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Training needs to support population education/communication activities in sub-Saharan African countries.  

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Sub-Saharan Africa has recently attracted the attention and concern of the international community because of the deepening economic crisis that has persisted since the mid-1970s. The quality of life and development of progress and improvement for the rural population will depend on the extent to which countries of the region appreciate the interrelationships between population and socioeconomic development and adopt strategies to influence population trends. At both regional and national levels, policy makers will have to take account of population characteristics in dealing with demand for 1) education; 2) health services, food, and nutritional needs; 3) demand and supply of labor; and 4) maternal and child health care. The 1984 Kilimanjaro Program of Action on Population emerged as a major document from the Arusha Population Conference; African states adopted the principle that improvement in the quality of life in the region reguires effective programs to reduce current high levels of fertility and mortality and alleviate the uneven distribution of population. This paper proposes the use of a multisectoral training strategy to integrate population education into rural development training programs as a step towards realizing desired national goals for economic growth and social development. Population education can be subdivided into 3 interrelated content areas: 1) population factors, 2) interrelationships between population factors, and 3) socioeconomic development at macro and micro levels. Although each population education program has its individual aims, at the national level it is necessary to identify criteria to guide the design and selection of content such as 1) a country's development goals and needs, 2) an institutional framework, 3) social and cultural factors, and 4) the availability of teaching materials. A Kenya case study is provided. PMID:12268117

Mlay, W

1985-06-01

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Molecular breast cancer subtypes prevalence in an indigenous Sub Saharan African population  

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Introduction Sub-Saharan Africa is predicted to face an unprecedented growth of cancers including breast cancer. There are indications of a significant burden of aggressive and late stage breast disease among premenopausal women in sub-Saharan Africa; because hormonal status tests are not routinely done, many women are given anti-hormonal therapy empirically. There is paucity of data on breast cancer molecular subtypes and their characteristics among women in sub Saharan Africa. The objective is to determine the prevalence of breast cancer molecular phenotypes among Ugandan women. Methods This was a cross sectional descriptive study, conducted at a tertiary hospital in Africa. Eligible participants’ formalin fixed and paraffin embedded sections were evaluated. H & E stains and Immunochemistry (Estrogen Receptor (ER), Progesterone Receptor (PR), Human Epidermal growth factor Receptor (HER2)) were performed. Ethical approval was obtained. Results A total of 226 patient samples were evaluated. The mean age was 45 years (SD 14);the prevalence of Triple Negative Breast Cancer (TNBC) was 34% (77/226), Luminal A 38% (83/226), HER2 positive was 22% (49/226), and Luminal B was 5% (13/226). High-grade (III) tumors were 68%, stage III and IV constituted 75% of presentations. Histological type was mostly invasive ductal carcinoma. Most patients (55%) were from rural areas. Conclusion Ugandan women had an over representation of TNBC and high-grade breast tumors. Underlying reasons ought to be investigated. The empirical use of tamoxifen (anti-hormonal therapy) should be reexamined.

Galukande, Moses; Wabinga, Henry; Mirembe, Florence; Karamagi, Charles; Asea, Alexzander

2014-01-01

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Frequency variation among sub-Saharan populations in virus restriction gene, BST-2 proximal promoter polymorphisms: implications for HIV-1 prevalence differences among African countries.  

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The present study reports promoter variants in four sub-Saharan African populations that may affect BST-2 gene regulation. Recently, an in/del within the BST-2 promoter has been associated with HIV-1 disease progression in a Spanish cohort. Hence, we sequenced the proximal promoter region of the BST-2 gene in 581 individuals from South Africa, Zimbabwe, Malawi, and Cameroon. Seven SNPs were identified: rs28413176 (+26i6/?6); rs28413175 (-160i1/?1), -187A>G (nucleotide position -17516614); rs28413174 (-193G>A); rs73921425 (-199G>A); rs12609479 (-201C>T); and rs112492472 (-225C>T). The -199A and -225T alleles showed interesting trends across the sub-Saharan continent. Using predictive bioinformatics tools, we show that allelic variation at -199 and -201 potentially affect key transcription factor binding sites including bHLH, c-Myb, and E47. Importantly, data available from the ENCODE study gave further credence to our hypothesis of transcriptional regulation of BST-2 by a bHLH TF such as Mxi1. The possible repressive transcriptional effect of Mxi1 combined with the allelic frequency trend seen at -199 between African populations overlays well with current HIV-1 prevalence data, and may be a contributing factor to this phenomenon. The differences in HIV-1 prevalence in African countries could be, in part, due to distribution of genetic variants that affect susceptibility to HIV-1. Our findings therefore have substantive value for the design of future diagnostics for global health oriented diagnostics for HIV-1 susceptibility, and rational therapeutics on the critical path to personalized medicine in the African continent. As HIV-1 epidemiology vastly impacts human populations around the world, the population genomics strategy we have utilized herein can have value for other global regions as well. PMID:24601767

Skelton, Michelle M; Kampira, Elizabeth E; Wonkam, Ambroise A; Mhandire, Kudakwashe K; Kumwenda, Johnstone J; Duri, Kerina K; Dandara, Collet C

2014-07-01

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A survey of Sub-Saharan African medical schools  

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Full Text Available Abstract Background Sub-Saharan Africa suffers a disproportionate share of the world's burden of disease while having some of the world's greatest health care workforce shortages. Doctors are an important component of any high functioning health care system. However, efforts to strengthen the doctor workforce in the region have been limited by a small number of medical schools with limited enrolments, international migration of graduates, poor geographic distribution of doctors, and insufficient data on medical schools. The goal of the Sub-Saharan African Medical Schools Study (SAMSS is to increase the level of understanding and expand the baseline data on medical schools in the region. Methods The SAMSS survey is a descriptive survey study of Sub-Saharan African medical schools. The survey instrument included quantitative and qualitative questions focused on institutional characteristics, student profiles, curricula, post-graduate medical education, teaching staff, resources, barriers to capacity expansion, educational innovations, and external relationships with government and non-governmental organizations. Surveys were sent via e-mail to medical school deans or officials designated by the dean. Analysis is both descriptive and multivariable. Results Surveys were distributed to 146 medical schools in 40 of 48 Sub-Saharan African countries. One hundred and five responses were received (72% response rate. An additional 23 schools were identified after the close of the survey period. Fifty-eight respondents have been founded since 1990, including 22 private schools. Enrolments for medical schools range from 2 to 1800 and graduates range from 4 to 384. Seventy-three percent of respondents (n = 64 increased first year enrolments in the past five years. On average, 26% of respondents' graduates were reported to migrate out of the country within five years of graduation (n = 68. The most significant reported barriers to increasing the number of graduates, and improving quality, related to infrastructure and faculty limitations, respectively. Significant correlations were seen between schools implementing increased faculty salaries and bonuses, and lower percentage loss of faculty over the previous five years (P = 0.018; strengthened institutional research tools (P = 0.00015 and funded faculty research time (P = 0.045 and greater faculty involvement in research; and country compulsory service requirements (P = 0.039, a moderate number (1-5 of post-graduate medical education programs (P = 0.016 and francophone schools (P = 0.016 and greater rural general practice after graduation. Conclusions The results of the SAMSS survey increases the level of data and understanding of medical schools in Sub-Saharan Africa. This data serves as a baseline for future research, policies and investment in the health care workforce in the region which will be necessary for improving health.

Chen Candice

2012-02-01

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Development of a single base extension method to resolve Y chromosome haplogroups in sub-Saharan African populations  

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Full Text Available Abstract Background The ability of the Y chromosome to retain a record of its evolution has seen it become an essential tool of molecular anthropology. In the last few years, however, it has also found use in forensic genetics, providing information on the geographic origin of individuals. This has been aided by the development of efficient screening methods and an increased knowledge of geographic distribution. In this study, we describe the development of single base extension assays used to resolve 61 Y chromosome haplogroups, mainly within haplogroups A, B and E, found in Africa. Results Seven multiplex assays, which incorporated 60 Y chromosome markers, were developed. These resolved Y chromosomes to 61 terminal branches of the major African haplogroups A, B and E, while also including a few Eurasian haplogroups found occasionally in African males. Following its validation, the assays were used to screen 683 individuals from Southern Africa, including south eastern Bantu speakers (BAN, Khoe-San (KS and South African Whites (SAW. Of the 61 haplogroups that the assays collectively resolved, 26 were found in the 683 samples. While haplogroup sharing was common between the BAN and KS, the frequencies of these haplogroups varied appreciably. Both groups showed low levels of assimilation of Eurasian haplogroups and only two individuals in the SAW clearly had Y chromosomes of African ancestry. Conclusions The use of these single base extension assays in screening increased haplogroup resolution and sampling throughput, while saving time and DNA. Their use, together with the screening of short tandem repeat markers would considerably improve resolution, thus refining the geographic ancestry of individuals.

Naidoo Thijessen

2010-09-01

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Gender Gaps in Political Participation across Sub-Saharan African Nations  

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A substantial literature has studied gender differences in political participation in Western industrialized democracies, but little is known about such gaps in sub-Saharan African nations. Using 2005 Afrobarometer data, this paper presents a systematic investigation of the gender gap in political participation across 18 sub-Saharan African

Coffe, Hilde; Bolzendahl, Catherine

2011-01-01

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How Can the Operating Environment for Nutrition Research Be Improved in Sub-Saharan Africa? The Views of African Researchers  

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Optimal nutrition is critical for human development and economic growth. Sub-Saharan Africa is facing high levels of food insecurity and only few sub-Saharan African countries are on track to eradicate extreme poverty and hunger by 2015. Effective research capacity is crucial for addressing emerging challenges and designing appropriate mitigation strategies in sub-Saharan Africa. A clear understanding of the operating environment for nutrition research in sub-Saharan Africa is a much needed p...

2013-01-01

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Fertility in Sub-Saharan African countries with consideration to health and poverty  

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Fertility has begun to fall in Sub-Saharan Africa but it remains high on average and particularly for a few countries. This paper examines African fertility using a panel data set of 47 Sub-Saharan countries between 1962 and 2003. Fixed and random country effect estimates are made in models where the explanatory variables are suggested by the theory of the demographic transition as modified by Caldwell. Special attention is paid to the economic status of women, urbanization, the poverty level...

Jeon, Yongil; Rhyu, Sang-young; Shields, Michael P.

2008-01-01

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19 CFR 10.178a - Special duty-free treatment for sub-Saharan African countries.  

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...sub-Saharan African country for purposes of that...sub-Saharan African country and meets the requirements...1995, as the GSP was in effect on that date; (5...is claimed; (d) Origin and related rules...beneficiary developing country,” wherever it...

2010-04-01

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Financial development and economic growth: Literature survey and empirical evidence from sub-Saharan African countries  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english In this paper we review the literature on the finance-growth nexus and investigate the causality between financial development and economic growth in sub-Saharan Africa for the period 1975-2005. Using panel co-integration and panel GMM estimation for causality, the results of the panel co-integratio [...] n analysis provide evidence of no long-run relationship between financial development and economic growth. The empirical findings in the paper show a bi-directional causal relationship between the growth of real GDP per capita and the domestic credit provided by the banking sector for the panels of 24 sub-Saharan African countries. The findings imply that African countries can accelerate their economic growth by improving their financial systems and vice versa.

Songul Kakilli, Acaravci; Ilhan, Ozturk; Ali, Acaravci.

2009-04-01

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The migration of physicians from sub-Saharan Africa to the United States of America: measures of the African brain drain  

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Full Text Available Abstract Background The objective of this paper is to describe the numbers, characteristics, and trends in the migration to the United States of physicians trained in sub-Saharan Africa. Methods We used the American Medical Association 2002 Masterfile to identify and describe physicians who received their medical training in sub-Saharan Africa and are currently practicing in the USA. Results More than 23% of America's 771 491 physicians received their medical training outside the USA, the majority (64% in low-income or lower middle-income countries. A total of 5334 physicians from sub-Saharan Africa are in that group, a number that represents more than 6% of the physicians practicing in sub-Saharan Africa now. Nearly 86% of these Africans practicing in the USA originate from only three countries: Nigeria, South Africa and Ghana. Furthermore, 79% were trained at only 10 medical schools. Conclusions Physician migration from poor countries to rich ones contributes to worldwide health workforce imbalances that may be detrimental to the health systems of source countries. The migration of over 5000 doctors from sub-Saharan Africa to the USA has had a significantly negative effect on the doctor-to-population ratio of Africa. The finding that the bulk of migration occurs from only a few countries and medical schools suggests policy interventions in only a few locations could be effective in stemming the brain drain.

Johnson Karin E

2004-12-01

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HIV knowledge among Canadian-born and sub-Saharan African-born patients living with HIV.  

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Research has revealed differences on scales measuring HIV knowledge between individuals from various ethnic backgrounds and cultures. Few studies have examined this knowledge with immigrant populations and persons living with HIV. This study examined HIV knowledge among persons living with HIV who were either born in Canada or in sub-Saharan Africa and, for comparison, in a sample of college students. All participants were residing in Canada. Participants completed questionnaires measuring demographic variables, sexual health behaviour, and HIV status, treatment, and knowledge. Canadian-born patients living with HIV were more likely to be older and male than the other groups. On average, patients living with HIV were diagnosed 6.4 years ago, and 80% reported having current or previous experience taking HIV medications. After adjusting for age and gender, significant differences were found between the groups on the Brief HIV Knowledge Questionnaire. Canadian-born persons living with HIV (n = 110) scored higher than sub-Saharan African-born patients (n = 23) and college students (n = 81); mean percentage correct was 86, 70, and 62%, respectively (P < .01). These results suggested that ongoing HIV education is needed for all groups, and that additional tailored and targeted educational interventions are needed to address important gaps in knowledge among persons living with HIV patients originating from Africa and among college students. PMID:21643728

Tulloch, Heather E; Balfour, Louise; Kowal, John; Tasca, Georgio A; Angel, Jonathan B; Garber, Gary; Macpherson, Paul; Cooper, Curtis; Cameron, D W

2012-02-01

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Why sub-Saharan African health workers migrate to European countries that do not actively recruit: a qualitative study post-migration.  

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BACKGROUND: Many studies have investigated the migration intentions of sub-Saharan African medical students and health professionals within the context of a legacy of active international recruitment by receiving countries. However, many health workers migrate outside of this recruitment paradigm. This paper aims to explore the reasons for migration of health workers from sub-Saharan Africa to Belgium and Austria; European countries without a history of active recruitment in sub-Saharan Afric...

Poppe, A.; Jirovsky, E.; Blacklock, C.; Laxmikanth, P.; Moosa, S.; Maeseneer, J.; Kutalek, R.; Peersman, W.

2014-01-01

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Sub-Saharan African ground water protection-building on international experience.  

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Sub-Saharan Africa faces significant challenges in dealing with ground water pollution. These countries can look to successes and missteps on other continents to help choose their own individual paths to ensuring reliable and clean supplies of ground water. In the large view, sub-Saharan Africa can define specific levels of acceptable risk in water quality that drive cleanup efforts and are amenable to acceptance across national and geographic boundaries. Ground water quality databases must be expanded, and data must be available in an electronic form that is flexible, expandable, and uniform, and that can be used over wide geographic areas. Guidance from other continents is available on well construction, sampling and monitoring, interim remediation, technical impracticability, monitored natural attenuation, and many specific issues such as how to deal with small waste generators and septic contamination of water supply wells. It is important to establish a common African view on the appropriateness of other nations' ground water quality guidance for African issues, economic conditions, and community circumstances. Establishing numerical, concentration-based, water quality action levels for pollutants in ground water, which many neighboring African nations could hold comparable, would set the stage for risk-based remediation of contaminated sites. Efforts to gain public, grass-roots understanding and support for stable and balanced enforcement of standards are also key. Finally, effective capacity building in the region could be an eventual solution to ground water quality problems; with increased numbers of trained environmental professionals, ground water throughout the region can be protected and contaminated sites cleaned up. PMID:19341368

Kreamer, David K; Usher, Brent

2010-01-01

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Psychosocial Distress and Alcohol Use as Factors in Adolescent Sexual Behavior among Sub-Saharan African Adolescents  

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Background: This study examines the relationship between sexual behavior, alcohol use, and indicators of psychosocial distress (mental health) of adolescents in 6 sub-Saharan African countries using the Global School-based Student Health Survey (GSHS). Methods: The sample consisted of 22,949 adolescents from Botswana, Kenya, Namibia, Uganda,…

Page, Randy M.; Hall, Cougar P.

2009-01-01

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Variation of female and male lineages in sub-Saharan populations: the importance of sociocultural factors.  

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In this paper, we present a study of genetic variation in sub-Saharan Africa, which is based on published and unpublished data on fast-evolving (hypervariable region 1 of mitochondrial DNA and six microsatellites of Y chromosome) and slow-evolving (haplogroup frequencies) polymorphisms of mtDNA and Y chromosome. Our study reveals a striking difference in the genetic structure of food-producer (Bantu and Sudanic speakers) and hunter-gatherer populations (Pygmies, Kung, and Hadza). In fact, the...

Destro-bisol, G.; Donati, F.; Coia, V.; Boschi, I.; Verginelli, F.; Caglia?, A.; Tofanelli, S.; Spedini, G.; Capelli, C.

2004-01-01

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Effects of Exchange Rate Volatility on Trade in Some Selected Sub-Saharan African Countries  

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Full Text Available The paper investigates the impact of exchange rate volatility on trade in 40 selected sub-Saharan African countries for the period 1986-2005. The study employs a gravity model with pooled ordinary least square (POLS allowing for fixed effect and panel Generalized Method of Moments (GMM techniques. The results of the analysis show that the net effect of exchange rate volatility on aggregate trade was positive using the two approaches. In the way the results show that there is not much difference between the impact of exchange rate volatility on primary and manufactured trade as well as between ECOWAS and non-ECOWAS countries. However, the results should be interpreted with caution as the history of exchange rate volatility is still relatively young compared with the developed countries.

David Olayungbo

2011-09-01

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Pattern and determinants of BCG immunisation delays in a sub-Saharan African community  

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Full Text Available Abstract Background Childhood immunisation is recognised worldwide as an essential component of health systems and an indispensable indicator of quality of care for vaccine-preventable diseases. While performance of immunisation programmes is more commonly measured by coverage, ensuring that every child is immunised at the earliest/appropriate age is an important public health goal. This study therefore set out to determine the pattern and predictors of Bacille de Calmette-Guérin (BCG immunisation delays in the first three months of life in a Sub-Saharan African community where BCG is scheduled at birth in order to facilitate necessary changes in current policy and practices for improved services. Methods A cross-sectional study in which immunisation delays among infants aged 0-3 months attending community-based BCG clinics in Lagos, Nigeria over a 2-year period from July 2005 to June 2007 were assessed by survival analysis and associated factors determined by multivariable logistic regression. Population attributable risk (PAR was computed for the predictors of delays. Results BCG was delayed beyond three months in 31.6% of all eligible infants. Of 5171 infants enrolled, 3380 (65.4% were immunised within two weeks and a further 1265 (24.5% by six weeks. A significantly higher proportion of infants born in hospitals were vaccinated in the first six weeks compared to those born outside hospitals. Undernourishment was predictive of delays beyond 2 and 6 weeks while treated hyperbilirubinaemia was associated with decreased odds for any delays. Lack of antenatal care and multiple gestations were also predictive of delays beyond 6 weeks. Undernourishment was associated with the highest PAR for delays beyond 2 weeks (18.7% and 6 weeks (20.8%. Conclusions BCG immunisation is associated with significant delays in this setting and infants at increased risk of delays can be identified and supported early possibly through improved maternal uptake of antenatal care. Combining BCG with subsequent immunisation(s at 6 weeks for infants who missed the BCG may be considered.

Olusanya Bolajoko O

2010-01-01

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IMPORT SUBSTITUTION INDUSTRIALIZATION AS LEARNING PROCESS: SUB SAHARAN AFRICAN EXPERIENCE AS DISTORTION OF THE “GOOD” BUSINESS MODE  

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Full Text Available The East Asian catch-up industrialization experience is often presented in the literature as a benchmark for Sub-Saharan African countries seeking to undergo an industrial revolution. A recurrent theme in the East Asian model is the use of the import substitution industrialization (ISI phase as a basis for technological learning and international business. The East Asian countries used ISI to build up an industrial technological competence. Starting with the low- skill, labour intensive manufactures, these countries gradually moved on to manufacture more technologically complex products for export using competencies and skills acquired in the ISI phase. Typically, protectionist industrial policy featured strongly in the East-Asian experiences. Sub-Saharan Africa embarked on ISI as early as the post war II decades, consolidating that process in the post-colonial decades of the 1960’s and 1970’s and employing also protectionist industrial policy. However, in stark contrast to East Asia, Sub-Saharan Africa’s ISI ended up in a cul-de-sac; it failed to develop capacities for export manufactures and even failed to produce enough to serve expanding domestic demand. Sub-Saharan Africa’s ISI and the protectionism that underpinned it could then be described as a distortion of the ‘good’ East Asian benchmark business model. This paper draws on extant literature to explain key aspects of the Sub-Saharan African model as a distortion of the good East Asian model. The paper focuses on the elements of the protectionism that featured in both models, the nature of industrial policy, and stresses the role of labour intensive manufacturing as a viable ‘entry route’ into export-based industrialization and technological learning.

Kanayo Ogujiub

2011-10-01

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African marketing boards under structural adjustment : the experience of Sub-Saharan Africa during the 1980s  

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Sum.: The economic policy of structural adjustment, which was initiated in most African countries during the 1980s, posed a serious threat to agricultural marketing boards in sub-Saharan Africa. Two elements of structural adjustment were particularly ominous: 'privatization' threatened the continued existence of marketing boards as public enterprises, and the 'liberalization of trade' worsened the conditions under which they operated. On the basis of an extensive study of the literature, this...

Laan, H. L.; Haaren, W. T. M.

1990-01-01

 
 
 
 
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An overview of cardiovascular risk factor burden in sub-Saharan African countries: a socio-cultural perspective  

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Abstract Background Sub-Saharan African (SSA) countries are currently experiencing one of the most rapid epidemiological transitions characterized by increasing urbanization and changing lifestyle factors. This has resulted in an increase in the incidence of non-communicable diseases, especially cardiovascular disease (CVD). This double burden of communicable and chronic non-communicable diseases has long-term public health impact as it undermines healthcare systems. P...

Degboe Arnold N; Taylor Kelly D; Iwelunmor Juliet; Okoror Titilayo A; BeLue Rhonda; Agyemang Charles; Ogedegbe Gbenga

2009-01-01

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Untangling the quality of governance from the level of income: Are Sub-Saharan African countries governed well?  

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We consider whether Sub-Saharan African (SSA) countries are mainly poor because they are governed worse than other countries, as suggested by recent studies on the supremacy of institutions. Our empirical results show that the supremacy of institutions does not hold. SSA countries appear to face very specific development problems. Given their geographic and economic constraints, we conclude that SSA countries are on average not governed worse than other comparable countries. Our finding suppo...

Gundlach, Erich; Hartmann, Susanne

2005-01-01

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Testing Finance-Led, Export-Led and Import-Led Growth Hypotheses on Four Sub-Saharan African Economies  

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This study carries out an empirical examination of the finance-led, export-led and import-led growth hypothesis for four of the largest Sub-Saharan African economies namely South Africa, Nigeria, Ghana and Kenya. Within a multivariate Vector-Auto Regressive (VAR) framework, the concept of Granger causality is employed to determine the direction of causation between exports and output, duly taking into account the stationarity properties of the time series data. With further substantiation fro...

Evans, Olaniyi

2013-01-01

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Corporate Ownership, Corporate Control and Corporate Performance in Sub-Saharan African: Evidence from Nigeria  

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Full Text Available This paper investigates the relation between corporate ownership and corporate performance of listed companies in Nigeria, a foremost Sub-Saharan African country during the period 2002-2007. The data is obtained from the firms’ annual reports and accounts and the Nigerian Stock Exchange daily performance reports. The combination of 70 firms and six-year period studied provides a balanced panel with 420 observations for panel data analysis. The results from the ordinary least square (OLS regression analyses show that there is a strong connection between foreign ownership structure and firm performance. Foreign ownership structure is found to exhibit significant improvements in firm performance; it adumbrates eclectic competitive advantages in ownership, control and internalization respects over other types of ownership structure. We find no statistically significant relation between concentrated ownership and firm performance. Insider or managerial ownership, however, exhibits significant decline in firm performance. These findings are consistent with the view that firm performance is a negative predictor of insider ownership. We also find support for the notion that management is apathetic to holding equity stakes in their underperforming firms.

Ioraver N. Tsegba

2014-10-01

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Assessing public and private sector contributions in reproductive health financing and utilization for six sub-Saharan African countries.  

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The present study provides evidence to support enhanced attention to reproductive health and comprehensive measures to increase access to quality reproductive health services. We compare and contrast the financing and utilization of reproductive health services in six sub-Saharan African countries using data from National Health Accounts and Demographic and Health Surveys. Spending on reproductive health in 2006 ranged from US$4 per woman of reproductive age in Ethiopia to US$17 in Uganda. These are below the necessary level for assuring adequate services given that an internationally recommended spending level for family planning alone was US$16 for 2006. Moreover, reproductive health spending shows signs of decline in tandem with insufficient improvement in service utilization. Public providers played a predominant role in antenatal and delivery care for institutional births, but home deliveries with unqualified attendants dominated. The private sector was a major supplier of condoms, oral pills and IUDs. Private clinics, pharmacies and drug vendors were important sources of STI treatment. The findings highlight the need to commit greatly increased funding for reproductive health services as well as more policy attention to the contribution of public, private and informal providers and the role of collaboration among them to expand access to services for under-served populations. PMID:21555087

Nguyen, Ha; Snider, Jeremy; Ravishankar, Nirmala; Magvanjav, Oyunbileg

2011-05-01

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Validation of a French adaptation of the Harvard Trauma Questionnaire among torture survivors from sub-Saharan African countries  

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Full Text Available Background: To date no validated instrument in the French language exists to screen for posttraumatic stress disorder (PTSD in survivors of torture and organized violence. Objective: The aim of this study is to adapt and validate the Harvard Trauma Questionnaire (HTQ to this population. Method: The adapted version was administered to 52 French-speaking torture survivors, originally from sub-Saharan African countries, receiving psychological treatment in specialized treatment centers. A structured clinical interview for DSM was also conducted in order to assess if they met criteria for PTSD. Results: Cronbach's alpha coefficient for the HTQ Part 4 was adequate (0.95. Criterion validity was evaluated using receiver operating characteristic curve analysis that generated good classification accuracy for PTSD (0.83. At the original cut-off score of 2.5, the HTQ demonstrated high sensitivity and specificity (0.87 and 0.73, respectively. Conclusion: Results support the reliability and validity of the French version of the HTQ.

Capucine de Fouchier

2012-12-01

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Complicated grief in help-seeking torture survivors in sub-Saharan African contexts.  

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Many help-seeking torture survivors in sub-Saharan Africa report sudden or violent bereavements, as well as risk factors associated with complicated grief. This mixed-methods article reviews 85 therapeutic client files from torture treatment centers in 3 countries in sub-Saharan Africa. Thirty-nine clients had lost loved ones and were at greater risk for depression (effect size 0.65) and thoughts of suicide (OR = 4.99). Qualitative analysis of case histories and interviews with clients elaborate the links between torture and complicated grief. Recommendations are offered for the treatment of complicated grief in sub-Saharan torture survivors, and implications for assessment, timing, and treatment duration are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved). PMID:25089758

Higson-Smith, Craig

2014-09-01

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Rehabilitation in Seven Sub-Saharan African Countries: Personnel Education and Training  

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This article outlines rehabilitation personnel education and training in seven countries representing a geo-culturally contiguous region of sub-Saharan Africa: Botswana, Cameroon, Rwanda, South Africa, Tanzania, Zambia, and Zimbabwe. It identifies and explicates practices to inform similar or parallel rehabilitation practices in the United States…

Mpofu, Elias; Jelsma, Jennifer; Maart, Soraya; Levers, Lisa Lopez; Montsi, Mercy M. R.; Tlabiwe, Pinkie; Mupawose, Anniah; Mwamwenda, Tuntufye; Ngoma, Mary Shilalukey; Tchombe,Therese Mungah S.

2007-01-01

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Exemplary Strategy for Corporate Competitiveness and Wealth Creation: Implications for sub-Saharan African Business Leaders and Managers  

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Full Text Available The paper begins with a brief review of the nature and historical perspective of strategy. This is followed by discussion of industry analysis as in important step in the strategy development process. The paper continues with an analysis of the strategy development process and the role of strategic leadership to sustain strategy. Also presented in the paper is the analysis of how the appropriate management system can be leveraged to support a successful strategy execution and evaluation. The paper ends with an outline of strategic implications and recommendations for sub-Saharan African business leaders and managers.

Ashford C. Chea

2012-04-01

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Variation of female and male lineages in sub-Saharan populations: the importance of sociocultural factors.  

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In this paper, we present a study of genetic variation in sub-Saharan Africa, which is based on published and unpublished data on fast-evolving (hypervariable region 1 of mitochondrial DNA and six microsatellites of Y chromosome) and slow-evolving (haplogroup frequencies) polymorphisms of mtDNA and Y chromosome. Our study reveals a striking difference in the genetic structure of food-producer (Bantu and Sudanic speakers) and hunter-gatherer populations (Pygmies, Kung, and Hadza). In fact, the ratio of mtDNA to Y-chromosome Nupsilon is substantially higher in food producers than in hunter-gatherers as determined by fast-evolving polymorphisms (1.76 versus 0.11). This finding indicates that the two population groups differ substantially in female and male migration rate and/or effective size. The difference also persists when linguistically homogeneous populations are used and outlier populations are eliminated (1.78 vs 0.19) or when the jacknife procedure is applied to a paired population data set (1.32 to 7.84 versus 0.14 to 0.66). The higher ratio of mtDNA to Y-chromosome Nnu in food producers than in hunter-gatherers is further confirmed by the use of slow-evolving polymorphisms (1.59 to 7.91 versus 0.12 to 0.35). To explain these results, we propose a model that integrates demographic and genetic aspects and incorporates ethnographic knowledge. In such a model, the asymmetric gene flow, polyginy, and patrilocality play an important role in differentiating the genetic structure of sub-Saharan populations. The existence of an asymmetric gene flow is supported by the phylogeographic features of mtDNA and Y-chromosome haplogroups found in the two population groups. The role of polyginy and patrilocality is sustained by the evidence of a differential pressure of genetic drift and gene flow on maternal and paternal lineages of food producers and hunter-gatherers that is revealed through the analysis of mitochondrial and Y-chromosomal intrapopulational variation. PMID:15190128

Destro-Bisol, Giovanni; Donati, Francesco; Coia, Valentina; Boschi, Ilaria; Verginelli, Fabio; Caglià, Alessandra; Tofanelli, Sergio; Spedini, Gabriella; Capelli, Cristian

2004-09-01

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From population to HIV: the organizational and structural determinants of HIV outcomes in sub-Saharan Africa  

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Full Text Available Abstract Background There exists no consistent explanation for why some countries are successful in combating HIV/AIDS and others are not, and we need such an explanation in order to design effective policies and programmes. Research evaluating HIV interventions from a biomedical or public health perspective does not always take full account of the historical and organizational characteristics of countries likely to influence HIV outcomes. The analysis in this paper addresses this shortcoming by testing the impact of organizational and structural factors, particularly those resulting from population interventions, on HIV outcomes at the country level in sub-Saharan Africa. Methods The primary independent variables are factors that originated from efforts to slow population growth: whether a country has a long-time affiliate of the International Planned Parenthood Federation and whether a country has a population policy. Additional structural factors likely to impact HIV outcomes include the level of wealth, the level of cultural fractionalization, and the former colonial power. The present study uses multivariate regression techniques with countries in sub-Saharan Africa as the unit of analysis, and four measures of success in addressing HIV: the change in prevalence between 2001 and 2009; the change in incidence between 2001 and 2009; the level of overall antiretroviral coverage in 2009; and the level of antiretroviral coverage for prevention of vertical transmission in 2009. Results Countries with the greatest declines in HIV prevalence and incidence had older International Planned Parenthood Federation affiliates and had adopted population policies, even after controlling for age of epidemic, level of antiretroviral coverage, and funding for HIV. Population policies are also important predictors of levels of overall antiretroviral coverage and of coverage of HIV-positive pregnant women to prevent vertical transmission. Structural factors with significant impacts include wealth, cultural fractionalization and former colonial power. Conclusions The organizational and structural context of African countries is strongly predictive of HIV outcomes. This finding implies that policy and programmatic efforts should be put towards strengthening existing organizations and perhaps even creating new ones. The fact that cultural fractionalization also influences HIV outcomes suggests that efforts must be put towards identifying ways to reach political consensus in diverse societies.

Robinson Rachel

2011-09-01

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Co-evolution of human leukocyte antigen (HLA) class I ligands with killer-cell immunoglobulin-like receptors (KIR) in a genetically diverse population of sub-Saharan Africans.  

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Interactions between HLA class I molecules and killer-cell immunoglobulin-like receptors (KIR) control natural killer cell (NK) functions in immunity and reproduction. Encoded by genes on different chromosomes, these polymorphic ligands and receptors correlate highly with disease resistance and susceptibility. Although studied at low-resolution in many populations, high-resolution analysis of combinatorial diversity of HLA class I and KIR is limited to Asian and Amerindian populations with low genetic diversity. At the other end of the spectrum is the West African population investigated here: we studied 235 individuals, including 104 mother-child pairs, from the Ga-Adangbe of Ghana. This population has a rich diversity of 175 KIR variants forming 208 KIR haplotypes, and 81 HLA-A, -B and -C variants forming 190 HLA class I haplotypes. Each individual we studied has a unique compound genotype of HLA class I and KIR, forming 1-14 functional ligand-receptor interactions. Maintaining this exceptionally high polymorphism is balancing selection. The centromeric region of the KIR locus, encoding HLA-C receptors, is highly diverse whereas the telomeric region encoding Bw4-specific KIR3DL1, lacks diversity in Africans. Present in the Ga-Adangbe are high frequencies of Bw4-bearing HLA-B*53:01 and Bw4-lacking HLA-B*35:01, which otherwise are identical. Balancing selection at key residues maintains numerous HLA-B allotypes having and lacking Bw4, and also those of stronger and weaker interaction with LILRB1, a KIR-related receptor. Correspondingly, there is a balance at key residues of KIR3DL1 that modulate its level of cell-surface expression. Thus, capacity to interact with NK cells synergizes with peptide binding diversity to drive HLA-B allele frequency distribution. These features of KIR and HLA are consistent with ongoing co-evolution and selection imposed by a pathogen endemic to West Africa. Because of the prevalence of malaria in the Ga-Adangbe and previous associations of cerebral malaria with HLA-B*53:01 and KIR, Plasmodium falciparum is a candidate pathogen. PMID:24204327

Norman, Paul J; Hollenbach, Jill A; Nemat-Gorgani, Neda; Guethlein, Lisbeth A; Hilton, Hugo G; Pando, Marcelo J; Koram, Kwadwo A; Riley, Eleanor M; Abi-Rached, Laurent; Parham, Peter

2013-10-01

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Population genetic structure of the malaria vector Anopheles nili in sub-Saharan Africa  

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Full Text Available Abstract Background Anopheles nili is a widespread efficient vector of human malaria parasites in the humid savannas and forested areas of sub-Saharan Africa. Understanding An. nili population structure and gene flow patterns could be useful for the development of locally-adapted vector control measures. Methods Polymorphism at eleven recently developed microsatelitte markers, and sequence variation in four genes within the 28s rDNA subunit (ITS2 and D3 and mtDNA (COII and ND4 were assessed to explore the level of genetic variability and differentiation among nine populations of An. nili from Senegal, Ivory Coast, Burkina Faso, Nigeria, Cameroon and the Democratic Republic of Congo (DRC. Results All microsatellite loci successfully amplified in all populations, showing high and very similar levels of genetic diversity in populations from West Africa and Cameroon (mean Rs = 8.10-8.88, mean He = 0.805-0.849 and much lower diversity in the Kenge population from DRC (mean Rs = 5.43, mean He = 0.594. Bayesian clustering analysis of microsatellite allelic frequencies revealed two main genetic clusters in the dataset. The first one included only the Kenge population and the second grouped together all other populations. High Fst estimates based on microsatellites (Fst > 0.118, P Conclusion Overall, high genetic homogeneity of the An. nili gene pool was found across its distribution range in West and Central Africa, although demographic events probably resulted in a higher level of genetic isolation in the marginal population of Kenge (DRC. The role of the equatorial forest block as a barrier to gene flow and the implication of such findings for vector control are discussed.

Awono-Ambene Parfait H

2010-06-01

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Socioeconomic status and the prevalence of fever in children under age five: evidence from four sub-Saharan African countries  

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Full Text Available Abstract Background The burden of fevers remains enormous in sub-Saharan Africa. While several efforts at reducing the burden of fevers have been made at the macro level, the relationship between socioeconomic status and fever prevalence has been inconclusive at the household and individual levels. The purpose of this study was to examine how individual and household socioeconomic status influences the prevalence of fever among children under age five in four sub-Saharan African countries. Methods The study used data from the 2008 Demographic and Health Survey (DHS from Ghana, Nigeria, Kenya and Sierra Leone with a total of 38,990 children below age five. A multi-level random effects logistic model was fitted to examine the socioeconomic factors that influence the prevalence of fever in the two weeks preceding the survey. Data from the four countries were also combined to estimate this relationship, after country-specific analysis. Results The results show that children from wealthier households reported lower prevalence of fever in Ghana, Nigeria and Kenya. Result from the combined dataset shows that children from wealthier households were less likely to report fever. In general, vaccination against fever-related diseases and the use of improved toilet facility reduces fever prevalence. The use of bed nets by children and mothers did not show consistent relationship across the countries. Conclusion Poverty does not only influence prevalence of fever at the macro level as shown in other studies but also the individual and household levels. Policies directed towards preventing childhood fevers should take a close account of issues of poverty alleviation. There is also the need to ensure that prevention and treatment mechanisms directed towards fever related diseases (such as malaria, pneumonia, measles, diarrhoea, polio, tuberculosis etc. are accessible and effectively used.

Novignon Jacob

2012-07-01

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Source apportionment and seasonal variation of PM2.5 in a Sub-Saharan African city: Nairobi, Kenya  

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Sources of airborne particulate matter and their seasonal variation in urban areas in Sub-Saharan Africa are poorly understood due to lack of long-term measurement data. In view of this, filter samples of airborne particulate matter (particle diameter ?2.5 ?m, PM2.5) were collected between May 2008 and April 2010 at two sites (urban background site and suburban site) within the Nairobi metropolitan area. A total of 780 samples were collected and analyzed for particulate mass, black carbon (BC) and 13 trace elements. The average PM2.5 concentration at the urban background site was 21±9.5 ?g m-3, whereas the concentration at the suburban site was 13±7.3 ?g m-3. The daily PM2.5 concentrations exceeded 25 ?g m-3 (the World Health Organization 24 h guideline value) on 29% of the days at the urban background site and 7% of the days at the suburban site. At both sites, BC, Fe, S and Cl accounted for approximately 80% of all detected elements. Positive matrix factorization analysis identified five source factors that contribute to PM2.5 in Nairobi, namely traffic, mineral dust, industry, combustion and a mixed factor (composed of biomass burning, secondary aerosol and aged sea salt). Mineral dust and traffic factors were related to approximately 74% of PM2.5. The identified source factors exhibited seasonal variation, apart from the traffic factor, which was prominently consistent throughout the sampling period. Weekly variations were observed in all factors, with weekdays having higher concentrations than weekends. The results provide information that can be exploited for policy formulation and mitigation strategies to control air pollution in Sub-Saharan African cities.

Gaita, S. M.; Boman, J.; Gatari, M. J.; Pettersson, J. B. C.; Janhäll, S.

2014-09-01

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Associations between premarital sex and leaving school in four sub-Saharan African countries.  

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With the spread of formal schooling in sub-Saharan Africa and delays in the age at marriage, a growing proportion of adolescents remain enrolled in school when they "come of age." As a consequence, more and more adolescents have to negotiate sexual maturation and sexual initiation in a vastly different context from that of prior generations. Using data from the 2004 National Survey of Adolescents conducted in Burkina Faso, Ghana, Malawi, and Uganda, we investigate the empirical association between premarital sex and leaving school among those who were enrolled in school at the outset of adolescence (age 12). Discrete-time logistic regression models show that, in general, girls are more likely than boys to leave school before completing secondary school, before completing primary school, and, among those completing primary school, before progressing to secondary school. Girls who complete primary school, however, do so at the same age as or a younger age than their male peers. Girls appear more vulnerable to leaving school once they engage in premarital sex. These findings can assist researchers, policymakers, program managers, and educators in understanding and addressing the challenges to educational attainment posed by the increasing proportion of school-aged adolescents engaging in premarital sex. PMID:19248719

Biddlecom, Ann; Gregory, Richard; Lloyd, Cynthia B; Mensch, Barbara S

2008-12-01

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La construcción del proyecto migratorio y las razones para emigrar en la población de África subsahariana francófona. Un estudio intercontinental Europa - África / Construction of migration project and reasons for emigrating in sub-Saharan African francophone population. An intercontinental study Europe-Africa  

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Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish Este estudio da cuenta de las razones de los ciudadanos de África subsahariana francófona para establecerse en Europa, y particularmente en Francia, mediante la creación de un marco comprensivo innovador que vincula tres ejes temáticos: la motivación, las migraciones, y África y sus relaciones con E [...] uropa. 155 participantes en ambos continentes respondieron a un cuestionario sobre su proyecto migratorio real o posible. Los resultados plantean un plano general de acercamiento a los imaginarios y la realidad de los migrantes en el contexto francés, marcado por la reflexión sobre la identidad nacional, los controles migratorios, un clima político reticente a la migración y un tejido social caracterizado por un creciente multiculturalismo. Abstract in english This study describes the motivations of citizens of sub-Saharan Africa francophone to establish in France thanks to the creation of an innovative framework for understanding with three key themes: motivation, migration and Africa and their relations with Europe. 155 participants from both continents [...] responded to a questionnaire about their actual or potential migration project. The results presented raise a general plan of approach to reality and imaginary of sub-Saharan African migrants in the French current context, marked by reflection on national identity, immigration and customs controls, a political climate reticent to migration and a social network characterized by a growing multiculturalism.

Carlos Roberto, Velandia Torres; Marie-Françoise, Lacassagne.

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La construcción del proyecto migratorio y las razones para emigrar en la población de África subsahariana francófona. Un estudio intercontinental Europa - África / Construction of migration project and reasons for emigrating in sub-Saharan African francophone population. An intercontinental study Europe-Africa  

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Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish Este estudio da cuenta de las razones de los ciudadanos de África subsahariana francófona para establecerse en Europa, y particularmente en Francia, mediante la creación de un marco comprensivo innovador que vincula tres ejes temáticos: la motivación, las migraciones, y África y sus relaciones con E [...] uropa. 155 participantes en ambos continentes respondieron a un cuestionario sobre su proyecto migratorio real o posible. Los resultados plantean un plano general de acercamiento a los imaginarios y la realidad de los migrantes en el contexto francés, marcado por la reflexión sobre la identidad nacional, los controles migratorios, un clima político reticente a la migración y un tejido social caracterizado por un creciente multiculturalismo. Abstract in english This study describes the motivations of citizens of sub-Saharan Africa francophone to establish in France thanks to the creation of an innovative framework for understanding with three key themes: motivation, migration and Africa and their relations with Europe. 155 participants from both continents [...] responded to a questionnaire about their actual or potential migration project. The results presented raise a general plan of approach to reality and imaginary of sub-Saharan African migrants in the French current context, marked by reflection on national identity, immigration and customs controls, a political climate reticent to migration and a social network characterized by a growing multiculturalism.

Carlos Roberto, Velandia Torres; Marie-Françoise, Lacassagne.

2012-09-01

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An overview of cardiovascular risk factor burden in sub-Saharan African countries: a socio-cultural perspective  

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Full Text Available Abstract Background Sub-Saharan African (SSA countries are currently experiencing one of the most rapid epidemiological transitions characterized by increasing urbanization and changing lifestyle factors. This has resulted in an increase in the incidence of non-communicable diseases, especially cardiovascular disease (CVD. This double burden of communicable and chronic non-communicable diseases has long-term public health impact as it undermines healthcare systems. Purpose The purpose of this paper is to explore the socio-cultural context of CVD risk prevention and treatment in sub-Saharan Africa. We discuss risk factors specific to the SSA context, including poverty, urbanization, developing healthcare systems, traditional healing, lifestyle and socio-cultural factors. Methodology We conducted a search on African Journals On-Line, Medline, PubMed, and PsycINFO databases using combinations of the key country/geographic terms, disease and risk factor specific terms such as "diabetes and Congo" and "hypertension and Nigeria". Research articles on clinical trials were excluded from this overview. Contrarily, articles that reported prevalence and incidence data on CVD risk and/or articles that report on CVD risk-related beliefs and behaviors were included. Both qualitative and quantitative articles were included. Results The epidemic of CVD in SSA is driven by multiple factors working collectively. Lifestyle factors such as diet, exercise and smoking contribute to the increasing rates of CVD in SSA. Some lifestyle factors are considered gendered in that some are salient for women and others for men. For instance, obesity is a predominant risk factor for women compared to men, but smoking still remains mostly a risk factor for men. Additionally, structural and system level issues such as lack of infrastructure for healthcare, urbanization, poverty and lack of government programs also drive this epidemic and hampers proper prevention, surveillance and treatment efforts. Conclusion Using an African-centered cultural framework, the PEN3 model, we explore future directions and efforts to address the epidemic of CVD risk in SSA.

Degboe Arnold N

2009-09-01

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Interactions and Feedbacks Between Biomass Burning and Water Cycle Dynamics Across the Northern Sub-Saharan African Region  

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The northern sub-Saharan African (NSSA) region, bounded on the north and south by the Sahara and the Equator, respectively, and stretching from the West to the East African coastlines, has one of the highest biomass-burning rates per unit land area among all regions of the world. Because of the high concentration and frequency of fires in this region, with the associated abundance of heat release and gaseous and particulate smoke emissions, biomass-burning activity is believed to be one of the drivers of the regional carbon and energy cycles, with serious implications for the water cycle. A new interdisciplinary research effort sponsored by NASA is presently being focused on the NSSA region, to better understand the possible connection between the intense biomass burning observed from satellite year after year across the region and the rapid depletion of the regional water resources, as exemplified by the dramatic drying of Lake Chad. A combination of remote sensing and modeling approaches is being utilized in investigating multiple regional surface, atmospheric, and water-cycle processes, and inferring possible links between them. In this presentation, we will discuss preliminary results as well as the path toward improved understanding of the interrelationships and feedbacks between the biomass burning and the environmental change dynamics in the NSSA region.

Ichoku, Charles

2012-01-01

 
 
 
 
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Extreme population differences in the human zinc transporter ZIP4 (SLC39A4) are explained by positive selection in Sub-Saharan Africa.  

