpellier, Université Paul-Valéry Montpellier, EPHE, IRD, 1919 Route de Mende, 34293 Montpellier Cedex 5, France
| | - Wentao Chen
- Centre d'Ecologie Fonctionnelle et Evolutive CEFE, UMR 5175, CNRS, Université de Montpellier, Université Paul-Valéry Montpellier, EPHE, IRD, 1919 Route de Mende, 34293 Montpellier Cedex 5, France
| | - Philippe Ciais
- Laboratoire des Sciences du Climat et de l'Environnement, LSCE/IPSL, CEA-CNRS-UVSQ, Université Paris-Saclay, Gif-sur-Yvette, France
| | - Emilio Chuvieco
- Universidad de Alcalá, Environmental Remote Sensing Research Group, Department of Geology, Geography and the Environment, Colegios 2, 28801 Alcalá de Henares, Spain.
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Li W, Sun H, Khan A, Gillies R. A qualitative study of career decision making among African and Asian international medical students in China: process, challenges, and strategies. Adv Health Sci Educ Theory Pract 2024:10.1007/s10459-024-10329-z. [PMID: 38592598 DOI: 10.1007/s10459-024-10329-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/31/2024] [Indexed: 04/10/2024]
Abstract
China hosts around 68,000 international medical students (IMSs) primarily from lower income countries in Africa and Asia, who have the potential to contribute to international medical services. Understanding how these IMSs make career decisions can help better address the issue of global medical workforce shortage. However, such research is limited. Our study aims to explore the career decision-making process of China-educated IMSs, the challenges they experienced and the strategies they employed.In this exploratory qualitative study, we conducted semi-structured interviews with IMSs educated in China in 2022 using purposeful sampling. Twenty virtual one-on-one interviews were conducted, and data were analysed through directed qualitative content analysis. Cognitive Information Processing (CIP) theory was applied as the guiding framework for organising and analysing the data.The career decision-making process of the participants generally followed the stages of decision-making cycle in CIP theory, with a combination of urgent migration decisions and specialisation considerations adding layers of complexity to their career trajectories. Identified challenges encompassed lack of knowledge about oneself and career options, lack of decision-making skills, concerns of contextual complexities that limited the career decision-making process, low motivation and negative thoughts. Specific challenges due to their role as IMSs arose, which were related to career information access, self-capability evaluation, degree accreditation, employment competitiveness and mental states. Participants' proposed strategies were categorised into personal and institutional aspects, providing insights into addressing these challenges.This study substantiates and expands the application of the CIP theory within the sphere of the particular cultural and educational context of IMSs educated in China. It highlights the significance of integrating migration decision-making into career guidance for IMSs, and contributes to the literature by proposing an evidence-based tiered career intervention programme for IMSs.
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Affiliation(s)
- Wen Li
- School of Education, Faculty of Humanities and Social Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia.
| | - Hong Sun
- School of Basic Medicine, Xuzhou Medical University, Xuzhou, 221004, China
| | - Asaduzzaman Khan
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Robyn Gillies
- School of Education, Faculty of Humanities and Social Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia.
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Bertola LD, Quinn L, Hanghøj K, Garcia-Erill G, Rasmussen MS, Balboa RF, Meisner J, Bøggild T, Wang X, Lin L, Nursyifa C, Liu X, Li Z, Chege M, Moodley Y, Brüniche-Olsen A, Kuja J, Schubert M, Agaba M, Santander CG, Sinding MHS, Muwanika V, Masembe C, Siegismund HR, Moltke I, Albrechtsen A, Heller R. Giraffe lineages are shaped by major ancient admixture events. Curr Biol 2024; 34:1576-1586.e5. [PMID: 38479386 DOI: 10.1016/j.cub.2024.02.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 09/29/2023] [Accepted: 02/21/2024] [Indexed: 04/11/2024]
Abstract
Strong genetic structure has prompted discussion regarding giraffe taxonomy,1,2,3 including a suggestion to split the giraffe into four species: Northern (Giraffa c. camelopardalis), Reticulated (G. c. reticulata), Masai (G. c. tippelskirchi), and Southern giraffes (G. c. giraffa).4,5,6 However, their evolutionary history is not yet fully resolved, as previous studies used a simple bifurcating model and did not explore the presence or extent of gene flow between lineages. We therefore inferred a model that incorporates various evolutionary processes to assess the drivers of contemporary giraffe diversity. We analyzed whole-genome sequencing data from 90 wild giraffes from 29 localities across their current distribution. The most basal divergence was dated to 280 kya. Genetic differentiation, FST, among major lineages ranged between 0.28 and 0.62, and we found significant levels of ancient gene flow between them. In particular, several analyses suggested that the Reticulated lineage evolved through admixture, with almost equal contribution from the Northern lineage and an ancestral lineage related to Masai and Southern giraffes. These new results highlight a scenario of strong differentiation despite gene flow, providing further context for the interpretation of giraffe diversity and the process of speciation in general. They also illustrate that conservation measures need to target various lineages and sublineages and that separate management strategies are needed to conserve giraffe diversity effectively. Given local extinctions and recent dramatic declines in many giraffe populations, this improved understanding of giraffe evolutionary history is relevant for conservation interventions, including reintroductions and reinforcements of existing populations.