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Extreme differences in allele frequency between West Africans and Eurasians were observed for a leucine-to-valine substitution (Leu372Val) in the human intestinal zinc uptake transporter, ZIP4, yet no further evidence was found for a selective sweep around the ZIP4 gene (SLC39A4). By interrogating allele frequencies in more than 100 diverse human populations and resequencing Neanderthal DNA, we confirmed the ancestral state of this locus and found a strong geographical gradient for the derived allele (Val372), with near fixation in West Africa. In extensive coalescent simulations, we show that the extreme differences in allele frequency, yet absence of a classical sweep signature, can be explained by the effect of a local recombination hotspot, together with directional selection favoring the Val372 allele in Sub-Saharan Africans. The possible functional effect of the Leu372Val substitution, together with two pathological mutations at the same codon (Leu372Pro and Leu372Arg) that cause acrodermatitis enteropathica (a disease phenotype characterized by extreme zinc deficiency), was investigated by transient overexpression of human ZIP4 protein in HeLa cells. Both acrodermatitis mutations cause absence of the ZIP4 transporter cell surface expression and nearly absent zinc uptake, while the Val372 variant displayed significantly reduced surface protein expression, reduced basal levels of intracellular zinc, and reduced zinc uptake in comparison with the Leu372 variant. We speculate that reduced zinc uptake by the ZIP4-derived Val372 isoform may act by starving certain pathogens of zinc, and hence may have been advantageous in Sub-Saharan Africa. Moreover, these functional results may indicate differences in zinc homeostasis among modern human populations with possible relevance for disease risk. PMID:24586184

Engelken, Johannes; Carnero-Montoro, Elena; Pybus, Marc; Andrews, Glen K; Lalueza-Fox, Carles; Comas, David; Sekler, Israel; de la Rasilla, Marco; Rosas, Antonio; Stoneking, Mark; Valverde, Miguel A; Vicente, Rubén; Bosch, Elena

2014-02-01

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Extreme Population Differences in the Human Zinc Transporter ZIP4 (SLC39A4) Are Explained by Positive Selection in Sub-Saharan Africa  

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Extreme differences in allele frequency between West Africans and Eurasians were observed for a leucine-to-valine substitution (Leu372Val) in the human intestinal zinc uptake transporter, ZIP4, yet no further evidence was found for a selective sweep around the ZIP4 gene (SLC39A4). By interrogating allele frequencies in more than 100 diverse human populations and resequencing Neanderthal DNA, we confirmed the ancestral state of this locus and found a strong geographical gradient for the derived allele (Val372), with near fixation in West Africa. In extensive coalescent simulations, we show that the extreme differences in allele frequency, yet absence of a classical sweep signature, can be explained by the effect of a local recombination hotspot, together with directional selection favoring the Val372 allele in Sub-Saharan Africans. The possible functional effect of the Leu372Val substitution, together with two pathological mutations at the same codon (Leu372Pro and Leu372Arg) that cause acrodermatitis enteropathica (a disease phenotype characterized by extreme zinc deficiency), was investigated by transient overexpression of human ZIP4 protein in HeLa cells. Both acrodermatitis mutations cause absence of the ZIP4 transporter cell surface expression and nearly absent zinc uptake, while the Val372 variant displayed significantly reduced surface protein expression, reduced basal levels of intracellular zinc, and reduced zinc uptake in comparison with the Leu372 variant. We speculate that reduced zinc uptake by the ZIP4-derived Val372 isoform may act by starving certain pathogens of zinc, and hence may have been advantageous in Sub-Saharan Africa. Moreover, these functional results may indicate differences in zinc homeostasis among modern human populations with possible relevance for disease risk. PMID:24586184

Pybus, Marc; Andrews, Glen K.; Lalueza-Fox, Carles; Comas, David; Sekler, Israel; de la Rasilla, Marco; Rosas, Antonio; Stoneking, Mark; Valverde, Miguel A.; Vicente, Ruben; Bosch, Elena

2014-01-01

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Fasting insulin sensitivity indices are not better than routine clinical variables at predicting insulin sensitivity among Black Africans: a clamp study in sub-Saharan Africans  

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Background We aimed to evaluate the predictive utility of common fasting insulin sensitivity indices, and non-laboratory surrogates [BMI, waist circumference (WC) and waist-to-height ratio (WHtR)] in sub-Saharan Africans without diabetes. Methods We measured fasting glucose and insulin, and glucose uptake during 80/mU/m2/min euglycemic clamp in 87 Cameroonians (51 men) aged (SD) 34.6 (11.4) years. We derived insulin sensitivity indices including HOMA-IR, quantitative insulin sensitivity check index (QUICKI), fasting insulin resistance index (FIRI) and glucose-to-insulin ratio (GIR). Indices and clinical predictors were compared to clamp using correlation tests, robust linear regressions and agreement of classification by sex-specific thirds. Results The mean insulin sensitivity was M =?10.5?±?3.2 mg/kg/min. Classification across thirds of insulin sensitivity by clamp matched with non-laboratory surrogates in 30-48% of participants, and with fasting indices in 27-51%, with kappa statistics ranging from ?0.10 to 0.26. Fasting indices correlated significantly with clamp (/r/=0.23-0.30), with GIR performing less well than fasting insulin and HOMA-IR (both p population. PMID:25106496

2014-01-01

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Why sub-Saharan African health workers migrate to European countries that do not actively recruit: a qualitative study post-migration  

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Full Text Available Background: Many studies have investigated the migration intentions of sub-Saharan African medical students and health professionals within the context of a legacy of active international recruitment by receiving countries. However, many health workers migrate outside of this recruitment paradigm. This paper aims to explore the reasons for migration of health workers from sub-Saharan Africa to Belgium and Austria; European countries without a history of active recruitment in sub-Saharan Africa. Methods: Data were collected using semistructured interviews. Twenty-seven health workers were interviewed about their migration experiences. Included participants were born in sub-Saharan Africa, had trained as health workers in sub-Saharan Africa, and were currently living in Belgium or Austria, though not necessarily currently working as a health professional. Results: Both Austria and Belgium were shown not to be target countries for the health workers, who instead moved there by circumstance, rather than choice. Three principal reasons for migration were reported: 1 educational purposes; 2 political instability or insecurity in their country of origin; and 3 family reunification. In addition, two respondents mentioned medical reasons and, although less explicit, economic factors were also involved in several of the respondents’ decision to migrate. Conclusion: These results highlight the importance of the broader economic, social, and political context within which migration decisions are made. Training opportunities proved to be an important factor for migration. A further development and upgrade of primary care might help to counter the common desire to specialize and improve domestic training opportunities.

Annelien Poppe

2014-05-01

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Human Capital, Productivity and Economic Growth in 31 Sub-Saharan African Countries for the Period 1975–2008  

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Full Text Available We evaluate the contributions of physical capital, human capital, and unskilled labor to economic growth for 31 Sub-Saharan African (SSA countries. We find that growth in physical capital accounts for 67 percent of growth in real GDP, whereas growth in human capital accounts for only 22 percent of real GDP growth and, the rest 11 percent is accounted for by growth of raw labor. When it comes to growth of productivity per employed worker, 90 percent is accounted for by growth rate of physical capital per employed worker, 46 percent by rate of increase in human capital per worker and negative 36 percent by rate of change of total factor of productivity (TFP. These findings are consistent with earlier studies. Negative contribution of growth rate in TFP may have to do with, poor governance, corruption, civil wars, draught and other adverse supply shocks to the production function. In addition, we find that the contributions of labor and human capital are positive but much lower in SSA countries than in high-income countries.

Girma Zelleke

2013-09-01

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Self-reported drunkenness among adolescents in four sub-Saharan African countries: associations with adverse childhood experiences  

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Full Text Available Abstract Background Consumption of alcohol is associated with acute and chronic adverse health outcomes. There is a paucity of studies that explore the determinants of alcohol use among adolescents in sub-Saharan Africa and, in particular, that examine the effects of adverse childhood experiences on alcohol use. Methods The paper draws on nationally-representative data from 9,819 adolescents aged 12-19 years from Burkina Faso, Ghana, Malawi, and Uganda. Logistic regression models were employed to identify correlates of self-reported past-year drunkenness. Exposure to four adverse childhood experiences comprised the primary independent variables: living in a food-insecure household, living with a problem drinker, having been physically abused, and having been coerced into having sex. We controlled for age, religiosity, current schooling status, the household head's sex, living arrangements, place of residence, marital status, and country of survey. All analyses were conducted separately for males and females. Results At the bivariate level, all independent variables (except for coerced sex among males were associated with the outcome variable. Overall, 9% of adolescents reported that they had been drunk in the 12 months preceding the survey. In general, respondents who had experienced an adverse event during childhood were more likely to report drunkenness. In the multivariate analysis, only two adverse childhood events emerged as significant predictors of self-reported past-year drunkenness among males: living in a household with a problem drinker before age 10, and being physically abused before age 10. For females, exposure to family-alcoholism, experience of physical abuse, and coerced sex increased the likelihood of reporting drunkenness in the last 12 months. The association between adverse events and reported drunkenness was more pronounced for females. For both males and females there was a graded relationship between the number of adverse events experienced and the proportion reporting drunkenness. Conclusions We find an association between experience of adverse childhood events and drunkenness among adolescents in four sub-Saharan African countries. The complex impacts of adverse childhood experiences on young people's development and behavior may have an important bearing on the effectiveness of interventions geared at reducing alcohol dependence among the youth.

Crichton Joanna

2010-06-01

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Perspectives on African Studies and Development in Sub-Saharan Africa Perspektiven der Afrikaforschung und der Entwicklung im subsaharischen Afrika  

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Full Text Available In this farewell lecture on the occasion of his departure as Professor of Development in sub-Saharan Africa at Leiden University and Director of the African Studies Centre (ASC, Leiden, the author starts with the vuvuzela issue as an illustration of the lack of confidence the world has in South Africa organizing and running the World Cup smoothly. He takes that as a sign that there still exists a stereotype of African incompetence, despite the social and economic progress Africa has witnessed in the last decade. He does not want to argue that African Studies have not been able to offset such a stereotype. What he tries to show is that it is not clear from the wealth of actor-oriented research in African Studies what the main social, political and economic trends in Africa are. He argues that actor-oriented research in African Studies should try to increase its relevance by contributing — through meta-analyses and comparative research — to the discussion on social, political and economic trends in Africa. Special attention should be paid to the possible rise of the developmental state in Africa. In doing so, African Studies may also substantiate its claim that it is able to challenge the universal pretensions of mainstream social science. In seiner Abschiedsvorlesung als Professor für Entwicklung im subsaharischen Afrika an der Universität Leiden und als Direktor des African Studies Centre (ASC, Leiden illustriert der Autor unter Hinweis auf die Diskussionen um die Vuvuzelas, wie gering das Vertrauen weltweit ist, dass der World Cup in Südafrika reibungslos organisiert und durchgeführt werden kann. Er sieht dies als Beispiel dafür, dass das Stereotyp der Inkompetenz in Afrika – trotz der sozialen und wirtschaftlichen Fortschritte auf dem Kontinent in der letzten Dekade – immer noch weit verbreitet ist. Er möchte nicht darüber klagen, dass die Afrikaforschung bislang nicht in der Lage war, ein solches Stereotyp zu beseitigen; vielmehr möchte er aufzeigen, dass die große Zahl handlungsorientierter Studien in der Afrikaforschung die wesentlichen sozialen, politischen und ökonomischen Trends in Afrika nicht klar herausgestellt hat. Er plädiert für eine Erhöhung der Relevanz handlungsorientierter Forschungsansätze, indem sie – durch Metaanalysen und vergleichende Forschung – zur Diskussion der sozialen, politischen und wirtschaftlichen Trends in Afrika beitragen. Besondere Aufmerksamkeit solle dem möglichen Wiederaufstieg des Entwicklungsstaates in Afrika gewidmet werden. Damit könne die Afrikaforschung auch ihren Anspruch untermauern, den Universalanspruch des Mainstreams der Sozialwissenschaften infrage zu stellen.

Leo J. de Haan

2010-01-01

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Harnessing microbiome and probiotic research in sub-Saharan Africa: recommendations from an African workshop  

Digital Repository Infrastructure Vision for European Research (DRIVER)

To augment capacity-building for microbiome and probiotic research in Africa, a workshop was held in Nairobi, Kenya, at which researchers discussed human, animal, insect, and agricultural microbiome and probiotics/prebiotics topics. Five recommendations were made to promote future basic and translational research that benefits Africans.

Swann, Jonathan R.; Reid, Gregor; Nduti, Nicholas; Sybesma, Wilbert; Kort, Remco; Kollmann, Tobias R.; Adam, Rod; Boga, Hamadi; Brown, Eric M.; Einerhand, Alexandra; El-nezami, Hani; Gloor, Gregory B.; Kavere, Irene I.; Lindahl, Johanna; Manges, Amee

2014-01-01

49

Exfoliation syndrome in sub-Saharan Africa.  

Science.gov (United States)

The goal of this review is to estimate the burden of exfoliation syndrome (XFS) and exfoliation glaucoma (XFG) in sub-Saharan Africa and to identify the gaps in knowledge of disease prevalence in this region. PubMed, Medline, African Journals Online and Google engine search were carried out using the following terms "pseudoexfoliation" or "exfoliation syndrome Africa", "pseudoexfoliation" or "exfoliation syndrome" + "glaucoma Africa," "glaucoma prevalence Africa," "pattern of glaucoma presentation Africa," "pseudoexfoliation" or "exfoliation syndrome" + "cataract Africa," "ophthalmic conditions Africa." Studies were included if they described the proportion or prevalence/incidence of XFG and XFS in sub-Saharan Africa or if they investigated lysyl oxidase-like 1 (LOXL1) variants in XFS among Africans. 22 papers were identified and classified as clinic-based studies (n = 16) and population-based (n = 4) studies. Two other studies were considered important, and therefore, included in the review. Clinic-based studies demonstrate that XFS is a common cause of glaucoma, as is true in many other parts of the world. Furthermore, XFS often co-exists with cataract and climatic droplet keratopathy. Its prevalence ranged from 5.1 to 7.7 % in patients >40 years in population-based studies, a value that is considerably higher than that reported in African Americans. XFS was strongly associated with increasing age in the prevalence studies. The burden of XFS in sub-Saharan Africa is high. More investigation is needed to determine why clinic-based studies report virtually no XFS in some countries (Ghana and Tanzania), while nearby countries report greater proportions (Nigeria and Ethiopia). PMID:24844849

Olawoye, Olusola O; Pasquale, Louis R; Ritch, Robert

2014-10-01

50

Digital Divide in Sub-Saharan African Universities: Recommendations and Monitoring  

Energy Technology Data Exchange (ETDEWEB)

The Digital Divide prevents Africa from taking advantages of new information technologies. One of the most urgent priorities is to bring the Internet in African Universities, Research, and Learning Centers to the level of other regions of the world. eGY-Africa, and the Sharing Knowledge Foundation are two bottom-up initiatives by scientists to secure better cyber-infrastructure and Internet facilities in Africa. Recommendations by the present scientific communities are being formulated at national, regional and international levels. The Internet capabilities are well documented at country level overall, but this is not the case at the University level. The snapshot of the Internet status in universities in 17 African countries, obtained by a questionnaire survey, is consistent with measures of Internet penetration in the corresponding country. The monitoring of Internet performance has been proposed to those African universities to provide an information base for arguing the need to improve the coverage for Africa. A pilot program is recommended that will start scientific collaboration with Europe in western Africa using ICT. The program will lay the foundations for the arrival of new technologies like Grids.

Barry, Boubakar; /Assoc. Afr. Univ.; Chukwuma, Victor; /Olabisi Onabanjo U.; Petitdidier, Monique; /CEPT, Velizy; Cottrell, Les; /SLAC; Bartons, Charles; /Australian Natl. U., RSES

2009-12-17

51

Assessment of the Vulnerability of Water Resources to Seasonal Fires Across the Northern Sub-Saharan African Region  

Science.gov (United States)

The northern sub-Saharan African (NSSA) region, extending from the southern fringes of the Sahara to the Equator, and stretching west to east from the Atlantic to the Indian ocean coasts, plays a prominent role in the distribution of Saharan dust and other airborne matter around the region and to other parts of the world, the genesis of global atmospheric circulation, and the birth of such major (and often catastrophic) events as hurricanes. Therefore, this NSSA region represents a critical variable in the global climate change equation. Recent satellite-based studies have revealed that the NSSA region has one of the highest biomass-burning rates per unit land area among all regions of the world. Because of the high concentration and frequency of fires in this region, with the associated abundance of heat release and gaseous and particulate smoke emissions, biomass-burning activity is believed to be a major driver of the regional carbon, energy, and water cycles. We acknowledge that the rainy season in the NSSA region is from April to September while biomass burning occurs mainly during the dry season (October to March). Nevertheless, these two phenomena are indirectly coupled to each other through a chain of complex processes and conditions, including land-cover and surface-albedo changes, the carbon cycle, evapotranspiration, drought, desertification, surface water runoff, ground water recharge, and variability in atmospheric composition, heating rates, and circulation. In this presentation, we will examine the theoretical linkages between these processes, discuss the preliminary results based on satellite data analysis, and provide an overview of plans for more integrated research to be conducted over the next few years.

Ichoku, Charles M.

2010-01-01

52

Gender and migration in Southern and Eastern Mediterranean and Sub-Saharan African countries  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Partant des mouvements migratoires internationaux, un double constat essentiel ressort à l’appui des données statistiques enregistrées au sein des pays d’accueil. Investis à l’échelle d’une zone géographique partant de la Méditerranée méridionale et orientale à l’Afrique sub-saharienne, les pays membres du réseau CARIM enregistrent des quantifications de départ à hauteur de dix millions d’individus, comptant, en outre, en son sein une population de près de quatre mil...

Blangiardo, Gian Carlo

2012-01-01

53

Training for rural radiology and imaging in sub-saharan Africa: addressing the mismatch between services and population.  

Science.gov (United States)

The objectives of this review are to outline the needs, challenges, and training interventions for rural radiology (RR) training in Sub-Saharan Africa (SSA). Rural radiology may be defined as imaging requirements of the rural communities. In SSA, over 80% of the population is rural. The literature was reviewed to determine the need for imaging in rural Africa, the challenges, and training interventions. Up to 50% of the patients in the rural health facilities in Uganda may require imaging, largely ultrasound and plain radiography. In Uganda, imaging is performed, on an average, in 50% of the deserving patients in the urban areas, compared to 10-13 % in the rural areas. Imaging has been shown to increase the utilization of facility-based rural health services and to impact management decisions. The challenges in the rural areas are different from those in the urban areas. These are related to disease spectrum, human resource, and socio-economic, socio-cultural, infrastructural, and academic disparities. Countries in Sub-Saharan Africa, for which information on training intervention was available, included: Uganda, Kenya, Tanzania, Rwanda, Zambia, Ghana, Malawi, and Sudan. Favorable national policies had been instrumental in implementing these interventions. The interventions had been made by public, private-for-profit (PFP), private-not-for profit (PNFP), local, and international academic institutions, personal initiatives, and professional societies. Ultrasound and plain radiography were the main focus. Despite these efforts, there were still gross disparities in the RR services for SSA. In conclusion, there have been training interventions targeted toward RR in Africa. However, gross disparities in RR provision persist, requiring an effective policy, plus a more organized, focused, and sustainable approach, by the stakeholders. PMID:22919551

Kawooya, Michael G

2012-01-01

54

The status of basic design ground motion provisions in seismic design codes of sub-Saharan African countries: A critical review  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english Basic provisions for design ground motions in seismic design codes of sub-Saharan African countries are critically reviewed. The seismic codes of Ethiopia, Kenya and Uganda are selected to represent the eastern region, Ghana to represent the west and South Africa to represent the south. The specific [...] provisions considered are those pertaining to site effect and the recurrence period of the design earthquake. The codes are also compared with one another and with selected current international codes from the US and Europe, with respect to selected provisions. The provisions are further viewed from the perspective of the state of the art and the state of the practice. It has been concluded that these basic provisions in most of the sub-Saharan African codes considered are inadequate in guaranteeing safety of human life and limiting damage to property, suggesting a need for immediate updating, an exception being the South African code.

A, Worku.

2014-01-01

55

The status of basic design ground motion provisions in seismic design codes of sub-Saharan African countries: A critical review  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english Basic provisions for design ground motions in seismic design codes of sub-Saharan African countries are critically reviewed. The seismic codes of Ethiopia, Kenya and Uganda are selected to represent the eastern region, Ghana to represent the west and South Africa to represent the south. The specific [...] provisions considered are those pertaining to site effect and the recurrence period of the design earthquake. The codes are also compared with one another and with selected current international codes from the US and Europe, with respect to selected provisions. The provisions are further viewed from the perspective of the state of the art and the state of the practice. It has been concluded that these basic provisions in most of the sub-Saharan African codes considered are inadequate in guaranteeing safety of human life and limiting damage to property, suggesting a need for immediate updating, an exception being the South African code.

A, Worku.

56

Strategies for heart disease in sub-Saharan Africa.  

Science.gov (United States)

The commonest forms of heart disease in sub-Saharan Africa are chronic rheumatic heart disease, dilated cardiomyopathy, pulmonary heart disease, infectious forms of heart disease including chronic, constrictive and infective endocarditis, genetic forms of heart disease and arrhythmias. Malnutrition, with cardiac manifestations such as beriberi, and alcoholism also play a part. Ischaemic heart disease in sub-Saharan Africa at present affects mainly the small, Westernised white population. Heart disease is a less important cause of morbidity and mortality than many other infectious diseases but is likely to escalate in the next generation(s). The changing demographic picture dictates the way in which funds for research, prevention and treatment must be channelled to best advantage. A concerted effort must be made by cardiologists of African countries to arrest the advance of heart disease, and a declaration outlining these strategies has been endorsed by the Pan-African Society of Cardiology (PASCAR). PMID:19628470

Brink, A J; Aalbers, J

2009-10-01

57

Population dynamics throughout the urban context: A case study in sub-Saharan Africa utilizing remotely sensed imagery and GIS  

Science.gov (United States)

The characteristics of places where people live and work play an important role in explaining complex social, political, economic and demographic processes. In sub-Saharan Africa rapid urban growth combined with rising poverty is creating diverse urban environments inhabited by people with a wide variety of lifestyles. This research examines how spatial patterns of land cover in a southern portion of the West African country of Ghana are associated with particular characteristics of family organization and reproduction decisions. Satellite imagery and landscape metrics are used to create an urban context definition based on landscape patterns using a gradient approach. Census data are used to estimate fertility levels and household structure, and the association between urban context, household composition and fertility levels is modeled through OLS regression, spatial autoregressive models and geographically weighted regression. Results indicate that there are significant differences in fertility levels between different urban contexts, with below average fertility levels found in the most urbanized end of the urban context definition and above average fertility levels found on the opposite end. The spatial patterns identified in the association between urban context and fertility levels indicate that, within the city areas with lower fertility have significant impacts on the reproductive levels of adjacent neighborhoods. Findings also indicate that there are clear patterns that link urban context to living arrangements and fertility levels. Female- and single-headed households are associated with below average fertility levels, a result that connects dropping fertility levels with the spread of smaller nuclear households in developing countries. At the same time, larger extended family households are linked to below average fertility levels for highly clustered areas, a finding that points to the prevalence of extended family housing in the West African city.

Benza, Magdalena

58

Saving-Investment Correlation and Capital Mobility in Sub-Saharan African Countries: A Reappraisal through Inward and Outward Capital Flows’ Correlation  

Directory of Open Access Journals (Sweden)

Full Text Available This paper analyses the Feldstein-Horioka puzzle in 15 sub-Saharan African countries accounting for the correlation between inward and outward capital flows. Applying cross section, panel data, and even time series analyses, we show that our results are consistent with previous studies related to developing countries.  More interesting, we confirm, for sub-Saharan African countries, the recent hypothesis of Georgepoulos and Hejazi (2009 that the Feldstein-Horioka home bias is unrelated to the correlation between inward and outward capital flows for developing countries. Although the saving-investment coefficient weakens in the correlation adjusted regression, we show that the coefficient on Flows, the variable which accounts for the correlation between inward and outward capital flows is always positive and insignificant. We argue that the downward movement in the saving-investment coefficient is due the omission of some factors (foreign aid and trade openness which are relevant for developing countries in the framework of the Feldstein-Horioka analysis. We also state that our results are more likely to reflect the poor financial structure of the countries in our sample. Therefore, we suggest that policymakers in Sub-Sahara Africa should put more emphasis in creating and developing efficient financial market which could favor portfolio diversification.

Samba Michel Cyrille

2010-04-01

59

Maternal nutrition among women from Sub-Saharan Africa, with a focus on Nigeria, and potential implications for pregnancy outcomes among immigrant populations in developed countries.  

LENUS (Irish Health Repository)

Pregnant women in countries of Sub-Saharan Africa (SSA) are at risk of poor nutritional status and adverse outcomes as a result of poverty, food insecurity, sub-optimal healthcare facilities, frequent infections and frequent pregnancies. Studies from Nigeria, for example, have revealed a high prevalence of both under- and over-nutrition, as well as nutrient deficiencies, including iron, folate, vitamin D and vitamin A. Subsequently, obstetric complications, including hypertension, anaemia, neural tube defects, night-blindness, low birth weight and maternal and perinatal mortality, are common. Migration patterns from SSA to the Western world are on the rise in recent years, with Nigerians now representing the most prevalent immigrant African population in many developed countries. However, the effect of immigration, if any, on the nutritional status and pregnancy outcomes of these women in their host countries has not yet been studied. Consequently, it is unknown to what extent the nutritional deficiencies and pregnancy complications occurring in Nigeria, and other countries of SSA, present in these women post-emigration. This may result in missed opportunities for appropriate antenatal care of a potential high-risk group in pregnancy. The present review discusses the literature regarding nutrition in pregnancy among SSA women, using Nigeria as an example, the common nutrition-related complications that arise and the subsequent obstetric outcomes. The concept of dietary acculturation among immigrant groups is also discussed and deficiencies in the literature regarding studies on the diets of pregnant immigrant women are highlighted.

Lindsay, K L

2012-12-01

60

Urban Health and Welfare in Sub-Saharan Africa: Population Growth, Urbanisation, Water/Sanitation Services, Slumisation and Poverty  

Directory of Open Access Journals (Sweden)

Full Text Available Spatio-temporal analysis was applied on data representing urbanisation, slumisation, poverty, safe water/ sanitation in urban sub-Saharan Africa (SSA. The findings include: rapid rates of national population growth and urbanisation throughout SSA from 1980 to 2005, averaging 93.8% (range: 90.5% points, lowest and highest rates being 40% (Lesotho and 130.5% (Niger, respectively; high national poverty rates, widespread in SSA: (>50% in about seven countries; it might have been similar in more countries if a large number of SSA countries had reported their 1993 poverty rates; high urban/rural poverty ratios (1.05-1.79 points range between Nigeria and Benin Republics. High average rate (73% of slumisation in SSA in 2001 (range: 96%, lowest and highest rates being in Zimbabwe (3% and Chad/Ethiopia (99%, respectively. SSA’s 2000 health adjusted life expectancy was generally low: 38.8 years (<40 years in 24 countries. Use of safe/improved water/sanitation services were poor almost throughout SSA: declined rapidly and ubiquitously from 72% (2000 to 55% (2002, minus 17% points decrease in three years within individual countries with alarming declines up to minus 69% points in Guinea. The policy implications of the findings include the urgent and imperative need to massively implement urban improvement programmes designed to provide health-inducing services/facilities across SSA.

RICHARD INGWE

2012-01-01

 
 
 
 
61

Sustainable electricity generation for rural and peri-urban populations of sub-Saharan Africa: The 'flexy-energy' concept  

International Nuclear Information System (INIS)

Access to energy is known as a key issue for poverty reduction. Electrification rate of sub-Saharan countries is one of the lowest among the developing countries. However, this part of the world has natural energy resources that could help raising its access to energy, then its economic development. An original 'flexy-energy' concept of hybrid solar PV/diesel/biofuel power plant, without battery storage, is performed in this paper. This concept is developed in order to not only make access to energy possible for rural and peri-urban populations in Africa (by reducing the electricity generation cost) but also to make the electricity production sustainable in these areas. For landlocked countries like Burkina Faso, this concept could help them reducing their electricity bill (then their fuel consumption) and accelerate their rural and peri-urban electrification coverage. - Research highlights: ? Design and load management Optimization are big concerns for hybrid systems. ? Hybrid solar PV/Diesel is economically viable for remote areas and environmental friendly. ? 'Flexy-energy' concept is a flexible hybrid solar PV/diesel/biomass suitable for remote areas. ? 'Flexy-energy' concept is a flexible hybrid solar PV/diesel/biomass suitable for remote areas.

62

Is the current decline in malaria burden in sub-Saharan Africa due to a decrease in vector population?  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background In sub-Saharan Africa (SSA, malaria caused by Plasmodium falciparum has historically been a major contributor to morbidity and mortality. Recent reports indicate a pronounced decline in infection and disease rates which are commonly ascribed to large-scale bed net programmes and improved case management. However, the decline has also occurred in areas with limited or no intervention. The present study assessed temporal changes in Anopheline populations in two highly malaria-endemic communities of NE Tanzania during the period 1998-2009. Methods Between 1998 and 2001 (1st period and between 2003 and 2009 (2nd period, mosquitoes were collected weekly in 50 households using CDC light traps. Data on rainfall were obtained from the nearby climate station and were used to analyze the association between monthly rainfall and malaria mosquito populations. Results The average number of Anopheles gambiae and Anopheles funestus per trap decreased by 76.8% and 55.3%, respectively over the 1st period, and by 99.7% and 99.8% over the 2nd period. During the last year of sampling (2009, the use of 2368 traps produced a total of only 14 Anopheline mosquitoes. With the exception of the decline in An. gambiae during the 1st period, the results did not reveal any statistical association between mean trend in monthly rainfall and declining malaria vector populations. Conclusion A longitudinal decline in the density of malaria mosquito vectors was seen during both study periods despite the absence of organized vector control. Part of the decline could be associated with changes in the pattern of monthly rainfall, but other factors may also contribute to the dramatic downward trend. A similar decline in malaria vector densities could contribute to the decrease in levels of malaria infection reported from many parts of SSA.

Rwegoshora Rwehumbiza T

2011-07-01

63

Is the current decline in malaria burden in sub-Saharan Africa due to a decrease in vector population?  

DEFF Research Database (Denmark)

ABSTRACT: BACKGROUND: In sub-Saharan Africa (SSA), malaria caused by Plasmodium falciparum has historically been a major contributor to morbidity and mortality. Recent reports indicate a pronounced decline in infection and disease rates which are commonly ascribed to large-scale bed net programmes and improved case management. However, the decline has also occurred in areas with limited or no intervention. The present study assessed temporal changes in Anopheline populations in two highly malaria-endemic communities of NE Tanzania during the period 1998-2009. METHODS: Between 1998 and 2001 (1st period) and between 2003 and 2009 (2nd period), mosquitoes were collected weekly in 50 households using CDC light traps. Data on rainfall were obtained from the nearby climate station and was used to analyze the association between monthly rainfall and malaria mosquito populations. RESULTS: The average number of Anopheles gambiae and Anopheles funestus per trap decreased by 76.8% and 55.3%, respectively over the 1st period, and by 99.7% and 99.8% over the 2nd period. During the last year of sampling (2009), the use of 2368 traps produced a total of only 14 Anopheline mosquitoes. With the exception of the decline in An. gambiae during the 1st period, the results did not reveal any statistical association between mean trend in monthly rainfall and declining malaria vector populations. CONCLUSION: A longitudinal decline in the density of malaria mosquito vectors was seen during both study periods despite the absence of organized vector control. Part of the decline could be associated with changes in the pattern of monthly rainfall, but other factors may also contribute to the dramatic downward trend. A similar decline in malaria vector densities could contribute to the decrease in levels of malaria infection reported from many parts of SSA.

Meyrowitsch, Dan Wolf; Pedersen, Erling MØller

2011-01-01

64

Understanding and Advancing the Health of Older Populations in sub-Saharan Africa: Policy Perspectives and Evidence Needs  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Debate on policy challenges associated with the health of older populations in sub-Saharan Africa (SSA has intensifi ed in recent years, centering on a concern about older persons’ vulnerability to ill-health and their exclusion from health services. Despite international policy calls and formal expressions of commitment on the part of SSA governments, comprehensive policy action has remained scant. The impasse refl ects a lack of political will and an uncertainty about required policy approaches, engendered by wide gaps in understanding of oldage-related health in the region.Purpose: The purpose of the paper is to pinpoint major approaches and areas of evidence needed as a priority to overcome the impasse in policy on ageing and health in SSA.Methodology: A critical review of relevant SSA and international scientific, policy and development literature conducted as part of a research project on Dimensions and determinants of health in old age in Kenya and Nigeria: implications for policy.Results: Six major areas of evidence and a spectrum of approaches are required to (i strengthen the case on why action on old age-related health should be pursued in the SSA setting and (ii clarify what concrete forms such action should take.Conclusion: A systematic research endeavour on the six areas is needed to advance policy and practice on the health of older populations in SSA. If accompanied by an explicit international comparative perspective such research also has the potential to significantly advance scientific debate on ageing and health globally.

Isabella Aboderin

2010-12-01

65

LM and Others v Government of the Republic of Namibia: The first sub-Saharan African case dealing with coerced sterilisations of HIV-positive women - Quo vadis?  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english It has been argued that three factors characterise the HIV epidemic in sub-Saharan Africa - its female face; the implications it poses for sexual and reproductive health services (particularly those provided to women); and the pervasive discrimination following those who are infected. These factors [...] also form the context within which there have been an increasing number of reports of HIV-positive women being coerced or forced into being permanently sterilised in order to prevent future pregnancies. The recent decision in LM and Others v Government of the Republic of Namibia deals with the alleged discriminatory and coerced sterilisation of three women living with HIV. This article describes and critiques the LM judgment. It concludes with brief comments on the way forward for similar litigation in other Southern African countries.

Chantal J, Badul; Ann, Strode.

66

LM and Others v Government of the Republic of Namibia: The first sub-Saharan African case dealing with coerced sterilisations of HIV-positive women - Quo vadis?  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english It has been argued that three factors characterise the HIV epidemic in sub-Saharan Africa - its female face; the implications it poses for sexual and reproductive health services (particularly those provided to women); and the pervasive discrimination following those who are infected. These factors [...] also form the context within which there have been an increasing number of reports of HIV-positive women being coerced or forced into being permanently sterilised in order to prevent future pregnancies. The recent decision in LM and Others v Government of the Republic of Namibia deals with the alleged discriminatory and coerced sterilisation of three women living with HIV. This article describes and critiques the LM judgment. It concludes with brief comments on the way forward for similar litigation in other Southern African countries.

Chantal J, Badul; Ann, Strode.

2013-01-01

67

HIV testing in primary care: feasibility and acceptability of provider initiated HIV testing and counseling for sub-Saharan African migrants.  

Science.gov (United States)

Provider-initiated HIV testing and counseling (PITC) is recommended to reduce late HIV diagnoses, common among Sub-Saharan African migrants (SAM) residing in Europe. Primary care represents an ideal entry point for PITC. To support Flemish general practitioners (GPs), we developed a culturally sensitive PITC tool. Over a 12-week period, 65 GPs implemented PITC to assess acceptability and feasibility of PITC. The qualitative evaluation showed high acceptability among physicians. Routine PITC was challenged by physicians' personal discomfort, assumptions of patients' sexual risk, perceived incoherence with reasons for consultation, and time pressure. The best opportunity for PITC was an indicated blood analysis for other medical reasons. Counseling skills improved during the implementation, but participants still advocated for reduced counseling requirements. PITC proved to be feasible in primary care settings, but the up-scaling requires a reformulation of counseling guidelines, a policy stipulating the role of GPs in the prevention-care continuum, and an investment in (continuous) training. PMID:24450280

Loos, Jasna; Manirankunda, Lazare; Hendrickx, Kristin; Remmen, Roy; Nöstlinger, Christiana

2014-02-01

68

Is Grant-Aid More Effective than Concessional Loans? Evidence from a Dynamic Panel of Sub-Saharan African Countries  

Directory of Open Access Journals (Sweden)

Full Text Available Despite being one of the highest aid recipient regions, the growth performance in Sub-Saharan Africa (SSA has been rather disappointing. In this paper, we answer two questions. 1 Is there any significant impact of foreign aid on economic growth? 2 Is grant more effective than loans in promoting growth? To answer these questions, we employ a GMM technique for a panel of 27 SSA countries over the period of 1961 to 2009. By using this technique, we are able to control for endogeneity that may arise from explanatory variables. Our results suggest that grant aid is more effective than concessional loans. On average, aggregate aid’s effect on economic growth is not discernable from zero in SSA countries. These questions are important for policymakers of SSA who often face the dilemma of high aid but low growth.

Anupam Das

2011-12-01

69

Research in sub-saharan African food systems must address post-sustainability challenges and increase developmental returns  

DEFF Research Database (Denmark)

Post-sustainability challenges to food systems of Sub-Saharan Africa (SSA) include climate change vulnerability, globalisation of agri-food chains and markets and emerging low-carbon energy systems. In addition, the lack of investment in research for development (R4D) in SSA, all underlines need to rethink R4D to pursue policy purposes. A starting point could be the sustainable livelihoods approach, as a research paradigm focusing on sector-related problems, while questioning the salience, credibility and legitimacy of research findings. Even with a sector-related prioritization of the investments in research in agriculture in the south, the north and south has to rethink partnership options to enhance capacity to do research. Without such rethinking, scientific logic will continue to limit the contribution that agricultural R4D can make toward achieving millennium development goals.

Jensen, Henning HØgh; Egelyng, Henrik

2009-01-01

70

Quality Assurance in Sub-Saharan Africa  

Science.gov (United States)

This article assesses the status and practice of higher education quality assurance in sub-Saharan Africa, focusing on degree-granting tertiary institutions. A main finding is that structured national-level quality assurance processes in African higher education are a very recent phenomenon and that most countries face major capacity constraints.…

Materu, Peter; Righetti, Petra

2010-01-01

71

Rickettsioses in sub-Saharan Africa.  

Science.gov (United States)

Although rickettsioses are among the oldest known vector-borne zoonoses, several species or subspecies of rickettsias have been identified in recent years as emerging pathogens throughout the world including in sub-Saharan Africa. To date, six tick-borne spotted fever group pathogenic rickettsias are known to occur in sub-Saharan Africa, including Rickettsia conorii conorii, the agent of Mediterranean spotted fever; R. conorii caspia, the agent of Astrakhan fever; R. africae, the agent of African tick-bite fever; R. aeschlimannii; R. sibirica mongolitimonae; and R. massiliae. On the other hand, fleas have long been known as vectors of the ubiquitous murine typhus, a typhus group rickettsiosis induced by R. typhi. However, a new spotted fever rickettsia, R. felis, has also been found to be associated with fleas, to be a human pathogen, and to be present in sub-Saharan Africa. Finally, R. prowazekii the agent of louse-borne epidemic typhus continues to strikes tens to hundreds of thousands of persons who live in Sub-Saharan with civil war, famine and poor conditions. We present an overview of these rickettsioses occurring in sub-Saharan Africa, focusing on the epidemiological aspects of emerging diseases. PMID:17114679

Parola, Philippe

2006-10-01

72

Proportionate Target Population Estimates Used by National Immunization Programmes in Sub-Saharan Africa and Comparison with Values from an External Source  

Directory of Open Access Journals (Sweden)

Full Text Available Background: In order to effectively plan the delivery of immunization services, manage stock and supply levels and target interventions, national immunization programmes (NIP must have an estimate of the target population they serve. To overcome challenges with target population estimation, some NIPs apply “rule-of-thumb” conversion factors to total population estimates. We compare these proportionate target population values with those from an external source. Methods: Using data reported by national immunization programmes in sub-Saharan Africa, we computed the proportionate target population as the number of births, surviving infants and children under 5 years of age, respectively, as a proportion of the total population size. We compared these values with those estimates computed from United Nations Population Division (UNPD data. We then recomputed NIP target population sizes using the proportionate target population values from the UNPD applied to the total population size reported by NIP. Results: Data were available from 47 sub-Saharan Africa countries. Births as a proportion of the total population were greater within reports from NIP (median, 0.0400; IQR: 0.350 - 0.0437 compared to values from UNPD estimates (median, 0.0364; IQR: 0.0332 - 0.0406. Similar patterns were observed for surviving infants (median: NIP, 0.0360; UNPD, 0.0337 and children under 5 years of age (median: NIP, 0.1735; UNPD, 0.1594. The percent difference in proportionate target population ratios between reports from NIPs and the UNPD was >10% in 23 countries for births, in 18 countries for surviving infants, in 15 countries for children under 5 years of age. After re-computing target populations using UNPD proportionate target population values applied to NIP reported total population, recomputed administrative coverage levels for the third dose of DTP containing vaccine were higher in 32 of the 47 countries compared to reported administrative coverage levels. Conclusion: Because childhood immunization-related target populations are among the more difficult ones to accurately estimate and project, immunization programmes in sub-Saharan Africa are encouraged to include a critical assessment of the target population values, in conjunction with their national statistics system, as part of the on-going programme monitoring process.

David W. Brown

2014-08-01

73

The effects of the African Green Revolution on nitrogen losses from two contrasting soil types in sub-Saharan Africa  

Science.gov (United States)

Nearly 80% of countries in sub-Saharan Africa (SSA) face problems of nitrogen (N) scarcity, which together with poverty causes food insecurity and malnutrition. The Alliance for a Green Revolution in Africa has set a goal of increasing fertilizer use in the region six-fold by 2015. While there is substantial evidence that greater N fertilizer use will improve crop yields, it could lead to increased N leaching and elevated nitrate (NO3-) concentrations in surface water and groundwater reservoirs. However, it is unclear what the magnitude of impacts will be in SSA given historically low nutrient additions (of less than 5 kg N/ha/yr), highly degraded soils (due to years of nutrient and soil organic matter depletion), and a wide range of soil types on which increased fertilizer use is occurring. Current estimates of N dynamics and balances in SSA agriculture now rely on data from other regions with different soil types, soil fertility, and land management practices. To understand the influence of increased fertilizer use on water quality requires data from representative areas in SSA. Experimental maize plots were established in a randomized complete block design in both western Kenya (clayey soil) and mid-western Tanzania (sandy soil). Plots were amended with 0, 50, 75, and 200 kg N/ha/yr as mineral fertilizer. Tension lysimeters were installed at three depths in each treatment, and water was collected throughout the maize growing season. Soil water solutions were analyzed for NO3--N. Flow through the soil column at each soil depth, was modeled using VS2DT, a variably saturated flow and solute transport model, and water flux values were multiplied by measured NO3--N concentrations to estimate seasonal N leaching flux. Soil texture was a major driver of N losses, altering both the pathways and magnitude of losses. Clayey soils in western Kenya show an enormous potential for loss of NO3--N immediately following the onset of rains as they trigger high rates of N mineralization and nitrification in the topsoil (known as the 'birch effect'). We did not observe this pulse in the sandy soils of central Tanzania. However, NO3- N concentrations in leachate were three times lower at 200 cm in clayey soils compared to sandy soils as a result of higher anion exchange capacity in clays. We show that while clayey soils lose NO3--N in a large pulse at the onset of rains, sandy soils lose large quantities of NO3--N over the course of the maize growing season. Results from this study can help inform recommended N application rates in similar soils (tropical Ultisols and Oxisols), to optimize yields while minimizing N leaching losses.

Tully, K. L.; Russo, T.; Hickman, J. E.; Palm, C.

2013-12-01

74

Decomposition analysis of CO2 emission intensity between oil-producing and non-oil-producing sub-Saharan African countries  

International Nuclear Information System (INIS)

The need to decompose CO2 emission intensity is predicated upon the need for effective climate change mitigation and adaptation policies. Such analysis enables key variables that instigate CO2 emission intensity to be identified while at the same time providing opportunities to verify the mitigation and adaptation capacities of countries. However, most CO2 decomposition analysis has been conducted for the developed economies and little attention has been paid to sub-Saharan Africa. The need for such an analysis for SSA is overwhelming for several reasons. Firstly, the region is amongst the most vulnerable to climate change. Secondly, there are disparities in the amount and composition of energy consumption and the levels of economic growth and development in the region. Thus, a decomposition analysis of CO2 emission intensity for SSA affords the opportunity to identify key influencing variables and to see how they compare among countries in the region. Also, attempts have been made to distinguish between oil and non-oil-producing SSA countries. To this effect a comparative static analysis of CO2 emission intensity for oil-producing and non oil-producing SSA countries for the periods 1971-1998 has been undertaken, using the refined Laspeyres decomposition model. Our analysis confirms the findings for other regions that CO2 emission intensity is attributable to energy consumption intensity, CO2 emission coefficient of energy types and economic structure. Particularly, CO2 emission coefficient of energy use was found to exercise the most influence on CO2 emission intensity for both oil and non-oil-producing sub-Saharan African countries in the first sub-interval period of our investigation from 1971-1981. In the second subinterval of 1981-1991, energy intensity and structural effect were the two major influencing factors on emission intensity for the two groups of countries. However, energy intensity effect had the most pronounced impact on CO2 emission intensity in non-oil-producing sub-Saharan African countries, while the structural effect explained most of the increase in CO2 emission intensity among the oil-producing countries. Finally, for the period 1991-1998, structural effect accounted for much of the decrease in intensity among non-oil-producers, while CO2 emission coefficient of energy use was the major force driving the decrease among oil-producing countries. The dynamic changes in the CO2 emission intensity and energy intensity effects for the two groups of countries suggest that fuel switching had been predominantly towards more carbon-intensive production in oil-producing countries and less carbon-intensive production in non-oil-producing SSA countries. In addition to the decomposition analysis, the article discusses policy implications of the results. We hope that the information and analyses provided here would help inform national energy and climate policy makers in SSA of the relative weaknesses and possible areas of strategic emphasis in their planning processes for mitigating the effects of climate change

75

Stakeholder Participation in International Higher Education Partnerships: Results of a Survey of Two Sub-Saharan African Universities  

Science.gov (United States)

In the last few years, foreign institutions have increasingly sought to establish partnerships with African universities. Likewise, African universities have increasingly sought to establish linkages with foreign institutions. Different factors suggest that these partnerships will continue to be a major focus in the future. This study draws from a…

Chiteng Kot, Felly

2014-01-01

76

Shaping the Role of sub-Saharan African Nurses and Midwives: Stakeholder’s perceptions of the Nurses’ and Midwives’ tasks and roles  

Directory of Open Access Journals (Sweden)

Full Text Available To explore the role expectations of different stakeholders in the health care system on the roles and tasks that nurses and midwives perform, in order to clarify and strengthen these roles and shape the future of nursing education and practice in sub-Saharan Africa. Qualitative focus group discussions were held with different stakeholders (nurses, health service managers, patients and their caregivers, community members and leaders and other health professionals in eight African countries in order to establish their role expectations of nurses and midwives. Three questions about their role expectations and the interviews were taped, transcribed, and translated into English and analysed. There was consensus amongst the stakeholders regarding eight role functions: taking care of patients; giving health information; managing the care environment; advocating for patients; services and policies; providing emergency care; collaborating with other stakeholders; and providing midwifery care to women, infants and their families. There was disagreement amongst the stakeholders about the role of diagnosis and prescribing treatment. Nursing derives its mandate from communities it serves, and the roles expected must therefore form part of nursing regulation, education and practice standards. Health planners must use these as a basis for job descriptions and rewards. Once these are accepted in the training and regulation of nursing, they must be marketed so that recipients are aware thereof.

Naomi M. Seboni

2013-05-01

77

The impact of energy consumption and CO2 emission on the economic growth and financial development in the Sub Saharan African countries  

International Nuclear Information System (INIS)

This study investigated the impact of energy consumption and CO2 emission on GDP (gross domestic product) growth and the financial development in thirty Sub Saharan African Countries. The panel model was used in this study from the period 1980 to 2008. The results showed that energy consumption had played an important role to increase both economic growth and the financial development in the investigated economies but with the consequence of high po llution. This study recommended that these countries should increase energy productivity by increasing energy efficiency, implementation of energy savings projects, energy conservation, and energy infrastructure outsourcing to achieve its financial development and GDP growth and to increase their investment on energy projects to achieve the full energy potential. -- Highlights: ? The impact of energy consumption, CO2 emission on GDP and the financial development in the SSA countries was investigated. ? The panel model was implied in this study from the period 1980 to 2008. ? The results show energy consumption increased economic growth and the financial development but with higher pollution.

78

Shaping the Role of sub-Saharan African Nurses and Midwives: Stakeholder's perceptions of the Nurses' and Midwives' tasks and roles  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english To explore the role expectations of different stakeholders in the health care system on the roles and tasks that nurses and midwives perform, in order to clarify and strengthen these roles and shape the future of nursing education and practice in sub-Saharan Africa. Qualitative focus group discussio [...] ns were held with different stakeholders (nurses, health service managers, patients and their caregivers, community members and leaders and other health professionals) in eight African countries in order to establish their role expectations of nurses and midwives. Three questions about their role expectations and the interviews were taped, transcribed, and translated into English and analysed. There was consensus amongst the stakeholders regarding eight role functions: taking care of patients; giving health information; managing the care environment; advocating for patients; services and policies; providing emergency care; collaborating with other stakeholders; and providing midwifery care to women, infants and their families. There was disagreement amongst the stakeholders about the role of diagnosis and prescribing treatment. Nursing derives its mandate from communities it serves, and the roles expected must therefore form part of nursing regulation, education and practice standards. Health planners must use these as a basis for job descriptions and rewards. Once these are accepted in the training and regulation of nursing, they must be marketed so that recipients are aware thereof.

Naomi M., Seboni; Mabel K.M., Magowe; Leana R., Uys; Mary B, Suh; Komba N., Djeko; Haouaou, Moumouni.

2013-10-01

79

Mesoscale modeling and satellite observation of transport and mixing of smoke and dust particles over northern sub-Saharan African region  

Science.gov (United States)

transport and vertical distribution of smoke and dust aerosols over the northern sub-Saharan African region are simulated in the Weather Research and Forecasting model with Chemistry (WRF-Chem), which uses hourly dynamic smoke emissions from the Fire Locating and Modeling of Burning Emissions database derived from the Moderate Resolution Imaging Spectroradiometer (MODIS) fire products. Model performance for February 2008 is evaluated using MODIS true color images, aerosol optical depth (AOD) measurements from the Aerosol Robotic Network, MODIS AOD retrievals, and the Cloud-Aerosol Lidar data with Orthogonal Polarization (CALIOP) atmospheric backscattering and extinction products. Specification of smoke injection height of 650 m in WRF-Chem yields aerosol vertical profiles that are most consistent with CALIOP observations of aerosol layer height. Between the equator and 10°N, Saharan dust is often mixed with smoke near the surface, and their transport patterns manifest the interplay of trade winds, subtropical highs, precipitation associated with the Intertropical Convergence Zone, and the high mountains located near the Great Rift Valley region. At the 700 hPa level and above, smoke layers spread farther to the north and south and are often above the dust layers over the Sahel region. In some cases, transported smoke can also be mixed with dust over the Saharan region. Statistically, 5% of the CALIOP valid measurements in February 2007-2011 show aerosol layers either above or between the clouds, reinforcing the importance of the aerosol vertical distribution for quantifying aerosol impact on climate in the Sahel region.

Yang, Zhifeng; Wang, Jun; Ichoku, Charles; Hyer, Edward; Zeng, Jing

2013-11-01

80

Shaping the Role of sub-Saharan African Nurses and Midwives: Stakeholder's perceptions of the Nurses' and Midwives' tasks and roles  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english To explore the role expectations of different stakeholders in the health care system on the roles and tasks that nurses and midwives perform, in order to clarify and strengthen these roles and shape the future of nursing education and practice in sub-Saharan Africa. Qualitative focus group discussio [...] ns were held with different stakeholders (nurses, health service managers, patients and their caregivers, community members and leaders and other health professionals) in eight African countries in order to establish their role expectations of nurses and midwives. Three questions about their role expectations and the interviews were taped, transcribed, and translated into English and analysed. There was consensus amongst the stakeholders regarding eight role functions: taking care of patients; giving health information; managing the care environment; advocating for patients; services and policies; providing emergency care; collaborating with other stakeholders; and providing midwifery care to women, infants and their families. There was disagreement amongst the stakeholders about the role of diagnosis and prescribing treatment. Nursing derives its mandate from communities it serves, and the roles expected must therefore form part of nursing regulation, education and practice standards. Health planners must use these as a basis for job descriptions and rewards. Once these are accepted in the training and regulation of nursing, they must be marketed so that recipients are aware thereof.

Naomi M., Seboni; Mabel K.M., Magowe; Leana R., Uys; Mary B, Suh; Komba N., Djeko; Haouaou, Moumouni.

 
 
 
 
81

First evaluation of a population-based screen to detect emotional-behavior disorders in orphaned children in Sub-Saharan Africa.  

Science.gov (United States)

Due to the HIV/AIDS pandemic which has left 12 million children orphaned in Sub-Saharan Africa, children are at increased risk for mental health problems. Currently, no validity data exist for any screening measure of emotional-behavior disorders in pre-adolescent children in Sub-Saharan Africa. The aims of the current study were to evaluate the construct validity of the caregiver-, teacher-, and self-report versions of the one-page Strengths and Difficulties Questionnaire (SDQ) in 466 orphans in South Africa between the ages of 7 and 11 (M age = 9.23 years, SD = 1.33, 51.93 % female) and to provide, for the first time, clinical cut-offs for this population. Findings demonstrated support for the caregiver SDQ, but not the teacher and self-report versions. We provide clinical cut-offs, but caution their use before further research is conducted. There remains a critical need for further psychometric studies of the SDQ in the developing world. PMID:24623068

Sharp, Carla; Venta, Amanda; Marais, Lochner; Skinner, Donald; Lenka, Molefi; Serekoane, Joe

2014-06-01

82

Population genetics of the African buffalo : from ecology to evolution  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The African buffalo ( Syncerus caffer ) is one of the most numerous mammals of sub-Saharan Africa. Since the end of the 19th it has been affected by rinderpest epidemics and by habitat fragmentation due to increasing urbanisation and cultivation. In this thesis the genetic diversity of the African buffalo is investigated. A better knowledge of the population genetics of the African buffalo is necessary for an effective management and protection of this species. The goals of this thesis were t...

Hooft, W. F.

2001-01-01

83

A review on aflatoxin contamination and its implications in the developing world : a sub-Saharan African perspective  

DEFF Research Database (Denmark)

Mycotoxins contamination in some agricultural food commodities seriously impact human and animal health and reduce the commercial value of crops. Mycotoxins are toxic secondary metabolites produced by fungi that contaminate agricultural commodities pre- or postharvest. Africa is one of the continents where environmental, agricultural and storage conditions of food commodities are conducive of Aspergillus fungi infection and aflatoxin biosynthesis. This paper reviews the commodity-wise aetiology and contamination process of aflatoxins and evaluates the potential risk of exposure from common African foods. Possible ways of reducing risk for fungal infection and aflatoxin development that are relevant to the African context. The presented database would be useful as benchmark information for development and prioritization of future research. There is need for more investigations on food quality and safety by making available advanced advanced equipments and analytical methods as well as surveillance and awareness creation in the region.

Gnonlonfin, Gbemenou Joselin Benoit; Hell, K.

2013-01-01

84

Energy Security and Sub-Saharan Africa  

Directory of Open Access Journals (Sweden)

Full Text Available Published by Palgrave MacmillanOver the last decade the topic of energy security has reappeared on global policy agendas. Most analyses of international energy geopolitics examine the interests and behaviour of powerful energy-importing countries like the US and China. This chapter begins by examining foreign powers’ expanded exploitation of oil and uranium resources in Sub-Saharan Africa. It goes on to examine how energy importers’ efforts to enhance their energy security through Africa are impacting energy security within Africa. It assesses Sub-Saharan states’ attempts to increase consumption of local oil and uranium reserves. Observing the constraints on these efforts, it then outlines some alternative strategies that have been employed to enhance African energy security. It concludes that, while local community-based development projects have improved the well-being of many households, they are not a sufficient guarantor of energy security. Inadequate petroleum access, in particular, remains a development challenge. Foreign powers’ efforts to increase their oil security are undermining the energy security of Sub-Saharan African citizens.

Emily Meierding

2012-03-01

85

The health and wellbeing of young people in sub-Saharan Africa: an under-researched area?  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract A third of sub-Saharan Africa’s (SSA population comprises persons aged 10–24 years. These youth are growing up in a context marked by pervasive poverty, limited educational opportunities, high HIV/AIDS prevalence, widespread conflict, and weak social controls. Published research on the broad issues that affect youth health and wellbeing in SSA is limited and centers heavily on sexual and reproductive health. In this commentary, we provide a broad overview of sub-Saharan African youth, highlight research gaps with respect to youth health and wellbeing, and describe potential avenues to develop the region’s research capacity on youth health and wellbeing.

Kabiru Caroline W

2013-02-01

86

The health and wellbeing of young people in sub-Saharan Africa: an under-researched area?  

Science.gov (United States)

A third of sub-Saharan Africa's (SSA) population comprises persons aged 10-24 years. These youth are growing up in a context marked by pervasive poverty, limited educational opportunities, high HIV/AIDS prevalence, widespread conflict, and weak social controls. Published research on the broad issues that affect youth health and wellbeing in SSA is limited and centers heavily on sexual and reproductive health. In this commentary, we provide a broad overview of sub-Saharan African youth, highlight research gaps with respect to youth health and wellbeing, and describe potential avenues to develop the region's research capacity on youth health and wellbeing. PMID:23406522

Kabiru, Caroline W; Izugbara, Chimaraoke O; Beguy, Donatien

2013-01-01

87

Sensitivity of mesoscale modeling of smoke direct radiative effect to the emission inventory: a case study in northern sub-Saharan African region  

Science.gov (United States)

An ensemble approach is used to examine the sensitivity of smoke loading and smoke direct radiative effect in the atmosphere to uncertainties in smoke emission estimates. Seven different fire emission inventories are applied independently to WRF-Chem model (v3.5) with the same model configuration (excluding dust and other emission sources) over the northern sub-Saharan African (NSSA) biomass-burning region. Results for November and February 2010 are analyzed, respectively representing the start and end of the biomass burning season in the study region. For February 2010, estimates of total smoke emission vary by a factor of 12, but only differences by factors of 7 or less are found in the simulated regional (15°W-42°E, 13°S-17°N) and monthly averages of column PM2.5 loading, surface PM2.5 concentration, aerosol optical depth (AOD), smoke radiative forcing at the top-of-atmosphere and at the surface, and air temperature at 2 m and at 700 hPa. The smaller differences in these simulated variables may reflect the atmospheric diffusion and deposition effects to dampen the large difference in smoke emissions that are highly concentrated in areas much smaller than the regional domain of the study. Indeed, at the local scale, large differences (up to a factor of 33) persist in simulated smoke-related variables and radiative effects including semi-direct effect. Similar results are also found for November 2010, despite differences in meteorology and fire activity. Hence, biomass burning emission uncertainties have a large influence on the reliability of model simulations of atmospheric aerosol loading, transport, and radiative impacts, and this influence is largest at local and hourly-to-daily scales. Accurate quantification of smoke effects on regional climate and air quality requires further reduction of emission uncertainties, particularly for regions of high fire concentrations such as NSSA.

Zhang, Feng; Wang, Jun; Ichoku, Charles; Hyer, Edward J.; Yang, Zhifeng; Ge, Cui; Su, Shenjian; Zhang, Xiaoyang; Kondragunta, Shobha; Kaiser, Johannes W.; Wiedinmyer, Christine; da Silva, Arlindo

2014-07-01

88

Effect of HIV status on fertility intention and contraceptive use among women in nine sub-Saharan African countries: evidence from Demographic and Health Surveys  

Science.gov (United States)

Background Expanding access to antiretroviral therapy (ART) means that HIV is no longer a death sentence. This change has implications for reproductive decisions and behaviors of HIV-infected individuals. Design Using multiple rounds of biomarker data from Demographic and Health Surveys (2004–2012) in nine sub-Saharan African countries, we compare patterns of associations between HIV status and fertility intention and between current use of modern contraception and HIV status in the context of expanding ART coverage. Results Generally, results show that knowledge of HIV status and proportion of women ever tested for HIV increased substantially between the two surveys for almost all countries. Whereas modern contraceptive use slightly increased, fertility intentions remained relatively stable, except for Rwanda, where they decreased. Results from the two surveys for the nine countries do however indicate that there is no clear consistent pattern of fertility intention and modern contraceptive use behavior by HIV status, with variations observed across countries. However, multivariate analyses show that for Rwanda and Zimbabwe women who were HIV positive, with knowledge of their status, had lower odds of wanting more children. Similarly only in Rwanda (both surveys) were HIV-positive women who knew their status more likely to be current users of contraception compared with women who were HIV negative. The reverse was observed for Zimbabwe. Conclusions Generally, the results point to the fact that the assumption that reproductive intention and behavior of HIV-positive women will differ compared with that of HIV-negative women may only hold true to the extent that women know their HIV status. Continuous expansion of voluntary counseling and testing services and integration of HIV treatment and care services with reproductive health services are thus warranted. PMID:25361729

Mumah, Joyce N.; Ziraba, Abdhalah K.; Sidze, Estelle M.

2014-01-01

89

Training for health services and systems research in Sub-Saharan Africa - a case study at four East and Southern African Universities  

Science.gov (United States)

Background The need to develop capacity for health services and systems research (HSSR) in low and middle income countries has been highlighted in a number of international forums. However, little is known about the level of HSSR training in Sub-Saharan Africa (SSA). We conducted an assessment at four major East and Southern African universities to describe: a) the numbers of HSSR PhD trainees at these institutions, b) existing HSSR curricula and mode of delivery, and c) motivating and challenging factors for PhD training, from the trainees’ experience. Methods PhD training program managers completed a pre-designed form about trainees enrolled since 2006. A desk review of existing health curricula was also conducted to identify HSSR modules being offered; and PhD trainees completed a self-administered questionnaire on motivating and challenging factors they may have experienced during their PhD training. Results Of the 640 PhD trainees enrolled in the health sciences since 2006, only 24 (3.8%) were in an HSSR field. None of the universities had a PhD training program focusing on HSSR. The 24 HSSR PhD trainees had trained in partnership with a university outside Africa. Top motivating factors for PhD training were: commitment of supervisors (67%), availability of scholarships (63%), and training attached to a research grant (25%). Top challenging factors were: procurement delays (44%), family commitments (38%), and poor Internet connection (35%). Conclusion The number of HSSR PhD trainees is at the moment too small to enable a rapid accumulation of the required critical mass of locally trained HSSR professionals to drive the much needed health systems strengthening and innovations in this region. Curricula for advanced HSSR training are absent, exposing a serious training gap for HSSR in this region. PMID:24365482

2013-01-01

90

The Realities of Community Based Natural Resource Management and Biodiversity Conservation in Sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This is an historic overview of conservation in Sub-Saharan Africa from pre-colonial times through the present. It demonstrates that Africans practiced conservation that was ignored by the colonial powers. The colonial market economy combined with the human and livestock population explosion of the 21st century are the major factors contributing to the demise of wildlife and critical habitat. Unique insight is provided into the economics of a representative safari company, something that has ...

Brian Kevin Reilly; Paul Andre DeGeorges

2009-01-01

91

Achieving food security for one million sub-Saharan African poor through push-pull innovation by 2020.  

Science.gov (United States)

Food insecurity is a chronic problem in Africa and is likely to worsen with climate change and population growth. It is largely due to poor yields of the cereal crops caused by factors including stemborer pests, striga weeds and degraded soils. A platform technology, 'push-pull', based on locally available companion plants, effectively addresses these constraints resulting in substantial grain yield increases. It involves intercropping cereal crops with a forage legume, desmodium, and planting Napier grass as a border crop. Desmodium repels stemborer moths (push), and attracts their natural enemies, while Napier grass attracts them (pull). Desmodium is very effective in suppressing striga weed while improving soil fertility through nitrogen fixation and improved organic matter content. Both companion plants provide high-value animal fodder, facilitating milk production and diversifying farmers' income sources. To extend these benefits to drier areas and ensure long-term sustainability of the technology in view of climate change, drought-tolerant trap and intercrop plants are being identified. Studies show that the locally commercial brachiaria cv mulato (trap crop) and greenleaf desmodium (intercrop) can tolerate long droughts. New on-farm field trials show that using these two companion crops in adapted push-pull technology provides effective control of stemborers and striga weeds, resulting in significant grain yield increases. Effective multi-level partnerships have been established with national agricultural research and extension systems, non-governmental organizations and other stakeholders to enhance dissemination of the technology with a goal of reaching one million farm households in the region by 2020. These will be supported by an efficient desmodium seed production and distribution system in eastern Africa, relevant policies and stakeholder training and capacity development. PMID:24535391

Khan, Zeyaur R; Midega, Charles A O; Pittchar, Jimmy O; Murage, Alice W; Birkett, Michael A; Bruce, Toby J A; Pickett, John A

2014-04-01

92

Achieving food security for one million sub-Saharan African poor through push–pull innovation by 2020  

Science.gov (United States)

Food insecurity is a chronic problem in Africa and is likely to worsen with climate change and population growth. It is largely due to poor yields of the cereal crops caused by factors including stemborer pests, striga weeds and degraded soils. A platform technology, ‘push–pull’, based on locally available companion plants, effectively addresses these constraints resulting in substantial grain yield increases. It involves intercropping cereal crops with a forage legume, desmodium, and planting Napier grass as a border crop. Desmodium repels stemborer moths (push), and attracts their natural enemies, while Napier grass attracts them (pull). Desmodium is very effective in suppressing striga weed while improving soil fertility through nitrogen fixation and improved organic matter content. Both companion plants provide high-value animal fodder, facilitating milk production and diversifying farmers’ income sources. To extend these benefits to drier areas and ensure long-term sustainability of the technology in view of climate change, drought-tolerant trap and intercrop plants are being identified. Studies show that the locally commercial brachiaria cv mulato (trap crop) and greenleaf desmodium (intercrop) can tolerate long droughts. New on-farm field trials show that using these two companion crops in adapted push–pull technology provides effective control of stemborers and striga weeds, resulting in significant grain yield increases. Effective multi-level partnerships have been established with national agricultural research and extension systems, non-governmental organizations and other stakeholders to enhance dissemination of the technology with a goal of reaching one million farm households in the region by 2020. These will be supported by an efficient desmodium seed production and distribution system in eastern Africa, relevant policies and stakeholder training and capacity development. PMID:24535391

Khan, Zeyaur R.; Midega, Charles A. O.; Pittchar, Jimmy O.; Murage, Alice W.; Birkett, Michael A.; Bruce, Toby J. A.; Pickett, John A.

2014-01-01

93

Implementation of a Socio-Ecological System Navigation Approach to Human Development in Sub-Saharan African Communities  

Science.gov (United States)

This paper presents a framework for the development of socio-ecological systems towards enhanced sustainability. Emphasis is given to the dynamic properties of complex, adaptive social-ecological systems, their structure and to the fundamental role of agriculture. The tangible components that meet the needs of specific projects executed in Kenya and Ethiopia encompass project objectives, innovation, facilitation, continuous recording and analyses of monitoring data, that allow adaptive management and system navigation. Two case studies deal with system navigation through the mitigation of key constraints; they aim to improve human health thanks to anopheline malaria vectors control in Nyabondo (Kenya), and to improve cattle health through tsetse control and antitrypanosomal drug administration to cattle in Luke (Ethiopia). The second case deals with a socio-ecological navigation system to enhance sustainability, establishing a periurban diversified enterprise in Addis Ababa (Ethiopia) and developing a rural sustainable social-ecological system in Luke (Ethiopia). The project procedures are briefly described here and their outcomes are analysed in relation to the stated objectives. The methodology for human and cattle disease vector control were easier to implement than the navigation of social-ecological systems towards sustainability enhancement. The achievements considerably differed between key constraints removal and sustainability enhancement projects. Some recommendations are made to rationalise human and cattle health improvement efforts and to smoothen the road towards enhanced sustainability: i) technology system implementation should be carried out through an innovation system; ii) transparent monitoring information should be continuously acquired and evaluated for assessing the state of the system in relation to stated objectives for (a) improving the insight into the systems behaviour and (b) rationalizing decision support; iii) the different views of all stakeholders should be reconciled in a pragmatic approach to social-ecological system management. Significance for public health Recently, there is a growing interest in studying the link between human, animal and environmental health. The connection between these different dimensions is particularly important for developing countries in which people face the challenge of escaping vicious cycle of high diseases prevalence, food insecurity driven by absolute poverty and population growth, and natural capital as a poverty trap. The design and implementation of such efforts, aiming at human health improvement and poverty alleviation, should be framed into adaptive social-ecological system management perspectives. In this paper, we present few case studies dealing with human health improvement through anopheline malaria vectors control in Kenya, cattle health improvement through tsetse vectored nagana control, antitrypanosomal drug administration to cattle in Ethiopia and with the development of rural sustainable communities in Ethiopia. Some recommendations are given to rationalise human and cattle health improvement efforts and to smoothen the road towards enhanced sustainability.

Gilioli, Gianni; Caroli, Anna Maria; Tikubet, Getachew; Herren, Hans R.; Baumgartner, Johann

2014-01-01

94

Implementation of a socio-ecological system navigation approach to human development in sub-saharan african communities.  

Science.gov (United States)

This paper presents a framework for the development of socio-ecological systems towards enhanced sustainability. Emphasis is given to the dynamic properties of complex, adaptive social-ecological systems, their structure and to the fundamental role of agriculture. The tangible components that meet the needs of specific projects executed in Kenya and Ethiopia encompass project objectives, innovation, facilitation, continuous recording and analyses of monitoring data, that allow adaptive management and system navigation. Two case studies deal with system navigation through the mitigation of key constraints; they aim to improve human health thanks to anopheline malaria vectors control in Nyabondo (Kenya), and to improve cattle health through tsetse control and antitrypanosomal drug administration to cattle in Luke (Ethiopia). The second case deals with a socio-ecological navigation system to enhance sustainability, establishing a periurban diversified enterprise in Addis Ababa (Ethiopia) and developing a rural sustainable social-ecological system in Luke (Ethiopia). The project procedures are briefly described here and their outcomes are analysed in relation to the stated objectives. The methodology for human and cattle disease vector control were easier to implement than the navigation of social-ecological systems towards sustainability enhancement. The achievements considerably differed between key constraints removal and sustainability enhancement projects. Some recommendations are made to rationalise human and cattle health improvement efforts and to smoothen the road towards enhanced sustainability: i) technology system implementation should be carried out through an innovation system; ii) transparent monitoring information should be continuously acquired and evaluated for assessing the state of the system in relation to stated objectives for (a) improving the insight into the systems behaviour and (b) rationalizing decision support; iii) the different views of all stakeholders should be reconciled in a pragmatic approach to social-ecological system management. Significance for public healthRecently, there is a growing interest in studying the link between human, animal and environmental health. The connection between these different dimensions is particularly important for developing countries in which people face the challenge of escaping vicious cycle of high diseases prevalence, food insecurity driven by absolute poverty and population growth, and natural capital as a poverty trap. The design and implementation of such efforts, aiming at human health improvement and poverty alleviation, should be framed into adaptive social-ecological system management perspectives. In this paper, we present few case studies dealing with human health improvement through anopheline malaria vectors control in Kenya, cattle health improvement through tsetse vectored nagana control, antitrypanosomal drug administration to cattle in Ethiopia and with the development of rural sustainable communities in Ethiopia. Some recommendations are given to rationalise human and cattle health improvement efforts and to smoothen the road towards enhanced sustainability. PMID:25170511

Gilioli, Gianni; Caroli, Anna Maria; Tikubet, Getachew; Herren, Hans R; Baumgärtner, Johann

2014-03-26

95

The private sector role in HIV/AIDS in the context of an expanded global response: expenditure trends in five sub-Saharan African countries.  

Science.gov (United States)

Global financing for the HIV response has reached unprecedented levels in recent years. Over US$10 billion were mobilized in 2007, an effort credited with saving the lives of millions of people living with HIV (PLHIV). A relatively unexamined aspect of the global HIV response is the role of the private sector in financing HIV/AIDS services. As the nature of the response evolves from emergency relief to long-term sustainability, understanding current and potential contributions from the private sector is critical. This paper examines trends in private sector financing, management and resource consumption related to HIV/AIDS in five sub-Saharan African countries, with a particular emphasis on the effects of recently scaled-up donor funding on private sector contributions. We analysed National Health Accounts HIV/AIDS subaccount data for Kenya, Malawi, Rwanda, Tanzania and Zambia between 2002 and 2006. HIV subaccounts provide comparable data on the flow of HIV/AIDS funding from source to use. Findings indicate that private sector contributions decreased in all countries except Tanzania. With regards to managing HIV/AIDS funds, non-governmental organizations are increasingly controlling the largest share of resources relative to other stakeholders, whereas private for-profit entities are managing fewer HIV/AIDS resources since the donor influx. The majority of HIV/AIDS funds were spent in the public sector, although a considerable amount was spent at private facilities, largely fuelled by out-of-pocket (OOP) payments. On the whole, OOP spending by PLHIV decreased over the 4-year period, with the exception of Malawi, demonstrating that PLHIV have increased access to free or subsidized HIV/AIDS services. Our findings suggest that the influx of donor funding has led to decreased private contributions for HIV/AIDS. The reduction in private sector investment and engagement raises concerns about the sustainability of HIV/AIDS programmes over the long term, particularly in light of current global economic crisis and emerging competing priorities. PMID:21729920

Sulzbach, Sara; De, Susna; Wang, Wenjuan

2011-07-01

96

Public health and research funding for childhood neurodevelopmental disorders in Sub-Saharan Africa: a time to balance priorities  

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Full Text Available Sub-Saharan African (SSA population consists of about 45% children, while in Europe and North America children population is 10- 15%. Lately, attention has been directed at mitigating childhood infectious and communicable diseases to reduce under-five mortality. As the under-five mortality index in Sub-Saharan Africa has relatively improved over the last two decades, more Sub-Saharan African children are surviving beyond the age of five and, apparently, a sizeable percentage of this population would be living with one or more childhood neurodevelopmental disorders (NDD. The distribution of child mental health service resources across the world is unequal. This manifests in the treatment gap of major childhood onset mental health problems in SSA, with the gap being more pronounced for childhood NDD. It is important to balance the public health focus and research funding priorities in Sub-Saharan Africa. We urgently need to define the burden of childhood NDD in the region for healthcare planning and policy formulation.

Muideen O. Bakare

2014-01-01

97

Obesity and the nutrition transition in Sub-Saharan Africa.  

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This review illustrates the outcomes of the nutrition transition in Sub-Saharan Africa (SSA) and its association with overweight and obesity; the relationship with the double burden of malnutrition is also explored. We describe the increase in overweight in nearly all Sub-Saharan African countries and present data on associated increased gross domestic product, and availability of energy, protein, fat, and sugar at country national levels. Predictors of overweight are described by means of various studies undertaken in SSA, and dietary intakes of numerous countries are presented. Overall, we show that socioeconomic status, gender, age, parity, physical inactivity, and increased energy, fat, and sugar intake are powerful predictors of overweight and/or obesity. The urgency for health interventions in countries in the early stages of the nutrition transition is emphasized, particularly in view of the fact that fat intake is still less than 30% of energy intake in nearly all Sub-Saharan African countries. PMID:24725148

Steyn, Nelia P; McHiza, Zandile J

2014-04-01

98

North African populations carry the signature of admixture with Neandertals  

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One of the main findings derived from the analysis of the Neandertal genome was the evidence for admixture between Neandertals and non-African modern humans. An alternative scenario is that the ancestral population of non-Africans was closer to Neandertals than to Africans because of ancient population substructure. Thus, the study of North African populations is crucial for testing both hypotheses. We analyzed a total of 780,000 SNPs in 125 individuals representing seven different North African locations and searched for their ancestral/derived state in comparison to different human populations and Neandertals. We found that North African populations have a significant excess of derived alleles shared with Neandertals, when compared to sub-Saharan Africans. This excess is similar to that found in non-African humans, a fact that can be interpreted as a sign of Neandertal admixture. Furthermore, the Neandertal's genetic signal is higher in populations with a local, pre-Neolithic North African ancestry. Therefore, the detected ancient admixture is not due to recent Near Eastern or European migrations. Sub-Saharan populations are the only ones not affected by the admixture event with Neandertals.

Sánchez-Quinto, Federico; Botigué, Laura R

2012-01-01

99

An approach to rural distribution network design for sub-Saharan Africa  

International Nuclear Information System (INIS)

The bulk of rural populations in sub-Saharan Africa have no access to electricity and are under-served by any other form of modern infrastructure. The cost of infrastructure to mainly scattered communities has been perennially cited as largely to blame. Quite often rural networks are overdesigned, resulting in under utilization and, therefore, costly overheads. One reason often cited for the overspecification is anticipation of load growth. In most sub-Sahara African rural areas, however, economic growth rates are low, and a designer has no justification in specifying an infrastructure capacity exceeding more than a few percent of existing consumer requirements. This paper proposes methods that critically look at the geometry of small grid network designs to address the construction challenges in rural sub-Saharan Africa

100

Ancient local evolution of African mtDNA haplogroups in Tunisian Berber populations.  

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Our objective is to highlight the age of sub-Saharan gene flows in North Africa and particularly in Tunisia. Therefore we analyzed in a broad phylogeographic context sub-Saharan mtDNA haplogroups of Tunisian Berber populations considered representative of ancient settlement. More than 2,000 sequences were collected from the literature, and networks were constructed. The results show that the most ancient haplogroup is L3*, which would have been introduced to North Africa from eastern sub-Saharan populations around 20,000 years ago. Our results also point to a less ancient western sub-Saharan gene flow to Tunisia, including haplogroups L2a and L3b. This conclusion points to an ancient African gene flow to Tunisia before 20,000 BP. These findings parallel the more recent findings of both archaeology and linguistics on the prehistory of Africa. The present work suggests that sub-Saharan contributions to North Africa have experienced several complex population processes after the occupation of the region by anatomically modern humans. Our results reveal that Berber speakers have a foundational biogeographic root in Africa and that deep African lineages have continued to evolve in supra-Saharan Africa. PMID:21082907

Frigi, Sabeh; Cherni, Lotfi; Fadhlaoui-Zid, Karima; Benammar-Elgaaied, Amel

2010-08-01

 
 
 
 
101

Progress towards the child mortality millennium development goal in urban sub-Saharan Africa: the dynamics of population growth, immunization, and access to clean water  

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Full Text Available Abstract Background Improvements in child survival have been very poor in sub-Saharan Africa (SSA. Since the 1990s, declines in child mortality have reversed in many countries in the region, while in others, they have either slowed or stalled, making it improbable that the target of reducing child mortality by two thirds by 2015 will be reached. This paper highlights the implications of urban population growth and access to health and social services on progress in achieving MDG 4. Specifically, it examines trends in childhood mortality in SSA in relation to urban population growth, vaccination coverage and access to safe drinking water. Methods Correlation methods are used to analyze national-level data from the Demographic and Health Surveys and from the United Nations. The analysis is complemented by case studies on intra-urban health differences in Kenya and Zambia. Results Only five of the 22 countries included in the study have recorded declines in urban child mortality that are in line with the MDG target of about 4% per year; five others have recorded an increase; and the 12 remaining countries witnessed only minimal decline. More rapid rate of urban population growth is associated with negative trend in access to safe drinking water and in vaccination coverage, and ultimately to increasing or timid declines in child mortality. There is evidence of intra-urban disparities in child health in some countries like Kenya and Zambia. Conclusion Failing to appropriately target the growing sub-group of the urban poor and improve their living conditions and health status – which is an MDG target itself – may result in lack of improvement on national indicators of health. Sustained expansion of potable water supplies and vaccination coverage among the disadvantaged urban dwellers should be given priority in the efforts to achieve the child mortality MDG in SSA.

Madise Nyovani

2007-08-01

102

Apparent Variation in Neanderthal Admixture among African Populations is Consistent with Gene Flow from Non-African Populations  

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Recent studies have found evidence of introgression from Neanderthals into modern humans outside of sub-Saharan Africa. Given the geographic range of Neanderthals, the findings have been interpreted as evidence of gene exchange between Neanderthals and modern humans descended from the Out-of-Africa (OOA) migration. Here, we examine an alternative interpretation in which the introgression occurred earlier within Africa, between ancestors or relatives of Neanderthals and a subset of African modern humans who were the ancestors of those involved in the OOA migration. Under the alternative model, if the population structure among present-day Africans predates the OOA migration, we might find some African populations show a signal of Neanderthal introgression whereas others do not. To test this alternative model, we compiled a whole-genome data set including 38 sub-Saharan Africans from eight populations and 25 non-African individuals from five populations. We assessed differences in the amount of Neanderthal-like single-nucleotide polymorphism alleles among these populations and observed up to 1.5% difference in the number of Neanderthal-like alleles among African populations. Further analyses suggest that these differences are likely due to recent non-African admixture in these populations. After accounting for recent non-African admixture, our results do not support the alternative model of older (e.g., >100 kya) admixture between modern humans and Neanderthal-like hominids within Africa. PMID:24162011

Wang, Shuoguo; Lachance, Joseph; Tishkoff, Sarah A.; Hey, Jody; Xing, Jinchuan

2013-01-01

103

Corruption in Sub-Saharan Africa: A practical-theological response  

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On the 2012 Corruption Perceptions Index of Transparency International, 89.6%of Sub-Saharan African countries received scores below 50, where a score of zero signifies that the country is highly corrupt and a score of 100 declares a country free of corruption. From these results, it seems as if Sub-Saharan African countries are quite vulnerable to corruption. In this article, the question whether certain traits in the Sub-Saharan African culture such as communalism, gift giving and a shame cu...

Theron, Petria M.

2013-01-01

104

Selected French Speaking Sub-Saharan African Countries: Burundi, Cameroon (Eastern), Chad, Congo (Brazzaville), Dahomey, Gabon, Ivory Coast, Mali, Mauritania, Niger, Rwanda, Senegal, Togo, Upper Volta, Zaire. A Guide to the Academic Placement of Students from These Countries in Academic Institutions of the United States.  

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The educational systems of 15 Sub-Saharan African countries are described, and guidelines concerning the academic placement of students who wish to study in U.S. institutions are provided. Tables indicate the grades covered by primary education and secondary education (academic and technical). Burundi, Rwanda, and Zaire have followed the Belgian…

Trudeau, Edouard J. C.

105

Urban Governance in Sub?Saharan Africa. For a geography of regulation  

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Implementation of governance principles entails intra-urban territorializations in sub- Saharan African cities, which increase the risks of fragmentation and raise the question of local scale regulation in both its political and spatial dimensions.

Dubresson, Alain; Jaglin, Sylvy

2003-01-01

106

Emigration dynamics in Sub-Saharan Africa.  

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The introduction to this description of emigration dynamics in sub-Saharan Africa notes that the region is characterized by intensive migration caused by such factors as population growth, negative economic growth, ethnic conflict, and human rights abuses. The second section of the report discusses the fragmentary and incomplete nature of data on international migration in the region, especially data on conventional migration. Section 3 looks at demographic factors such as high population growth, illiteracy levels, HIV seroprevalence, and urbanization which lead to high unemployment and emigration. The fourth section considers the effects of the rapid expansion of education which is outstripping the absorptive capacity of the economies of many countries. Unemployment is a serious problem which is projected to become worse as increases in employment opportunities continue to lag behind increases in output. Sections five, six, and seven of the report describe relevant economic factors such as per capita income, income distribution, the economic resource base, and economic development; poverty; and the effects of economic adjustment programs, especially on employment opportunities and wages in the public and private sectors. The next section is devoted to sociocultural factors influencing migration both on the micro- and the macro-levels, including the influence of ethnicity and ethnic conflicts as well as the domination of leadership positions by members of minority groups. The political factors discussed in section 9 include women's status, repressive regimes, political instability which leads to underdevelopment, and the policies of the Organization of African Unity which broadened the definition of refugees and set inviolable borders of member states identical to those inherited upon independence. Section 10 outlines ecological factors contributing to migration, including the decline in acreage of arable land, soil deterioration, poor land management, and the effects of draught. The interaction of all of these factors has contributed to refugee flows of acute magnitude and complexity. The next major section of the report describes the migration situation in each subregion (Western Africa, Nigeria and Ghana, the Sahel, Mail, Eastern Africa, Southern Africa, and Lesotho). The report concludes that migration in response to socioeconomic conditions will continue until conditions improve in the countries of origin. PMID:12347006

Adepoju, A

1995-01-01

107

Youth in sub-Saharan Africa.  

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Sub-Saharan Africa is going through rapid social, political, and economic transformations that have a profound impact on youth. The present review explores trends and outcomes as they relate to education, family formation and sexual and reproductive health and the interrelationships among these areas. It is based on both published and unpublished reports. Over the past 20 years, school enrollment has increased for much of the subcontinent; although the gender gap has narrowed, females remain educationally disadvantaged. Likewise, marriage is occurring later today than a generation ago, posing new challenges of out-of-wedlock births, clandestine abortions, and an increased likelihood of engaging in premarital sex. So, too, although there has been a slowing of the population growth in much of the region, in many countries of sub-Saharan Africa, the population is doubling every 30 years. Although acquired immunodeficiency syndrome is the predominant cause of death among youth, maternal mortality remains a major risk of death for youth--in some countries 600 times greater than that of peers in the industrialized world. PMID:17707292

Blum, Robert W

2007-09-01

108

Methylenetetrahydrofolate Reductase (MTHFR from Mediterranean to Sub-Saharan Areas  

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Full Text Available There are differences in the allele frequency of MTHFR polymorphism between Western and African population. The aim of this study is to determinate the prevalence of MTHFR C677T and A1298C polymorphisms in young and old people living in different areas from Mediterranean to sub-Saharan areas. The observed vs expected genotype frequencies of 677T were in Hardy Weinberg equilibrium, with the exception of old Sardinian subjects (P=0.02. Calculation of 677T allele frequency in young and old African subjects (8% and 3%, respectively indicated that the 677T allele was disadvantaged in old Africans (P=0.02. The difference among young and old Sardinians and Sicilians were not significant at the same degree (43% vs 37% P=0.07 and 46% vs 42% P=0.28, respectively. However, the reproducible trend that showed the prevalence of 677T allele in the young subjects of the three studied areas confirms the disadvantage of this polymorphism with the age. There was a significant difference (P=0.005 on the observed vs expected frequency of 1298C homozygosity in African old subjects compared to younger ones, while the observed vs expected genotype frequencies were in equilibrium in young and old Sardinian and Sicilian subjects. The frequencies of 1298C and 1298A alleles were comparable between young and old African, Sardinian and Sicilian subjects. The lower frequency of 677T allele in old African, Sardinian and Sicilian subjects compared to young ones and the absence of TT genotype among old African subjects, should be considered as a consequence of an elevated mortality of 677T carriers.

Rosa Chillemi

2006-01-01

109

Prospective evaluation of the usefulness of C-reactive protein in the diagnosis of neonatal sepsis in a sub-Saharan African region  

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Full Text Available Abstract Background Sepsis is one of the most common causes of morbidity and mortality in the newborn. Early diagnosis and treatment is vital to improve outcome. The present study was therefore carried out to determine the usefulness of C-reactive protein (CRP for evaluation of neonatal sepsis in Port Harcourt, Nigeria in Sub-Saharan Africa. Method Four hundred and twenty neonates with clinical suspicion of sepsis were prospectively studied over a 6?month period. Blood was obtained from each subject recruited for the qualitative estimation of CRP. Blood culture was used as gold standard for diagnosis of NNS. Results Of 420 neonates studied, 196 (46.7% had positive CRP while 181 (43.1% had positive blood culture. The sensitivity, specificity, positive and negative predictive values of CRP were 74.0%, 74.1%, 68.4% and 79.0% respectively. Conclusion The qualitative method of estimating CRP which is cheap and rapid has moderate sensitivity, specificity and negative predictive value.

West Boma A

2012-06-01

110

Integration of Highly Qualified Sub-Saharan Immigrants in Prague  

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Full Text Available Successful integration of immigrants into the host society demands a creation of specific conditions that would facilitate immigrants their adaptation to a new sociocultural, economic and political environment. Therefore, the process of integration itself is not only a task for immigrants, but also for a majority. One of the key factors for a creation of truly cohesive society is the support of positive aspects of mutual inter-cultural relations. This could be reinforced by implementation of “adequate” integration programs adapted to the local context as well as sensible use of mass media. If the host society does not dispose of effective instruments to integrate its “own citizens”, it is generally difficult to create strategies for insertion of immigrants of different cultural backgrounds (such as Sub-Saharan Africans. Basic features of the integration process of Sub-Saharan Africans and political reactions of the major society were identified in Prague, Paris, London and Liege.

Andrea Gerstnerová

2011-04-01

111

Development in Sub-Saharan Africa: Overcoming the Digital Divide  

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In an increasingly digitalized world economy, there exists a digital gap between Sub-Saharan Africa and the rest of the world that translates into economic marginalization of the African region. Consequently, the following phases of development are crucial for the region: (1) the phase of massive digitalization during which the digital divide is bridged and (2) the phase of information and knowledge management in which information is systematically converted into knowledge and the latter into...

Oyedokun Agbeja; Salawu, R. O.

2007-01-01

112

What lies behind gender inequalities in HIV/AIDS in sub-Saharan African countries: evidence from Kenya, Lesotho and Tanzania.  

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Within sub-Saharan Africa, women are disproportionately at risk for acquiring and having human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). It is important to clarify whether gender inequalities in HIV prevalence in this region are explained by differences in the distributions of HIV risk factors, differences in the effects of these risk factors or some combination of both. We used an extension of the Blinder-Oaxaca decomposition approach to explain gender inequalities in HIV/AIDS in Kenya, Lesotho and Tanzania using data from the demographic and health and AIDS indicator surveys. After adjusting for covariates using Poisson regression models, female gender was associated with a higher prevalence of HIV/AIDS in Kenya [prevalence ratio (PR) = 1.73, 95% confidence interval (CI) = 1.33, 2.23 in 2003] and Lesotho (PR = 1.39, 95% CI = 1.20, 1.62 in 2004/05), but not in Tanzania. Decomposition analyses demonstrated two distinct patterns over time. In Tanzania, the gender inequality in HIV/AIDS was explained by differences in the distributions of HIV risk factors between men and women. In contrast, in Kenya and Lesotho, this inequality was partly explained by differences in the effects across men and women of measured HIV/AIDS risk factors, including socio-demographic characteristics (age and marital status) and sexual behaviours (age at first sex); these results imply that gender inequalities in HIV/AIDS would persist in Kenya and Lesotho even if men and women had similar distributions of HIV risk factors. The production of gender inequalities may vary across countries, with inequalities attributable to the unequal distribution of risk factors among men and women in some countries and the differential effect of these factors between groups in others. These different patterns have important implications for policies to reduce gender inequalities in HIV/AIDS. PMID:24345343

Sia, Drissa; Onadja, Yentéma; Nandi, Arijit; Foro, Anne; Brewer, Timothy

2014-10-01

113

Underdeveloped ICT areas in Sub-Saharan Africa  

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Full Text Available As universal service in terms of ICTs provision cannot be achieved in the times agreed for several international bilateral and multilateral aid organizations. It is important to create mechanisms to reduce the lack of use of ICTs in sub-Saharan African countries. This paper specifically analyses the different ICT underdeveloped areas in the sub-Saharan African countries and the factors explain such status. At the same time, the paper proposes a set of policy guidelines that might help improving the current situation in several areas such as investment, employment, infrastructure and technology in order that some countries may overcome unfavourable ICT development. The main research question is: is there any chance that sub-Saharan African countries can overcome the critical situation in which they currently are? And if so, what are the key components and processes to develop and to do changes. In this way, a proposed framework is provided for the examination of policy makers, investors, and other stakeholders in the ICT field in these countries.

Alfonso AVILA

2009-01-01

114

Human genetic variation, relationships of peoples of sub- Saharan Africa and implications for healthcare  

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Sub-Saharan Africa is thought to have the most genetic variation of any continent and to be the place of origin of anatomically modern human. Nevertheless it is the subject of relatively few studies of human genetic variation. This thesis contributes to redressing this imbalance. Sex-specific genetic systems (non-recombining portion of the Y chromosome (NRY) and mitochondrial DNA (mtDNA)) along with functional nuclear loci were characterised in multiple sub-Saharan African popu...

Ansari Pour, N.

2011-01-01

115

Stock Markets Development in Sub-Saharan Africa: Business Regulations, Governance and Fiscal Policy  

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This study examines the effectiveness of the state in stimulating stock market activity in sub-Saharan Africa (SSA) using fiscal policy, governance quality and stock market as the main determinant variables. Using annual data from six selected sub-Saharan African economies and employing a dynamic panel data estimating technique, we find that government effectiveness stimulates capitalization while business regulations decrease it in SSA. In addition, we find that final consumption expendit...

Afful, Kofi B.; Asiedu, Kofi F.

2013-01-01

116

Monitoring parasite diversity for malaria elimination in sub-Saharan Africa.  