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Affiliation(s)
- Laura D Bertola
- Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Liam Quinn
- Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Kristian Hanghøj
- Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Renzo F Balboa
- Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Jonas Meisner
- Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Bøggild
- Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Xi Wang
- Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Long Lin
- Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Casia Nursyifa
- Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Xiaodong Liu
- Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Zilong Li
- Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Mumbi Chege
- Institute of Environmental Sciences (CML), Leiden University, Leiden, The Netherlands; Wildlife Research and Training Institute, Naivasha, Kenya
| | - Yoshan Moodley
- Department of Biological Sciences, University of Venda, Private Bag X5050, Thohoyandou 0950, Republic of South Africa
| | | | - Josiah Kuja
- Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Mikkel Schubert
- Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Morris Agaba
- School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Nelson Mandela Road, Arusha, Tanzania
| | - Cindy G Santander
- Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | | | - Vincent Muwanika
- College of Agricultural and Environmental Sciences, Makerere University, P.O. Box 7062, Kampala, Uganda
| | - Charles Masembe
- College of Natural Sciences, Makerere University, P O. Box 7062, Kampala, Uganda
| | - Hans R Siegismund
- Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Ida Moltke
- Department of Biology, University of Copenhagen, Copenhagen, Denmark.
| | | | - Rasmus Heller
- Department of Biology, University of Copenhagen, Copenhagen, Denmark.
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Nguea SM. Combining the role of urbanization and renewable energy in sustainable development: testing the EKC hypothesis for Africa. Environ Sci Pollut Res Int 2024:10.1007/s11356-024-33175-3. [PMID: 38581630 DOI: 10.1007/s11356-024-33175-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 03/28/2024] [Indexed: 04/08/2024]
Abstract
The pressing necessity to curb greenhouse gas emissions due to climate change has sparked significant scientific interest in comprehending the factors behind CO2 emissions, particularly concerning environmental sustainability challenges. Nonetheless, there exists a notable gap in our understanding of how the process of urbanization interacts with the utilization of renewable energy to impact CO2 emissions. This research endeavor seeks to evaluate the complex interplay among urbanization, renewable energy, and CO2 emissions across 46 African nations spanning from 1990 to 2019. To accomplish this objective, a variety of econometric methodologies are employed, including Driscoll-Kraay standard errors, IV-GMM, and method of moments quantile regression (MMQR) panel estimations to address issues like cross-sectional dependencies, endogeneity, heterogeneity, and panel Granger causality examination. The empirical results suggest that urbanization leads to an increase in CO2 emissions, whereas the consumption of renewable energy plays a role in enhancing environmental quality by reducing CO2 emissions. A significant outcome of the study is the revelation that a combination of urbanization and renewable energy leads to a decrease in carbon emissions. Moreover, the Environmental Kuznets Curve (EKC) hypothesis is validated. Lastly, through the Dumitrescu-Hurlin panel causality test, it is uncovered that urbanization and renewable energy consumption exhibit a bidirectional relationship with CO2 emissions. To reduce dependence on fossil fuels and curb CO2 emissions, policymakers should promote renewable energy usage in urban areas.
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Billings BK, Kramer B, Augustine TN, Brits D, Hutchinson EF, Libhaber E, Štrkalj G. Leading the transition to ethical human body sourcing in Africa: The South African experience. Ann Anat 2024; 254:152263. [PMID: 38588731 DOI: 10.1016/j.aanat.2024.152263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/01/2024] [Accepted: 04/04/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND The use of human bodies for anatomy education and research forms an integral part of the training of health professionals around the world. However, the ethical acquisition of human remains for this purpose has been a challenge in many countries, particularly for those on the African continent. South African institutions have however, been able to progressively transition to a more ethical approach to human body acquisition. The aim of the current study was to investigate the provenance of human bodies and the number used in South African health sciences institutions during the period 2017-2021. METHODS an online self-administered anonymised questionnaire was circulated to all health sciences institutions in South Africa. Questions were focused on establishing the provenance and the associated number of bodies and body donor programmes. RESULTS responses were received from thirteen of the fourteen South African institutions. All thirteen institutions use human bodies for teaching and research, with the majority of the institutions being reliant on bequests (77%) and family donations (62%), and less on unclaimed remains (46%). Most institutions have established body donor programmes. Four institutions were negatively affected by the effects of the pandemic. Memorial services, which continued during the pandemic, were conducted by eight of the thirteen institutions. CONCLUSION South Africa is leading the transition to the ethical acquisition of human remains on the African continent. It is hoped that South African institutions will soon transform to the exclusive sourcing of bodies through willed donation and provide guidance and support for the other countries on the continent.