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The African continent continues to bear the greatest burden of malaria and the greatest diversity of parasites, mosquito vectors, and human victims. The evolutionary plasticity of malaria parasites and their vectors is a major obstacle to eliminating the disease. Of current concern is the recently reported emergence of resistance to the front-line drug, artemisinin, in South-East Asia in Plasmodium falciparum, which calls for preemptive surveillance of the African parasite population for genetic markers of emerging drug resistance. Here we describe the Plasmodium Diversity Network Africa (PDNA), which has been established across 11 countries in sub-Saharan Africa to ensure that African scientists are enabled to work together and to play a key role in the global effort for tracking and responding to this public health threat. PMID:25214619

Ghansah, Anita; Amenga-Etego, Lucas; Amambua-Ngwa, Alfred; Andagalu, Ben; Apinjoh, Tobias; Bouyou-Akotet, Marielle; Cornelius, Victoria; Golassa, Lemu; Andrianaranjaka, Voahangy Hanitriniaina; Ishengoma, Deus; Johnson, Kimberly; Kamau, Edwin; Maïga-Ascofaré, Oumou; Mumba, Dieudonne; Tindana, Paulina; Tshefu-Kitoto, Antoinette; Randrianarivelojosia, Milijaona; William, Yavo; Kwiatkowski, Dominic P; Djimde, Abdoulaye A

2014-09-12

117

Cost-effectiveness of medical interventions to prevent cardiovascular disease in a sub-Saharan African country – the case of Tanzania  

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Full Text Available Abstract Background There is a high and rising prevalence of cardiovascular risk in sub-Saharan Africa, a development typical for countries in epidemiological transition. Contrary to recommendations in treatment guidelines, medical interventions to prevent cardiovascular disease are implemented only on a limited scale in these settings. There is a widespread concern that such treatment is not cost-effective compared to alternative health interventions. The main objectives of this article are therefore to calculate costs-, effects and cost-effectiveness of fourteen medical interventions of primary prevention of cardiovascular disease in Tanzania, including Acetylsalicylic acid, a diuretic drug (Hydrochlorothiazide, a ?-blocker (Atenolol, a calcium channel blocker (Nifedepine, a statin (Lovastatin and various combinations of these. Methods Effect sizes were derived from systematic reviews or meta-analyses, and calculated as Disability Adjusted Life Years (DALYs. Data on drug costs were calibrated to a Tanzanian setting. Other recurrent and capital costs were derived from previous studies and reviewed by local experts. Expected lifetime costs and health outcomes were calculated using a life-cycle model. Probabilistic cost-effectiveness analysis was performed using Monte Carlo simulation, and results presented as cost-effectiveness acceptability curves and frontiers. The potential impacts of uncertainty in value laden single parameters were explored in one-way sensitivity analyses. Results The incremental cost-effectiveness ratios for the fourteen interventions and four different levels of risk (totally 56 alternative interventions ranged from about USD 85 per DALY to about USD 4589 per DALY saved. Hydrochlorothiazide as monotherapy is the drug yielding the most favorable cost-effectiveness ratio, although not significantly lower than when it is combined in duo-therapy with Aspirin or a ?-blocker, in triple-therapy with Aspirin and a ?-blocker, or than Aspirin given as mono-therapy. Conclusion Preventive cardiology is not cost-effective for any patient group in this setting until willingness to pay exceeds USD 85 per DALY. At this level of willingness to pay, the optimal intervention is Hydrochlorothiazide to patients with very high cardiovascular risk. As willingness to pay for health increase further, it becomes optimal to provide this treatment also to patients with lower cardiovascular risk, and to substitute to more sophisticated interventions.

Hemed Yusuf

2007-02-01

118

The Environmental and Social Influences of HIV/AIDS in Sub-Saharan Africa: A Focus on Rural Communities  

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Full Text Available The Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS pandemic has caused far-reaching effects in sub-Saharan Africa. The pandemic has effectively diminished the workforce, increased poverty rates, reduced agricultural productivity, and transformed the structure of many rural households. HIV/AIDS further strains the already fragile relationship between livelihood and the natural and social environments of these regions. Therefore, the objective of this review is to characterize the impact of HIV/AIDS on the environment and the social infrastructure of rural sub-Saharan Africa. There are many aspects of rural life that contribute to disease transmission of HIV/AIDS and that pose unique challenges to the population dynamics in sub-Saharan Africa. Widespread AIDS-related mortality has caused a decrease in population growth for many African countries. In turn, these alterations in population dynamics have resulted in a decrease in the percentage of prime-age working adults, as well as a gender disparity, whereby, females carry a growing burden of household responsibilities. There is a rising proportion of older adults, often females, who assume the role of provider and caretaker for other dependent family members. These changing dynamics have caused many to exploit their natural surroundings, adopting less sustainable land use practices and utilizing protected resources as a primary means of generating revenue.

Christopher R. Frei

2011-07-01

119

TRENDS IN STOCK MARKET IN SUB-SAHARAN AFRICA  

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Full Text Available his study uses a panel data, to study the recent contribution of stock markets in economic growth in 6 selected countries of sub-Saharan Africa from 1991-2009. Over the last two decades, most of the countries in sub-Sahara Africa have either gone through one form of Market oriented reform of its economy or trade liberalization. However, these market oriented reforms are just beginning to yield dividends in some areas of the economy. These results show that private capital stock market development measured by market capitalization and stock turnover ratio, and foreign direct investment have positive significant correlations with growth in per capita output in the selected sub-Saharan African countries. These results point to the positive correlation between market liberalization, economic reforms and increase in stock market capitalization as well as the liquidity measured by stock traded turnover ratio. More importantly, the negative correlation between financial crisis and growth in per capita GDP shows that sub-Saharan African economies are not immune to global market problems.

Okechukwu D. Anyamele, PhD

2013-12-01

120

The impact of Christianity on sub-Saharan Africa  

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Full Text Available SciELO South Africa | Language: English Abstract in english The aim of this article is to describe the impact of Christianity on sub-Saharan Africa. I shall start by first examining the key words in the title of this article, and by briefly discussing the phenomenal growth of Christianity in sub-Saharan Africa. The article further describes the impact of Chr [...] istianity on sub-Saharan Africa in terms of education, socio-politics, and health; here I shall base my remarks on the history of Christian missions in the region since the late nineteen century. As far as education is concerned, this article recognises that education that focuses on holistic human development is a positive force, and a force that was introduced by Christianity. I shall also point out that Christianity initiated medical advances that improved the health of those who live in the region. Regeneration as espoused by Christianity constitutes something of great value. On the downside, Christianity led to the demise of the African customs, which it viewed as pagan and evil; the religion also led to the implementation of apartheid (to which it gave its theological support), and undermined the leadership role of women. Finally, Christianity has bedevilled race relations in Africa generally.

Matsobane J, Manala.

2013-02-01

 
 
 
 
121

The impact of Christianity on sub-Saharan Africa  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english The aim of this article is to describe the impact of Christianity on sub-Saharan Africa. I shall start by first examining the key words in the title of this article, and by briefly discussing the phenomenal growth of Christianity in sub-Saharan Africa. The article further describes the impact of Chr [...] istianity on sub-Saharan Africa in terms of education, socio-politics, and health; here I shall base my remarks on the history of Christian missions in the region since the late nineteen century. As far as education is concerned, this article recognises that education that focuses on holistic human development is a positive force, and a force that was introduced by Christianity. I shall also point out that Christianity initiated medical advances that improved the health of those who live in the region. Regeneration as espoused by Christianity constitutes something of great value. On the downside, Christianity led to the demise of the African customs, which it viewed as pagan and evil; the religion also led to the implementation of apartheid (to which it gave its theological support), and undermined the leadership role of women. Finally, Christianity has bedevilled race relations in Africa generally.

Matsobane J, Manala.

122

The Global Financial Meltdown of 2008, Sub-Saharan Africa, and the Way Forward for Sustainable Economic Growth and Development  

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Full Text Available The author began the paper with a brief historical perspective of the global financial crisis. This was followed by the review of the literature. Next, the researcher outlined his findings preceded by some policy analyses and implications of the crisis for sub-Saharan African economies. The writer ended the paper with recommendations for both sub-Saharan African policymakers and the international finance and development community.

Ashford C. Chea

2011-12-01

123

Malaria risk perception, knowledge and prophylaxis practices among travellers of African ethnicity living in Paris and visiting their country of origin in sub-Saharan Africa.  

Science.gov (United States)

An observational prospective cohort study assessed malaria risk perception, knowledge and prophylaxis practices among individuals of African ethnicity living in Paris and travelling to their country of origin to visit friends or relatives (VFR). The study compared two groups of VFR who had visited a travel clinic (TC; n=122) or a travel agency (TA; n=69) before departure. Of the 47% of VFR citing malaria as a health concern, 75% knew that malaria is mosquito-borne and that bed nets are an effective preventive measure. Perception of high malaria risk was greater in the TA group (33%) than in the TC group (7%). The availability of a malaria vaccine was mentioned by 35% of VFR, with frequent confusion between yellow fever vaccine and malaria prevention. Twenty-nine percent took adequate chemoprophylaxis with complete adherence, which was higher among the TC group (41%) than the TA group (12%). Effective antivector protection measures used were bed nets (16%), wearing long clothes at night (14%) and air conditioning (8%), with no differences between the study groups except in the use of impregnated bed nets (11% of the TC group and none of the TA group). Media coverage, malaria chemoprophylaxis repayment and cultural adaptation of preventive messages should be improved to reduce the high rate of inadequate malaria prophylaxis in VFR. PMID:17643457

Pistone, T; Guibert, P; Gay, F; Malvy, D; Ezzedine, K; Receveur, M C; Siriwardana, M; Larouzé, B; Bouchaud, O

2007-10-01

124

Sub-Saharan Northern African climate at the end of the twenty-first century: forcing factors and climate change processes  

Energy Technology Data Exchange (ETDEWEB)

A regional climate model, the Weather Research and Forecasting (WRF) Model, is forced with increased atmospheric CO{sub 2} and anomalous SSTs and lateral boundary conditions derived from nine coupled atmosphere-ocean general circulation models to produce an ensemble set of nine future climate simulations for northern Africa at the end of the twenty-first century. A well validated control simulation, agreement among ensemble members, and a physical understanding of the future climate change enhance confidence in the predictions. The regional model ensembles produce consistent precipitation projections over much of northern tropical Africa. A moisture budget analysis is used to identify the circulation changes that support future precipitation anomalies. The projected midsummer drought over the Guinean Coast region is related partly to weakened monsoon flow. Since the rainfall maximum demonstrates a southward bias in the control simulation in July-August, this may be indicative of future summer drying over the Sahel. Wetter conditions in late summer over the Sahel are associated with enhanced moisture transport by the West African westerly jet, a strengthening of the jet itself, and moisture transport from the Mediterranean. Severe drought in East Africa during August and September is accompanied by a weakened Indian monsoon and Somali jet. Simulations with projected and idealized SST forcing suggest that overall SST warming in part supports this regional model ensemble agreement, although changes in SST gradients are important over West Africa in spring and fall. Simulations which isolate the role of individual climate forcings suggest that the spatial distribution of the rainfall predictions is controlled by the anomalous SST and lateral boundary conditions, while CO{sub 2} forcing within the regional model domain plays an important secondary role and generally produces wetter conditions. (orig.)

Patricola, C.M. [Cornell University, Department of Earth and Atmospheric Sciences, Ithaca, NY (United States); Texas A and M University, Department of Atmospheric Sciences, College Station, TX (United States); Cook, K.H. [The University of Texas at Austin, Department of Geological Sciences, Jackson School of Geosciences, Austin, TX (United States)

2011-09-15

125

Mental and Substance Use Disorders in Sub-Saharan Africa: Predictions of Epidemiological Changes and Mental Health Workforce Requirements for the Next 40 Years  

Science.gov (United States)

The world is undergoing a rapid health transition, with an ageing population and disease burden increasingly defined by disability. In Sub-Saharan Africa the next 40 years are predicted to see reduced mortality, signalling a surge in the impact of chronic diseases. We modelled these epidemiological changes and associated mental health workforce requirements. Years lived with a disability (YLD) predictions for mental and substance use disorders for each decade from 2010 to 2050 for four Sub-Saharan African regions were calculated using Global Burden of Disease 2010 study (GBD 2010) data and UN population forecasts. Predicted mental health workforce requirements for 2010 and 2050, by region and for selected countries, were modelled using GBD 2010 prevalence estimates and recommended packages of care and staffing ratios for low- and middle-income countries, and compared to current staffing from the WHO Mental Health Atlas. Significant population growth and ageing will result in an estimated 130% increase in the burden of mental and substance use disorders in Sub-Saharan Africa by 2050, to 45 million YLDs. As a result, the required mental health workforce will increase by 216,600 full time equivalent staff from 2010 to 2050, and far more compared to the existing workforce. The growth in mental and substance use disorders by 2050 is likely to significantly affect health and productivity in Sub-Saharan Africa. To reduce this burden, packages of care for key mental disorders should be provided through increasing the mental health workforce towards targets outlined in this paper. This requires a shift from current practice in most African countries, involving substantial investment in the training of primary care practitioners, supported by district based mental health specialist teams using a task sharing model that mobilises local community resources, with the expansion of inpatient psychiatric units based in district and regional general hospitals. PMID:25310010

Charlson, Fiona J.; Diminic, Sandra; Lund, Crick; Degenhardt, Louisa; Whiteford, Harvey A.

2014-01-01

126

Military HIV policy assessment in sub-Saharan Africa.  

Science.gov (United States)

While HIV/AIDS continues to inflict a heavy toll on African militaries, the military commitment and leadership response has been inconsistent, as reflected by variable presence of a written HIV policy. The Department of Defense HIV/AIDS Prevention Program collaborates with most sub-Saharan military HIV/AIDS programs. In 2010, 28 invited countries (80%) completed a self-administered survey describing their program, including policy. Descriptive and nonparametric measures were calculated. The majority (57%) of respondents reported having a written military HIV policy. Of these, 86% included HIV testing, 88% required recruit testing, and 96% denied entry for those testing HIV-positive. Mandatory HIV testing was reported by 71%, occurring before deployments, peacekeeping missions, foreign training, and when clinically indicated. Southern African militaries were most likely to require HIV testing. The majority of militaries allowed deployment of HIV-positive personnel in-country, whereas few allowed foreign deployment. Most sub-Saharan militaries screen applicants for HIV and other diseases to determine duty fitness, resulting in near universal HIV negative recruit cohorts. No militaries discharge personnel from service if they acquire HIV. Legal challenges to military HIV policies may hinder finalization and dissemination of policies. Lack of HIV policies impedes routine testing and earlier care and treatment for HIV-infected personnel. PMID:25003863

Thomas, Anne Goldzier; Grillo, Michael P; Djibo, Djeneba Audrey; Hale, Braden; Shaffer, Richard A

2014-07-01

127

Primary Education in Sub-Saharan Africa--A Moral Issue, an Economic Matter, or Both?  

Science.gov (United States)

Rates of primary enrollment, female primary enrollment, private school enrollment, and literacy during 1960-92 were analyzed for 39 sub-Saharan African countries. Throughout the period, strongly Christian countries had higher enrollment and literacy rates than strongly Islamic countries, regardless of economic level, type of state, or colonial…

Daun, Holger

2000-01-01

128

Association of HIV and ART with cardiometabolic traits in sub-Saharan Africa : a systematic review and meta-analysis  

DEFF Research Database (Denmark)

Sub-Saharan Africa (SSA) has the highest burden of HIV in the world and a rising prevalence of cardiometabolic disease; however, the interrelationship between HIV, antiretroviral therapy (ART) and cardiometabolic traits is not well described in SSA populations.

Dillon, David G; Gurdasani, Deepti

2013-01-01

129

Urban malaria risk in sub-Saharan Africa: where is the evidence?  

Science.gov (United States)

It is essential that the precautions that are advisable for travel in sub-Saharan Africa, including antimalarial prophylaxis, are supported by evidence. Sub-Saharan Africa accounts for 90% of global malaria cases and the more serious falciparum form predominates. The risk of malaria transmission is qualitatively much greater in rural than urban areas. However, there is little quantitative data on the risk in urban areas on which to base a risk assessment. Rapid urban population growth and trends of tourism to urban-only (rather than rural) areas both support the need to focus attention on the level of risk in malaria endemic African cities. There is evidence in urban settings that the reduced intensity of malaria transmission is due to a decline in the level of parasitism in the local population and reduced anophelism. The most useful evidence for an urban risk assessment is the entomological inoculation rate (EIR) which is generally below 30 infective bites per person per year. Transmission is acknowledged to be much lower in central urban areas compared with peri-urban areas or rural areas. Transmission is local and focal because the anopheles mosquito has a limited flight range of several kilometres. The risk assessment should examine nocturnal activities outside an air-conditioned environment (because the anopheline mosquito only bites between dusk and dawn) and the level of adherence to accompanying protective measures. Several studies have noted the protection air-conditioning provides against malaria. Evidence of low occupational risk for airline crew, unprotected by prophylaxis, from brief layovers of several nights in quality hotels in 8 endemic cities is explored. A literature search examines the evidence of environmental surveys and entomological inoculation rates. The limitations of the available data are discussed, including the highly focal nature of malaria transmission. PMID:17298922

Byrne, Neville

2007-03-01

130

Medical care on the brink: the need for re-engineering healthcare services in sub-Saharan Africa.  

Science.gov (United States)

The sub-Saharan region of Africa is home to more of the ills of mankind than any other region on earth. Nowhere is the aggregate of disease, political turmoil, inadequate resources and a crumbling infrastructure so completely packaged in a seemingly "escape proof" pod as in sub-Saharan Africa. This continent is a kaleidoscope of people and problems derived from artificial boundaries drawn by European colonial powers, resulting in a litany of problems that have flourished for many decades. In the immediate postcolonial era, there was some oversight by the departed powers, but this has changed recently with decreasing interest in African affairs and only episodic worldwide news coverage because of other world events that overshadow Africa and its problems. The end of the cold war also eliminated the attention Africa received when the superpowers were courting nations. The American Medical Team for Africa has conducted medical missionary work throughout Africa for over a decade and, through its observations, has developed recommendations that are germane to all of sub-Saharan Africa. The organization thinks that this might warrant the attention of governments, international pharmaceutical houses, foundations, the United Nations and all international aid agencies concerned about the plight of healthcare in Africa. These recommendations should enable these countries to re-establish an affordable, efficient and sustainable infrastructure for basic hospital services so that they can diagnosis, monitor, treat and manage disease populations. In some areas, Africa needs to be retrofitted with technology from the past, while in others it needs to be fast-forwarded into the future. The purpose of this manuscript is to try putting the various healthcare challenges into one of these two categories. PMID:15779506

Hoover, Eddie L; Cole-Hoover, Gwendolyn; Berry, Paula K; Hoover, Evan T; Harris, Betsy L; Rageh, Deman; Weaver, W Lynn

2005-03-01

131

Model-based impact and cost-effectiveness of cervical cancer prevention in sub-Saharan Africa.  

Science.gov (United States)

Using population and epidemiologic data for 48 countries in sub-Saharan Africa, we used a model-based approach to estimate cervical cancer cases and deaths averted, disability-adjusted life years (DALYs) averted and incremental cost-effectiveness ratios (I$ (international dollar) per DALY averted) for human papillomavirus (HPV) vaccination of pre-adolescent girls. Additional epidemiologic data from Uganda and South Africa informed estimates of cancer risk reduction and cost-effectiveness ratios associated with pre-adolescent female vaccination followed by screening of women over age 30. Assuming 70% vaccination coverage, over 670,000 cervical cancer cases would be prevented among women in five consecutive birth cohorts vaccinated as young adolescents; over 90% of cases averted were projected to occur in countries eligible for GAVI Alliance support. There were large variations in health benefits across countries attributable to differential cancer rates, population size, and population age structure. More than half of DALYs averted in sub-Saharan Africa were in Nigeria, Tanzania, Uganda, the Democratic Republic of the Congo, Ethiopia, and Mozambique. When the cost per vaccinated girl was I$5 ($0.55 per dose), HPV vaccination was cost-saving in 38 sub-Saharan African countries, and cost I$300 per DALY averted or less in the remaining countries. At this vaccine price, pre-adolescent HPV vaccination followed by screening three times per lifetime in adulthood cost I$300 per year of life saved (YLS) in Uganda (per capita GDP I$1,140) and I$1,000 per YLS in South Africa (per capita GDP I$9,480). In nearly all countries assessed, HPV vaccination of pre-adolescent girls could be very cost-effective if the cost per vaccinated girl is less than I$25-I$50, reflecting a vaccine price being offered to the GAVI Alliance. In-country decision makers will need to consider many other factors, such as affordability, acceptability, feasibility, and competing health priorities, when making decisions about cervical cancer prevention. This article forms part of a regional report entitled "Comprehensive Control of HPV Infections and Related Diseases in the Sub-Saharan Africa Region" Vaccine Volume 31, Supplement 5, 2013. Updates of the progress in the field are presented in a separate monograph entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012. PMID:24331749

Kim, Jane J; Campos, Nicole G; O'Shea, Meredith; Diaz, Mireia; Mutyaba, Innocent

2013-12-29

132

The effects of HIV/AIDS on the achievement of the Millennium Development Goals in sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The primary means of HIV transmission – sexual intercourse – has been known for over two decades, but that information does not prevent thousands of men and women from contracting the virus every day. The AIDS epidemic creates a high and ongoing mortality in the economic and social active sector of populations in sub-Saharan Africa. The epidemic is being driven by inequities and uneven development, exacerbating existing poverty and human misery. In hard-hit countries in sub-Saharan Africa...

Fourie, D. J.; Schoeman, R. E.

2010-01-01

133

Sub-Saharan hydroelectric power development potential  

International Nuclear Information System (INIS)

Though evidencing a power demand which is amongst the lowest in the world, the sub-Saharan regions of Africa are blessed with an enormous hydroelectric power resource potential, which, if suitably developed and tapped, may become a source of economic electric energy for Europe. With the aid of numerous statistical supply and demand data, this paper surveys the marketing potential of this energy source in Africa. The analysis of future development prospects is carried out with reference to the local socio-economic framework

134

Analysis of pharmacogenetic traits in two distinct South African populations  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Our knowledge of pharmacogenetic variability in diverse populations is scarce, especially in sub-Saharan Africa. To bridge this gap in knowledge, we characterised population frequencies of clinically relevant pharmacogenetic traits in two distinct South African population groups. We genotyped 211 tagging single nucleotide polymorphisms (tagSNPs in 12 genes that influence antiretroviral drug disposition, in 176 South African individuals belonging to two distinct population groups residing in the Western Cape: the Xhosa (n = 109 and Cape Mixed Ancestry (CMA (n = 67 groups. The minor allele frequencies (MAFs of eight tagSNPs in six genes (those encoding the ATP binding cassette sub-family B, member 1 [ABCB1], four members of the cytochrome P450 family [CYP2A7P1, CYP2C18, CYP3A4, CYP3A5] and UDP-glucuronosyltransferase 1 [UGT1A1] were significantly different between the Xhosa and CMA populations (Bonferroni p CYP2C18, CYP3A4, the gene encoding solute carrier family 22 member 6 [SLC22A6] and UGT1A1 between the two South African populations. Characterising the Xhosa and CMA population frequencies of variant alleles important for drug transport and metabolism can help to establish the clinical relevance of pharmacogenetic testing in these populations.

Ikediobi Ogechi

2011-05-01

135

A brief history of medical education in Sub-Saharan Africa.  

Science.gov (United States)

Developments in medical education in Sub-Saharan Africa over the past 100 years have been characterized by the continent's unique history. During the first half of the 20th century, the Europeans effectively installed medical education in their African colonies. The years 1950 to 1960 were distinguished by successful movements for independence, with new governments giving priority to medical education. By 1980, there were 51 medical schools in Sub-Saharan Africa. The period from 1975 to 1990 was problematic both politically and economically for Sub-Saharan Africa, and medical schools did not escape the general difficulties. War, corruption, mounting national debts, and political instability were characteristics of this period. In many countries, maintaining medical school assets--faculty members, buildings, laboratories, libraries--became difficult, and emigration became the goal of many health professionals. In contrast, the past 20 years have seen rapid growth in the number of medical schools in Sub-Saharan Africa. Economic growth and political stability in most Sub-Saharan African countries augur well for investment in health systems strengthening and in medical education. There are, nonetheless, major problem areas, including inadequate funding, challenges of sustainability, and the continuing brain drain. The 20th century was a time of colonialism and the struggle for independence during which medical education did not advance as quickly or broadly as it did in other regions of the world. The 21st century promises a different history, one of rapid growth in medical education, leading to better care and better health for the people of Africa. PMID:25072563

Monekosso, G L

2014-08-01

136

The case for investing in secondary education in sub-Saharan Africa (SSA): challenges and opportunities  

Science.gov (United States)

Over the next two decades, sub-Saharan Africa will face substantial pressure to expand its secondary education system. This is driven by the current low development of secondary education compared to other world regions, continued rapid population growth, the increase in the enrolment and completion rates at the primary education level, and the upsurge in the demand for skills. This paper suggests that in order to help countries respond to these pressures, external partners should now increase their support for secondary education, in terms of academic as well as technical and vocational skills training. Given the attributes of the African economies and the continuing need for foundation skills, this paper argues that in the current situation, particularly the lower secondary level will have to be strengthened, in many cases through a longer basic education cycle for all. The necessary rapid expansion of secondary education will require substantial investments, and this paper discusses how aid allocation can be made more evidence-based and used in a more strategic way to make these investments more effective and sustainable. While aid will continue to have a role to play over the next decade especially in fragile states, in the long run it is African countries' capacity to achieve sustained economic growth which will be the single most important factor determining their ability to meet the financing needs.

Fredriksen, Birger; Fossberg, Camilla Helgø

2014-04-01

137

The external debt-servicing constraint and public-expenditure composition in sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In the light of the current global financial and economic crises, how would governments in sub-Saharan Africa (SSA) allocate their budgets across sectors in response to a binding debt-servicing constraint? Within a framework of public-expenditure choice, the present paper estimates constraint-consistent debt-service ratios and employs them in Seemingly Unrelated Regression involving five-year panel for up to 35 African countries over 1975-94, a period preceding the Highly Indebted Poor Coun...

Fosu, Augustin

2010-01-01

138

Globalization, governance, and the economic performance of Sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

I estimate and compare the effects of globalization, governance, and conventional factors and forces on the economic performance of Sub-Saharan African countries. The analysis finds that both physical and human capita as well as unexplained technical residuals affect economic performance, although human capital and technical change do not always have statistically significant impacts. The policy implication of these results calls for improvement of all three variables. Economic ...

Amavilah, Voxi Heinrich

2009-01-01

139

Radiation of Pollination Systems in the Iridaceae of sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

• Background Seventeen distinct pollination systems are known for genera of sub-Saharan African Iridaceae and recurrent shifts in pollination system have evolved in those with ten or more species. Pollination by long-tongued anthophorine bees foraging for nectar and coincidentally acquiring pollen on some part of their bodies is the inferred ancestral pollination strategy for most genera of the large subfamilies Iridoideae and Crocoideae and may be ancestral for the latter. Derived strategi...

Goldblatt, Peter; Manning, John C.

2006-01-01

140

LPG market in sub Saharan Africa  

International Nuclear Information System (INIS)

This article provides an overview of the current state of the liquefied petroleum gases (LPG) market in sub Saharan Africa (SSA) and analyses the supply and demand patterns, the constraints on supply imposed by the insufficient output from refineries unable to meet the increasing demand, and institutional and regulatory issues. Details are given of the pricing policies, the economic benefits that could be obtained by increasing the scale of operations, the use of subsidies, private sector participation, and LPG activities in Angola, Cameroon, the Congo, and the Ivory Coast. The role of the World Bank in the Africa Gas Initiative to promote the use of natural gas reserves in SSA, and requirements for developing the LPG market are discussed

 
 
 
 
141

Fuel substitution in sub-Saharan Africa  

Science.gov (United States)

Deforestation and decline in agricultural productivity are major concerns over large parts of sub-Saharan Africa. One of the principal causes for both these phenomena is the export of woodfuels from rural agroecosystems to urban markets. This process is noteworthy because of the size of the trade. Wood fuels (fuelwood, charcoal, and agricultural residues) constitute the most important source of energy in these countries, varying from 60% to 95% of total energy consumption. In terms of the environmental impact of the fuelwood trade, solutions typically considered are the introduction of improved cookstoves, fuelwood plantations, and fuel substitution by conventional fuels. This article examines the structure of the fuelwood problem, reviews the successes and failures of past experiences, and focuses on the potential for fuel substitution as an option to reduce the urban demand for fuelwood.

Dang, Himraj

1993-05-01

142

Can the woodfuel supply in sub-Saharan Africa be sustainable? The case of N'Djamena, Chad  

International Nuclear Information System (INIS)

Chad, like many other sub-Saharan African countries, depends for most of its energy demand on woodfuels; 90% or more of the country's energy balance comes from biomass energy. Obvious environmental problems appear around cities because of their highly concentrated demand, and this threatens the sustainability of supply. But, this does not need to be a problem, and woodfuel can also be an engine of economic growth, particularly in rural areas. A few policy conditions will need to be satisfied and in Chad this appears to be the case. As a result, the woodfuel supply of the capital N'Djamena could become sustainable, thereby continuing to provide low-cost energy to the urban population for the foreseeable future while giving income generation opportunities in rural areas. A win-win situation?!

143

Public Policy and the Management of Higher Education in Sub-Saharan Africa: The Case of Kenya.  

Science.gov (United States)

Examines Kenya's policy concerning growth and development of higher education over the last 20 years. Concludes that Kenya has problems of infrastructure quality and physical plant similar to those of other Sub-Saharan African countries, that resource allocation policies are inconsistent, and that expansion should be guided by popular demand for…

Gray, Kenneth R.; Credle, Sid Howard

1996-01-01

144

A multilevel approach to explain child mortality and undernutrition in South Asia and Sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

While undernutrition among children is very pervasive both in Sub- Saharan Africa and South Asia, child mortality is rather low in South Asia. In contrast to that Sub-Saharan African countries su er by far the worst from high rates of child mortality. This di erent pattern of child mortality and undernutrition in both regions is well known, but approaches using aggregated macro data have not been able to explain it appropriately. In this paper we analyze the determinants of child mortality as...

Misselhorn, Mark; Harttgen, Kenneth

2006-01-01

145

Financing renewable energy in developing countries. Drivers and barriers for private finance in sub-Saharan Africa  

Energy Technology Data Exchange (ETDEWEB)

The focus of this report is to identify and portray current barriers to the scaling up of private investment and finance for electricity generation from renewable energy sources in the sub-Saharan region. Best practice in tackling these barriers is identified, partly from a literature review but especially from the results of a survey conducted among 36 financial institutions that are UNEP Finance Initiative members and two non-member banks (all survey respondents have experience in the field of energy infrastructure finance). Promising avenues in the areas of local policy reform, incentive mechanisms and international de-risking instruments are highlighted. In particular, this report addresses the following questions: (a) Why are sub-Saharan Africa and developing countries elsewhere failing to expand electricity generation from renewable sources? What are the barriers to such expansion? What is keeping the risk-return profile of renewable energy investments in sub-Saharan Africa unattractive and projects commercially unviable?; (b) What have been the experiences of private sector lenders and investors in the area of renewable energy projects in developing countries? What barriers and drivers have they encountered, and how can these experiences be of use in sub-Saharan Africa?; (c) What can be learned from the modest but encouraging successes of a few sub-Saharan African countries? Can these results be replicated? What was done in these countries to improve the risk-return profile of renewable energy and unlock private finance?.

NONE

2012-02-15

146

Polygyny, partnership concurrency, and HIV transmission in Sub-Saharan Africa.  

Science.gov (United States)

We study the relationship between polygyny and HIV infection using nationally representative survey data with linked serostatus information from 20 African countries. Our results indicate that junior wives in polygynous unions are more likely to be HIV positive than spouses of monogamous men, but also that HIV prevalence is lower in populations with more polygyny. With these results in mind, we investigate four explanations for the contrasting individual- and ecological-level associations. These relate to (1) the adverse selection of HIV-positive women into polygynous unions, (2) the sexual network structure characteristic of polygyny, (3) the relatively low coital frequency in conjugal dyads of polygynous marriages (coital dilution), and (4) the restricted access to sexual partners for younger men in populations where polygynous men presumably monopolize the women in their community (monopolizing polygynists). We find evidence for some of these mechanisms, and together they support the proposition that polygynous marriage systems impede the spread of HIV. We relate these results to the debate about partnership concurrency as a primary behavioral driver for the fast propagation of HIV in some parts of sub-Saharan Africa. PMID:22661302

Reniers, Georges; Tfaily, Rania

2012-08-01

147

Harnessing Open Educational Resources to the Challenges of Teacher Education in Sub-Saharan Africa  

Directory of Open Access Journals (Sweden)

Full Text Available The challenges to teacher educators in sub-Saharan Africa are acute. This paper describes how the Teacher Education in Sub-Saharan Africa (TESSA consortium is working within institutional and national policy systems to support school-based teacher professional development. The TESSA consortium (13 African institutions and 5 international organisations delivering teacher education across 9 countries designed and produced a bank of open educational resources (OERs to guide teachers’ classroom practices in school-based teacher education. Drawing on examples from the TESSA consortium and from the University of Fort Hare, South Africa, the authors categorize the forms of TESSA OER integration as highly structured, loosely structured, or guided use. The paper concludes by outlining success factors for the integration of OERs: accessibility, adequate resources, support for teachers, accommodation of local cultural and institutional practices, and sustainable funding.

Jayshree Thakrar

2009-09-01

148

The European Union and sub-Saharan Africa : from intervention towards deterrence?  

DEFF Research Database (Denmark)

This article argues that aspirations of maintaining a dominant influence over sub-Saharan security issues has spurred the French and British leadership of European Union (EU) foreign and security policy integration, just as it has informed military capability expansions by the armed forces of the main EU powers. While Europe's initial African focus was on stabilising a continent marred by state failure, civil wars and genocides, changes in the global security context, especially the shift towards multipolarity manifest in China's growing engagement, has prompted a complementary focus on deterring other powers from making military inroads into the subcontinent. Hence Europe's sub-Saharan security focus is shifting from stabilisation towards deterrence. This helps explain recent military procurements which, in spite of the extremely challenging fiscal position of most EU member states, feature large-scale investments in long-range deterrence capabilities.

Kluth, Michael Friederich

2013-01-01

149

Rickettsia africae in Hyalomma dromedarii ticks from sub-Saharan Algeria.  

Science.gov (United States)

Spotted fever group (SFG) rickettsioses are caused by obligate, intracellular Gram-negative bacteria of the genus Rickettsia. In recent years, several species and subspecies of rickettsias have been identified as emerging pathogens throughout the world, including sub-Saharan Africa. We report here the detection of Rickettsia africae, the agent responsible for African tick-bite fever, by amplification of fragments of gltA and ompA genes and multi-spacer typing from Hyalomma dromedarii ticks collected from the camel Camelus dromedarius in the Adrar and Béchar region (sub-Saharan Algeria). To date, R. africae has been associated mainly with Amblyomma spp. The role of H. dromedarii in the epidemiology of R. africae requires further investigation. PMID:23164496

Kernif, Tahar; Djerbouh, Amel; Mediannikov, Oleg; Ayach, Bouhous; Rolain, Jean-Marc; Raoult, Didier; Parola, Philippe; Bitam, Idir

2012-12-01

150

Sub-Saharan Africa's HIV pandemic.  

Science.gov (United States)

Longitudinal studies and household surveys suggest that sub-Saharan Africa's (SSA's) HIV/AIDS crisis is not a pandemic of the poor but rather one of inequalities, where wealthier individuals are more likely to be infected as a result of greater mobility and multiple relationships (Fox, 2012). This is in sharp contrast to the situation in the United States, where HIV infections "are concentrated among the poor with very few people in the middle and upper social strata contracting HIV" (Pellowski, Kalichman, Matthews, & Adler, May-June 2013, p. 199). Yet from a global perspective, wherein SSA is the poorest region in the world, the pandemic is of course one of poverty as well as one with pronounced racial and gender disparities. Both the May-June 2013 special issue of the American Psychologist ("HIV/AIDS: Social Determinants and Health Disparities") and another American Psychologist special issue 25 years earlier ("Psychology and AIDS," November 1988) help shed light on Africa's HIV/AIDS crisis. PMID:24446856

Simms, Chris

2014-01-01

151

European MRSA Originated in Sub-Saharan Africa, Study Finds  

Science.gov (United States)

... sharing features on this page, please enable JavaScript. European MRSA Originated in Sub-Saharan Africa, Study Finds ... other countries and growth in the number of European tourists traveling to this part of Africa, according ...

152

Development in Sub-Saharan Africa: Overcoming the Digital Divide  

Directory of Open Access Journals (Sweden)

Full Text Available In an increasingly digitalized world economy, there exists a digital gap between Sub-Saharan Africa and the rest of the world that translates into economic marginalization of the African region. Consequently, the following phases of development are crucial for the region: (1 the phase of massive digitalization during which the digital divide is bridged and (2 the phase of information and knowledge management in which information is systematically converted into knowledge and the latter into innovative-sustainable development. Information for conversion into knowledge is supplied by the first phase. The second phase is therefore existence dependent on the first. Therefore, the attainment of digitalized state is primary-sine qua non. The envisaged digitalized state can be actualized and consolidated with a combination of: (a curriculum in computer education consisting of computer taxonomy, networking and ICTS in general for secondary and tertiary institutions but also aptly adoptable for informal groups and (b establishment of multipurpose telecentres in rural areas and a diffusion of networks in urban centres. Once a steady digitalized state evidenced by uninterrupted connectivity to the internet is attained, the second phase can be realized. Without steady supply of electricity, however, sustainable development and competitive edge may be hard to come by in a world of fierce competition.

Oyedokun Agbeja

2007-01-01

153

Nutrient composition of selected indigenous fruits from sub-Saharan Africa.  

Science.gov (United States)

Indigenous fruits constitute an important part of human diets in many sub-Saharan African countries, particularly in rural areas and during droughts. In order to promote and expand the utilisation of these fruits, knowledge on their nutritional composition is essential. This review presents the results of a literature research of the nutritional composition of ten selected indigenous fruits from sub-Saharan Africa. Species were selected based on their current importance as well as their future potential for nutrition, processing and cash income generation. Compositional data were compiled and mean values of components per species were calculated. Most papers were compiled for Adansonia digitata (26) and Dacryodes edulis (16), followed by Tamarindus indica (ten), Balanites aegyptiaca (nine), Sclerocarya birrea (nine), Ziziphus mauritiana (nine), Vitex doniana (seven) and Irvingia gabonensis (five), and least for Uapaca kirkiana (three) and Syzygium guineense (three). Fruits were found to be mainly analysed for macronutrients and minerals. Vitamins, apart from vitamin C, were rarely reported. Substantial compositional differences were found among as well as within the different fruit species. The results of this study emphasise the need to generate more high-quality data on a wider spectrum of components of the selected indigenous fruits in sub-Saharan Africa. © 2013 Food and Agriculture Organization of the United Nations. PMID:23633245

Stadlmayr, Barbara; Charrondière, U Ruth; Eisenwagen, Sandra; Jamnadass, Ramni; Kehlenbeck, Katja

2013-08-30

154

The current status of international partnerships for child surgery in sub-saharan Africa.  

Science.gov (United States)

Abstract Disparity still exists in the surgical care between sub-Saharan Africa and developed countries. Several international initiatives have been undertaken in the past decades to address the disparity. This study looks at the impact of these programs in child surgery in Sub-Saharan Africa. Review of electronic databases Medline and African Index Medicus on international partnerships for child surgery in Sub-Saharan Africa was undertaken. Four types of international initiatives were identified and consist of periodic medical missions; partnerships between foreign medical institutions or charities and local institutions; international health electives by surgical residents; and training of individual surgeons from developing countries in foreign institutions. The results of these efforts were variable, but sustainability and self-reliance of host nations were limited. Sociocultural factors, dearth of facilities, and lack of local governments' commitment were main impediments to effective local development or transfer of modern protocols of surgical management and improvement of pediatric surgical care at the host community level. Current initiatives may need improvements with better understanding of the sociocultural dynamics and local politics of the host nation, and improved host nation involvement and commitment. This may engender development of locally controlled viable services and sustainable high level of care. PMID:25216431

Ekenze, Sebastian O; Onumaegbu, Okechukwu O; Nwankwo, Okechukwu E

2014-01-01

155

Assessing and forecasting groundwater development costs in Sub-Saharan Africa  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english Greater use of groundwater in Sub-Saharan Africa is a pre-requisite for improved human welfare; however, the costs associated with groundwater development are prohibitively high and poorly defined. This study identifies and disaggregates the costs of groundwater development in 11 Sub-Saharan African [...] countries, while the cost factors that most strongly affect drilling expenditures are traced. Further, the institutional and technical constraints impeding groundwater development are also explored while a time-series analysis forecasts future drilling expenditures. The results indicate that mobilisation and demobilisation costs, together with well development costs, factors that are difficult to change, are most significantly affecting the total costs of drilling. Further, the nature of the hydrogeological formation (which is largely a site characteristic), along with the often-aged machinery (which can be controlled), are also major impediments to lowering the cost of drilling. All countries are forecasted to have a slight to considerable drilling cost decrease for the next decade which offers encouragement for future groundwater development. Greater attention to the individual cost factors and to forecasting analysis could help to design more coherent and consistent groundwater development policies in Sub-Saharan Africa.

Stefanos, Xenarios; Paul, Pavelic.

156

Progress report on the first sub-Saharan trial of newer versus older antihypertensive drugs in native black patients  

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ABSTRACT: BACKGROUND: The epidemic surge in hypertension in sub-Saharan Africa is not matched by clinical trials of antihypertensive agents in Black patients recruited in this area of the world. We mounted the Newer versus Older Antihypertensive agents in African Hypertensive patients (NOAAH) trial to compare, in native African patients, a single-pill combination of newer drugs, not involving a diuretic, with a combination of older drugs including a diuretic. METHODS: Patients aged 30 to 69 y...

Odili, Augustine N.; Ezeala-adikaibe, Birinus; Anisiuba, Benedict C.; Kamdem, Marius M.; Ndiaye, Mouhamadou B.; Ijoma, Chinwuba K.; Kaptue, Joseph; Boombhi, Hilaire J.; Kolo, Philip M.; Shu, Elvis N.; Thijs, Lutgarde; Staessen, Jan A.; Omotoso, Babatunde A.; Kingue, Samuel; Lemogoum, Daniel

2012-01-01

157

The Long-Term Effects of the Printing Press in Sub-Saharan Africa  

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This article delves into the relationship between newspaper readership and civic attitudes, and its effect on economic development. To this end, we investigate the long-term consequences of the introduction of the printing press in the 19th century. In sub-Saharan Africa, Protestant missionaries were the first both to import the printing press technology and to allow the indigenous population to use it. We build a new geocoded dataset locating Protestant missions in 1903. This dataset include...

Cage, Julia; Rueda, Valeria

2014-01-01

158

The absence of adult mortality data for sub-Saharan Africa: a practical solution.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Information on cause of death among adults in sub-Saharan Africa is essentially nonexistent. Published sources provide statistics on both cause-specific and overall rates of mortality, but closer examination reveals that these data consist mostly of extrapolations and outright guesses. In the absence of accurate and comprehensive registries of vital events for the majority of the region's inhabitants, longitudinal studies of defined population-based cohorts represent the only realistic strate...

Kaufman, J. S.; Asuzu, M. C.; Rotimi, C. N.; Johnson, O. O.; Owoaje, E. E.; Cooper, R. S.

1997-01-01

159

Climate Change and Food Security in Sub-Saharan Africa: A Systematic Literature Review  

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In recent years it has become clear that climate change is an inevitable process. In Sub-Saharan Africa, the expectation is that climate change will have an especially negative impact, not only a result of projected warming and rainfall deficits, but also because of the vulnerability of the population. The impact upon food security will be of great significance, and may be defined as being composed of three components: availability, access, and utilization. To further investigate the link, a ...

Thompson, Heather E.; Ford, James D.; Lea Berrang-Ford

2010-01-01

160

Ocular infections in sub-Saharan Africa in the context of high HIV prevalence.  

Science.gov (United States)

Healthy eyes and good vision are important determinants of populations' health across the globe. Sub-Saharan Africa is affected by simultaneous epidemics of ocular infections and human immunodeficiency virus (HIV). Ocular infection and its complications, along with cataract and ocular trauma, are common conditions in this region with great impact on daily life. In this review, we discuss the epidemiology, clinical manifestations and microbial aetiology of the most important infectious ocular conditions in sub-Saharan Africa: conjunctivitis, keratitis and uveitis. We focus specifically on the potential association of these infections with HIV infection, including immune recovery uveitis. Finally, challenges and opportunities for clinical management are discussed, and recommendations made to improve care in this neglected but very important clinical field. PMID:25039335

Schaftenaar, Erik; van Gorp, Eric C M; Meenken, Christina; Osterhaus, Albert D M E; Remeijer, Lies; Struthers, Helen E; McIntyre, James A; Baarsma, G Seerp; Verjans, Georges M G M; Peters, Remco P H

2014-09-01

 
 
 
 
161

A review of co-morbidity between infectious and chronic disease in Sub Saharan Africa: TB and Diabetes Mellitus, HIV and Metabolic Syndrome, and the impact of globalization  

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Full Text Available Abstract Background Africa is facing a rapidly growing chronic non-communicable disease burden whilst at the same time experiencing continual high rates of infectious disease. It is well known that some infections increase the risk of certain chronic diseases and the converse. With an increasing dual burden of disease in Sub Saharan Africa the associations between diseases and our understanding of them will become of increased public health importance. Aims In this review we explore the relationships reported between tuberculosis and diabetes mellitus, human immunodeficiency virus, its treatment and metabolic risk. We aimed to address the important issues surrounding these associations within a Sub Saharan African setting and to describe the impact of globalization upon them. Findings Diabetes has been associated with a 3-fold incident risk of tuberculosis and it is hypothesised that tuberculosis may also increase the risk of developing diabetes. During co-morbid presentation of tuberculosis and diabetes both tuberculosis and diabetes outcomes are reported to worsen. Antiretroviral therapy for HIV has been associated with an increased risk of developing metabolic syndrome and HIV has been linked with an increased risk of developing both diabetes and cardiovascular disease. Globalization is clearly related to an increased risk of diabetes and cardiovascular disease. It may be exerting other negative and positive impacts upon infectious and chronic non-communicable disease associations but at present reporting upon these is sparse. Conclusion The impact of these co-morbidities in Sub Saharan Africa is likely to be large. An increasing prevalence of diabetes may hinder efforts at tuberculosis control, increasing the number of susceptible individuals in populations where tuberculosis is endemic, and making successful treatment harder. Roll out of anti-retroviral treatment coverage within Sub Saharan Africa is an essential response to the HIV epidemic however it is likely to lead to a growing number of individuals suffering adverse metabolic consequences. One of the impacts of globalization is to create environments that increase both diabetes and cardiovascular risk but further work is needed to elucidate other potential impacts. Research is also needed to develop effective approaches to reducing the frequency and health impact of the co-morbidities described here.

Johnstone Lucy K

2009-09-01

162

Future prospectives of sub-Saharan women living with HIV residing in France for more than seven years: prospective pilot study  

Science.gov (United States)

Introduction In 2011, a French national survey of people living with HIV (PLHIV) has shown that 40% of persons diagnosed since 2003 are originated from sub-Saharan Africa, two thirds of them being women. For them, in the short term, access to social rights is a priority. Today, over 90% of PLHIV are treated effectively and with the aging of this population, questions about their future perspectives arise. Our service provides a multidisciplinary (medical, psychological, social) approach to PLHIV. The aim of our study is to describe the future perspectives of sub-Saharan women living with HIV residing in France for more than 7 years, because it is the time required for the implementation of fundamental rights and social insertion. Do they plan to return to their country of origin after their retirement? Does the HIV infection force them to stay in France? Materials and Methods Prospective pilot mono-centric study. Between January and April 2014, every HIV-infected woman born in a sub-Saharan country, resident in France for at least 7 years, attending for their routine outpatient visit was consecutively included. Data were collected through a structured, semi-directed interview made by their usual hospital physician or social worker. Results Consecutively, 76 women agreed to participate to the interview, none refused. Mean age: 42 years [26–70], time since HIV diagnosis: 12 years [1–25]. HIV diagnosis was made before arriving in France for 3% of them; in 33% diagnosis was made in the year of arrival; diagnosis made several years after arrival in 63%. Even if 69% of these women had been irregularly residing in France for a period, all of them had obtained a regular situation for residence and 50% acquired the French nationality. Mean duration of residence was 15 years [7–33]. Two thirds of them are employed. In the future, although 50% plan to have a shared residence between France and Africa, only 20% of them plan to settle back definitely in Africa and no woman declared that she would look for a medical follow up in Africa for their HIV infection. Conclusions This study shows a good integration in France of HIV-infected sub-Saharan woman. Their links with Africa remain strong but very few plan to return in their country of origin due to lack of confidence in the African health infrastructures. PMID:25394106

Dimi, Svetlane; Albucher, Dominique; Zucman, David

2014-01-01

163

The need for multipurpose prevention technologies in sub-Saharan Africa.  

Science.gov (United States)

Women bear a disproportionate burden of the HIV epidemic in sub-Saharan Africa and account for about 60% of all adults living with HIV in that region. Young women, including adolescent girls, unable to negotiate mutual faithfulness and/or condom use with their male partners are particularly vulnerable. In addition to the high HIV burden, women in Africa also experience high rates of other sexually transmitted infections and unwanted pregnancies. The development of technologies that can simultaneously meet these multiple sexual reproductive health needs would therefore be extremely beneficial in the African setting. PMID:25335838

Abdool Karim, S; Baxter, C; Frohlich, J; Abdool Karim, Q

2014-10-01

164

Estimates of gender differences in firm’s access to credit in Sub-Saharan Africa  

DEFF Research Database (Denmark)

Based on firm level data from 16 Sub-Saharan African countries we show how three different measures of credit constraints lead to three different estimates of gender differences in manufacturing firms’ credit situation. Using a perception based credit constraint measure female owned firms appear relatively more constrained than male owned firms. Using formal financial access data we find no gender effect. Finally, using direct information on credit constraints, male owned small firms appear disadvantaged. Furthermore we show a strong size gradient in the gender gap for the two measures for which we find significant gender differences.

Hansen, Henrik; Rand, John

2014-01-01

165

A Machine Learning Approach to Mapping Agricultural Fields Across Sub-Saharan Africa  

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Food production in sub-Saharan Africa is dominated by smallholder agriculture. Rainfed farming practices and the prevailing dryland conditions render crop yields vulnerable to increasing climatic variability. As a result, smallholder farmers are among the poorest and most food insecure groups among the region's population. Quantifying the distribution of smallholder agriculture across sub-Saharan Africa would greatly assist efforts to boost food security. Existing agricultural land cover data sets are limited to estimating the percentage of cropland within a coarse grid cell. The goal of this research is to develop a statistical machine learning algorithm to map individual agricultural fields, mirroring the accuracy of hand-digitization. For the algorithm, a random forest pixel-wise classifier learns by example from training data to distinguish between fields and non-fields. The algorithm then applies this training to classify previously unseen data. These classifications can then be smoothed into coherent regions corresponding to agricultural fields. Our training data set consists of hand-digitized boundaries of agricultural fields in South Africa, commissioned by its government in 2008. Working with 1 km x 1 km scenes across South Africa, the hand-digitized field boundaries are matched with satellite images extracted from Google Maps. To highlight different information contained within the images, several image processing filters are applied. The inclusion of Landsat images for additional training information is also explored. After training and testing the algorithm in South Africa, we aim to expand our mapping efforts across sub-Saharan Africa. Through Princeton's Mapping Africa project, crowdsourcing will produce additional training data sets of hand-digitized field boundaries in new areas of interest. This algorithm and the resulting data sets will provide previously unavailable information at an unprecedented level of detail on the largest and most vulnerable group of farmers in sub-Saharan Africa.

Debats, S. R.; Fuchs, T. J.; Thompson, D. R.; Estes, L. D.; Evans, T. P.; Caylor, K. K.

2013-12-01

166

Modern Biotechnology—Potential Contribution and Challenges for Sustainable Food Production in Sub-Saharan Africa  

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Full Text Available Modern biotechnology, including the application of transgenic techniques to produce Genetically Modified Organisms (GMOs, can play a significant role in increasing agricultural production in a sustainable way, but its products need to be tailored for the developing world. In sub-Saharan Africa, the capacity to develop GMOs and ensure they meet stringent regulatory requirements is somewhat limited. Most African governments contribute little to science and technology either financially or through strong policies. This leaves the determination of research and development priorities in the hands of international funding agencies. Whereas funding from the United States is generally supportive of GM technology, the opposite is true of funding from European sources. African countries are thus pulled in two different directions. One alternative to this dilemma might be for countries in the sub-Saharan Africa region to develop stronger South-South collaborations, but these need to be supported with adequate funding. African governments as well as external funding agencies are urged to consider the important role that biotechnology, including GM technology, can play in contributing to sustainable development in Africa, and to provide adequate support to the development of capacity to research, develop and commercialize GMOs in the region.

E. Jane Morris

2011-06-01

167

The Concept ‘Development’ Revisited towards Understanding: in the Context of Sub-Saharan Africa  

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Full Text Available There has been lingering contention on what development means in the African context. The meaning of development in the African context is crucial in order to know whether Africa is developing or not, particularly since 1970. This debate becomes critical when it is appreciated that Africa appears as the least developed continent in the world. This paper conceptualises ‘development’; in doing this, the paper considers both economic and political development, and looks into the complex question: Must economic development precede political development in Africa or vice-versa? In an attempt to address these issues, the paper considers and examines the views of many scholars and studies on these subject matters. While the paper recognises the rise and importance of recent global development paradigms, such as feminism, and green-environmentalism, it however, applies the long traditional approaches – modernisation, liberalism, dependency and Marxism in analysing the meaning of development in Sub-Saharan African context. This is because this paper is concerned with the real development stage of this Sub continent of Africa, and not merely an intellectual exercise. The paper finally proffers a definition of development, which it believes to be germane in the context of real developmental stage of Sub-Saharan Africa.

Brian-Vincent IKEJIAKU

2009-02-01

168

The Challenges for Sub-Saharan Africa. Sir John Crawford Memorial Lecture (1st, Washington, DC, November 1, 1985).  

Science.gov (United States)

The economic crisis in Sub-Saharan Africa threatens to condemn an entire continent to human misery unless stronger action is taken to control population growth, reverse ecological devastation, eliminate distortions in domestic economic policies, and increase external development finance. Substantial increases in financial assistance to Africa are…

McNamara, Robert S.

169

75 FR 81077 - To Take Certain Actions Under the African Growth and Opportunity Act, and for Other Purposes  

Science.gov (United States)

...designated the Democratic Republic of Congo (DRC) as an eligible sub-Saharan African country...1) of the 1974 Act to designate the DRC as a beneficiary sub- Saharan African country...October 31, 2003, the USTR designated the DRC as a beneficiary sub-Saharan African...

2010-12-27

170

The linkages between FDI and domestic investment: unravelling the developmental impact of foreign investment in Sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

While the recent increase in foreign direct investment (FDI) to African countries is a welcome development, the question remains as to the impact of these resource inflows on economic development. This study posits that a key channel of the impact of FDI on development is through its effects on domestic factor markets, especially domestic investment and employment. In this context, this study analyses the two-way linkages between FDI and domestic investment in Sub-Saharan Africa. The results ...

Ndikumana, Le?once; Verick, Sher

2008-01-01

171

Improving credit allocation to sustainable agriculture in Sub-Saharan Africa: Review of bio-based economy benefits  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Financing of agriculture by commercial and non-commercial institutions in rural Sub-Saharan African in recent years has being relatively constant despite remarkable increase in the number of institutions operating within this area. This development may be attributed to how these institutions rate the business of agriculture and the risks involved. However the slow pace of financing sustainable agriculture such as bio-based economy in the presence of internationaliza...

Benjamin, Olatunbosun

2012-01-01

172

Electronic Voting; A Possible Solution for Sub-Saharan Africa? : A focus on the Ghanaian Electoral System  

Digital Repository Infrastructure Vision for European Research (DRIVER)

One of the major reasons for political instability in Sub-Saharan Africa originates from the way elections are conducted. Most African countries have quite a handful of electoral malpractices which lead to political instability, civil wars and low economic growth.  Electronic voting might be a solution to the election problems and thus bring in a stable political atmosphere which attracts investors. This thesis looks at the prospects and challenges of implementing e-voting in Ghana and Sub-S...

Gyimah, Nana Afua Boamah; Tita, Bertrand Asongwe

2010-01-01

173

Effect of Media Use on HIV-Related Stigma in Sub-Saharan Africa: A Cross-Sectional Study  

Digital Repository Infrastructure Vision for European Research (DRIVER)

It is known that HIV-related stigma hinders prevention efforts. Previous studies have documented that HIV-related stigma may be associated with socioeconomic and socioecological factors. Mass media use may moderate this association, but there is limited research addressing that possibility. In this study, based on cross-sectional data pooled from the 2006–2011 Demographic and Health Surveys of 11 sub-Saharan African countries (N = 204,343), we investigated the moderating effects of exposure...

Bekalu, Mesfin Awoke; Eggermont, Steven; Ramanadhan, Shoba; Viswanath, Kasisomayajula

2014-01-01

174

Differentiation between African populations is evidenced by the diversity of alleles and haplotypes of HLA class I loci.  

Science.gov (United States)

The allelic and haplotypic diversity of the HLA-A, HLA-B, and HLA-C loci was investigated in 852 subjects from five sub-Saharan populations from Kenya (Nandi and Luo), Mali (Dogon), Uganda, and Zambia. Distributions of genotypes at all loci and in all populations fit Hardy-Weinberg equilibrium expectations. There was not a single allele predominant at any of the loci in these populations, with the exception of A*3002 [allele frequency (AF) = 0.233] in Zambians and Cw*1601 (AF = 0.283) in Malians. This distribution was consistent with balancing selection for all class I loci in all populations, which was evidenced by the homozygosity F statistic that was less than that expected under neutrality. Only in the A locus in Zambians and the C locus in Malians, the AF distribution was very close to neutrality expectations. There were six instances in which there were significant deviations of allele distributions from neutrality in the direction of balancing selection. All allelic lineages from each of the class I loci were found in all the African populations. Several alleles of these loci have intermediate frequencies (AF = 0.020-0.150) and seem to appear only in the African populations. Most of these alleles are widely distributed in the African continent and their origin may predate the separation of linguistic groups. In contrast to native American and other populations, the African populations do not seem to show extensive allelic diversification within lineages, with the exception of the groups of alleles A*02, A*30, B*57, and B*58. The alleles of human leukocyte antigen (HLA)-B are in strong linkage disequilibrium (LD) with alleles of the C locus, and the sets of B/C haplotypes are found in several populations. The associations between A alleles with C-blocks are weaker, and only a few A/B/C haplotypes (A*0201-B*4501-Cw*1601; A*2301-B*1503-Cw*0202; A*7401-B* 1503-Cw*0202; A*2902-B*4201-Cw*1701; A*3001-B*4201-Cw*1701; and A*3601-B*5301-Cw*0401) are found in multiple populations with intermediate frequencies [haplotype frequency (HF) = 0.010-0.100]. The strength of the LD associations between alleles of HLA-A and HLA-B loci and those of HLA-B and HLA-C loci was on average of the same or higher magnitude as those observed in other non-African populations for the same pairs of loci. Comparison of the genetic distances measured by the distribution of alleles at the HLA class I loci in the sub-Saharan populations included in this and other studies indicate that the Luo population from western Kenya has the closest distance with virtually all sub-Saharan population so far studied for HLA-A, a finding consistent with the putative origin of modern humans in East Africa. In all African populations, the genetic distances between each other are greater than those observed between European populations. The remarkable current allelic and haplotypic diversity in the HLA system as well as their variable distribution in different sub-Saharan populations is probably the result of evolutionary forces and environments that have acted on each individual population or in their ancestors. In this regard, the genetic diversity of the HLA system in African populations poses practical challenges for the design of T-cell vaccines and for the transplantation medical community to find HLA-matched unrelated donors for patients in need of an allogeneic transplant. PMID:15009803

Cao, K; Moormann, A M; Lyke, K E; Masaberg, C; Sumba, O P; Doumbo, O K; Koech, D; Lancaster, A; Nelson, M; Meyer, D; Single, R; Hartzman, R J; Plowe, C V; Kazura, J; Mann, D L; Sztein, M B; Thomson, G; Fernández-Viña, M A

2004-04-01

175

Hospital based palliative care in sub-Saharan Africa; a six month review from Malawi  

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Full Text Available Abstract Background The World Health Organisation recognises the importance of palliative care in an African setting. Despite this services are often patchy and inconsistent, and many operate at health centre and/or community level. Few reports from hospital based palliative care services in sub-Saharan Africa exist in the current literature. As part of its activities Tiyanjane Clinic has been providing hospital based palliative care to patients at Queen Elizabeth Central Hospital, a large government tertiary referral institution, in the Southern region of Malawi since 2003, caring for patients with HIV, cancer and other non-malignant palliative diagnoses. Methods A retrospective review of case notes for all in-patients seen by Tiyanjane Clinic over a six month period (April-Sept 2009 was undertaken. Results A total of 177 patients were seen, for whom 137 case notes were available (77%. 58% of patients were male, 42% female. The average age of patients was 39.1 years (range 15-92 years. 54% of patients were HIV positive, with 34% on ARV drugs at the time of care. 42% of patients had HIV related diagnoses, including AIDS defining malignancies, 48% had (non AIDS related cancers and 9% had other palliative diagnoses. The mean age of patients with HIV related diagnoses was 34 years, for cancer patients it was 48 years. Pain was the most commonly reported symptom (74%, with 56% of patients requiring oral morphine. The mean daily dose of morphine was 30 mg/day (range 9-100 mg. 65% of patients were discharged home, 26% of patients died during admission. Conclusions The palliative care population in this setting is relatively young, especially among patients with HIV related diagnoses. HIV and cancer are the main diagnostic groups. Pain is the most commonly reported symptom, with oral morphine frequently required. Health workers require access to and knowledge of oral morphine in order to provide appropriate assistance to patients under their care.

Jane Bates M

2011-07-01

176

Similar Levels of X-linked and Autosomal Nucleotide Variation in African and non-African populations of Drosophila melanogaster  

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Full Text Available Abstract Background Levels of molecular diversity in Drosophila have repeatedly been shown to be higher in ancestral, African populations than in derived, non-African populations. This pattern holds for both coding and noncoding regions for a variety of molecular markers including single nucleotide polymorphisms and microsatellites. Comparisons of X-linked and autosomal diversity have yielded results largely dependent on population of origin. Results In an attempt to further elucidate patterns of sequence diversity in Drosophila melanogaster, we studied nucleotide variation at putatively nonfunctional X-linked and autosomal loci in sub-Saharan African and North American strains of D. melanogaster. We combine our experimental results with data from previous studies of molecular polymorphism in this species. We confirm that levels of diversity are consistently higher in African versus North American strains. The relative reduction of diversity for X-linked and autosomal loci in the derived, North American strains depends heavily on the studied loci. While the compiled dataset, comprised primarily of regions within or in close proximity to genes, shows a much more severe reduction of diversity on the X chromosome compared to autosomes in derived strains, the dataset consisting of intergenic loci located far from genes shows very similar reductions of diversities for X-linked and autosomal loci in derived strains. In addition, levels of diversity at X-linked and autosomal loci in the presumably ancestral African population are more similar than expected under an assumption of neutrality and equal numbers of breeding males and females. Conclusion We show that simple demographic scenarios under assumptions of neutral theory cannot explain all of the observed patterns of molecular diversity. We suggest that the simplest model is a population bottleneck that retains an ancestral female-biased sex ratio, coupled with higher rates of positive selection at X-linked loci in close proximity to genes specifically in derived, non-African populations.

Jensen Jeffrey D

2007-10-01

177

Education and Primitive Accumulation in Sub-Saharan Africa.  

Science.gov (United States)

The 1988 World Bank report on education in sub-Saharan Africa overstates the regional "crisis" in educational quality and recommends unrealistic strategies, ignoring the fact that basic human needs such as education are unmet because political elites corruptly privatize much of the wealth generated by their nations' economies. (SV)

Emoungu, Paul-Albert N.

1992-01-01

178

Peculiarities of the Digital Divide in Sub-Saharan Africa  

Science.gov (United States)

Purpose: Seeks to argue that the peculiarities of sub-Saharan Africa, in terms of its socio-cultural diversity, low economic development, linguistic factors, HIV/AIDS pandemic, gender discrimination, low ICT awareness and so on, demand a new model of addressing the digital divide. Design/methodology/approach: Paper largely based on literature…

Mutula, Stephen M.

2005-01-01

179

Polygynous contexts, family structure, and infant mortality in sub-saharan Africa.  

Science.gov (United States)

Contextual characteristics influence infant mortality above and beyond family-level factors. The widespread practice of polygyny is one feature of many sub-Saharan African contexts that may be relevant to understanding patterns of infant mortality. Building on evidence that the prevalence of polygyny reflects broader economic, social, and cultural features and that it has implications for how families engage in the practice, we investigate whether and how the prevalence of polygyny (1) spills over to elevate infant mortality for all families, and (2) conditions the survival disadvantage for children living in polygynous families (i.e., compared with monogamous families). We use data from Demographic and Health Surveys to estimate multilevel hazard models that identify associations between infant mortality and region-level prevalence of polygyny for 236,336 children in 260 subnational regions across 29 sub-Saharan African countries. We find little evidence that the prevalence of polygyny influences mortality for infants in nonpolygynous households net of region-level socioeconomic factors and gender inequality. However, the prevalence of polygyny significantly amplifies the survival disadvantage for infants in polygynous families. Our findings demonstrate that considering the broader marital context reveals important insights into the relationship between family structure and child well-being. PMID:24402794

Smith-Greenaway, Emily; Trinitapoli, Jenny

2014-04-01

180

From Theory to Practice: Exploring the Organised Crime-Terror Nexus in Sub-Saharan Africa  

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Full Text Available  A growing body of scholarly literature suggests confluence or even convergence of organized crime and terrorism in various parts of the world. However, links remain somewhat nebulous at this stage and vary considerably, based on region and context. Africa has come under the spotlight due to perceived weaknesses in the criminal justice sector, limited law enforcement capacity, political and systemic corruption, poor border patrol and weak anti-terror and organized crime laws which are believed to provide an ideal environment for the terror-crime nexus to flourish. This article provides an African perspective on the links between organized crime and terror networks in Sub-Saharan Africa, with a particular focus on Southern Africa. The discussion begins with an overview of the theoretical discourse on the subject – relying on African definitions of the contested concepts of ‘terrorism’ and ‘organized crime’ – and will then narrow the analysis on the sub-Saharan case. It relies on an extensive literature review and concludes with empirical findings of a research project on organized crime in Southern Africa, which found no strong empirical links between criminal and terrorist organizations.

Annette Hübschle

2011-09-01

 
 
 
 
181

Plant Variety Protection in Sub-Saharan Africa: Balancing Commercial and Smallholder Farmers’ Interests  

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Full Text Available Sub-Saharan African countries, through their regional organizations, have embarked on the harmonisation of plant variety protection (PVP systems. These initiatives are largely modelled on the UPOV 1991 act, which claims to incentivize plant breeding and facilitate agricultural development. Civil Society Organisations (CSO, however, strongly criticise this process for being out of step with Sub-Saharan African agricultural realities, undermining smallholder farmers’ agricultural practices and, ultimately, threatening food security. Among their main concerns are the fear that the proposed regimes facilitate biopiracy and lack recognition of farmers’ rights. This article discussed three of the main CSO concerns in tandem with examples of alternative provisions from PVP systems from around the world. While it will be shown that the CSO concerns are not likely to be acted upon, this article aims to answer the pressing question whether a UPOV ’91 based PVP system hampers farming practices in developing countries, and explores several legal avenues to accommodate the needs and traditions of smallholder farmers.

Bram De Jonge

2014-08-01

182

Cardiovascular autonomic function tests in an African population  

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Full Text Available Abstract Background Diabetes mellitus is becoming increasingly common in sub-Saharan Africa. Autonomic dysfunction contributes to morbidity and mortality in diabetic patients. Data on autonomic dysfunction in the African population is scarce, and no reference values for standardized autonomic function tests are available. The aim of this study was to establish cut off values for five easy-to-use cardiovascular autonomic function tests that may be suitable for resource-poor settings. Methods We recruited 276 healthy African individuals, 156 men and 120 women, aged > 20 years. Participants were tested for (1 resting heart rate (HR, (2 HR variation in response to deep breathing, (3 HR response to standing, and (4 postural changes in systolic and diastolic blood pressure (SBP and DBP. Respective cut-off values were calculated according to the 95th or 5th percentile. Results Taking an association of the autonomic test results with gender and age into consideration, we defined the following cut-off values: resting HR (bpm ? 89 for men and ? 97 for women; HR (bpm in response to deep breathing ? 13, ? 11, ? 9, ? 8, and ? 7 for age groups 20–29, 30–39, 40–49, 50–59, and 60+ years, respectively; HR (bpm in response to standing ? 14 for 20–29 years, and ? 11 for 30+ years; postural decreases in SBP ? 17 mmHg for all age groups; and postural decreases in DBP (mmHg ? 2 for men and ? 5 for women. Conclusion The test battery revealed cut-off values different from those measured in Caucasians. Further studies are recommended a to assess whether these cut off values are generally applicable, and b to establish population specific reference values for Africans.

Schmutzhard Erich

2008-12-01

183

Rapid urban malaria appraisal (RUMA in sub-Saharan Africa  

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Full Text Available Abstract Background The rapid urban malaria appraisal (RUMA methodology aims to provide a cost-effective tool to conduct rapid assessments of the malaria situation in urban sub-Saharan Africa and to improve the understanding of urban malaria epidemiology. Methods This work was done in Yopougon municipality (Abidjan, Cotonou, Dar es Salaam and Ouagadougou. The study design consists of six components: 1 a literature review, 2 the collection of available health statistics, 3 a risk mapping, 4 school parasitaemia surveys, 5 health facility-based surveys and 6 a brief description of the health care system. These formed the basis of a multi-country evaluation of RUMA's feasibility, consistency and usefulness. Results A substantial amount of literature (including unpublished theses and statistics was found at each site, providing a good overview of the malaria situation. School and health facility-based surveys provided an overview of local endemicity and the overall malaria burden in different city areas. This helped to identify important problems for in-depth assessment, especially the extent to which malaria is over-diagnosed in health facilities. Mapping health facilities and breeding sites allowed the visualization of the complex interplay between population characteristics, health services and malaria risk. However, the latter task was very time-consuming and required special expertise. RUMA is inexpensive, costing around 8,500–13,000 USD for a six to ten-week period. Conclusion RUMA was successfully implemented in four urban areas with different endemicity and proved to be a cost-effective first approach to study the features of urban malaria and provide an evidence basis for planning control measures.

Akogbeto Martin

2005-09-01

184

Progress report on the first sub-Saharan Africa trial of newer versus older antihypertensive drugs in native black patients  

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Full Text Available Abstract Background The epidemic surge in hypertension in sub-Saharan Africa is not matched by clinical trials of antihypertensive agents in Black patients recruited in this area of the world. We mounted the Newer versus Older Antihypertensive agents in African Hypertensive patients (NOAAH trial to compare, in native African patients, a single-pill combination of newer drugs, not involving a diuretic, with a combination of older drugs including a diuretic. Methods Patients aged 30 to 69?years with uncomplicated hypertension (140 to 179/90 to 109?mmHg and ?2 associated risk factors are eligible. After a four week run-in period off treatment, 180 patients have to be randomized to once daily bisoprolol/hydrochlorothiazide 5/6.25?mg (R or amlodipine/valsartan 5/160?mg (E. To attain blood pressure Results At the time of writing of this progress report, of 206 patients enrolled in the run-in period, 140 had been randomized. At randomization, the R and E groups were similar (P???0.11 with respect to mean age (50.7?years, body mass index (28.2?kg/m2, blood pressure (153.9/91.5?mmHg and the proportions of women (53.6% and treatment naïve patients (72.7%. After randomization, in the R and E groups combined, blood pressure dropped by 18.2/10.1?mmHg, 19.4/11.2?mmHg, 22.4/12.2?mmHg and 25.8/15.2?mmHg at weeks two (n?=?122, four (n?=?109, eight (n?=?57, and 12 (n?=?49, respectively. The control rate was >65% already at two weeks. At 12?weeks, 12 patients (24.5% had progressed to the higher dose of R or E and/or had ?-methyldopa added. Cohort analyses of 49 patients up to 12?weeks were confirmatory. Only two patients dropped out of the study. Conclusions NOAAH (NCT01030458 demonstrated that blood pressure control can be achieved fast in Black patients born and living in Africa with a simple regimen consisting of a single-pill combination of two antihypertensive agents. NOAAH proves that randomized clinical trials of cardiovascular drugs in the indigenous populations of sub-Saharan Africa are feasible.

Odili Augustine N

2012-05-01

185

Male partner involvement in prevention of mother to child transmission of HIV in Sub-Saharan Africa: Successes, challenges and way forward  

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Full Text Available Sub-Saharan Africa has the highest number of mother to child transmissions of HIV. PMTCT programme plays a big role in reducing the MTCT nevertheless its effectiveness in Sub-Saharan Africa depends on involvement of male partners considering the fact that men are decision makers in African families. They make important decisions that have big impact on women’s health. Male partner involvement has been seen to increase uptake of PMTCT services and their involvement underscores their importance in reducing HIV infection in children. Recently many sub-Saharan countries adopted male partner involvement in PMTCT programme with an aim of increasing the uptake of PMTCT services. The programme has made some progress in improving the effectiveness of PMTCT services. On the other hand the strategy is facing a lot of challenges, the biggest being low male partner involvement. This article therefore seeks to review the successes and challenges faced by male involvement in Sub-Saharan Africa. It also proposes the way forward in order to improve its effectiveness. We used peer reviewed articles of research studies conducted in Sub-Saharan Africa and other related reliable sources of data to write the paper.

Qiu Jun

2012-02-01

186

Investing in amnesia, or fantasy and forgetfulness in the World Bank's approach to healthcare reform in sub-Saharan Africa.  

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"Investing in Health," the World Bank's 1993 World Development Report, and a follow-up report, "Better Health in Africa," advocate investments in Third World health sectors as a means of increasing individual productivity and strengthening economic growth. Both reports maintain that structural adjustment policies have enhanced the physical health of low-income populations by improving the fiscal health of business elites. This essay critiques the World Bank's approach through a historical analysis of health care problems in sub-Saharan Africa with an emphasis on the devastating effects of colonialism, patriarchy, and imperialism. Although these documents contain many useful recommendations for Western donors (e.g., recognition of the destructive potential of alcohol and tobacco, the need for state regulation over key parts of the health sector, and the effects of gender on health status), they reflect an "investment in amnesia" regarding historical evidence on health care reform in Africa and an erroneous assumption that Western biomedicine is politically neutral. Foreign aid has tended to serve the needs of multinational corporations rather than African populations. Recommended, in place of structural adjustment policies, are measures such as a massive rebuilding of Africa's urban infrastructure, the enforcement of minimum wage laws, the preservation of ecosystems that supply traditional medicines, attention to the ecologic and health consequences of economic growth, and a feminist-led reproductive rights movement. PMID:12321262

Epprecht, M

1997-01-01

187

An outlook on the Sub-Saharan Africa carbon balance  

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Full Text Available This study gives an outlook on the carbon balance of Sub-Saharan Africa (SSA by presenting a summary of currently available results from the project CarboAfrica (namely net ecosystem productivity and emissions from fires, deforestation and forest degradation, by field and model estimates supplemented by bibliographic data and compared with a new synthesis of the data from national communications to UNFCCC. According to these preliminary estimates the biogenic carbon balance of SSA varies from 0.16 Pg C y?1 to a much higher sink of 1.00 Pg C y?1 (depending on the source data. Models estimates would give an unrealistic sink of 3.23 Pg C y?1, confirming their current inadequacy when applied to Africa. The carbon uptake by forests and savannas (0.34 and 1.89 Pg C y?1, respectively, are the main contributors to the resulting sink. Fires (0.72 Pg C y?1 and deforestation (0.25 Pg C y?1 are the main contributors to the SSA carbon emissions, while the agricultural sector and forest degradation contributes only with 0.12 and 0.08 Pg C y?1, respectively. Savannas play a major role in shaping the SSA carbon balance, due to their large extension, their fire regime, and their strong interannual NEP variability, but they are also a major uncertainty in the overall budget. Even if fossil fuel emissions from SSA are relative low, they can be crucial in defining the sign of the overall SSA carbon balance by reducing the natural sink potential, especially in the future. This paper shows that Africa plays a key role in the global carbon cycle system and probably could have a potential for carbon sequestration higher than expected, even if still highly uncertain. Further investigations are needed, particularly to better address the role of savannas and tropical forests and to improve biogeochemical models. The CarboAfrica network of carbon measurements could provide future unique data sets for better estimating the African carbon balance.

A. Bombelli

2009-10-01

188

The Sub-Saharan Africa carbon balance, an overview  

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Full Text Available This study presents a summary overview of the carbon balance of Sub-Saharan Africa (SSA by synthesizing the available data from national communications to UNFCCC and first results from the project CarboAfrica (net ecosystem productivity and emissions from fires, deforestation and forest degradation, by field and model estimates. According to these preliminary estimates the overall carbon balance of SSA varies from 0.43 Pg C y?1 (using in situ measurements for savanna NEP to a much higher sink of 2.53 Pg C y?1 (using model estimates for savanna NEP. UNFCCC estimates lead to a moderate carbon sink of 0.58 Pg C y?1. Excluding anthropogenic disturbance and intrinsic episodic events, the carbon uptake by forests (0.98 Pg C y?1 and savannas (from 1.38 to 3.48 Pg C y?1, depending on the used methodology are the main components of the SSA sink effect. Fires (0.72 Pg C y?1, deforestation (0.25 Pg C y?1 and forest degradation (0.77 Pg C y?1 are the main contributors to the SSA carbon emissions, while the agricultural sector contributes only with 0.12 Pg C y?1. Notably, the impact of forest degradation is higher than that caused by deforestation, and the SSA forest net carbon balance is close to equilibrium. Savannas play a major role in shaping the SSA carbon balance, due to their large areal extent, their fire regime, and their strong interannual NEP variability, but they are also a major uncertainty in the overall budget. This paper shows that Africa plays a key role in the global carbon cycle system and probably could have a potential for carbon sequestration higher than expected, even if still highly uncertain. Further investigations are needed, particularly to better address the role of savannas and tropical forests. The current CarboAfrica network of carbon measurements could provide future unique data sets for better estimating the African carbon balance.

A. Bombelli

2009-02-01

189

Experiences of leadership in health care in sub-Saharan Africa  

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Full Text Available Abstract Background Leadership is widely regarded as central to effective health-care systems, and resources are increasingly devoted to the cultivation of strong health-care leadership. Nevertheless, the literature regarding leadership capacity building has been developed primarily in the context of high-income settings. Less research has been done on leadership in low-income settings, including sub-Saharan Africa, particularly in health care, with attention to historical, political and sociocultural context. We sought to characterize the experiences of individuals in key health-care leadership roles in sub-Saharan Africa. Methods We conducted a qualitative study using in-person interviews with individuals (n?=?17 in health-care leadership roles in four countries in sub-Saharan Africa: the Federal Democratic Republic of Ethiopia, the Republic of Ghana, the Republic of Liberia and the Republic of Rwanda. Individuals were identified by their country’s minister of health as key leaders in the health sector and were nominated to serve as delegates to a global health leadership conference in June 2010, at Yale University in the United States. Interviews were audio recorded and professionally transcribed. Data analysis was performed by a five-person multidisciplinary team using the constant comparative method, facilitated by ATLAS.ti 5.0 software. Results Five key themes emerged as important to participants in their leadership roles: having an aspirational, value-based vision for improving the future health of the country, being self-aware and having the ability to identify and use complementary skills of others, tending to relationships, using data in decision making, and sustaining a commitment to learning. Conclusions Current models of leadership capacity building address the need for core technical and management competencies. While these competencies are important, skills relevant to managing relationships are also critical in the sub-Saharan African context. Developing such skills may require more time and a deeper level of engagement and collaboration than is typically invested in efforts to strengthen health systems.

Curry Leslie

2012-09-01

190

Policy and regulatory framework conditions for small hydro power in Sub-Saharan Africa  

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The vast potential of mini and micro hydro power (MHP) in Sub-Saharan African countries is one promising option to cover increasing energy demand and to enable electricity access for remote rural communities. Based on the analysis of 6 African countries (Ethiopia, Kenya, Mozambique, Nigeria, Rwanda, South Africa), this study sheds light on some of the main barriers on the level of political and regulatory framework conditions which include gap between the national-level policies and regulations and local MHP project implementation, lack of financing and limited capacities for project planning, building and operation. The paper also identifies some promising practices employed in several SSA countries of how to overcome these barriers and concludes with recommendations of how to create positive feed-backs between ambitious policies and regulations and MHP financing and capacity development needs in order to scale up MHP deployment and MHP sector development. (orig.)

Koelling, Fritz [Sustainable Energy and Environment, Karlsruhe (Germany); Gaul, Mirco; Schroeder, Miriam [SiNERGi Consultancy for Renewable Energies, Berlin (Germany)

2011-07-01

191

Scaling up delivery of contraceptive implants in sub-Saharan Africa: operational experiences of Marie Stopes International.  

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Contraceptive implants offer promising opportunities for addressing the high and growing unmet need for modern contraceptives in sub-Saharan Africa. Marie Stopes International (MSI) offers implants as one of many family planning options. Between 2008 and 2012, MSI scaled up voluntary access to implants in 15 sub-Saharan African countries, from 80,041 implants in 2008 to 754,329 implants in 2012. This 9-fold increase amounted to more than 1.7 million implants delivered cumulatively over the 5-year period. High levels of client satisfaction were attained alongside service provision scale up by using existing MSI service delivery channels-mobile outreach, social franchising, and clinics-to implement strategies that broadened access for underserved clients and maintained service quality. Use of adaptive and context-specific service delivery models and attention to key operational components, including sufficient numbers of trained providers, strong supply chains, diverse financing mechanisms, and implant removal services, underpinned our service delivery efforts. Accounting for 70% of the implants delivered by MSI in 2012, mobile outreach services through dedicated MSI provider teams played a central role in scale-up efforts, fueled in part by the provision of free or heavily subsidized services. Social franchising also demonstrated promise for future program growth, along with MSI clinics. Continued high growth in implant provision between 2011 and 2012 in all sub-Saharan African countries indicates the region's capacity for further service delivery expansion. Meeting the expected rising demand for implants and ensuring long-term sustainable access to the method, as part of a comprehensive method mix, will require continued use of appropriate service delivery models, effective operations, and ongoing collaboration between the private, public, and nongovernmental sectors. MSI's experience can be instructive for future efforts to ensure contraceptive access and choice in sub-Saharan Africa, especially as the global health community works to achieve its Family Planning 2020 (FP2020) commitments to expand family planning access to 120 million new users. PMID:25276564

Duvall, Susan; Thurston, Sarah; Weinberger, Michelle; Nuccio, Olivia; Fuchs-Montgomery, Nomi

2014-02-01

192

Natural selection at genomic regions associated with obesity and type-2 diabetes: East Asians and sub-Saharan Africans exhibit high levels of differentiation at type-2 diabetes regions  

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Different populations suffer from different rates of obesity and type-2 diabetes (T2D). Little is known about the genetic or adaptive component, if any, that underlies these differences. Given the cultural, geographic, and dietary variation that accumulated among humans over the last 60,000 years, we examined whether loci identified by genome-wide association studies for these traits have been subject to recent selection pressures. Using genome-wide SNP data on 938 individuals in 53 populatio...

Klimentidis, Yann C.; Abrams, Marshall; Wang, Jelai; Fernandez, Jose R.; Allison, David B.

2011-01-01

193

Stock Markets Development in Sub-Saharan Africa: Business Regulations, Governance and Fiscal Policy  

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Full Text Available This study examines the effectiveness of the state in stimulating stock market activity in sub-Saharan Africa (SSA using fiscal policy, governance quality and stock market as the main determinant variables. Using annual data from six selected sub-Saharan African economies and employing a dynamic panel data estimating technique, we find that government effectiveness stimulates capitalization while business regulations decrease it in SSA. In addition, we find that final consumption expenditure, interest rate spread and credit to the state increase capitalization whereas credit to the private sector and inflation had adverse effects. With respect to business regulations, our study reveals that starting a business, closing it and enforcing contracts engender stock market activity in SSA. Among the several variables that stimulate stock market activity; only foreign direct investment (FDI did increase capitalization. Thus, the study concludes that since not all government institutions and business regulations are critical to stock market development, various governments should be careful and selective in their economic stimulants if they want to develop their stock markets. 

Kofi B. Afful

2013-12-01

194

Divided We Fall: Rethinking Biodiversity Planning in the Context of Development in Sub-Saharan Africa  

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Full Text Available The signatory countries of the Convention on Biological Diversity set the objective of halting the decline of biodiversity by 2010, but as the target date arrived and passed, the status of biodiversity on the planet remained dismal. With the dawn of the UN Decade for Biodiversity at the Rio+20 Earth Summit in June 2012 and as the UN Biodiversity Strategic Plan moves forward, this article contextualizes biodiversity prospects in sub-Saharan Africa by examining the history of interactions between African communities and the environment, from the pre-colonial period to today. It provides a critical analysis of the current biodiversity conservation planning methodologies and pinpoints several inherent obstacles, including the neo-Malthusianism that dominates the thinking of certain wildlife experts. Setting out an argument with far-reaching implications for the success of future conservation efforts all over the world, the author examines the basis of emerging conservation approaches in sub-Saharan Africa, focusing on the need to forge a more inclusive conservation practice and open up to the perceptions, representations and cultural universe of the Other.

Robert Kasisi

2012-08-01

195

Industrialization in Sub-Saharan Africa and import substitution policy  

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Full Text Available SciELO Brazil | Language: English Abstract in english This article aims to contribute to the understanding of the process of import substitution in Sub-Saharan Africa. The process of industrialization in Sub-Saharan Africa occurred in two phases: a first step, even very early during the colonial regime began around the 1920s and ended in the late forti [...] es; a second phase of industrialization began in the late fifties and gained momentum in the sixties, when import substitution was implemented more widely. Although these countries were the last to embark on the strategy of import substitution, they followed the same steps of Latin American countries, and as the structural domestic and external constraints were too strong, the failure of the policy of import substitution arrived early and the negative impact on these economies had a greater magnitude.

Ana Paula F., Mendes; Mário A., Bertella; Rudolph F. A. P., Teixeira.

2014-03-01

196

IPPs in Sub-Saharan Africa: Determinants of success  

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This study analyses the outcomes of independent power projects (IPPs) across Sub-Saharan Africa. Approximately 20 such projects have taken root to date, concentrated mainly in 8 countries. A suite of country level and project level factors play a critical role in determining project success, chief among them: the manner in which planning, procurement and contracting are coherently linked, the role of development finance institutions along with the development origins of firms and credit enhancements. - Highlights: > We analyse the outcomes of independent power projects (IPPs) across Sub-Saharan Africa. > Approximately 20 IPPs have taken root to date, concentrated mainly in 8 countries. > A suite of country level and project level factors play a critical role in determining project success. > Key success factors are the coherence of planning, procurement and contracting. > Also important is the role of DFIs, the development origins of firms, and credit enhancements.

Eberhard, Anton, E-mail: eberhard@gsb.uct.ac.za [University of Cape Town' s Graduate School of Business, Cape Town 8001 (South Africa); Gratwick, Katharine Nawaal [University of Cape Town' s Graduate School of Business, Cape Town 8001 (South Africa)

2011-09-15

197

IPPs in Sub-Saharan Africa: Determinants of success  

International Nuclear Information System (INIS)

This study analyses the outcomes of independent power projects (IPPs) across Sub-Saharan Africa. Approximately 20 such projects have taken root to date, concentrated mainly in 8 countries. A suite of country level and project level factors play a critical role in determining project success, chief among them: the manner in which planning, procurement and contracting are coherently linked, the role of development finance institutions along with the development origins of firms and credit enhancements. - Highlights: ? We analyse the outcomes of independent power projects (IPPs) across Sub-Saharan Africa. ? Approximately 20 IPPs have taken root to date, concentrated mainly in 8 countries. ? A suite of country level and project level factors play a critical role in determining project success. ? Key success factors are the coherence of planning, procurement and contracting. ? Also important is the role of DFIs, the development origins of firms, and credit enhancements.

198

Epidemiology and impact of HIV coinfection with hepatitis B and hepatitis C viruses in Sub-Saharan Africa.  

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Human immunodeficiency virus (HIV), Hepatitis B (HBV) and Hepatitis C (HCV) are blood-borne viruses with potentially shared routes of transmission. In high-income settings, the impact of antiretroviral therapy (ART) on survival has unmasked chronic liver disease from viral hepatitis B or hepatitis C as a leading cause of morbidity and mortality in individuals with HIV infection. It is now feared that progressive liver disease may threaten the success of ART programmes in developing countries, where HCV or HBV testing and monitoring are not yet systematic among HIV-infected patients and ART use is generally blind to these co-infections. We set out to review recent data from Sub-Saharan Africa, in order to build a detailed and up-to-date picture of the epidemiology and emerging impact of HBV and HCV coinfection in countries at the heart of the HIV pandemic. There is a preponderance of HIV/HBV coinfection compared to HIV/HCV in this region, and significant caveats exist regarding the accuracy of published HCV seroprevalence surveys. Morbidity and mortality of coinfection is significant, and may be further enhanced in African populations due to the influence of host, viral and environmental factors. Careful scrutiny of the coinfection problem is vital to inform an approach to directing resources, planning public health initiatives, providing clinical care, and guiding future research. PMID:24973812

Matthews, Philippa C; Geretti, Anna Maria; Goulder, Philip J R; Klenerman, Paul

2014-09-01

199

Is screen-and-treat approach suited for screening and management of precancerous cervical lesions in Sub-Saharan Africa?  

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The World Health Organization guidelines for screening and management of cervical precancerous lesions updated in 2013 made an emphasis on the use of the 'screen-and-treat' approach for cervical cancer prevention. In order to facilitate scaling-up in low income settings, most of these screen-and-treat strategies do not involve confirmatory biopsy. This yields a certain rate of overtreatment. In other words, a majority of people undergoing screen-and-treat intervention who are treated does not necessarily benefit from the treatment. Therefore, the issue of potential short term and long term complications of the recommended treatment procedures (cryotherapy and Loop Electrosurgical Excision Procedure) arises. This question has seldom been studied in resource poor countries, particularly in Sub-Saharan Africa where Human Immunodeficiency Virus infection is rampant in an epidemic fashion and where the procreative capacities are socially rewarding for women. We draw the attention of the scientific community and policy makers to the fact that the lack of evidence supporting the safety of these treatment procedures in African populations may have an impact on the acceptability of these strategies and therefore on the effectiveness of screening programs. PMID:24879892

Fokom-Domgue, Joël; Vassilakos, Pierre; Petignat, Patrick

2014-08-01

200

Economic geography and economic development in Sub-Saharan Africa  

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The physical or absolute geography of Sub-Saharan Africa (SSA) is often blamed for its poor economic performance. A country's location however not only determines its absolute geography, it also pins down its relative position on the globe vis-à-vis other countries. This paper assesses the importance of relative geography, and access to foreign markets in particular, in explaining the substantial income differences between SSA countries. We base our empirical analysis on a new economic geogr...

Bosker, E. Maarten; Garretsen, Harry

2008-01-01

 
 
 
 
201

Sub-Saharan Africa and Global Capital Markets  

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Recent years have seen a considerable shift in economic conditions in sub-Saharan Africa. Economic growth has been robust, international reserves are on the rise and levels of external debt are falling. Combined with the global boom in commodity prices, as well as expansion of Chinese interests in the region, international investors are increasingly viewing Africa as a serious investment option. As a result of these trends, the landscape in which foreign donors have operated is changing rapid...

Jones, Sam

2007-01-01

202

Greenhouse gas emissions in Sub-Saharan Africa  

Energy Technology Data Exchange (ETDEWEB)

Current and future carbon emissions from land-use change and energy consumption were analyzed for Sub-Saharan Africa. The energy sector analysis was based on UN energy data tapes while the land-use analysis was based on a spatially-explicit land-use model developed specifically for this project. The impacts of different energy and land-use strategies on future carbon emissions were considered. (A review of anthropogenic emissions of methane, nitrous oxides, and chlorofluorocarbons in Sub-Saharan Africa indicated that they were probably minor in both a global and a regional context. The study therefore was focused on emissions of carbon dioxide.) The land-use model predicts carbon emissions from land use change and the amount of carbon stored in vegetation (carbon inventory) on a yearly basis between 1985 and 2001. Emissions and inventory are modeled at 9000 regularly-spaced point locations in Sub-Saharan Africa using location-specific information on vegetation type, soils, climate and deforestation. Vegetation, soils, and climate information were derived from continental-scale maps while relative deforestation rates(% of forest land lost each year) were developed from country-specific forest and deforestation statistics (FAO Tropical Forest Resources Assessment for Africa, 1980). The carbon emissions under different land use strategies in Sub-Saharan Africa were analyzed by modifying deforestation rates and altering the amount of carbon stored under different land uses. The considered strategies were: preservation of existing forests, implementation of agroforestry, and establishment of industrial tree plantations. 82 refs., 16 figs., 25 tabs.

Graham, R.L.; Perlack, R.D.; Prasad, A.M.G.; Ranney, J.W.; Waddle, D.B.

1990-11-01

203

Heart failure in sub-Saharan Africa: A literature review with emphasis on individuals with diabetes  

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Full Text Available Andre Pascal Kengne1, Anastase Dzudie2, Eugene Sobngwi31The George Institute for International Health, University of Sydney, Australia; 2Heart failure and transplantation Unit, Louis Pradel’s Cardiovascular Hospital, Lyon, France; 3National Obesity Centre, Yaounde Central Hospital, CameroonPurpose: Heart failure is the ultimate complication of cardiac involvements in diabetes. The purpose of this review was to summarize current literature on heart failure among people with diabetes mellitus in sub-Saharan Africa (SSA.Method: Bibliographic search of published data on heart failure and diabetes in sub-Saharan Africa over the past 26 years.Results: Heart failure remains largely unexplored in general population and among people with diabetes in Africa. Heart failure accounts for over 30% of hospital admission in specialized cardiovascular units and 3%–7% in general internal medicine. Over 11% of adults with heart failure have diabetes. Risk factors for heart failure among those with diabetes include classical cardiovascular risk factors, without evidence of diabetes distinctiveness for other predictors common in Africa. Prevention, management, and outcomes of heart failure are less well known; recent data suggest improvement in the management of risk factors in clinical settings.Conclusions: Diabetes mellitus is growing in SSA. Related cardiovascular diseases are emerging as potential health problem. Heart failure as cardiovascular complication remains largely unexplored. Efforts are needed through research to improve our knowledge of heart failure at large in Africa. Multilevel preventive measures, building on evidences from other parts of the world must go along side.Keywords: diabetes mellitus, cardiovascular diseases, heart failure, sub-Saharan Africa

Andre Pascal Kengne

2008-03-01

204

Non-B HIV-1 subtypes in sub-Saharan Africa: impact of subtype on protease inhibitor efficacy.  