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Affiliation(s)
- Brendon K Billings
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Beverley Kramer
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Tanya N Augustine
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Desiré Brits
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Erin F Hutchinson
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Elena Libhaber
- Health Sciences Research Office, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Goran Štrkalj
- Department of Anatomy, Faculty of Medicine and Health, The University of New South Wales, Sydney, Australia
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Morang’a AK, Muloi DM, Kamau SM, Onono JO, Gathura PB, Moodley A. Mapping the flow of veterinary antibiotics in Kenya. Front Vet Sci 2024; 11:1304318. [PMID: 38645649 PMCID: PMC11027570 DOI: 10.3389/fvets.2024.1304318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 03/14/2024] [Indexed: 04/23/2024] Open
Abstract
Introduction To effectively regulate and reduce antibiotic use, in the livestock sector, a thorough understanding of the flow of veterinary antibiotics will help to identify key nodes in the chain for targeted interventions. The aim of this study was to understand the flow of antibiotics from import to end-user, and identify relevant governance mechanisms. Methods A mixed methods approach was used to collect data in three Kenyan counties (Nairobi, Kiambu, and Kajiado). Focus group discussions (n = 23), individual interviews (n = 148), and key informant interviews (n = 10) were conducted. Results The key actors identified include primary wholesalers, secondary wholesalers, retailers, animal health service providers (AHSPs), and farmers. Kenya imports 100% of its veterinary antibiotics: primary wholesalers legally import antibiotics as finished pharmaceutical products (90%) or active pharmaceutical ingredients (10%) after approval by the Veterinary Medicines Directorate. Secondary wholesalers play a major role in the distribution of antibiotics (60% of antibiotics) from importers to farmers, AHSPs, and retailers. Some of the illegal sources of antibiotics include unlicenced/unauthorized middlemen and online platforms that sell directly to retailers, AHSPs, and farmers. Discussion Despite the presence of various laws and regulations governing the antibiotic value chain, implementation has been a challenge due to financial and human resource constraints. This contributes to over-the-counter sale of antibiotics without prescription, unlicensed businesses selling antibiotics, illegal importation, and presence of poor-quality drugs. There is a need to review the applicability of existing policies and address policy gaps (e.g., product containing antibiotic combinations, and use of human critically important antibiotics) to ensure the prudent sale and use of antibiotics, pharmacovigilance, antimicrobial use surveillance, and developing a business model that aligns with antibiotic stewardship. Additional interventions include awareness raising and capacity building of the different stakeholders along the antibiotic distribution chain to reduce antibiotic mis- and overuse.
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Affiliation(s)
- Alexina K. Morang’a
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, Kenya
- Department of Public Health, Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Nairobi, Nairobi, Kenya
| | - Dishon M. Muloi
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, Kenya
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Simon M. Kamau
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, Kenya
- Department of Public Health, Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Nairobi, Nairobi, Kenya
| | - Joshua O. Onono
- Department of Public Health, Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Nairobi, Nairobi, Kenya
| | - Peter B. Gathura
- Department of Public Health, Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Nairobi, Nairobi, Kenya
| | - Arshnee Moodley
- Animal and Human Health Program, International Livestock Research Institute, Nairobi, Kenya
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
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Torimiro JNE, Duri K, Goumkwa NM, Atah SM, Ndzie Ondigui JL, Lobe C, Bouyou M, Ndeboko B, Mahamat Moussa A, Police C, Awoumou P, Peyonga P, Djivida PV, Felix A, Nchinda GW, Wandji B, Simo RK, Agnès Moudourou S, Gutierrez A, Garcia R, Fernandez I, Mah E, Rowland-Jones S, Mbu R. Toward the elimination of hepatitis B: networking to promote the prevention of vertical transmission of hepatitis B virus through population-based interventions and multidisciplinary groups in Africa. Front Public Health 2024; 12:1283350. [PMID: 38645447 PMCID: PMC11026850 DOI: 10.3389/fpubh.2024.1283350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/16/2024] [Indexed: 04/23/2024] Open
Abstract
The WHO African Region had 81 million people with chronic hepatitis B in 2019, which remains a silent killer. Hepatitis B virus (HBV), hepatitis delta virus (HDV), and HIV can be transmitted from the mother to child. If the HBV infection is acquired at infancy, it may lead to chronic hepatitis B in 90% of the cases. WHO reports that 6.4 million children under 5 years live with chronic hepatitis B infection worldwide. The prevention of mother-to-child transmission (PMTCT) of HBV is therefore critical in the global elimination strategy of viral hepatitis as we take lessons from PMTCT of HIV programs in Africa. We sought to create a network of multidisciplinary professional and civil society volunteers with the vision to promote cost-effective, country-driven initiatives to prevent the MTCT of HBV in Africa. In 2018, the Mother-Infant Cohort Hepatitis B Network (MICHep B Network) with members from Cameroon, Zimbabwe, and the United Kingdom and later from Chad, Gabon, and Central African Republic was created. The long-term objectives of the network are to organize capacity-building and networking workshops, create awareness among pregnant women, their partners, and the community, promote the operational research on MTCT of HBV, and extend the network activities to other African countries. The Network organized in Cameroon, two "Knowledge, Attitude and Practice" (KAP) surveys, one in-depth interview of 45 health care workers which revealed a high acceptability of the hepatitis B vaccine by families, two in-person workshops in 2018 and 2019, and one virtual in 2021 with over 190 participants, as well as two workshops on grant writing, bioethics, and biostatistics of 30 postgraduate students. Two HBV seroprevalence studies in pregnant women were conducted in Cameroon and Zimbabwe, in which a prevalence of 5.8% and 2.7%, respectively, was reported. The results and recommendations from the MICHep B Network activities could be implemented in countries of the MICHep B Network and beyond, with the goal of providing free birth dose vaccine against hepatitis B in Africa.