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Abstract In 2012, 25 million people [71% of global human immunodeficiency virus (HIV) infection] were estimated to be living with HIV in sub-Saharan Africa. Of these, approximately 1.6 million were new infections and 1.2 million deaths occurred. South Africa alone accounted for 31% of HIV/acquired immunodeficiency syndrome (AIDS) deaths in sub-Saharan Africa. This disturbing statistic indicates that South Africa remains the epicenter of the HIV/AIDS pandemic, compounded by the fact that only 36% of HIV-positive patients in South Africa have access to antiretroviral (ARV) treatment. Drug resistance mutations have emerged, and current ARVs show reduced efficacy against non-B subtypes. In addition, several recent studies have shown an increased prevalence of non-B African HIV strains in the Americas and Europe. Therefore, the use of ARVs in a non-B HIV-1 subtype context requires further investigation. HIV-1 subtype C protease, found largely in sub-Saharan Africa, has been under-investigated when compared with the subtype B protease, which predominates in North America and Europe. This review, therefore, focuses on HIV-1 proteases from B and C subtypes. PMID:25205728

Naicker, Previn; Sayed, Yasien

2014-10-01

205

Family medicine training in sub-Saharan Africa: South–South cooperation in the Primafamed project as strategy for development  

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Background. Health-care systems based on primary health care (PHC) are more equitable and cost effective. Family medicine trains medical doctors in comprehensive PHC with knowledge and skills that are needed to increase quality of care. Family medicine is a relatively new specialty in sub-Saharan Africa. Objective. To explore the extent to which the Primafamed South–South cooperative project contributed to the development of family medicine in sub-Saharan Africa. Methods. The Primafamed (Primary Health Care and Family Medicine Education) project worked together with 10 partner universities in sub-Saharan Africa to develop family medicine training programmes over a period of 2.5 years. A SWOT (strengths, weaknesses, opportunities and threats) analysis was done and the training development from 2008 to 2010 in the different partner universities was analysed. Results. During the 2.5 years of the Primafamed project, all partner universities made progress in the development of their family medicine training programmes. The SWOT analysis showed that at both national and international levels, the time is ripe to train medical doctors in family medicine and to integrate the specialty into health-care systems, although many barriers, including little awareness, lack of funding, low support from other specialists and reserved support from policymakers, are still present. Conclusions. Family medicine can play an important role in health-care systems in sub-Saharan Africa; however, developing a new discipline is challenging. Advocacy, local ownership, action research and support from governments are necessary to develop family medicine and increase its impact. The Primafamed project showed that development of sustainable family medicine training programmes is a feasible but slow process. The South–South cooperation between the ten partners and the South African departments of family medicine strengthened confidence at both national and international levels. PMID:24857843

Flinkenflögel, Maaike; Essuman, Akye; Chege, Patrick; Ayankogbe, Olayinka; De Maeseneer, Jan

2014-01-01

206

Progress toward prevention of transfusion-transmitted hepatitis B and hepatitis C infection--sub-Saharan Africa, 2000-2011.  

Science.gov (United States)

Infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) are major causes of morbidity and mortality globally, primarily because of sequelae of chronic liver disease including cirrhosis and hepatocellular carcinoma. The risks for HBV and HCV transmission via blood transfusions have been described previously and are believed to be higher in countries in sub-Saharan Africa. Reducing the risk for transfusion-transmitted human immunodeficiency virus (HIV), HBV, and HCV infection is a priority for international aid organizations, such as the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the Global Fund to Combat HIV/AIDS, Malaria, and Tuberculosis, and the World Health Organization (WHO). Over the last decade, PEPFAR and the Global Fund have supported blood safety programs in many sub-Saharan African countries with heavy burdens of HIV and acquired immunodeficiency syndrome (AIDS), hepatitis, malaria, and maternal mortality. This report summarizes HBV- and HCV-related surveillance data reported by the blood transfusion services of WHO member states to WHO's Global Database on Blood Safety (GDBS) (4). It also evaluates the performance of blood safety programs in screening for HBV and HCV in 38 sub-Saharan Africa countries. Selected GDBS indicators were compared for the years 2000 and 2004 (referred to as the 2000/2004 period) and 2010 and 2011 (referred to as the 2010/2011 period). From 2000/2004 to 2010/2011, the median of the annual number of units donated per country increased, the number of countries screening at least 95% of blood donations for HBV and HCV increased, and the median of the national prevalence of HBV and HCV marker-reactive blood donations decreased. These findings suggest that during the past decade, more blood has been donated and screened for HBV and HCV, resulting in a safer blood supply. Investments in blood safety should be continued to further increase the availability and safety of blood products in sub-Saharan Africa. PMID:25055184

Apata, Ibironke W; Averhoff, Francisco; Pitman, John; Bjork, Adam; Yu, Junping; Amin, Noryati Abu; Dhingra, Neelam; Kolwaite, Amy; Marfin, Anthony

2014-07-25

207

A multilevel analysis of the determinants of high-risk sexual behaviour in sub-Saharan Africa.  

Science.gov (United States)

A number of authors have identified multiple concurrent sexual partnerships by both men and women to lie at the root of the HIV/AIDS epidemic in sub-Saharan Africa. This study applies multilevel models to Demographic and Health Survey data collected during 2003-2008 in 20 sub-Saharan African countries to examine the influence of social and cultural context on involvement with multiple sexual partnerships in the region, above and beyond the effects of individual characteristics. The findings provide support for the ecological argument that health behaviours are shaped and determined by societal conditions, in addition to the effects of individual and household characteristics. Involvement with multiple sex partners is most prevalent in societies in which sexual norms are widely permissive and where polygyny is common. Individual autonomy is substantial and attitudes towards sexuality are more liberal among men and women who live in communities in which sexual norms are widely permissive. Men and women who are most likely to have multiple sex partners in the sub-Saharan region are those who initiated sexual activity earlier and those who have the individual attributes (e.g. young age, urban residence, education, media exposure and working for cash and away from home) that bring to them more rights and/or decision-making autonomy, but not necessarily more financial resources and economic security (mostly among women). On the other hand, involvement with multiple partners is determined by cultural norms (i.e. permissive sexual norms) and social change (i.e. mass education, expansion of cash employment). The findings suggest a number of opportunities for more effective policy and programmatic responses to curb the prevalence of multiple partnerships in sub-Saharan Africa. PMID:22067066

Uchudi, Joseph; Magadi, Monica; Mostazir, Mohammod

2012-05-01

208

Climate change and health in sub-Saharan Africa: a case-based perspective.  

Science.gov (United States)

Over the coming decades, sub-Saharan Africa will face profound stresses and challenges from global climate change. Many of these will manifest as adverse health outcomes. This article uses a series of five hypothetical cases to review the climate impacts on the health and well-being of individuals and populations in sub-Saharan Africa. This approach fosters insights into the human dimensions of the risks to health, their interaction with local human ecology, and awareness of the diverse health ramifications of external environmental changes. Each case illustrates the health impact resulting from a specific environmental or social consequence of climate change, including impacts on agriculture and food security, droughts, floods, malaria, and population displacement. Whereas the article focuses on discrete manifestations of climate change, individuals will, in practice, face multiple stresses from climate change (i.e., floods and malaria) concomitant with other non-climate stressors (i.e., HIV/AIDS, globalization, etc.). These multiple sources of vulnerability must be considered when designing climate change and socioeconomic development interventions. PMID:19418098

Ramin, Brodie Morgan; McMichael, Anthony J

2009-03-01

209

Irrigation with saline water using low-cost drip-irrigation systems in sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In the scope of future population support, agricultural productivity, in particular in sub-Saharan Africa, has to increase drastically to meet the UN’s millennium development goals of eradicating extreme poverty and hunger by 2015. Water availability in the root-zone limits crop production in large parts of the developing world. As competition for fresh water increases, water of lower quality, for example saline or polluted water, is often used for irrigation. Low-cost drip systems are suit...

Karlberg, Louise

2005-01-01

210

Is age-related macular degeneration a problem in Ibadan, Sub-Saharan Africa?  

Directory of Open Access Journals (Sweden)

Full Text Available Tunji Sunday OluleyeRetina and Vitreous Unit, Department of Ophthalmology, University College Hospital, Ibadan, Nigeria, West AfricaBackground: Age-related macular degeneration (AMD is considered uncommon in black populations including those of Sub-Saharan Africa. The aim of this review was to determine the pattern of presentation of AMD in our hospital located in Ibadan, the largest city in Sub-Saharan Africa.Methods: A retrospective review of all cases with AMD presenting to the Eye and Retinal Clinic of the University College Hospital, Ibadan, West Africa was undertaken between October 2007 and September 2010.Results: In the 3 years reviewed, 768 retinal cases were seen in the hospital, 101 (14% of which were diagnosed with AMD. The peak age was 60–79 years. The male to female ratio was approximately 2:3. More males presented with the advanced form of dry AMD than females (odds ratio = 2.33. However, more females had advanced wet AMD than males (odds ratio = 1.85. Wet AMD was seen in 40 cases (40%.Conclusion: The review determined that, as AMD is not uncommon and wet AMD is relatively more common in our hospital than has been reported previously, this is probably true of Ibadan in general.Keywords: age-related maculopathy, choroidal neovascular membrane, retinal, vitreoretinal, drusen

Oluleye TS

2012-04-01

211

Weather patterns, food security and humanitarian response in sub-Saharan Africa.  

Science.gov (United States)

Although considerable achievements in the global reduction of hunger and poverty have been made, progress in Africa so far has been very limited. At present, a third of the African population faces widespread hunger and chronic malnutrition and is exposed to a constant threat of acute food crisis and famine. The most affected are rural households whose livelihood is heavily dependent on traditional rainfed agriculture. Rainfall plays a major role in determining agricultural production and hence the economic and social well being of rural communities. The rainfall pattern in sub-Saharan Africa is influenced by large-scale intra-seasonal and inter-annual climate variability including occasional El Niño events in the tropical Pacific resulting in frequent extreme weather event such as droughts and floods that reduce agricultural outputs resulting in severe food shortages. Households and communities facing acute food shortages are forced to adopt coping strategies to meet the immediate food requirements of their families. These extreme responses may have adverse long-term, impacts on households' ability to have sustainable access to food as well as the environment. The HIV/AIDS crisis has also had adverse impacts on food production activities on the continent. In the absence of safety nets and appropriate financial support mechanisms, humanitarian aid is required to enable households effectively cope with emergencies and manage their limited resources more efficiently. Timely and appropriate humanitarian aid will provide households with opportunities to engage in productive and sustainable livelihood strategies. Investments in poverty reduction efforts would have better impact if complemented with timely and predictable response mechanisms that would ensure the protection of livelihoods during crisis periods whether weather or conflict-related. With an improved understanding of climate variability including El Niño, the implications of weather patterns for the food security and vulnerability of rural communities have become more predictable and can be monitored effectively. The purpose of this paper is to investigate how current advances in the understanding of climate variability, weather patterns and food security could contribute to improved humanitarian decision-making. The paper will propose new approaches for triggering humanitarian responses to weather-induced food crises. PMID:16433102

Haile, Menghestab

2005-11-29

212

Ritual uses of palms in traditional medicine in sub-Saharan Africa: a review.  

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Palms (Arecaceae) are prominent elements in African traditional medicines. It is, however, a challenge to find detailed information on the ritual use of palms, which are an inextricable part of African medicinal and spiritual systems. This work reviews ritual uses of palms within African ethnomedicine. We studied over 200 publications on uses of African palms and found information about ritual uses in 26 of them. At least 12 palm species in sub-Saharan Africa are involved in various ritual practices: Borassus aethiopum, Cocos nucifera, Dypsis canaliculata, D. fibrosa, D. pinnatifrons, Elaeis guineensis, Hyphaene coriacea, H. petersiana, Phoenix reclinata, Raphia farinifera, R. hookeri, and R. vinifera. In some rituals, palms play a central role as sacred objects, for example the seeds accompany oracles and palm leaves are used in offerings. In other cases, palms are added as a support to other powerful ingredients, for example palm oil used as a medium to blend and make coherent the healing mixture. A better understanding of the cultural context of medicinal use of palms is needed in order to obtain a more accurate and complete insight into palm-based traditional medicines. PMID:25056559

Gruca, Marta; van Andel, Tinde R; Balslev, Henrik

2014-01-01

213

Ritual uses of palms in traditional medicine in sub-Saharan Africa: a review  

DEFF Research Database (Denmark)

Palms (Arecaceae) are prominent elements in African traditional medicines. It is, however, a challenge to find detailed information on the ritual use of palms, which are an inextricable part of African medicinal and spiritual systems. This work reviews ritual uses of palms within African ethnomedicine. We studied over 200 publications on uses of African palms and found information about ritual uses in 26 of them. At least 12 palm species in sub-Saharan Africa are involved in various ritual practices: Borassus aethiopum, Cocos nucifera, Dypsis canaliculata, D. fibrosa, D. pinnatifrons, Elaeis guineensis, Hyphaene coriacea, H. petersiana, Phoenix reclinata, Raphia farinifera, R. hookeri, and R. vinifera. In some rituals, palms play a central role as sacred objects, for example the seeds accompany oracles and palm leaves are used in offerings. In other cases, palms are added as a support to other powerful ingredients, for example palm oil used as a medium to blend and make coherent the healing mixture. A better understanding of the cultural context of medicinal use of palms is needed in order to obtain a more accurate and complete insight into palm-based traditional medicines.

Gruca, Marta; van Andel, Tinde

2014-01-01

214

The current bioenergy production potential of semi-arid and arid regions in sub-Saharan Africa  

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This article assesses the current technical and economic potential of three bioenergy production systems (cassava ethanol, jatropha oil and fuelwood) in semi-arid and arid regions of eight sub-Saharan African countries. The results indicate that the availability of land for energy production ranges from 2% (1.3 Mha) of the total semi-arid and arid area in South Africa to 21% (12 Mha) in Botswana. Land availability for bioenergy production is restricted mainly by agricultural land use, but als...

Wicke, B.; Smeets, E. M. W.; Watson, H.; Faaij, A. P. C.

2011-01-01

215

Cosmovisión de emigrantes subsaharianos y cuidados de enfermería / Worldview of Sub-Saharan emigrants and nursing care  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: Spanish Abstract in spanish Justificación: La población inmigrante subsahariana es la más desconocida para los profesionales de la salud. Objetivo: Conocer, a través de sus voces, su cosmovisión que enmarca valores, creencias y prácticas sobre salud y enfermedad, centrándonos en el ser humano con enfoque holístico. Metodología [...] : Cualitativa, fenomenología. Resultados: Su concepción de la vida y del universo está impregnada de la religión más antigua del mundo: el animismo. Los antepasados que murieron siguen estando para protegerles. Aprecian la atención sanitaria española pero hay padecimientos que resuelve mejor la medicina tradicional africana. Aunque la atención es correcta puede despertarse susceptibilidad al no conocer los códigos culturales de la nueva sociedad. La solidaridad familiar es el valor fundamental. Conclusión: La solidaridad, valor ancestral en los humanos, debe seguir guiando a los profesionales de la salud comprometidos con la salud de la población, defendiendo el Estado de Bienestar frente a las voces que pretenden desmantelarlo. Abstract in english The population of sub-Saharan immigrants is unknown by health care professionals. Objective: know, across his voices, his cosmovision that frames values, beliefs and practices on health and disease, centring on the human being with holistic approach. Methodology qualitative, phenomenology. Results: [...] His conception of the life and of the universe is impregnated with the most ancient religion of the world: the animism. The forbears who died continue being to protect them. They estimate the sanitary Spanish attention though there are sufferings that there solves better the traditional African medicine. Though the attention is correct one can wake susceptibility up on not having known all the cultural codes of the new company. The familiar solidarity is a fundamental value. Conclusions: the ancient solidarity in the human beings must continue guiding the professionals of the health compromised with the health of the population, defending the Welfare state opposite to the voices they it tries to dismantle.

Isabel, Gentil García.

2012-09-01

216

Adjustment, social sectors, and demographic change in Sub-Saharan Africa.  

Science.gov (United States)

This discussion concludes that the economic crises of the 1980s resulted in a halt to the social and economic development of sub-Saharan Africa. Employment, health, and education sectors all deteriorated under structural adjustment programs (SAPs) and poor economic performance. SAPs are considered inadequate solutions to long-term problems. Economic crises were found to affect countries differently in their demographic impact. Delayed demographic transition occurred both through economic development as a prerequisite and as a result of poor economic development. Case studies of each country are considered the appropriate geographic unit of analysis of demographic change rather than regional or comparative studies. The economic crises in sub-Saharan Africa occurred due to both external (commodity prices, high real interest rates, and decreasing net capital flows) and internal distortions (strategies of development such as import substitution, neglect of the agricultural sector, and government control of prices and trade). The unfavorable external context reduced export prices and earnings while increasing the costs of imports. Internal controls were detrimental to farmers. During the 1970s and 1980s African countries experienced declines in both the volume and value of exports, increases in import volume, and imbalances in the balance of payments. Large domestic borrowing and foreign borrowing was done by governments, which was at the expense of the private sector. Economic management and corruption were rampant. SAPs restrained demand, reduced public expenditures, adjusted exchange rates, contracted the size of the public sector, liberalized trade, deregulated the interest rate, stimulated domestic production, and used market forces for balancing optimum allocation of resources. SAPs were the fix for trade imbalances and government debt. Development was slowed or stopped. During 1980-87 spending on health care, education, and infrastructure was drastically reduced. These already weak sectors were further weakened. Inflation rose. Public sector employment was reduced. Wages declined, which resulted in a massive demoralization, unemployment, and poverty. Manpower development was threatened by declines in education. PMID:12319912

Ekouevi, K; Adepoju, A

1995-01-01

217

Spouses' socioeconomic characteristics and fertility differences in sub-Saharan Africa: does spouse's education matter?  

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Although the general objective of this study is to examine the extent to which spouses' socioeconomic characteristics determine whether modern contraception is used and whether family limitation (the demand for no more children) is desired, its central goal is to evaluate the degree to which the net effect of a woman's education on those fertility decisions is altered once a control is made for the level of schooling of the husband. Individual characteristics of spouses included as controls in this analysis are on the one hand women's attributes relating to employment, age, parity, ethnic identity, and urban residence and, on the other hand, the occupation of the husband. Data used in this research are provided by DHS surveys conducted in fourteen sub-Saharan countries: Mali. Burkina Faso, Niger, Nigeria, Cameroon, Benin, Senegal. Ghana, Central African Republic, Kenya, Zambia, Zimbabwe, Namibia and Rwanda. With two dichotomous outcome variables, logistic regression was used to estimate two nested models for each dependent variable and for each country covered by the study. DHS respondents used as units of analysis in this study are women who were married (any kind of union) and non-pregnant at the time when each national survey was conducted. The findings suggest that, while an educated wife needs the support of an educated husband to state a preference for family limitation in contemporary sub-Saharan Africa, controlling for husband's education and other relevant covariates does little to undermine the evidence that woman's advanced education and the adoption of modern family planning are positively related in the developing world. PMID:11683221

Uchudi, J M

2001-10-01

218

Challenges of Economic Growth, Poverty and Development: Why Are the Millennium Development Goals (MDGs) not Fair to Sub-Saharan Africa?  

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Sub-Saharan African countries report high levels of growth and GDP per capita and yet they are unable to achieve the Millennium Development Goals (MDGs) such as quality education and health. The paper argued that GDP might not be sufficient for measuring development because the funds obtained may not necessarily be used to improve the quality of life of worse off communities. Even with a constituent level of GDP, the problem of poverty and underdevelopment is becoming more intractable in S...

Kanayo Ogujiuba; Fadila Jumare

2012-01-01

219

[Schistosomiasis Control in Sub-Saharan Africa. Proceedings of a round table, Lisbon, Portugal, September 9, 2002].  

Science.gov (United States)

The Round Table organized by the Société de pathologie exotique during the 3rd European Congress on Tropical medicine and International Health held in Lisbon on September 9, 2002 has been attended by a hundred participants. Five communications were presented and followed by a debate concerning the main aspects of the epidemiology and the control of schistosomiasis in sub-Saharan Africa. The necessity of studying intermediate hosts to identify vectors, some of which being able to colonize new areas or to modify their susceptibility to parasites, has been emphasized. The population is infected during water contacts and Poda et al. showed the importance of water projects, necessary for the development of poor countries, but facilitating the transmission of schistosomiasis. Most current activities force the population to use stagnant water However, it is well known that children are more infected, with severe clinical and functional consequences. The contamination of the environment is linked to hygienic practices. Sow et al. demonstrated that usually recommended solutions are inappropriate. Latrines, for example, are notably sub-used by some at risk groups because culturally unsuitable and considered as avoiding discretion or comfort. Besides the technical improvement which can be proposed, education by the parents and the teachers must begin from the youngest age. Ernould et al. showed the strong heterogeneity of schistosomiasis transmission in water projects due notably to the distance between habitations and transmission sites as well as modalities of use and maintenance of the irrigation system. In this respect, the communication of Poda et al. showed that schistosomiasis was underestimated by the health system due to the lack of training of health staff, poor equipment of health centers and low awareness of both populations and political authorities. Garba et al. confirmed the efficiency of mass treatments with praziquantel, even with a low therapeutic coverage. The renewal of the treatment can be adapted to the intensity of the transmission. The modeling of the performances of the hematuria test described by Etard allows to adjust the sample of population participating to a survey. Other indicators must be proposed to estimate the efficiency of the strategy of control and, possibly, to adapt it to local constraints. Ultrasonographic scores have been proved as faithful and specific indicators for clinical surveillance of complications. Several participants evoked the promising experimental results of candidate vaccines against schistosomiasis and noticed delay taken by clinical trials. The weakness of the financial support postponed considerably the development of the vaccines which interests a numerous population but unable to pay for them. Participants insisted on health education, hygiene, construction or modernization of infrastructures and sanitation which, together, will guarantee durability. Mass treatment with praziquantel appears as a method, certainly indispensable at this stage, but which must be transient. A wide consensus emerged in favor of a community based and integrated control strategies organized at peripheral level in association with technical services (health, hydraulics, agriculture, education) and local governments. Although schistosomiasis seems not to drain any more financial supports, restricting human and scientific resources mobilization of industrial countries, this Round Table underlined the dynamism of researches performed by sub-Saharan African scientists. PMID:15104148

2004-02-01

220

Health promotion and cardiovascular disease prevention in sub-Saharan Africa.  

Science.gov (United States)

Recent population studies demonstrate an increasing burden of cardiovascular disease (CVD) and related risk factors in sub-Saharan Africa (SSA). The mitigation or reversal of this trend calls for effective health promotion and preventive interventions. In this article, we review the core principles, challenges, and progress in promoting cardiovascular health with special emphasis on interventions to address physical inactivity, poor diet, tobacco use, and adverse cardiometabolic risk factor trends in SSA. We focus on the five essential strategies of the Ottawa Charter for Health Promotion. Successes highlighted include community-based interventions in Ghana, Nigeria, South Africa, and Mauritius and school-based programs in Kenya, Namibia, and Swaziland. We address the major challenge of developing integrated interventions, and showcase partnerships opportunities. We conclude by calling for intersectoral partnerships for effective and sustainable intervention strategies to advance cardiovascular health promotion and close the implementation gap in accordance with the 2009 Nairobi Call to Action on Health Promotion. PMID:24267442

Sampson, Uchechukwu K A; Amuyunzu-Nyamongo, Mary; Mensah, George A

2013-01-01

 
 
 
 
221

[Critical review of control strategies for meningococcal meningitis epidemics in Sub-Saharan Africa].  

Science.gov (United States)

Strategies for controlling meningitis epidemics in Sub-Saharan countries, although regularly re-examined, are based on epidemiological, immunological and logistical considerations dating from the 1970s. The strategy recommended by WHO consists in organising large-scale vaccinations in the event of declared epidemic. However, the obvious failure of this strategy has meant that a review and evaluation of the emergency vaccination criteria is necessary. In spite of the current controversy regarding the immunogenicity of the polysaccharide vaccine, its safety, effectiveness in the field and low cost should justify the renewal of a debate on its use in routine vaccination. Routine--or preventive--vaccination could significantly reduce the incidence of meningococcal meningitis as well as its severity. The conjugate vaccine, when available, will constitute an additional advantage in the prevention of meningococcal meningitis. The organisation of a strategy combining both polysaccharide and conjugate vaccines according to the population targets and possibilities of funding remains to be defined. PMID:12012963

Chippaux, J P; Debois, H; Saliou, P

2002-03-01

222

Limited electricity access in health facilities of sub-Saharan Africa: a systematic review of data on electricity access, sources, and reliability  

Science.gov (United States)

ABSTRACT Background: Access to electricity is critical to health care delivery and to the overarching goal of universal health coverage. Data on electricity access in health care facilities are rarely collected and have never been reported systematically in a multi-country study. We conducted a systematic review of available national data on electricity access in health care facilities in sub-Saharan Africa. Methods: We identified publicly-available data from nationally representative facility surveys through a systematic review of articles in PubMed, as well as through websites of development agencies, ministries of health, and national statistics bureaus. To be included in our analysis, data sets had to be collected in or after 2000, be nationally representative of a sub-Saharan African country, cover both public and private health facilities, and include a clear definition of electricity access. Results: We identified 13 health facility surveys from 11 sub-Saharan African countries that met our inclusion criteria. On average, 26% of health facilities in the surveyed countries reported no access to electricity. Only 28% of health care facilities, on average, had reliable electricity among the 8 countries reporting data. Among 9 countries, an average of 7% of facilities relied solely on a generator. Electricity access in health care facilities increased by 1.5% annually in Kenya between 2004 and 2010, and by 4% annually in Rwanda between 2001 and 2007. Conclusions: Energy access for health care facilities in sub-Saharan African countries varies considerably. An urgent need exists to improve the geographic coverage, quality, and frequency of data collection on energy access in health care facilities. Standardized tools should be used to collect data on all sources of power and supply reliability. The United Nations Secretary-General's “Sustainable Energy for All” initiative provides an opportunity to comprehensively monitor energy access in health care facilities. Such evidence about electricity needs and gaps would optimize use of limited resources, which can help to strengthen health systems. PMID:25276537

Adair-Rohani, Heather; Zukor, Karen; Bonjour, Sophie; Wilburn, Susan; Kuesel, Annette C; Hebert, Ryan; Fletcher, Elaine R

2013-01-01

223

Understanding the Environmental and Climate Impacts of Biomass Burning in Northern Sub-Saharan Africa  

Science.gov (United States)

The northern sub-Saharan African (NSSA) region, bounded on the north and south by the Sahara and the Equator, respectively, and stretching from the West to the East African coastlines, has one of the highest biomass-burning rates per unit land area among all regions of the world. Because of the high concentration and frequency of fires in this region, with the associated abundance of heat release and gaseous and particulate smoke emissions, biomass-burning activity is believed to be one of the drivers of the regional carbon and energy cycles, with serious implications for the water cycle. A new interdisciplinary research effort sponsored by NASA is presently being focused on the NSSA region, to better understand the possible connection between the intense biomass burning observed from satellite year after year across the region and the rapid depletion of the regional water resources, as exemplified by the dramatic drying of Lake Chad. A combination of remote sensing and modeling approaches is being utilized in investigating multiple regional surface, atmospheric, and water-cycle processes, and inferring possible links between them. In this presentation, we will discuss preliminary results as well as the path toward improved understanding'of the interrelationships and feedbacks between the biomass burning and the environmental change dynamics in the NSSA region.

Ichoku, Charles; Gatebe, Charles; Bolten, John; Policelli, Fritz; Habib, Shahid; Lee, Jejung; Wang, Jun; Wilcox, Eric; Adegoke, Jimmy

2011-01-01

224

Understanding the Environmental and Climate Impacts of biomass burning in Northern sub-Saharan Africa  

Science.gov (United States)

The northern sub-Saharan African (NSSA) region, bounded on the north and south by the Sahara and the Equator, respectively, and stretching from the West to the East African coastlines, has one of the highest biomass-burning rates per unit land area among all regions of the world. Because of the high concentration and frequency of fires in this region, with the associated abundance of heat release and gaseous and particulate smoke emissions, biomass-burning activity is believed to be one of the drivers of the regional carbon and energy cycles, with serious implications for the water cycle. A new interdisciplinary research effort sponsored by NASA is presently being focused on the NSSA region, to better understand the possible connection between the intense biomass burning observed from satellite year after year across the region and the rapid depletion of the regional water resources, as exemplified by the dramatic drying of Lake Chad. A combination of remote sensing and modeling approaches is being utilized in investigating multiple regional surface, atmospheric, and water-cycle processes, and inferring possible links between them. In this presentation, we will discuss preliminary results as well as the path toward improved understanding of the interrelationships and feedbacks between the biomass burning and the environmental change dynamics in the NSSA region.

Ichoku, C. M.; Gatebe, C. K.; Lee, J.; Wang, J.; Bolten, J. D.; Wilcox, E. M.; Policelli, F.; Habib, S.; Adegoke, J. O.

2011-12-01

225

Managing health professional migration from sub-Saharan Africa to Canada: a stakeholder inquiry into policy options  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Canada is a major recipient of foreign-trained health professionals, notably physicians from South Africa and other sub-Saharan African countries. Nurse migration from these countries, while comparatively small, is rising. African countries, meanwhile, have a critical shortage of professionals and a disproportionate burden of disease. What policy options could Canada pursue that balanced the right to health of Africans losing their health workers with the right of these workers to seek migration to countries such as Canada? Methods We interviewed a small sample of émigré South African physicians (n = 7 and a larger purposive sample of representatives of Canadian federal, provincial, regional and health professional departments/organizations (n = 25; conducted a policy colloquium with stakeholder organizations (n = 21; and undertook new analyses of secondary data to determine recent trends in health human resource flows between sub-Saharan Africa and Canada. Results Flows from sub-Saharan Africa to Canada have increased since the early 1990s, although they may now have peaked for physicians from South Africa. Reasons given for this flow are consistent with other studies of push/pull factors. Of 8 different policy options presented to study participants, only one received unanimous strong support (increasing domestic self-sufficiency, one other received strong support (increased health system strengthening in source country, two others mixed support (voluntary codes on ethical recruitment, bilateral or multilateral agreements to manage flows and four others little support or complete rejection (increased training of auxiliary health workers in Africa ineligible for licensing in Canada, bonding, reparation payments for training-cost losses and restrictions on immigration of health professionals from critically underserved countries. Conclusion Reducing pull factors by improving domestic supply and reducing push factors by strengthening source country health systems have the greatest policy traction in Canada. The latter, however, is not perceived as presently high on Canadian stakeholder organizations' policy agendas, although support for it could grow if it is promoted. Canada is not seen as "actively' recruiting" ("poaching" health workers from developing countries. Recent changes in immigration policy, ongoing advertising in southern African journals and promotion of migration by private agencies, however, blurs the distinction between active and passive recruitment.

Klassen Nathan

2006-08-01

226

Diabetes in sub-saharan Africa: kenya, mali, mozambique, Nigeria, South Africa and zambia.  

Science.gov (United States)

Until a few years ago, a limited number of epidemiologists or public health experts mentioned the words "diabetes." As new lifestyles, imported dietary practices, and globalization take roots in the developing world, as Africa is, today, diabetes and its complications are considered an epidemic in Africa, compelling African governments to start paying more attention to its impact as thousands of Africans run the risk of dying young. The potential severity of diabetes is such that some epidemiologists predict that its economic impact and death toll will surpass the ravages of HIV and AIDS in the near future. On the African sub-continent, present literature and the work of the World Diabetes Foundation have highlighted three countries, namely, Mali, Mozambique, and Zambia. However, the conditions in South Africa, Kenya, and Nigeria, some of the most developed areas of the continent, provide a clue to how people are coping and how governments are responding to diabetes and its full impact. This study is, therefore, a meta-summary of the incidence and prevalence of today's emerging silent killer or diabetes in Sub-Saharan Africa. The theme is that time is running out for Africa and that, as was for HIV/AIDS, by the time the governments wake up and stop denying the catastrophic potential of the epidemic, diabetes will simply overwhelm the continent's resources, and the world will witness the death of millions of Africans. The last section is a call for action against diabetes in terms of advocacy, promotion of awareness, and public health policies that empower people to diabetes self-management. PMID:20165596

Azevedo, Mario; Alla, Sridevi

2008-10-01

227

Antibacterial resistance in sub-Saharan Africa: an underestimated emergency.  

Science.gov (United States)

Antibacterial resistance-associated infections are known to increase morbidity, mortality, and cost of treatment, and to potentially put others in the community at higher risk of infections. In high-income countries, where the burden of infectious diseases is relatively modest, resistance to first-line antibacterial agents is usually overcome by use of second- and third-line agents. However, in developing countries where the burden of infectious diseases is high, patients with antibacterial-resistant infections may be unable to obtain or afford effective second-line treatments. In sub-Saharan Africa (SSA), the situation is aggravated by poor hygiene, unreliable water supplies, civil conflicts, and increasing numbers of immunocompromised people, such as those with HIV, which facilitate both the evolution of resistant pathogens and their rapid spread in the community. Because of limited capacity for disease detection and surveillance, the burden of illnesses due to treatable bacterial infections, their specific etiologies, and the awareness of antibacterial resistance are less well established in most of SSA, and therefore the ability to mitigate their consequences is significantly limited. PMID:24628272

Kariuki, Samuel; Dougan, Gordon

2014-09-01

228

External financial aid to blood transfusion services in sub-Saharan Africa : a need for reflection  

DEFF Research Database (Denmark)

Jean-Pierre Allain and colleagues argue that, while unintended, the foreign aid provided for blood transfusion services in sub-Saharan Africa has resulted in serious negative outcomes, which requires reflection and rethinking.

Ala, Fereydoun; Allain, Jean-Pierre

2012-01-01

229

Harnessing Poverty Alleviation to Reduce the Stigma of HIV in Sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Alexander Tsai and colleagues highlight the complex relationship between poverty and HIV stigma in sub-Saharan Africa, and discuss possible ways to break the cycle. Please see later in the article for the Editors' Summary

Tsai, Alexander C.; Bangsberg, David R.; Weiser, Sheri D.

2013-01-01

230

Harnessing poverty alleviation to reduce the stigma of HIV in Sub-Saharan Africa.  

Science.gov (United States)

Alexander Tsai and colleagues highlight the complex relationship between poverty and HIV stigma in sub-Saharan Africa, and discuss possible ways to break the cycle. Please see later in the article for the Editors' Summary. PMID:24319400

Tsai, Alexander C; Bangsberg, David R; Weiser, Sheri D

2013-11-01

231

Earthquake and Volcanic Hazard Mitigation and Capacity Building in Sub-Saharan Africa  

Science.gov (United States)

The East African Rift System (EARS) is a classic example of active continental rifting, and a natural laboratory setting to study initiation and early stage evolution of continental rifts. The EARS is at different stages of development that varies from relatively matured rift (16 mm/yr) in the Afar to a weakly extended Okavango Delta in the south with predicted opening velocity studies in the region helped researchers to highlight the length and timescales of magmatism and faulting, the partitioning of strain between faulting and magmatism, and their implications for the development of along-axis segmentation. Although the human resource and instrument coverage is sparse in the continent, our understanding of rift processes and deep structure has improved in the last decade after the advent of space geodesy and broadband seismology. The recent major earthquakes, volcanic eruptions and mega dike intrusions that occurred along the EARS attracted several earth scientist teams across the globe. However, most African countries traversed by the rift do not have the full capacity to monitor and mitigate earthquake and volcanic hazards. Few monitoring facilities exist in some countries, and the data acquisition is rarely available in real-time for mitigation purpose. Many sub-Saharan Africa governments are currently focused on achieving the millennium development goals with massive infrastructure development scheme and urbanization while impending natural hazards of such nature are severely overlooked. Collaborations with overseas researchers and other joint efforts by the international community are opportunities to be used by African institutions to best utilize limited resources and to mitigate earthquake and volcano hazards.

Ayele, A.

2012-04-01

232

OPEN FLEXIBLE LIFELONG LEARNING AS A CATALYST FOR SUSTAINABLE DEVELOPMENT IN SUB-SAHARAN AFRICA  

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Full Text Available Educational provision in developing sub-Saharan Africa states has been severely hindered by the hydra-headed problems of access, cost and quality. Amidst these challenges is the pledge of regional and national education policymakers and development planners to ensure that there is maximum access equitable and qualitative education for all (EFA in Africa. There is also a burning need for improved literacy levels and functional education, in order to overcome the development deficits that are currently facing the region. The pledge of education for all resonates the agreement which representatives of several nations of the world signed at the Jomtien summit on Education for All and the subsequent evaluation meetings. Following this pledge, several developing, sub-Sahara African nations have evolved initiatives for instituting sustainable Open Flexible Learning (ODL systems in order to meet up with the seemingly intractable EFA objectives. This paper examined the potential impact of these OFL initiatives on the achievement of the EFA objectives which is seen as the basis of development planning, administration and implementation in Africa. It identified the various challenges confronting effective implementation of ODL on the continent, amidst the need to expand access to educational opportunities. An attempt was made to situate the OFL system at the centre of the strategies for achieving these EFA objectives in the region and finally, a proposal for sustainable policy initiatives for implementing OFL systems for the attainment of education for all in Africa is made.

Felix Kayode OLAKULEHIN

2010-10-01

233

Agriculture and food systems in sub-Saharan Africa in a 4°C+ world.  

Science.gov (United States)

Agricultural development in sub-Saharan Africa faces daunting challenges, which climate change and increasing climate variability will compound in vulnerable areas. The impacts of a changing climate on agricultural production in a world that warms by 4°C or more are likely to be severe in places. The livelihoods of many croppers and livestock keepers in Africa are associated with diversity of options. The changes in crop and livestock production that are likely to result in a 4°C+ world will diminish the options available to most smallholders. In such a world, current crop and livestock varieties and agricultural practices will often be inadequate, and food security will be more difficult to achieve because of commodity price increases and local production shortfalls. While adaptation strategies exist, considerable institutional and policy support will be needed to implement them successfully on the scale required. Even in the 2°C+ world that appears inevitable, planning for and implementing successful adaptation strategies are critical if agricultural growth in the region is to occur, food security be achieved and household livelihoods be enhanced. As part of this effort, better understanding of the critical thresholds in global and African food systems requires urgent research. PMID:21115516

Thornton, Philip K; Jones, Peter G; Ericksen, Polly J; Challinor, Andrew J

2011-01-13

234

Searching for Opportunities for Sub-Saharan Africa's Renewal in the Era of Globalisation  

DEFF Research Database (Denmark)

Sub-Saharan African (SSA) countries rely heavily on donor assistance and international borrowing. The Official Development Assistance (ODA)/GNP ratio in SSA is expected to rise well into the next century. Increases or decreases of ODA, which is known to be the main source of SSA's investment, may depend on the type of global settlement expected to emerge in the post-cold war world. SSA has therefore a stake on the type of globalisation which may frame world economic policy and financial aid to it. Neo-liberal globalisation has no enthusiasm for massive financial transfers. The incipient globalising ideas which emerged from the Rio Summit in 1992 have suggested to increase ODAs in real terms and debt relief to control crushing debt service payments. Agenda 21 has created new and additional facilities formally for increasing donor assistance in the form of financial and investment transfers. The question is whether this new mechanism will make any difference to stem the SSA decline and can "incentivise" the region's renewal or renaissance. This article will focus on how globalisation may be related to increase or decrease of financial transfer to SSA. (C) 2000 Elsevier Science Ltd. All rights reserved.

Muchie, Mammo

2000-01-01

235

Globalisation and the internationalisation of higher education in sub-Saharan Africa  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english In a shrinking world, in which a neo-liberal discourse has permeated sub-Saharan African higher education, critical reflection is required to assess the merits and demerits of globalisation. Research, intensive discussion and hearings conducted over a two-year period by the Task Force on Higher Educ [...] ation and Society, convened by the World Bank and United Nations Educational, Scientific, and Cultural Organization (UNESCO) for the purpose of exploring the future of higher education in the developing world, led to the conclusion that without more and better higher education, developing countries would find it increasingly difficult to benefit from the global knowledge economy. A decade later, we argue for a radical change in the traditional discourse on globalisation because of the emergence of countries such as China, South Africa, India, and Brazil as global players in the world economy. These emerging global powers, reframe the political and imperial philosophy at the epicentre of globalisation discourse - an economic creed, through their mutual consultation and coordination on significant political issues. Their economic and military capabilities enable them to influence the trade regime and thereby strengthen the voice of the developing world as a whole. In relation to this paper's inquiry, the cooperation of these emerging powers gives the free enfranchised people of the world an opportunity to choose a different path of international relations (internationalisation) formed on more liberal lines, as opposed to the neo-liberal economic rationality of globalisation. This paper therefore examines globalisation and internationalisation of higher education in sub-Saharan Africa, a field in which increased knowledge production and distribution open up opportunities for users, institutions and societies. Against a background of chronic economic uncertainty we examine the influence of major international institutions on the direction of higher education, in particular teacher education. Drawing on relevant literature and our own experience, reflexively, we argue that the tendency, towards free market regulation ideologies, privileges neo-liberal global knowledge discourses, such that they impose on higher education a need to respond across a range of fields.

Kuzvinetsa Peter, Dzvimbo; Kholeka Constance, Moloi.

236

Remote sensing applications in African agriculture and natural resources: Highlighting and managing the stress of increasing population pressure  

Science.gov (United States)

Given current population trends and projections in sub-Saharan Africa, it is anticipated that substantial intensification of agricultural cropland is certain within the next decades. In the absence of adoption of improved technologies poor rural populations in this region will continue to degrade and mine the natural resources to ensure their survival. All these actions will have far-reaching implications for environmental quality and human health. However, only through the integration of environment and development concerns with greater attention to these link can we achieve the goal of fulfilling the basic needs, improved living standards for all, better protected and managed eco-systems and a safer, more prosperous future. The paper reviews case studies and provides examples of the integration, analysis, and visualization of information from remotely sensed, biophysical and socioeconomic information to assess the present situation hindering agricultural development in sub-Saharan Africa. These studies show the interactions between socio-economic and environmental factors that can help governments and policy-makers assess the scope of the problems, examine alternatives and decide on a course of action. Sound decisions depend on accurate information, yet most African countries face severe competing demands for the financial and human commitments necessary to staff an information system equal to its policy-making requirements. The role of international data centers is reviewed in terms of their abilities to develop and maintain information systems that bring together available accumulated knowledge and data. This permits comparative studies, which make it possible to develop a better understanding of the relationships among demographic dynamics, technology, cultural behavioral norms, and land resources and hence better decision making for sustainable development.

Amissah-Arthur, Abigail; Balstad Miller, Roberta

237

Perspectives on key principles of generalist medical practice in public service in sub-saharan africa: a qualitative study  

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Full Text Available Abstract Background The principles and practice of Family Medicine that arose in developed Western countries have been imported and adopted in African countries without adequate consideration of their relevance and appropriateness to the African context. In this study we attempted to elicit a priori principles of generalist medical practice from the experience of long-serving medical officers in a variety of African counties, through which we explored emergent principles of Family Medicine in our own context. Methods A descriptive study design was utilized, using qualitative methods. 16 respondents who were clinically active medical practitioners, working as generalists in the public services or non-profit sector for at least 5 years, and who had had no previous formal training or involvement in academic Family Medicine, were purposively selected in 8 different countries in southern, western and east Africa, and interviewed. Results The respondents highlighted a number of key issues with respect to the external environment within which they work, their collective roles, activities and behaviours, as well as the personal values and beliefs that motivate their behaviour. The context is characterized by resource constraints, high workload, traditional health beliefs, and the difficulty of referring patients to the next level of care. Generalist clinicians in sub-Saharan Africa need to be competent across a wide range of clinical disciplines and procedural skills at the level of the district hospital and clinic, in both chronic and emergency care. They need to understand the patient's perspective and context, empowering the patient and building an effective doctor-patient relationship. They are also managers, focused on coordinating and improving the quality of clinical care through teamwork, training and mentoring other health workers in the generalist setting, while being life-long learners themselves. However, their role in the community, was found to be more aspirational than real. Conclusions The study derived a set of principles for the practice of generalist doctors in sub-Saharan Africa based on the reported activities and approaches of the respondents. Patient-centred care using a biopsychosocial approach remains as a common core principle despite wide variations in context. Procedural and hospital care demands a higher level of skills particularly in rural areas, and a community orientation is desirable, but not widely practiced. The results have implications for the postgraduate training of family physicians in sub-Saharan Africa, and highlight questions regarding the realization of community-orientated primary care.

Downing Raymond V

2011-07-01

238

Provision of Antiretroviral Therapy for HIV-Positive TB Patients - 19 Countries, Sub-Saharan Africa, 2009-2013.  

Science.gov (United States)

Considerable progress has been made in the provision of life-saving antiretroviral therapy (ART) for persons with human immunodeficiency virus (HIV) infection worldwide, resulting in an overall decrease in HIV incidence and acquired immunodeficiency syndrome (AIDS)-related mortality. In the strategic scale-up of HIV care and treatment programs, persons with HIV and tuberculosis (TB) are a priority population for receiving ART. TB is the leading cause of death among persons living with HIV in sub-Saharan Africa and remains a potential risk to the estimated 35 million persons living with HIV globally. Of the 9 million new cases of TB disease globally in 2013, an estimated 1.1 million (13%) were among persons living with HIV; of the 1.5 million deaths attributed to TB in 2013, a total of 360,000 (24%) were among persons living with HIV. ART reduces the incidence of HIV-associated TB disease, and early initiation of ART after the start of TB treatment reduces progression of HIV infection and death among HIV-positive TB patients. To assess the progress in scaling up ART provision among HIV-positive TB patients in 19 countries in sub-Saharan Africa with high TB and HIV burdens, TB and HIV data collected by the World Health Organization (WHO) were reviewed. The results found that the percentage of HIV-positive TB patients receiving ART increased from 37% in 2010 to 69% in 2013. However, many TB cases among persons who are HIV-positive go unreported, and only 38% of the estimated number of HIV-positive new TB patients received ART in 2013. Although progress has been made, the combination of TB and HIV continues to pose a threat to global health, particularly in sub-Saharan Africa. PMID:25426652

Dokubo, E Kainne; Baddeley, Annabel; Pathmanathan, Ishani; Coggin, William; Firth, Jacqueline; Getahun, Haileyesus; Kaplan, Jonathan; Date, Anand

2014-11-28

239

Eurasian and African mitochondrial DNA influences in the Saudi Arabian population  

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Full Text Available Abstract Background Genetic studies of the Arabian Peninsula are scarce even though the region was the center of ancient trade routes and empires and may have been the southern corridor for the earliest human migration from Africa to Asia. A total of 120 mtDNA Saudi Arab lineages were analyzed for HVSI/II sequences and for haplogroup confirmatory coding diagnostic positions. A phylogeny of the most abundant haplogroup (preHV1 (R0a was constructed based on 13 whole mtDNA genomes. Results The Saudi Arabian group showed greatest similarity to other Arabian Peninsula populations (Bedouin from the Negev desert and Yemeni and to Levantine populations. Nearly all the main western Asia haplogroups were detected in the Saudi sample, including the rare U9 clade. Saudi Arabs had only a minority sub-Saharan Africa component (7%, similar to the specific North-African contribution (5%. In addition, a small Indian influence (3% was also detected. Conclusion The majority of the Saudi-Arab mitochondrial DNA lineages (85% have a western Asia provenance. Although the still large confidence intervals, the coalescence and phylogeography of (preHV1 haplogroup (accounting for 18 % of Saudi Arabian lineages matches a Neolithic expansion in Saudi Arabia.

Bosley Thomas M

2007-03-01

240

Earthquake Hazard and Risk in Sub-Saharan Africa: current status of the Global Earthquake model (GEM) initiative in the region  

Science.gov (United States)

Large magnitude earthquakes have been observed in Sub-Saharan Africa in the recent past, such as the Machaze event of 2006 (Mw, 7.0) in Mozambique and the 2009 Karonga earthquake (Mw 6.2) in Malawi. The December 13, 1910 earthquake (Ms = 7.3) in the Rukwa rift (Tanzania) is the largest of all instrumentally recorded events known to have occurred in East Africa. The overall earthquake hazard in the region is on the lower side compared to other earthquake prone areas in the globe. However, the risk level is high enough for it to receive attention of the African governments and the donor community. The latest earthquake hazard map for the sub-Saharan Africa was done in 1999 and updating is long overdue as several development activities in the construction industry is booming allover sub-Saharan Africa. To this effect, regional seismologists are working together under the GEM (Global Earthquake Model) framework to improve incomplete, inhomogeneous and uncertain catalogues. The working group is also contributing to the UNESCO-IGCP (SIDA) 601 project and assessing all possible sources of data for the catalogue as well as for the seismotectonic characteristics that will help to develop a reasonable hazard model in the region. In the current progress, it is noted that the region is more seismically active than we thought. This demands the coordinated effort of the regional experts to systematically compile all available information for a better output so as to mitigate earthquake risk in the sub-Saharan Africa.

Ayele, Atalay; Midzi, Vunganai; Ateba, Bekoa; Mulabisana, Thifhelimbilu; Marimira, Kwangwari; Hlatywayo, Dumisani J.; Akpan, Ofonime; Amponsah, Paulina; Georges, Tuluka M.; Durrheim, Ray

2013-04-01

 
 
 
 
241

The modern pre-levodopa era of Parkinson's disease: insights into motor complications from sub-Saharan Africa.  

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During the past decade, a number of large drug trials suggested that the initiation of levodopa therapy should be delayed to reduce the risk of motor complications in patients with Parkinson's disease. However, the relative contribution of the cumulative exposure to levodopa and of disease progression to the pathophysiology of motor fluctuations and dyskinesias is still poorly understood. In this 4-year multicentre study, we investigated a large cohort of patients with Parkinson's disease in a sub-Saharan African country (Ghana), where access to medication is limited and the initiation of levodopa therapy often occurs many years after onset. The primary objective was to investigate whether the occurrence of motor complications is primarily related to the duration of levodopa therapy or to disease-related factors. Study design included a cross-sectional case-control analysis of data collected between December 2008 and November 2012, and a prospective study of patients followed-up for at least 6 months after the initiation of levodopa therapy. Ninety-one patients fulfilled criteria for clinical diagnosis of idiopathic Parkinson's disease (58 males, mean age at onset 60.6 ± 11.3 years). Demographic data were compared to those of 2282 consecutive Italian patients recruited during the same period, whereas nested matched subgroups were used to compare clinical variables. Demographic features, frequency and severity of motor and non-motor symptoms were comparable between the two populations, with the only exception of more frequent tremor-dominant presentation in Ghana. At baseline, the proportion of Ghanaian patients with motor fluctuations and dyskinesias was 56% and 14%, respectively. Although levodopa therapy was introduced later in Ghana (mean disease duration 4.2 ± 2.8 versus 2.4 ± 2.1 years, P < 0.001), disease duration at the occurrence of motor fluctuations and dyskinesias was similar in the two populations. In multivariate analysis, disease duration and levodopa daily dose (mg/kg of body weight) were associated with motor complications, while the disease duration at the initiation of levodopa was not. Prospective follow-up for a mean of 2.6 ± 1.3 years of a subgroup of 21 patients who were drug-naïve at baseline [median disease duration 4.5 (interquartile range, 2.3-5) years] revealed that the median time to development of motor fluctuations and dyskinesias after initiation of levodopa therapy was 6 months. We conclude that motor fluctuations and dyskinesias are not associated with the duration of levodopa therapy, but rather with longer disease duration and higher levodopa daily dose. Hence, the practice to withhold levodopa therapy with the objective of delaying the occurrence of motor complications is not justified. PMID:25034897

Cilia, Roberto; Akpalu, Albert; Sarfo, Fred Stephen; Cham, Momodou; Amboni, Marianna; Cereda, Emanuele; Fabbri, Margherita; Adjei, Patrick; Akassi, John; Bonetti, Alba; Pezzoli, Gianni

2014-10-01

242

Poverty reduction in rural areasof low-income countries in Sub-Saharan Africa: Assessing the role of agricultural productivity and socio-economic environment  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Nowadays, agricultural prices are highlighted combined with, as alleged collateral effects, hunger and malnutrition in Sub-Saharan Africa (SSA). However, today, SSA has around 47,5 percent of rural population in extreme poverty and between 1990 and 2005 when the food prices was stable and with low prices, extreme poverty in SSA involved around 64.6 percent. We assumed that the undernourishment or starvation continued in SSA because there the misery persisted. Poverty reduction is the only ...

Godinho Bertoncello, Alexandre

2013-01-01

243

Features of agricultural extension models and policy in selected sub - Saharan Africa countries  

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Full Text Available This paper reviews the features of agricultural extension models and policy in selected sub- Saharan Africa countries. This is based on the premise that the discussion of extension policy in SSA countries can not be isolated from the extension models that are applied in these countries. While the models are direct products of the type of policy that has been adopted, the policy dictates the models to be used in each country. A major problem of organizing agricultural extension in developing countries is the absence of a legal and policy framework for providing the service. Putting in place a legal and policy framework is one basic new and indispensable way of conducting extension in the developing countries. It will help streamline the confusion currently existing in the effort to transfer agricultural knowledge to farmers, particularly in the areas of service provision, programme development and funding. In literature, the present forms of extension policy are Provisional Extension Policies, decrees and proclamation and legislated extension policies. Factors driving extension policy are population, natural resources and environment. Increasing population will demand more resources from extension in forms of skills, training, diversification of livelihoods and pressure on natural resources. The paper recommends that SSA countries adopt the legislated extension policies option for the improvement extension service delivery and reduce the contradictions in extension models.

Oladimeji Idowu Oladele

2011-10-01

244

Climate Change and Food Security in Sub-Saharan Africa: A Systematic Literature Review  

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Full Text Available In recent years it has become clear that climate change is an inevitable process. In Sub-Saharan Africa, the expectation is that climate change will have an especially negative impact, not only a result of projected warming and rainfall deficits, but also because of the vulnerability of the population. The impact upon food security will be of great significance, and may be defined as being composed of three components: availability, access, and utilization. To further investigate the link, a systematic literature review was done of the peer-reviewed literature related to climate change and food security, employing the realist review method. Analysis of the literature found consistent predictions of decreased crop productivity, land degradation, high market prices, negative impacts on livelihoods, and increased malnutrition. Adaptation strategies were heavily discussed as a means of mitigating a situation of severe food insecurity across the entire region. This is linked to issues of development, whereby adaptation is essential to counteract the negative impacts and improve the potential of the population to undergo development processes. Findings additionally revealed a gap in the literature about how nutrition will be affected, which is of importance given the links between poor nutrition and lack of productivity.

Heather E. Thompson

2010-08-01

245

New technologies to diagnose and monitor infectious diseases of livestock: Challenges for sub-Saharan Africa  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english Using foot-and-mouth disease (FMD) as an example, this review describes new tools that can be used to detect and characterise livestock diseases. In recent years, molecular tests that can detect and characterise pathogens in a diverse range of sample types have revolutionised laboratory diagnostics. [...] In addition to use in centralised laboratories, there are opportunities to locate diagnostic technologies close to the animals with suspected clinical signs. Work in this area has developed simple-to-use lateral-flow devices for the detection of FMD virus (FMDV), as well as new hardware platforms to allow molecular testing to be deployed into the field for use by non-specialists. Once FMDV has been detected, nucleotide sequencing is used to compare field strains with reference viruses. Transboundary movements of FMDV are routinely monitored using VP1 sequence data, while higher resolution transmission trees (at the farm-to-farm level) can be reconstructed using full-genome sequencing approaches. New technologies such as next-generation sequencing technologies are now being applied to dissect the viral sequence populations that exist within single samples. The driving force for the use of these technologies has largely been influenced by the priorities of developed countries with FMD-free (without vaccination) status. However, it is important to recognise that these approaches also show considerable promise for use in countries where FMD is endemic, although further modifications (such as sample archiving and strain and serotype characterisation) may be required to tailor these tests for use in these regions. Access to these new diagnostic and sequencing technologies in sub-Saharan Africa have the potential to provide novel insights into FMD epidemiology and will impact upon improved strategies for disease control. Effective control of infectious diseases is reliant upon accurate diagnosis of clinical cases using laboratory tests, together with an understanding of factors that impact upon the epidemiology of the infectious agent. A wide range of new diagnostic tools and nucleotide sequencing methods are used by international reference laboratories to detect and characterise the agents causing outbreaks of infectious diseases. In the past, high costs (initial capital expenses, as well as day-to-day maintenance and running costs) and complexity of the protocols used to perform some of these tests have limited the use of these methods in smaller laboratories. However, simpler and more cost-effective formats are now being developed that offer the prospect that these technologies will be even more widely deployed into laboratories particularly those in developing regions of the world such as sub-Saharan Africa.

Donald P., King; Miki, Madi; Valerie, Mioulet; Jemma, Wadsworth; Caroline F., Wright; Bego& #241; a, Valdazo-González; Nigel P., Ferris; Nick J., Knowles; Jef, Hammond.

246

The burden of human papillomavirus infections and related diseases in sub-saharan Africa.  

Science.gov (United States)

Despite the scarcity of high quality cancer registries and lack of reliable mortality data, it is clear that human papillomavirus (HPV)-associated diseases, particularly cervical cancer, are major causes of morbidity and mortality in sub-Saharan Africa (SSA). Cervical cancer incidence rates in SSA are the highest in the world and the disease is the most common cause of cancer death among women in the region. The high incidence of cervical cancer is a consequence of the inability of most countries to either initiate or sustain cervical cancer prevention services. In addition, it appears that the prevalence of HPV in women with normal cytology is higher than in more developed areas of the world, at an average of 24%. There is, however, significant regional variation in SSA, with the highest incidence of HPV infection and cervical cancer found in Eastern and Western Africa. It is expected that, due to aging and growth of the population, but also to lack of access to appropriate prevention services and the concomitant human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) epidemic, cervical cancer incidence and mortality rates in SSA will rise over the next 20 years. HPV16 and 18 are the most common genotypes in cervical cancer in SSA, although other carcinogenic HPV types, such as HPV45 and 35, are also relatively more frequent compared with other world regions. Data on other HPV-related anogenital cancers including those of the vulva, vagina, anus, and penis, are limited. Genital warts are common and associated with HPV types 6 and 11. HIV infection increases incidence and prevalence of all HPV-associated diseases. Sociocultural determinants of HPV-related disease, as well as the impact of forces that result in social destabilization, demand further study. Strategies to reduce the excessive burden of HPV-related diseases in SSA include age-appropriate prophylactic HPV vaccination, cervical cancer prevention services for women of the reproductive ages, and control of HIV/AIDS. This article forms part of a regional report entitled "Comprehensive Control of HPV Infections and Related Diseases in the Sub-Saharan Africa Region" Vaccine Volume 31, Supplement 5, 2013. Updates of the progress in the field are presented in a separate monograph entitled "Comprehensive Control of HPV Infections and Related Diseases" Vaccine Volume 30, Supplement 5, 2012. PMID:24331746

De Vuyst, Hugo; Alemany, Laia; Lacey, Charles; Chibwesha, Carla J; Sahasrabuddhe, Vikrant; Banura, Cecily; Denny, Lynette; Parham, Groesbeck P

2013-12-29

247

Best practices for an insecticide-treated bed net distribution programme in sub-Saharan eastern Africa  

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Full Text Available Abstract Insecticide-treated bed nets are the preeminent malaria control means; though there is no consensus as to a best practice for large-scale insecticide-treated bed net distribution. In order to determine the paramount distribution method, this review assessed literature on recent insecticide treated bed net distribution programmes throughout sub-Saharan Eastern Africa. Inclusion criteria were that the study had taken place in sub-Saharan Eastern Africa, targeted malaria prevention and control, and occurred between 1996 and 2007. Forty-two studies were identified and reviewed. The results indicate that distribution frameworks varied greatly; and consequently so did outcomes of insecticide-treated bed net use. Studies revealed consistent inequities between urban and rural populations; which were most effectively alleviated through a free insecticide-treated bed net delivery and distribution framework. However, cost sharing through subsidies was shown to increase programme sustainability, which may lead to more long-term coverage. Thus, distribution should employ a catch up/keep up programme strategy. The catch-up programme rapidly scales up coverage, while the keep-up programme maintains coverage levels. Future directions for malaria should include progress toward distribution of long-lasting insecticide-treated nets.

Sexton Alexis R

2011-06-01

248

Priority interventions to reduce HIV transmission in sex work settings in sub-Saharan Africa and delivery of these services  

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Full Text Available Introduction: Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery. Methods: We systematically reviewed studies reporting interventions for reducing HIV transmission among female sex workers in sub-Saharan Africa between January 2000 and July 2011. Medline (PubMed and non-indexed journals were searched for studies with quantitative study outcomes. Results: We located 26 studies, including seven randomized trials. Evidence supports implementation of the following interventions to reduce unprotected sex among female sex workers: peer-mediated condom promotion, risk-reduction counselling and skills-building for safer sex. One study found that interventions to counter hazardous alcohol-use lowered unprotected sex. Data also show effectiveness of screening for sexually transmitted infections (STIs and syndromic STI treatment, but experience with periodic presumptive treatment is limited. HIV testing and counselling is essential for facilitating sex workers’ access to care and antiretroviral treatment (ART, but testing models for sex workers and indeed for ART access are little studied, as are structural interventions, which create conditions conducive for risk reduction. With the exception of Senegal, persistent criminalization of sex work across Africa reduces sex workers’ control over working conditions and impedes their access to health services. It also obstructs health-service provision and legal protection. Conclusions: There is sufficient evidence of effectiveness of targeted interventions with female sex workers in Africa to inform delivery of services for this population. With improved planning and political will, services – including peer interventions, condom promotion and STI screening – would act at multiple levels to reduce HIV exposure and transmission efficiency among sex workers. Initiatives are required to enhance access to HIV testing and ART for sex workers, using current CD4 thresholds, or possibly earlier for prevention. Services implemented at sufficient scale and intensity also serve as a platform for subsequent community mobilization and sex worker empowerment, and alleviate a major source of incident infection sustaining even generalized HIV epidemics. Ultimately, structural and legal changes that align public health and human rights are needed to ensure that sex workers on the continent are adequately protected from HIV.

Matthew F Chersich

2013-03-01

249

Geographic distribution and ecological niche of plague in sub-Saharan Africa  

DEFF Research Database (Denmark)

Background Plague is a rapidly progressing, serious illness in humans that is likely to be fatal if not treated. It remains a public health threat, especially in sub-Saharan Africa. In spite of plague's highly focal nature, a thorough ecological understanding of the general distribution pattern of plague across sub-Saharan Africa has not been established to date. In this study, we used human plague data from sub-Saharan Africa for 1970-2007 in an ecological niche modeling framework to explore the potential geographic distribution of plague and its ecological requirements across Africa. Results We predict a broad potential distributional area of plague occurrences across sub-Saharan Africa. General tests of model's transferability suggest that our model can anticipate the potential distribution of plague occurrences in Madagascar and northern Africa. However, generality and predictive ability tests using regional subsets of occurrence points demonstrate the models to be unable to predict independent occurrence points outside the training region accurately. Visualizations show plague to occur in diverse landscapes under wide ranges of environmental conditions. Conclusion We conclude that the typical focality of plague, observed in sub-Saharan Africa, is not related to fragmented and insular environmental conditions manifested at a coarse continental scale. However, our approach provides a foundation for testing hypotheses concerning focal distribution areas of plague and their links with historical and environmental factors.

Neerinckx, Simon B; Peterson, Andrew T

2008-01-01

250

Geographic distribution and ecological niche of plague in sub-Saharan Africa  

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Full Text Available Abstract Background Plague is a rapidly progressing, serious illness in humans that is likely to be fatal if not treated. It remains a public health threat, especially in sub-Saharan Africa. In spite of plague's highly focal nature, a thorough ecological understanding of the general distribution pattern of plague across sub-Saharan Africa has not been established to date. In this study, we used human plague data from sub-Saharan Africa for 1970–2007 in an ecological niche modeling framework to explore the potential geographic distribution of plague and its ecological requirements across Africa. Results We predict a broad potential distributional area of plague occurrences across sub-Saharan Africa. General tests of model's transferability suggest that our model can anticipate the potential distribution of plague occurrences in Madagascar and northern Africa. However, generality and predictive ability tests using regional subsets of occurrence points demonstrate the models to be unable to predict independent occurrence points outside the training region accurately. Visualizations show plague to occur in diverse landscapes under wide ranges of environmental conditions. Conclusion We conclude that the typical focality of plague, observed in sub-Saharan Africa, is not related to fragmented and insular environmental conditions manifested at a coarse continental scale. However, our approach provides a foundation for testing hypotheses concerning focal distribution areas of plague and their links with historical and environmental factors.

Gulinck Hubert

2008-10-01

251

Operationalising sexual and reproductive health and rights in sub-Saharan Africa: constraints, dilemmas and strategies  

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Full Text Available Abstract Background The continued poor sexual and reproductive health (SRH outcomes in sub-Saharan Africa highlight the difficulties in reforming policies and laws, and implementing effective programmes. This paper uses one international and two national case studies to reflect on the challenges, dilemmas and strategies used in operationalising sexual and reproductive health and rights (SRHR in different African contexts. Methods The international case study focuses on the progress made by African countries in implementing the African Union’s Maputo Plan of Action (for the Operationalisation of the Continental Policy Framework for Sexual and Reproductive Health and Rights and the experiences of state and non-state stakeholders in this process. The case was developed from an evaluation report of the progress made by nine African countries in implementing the Plan of Action, qualitative interviews exploring stakeholders’ experiences and perceptions of the operationalisation of the plan (carried out as part of the evaluation in Botswana and Nigeria, and authors’ reflections. The first national case study explores the processes involved in influencing Ghana’s Domestic Violence Act passed in 2007; developed from a review of scientific papers and organisational publications on the processes involved in influencing the Act, qualitative interview data and authors’ reflections. The second national case study examines the experiences with introducing the 2006 Sexual Offences Act in Kenya, and it is developed from organisational publications on the processes of enacting the Act and a review of media reports on the debates and passing of the Act. Results Based on the three cases, we argue that prohibitive laws and governments’ reluctance to institute and implement comprehensive rights approaches to SRH, lack of political leadership and commitment to funding SRHR policies and programmes, and dominant negative cultural framing of women’s issues present the major obstacles to operationalising SRH rights. Analysis of successes points to the strategies for tackling these challenges, which include forming and working through strategic coalitions, employing strategic framing of SRHR issues to counter opposition and gain support, collaborating with government, and employing strategic opportunism. Conclusion The strategies identified show future pathways through which challenges to the realisation of SRHR in Africa can be tackled.

Oronje Rose

2011-12-01

252

Trends in the control of theileriosis in sub-Saharan Africa : tick-borne diseases  

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Full Text Available The declining efficacy of acaricide treatment as a means of reducing the prevalence of Theileria parva infections in sub-Saharan Africa has intensified efforts to achieve control through immunization of susceptible cattle. The infection and treatment method of immunization has enjoyed a resurgence with the availability of more effective cold chain facilities, although concerns remain regarding the possibility of vaccine strains spreading in local tick populations. In addition, an in-depth understanding of protective mechanisms deployed by immune cattle and the antigens targeted by them has led to substantial progress in the development of candidate subunit vaccines against both sporozoite and schizont stages of the parasite. The likely success of these vaccines, as well as infection and treatment immunization, will ultimately depend on the extent to which they disturb the endemic status of the parasite. These issues are discussed in the light of recent information on the genotypic diversity of T. parva in the field and the extent to which this is compromised by the immune response.

D. McKeever

2010-09-01

253

Environmental and economic impacts of livestock productivity increase in sub-Saharan Africa.  

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Livestock production in sub-Saharan Africa (SSA) is not matching the annual 2.5 % growth of its population. Regional per capita meat and milk production corresponds, respectively, to about 13 and 8 % of developed countries indicators. Livestock performances in this region have decreased within the last 30 years. In fact, SSA, with a 12 % bovine extraction rate against a world average of 21 %, includes about 16 % of world cattle, only producing 6 and 2.6 % of global meat and milk, respectively. These low performances have economic and environmental consequences reflecting the necessity for upgrading livestock managing skills in the region. This effort includes various components such as sanitary prophylaxis, reproduction, nutrition, and in particular, substantial increase in livestock yield for human consumption. This will allow for an improved animal and pasture management and soil preservation, enhancing meat production and decreasing methane and nitrogen emissions from enteric fermentation and manure processing. These environmental gains due to increased livestock off-take rates can represent relevant credits in the global Environmental Carbon Market under the United Nations Framework Convention on Climate Change Kyoto protocol. These credits can be used for investments in livestock essential services and marketing facilities leading to improved productivity. PMID:22528537

Cardoso, Luis Alfaro

2012-12-01

254

Energy services in sub-Saharan Africa: how conducive is the environment?  

International Nuclear Information System (INIS)

The bulk of rural populations in sub-Saharan Africa have no access to electricity and are under-served by any other form of modern infrastructure. The cost of infrastructure to mainly scattered communities has been perennially cited as largely to blame. This is an undeniable truth, but only part of it. There are in addition, myriads of social, economic and political obstacles that play an unquantified and frequently unrecognized negative role. At the route of the problem lies a subdued role of the would-be recipients who in fact, unlike anybody else, are conversant with their problems. Consequently, a number of products may come as impositions or misplaced priorities. Consumer participation for sustainable development has been articulated at international forums and in publications as being advantageous. In practice however, the concept appears to be generally shunned and even when, occasionally, tried the needs of the consumers are presumed and their roles prescribed. This paper discusses a range of social, economic and political issues that constitute major obstacles to the realisation of sustainable rural development

255

Immunising the HIV-infected child: a view from sub-Saharan Africa.  

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The HIV-infected children are prone to multitude of infections. In sub-Saharan Africa, HIV/AIDS is certainly an important acquired immunodeficiency and is more likely to negatively impact on immunisation programmes than other forms of immunodeficiencies. Although HIV infection is generally not a contra-indication for immunisation, high background HIV prevalence in the region may result in lower rates of vaccine immunogenicity, efficacy and population immunity. Nevertheless, vaccination is still better than natural infection; the risk of vaccination far outweighs the risk of infection with the pathogen. The primary focus of this review is to discuss the lessons learned in vaccinating HIV-infected children particularly with key live-attenuated vaccines in Africa such as Bacille Calmette-Guérin (BCG), measles, oral polio vaccine (OPV), yellow fever and rotavirus. Immunisation against influenza virus, a common cause of respiratory illness, is also discussed as multiple guidelines recommend influenza vaccination for number of groups at high risk such as patients infected with HIV. PMID:22939024

Mphahlele, M Jeffrey; Mda, Siyazi

2012-09-01

256

Prevention of sexual transmission of HIV in sub-Saharan Africa: lessons learned.  

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More than 80% of cases of HIV infection in Africa are attributed to heterosexual transmission, and most prevention efforts have focused upon checking the sexual spread of HIV. A range of interventions have been implemented over the past 10-15 years in different countries throughout the continent. The nature of the activities depends upon the stage of the epidemic, the target population, the funding level, the level of policy support, donor interests, and the capabilities of implementing agencies in the public and private sectors. Despite reports of some encouraging results, the epidemic remains powerful, dynamic, and spreading. Slowing the HIV/AIDS epidemic in Africa will probably require comprehensive, integrated, and multisectoral programs. Most programs to date, however, intervene almost exclusively at the individual level. The authors describe the evolution of intervention programs to prevent the sexual transmission of HIV in sub-Saharan Africa, discuss lessons learned from programs, and identify gaps in the existing knowledge. Sections review interventions to prevent the sexual transmission of HIV, STD treatment, promoting condoms and making them more available, and behavior change interventions. PMID:9416368

Lamptey, P R; Kamenga, M C; Weir, S S

1997-01-01

257

Epidemiology of Dementia among the Elderly in Sub-Saharan Africa  

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Objectives. To review epidemiologic studies on the prevalence, incidence, and risk factors of dementia in sub-Saharan Africa (SSA). Methods. A MEDLINE search (from January 1992 to December 31, 2013) of epidemiologic studies, with no language restriction, was conducted using the keywords “dementia” or “Alzheimer's” and “Africa.” We selected for review population and hospital-based studies that reported the prevalence, incidence, or risk factors of dementia in SSA in people aged 60 years and above. References of selected articles were reviewed to identify additional relevant articles that met our selection criteria. Results. Of a total of 522 articles, 41 were selected and reviewed. The reported prevalence of dementia in SSA varied widely (range: 2.29%–21.60%); Alzheimer's disease was the most prevalent type of dementia. Only two studies conducted in Nigeria reported incidence data. Major risk factors identified include older age, female gender, cardiovascular disease, and illiteracy. Conclusion. Data on the epidemiology of dementia in SSA is limited. While earlier studies reported a lower prevalence of dementia in older persons, recent studies have put these findings into question suggesting that dementia prevalence rates in SSA in fact parallel data from Western countries.

Olayinka, Olaniyi O.; Mbuyi, Nadine N.

2014-01-01

258

A cross-sectional study of vascular risk factors in a rural South African population: data from the Southern African Stroke Prevention Initiative (SASPI  

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Full Text Available Abstract Background Rural sub-Saharan Africa is at an early stage of economic and health transition. It is predicted that the 21st century will see a serious added economic burden from non-communicable disease including vascular disease in low-income countries as they progress through the transition. The stage of vascular disease in a population is thought to result from the prevalence of vascular risk factors. Already hypertension and stroke are common in adults in sub-Saharan Africa. Using a multidisciplinary approach we aimed to assess the prevalence of several vascular risk factors in Agincourt, a rural demographic surveillance site in South Africa. Methods We performed a cross sectional random sample survey of adults aged over 35 in Agincourt (population ? 70 000. Participants were visited at home by a trained nurse who administered a questionnaire, carried out clinical measurements and took a blood sample. From this we assessed participants' history of vascular risk, blood pressure using an OMRON 705 CP monitor, waist circumference, body mass index (BMI, ankle brachial index (ABI, and total and HDL cholesterol. Results 402 people (24% men participated. There was a high prevalence of smoking in men, but the number of cigarettes smoked was small. There was a striking difference in mean BMI between men and women (22.8 kg/m2 versus 27.2 kg/m2, but levels of blood pressure were very similar. 43% of participants had a blood pressure greater than 140/90 or were on anti-hypertensive treatment and 37% of participants identified with measured high blood pressure were on pharmacological treatment. 12% of participants had an ABI of 5 mmol/l. Conclusion We found a high prevalence of hypertension, obesity in women, and a suggestion of subclinical atheroma despite relatively favourable cholesterol levels in a rural South African population. South Africa is facing the challenge of an emerging epidemic of vascular disease. Research to establish the social determinates of these risk factors and interventions to reduce both individual and population risk are required.

Tollman Stephen

2007-11-01

259

Possible Links Between Biomass Burning And The Water Cycle In Northern Sub-Saharan Africa  

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The northern sub-Saharan African (NSSA) region, bounded on the north and south by the Sahara and the Equator, respectively, and stretching East-West across Africa, is very vulnerable because of the highly active environmental and meteorological processes associated with its unique location and human activities that potentially impact the regional water cycle. Over the years, this region has suffered frequent severe droughts that have caused tremendous hardship and loss of life to millions of its inhabitants due to the rapid depletion of the regional water resources, as exemplified by the dramatic drying of Lake Chad. On the other hand, the NSSA region shows one of the highest biomass-burning rates per unit land area among all regions of the world. Because of the high concentration and frequency of fires in this region, with the associated abundance of heat release and gaseous and particulate smoke emissions, biomass-burning activity is believed to be one of the drivers of the regional carbon and energy cycles, with serious implications for the water cycle. An interdisciplinary research effort sponsored by NASA is presently being focused on the NSSA region, to better understand possible connections between the intense biomass burning observed from satellite year after year across the region and the water cycle, through associated changes in land-cover, albedo, soil moisture, evapotranspiration, emissions, atmospheric processes, precipitation, surface runoff, and groundwater recharge. A combination of remote sensing and modeling approaches is being utilized to investigate these multiple processes to clarify possible links between them. We are finding significant covariance (positive or negative) between them, although we are yet to establish cause-and-effect relationships. In this presentation, we will discuss interesting results as well as the path toward improved understanding of the interrelationships and feedbacks between the water cycle components and the environmental change dynamics due to biomass burning and related processes in the NSSA region.

Ichoku, C. M.; Gatebe, C. K.; Lee, J.; Wang, J.; Bolten, J. D.; Policelli, F.; Wilcox, E. M.; Adegoke, J. O.; Habib, S.

2012-12-01

260

Foreign agricultural land acquisition and the visibility of water resource impacts in sub-Saharan Africa  

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Full Text Available The many headlines focusing on 'land grabbing' have distracted attention from the role that access to water plays in underpinning the projected productivity of foreign direct investment in acquisition of agricultural land in developing countries. This paper identifies questions that arise about the explicit and implicit water requirements for irrigation in agricultural projects on land that is subject to such foreign investment deals. It focuses particularly on land acquisition in sub-Saharan Africa (SSA, where, for savanna ecosystems that cover some two thirds of the region, rainfall uncertainty is the principal constraint to increased agricultural productivity. The paper argues that, even where land acquisition deals do not specify irrigation, choice of location and/or crop type indicates this is invariably an implicit requirement of projects. It is arguable that private investment in water infrastructure (e.g. for water storage could provide wider benefits to neighbouring small-scale producers, thus reducing the risk inherent in much of African agriculture. However, it is also possible that foreign investment may compete with existing water use, and some land deals have included provisions for priority access to water in cases of scarcity. Empirical studies are used to identify the mechanisms through which large-scale land investments influence water availability for smaller-scale land users. The paper concludes that, although effects on water resources may constitute one of the main impacts of land deals, this is likely to be obscured by the lack of transparency over water requirements of agricultural projects and the invisibility of much existing local agricultural water management to government planning agencies.

Philip Woodhouse

2012-06-01

 
 
 
 
261

Dynamic Predictions of Crop Yield and Irrigation in Sub-Saharan Africa Due to Climate Change Impacts  

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The highest damages from climate change are predicted to be in the agricultural sector in sub-Saharan Africa. Agriculture is predicted to be especially vulnerable in this region because of its current state of high temperature and low precipitation and because it is usually rain-fed or relies on relatively basic technologies which therefore limit its ability to sustain in increased poor climatic conditions [1]. The goal of this research is to quantify the vulnerability of this ecosystem by projecting future changes in agriculture due to IPCC predicted climate change impacts on precipitation and temperature. This research will provide a better understanding of the relationship between precipitation and rain-fed agriculture in savannas. In order to quantify the effects of climate change on agriculture, the impacts of climate change are modeled through the use of a land surface vegetation dynamics model previously developed combined with a crop model [2,4]. In this project, it will be used to model yield for point cropland locations within sub-Saharan Africa between Kenya and Botswana with a range of annual rainfall. With this model, future projections are developed for what can be anticipated for the crop yield based on two precipitation climate change scenarios; (1) decreased depth and (2) decreased frequency as well as temperature change scenarios; (3) only temperature increased, (4) temperature increase dand decreased precipitation depth, and (5) temperature increased and decreased precipitation frequency. Therefore, this will allow conclusions to be drawn about how mean precipitation and a changing climate effect food security in sub-Saharan Africa. As an additional analysis, irrigation is added to the model as it is thought to be the solution to protect food security by maximizing on the potential of food production. In water-limited areas such as Sub-Saharan Africa, it is important to consider water efficient irrigation techniques such as demand-based micro-irrigation where less water is lost to evaporative demand. Demand-based irrigation is based on two main parameters; a trigger level, to initiate the irrigation, and a target level to calculate the amount of irrigation [3]. In order to understand the impact of these two parameters on amount of irrigated water and yield, irrigation is added to the model with variations of these two parameters considered. This analysis will provide the information needed to understand whether irrigation is a feasible and sustainable solution to the loss of food production due to climate change. Resources: [1]Kurukulasuriya, P., and Mendelsohn, Robert (2008). "A Ricardian analysis of the impact of climate change on African cropland." African Journal Agriculture and Resource Economics 02(1). [2]Raes, D., Steduto, P., Hsiao, T., and Fereres, E. (2011). Chapter 3: Calculation Procedure. . AquaCrop Reference Manual Version 3.1 Plus. [3]Vico, G. and A. Porporato (2011). "From rainfed agriculture to stress-avoidance irrigation: I. A generalized irrigation scheme with stochastic soil moisture." Advances in Water Resources 34(2): 263-271. [4]Williams, C., and Albertson, J. (2005). "Contrasting Short- and Long-Timescale Effects of Vegetation Dynamics on Water and Carbon Fluxes in Water-Limited Ecosystems." Water Resources Research. 41: 1-13

Foster-Wittig, T.

2012-12-01

262

State Recognition and Democratization in Sub-Saharan Africa : A New Dawn for Chiefs?  

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State Recognition and Democractization in Sub-Saharan Africa? explores the link between liberal-style democratization and state recognition of traditional authority in Sub-Saharan Africa. Being critical and empirically grounded, the book explores the complex, often counter-balancing consequences of the involvement of traditional authority in the wave of democratization and liberal-style state-building that has rolled over sub-Saharan Africa in the past decade. It scrutinizes how, in practice, traditional leaders are being drawn into governance in Mozambique, Zambia, Namibia, Malawi, Burkina Faso, and the Somali region of Ethiopia, and relates these developments to state governance in the declining democracy of Zimbabwe and the emerging state of Northern Somalia.

Buur, Lars; Kyed, Helene Maria

2007-01-01

263

Black or African American Populations  

Science.gov (United States)

... issued September, 2011 US Census Bureau, Annual Social & Economic (ASEC) Supplement The Black Alone or in Combination ... Highlights: African Americans Smoking Fast Stats Overweight and Obesity Adult Obesity Facts Overweight & Obesity Fast Stats High ...

264

An evaluation of a morphine public health programme for cancer and AIDS pain relief in Sub-Saharan Africa  

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Background Despite growing HIV and cancer prevalence in Sub-Saharan Africa, and WHO advocacy for a public health approach to palliative care provision, opioid availability is severely limited. Uganda has achieved a morphine roll-out programme in partnership with the Ministry of Health. This study aimed to evaluate that programme by identifying challenges to implementation that may inform replication. Methods A multi-methods protocol appraised morphine regulation, storage, prescribing, and consumption in three phases: key informant interviews throughout the opioid supply chain, and direct observation and audit of clinical practice. Results Regulation had achieved its goal of preventing misuse and leakage from the supply chain. However, the Government felt that relaxation of regulation was now appropriate. Confusion and complexity in storage and authorisation rules led to discontinuation of opioid pain management at the patient level and also wasted service time in trying to obtain supplies to which they were entitled. Continued neglect to prescribe among clinicians and public fear of opioids led to under prescribing, and clinical skills showed some evidence of need for improvement with respect to physical assessment and follow-up. Conclusion The Ugandan programme offers a successful model for both advocacy and Governmental support in achieving opioid roll-out across health districts. Despite initial concerns, abuse of opioids has not been evident. Further work is required to ensure that available supplies of opioids are prescribed to those in need, and that clinical standards are met. However, the programme for roll-out has proved a useful model to expand opioid availability as the first step in improving patient care, and may prove a useful template for other Sub-Saharan African countries. PMID:16092958

Logie, Dorothy E; Harding, Richard

2005-01-01

265

Factors associated with attitudes towards intimate partner violence against women: a comparative analysis of 17 sub-Saharan countries  

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Full Text Available Abstract Background Violence against women, especially by intimate partners, is a serious public health problem that is associated with physical, reproductive and mental health consequences. Even though most societies proscribe violence against women, the reality is that violations against women's rights are often sanctioned under the garb of cultural practices and norms, or through misinterpretation of religious tenets. Methods We utilised data from 17 Demographic and Health Surveys (DHS conducted between 2003 and 2007 in sub-Saharan Africa to assess the net effects of socio-demographic factors on men's and women's attitudes toward intimate partner violence against women (IPVAW using multiple logistic regression models estimated by likelihood ratio test. Results IPVAW was widely accepted under certain circumstances by men and women in all the countries studied. Women were more likely to justify IPVAW than men. "Neglecting the children" was the most common reason agreed to by both women and men for justifying IPVAW followed by "going out without informing husband" and "arguing back with the husband". Increasing wealth status, education attainment, urbanization, access to media, and joint decision making were associated with decreased odds of justifying IPVAW in most countries. Conclusion In most Sub-Saharan African countries studied where IPVAW is widely accepted as a response to women's transgressing gender norms, men find less justification for the practice than do women. The present study suggests that proactive efforts are needed to change these norms, such as promotion of higher education and socio-demographic development. The magnitude and direction of factors associated with attitudes towards IPVAW varies widely across the countries, thus suggesting the significance of capitalizing on need-adapted interventions tailored to fit conditions in each country.

Lawoko Stephen

2009-07-01

266

Is HIV/AIDS Epidemic Outcome of Poverty in Sub-Saharan Africa?  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Undisputable fact is that 14?000 people in Sub-Saharan Africa are being infected daily with HIV and 11?000 are dying every day due to HIV/AIDS related illnesses. In this region more than 60% of the people live below UN poverty line of US$ 1 per day. Some studies have shown that poverty and HIV infection are in correlation, but none has shown whether HIV/AIDS in Sub-Saharan Africa is an outcome of poverty. This article, therefore, shows that HIV is an important outcome of poverty, with sex...

Dzimnenani Mbirimtengerenji, Noel

2007-01-01

267

Injuries as a public health problem in sub-Saharan Africa: epidemiology and prospects for control.  

Science.gov (United States)

Injuries are common and on increase in most developing countries, including sub-Saharan Africa. A large proportion of the injuries are caused by road traffic accidents, falls, burns, assaults, bites, stings and other animal-related injuries, poisonings, drownings/near-drownings and suicide. Globally, injuries are responsible for about five per cent of the total mortality, and the overall global annual costs were estimated in the late 1980s at around 500 billion US dollars. The burden and pattern of injuries in Africa and other developing areas are poorly known and not well studied. The incidence is on the increase, partly due to rapid growth of motorised transport and to expansion of industrial production without adequate safety precautions. This is a review of data on various kinds of injuries in developing countries with a focus on sub-Saharan Africa. A computerised search of the relevant literature published between 1985 and 1998 was conducted and a manual search of journals publishing texts on health in low-income countries and in tropical environments was also done. A few studies on injury prevention policy and on research related to injury epidemiology and prevention have also been identified and included. It is concluded that in a relatively typical East African area with a total mortality rate of 1,300/100,000/year, injuries are likely to cause around 100 of these deaths. The corresponding total rate of significant injuries is estimated at 40,000/100,000/year with a breakdown as tabulated below. [table: see text] Although a few surveys and other investigations of injuries have been conducted over the years, injury epidemiology and control remain under-researched and relatively neglected subject areas. Much needs to be done. Collection and analysis of injury data need to be standardised, for example regarding age groups, gender disaggregation and severity. Injuries and accidents should be subdivided in at least road traffic injury, fall, burn, assault, poisoning, drowning, suicide, homicide and others, and details regarding time and place, victim and main cause should be noted. Morbidity survey field staff should be informed that injuries are part of the illness concept and that questions should be asked accordingly. Details regarding the circumstances surrounding different injuries must be known to those who develop preventive programmes. Injury is a public health problem affecting some people more than others. Our ordinary environment--the home, the work-site, the street or road--represents various kinds of risk, and some of these are difficult to eliminate. Not only do we have to accept much of our environment with its existing houses, equipment, vehicles, transport systems, energy supply, toxic substances etcetera, many also suffer from various inherited or acquired conditions that increase the risk. We therefore need to develop safer and more "forgiving" living environments where ordinary people can live and move around safely. Injury control activities may focus on different categories of injury. Road safety measures often include information and education campaigns, improved driver training, road design and maintenance, regular vehicle safety checks, separation of pedestrians from vehicle traffic, speed limits, safety belt, air-bag and helmet use, special training and control of public service vehicle drivers, bicycle lane separation, road lighting, reflectorised materials on clothing, review of the road traffic related legislation and law enforcement, and emergency medical services improvement. Domestic injuries can be prevented for example with window guards, child barriers at stairs, smoke detectors, clothes and furniture in less flammable materials, replacement of open stoves, stabilising of open lamps, fire-fighting equipment and practice, child-proof poison packaging and storage, safe disposal of toxic waste, home safety education of parents, and strict building code enforcement. Occupational injuries can largely be prevented if well adapted to the work environment. Research is required in s

Nordberg, E

2000-12-01

268

[Molecular epidemiology of large bacterial endemics in Sub-Saharan Africa].  

Science.gov (United States)

Over the past decades, the differentiation of bacterial strains for epidemiological purposes had been based on conventional phenotypic characters. More recently, methods studying the directly coded molecules or semantides (nucleic acids or proteins) have allowed, concomitantly with the technical progresses of electrophoresis, the description of stable, discriminant, reproducible markers, which were applicable to large series of isolates. Initially applied to study nosocomial infections in industrialised countries, these methods appear to be particularly suitable for an approach of the epidemiology of endemic bacterial infections in sub-Saharan Africa. The fact that these tools remain costly and technically complicated explains that most of these studies are conducted in the laboratories of industrialized countries. This research reveals the epidemiological complexity of most of these infections. Thus, the epidemiology of trachoma was studied by the analysis of polymorphism of the major outer membrane protein gene of Chlamydia trachomatis in a village of Gambia. A PCR based technique was used to determine the frequency of infection in symptomatic and clinically negative subjects and to specify the prevalence of the genotypes. The epidemiology of plague was studied by the restriction fragment length polymorphism (RFLP) analysis of the ribosomal RNA genes (ribotyping). Distinct ribotypes differentiated the strains of the first two pandemics from the third one. The strains of African origin were particularly heterogeneous, especially in Kenya. This diversity may be explained by the fact that the plague focus is extremely ancient in Central Africa. Bacterial agents of meningitis were also studied. The electrophoretic polymorphism of outer membrane proteins of Haemophilus influenzae of b type was used to specify the epidemiology of meningitis in Gambia. The invasive strains exhibited distinct profiles from non-invasive strains. Different types were evidenced in the west, east and central parts of the country. The antigenic polymorphism of outer membrane proteins of Neisseria meningitidis allowed the differentiation of the strains isolated in Mali according to the period of isolation. Thus, the endemic strains of A serotype were distinguished from those belonging to the same serotype, which were responsible for the 1994 epidemic. Several molecular methods were applied to the typing of Vibrio cholerae strains, particularly those of the seventh pandemic. The enzyme electrophoretic polymorphism (MLEE), a technique based on RFLP analysis of toxin genes, the arbitrarily primed PCR (AP-PCR) and mainly the ribotyping were applied. This last method revealed that in Africa several clones of V. Cholerae El Tor were responsible for the seventh pandemic. Moreover the technique has evidenced the intercontinental spread of a clone of V. Cholerae isolated in 1993 in Calcutta and identified a year later in Guinea-Bissau. Tuberculosis is at present the first opportunistic infection linked to HIV infection in sub-Saharan Africa. Tuberculosis incidence is particularly high and is expected to increase. Several molecular methods, including IS 6110 RFLP analysis, AP-PCR and spoligotyping were used to study the epidemiology of tuberculosis in various countries: South Africa, Tanzania, Zimbabwe, Kenya and Malawi. The aims of this research varied: prevalence of reactivation and of recently acquired infections, routes of contamination, degree of genetic diversity of the organisms isolated in a given geographic area, urban and rural origins of the infections, comparison of isolates from HIV seropositive and HIV seronegative patients. Identical profiles in the strains isolated from several patients could correspond to clusters of infections. However, the identification of epidemiological links in most clusters is hard to obtain. (ABSTRACT TRUNCATED) PMID:11030062

Picard, B

2000-07-01

269

Smallholder Irrigation and Crop Diversification under Climate Change in sub-Saharan Africa: Evidence and Potential for Simultaneous Food Security, Adaptation, and Mitigation  

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The poorest populations in sub-Saharan Africa live in rural areas and depend on smallholder agricultural production for their livelihoods. Over 90% of all farmed area in Sub-Saharan Africa is rainfed, with crop production centering on 3-5 months of rainfall. Rapid population growth is reducing land per capita ratios, and low yields for staple crops make food security an increasingly challenging goal. Malnutrition, most noticeable among children, peaks during the dry season. Recent data on aggregate economic growth and investment in Africa hide these patterns of seasonal hunger and income disparity. Perhaps most perversely, smallholder farmers in the dry tropical regions of sub-Saharan Africa are (and will continue to be) some of the earliest and hardest hit by climate change. Our research focuses on the role distributed, small-scale irrigation can play in food security and climate change adaptation in sub-Saharan Africa. As Asia's agricultural success has demonstrated, irrigation, when combined with the availability of inputs (fertilizer) and improved crop varieties, can enable year-round production, growth in rural incomes, and a dramatic reduction in hunger. The situation in Africa is markedly different: agroecological conditions are far more heterogeneous than in Asia and evaporation rates are relatively high; most smallholders lack access to fertilizers; and market integration is constrained by infrastructure, information, and private sector incentives. Yet from a resource perspective, national- and regional-level estimates suggest that Internal Renewable Water Resources (IRWR) are nowhere near fully exploited in Sub-Saharan Africa -- even in the Sudano-Sahel, which is considered to be one of the driest regions of the continent. Irrigation can thus be implemented on a much larger scale sustainably. We will present (a) results from controlled, experimental field studies of solar-powered drip irrigation systems in the rural Sudano-Sahel region of West Africa. We have shown that such systems can be implemented in a cost-competitive and environmentally responsible manner, with significant and sustained impact on livelihoods. These findings will be coupled with (b) case studies of successful and failed irrigation projects across the continent that reveal technical and institutional requirements for success; and (c) regional and continental data that quantify the larger-scale food security, development, adaptation, and mitigation potentials of these types of smallholder systems.