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Affiliation(s)
- Judith Ndongo Embola Torimiro
- Molecular Biology Laboratory, Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
- Department of Biochemistry, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Kerina Duri
- Department of Immunology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Nadège M. Goumkwa
- Molecular Biology Laboratory, Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
| | - Solange M. Atah
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | | | - Cindy Lobe
- Molecular Biology Laboratory, Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
- Department of Food Science and Nutrition, University of Ngaoundere, Ngaoundere, Cameroon
| | - Marielle Bouyou
- Department of Parasitology, Mycology and Tropical Medicine, University of Health Sciences, Libreville, Gabon
| | - Bénédicte Ndeboko
- Department of Cell and Molecular Biology-Genetics, Faculty of Medicine, University of Health Sciences, Libreville, Gabon
- Centre Hospitalier Universitaire Mère-Enfant de la Fondation Jeanne EBORI (CHUMEFJE), Libreville, Gabon
| | - Ali Mahamat Moussa
- Gastroenterology and Internal Medicine Unit, University Reference Hospital, Gamena, Chad
| | - Camengo Police
- Department of Hepato-Gastroenterology and Internal Medicine of “Amitié Sino Centrafraine”, University Hospital Center, Bangui, Central African Republic
| | - Patrick Awoumou
- Molecular Biology Laboratory, Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
- Department of Biochemistry, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Puinta Peyonga
- Department of Biochemistry, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Prisca V. Djivida
- Department of Biochemistry, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Assah Felix
- Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Godwin W. Nchinda
- Vaccinology Laboratory, Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
| | - Brigitte Wandji
- Yaoundé Gynaecology, Obstetrics and Pediatrics Hospital, Yaoundé, Cameroon
| | - Rachel K. Simo
- Clinical Diagnostic Laboratory, Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
| | - Sylvie Agnès Moudourou
- Medical Unit, Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
| | | | - Rosi Garcia
- Bikop Catholic Health Center, Bikop, Cameroon
| | | | - Evelyn Mah
- Yaoundé Gynaecology, Obstetrics and Pediatrics Hospital, Yaoundé, Cameroon
- Department of Paediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Sarah Rowland-Jones
- Molecular Biology Laboratory, Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaoundé, Cameroon
- Nuffield Department of Medicine, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
| | - Robinson Mbu
- Yaoundé Gynaecology, Obstetrics and Pediatrics Hospital, Yaoundé, Cameroon
- Department of Gynaecology and Obstetrics, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
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Muganzi DJ, Namara CM, Kintu TM, Atulinda L, Kihumuro RB, Ahaisibwe B, Montori VM. Paving the Path to Patient-Centered Healthcare in Africa: Insights From a Student Led Initiative. Ann Glob Health 2024; 90:27. [PMID: 38618271 PMCID: PMC11012222 DOI: 10.5334/aogh.4250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 01/23/2024] [Indexed: 04/16/2024] Open
Abstract
Patient-centered care (PCC) is a key domain of healthcare quality. Its importance is driven by evidence-based medicine, the predominance of chronic conditions requiring self-care, and the recognition of the priority of patient goals, values, priorities, and preferences in determining care plans. This article emphasizes the urgent need for Africa to develop PCC and a workforce committed to its implementation, as well as highlights an initiative by African medical students to champion PCC continent-wide. Embracing this transformative approach presents Africa with an unprecedented opportunity to improve care for each person. Through a comprehensive exploration of unique strategies and considerations in African health professions education, this viewpoint seeks to spark dialogue and inspire action towards a future where patient-centered care is the foundation of healthcare delivery in Africa.
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Affiliation(s)
- David Jolly Muganzi
- Patient Centered Care movement Africa (PaCeM-Afro), Kampala, Uganda
- The Patient Revolution, Inc, United States
| | | | - Timothy Mwanje Kintu
- Patient Centered Care movement Africa (PaCeM-Afro), Kampala, Uganda
- African Center of Excellence in Bioinformatics and Data Intensive Sciences, Makerere, University, Kampala, Uganda
| | - Linda Atulinda
- Patient Centered Care movement Africa (PaCeM-Afro), Kampala, Uganda
| | | | | | - Victor M. Montori
- The Patient Revolution, Inc, United States
- Knowledge and Evaluation Research Unit, Mayo Clinic (Rochester, Minnesota), United States
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Desclaux A, Sow K, Sams K. Uncertainties beyond preparedness: COVID-19 vaccination in Senegal. J Biosoc Sci 2024:1-21. [PMID: 38572543 DOI: 10.1017/s0021932024000075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Vaccination is one of the most recognised strategies in public health for preventing the spread of epidemics, and the availability of a vaccine is often expected by health actors to be a 'game-changer'. However, the COVID-19 (coronavirus disease 2019) vaccine in Senegal was not the magic bullet that the international community expected. A very low vaccination coverage rate (less than 10% by April 2023) was observed in this country, once considered a model in West Africa for its epidemic response. Beyond the population's alleged hesitancy to be vaccinated, was a lack of preparedness to blame? Previous analyses show that outbreak preparation limited to standard interventions is not sufficient in the face of the social, cultural, and political configurations of each epidemic context and that uncertainty limits response capacity. This paper examines the social life of the COVID-19 vaccine to identify the forms and contextual dimensions of uncertainty related to immunisation in Senegal. The authors explore how vaccination was implemented and compare experiences with the preparedness process, to offer insight on uncertainties. Using Stirling's theoretical model that defines various expressions of incertitude, the authors identify four nexuses at various stages of the social life of COVID-19 vaccine in Senegal: (1) material uncertainty related to vaccine availability, (2) ambiguity of the population about the purpose of vaccination and the risks of the disease, (3) uncertainty related to side effects, and (4) uncertainty about vaccination strategies shared by scientific and health authorities. These uncertainties were only partly considered in the preparedness process, for they are related to systemic structural dimensions and reflect the impact of global/regional powers on the local level. The findings of this research are relevant not only to support better communication around vaccines in Senegal but also more generally to the prevention of emerging epidemics shaped by human behaviours.
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Affiliation(s)
- Alice Desclaux
- IRD, TransVIHMI (University of Montpellier, French Research Institute for Sustainable Development IRD, INSERM), Montpellier, France
- Centre Régional de Recherche et de Formation à la prise en charge (CRCF), Fann University Hospital, Dakar, Senegal
| | - Khoudia Sow
- Centre Régional de Recherche et de Formation à la prise en charge (CRCF), Fann University Hospital, Dakar, Senegal
| | - Kelley Sams
- Center for Arts in Medicine, University of Florida, Gainesville, FL, USA
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Ndlovu N, Mataka A, Lombard C, Erasmus RT, Zemlin AE. Survey and situation analysis of personal, employer-related, and environmental factors affecting participation in continuous professional development (CPD) programs of laboratory professionals in Africa. Am J Clin Pathol 2024; 161:360-368. [PMID: 38035716 DOI: 10.1093/ajcp/aqad154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/13/2023] [Indexed: 12/02/2023] Open
Abstract
OBJECTIVES To determine the level and evaluate factors affecting the participation of laboratory professionals in continuous professional development (CPD) programs in eastern and southern Africa. METHODS A survey was conducted among laboratory professionals from 14 countries. The CPD participation was defined as low if it was fewer than 2 CPD trainings in the past 2 years. Associations between categorical variables were tested for significance using Fisher exact test. RESULTS Of the expected 400, 283 (70% response rate) individuals participated in the survey. Of these, 153 (54%) had low CPD participation and 199 (70%) were aware of CPD educational activities in their respective country. Those with diploma certificates attended more CPD programs (P < .001) than those with undergraduate and master's degrees. Awareness of CPD programs was associated with a higher level of CPD participation (P = .0001). Job satisfaction was significantly associated with high levels of CPD participation (P = .02). Other factors associated with high level of participation in CPD programs included affordability (P = .03), funding by employer (P = .0005), and awareness of legal CPD requirements (P = .002). CONCLUSIONS The CPD programs are considered useful to an individual's professional development, although there was low participation. It is recommended that different formats and platforms be used to expand CPD programs.
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Affiliation(s)
- Nqobile Ndlovu
- African Society for Laboratory Medicine, Johannesburg, South Africa
| | - Anafi Mataka
- African Society for Laboratory Medicine, Johannesburg, South Africa
| | - Carl Lombard
- Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Rajiv T Erasmus
- Division of Chemical Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa
| | - Annalise E Zemlin
- Division of Chemical Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa
- Division of Chemical Pathology, National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa
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Bourdon C, Diallo AH, Mohammad Sayeem Bin Shahid AS, Khan MA, Saleem AF, Singa BO, Gnoumou BS, Tigoi C, Otieno CA, Oduol CO, Lancioni CL, Manyasi C, McGrath CJ, Maronga C, Lwanga C, Brals D, Ahmed D, Mondal D, Denno DM, Mangale DI, Chimwezi E, Mbale E, Mupere E, Salauddin Mamun GM, Ouédraogo I, Berkley JA, Njunge JM, Njirammadzi J, Mukisa J, Thitiri J, Walson JL, Jemutai J, Tickell KD, Shahrin L, Mallewa M, Hossain MI, Chisti MJ, Timbwa M, Mburu M, Ngari MM, Ngao N, Aber P, Harawa PP, Sukhtankar P, Bandsma RH, Bamouni RM, Molyneux S, Mwaringa S, Shaima SN, Ali SA, Afsana SM, Banu S, Ahmed T, Voskuijl WP, Kazi Z. Childhood growth during recovery from acute illness in Africa and South Asia: a secondary analysis of the childhood acute illness and nutrition (CHAIN) prospective cohort. EClinicalMedicine 2024; 70:102530. [PMID: 38510373 PMCID: PMC10950691 DOI: 10.1016/j.eclinm.2024.102530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/22/2024] Open
Abstract
Background Growth faltering is well-recognized during acute childhood illness and growth acceleration during convalescence, with or without nutritional therapy, may occur. However, there are limited recent data on growth after hospitalization in low- and middle-income countries. Methods We evaluated growth following hospitalization among children aged 2-23 months in sub-Saharan Africa and South Asia. Between November 2016 and January 2019, children were recruited at hospital admission and classified as: not-wasted (NW), moderately-wasted (MW), severely-wasted (SW), or having nutritional oedema (NO). We describe earlier (discharge to 45-days) and later (45- to 180-days) changes in length-for-age [LAZ], weight-for-age [WAZ], mid-upper arm circumference [MUACZ], weight-for-length [WLZ] z-scores, and clinical, nutritional, and socioeconomic correlates. Findings We included 2472 children who survived to 180-days post-discharge: NW, 960 (39%); MW, 572 (23%); SW, 682 (28%); and NO, 258 (10%). During 180-days, LAZ decreased in NW (-0.27 [-0.36, -0.19]) and MW (-0.23 [-0.34, -0.11]). However, all groups increased WAZ (NW, 0.21 [95% CI: 0.11, 0.32]; MW, 0.57 [0.44, 0.71]; SW, 1.0 [0.88, 1.1] and NO, 1.3 [1.1, 1.5]) with greatest gains in the first 45-days. Of children underweight (<-2 WAZ) at discharge, 66% remained underweight at 180-days. Lower WAZ post-discharge was associated with age-inappropriate nutrition, adverse caregiver characteristics, small size at birth, severe or moderate anaemia, and chronic conditions, while lower LAZ was additionally associated with household-level exposures but not with chronic medical conditions. Interpretation Underweight and poor linear growth mostly persisted after an acute illness. Beyond short-term nutritional supplementation, improving linear growth post-discharge may require broader individual and family support. Funding Bill & Melinda Gates FoundationOPP1131320; National Institute for Health ResearchNIHR201813.
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Affiliation(s)
- Celine Bourdon
- Translational Medicine, Hospital for Sick Children, Toronto, ON, Canada
| | - Abdoulaye Hama Diallo
- Department of Public Health, University Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
- Department of Public Health, Centre Muraz Research Institute, Bobo-Dioulasso, Burkina Faso
| | | | - Md Alfazal Khan
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Ali Faisal Saleem
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | | | | | - Caroline Tigoi
- Clinical Research Department, KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | | | | | | | | | - Christine J. McGrath
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Christopher Maronga
- Clinical Research Department, KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
| | - Christopher Lwanga
- Uganda-Case Western Reserve University Research Collaboration, Kampala, Uganda
| | - Daniella Brals
- Department of Global Health, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Dilruba Ahmed
- Clinical Microbiology and Immunology Laboratory, Office of Executive Director, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Dinesh Mondal
- Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Donna M. Denno
- Department of Global Health, University of Washington, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
| | | | - Emmanuel Chimwezi
- Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Emmie Mbale
- Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Ezekiel Mupere
- Department of Paediatrics and Child Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Gazi Md Salauddin Mamun
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Issaka Ouédraogo
- Department of Pediatrics, Banfora Referral Regional Hospital, Banfora, Burkina Faso
| | - James A. Berkley
- Clinical Research Department, KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - James M. Njunge
- Clinical Research Department, KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
| | - Jenala Njirammadzi
- Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - John Mukisa
- Department of Immunology and Department of Molecular Biology Makerere University College of Health Sciences, Kampala, Uganda
| | - Johnstone Thitiri
- Clinical Research Department, KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
| | - Judd L. Walson
- Departments of International Health and Medicine, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Julie Jemutai
- Clinical Research Department, KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
| | - Kirkby D. Tickell
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Lubaba Shahrin
- Hospitals, Office of Executive Director, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Macpherson Mallewa
- Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Md Iqbal Hossain
- Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammod Jobayer Chisti
- Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Molline Timbwa
- Clinical Research Department, KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
| | - Moses Mburu
- Clinical Research Department, KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
| | - Moses M. Ngari
- Clinical Research Department, KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
| | - Narshion Ngao
- Clinical Research Department, KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
| | - Peace Aber
- Uganda-Case Western Reserve University Research Collaboration, Kampala, Uganda
| | - Philliness Prisca Harawa
- Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Priya Sukhtankar
- Clinical Research Department, KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Robert H.J. Bandsma
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Sassy Molyneux
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
- Health Systems and Research Ethics Department, KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
| | - Shalton Mwaringa
- Clinical Research Department, KEMRI–Wellcome Trust Research Programme, Kilifi, Kenya
| | - Shamsun Nahar Shaima
- Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Syed Asad Ali
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
| | - Syeda Momena Afsana
- Clinical Biochemistry Laboratory, Office of Executive Director, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Sayera Banu
- Infectious Diseases Division, International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Tahmeed Ahmed
- Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
- Office of Executive Director, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Wieger P. Voskuijl
- Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi
- Amsterdam UMC, Location University of Amsterdam, Amsterdam Institute for Global Child Health, Emma Children’s Hospital, Meibergdreef 9, Amsterdam, the Netherlands
- Amsterdam UMC, Location University of Amsterdam, Department of Global Health, Amsterdam Institute for Global Health and Development, Meibergdreef 9, Amsterdam, the Netherlands
| | - Zaubina Kazi
- Department of Pediatrics and Child Health, Aga Khan University, Karachi, Pakistan
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Lawton BP, Hallmark SL, Basulto-Elias G, Obeng DA, Ackaah W. Understanding the relationship between road users and the roadway infrastructure in Ghana. Accid Anal Prev 2024; 198:107475. [PMID: 38309150 DOI: 10.1016/j.aap.2024.107475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 01/02/2024] [Accepted: 01/10/2024] [Indexed: 02/05/2024]
Abstract
Ghana exemplifies the contribution of road crashes to mortality and morbidity in Africa, partly due to a growing population and increasing car ownership, where fatalities have increased by 12 to 15 % annually since 2008 (National Road Safety Authority (NRSA), 2017). The study described in this paper focused on understanding driver behavior at unsignalized junctions in the Ashanti Region of Ghana. Understanding driver behavior at unsignalized junctions is particularly important since failure to stop or yield can seriously affect vulnerable road users. The study's objectives were to develop relationships between driver behavior and junction characteristics. Understanding the characteristics that lead to determining what factors influence a driver's behavioral response at rural junctions provides information for policy makers to determine the best strategies to address these behaviors. The study evaluated stopping behavior at rural junctions. Driver behavior was extracted from video views of ten junctions in the Ashanti Region of Ghana. A total of 3,420 vehicles were observed across all ten junctions during data collection before any analysis was conducted. The type of stop was selected as a surrogate measure of safety. Logistic regression was used to model stopping behavior at the selected junctions. The analysis showed drivers were more likely to stop when going straight (versus a left turn) and left turning vehicles were more likely to stop than right turning vehicles. Additionally, single unit trucks and tro-tros were more likely to stop than other vehicle types. Drivers were also much more likely to stop when channelization, intersection lighting, or speed humps were present. Drivers at junctions with 4-approaches were also more likely to stop than those with 3 approaches. The results from this research contribute valuable information about what factors contribute to positive safety behaviors at rural junctions. This provides guidance for safety professionals to select solutions and can be a valuable tool to predict the economical effectiveness of solutions to addressing junction safety in low- and middle-income countries (LMIC) such as Ghana. The results can also provide insight and recommendations to Ghanaian road safety agencies and launch sustainable efforts to raise community awareness toward decreasing road crash fatalities in Ghana.
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Oyeyemi OV, Rais MA, Eguavoen OG, Oluwaferanmi A, Abdalazez H, Osunronbi T. Oral and Maxillofacial Surgery: Availability of Specialist Training and Different Training Pathways across Africa. J West Afr Coll Surg 2024; 14:199-207. [PMID: 38562390 PMCID: PMC10980326 DOI: 10.4103/jwas.jwas_112_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/31/2023] [Indexed: 04/04/2024]
Abstract
Background Oral and maxillofacial surgery (OMFS) is the surgical specialty concerned with the treatment of a broad range of conditions that affect the head, face, mouth, neck, and jaw. In Africa, there is a paucity of information about the specialist training available to aspiring African Oral and Maxillofacial Surgeons. Objective This paper aimed at shedding light on the available OMFS specialist training programmes and training pathways across Africa. Materials and Methods The authors searched on PubMed, AJOL, and Google Scholar using the keywords "Africa," "Oral and Maxillofacial Surgery," "Residency," "Postgraduate," and "Education" and the individual African countries in English and official languages from inception till July 11, 2022. The authors utilised a questionnaire to interview native oral and maxillofacial surgeons and dentists in African countries where there were no published data on OMFS specialist training. Results A total of 21 (38.8%) African countries had OMFS specialist training programmes (n = 69). The duration of training varies between 2 and 7 years. The number of training programmes per country ranges between one and thirteen. Countries with the most training programmes for OMFS in Africa are Nigeria, Egypt, Sudan, and Algeria. Northern Africa and Central Africa had the most and least numbers of specialist training programmes in OMFS, respectively. Conclusion There remains a disparity in the number of specialist training programmes available to aspiring African Oral and Maxillofacial Surgeons as compared with other parts of the world. This paper is intended to function both as a means of advocacy to increase funding and resources in support of the infrastructure and development of facilities for African OMFS specialist training programmes and also serve as a valuable reference for future research in OMFS.
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Affiliation(s)
- Opeyemi Victor Oyeyemi
- Maxillofacial Surgery Section, Surgery Interest Group of Africa, Zaria, Nigeria
- Department of Dental Surgery, Ahmadu Bello University, Zaria, Nigeria
| | | | | | | | - Hager Abdalazez
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Lindquist L, Kilembe W, Karita E, Price MA, Kamali A, Kaleebu P, Tang J, Allen S, Hunter E, Gilmour J, Rowland-Jones SL, Sanders EJ, Hassan AS, Esbjörnsson J. HLA-A*23 Is Associated With Lower Odds of Acute Retroviral Syndrome in Human Immunodeficiency Virus Type 1 Infection: A Multicenter Sub-Saharan African Study. Open Forum Infect Dis 2024; 11:ofae129. [PMID: 38560608 PMCID: PMC10977907 DOI: 10.1093/ofid/ofae129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/11/2024] [Indexed: 04/04/2024] Open
Abstract
The role of human leukocyte antigen (HLA) class I and killer immunoglobulin-like receptor molecules in mediating acute retroviral syndrome (ARS) during human immunodeficiency virus type 1 (HIV-1) infection is unclear. Among 72 sub-Saharan African adults, HLA-A*23 was associated with lower odds of ARS (adjusted odds ratio, 0.10 [95% confidence interval, .01-.48]; P = .009), which warrants further studies to explore its role on HIV-1-specific immunopathogenesis.
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Affiliation(s)
- Lovisa Lindquist
- Lund University Centre, Lund University, Lund, Sweden
- Department of Translational Medicine, Lund University, Lund, Sweden
| | - William Kilembe
- Rwanda/Zambia HIV Research Group, Kigali, Rwanda and Lusaka, Zambia
| | - Etienne Karita
- Rwanda/Zambia HIV Research Group, Kigali, Rwanda and Lusaka, Zambia
| | - Matt A Price
- International AIDS Vaccine Initiative, New York, New York, USA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | | | - Pontiano Kaleebu
- Medical Research Council/Uganda Virus Centre Research Institute, Entebbe, Uganda
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jianming Tang
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Susan Allen
- Rwanda/Zambia HIV Research Group, Kigali, Rwanda and Lusaka, Zambia
- Emory Vaccine Center, Emory University, Atlanta, Georgia, USA
| | - Eric Hunter
- Rwanda/Zambia HIV Research Group, Kigali, Rwanda and Lusaka, Zambia
- Emory Vaccine Center, Emory University, Atlanta, Georgia, USA
| | - Jill Gilmour
- International AIDS Vaccine Initiative, New York, New York, USA
- Human Immunology Laboratory, International AIDS Vaccine Initiative, London, United Kingdom
| | - Sarah L Rowland-Jones
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Eduard J Sanders
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
- Aurum Institute, Johannesburg, South Africa
| | - Amin S Hassan
- Lund University Centre, Lund University, Lund, Sweden
- Department of Translational Medicine, Lund University, Lund, Sweden
- Kenya Medical Research Institute/Wellcome Trust Research Programme, Kilifi, Kenya
| | - Joakim Esbjörnsson
- Lund University Centre, Lund University, Lund, Sweden
- Department of Translational Medicine, Lund University, Lund, Sweden
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
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McClanahan TR. Usage and coordination of governance principles to address proximate and distal drivers of conflicts in fisheries commons. Conserv Biol 2024; 38:e14178. [PMID: 37700665 DOI: 10.1111/cobi.14178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 08/23/2023] [Accepted: 08/31/2023] [Indexed: 09/14/2023]
Abstract
Commons' problems and solutions have the elements of local, proximate, and large-scale distal processes. Solutions, therefore, require accessing, implementing, and coordinating information and actions at multiple scales. Restoring commons, such as fisheries, will require a better understanding of how stakeholders access and use information at various scales to resolve governance and restrictions problems. In 179 household interviews, perceptions of fisheries conflicts and their causes were identified, and 16 management committee key informants described their methods for mediating hypothetical small-scale fisheries problems in Kenya. The 6 studied sites varied in human development and demographic contexts but had notable similarities that reflected a respondent's focus on localized, direct, and proximate fishing conflicts. The most cited problems included limited space, disagreement about gears, poor resource conditions, and locally inadequate benefits. The most cited sources of information were local households and the community, and there was considerably less acknowledgment of distal problems and solutions. Key informants selected a limited number of local community-focused solutions. For example, informants chose to mediate conflicts between neighbors with local community meetings rather than through formal national institutions. Therefore, distal solutions were likely to be perceived as ineffectual, possibly due to the challenges of polycentric governance coordination. However, widespread overfishing arises from overarching distal processes not fully amenable to local solutions. Therefore, a focus on local action is expected to limit the ability to address distal problems. These include conflicting values, demographic changes, supportive governance frameworks, emerging technologies, resolving conflicting local rules, fair between-group enforcement, responding to temporary shortages of fish, and intercommunity border and rule disputes. Improved coordination and integration of information and institutions to simultaneously address both proximate and distal common's problems are recommended.
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Affiliation(s)
- Tim R McClanahan
- Global Marine Programs, Wildlife Conservation Society, Bronx, New York, USA
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Faysal S, Penn-Kekana L, Day LT, Tripathi V, Khan F, Stafford R, Levin K, Campbell O, Filippi V. Counseling, informed consent, and debriefing for cesarean section in sub-Saharan Africa: A scoping review. Int J Gynaecol Obstet 2024; 165:43-58. [PMID: 37698080 DOI: 10.1002/ijgo.15079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/17/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND Counseling as part of the informed consent process is a prerequisite for cesarean section (CS). Postnatal debriefing allows women to explore their CS with their healthcare providers (HCPs). OBJECTIVES To describe the practices and experiences of counseling and debriefing, the barriers and facilitators to informed consent for CS; and to document the effectiveness of the interventions used to improve informed consent found in the peer-reviewed literature. SEARCH STRATEGY The databases searched were PubMed, EMBASE, PsycINFO, Africa-wide information, African Index Medicus, IMSEAR and LILACS. SELECTION CRITERIA English-language papers focusing on consent for CS, published between 2011 and 2022, and assessed to be of medium to high quality were included. DATA COLLECTION AND ANALYSIS A narrative synthesis was conducted using Beauchamp and Childress's elements of informed consent as a framework. MAIN RESULTS Among the 21 included studies reporting on consent for CS, 12 papers reported on counseling for CS, while only one reported on debriefing. Barriers were identified at the service, woman, provider, and societal levels. Facilitators all operated at the provider level and interventions operated at the service or provider levels. CONCLUSIONS There is a paucity of research on informed consent, counseling, and debriefing for CS in sub-Saharan Africa.
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Affiliation(s)
- Sumeya Faysal
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Loveday Penn-Kekana
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Louise-Tina Day
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Farhad Khan
- EngenderHealth, Washington, District of Columbia, USA
| | | | - Karen Levin
- EngenderHealth, Washington, District of Columbia, USA
| | - Oona Campbell
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Veronique Filippi
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
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50
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Olatunji G, Kokori E, Kwape JM, Olatunji D, Anthony CS, Ogieuhi IJ, Damian JU, Abraham IC, Igwe SC, Alabi O, Aderinto N. Anopheles stephensi and the impending challenge to malaria eradication in Africa. New Microbes New Infect 2024; 58:101232. [PMID: 38425456 PMCID: PMC10901900 DOI: 10.1016/j.nmni.2024.101232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/09/2024] [Accepted: 02/14/2024] [Indexed: 03/02/2024] Open
Affiliation(s)
- Gbolahan Olatunji
- Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria
| | - Emmanuel Kokori
- Department of Medicine and Surgery, University of Ilorin, Ilorin, Nigeria
| | | | - Doyin Olatunji
- Department of Health Sciences, Western Illinois University, USA
| | | | | | | | | | | | | | - Nicholas Aderinto
- Department of Medicine and Surgery, Ladoke, Akintola University Teaching Hospital, Ogbomoso, Nigeria
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