Naylor, R.; Burney, J. A.; Postel, S.

2011-12-01

270

Long-Term Adherence to Antiretroviral Treatment and Program Drop-Out in a High-Risk Urban Setting in Sub-Saharan Africa: A Prospective Cohort Study  

Science.gov (United States)

Background Seventy percent of urban populations in sub-Saharan Africa live in slums. Sustaining HIV patients in these high-risk and highly mobile settings is a major future challenge. This study seeks to assess program retention and to find determinants for low adherence to antiretroviral treatment (ART) and drop-out from an established HIV/ART program in Kibera, Nairobi, one of Africa's largest informal urban settlements. Methods and Findings A prospective open cohort study of 800 patients was performed at the African Medical Research Foundation (AMREF) clinic in the Kibera slum. Adherence to ART and drop-out from the ART program were independent outcomes. Two different adherence measures were used: (1) “dose adherence” (the proportion of a prescribed dose taken over the past 4 days) and (2) “adherence index” (based on three adherence questions covering dosing, timing and special instructions). Drop-out from the program was calculated based on clinic appointment dates and number of prescribed doses, and a patient was defined as being lost to follow-up if over 90 days had expired since the last prescribed dose. More than one third of patients were non-adherent when all three aspects of adherence – dosing, timing and special instructions – were taken into account. Multivariate logistic regression revealed that not disclosing HIV status, having a low level of education, living below the poverty limit (US$ 2/day) and not having a treatment buddy were significant predictors for non-adherence. Additionally, one quarter of patients dropped out for more than 90 days after the last prescribed ART dose. Not having a treatment buddy was associated with increased risk for drop-out (hazard ratio 1.4, 95% CI?=?1.0–1.9). Conclusion These findings point to the dilemma of trying to sustain a growing number of people on life-long ART in conditions where prevailing stigma, poverty and food shortages threatens the long-term success of HIV treatment. PMID:21049045

Unge, Christian; Sodergard, Bjorn; Marrone, Gaetano; Thorson, Anna; Lukhwaro, Abigael; Carter, Jane; Ilako, Festus; Ekstrom, Anna Mia

2010-01-01

271

Rural electrification in Sub Saharan Africa in a context of fluctuating oil-prices  

DEFF Research Database (Denmark)

Solar PV is one among other low carbon technologies for rural electrification in Sub Saharan Africa (SSA). Solar PV systems have for almost 30 years been disseminated in SSA, resulting in more than half a million installations concentrated in a few countries. While PV systems have technically matured and markets have gradually developed, PV for rural electrification has often been perceived with scepticism from potential users, donors, government officials and researchers, and solar PV has in many camps been labelled as donor driven, expensive and fragile technology mainly serving the richest parts of the populations and with little or no value for productive uses. However, feasibility for solar PV has improved in the last few years. Retail prices for solar photovoltaic modules are reduced by 20-30% since 2001, and although far from the peak in 2008, oil prices in the next two years to come are expected to settle at a level, which is about three times the world market average in the years from 1985-2003. Therefore, rather than being limited to a niche for populations living in dispersed settlements outside the reach of grid electrification, solar PV is expected to play an important role in mini grid rural electrification schemes based on hybrid solar PVdiesel generators. This may bring PV systems in line with fossil fuel based systems in terms of consumer cost and options for productive use and it changes the market for PV from mainly donor supported schemes into mainstream rural electrification schemes governed and financed by electric utilities and rural electrification agencies. Based on a literature review and the experience with a full scale hybrid wind/PV diesel system at RISØ DTU, this paper provides cost estimates for hybrid PV-diesel systems and policy recommendations to change the application of PV technologies for development in SSA.

Nygaard, Ivan; Bindner, Henrik W.

2009-01-01

272

Urbanization, Physical Activity, and Metabolic Health in Sub-Saharan Africa  

Science.gov (United States)

OBJECTIVE We examined the independent associations between objectively measured free-living physical activity energy expenditure (PAEE) and the metabolic syndrome in adults in rural and urban Cameroon. RESEARCH DESIGN AND METHODS PAEE was measured in 552 rural and urban dwellers using combined heart rate and movement sensing over 7 continuous days. The metabolic syndrome was defined using the National Cholesterol Education Program-Adult Treatment Panel III criteria. RESULTS Urban dwellers had a significantly lower PAEE than rural dwellers (44.2 ± 21.0 vs. 59.6 ± 23.7 kJ/kg/day, P < 0.001) and a higher prevalence of the metabolic syndrome (17.7 vs. 3.5%, P < 0.001). In multivariate regression models adjusted for possible confounders, each kJ/kg/day of PAEE was associated with a 2.1% lower risk of prevalent metabolic syndrome (odds ratio 0.98, P = 0.03). This implies a 6.5 kJ/kg/day difference in PAEE, equivalent to 30 min/day of brisk walking, corresponds to a 13.7% lower risk of prevalent metabolic syndrome. The population attributable fraction of prevalent metabolic syndrome due to being in the lowest quartile of PAEE was 26.3% (25.3% in women and 35.7% in men). CONCLUSIONS Urban compared with rural residence is associated with lower PAEE and higher prevalence of metabolic syndrome. PAEE is strongly independently associated with prevalent metabolic syndrome in adult Cameroonians. Modest population-wide changes in PAEE may have significant benefits in terms of reducing the emerging burden of metabolic diseases in sub-Saharan Africa. PMID:21270205

Assah, Felix K.; Ekelund, Ulf; Brage, Soren; Mbanya, Jean Claude; Wareham, Nicholas J.

2011-01-01

273

The challenges of managing breast cancer in the developing world - a perspective from sub-Saharan Africa  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english Communicable diseases are the major cause of mortality in lower-income countries. Consequently, local and international resources are channelled mainly into addressing the impact of these conditions. HIV, however, is being successfully treated, people are living longer, and disease patterns are chan [...] ging. As populations age, the incidence of cancer inevitably increases. The World Health Organization has predicted a dramatic increase in global cancer cases during the next 15 years, the majority of which will occur in low- and middle-income countries. Cancer treatment is expensive and complex and in the developing world 5% of global cancer funds are spent on 70% of cancer cases. This paper reviews the challenges of managing breast cancer in the developing world, using sub-Saharan Africa as a model.

J, Edge; I, Buccimazza; H, Cubasch; E, Panieri.

274

The challenges of managing breast cancer in the developing world - a perspective from sub-Saharan Africa  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english Communicable diseases are the major cause of mortality in lower-income countries. Consequently, local and international resources are channelled mainly into addressing the impact of these conditions. HIV, however, is being successfully treated, people are living longer, and disease patterns are chan [...] ging. As populations age, the incidence of cancer inevitably increases. The World Health Organization has predicted a dramatic increase in global cancer cases during the next 15 years, the majority of which will occur in low- and middle-income countries. Cancer treatment is expensive and complex and in the developing world 5% of global cancer funds are spent on 70% of cancer cases. This paper reviews the challenges of managing breast cancer in the developing world, using sub-Saharan Africa as a model.

J, Edge; I, Buccimazza; H, Cubasch; E, Panieri.

2014-05-01

275

Religious Education in the Context of Sub-Saharan Africa: The Malawian Example  

Science.gov (United States)

The argument in this paper is that in spite of the acknowledgement of plurality, many countries in sub-Saharan Africa seem reluctant to introduce multi-faith approaches preferring to maintain Christian confessionalism in religious education. Even in those countries where new approaches are being tried, there is some unwillingness to make wholesale…

Matemba, Yonah Hisbon

2009-01-01

276

Heavy metal pollution in sub-Saharan Africa and possible implications in cancer epidemiology.  

Science.gov (United States)

The increasing scourge of cancer epidemiology is a global concern. With WHO emphasizing that 40% of all cancer cases are preventable, exposure to known and suspected carcinogens must be discouraged. The battle with communicable diseases and other third world challenges has greatly de-emphasized anti-cancer campaigns in sub-Saharan Africa. The abundant deposit of mineral resources in sub-Saharan Africa has attracted high mining activity with its negative environmental aftermath. Poor regulatory mechanisms have led to environmental contamination by products of mining including heavy metals. In addition to poor urban planning, the springing up of settlements in industrial areas has led to generation and exposure to more hazardous wastes consequent on poor disposal systems. Studies establishing close association between exposure to heavy metals and cancer epidemiology in sub-Saharan Africa are increasing. The current review assesses the level of environmental pollution by heavy metals in sub-Saharan Africa, and brings to the fore available evidence implicating such in the increasing cancer epidemiology in the sub-continent. PMID:23886118

Fasinu, Pius; Orisakwe, Orish Ebere

2013-01-01

277

The impact of solar ultraviolet radiation on human health in sub-Saharan Africa  

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Full Text Available Photoprotection messages and ‘SunSmart’ programmes exist mainly to prevent skin cancers and, more recently, to encourage adequate personal sun exposure to elicit a vitamin D response for healthy bone and immune systems. Several developed countries maintain intensive research networks and monitor solar UV radiation to support awareness campaigns and intervention development. The situation is different in sub-Saharan Africa. Adequate empirical evidence of the impact of solar UV radiation on human health, even for melanomas and cataracts, is lacking, and is overshadowed by other factors such as communicable diseases, especially HIV, AIDS and tuberculosis. In addition, the established photoprotection messages used in developed countries have been adopted and implemented in a limited number of sub-Saharan countries but with minimal understanding of local conditions and behaviours. In this review, we consider the current evidence for sun-related effects on human health in sub-Saharan Africa, summarise published research and identify key issues. Data on the prevalence of human diseases affected by solar UV radiation in all subpopulations are not generally available, financial support is insufficient and the infrastructure to address these and other related topics is inadequate. Despite these limitations, considerable progress may be made regarding the management of solar UV radiation related health outcomes in sub-Saharan Africa, provided researchers collaborate and resources are allocated appropriately.

Caradee Y. Wright

2012-10-01

278

The impact of solar ultraviolet radiation on human health in sub-Saharan Africa  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english Photoprotection messages and 'SunSmart' programmes exist mainly to prevent skin cancers and, more recently, to encourage adequate personal sun exposure to elicit a vitamin D response for healthy bone and immune systems. Several developed countries maintain intensive research networks and monitor sol [...] ar UV radiation to support awareness campaigns and intervention development. The situation is different in sub-Saharan Africa. Adequate empirical evidence of the impact of solar UV radiation on human health, even for melanomas and cataracts, is lacking, and is overshadowed by other factors such as communicable diseases, especially HIV, AIDS and tuberculosis. In addition, the established photoprotection messages used in developed countries have been adopted and implemented in a limited number of sub-Saharan countries but with minimal understanding of local conditions and behaviours. In this review, we consider the current evidence for sun-related effects on human health in sub-Saharan Africa, summarise published research and identify key issues. Data on the prevalence of human diseases affected by solar UV radiation in all subpopulations are not generally available, financial support is insufficient and the infrastructure to address these and other related topics is inadequate. Despite these limitations, considerable progress may be made regarding the management of solar UV radiation related health outcomes in sub-Saharan Africa, provided researchers collaborate and resources are allocated appropriately.

Caradee Y., Wright; Mary, Norval; Beverley, Summers; Lester, Davids; Gerrie, Coetzee; Matthew O., Oriowo.

279

Family Medicine may be helpful in improving health care delivery in sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Efforts to introduce and integrate the discipline of family medicine in sub-Saharan Africa have remained slow due to failure to understand what role and benefit such physicians can play in the existing health care systems in the region. An attempt is made here to explain reasons for this trend and suggest ways to overcome it.

Ssenyonga, Richard

2007-01-01

280

Rural Health and Family Medicine: An Agenda for sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

How to cite this article: Monjok E, Okokon IB, Smesny A, Essien EJ. Rural Health and Family Medicine: An Agenda for sub-Saharan Africa. Afr J Prm Health Care Fam Med. 2011;3(1), Art. #271, 2 pages. http://dx.doi.org/10.4102/phcfm.v3i1.271

Emmanuel Monjok; Okokon, Ita B.; Andrea Smesny; Essien, Ekere J.

2011-01-01

 
 
 
 
281

Challenging Educational Injustice: "Grassroots" Privatisation in South Asia and Sub-Saharan Africa  

Science.gov (United States)

The phenomenon of low-cost private schools "mushrooming" in poor areas of sub-Saharan Africa and South Asia, and elsewhere, is now well-documented. Findings from research by the author's teams and others show that these schools are serving a majority (urban and peri-urban) or significant minority (rural) of the poor, including…

Tooley, James

2013-01-01

282

Library Automation in Sub Saharan Africa: Case Study of the University of Botswana  

Science.gov (United States)

Purpose: This article aims to present experiences and the lessons learned from the University of Botswana (UB) library automation project. The implications of the project for similar libraries planning automation in sub Saharan Africa and beyond are adduced. Design/methodology/approach: The article is a case study of library automation at the…

Mutula, Stephen Mudogo

2012-01-01

283

Reducing Vulnerability to Climate Change in Sub-Saharan Africa: The Need for Better Evidence  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Robert Fryatt and colleagues argue for more attention to climate change in sub-Saharan Africa, a region that has contributed the least greenhouse gas emissions to the world's total but is more vulnerable to the impacts of climate change than any other.

Kula, Nothemba; Haines, Andy; Fryatt, Robert

2013-01-01

284

How many births in sub-Saharan Africa and South Asia will not be attended by a skilled birth attendant between 2011 and 2015?  

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Full Text Available Abstract Background The fifth Millennium Development Goal target for 90% of births in low and middle income countries to have a skilled birth attendant (SBA by 2015 will not be met. In response to this, policy has focused on increasing SBA access. However, reducing maternal mortality also requires policies to prevent deaths among women giving birth unattended. We aimed to generate estimates of the absolute number of non-SBA births between 2011 and 2015 in South Asia and sub-Saharan Africa, given optimistic assumptions of future trends in SBA attendance. These estimates could be used by decision makers to inform the extent to which reductions in maternal mortality will depend on policies aimed specifically at those women giving birth unattended. Methods For each country within South Asia and sub-Saharan Africa we estimated recent trends in SBA attendance and used these as the basis for three increasingly optimistic projections for future changes in SBA attendance. For each country we obtained estimates for the current SBA attendance in rural and urban settings and forecasts for the number of births and changes in rural/urban population over 2011-2015. Based on these, we calculated estimates for the number of non-SBA births for 2011-2015 under a variety of scenarios. Results Conservative estimates are that there will be between 130 and 180 million non-SBA births in South Asia and sub-Saharan Africa from 2011 to 2015 (90% of these in rural areas. Currently, there are more non-SBA births per year in South Asia than sub-Saharan Africa, but our projections suggest that the regions will have approximately the same number of non-SBA births by 2015. We also present results for each of the six countries currently accounting for more than 50% of global maternal deaths. Conclusions Over the next five years, many millions of women within South Asia and sub-Saharan Africa will give birth without an SBA. Efforts to improve access to skilled attendance should be accompanied by interventions to improve the safety of non-attended deliveries.

Crowe Sonya

2012-01-01

285

Patterns of biomedical science production in a sub-Saharan research center  

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Full Text Available Abstract Background Research activities in sub-Saharan Africa may be limited to delegated tasks due to the strong control from Western collaborators, which could lead to scientific production of little value in terms of its impact on social and economic innovation in less developed areas. However, the current contexts of international biomedical research including the development of public-private partnerships and research institutions in Africa suggest that scientific activities are growing in sub-Saharan Africa. This study aims to describe the patterns of clinical research activities at a sub-Saharan biomedical research center. Methods In-depth interviews were conducted with a core group of researchers at the Medical Research Unit of the Albert Schweitzer Hospital from June 2009 to February 2010 in Lambaréné, Gabon. Scientific activities running at the MRU as well as the implementation of ethical and regulatory standards were covered by the interview sessions. Results The framework of clinical research includes transnational studies and research initiated locally. In transnational collaborations, a sub-Saharan research institution may be limited to producing confirmatory and late-stage data with little impact on economic and social innovation. However, ethical and regulatory guidelines are being implemented taking into consideration the local contexts. Similarly, the scientific content of studies designed by researchers at the MRU, if local needs are taken into account, may potentially contribute to a scientific production with long-term value on social and economic innovation in sub-Saharan Africa. Conclusion Further research questions and methods in social sciences should comprehensively address the construction of scientific content with the social, economic and cultural contexts surrounding research activities.

Agnandji Selidji T

2012-03-01

286

Science-based health innovation in sub-Saharan Africa  

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Full Text Available Abstract In recent years emerging markets such as India, China, and Brazil have developed appropriate business models and lower-cost technological innovations to address health challenges locally and internationally. But it is not well understood what capabilities African countries, with their high disease burden, have in science-based health innovation. This gap in knowledge is addressed by this series in BMC International Health and Human Rights. The series presents the results of extensive on-the-ground research in the form of four country case studies of health and biotechnology innovation, six studies of institutions within Africa involved in health product development, and one study of health venture funds in Africa. To the best of our knowledge it is the first extensive collection of empirical work on African science-based health innovation. The four country cases are Ghana, Rwanda, Tanzania and Uganda. The six case studies of institutions are A to Z Textiles (Tanzania, Acorn Technologies (South Africa, Bioventures venture capital fund (South Africa, the Malagasy Institute of Applied Research (IMRA; Madagascar, the Kenyan Medical Research Institute (KEMRI; Kenya, and Niprisan’s development by Nigeria’s National Institute for Pharmaceutical Research and Development and Xechem (Nigeria. All of the examples highlight pioneering attempts to build technological capacity, create economic opportunities, and retain talent on a continent significantly affected by brain drain. They point to the practical challenges for innovators on the ground, and suggest potentially helpful policies, funding streams, and other support systems. For African nations, health innovation represents an opportunity to increase domestic capacity to solve health challenges; for international funders, it is an opportunity to move beyond foreign aid and dependency. The shared goal is creating self-sustaining innovation that has both health and development impacts. While this is a long-term strategy, this series shows the potential of African-led innovation, and indicates how it might balance realism against opportunity. There is ample scope to learn lessons more systematically from cases like those we discuss; to link entrepreneurs, scientists, funders, and policy-makers into a network to share opportunities and challenges; and ultimately to better support and stimulate African-led health innovation.

Daar Abdallah S

2010-12-01

287

Rethinking HIV exceptionalism: the ethics of opt-out HIV testing in sub-Saharan Africa.  

Science.gov (United States)

Opt-out testing for the human immunodeficiency virus (HIV) incorporates testing as a routine part of health care for all patients unless they refuse. The ethics of this approach to testing in sub-Saharan Africa is a source of controversy. Opt-out HIV testing is expected to improve survival by increasing case detection and thus linking more HIV-infected people to earlier treatment, provided there is effective patient follow-up and programme sustainability. At the population level, these benefits will likely outweigh the potential negative consequences of individuals experiencing HIV-related stigma. These justifications appeal to consequentialist moral theories that the acceptability of an action depends upon its outcomes. On the other hand, liberal moral theories state that the autonomy of individuals should always be protected unless restricting autonomy is necessary to protect the welfare of others. Opt-out consent may restrict autonomy and it is unclear whether it would benefit people other than those being tested. Yet, the doctrine of libertarian paternalism proposes that it is justifiable and desirable to use unobtrusive mechanisms to help individuals make choices to maximize their own welfare. Central to this idea are the premises featured by supporters of opt-out consent that individuals will not always make the best choices for their own welfare but they may be influenced to do so in ways that will not compromise their freedom of choice. Also important is the premise that all policies inevitably exert some such influence: opt-in consent encourages test refusal just as opt-out consent encourages acceptance. Based on these premises, opt-out testing may be an effective and ethically acceptable policy response to Africa's HIV epidemic. PMID:20865076

April, Michael D

2010-09-01

288

Mobile Phone-Based mHealth Approaches for Public Health Surveillance in Sub-Saharan Africa: A Systematic Review  

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Full Text Available Whereas mobile phone-based surveillance has the potential to provide real-time validated data for disease clustering and prompt respond and investigation, little evidence is available on current practice in sub-Sahara Africa. The objective of this review was to examine mobile phone-based mHealth interventions for Public Health surveillance in the region. We conducted electronic search in MEDLINE, EMBASE, IEE Xplore, African Index Medicus (AIM, BioMed Central, PubMed Central (PMC, the Public Library of Science (PLoS and IRIS for publications used in the review. In all, a total of nine studies were included which focused on infectious disease surveillance of malaria (n = 3, tuberculosis (n = 1 and influenza-like illnesses (n = 1 as well as on non-infectious disease surveillance of child malnutrition (n = 2, maternal health (n = 1 and routine surveillance of various diseases and symptoms (n = 1. Our review revealed that mobile phone-based surveillance projects in the sub-Saharan African countries are on small scale, fragmented and not well documented. We conclude by advocating for a strong drive for more research in the applied field as well as a better reporting of lessons learned in order to create an epistemic community to help build a more evidence-based field of practice in mHealth surveillance in the region.

Johanna Brinkel

2014-11-01

289

Population genetics of African ungulates  

DEFF Research Database (Denmark)

Molecular genetic techniques were used to gain insights into the evolutionary forces that have shaped the present day diversity of African savannah ungu-lates, which constitute the most species-rich mega faunal assemblage on earth. The studies included in this thesis represent individual species-specific data sets, which are used to elucidate evolutionary processes of importance to the savannah ungulate community. Patterns of DNA variation were analyzed to assess the genetic signatures of Pleistocene refugia and investigate aspects of speciation, intraspecific structuring, hybridization, and historic migration pat-terns.

Lorenzen, Eline

2009-01-01

290

Cytochrome P450 pharmacogenetics in African populations.  

Science.gov (United States)

The Cytochrome P450 (CYP450) family of enzymes is involved in the oxidative metabolism of many therapeutic drugs, carcinogens and various endogenous substrates. These enzymes are highly polymorphic at an inter-individual and inter-ethnic level. Polymorphisms or genetic variations account for up to 30% of inter-individual differences seen in a variety of drug responses. The frequencies of the different metabolizer categories (slow, intermediate, extensive and ultra-rapid), the distribution of genetic variants, genotype-phenotype correlations and the clinical importance of the CYP450 enzymes have been extensively documented in Caucasian and Oriental populations. Limited data exists for African populations, despite the fact that this knowledge is critically important for these populations who experience a heavy burden of communicable and non-communicable diseases. In addition, the costs incurred through adverse drug reactions and non-responsiveness to therapy could be reduced through the wide-scale application of pharmacogenetics. This review provides an overview and investigation of CYP450 genotypic and phenotypic reports published from 1980 to present in African populations. Our findings confirm the high degree of variability that is expected when comparing individuals of African origin to other ethnic groups and also highlight the distribution of clinically relevant CYP450 alleles amongst the various African populations. The notable discordance in genotypic and phenotypic data amongst African populations exemplifies the need for in-depth and well-orchestrated molecular and pharmacological investigations of these populations in the future, for which whole genome sequencing and association studies will be critical. PMID:23590174

Alessandrini, Marco; Asfaha, Sahle; Dodgen, Tyren Mark; Warnich, Louise; Pepper, Michael Sean

2013-05-01

291

Novel IRF6 mutations in families with Van Der Woude syndrome and popliteal pterygium syndrome from sub-Saharan Africa.  

Science.gov (United States)

Orofacial clefts (OFC) are complex genetic traits that are often classified as syndromic or nonsyndromic clefts. Currently, there are over 500 types of syndromic clefts in the Online Mendelian Inheritance in Man (OMIM) database, of which Van der Woude syndrome (VWS) is one of the most common (accounting for 2% of all OFC). Popliteal pterygium syndrome (PPS) is considered to be a more severe form of VWS. Mutations in the IRF6 gene have been reported worldwide to cause VWS and PPS. Here, we report studies of families with VWS and PPS in sub-Saharan Africa. We screened the DNA of eight families with VWS and one family with PPS from Nigeria and Ethiopia by Sanger sequencing of the most commonly affected exons in IRF6 (exons 3, 4, 7, and 9). For the VWS families, we found a novel nonsense variant in exon 4 (p.Lys66X), a novel splice-site variant in exon 4 (p.Pro126Pro), a novel missense variant in exon 4 (p.Phe230Leu), a previously reported splice-site variant in exon 7 that changes the acceptor splice site, and a known missense variant in exon 7 (p.Leu251Pro). A previously known missense variant was found in exon 4 (p.Arg84His) in the PPS family. All the mutations segregate in the families. Our data confirm the presence of IRF6-related VWS and PPS in sub-Saharan Africa and highlights the importance of screening for novel mutations in known genes when studying diverse global populations. This is important for counseling and prenatal diagnosis for high-risk families. PMID:24936515

Butali, Azeez; Mossey, Peter A; Adeyemo, Wasiu L; Eshete, Mekonen A; Gaines, LauRen A; Even, Dee; Braimah, Ramat O; Aregbesola, Babatunde S; Rigdon, Jennifer V; Emeka, Christian I; James, Olutayo; Ogunlewe, Mobolanle O; Ladeinde, Akinola L; Abate, Fikre; Hailu, Taye; Mohammed, Ibrahim; Gravem, Paul E; Deribew, Milliard; Gesses, Mulualem; Adeyemo, Adebowale A; Murray, Jeffrey C

2014-05-01

292

Efficacy of newer versus older antihypertensive drugs in black patients living in sub-Saharan Africa.  

Science.gov (United States)

To address the epidemic of hypertension in blacks born and living in sub-Saharan Africa, we compared in a randomised clinical trial (NCT01030458) single-pill combinations of old and new antihypertensive drugs in patients (30-69 years) with uncomplicated hypertension (140-179/90-109?mm?Hg). After ?4 weeks off treatment, 183 of 294 screened patients were assigned to once daily bisoprolol/hydrochlorothiazide 5/6.25?mg (n=89; R) or amlodipine/valsartan 5/160?mg (n=94; E) and followed up for 6 months. To control blood pressure (bisoprolol and amlodipine could be doubled (10?mg per day) and ?-methyldopa (0.5-2?g per day) added. Sitting blood pressure fell by 19.5/12.0?mm?Hg in R patients and by 24.8/13.2?mm?Hg in E patients and heart rate decreased by 9.7 beats per minute in R patients with no change in E patients (-0.2 beats per minute). The between-group differences (R minus E) were 5.2?mm?Hg (P<0.0001) systolic, 1.3?mm?Hg (P=0.12) diastolic, and 9.6 beats per minute (P<0.0001). In 57 R and 67 E patients with data available at all visits, these estimates were 5.5?mm?Hg (P<0.0001) systolic, 1.8?mm?Hg (P=0.07) diastolic and 9.8 beats per minute (P<0.0001). In R compared with E patients, 45 vs 37% (P=0.13) proceeded to the higher dose of randomised treatment and 33 vs 9% (P<0.0001) had ?-methyldopa added. There were no between-group differences in symptoms except for ankle oedema in E patients (P=0.012). In conclusion, new compared with old drugs lowered systolic blood pressure more and therefore controlled hypertension better in native African black patients. PMID:23803591

M'Buyamba-Kabangu, J R; Anisiuba, B C; Ndiaye, M B; Lemogoum, D; Jacobs, L; Ijoma, C K; Thijs, L; Boombhi, H J; Kaptue, J; Kolo, P M; Mipinda, J B; Osakwe, C E; Odili, A; Ezeala-Adikaibe, B; Kingue, S; Omotoso, B A; Ba, S A; Ulasi, I I; Staessen, J A

2013-12-01

293

Giving tranexamic acid to reduce surgical bleeding in sub-Saharan Africa: an economic evaluation  

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Full Text Available Abstract Background The identification of safe and effective alternatives to blood transfusion is a public health priority. In sub-Saharan Africa, blood shortage is a cause of mortality and morbidity. Blood transfusion can also transmit viral infections. Giving tranexamic acid (TXA to bleeding surgical patients has been shown to reduce both the number of blood transfusions and the volume of blood transfused. The objective of this study is to investigate whether routinely administering TXA to bleeding elective surgical patients is cost effective by both averting deaths occurring from the shortage of blood, and by preventing infections from blood transfusions. Methods A decision tree was constructed to evaluate the cost-effectiveness of providing TXA compared with no TXA in patients with surgical bleeding in four African countries with different human immunodeficiency virus (HIV prevalence and blood donation rates (Kenya, South Africa, Tanzania and Botswana. The principal outcome measures were cost per life saved and cost per infection averted (HIV, Hepatitis B, Hepatitis C averted in 2007 International dollars ($. The probability of receiving a blood transfusion with and without TXA and the risk of blood borne viral infection were estimated. The impact of uncertainty in model parameters was explored using one-way deterministic sensitivity analyses. Probabilistic sensitivity analysis was performed using Monte Carlo simulation. Results The incremental cost per life saved is $87 for Kenya and $93 for Tanzania. In Botswana and South Africa, TXA administration is not life saving but is highly cost saving since fewer units of blood are transfused. Further, in Botswana the administration of TXA averts one case of HIV and four cases of Hepatitis B (HBV per 1,000 surgical patients. In South Africa, one case of HBV is averted per 1,000 surgical patients. Probabilistic sensitivity analyses confirmed the robustness of the model. Conclusion An economic argument can be made for giving TXA to bleeding elective surgical patients. In countries where there is a blood shortage, TXA would be a cost effective way to reduce mortality. In countries where there is no blood shortage, TXA would reduce healthcare costs and avert blood borne infections.

Perel Pablo

2010-02-01

294

The modern pre-levodopa era of Parkinson's disease: insights into motor complications from sub-Saharan Africa  

Science.gov (United States)

During the past decade, a number of large drug trials suggested that the initiation of levodopa therapy should be delayed to reduce the risk of motor complications in patients with Parkinson’s disease. However, the relative contribution of the cumulative exposure to levodopa and of disease progression to the pathophysiology of motor fluctuations and dyskinesias is still poorly understood. In this 4-year multicentre study, we investigated a large cohort of patients with Parkinson’s disease in a sub-Saharan African country (Ghana), where access to medication is limited and the initiation of levodopa therapy often occurs many years after onset. The primary objective was to investigate whether the occurrence of motor complications is primarily related to the duration of levodopa therapy or to disease-related factors. Study design included a cross-sectional case-control analysis of data collected between December 2008 and November 2012, and a prospective study of patients followed-up for at least 6 months after the initiation of levodopa therapy. Ninety-one patients fulfilled criteria for clinical diagnosis of idiopathic Parkinson’s disease (58 males, mean age at onset 60.6 ± 11.3 years). Demographic data were compared to those of 2282 consecutive Italian patients recruited during the same period, whereas nested matched subgroups were used to compare clinical variables. Demographic features, frequency and severity of motor and non-motor symptoms were comparable between the two populations, with the only exception of more frequent tremor-dominant presentation in Ghana. At baseline, the proportion of Ghanaian patients with motor fluctuations and dyskinesias was 56% and 14%, respectively. Although levodopa therapy was introduced later in Ghana (mean disease duration 4.2 ± 2.8 versus 2.4 ± 2.1 years, P < 0.001), disease duration at the occurrence of motor fluctuations and dyskinesias was similar in the two populations. In multivariate analysis, disease duration and levodopa daily dose (mg/kg of body weight) were associated with motor complications, while the disease duration at the initiation of levodopa was not. Prospective follow-up for a mean of 2.6 ± 1.3 years of a subgroup of 21 patients who were drug-naïve at baseline [median disease duration 4.5 (interquartile range, 2.3–5) years] revealed that the median time to development of motor fluctuations and dyskinesias after initiation of levodopa therapy was 6 months. We conclude that motor fluctuations and dyskinesias are not associated with the duration of levodopa therapy, but rather with longer disease duration and higher levodopa daily dose. Hence, the practice to withhold levodopa therapy with the objective of delaying the occurrence of motor complications is not justified. PMID:25034897

Akpalu, Albert; Sarfo, Fred Stephen; Cham, Momodou; Amboni, Marianna; Cereda, Emanuele; Fabbri, Margherita; Adjei, Patrick; Akassi, John; Bonetti, Alba; Pezzoli, Gianni

2014-01-01

295

MtDNA of Fulani nomads and their genetic relationships to neighboring sedentary populations.  

Science.gov (United States)

Despite the large size of the contemporary nomadic Fulani population (roughly 13 million people), the genetic diversity and degree of differentiation of Fulanis compared to other sub-Saharan populations remain unknown. We sampled four Fulani nomad populations (n = 186) in three countries of sub-Saharan Africa (Chad, Cameroon, and Burkina Faso) and analyzed sequences of the first hypervariable segment of the mitochondrial DNA. Most of the haplotypes belong to haplogroups of West African origin, such as L1b, L3b, L3d, L2b, L2c, and L2d (79.6% in total), which are all well represented in each of the four geographically separated samples. The haplogroups of Western Eurasian origin, such as J1b, U5, H, and V, were also detected but in rather low frequencies (8.1% in total). As in African hunter-gatherers (Pygmies and Khoisan) and some populations from central Tunisia (Kesra and Zriba), three of the Fulani nomad samples do not reveal significant negative values of Fu's selective neutrality test. The multidimensional scaling of FST genetic distances of related sub-Saharan populations and the analysis of molecular variance (AMOVA) show clear and close relationships between all pairs of the four Fulani nomad samples, irrespective of their geographic origin. The only group of nomadic Fulani that manifests some similarities with geographically related agricultural populations (from Guinea-Bissau and Nigeria) comes from Tcheboua in northern Cameroon. PMID:16900879

Cerný, V; Hájek, M; Bromová, M; Cmejla, R; Diallo, I; Brdicka, R

2006-02-01

296

Impact of vital status investigation procedures on estimates of survival in cohorts of HIV-infected patients from Sub-Saharan Africa.  

Science.gov (United States)

In HIV cohorts in sub-Saharan Africa, documenting vital status of patients lost to follow-up is a major challenge. The effect of specific vital status investigation procedures (VSIPs) on the number of known deaths has never been shown. We assessed the effects of VSIP on survival estimates in a 4-year prospective cohort study in Abidjan, Côte d'Ivoire. As of June 2000, 545 HIV-infected adults had been followed for 1186 person-years, of whom 233 were documented as deceased. Forty-eight percent of deaths were known through scheduled VSIPs, including reading of the newspaper obituaries (2%), telephone calls to relatives (10%), and home visits (36%). Survival probability at 1, 2, and 3 years was estimated to be 0.79, 0.65, and 0.56, respectively. Without VSIP, survival at 1, 2, and 3 years would have been estimated to be 11, 23, and 30% higher, respectively. In this large African capital city, survival estimates closely depended on VSIPs, mainly home visits. We suggest that the percentage of deaths known through VSIPs would be a useful indicator to be added when reporting survival data from urban HIV cohort studies in sub-Saharan Africa. PMID:15076249

Anglaret, Xavier; Toure, Siaka; Gourvellec, Gwénola; Tchehy, Amah; Zio, Lambert; Zaho, Marcel; Kassi, Marie-Cécile; Lehou, Jean; Coulibaly, Hélène; Seyler, Catherine; N'Dri-Yoman, Thérèse; Salamon, Roger; Chêne, Geneviève

2004-03-01

297

Quantitative urban classification for malaria epidemiology in sub-Saharan Africa  

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Full Text Available Abstract Background Although sub-Saharan Africa (SSA is rapidly urbanizing, the terms used to classify urban ecotypes are poorly defined in the context of malaria epidemiology. Lack of clear definitions may cause misclassification error, which likely decreases the accuracy of continent-wide estimates of malaria burden, limits the generalizability of urban malaria studies, and makes identification of high-risk areas for targeted interventions within cities more difficult. Accordingly, clustering techniques were applied to a set of urbanization- and malaria-related variables in Kisumu, Kenya, to produce a quantitative classification of the urban environment for malaria research. Methods Seven variables with a known or expected relationship with malaria in the context of urbanization were identified and measured at the census enumeration area (EA level, using three sources: a the results of a citywide knowledge, attitudes and practices (KAP survey; b a high-resolution multispectral satellite image; and c national census data. Principal components analysis (PCA was used to identify three factors explaining higher proportions of the combined variance than the original variables. A k-means clustering algorithm was applied to the EA-level factor scores to assign EAs to one of three categories: "urban," "peri-urban," or "semi-rural." The results were compared with classifications derived from two other approaches: a administrative designation of urban/rural by the census or b population density thresholds. Results Urban zones resulting from the clustering algorithm were more geographically coherent than those delineated by population density. Clustering distributed population more evenly among zones than either of the other methods and more accurately predicted variation in other variables related to urbanization, but not used for classification. Conclusion Effective urban malaria epidemiology and control would benefit from quantitative methods to identify and characterize urban areas. Cluster analysis techniques were used to classify Kisumu, Kenya, into levels of urbanization in a repeatable and unbiased manner, an approach that should permit more relevant comparisons among and within urban areas. To the extent that these divisions predict meaningful intra-urban differences in malaria epidemiology, they should inform targeted urban malaria interventions in cities across SSA.

Slutsker Laurence

2008-02-01

298

Prevalence of vitamin D insufficiency and risk factors for type 2 diabetes and cardiovascular disease among African migrant and refugee adults in Melbourne: a pilot study.  

Science.gov (United States)

Migration to industrialised countries poses a "double whammy" for type 2 diabetes among sub-Saharan African migrant and refugee adults. This population group has been found to be at an increased risk of obesity and type 2 diabetes, which may be further aggravated by inadequate vitamin D status. Thus, this study aimed to describe the demographics of vitamin D insufficiency, obesity, and risk factors for type 2 diabetes among sub-Saharan African migrants and refugees aged 20 years or older living in Melbourne, Australia (n=49). Data were obtained by a questionnaire, medical assessment, and fasting blood samples. The mean serum 25-hydroxyvitamin D level was 27.3 nmol/L (95% CI: 22.2, 32.4 nmol/L); with 25-hydroxyvitamin D levels =2), 25% had low density lipoprotein cholesterol levels >=3.5 mmol/L, 24.5% had high density lipoprotein cholesterol levels =5.2 mmol/L), 18.2% had borderline or high levels of triglyceride (>=1.7 mmol/L), and 16% had hypertension (systolic blood pressure >=140 mmHg or diastolic blood pressure >=90 mmHg). These findings suggest that sub-Saharan African migrants and refugees may be at risk of type 2 diabetes and atherosclerosis-related diseases such as ischemic heart disease, stroke, and peripheral vascular disease. Well-designed vitamin D interventions that incorporate lifestyle changes are urgently needed in this sub-population. PMID:21859658

Renzaho, Andre Mn; Nowson, Caryl; Kaur, Ambi; Halliday, Jennifer A; Fong, David; Desilva, Janina

2011-01-01

299

Evidence of an Overweight/Obesity Transition among School-Aged Children and Youth in Sub-Saharan Africa: A Systematic Review  

Science.gov (United States)

Background Prevalence of childhood overweight/obesity has increased considerably in recent years. The transition to higher rates of overweight/obesity has been well documented in high income countries; however, consistent or representative data from lower income countries is scarce. It is therefore pertinent to assess if rates of overweight/obesity are also increasing in lower income countries, to inform public health efforts. Objective This systematic review aimed to investigate the evidence for an overweight/obesity transition occurring in school-aged children and youth in Sub Saharan Africa. Methods Studies were identified by searching the MEDLINE, Embase, Africa Index Medicus, Global Health, Geobase, and EPPI-Centre electronic databases. Studies that used subjective or objective metrics to assess body composition in apparently healthy or population-based samples of children and youth aged 5 to 17 years were included. Results A total of 283 articles met the inclusion criteria, and of these, 68 were used for quantitative synthesis. The four regions (West, Central, East, and South) of Sub Saharan Africa were well represented, though only 11 (3.9%) studies were nationally representative. Quantitative synthesis revealed a trend towards increasing proportions of overweight/obesity over time in school-aged children in this region, as well as a persistent problem of underweight. Weighted averages of overweight/obesity and obesity for the entire time period captured were 10.6% and 2.5% respectively. Body composition measures were found to be higher in girls than boys, and higher in urban living and higher socioeconomic status children compared to rural populations or those of lower socioeconomic status. Conclusions This review provides evidence for an overweight/obesity transition in school-aged children in Sub Saharan Africa. The findings of this review serve to describe the region with respect to the growing concern of childhood overweight/obesity, highlight research gaps, and inform interventions. PROSPERO Registration Number CRD42013004399 PMID:24676350

Muthuri, Stella K.; Francis, Claire E.; Wachira, Lucy-Joy M.; LeBlanc, Allana G.; Sampson, Margaret; Onywera, Vincent O.; Tremblay, Mark S.

2014-01-01

300

Disability and HIV: a systematic review and a meta-analysis of the risk of HIV infection among adults with disabilities in Sub-Saharan Africa.  

Science.gov (United States)

More than one billion people worldwide are estimated to be living with a disability. A significant proportion of them lives in Sub-Saharan Africa where they are reported to be at increased risk of HIV. However, quantitative evidence on this remains scarce. A systematic review and a meta-analysis of the risk of HIV infection among people with disabilities living in Sub-Saharan Africa were undertaken. We searched all published or unpublished studies and national surveys reporting HIV prevalence among adults with disabilities living in Sub-Saharan Africa between 2000 and 2013. The risk ratio (RR) of HIV infection in people with disabilities versus people without disabilities was estimated through a random-effects meta-analysis. Of the 12,252 references screened, 13 studies were selected. HIV prevalence varied widely across studies from 1.1% to 29%. Pooled RRs of HIV infection in people with disabilities compared to the general population were 1.31 (1.02-1.69) overall; 1.16 (0.71-1.87) among people with mental illness or intellectual disabilities and 1.07 (0.58-1.95) among people with hearing disabilities. This meta-analysis provides evidence that people with disabilities do not have a lower risk of HIV when compared to the general population, and that women with disabilities are especially affected. A clear increasing gradient in the risk of HIV according to gender and disability status was also observed. The important heterogeneity across studies and their varying quality warrant a closer look at the intersection between disability and HIV. Additional studies with more systematic approaches and with higher-quality methodologies are required to further address this knowledge gap. PMID:25033274

De Beaudrap, Pierre; Mac-Seing, Muriel; Pasquier, Estelle

2014-12-01

 
 
 
 
301

A Concept for a Flexible Rehabilitation Tool for sub-Saharan Africa  

DEFF Research Database (Denmark)

This concept paper explores a technological building block approach to the development of a flexible rehabilitation tool that may address some of the needs in sub-Saharan Africa. We briefly outline some of the health challenges that lead us to suggest a concept for physical rehabilitation solutions to address many diverse patient groups (e.g. disabled children, cardiac, and stroke patients), to be used in both urban and rural areas, to be easily used in community based rehabilitation (e.g. by community rehabilitation workers), to motivate the users, and to be robust to failure (e.g. power failure) in remote areas. The concept leads to the implementation of modular interactive tiles for rehabilitation, and suggestions for future use in sub-Saharan Africa.

Lund, Henrik Hautop

2012-01-01

302

SME Adoption of Enterprise Systems in Sub-Saharan Africa : A Clarion Call to Action  

DEFF Research Database (Denmark)

This paper discusses the need for IS research with a focus on SME adoption of enterprise systems in the context of Sub-Saharan Africa. Previous IS research into general adoption in several developing countries have shown that local context play a significant role in the successful implementation of any information system. SMEs constitute a majority of all organizations in most Sub Saharan economies, thus their importance to the socioeconomic development and empowerment of the region cannot be overemphasized. However, the absence of literature and focused research into factors that influence enterprise systems adoption and use that are particular to this region represents a huge gap for both researchers and practitioners. This call to action paper will attempt to present the implications of this deficiency and outline areas where future research can be most beneficial to stakeholders.

Adisa, Femi

303

Admixture and population stratification in African Caribbean populations.  

Science.gov (United States)

Throughout biomedical research, there is growing interest in the use of ancestry informative markers (AIMs) to deconstruct racial categories into useful variables. Studies on recently admixed populations have shown significant population substructure due to differences in individual ancestry; however, few studies have examined Caribbean populations. Here we used a panel of 28 AIMs to examine the genetic ancestry of 298 individuals of African descent from the Caribbean islands of Jamaica, St. Thomas and Barbados. Differences in global admixture were observed, with Barbados having the highest level of West African ancestry (89.6%+/- 2.0) and the lowest levels of European (10.2%+/- 2.2) and Native American ancestry (0.2%+/- 2.0), while Jamaica possessed the highest levels of European (12.4%+/- 3.5) and Native American ancestry (3.2%+/- 3.1). St. Thomas, USVI had ancestry levels quite similar to African Americans in continental U.S. (86.8%+/- 2.2 West African, 10.6%+/- 2.3 European, and 2.6%+/- 2.1 Native American). Significant substructure was observed in the islands of Jamaica and St. Thomas but not Barbados (K=1), indicating that differences in population substructure exist across these three Caribbean islands. These differences likely stem from diverse colonial and historical experiences, and subsequent evolutionary processes. Most importantly, these differences may have significant ramifications for case-control studies of complex disease in Caribbean populations. PMID:17908263

Benn-Torres, J; Bonilla, C; Robbins, C M; Waterman, L; Moses, T Y; Hernandez, W; Santos, E R; Bennett, F; Aiken, W; Tullock, T; Coard, K; Hennis, A; Wu, S; Nemesure, B; Leske, M C; Freeman, V; Carpten, J; Kittles, R A

2008-01-01

304

Rural development from a territorial perspective: lessons and potential in sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The paper analyzes the lessons and potential poverty impacts involved in the application of approaches for building socially inclusive, decentralized and spatially accented approaches to rural (and rural-urban) economic development in South Africa and other experiences making a preliminary assessment of the transferability of LED / RTD approaches to other countries in Sub-Saharan Africa such as Mozambique, Zambia and Ghana. In each case the role of the drivers of change, the rural-urban lin...

Quan, Julian; Davis, Junior; Proctor, Felicity

2006-01-01

305

Factors associated with maternal mortality in Sub-Saharan Africa: an ecological study  

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Full Text Available Abstract Background Maternal health is one of the major worldwide health challenges. Currently, the unacceptably high levels of maternal mortality are a common subject in global health and development discussions. Although some countries have made remarkable progress, half of the maternal deaths in the world still take place in Sub-Saharan Africa where little or no progress has been made. There is no single simple, straightforward intervention that will significantly decrease maternal mortality alone; however, there is a consensus on the importance of a strong health system, skilled delivery attendants, and women's rights for maternal health. Our objective was to describe and determine different factors associated with the maternal mortality ratio in Sub-Saharan countries. Methods An ecological multi-group study compared variables between many countries in Sub-Saharan Africa using data collected between 1997 and 2006. The dependent variable was the maternal mortality ratio, and Health care system-related, educational and economic indicators were the independent variables. Information sources included the WHO, World Bank, UNICEF and UNDP. Results Maternal mortality ratio values in Sub-Saharan Africa were demonstrated to be high and vary enormously among countries. A relationship between the maternal mortality ratio and some educational, sanitary and economic factors was observed. There was an inverse and significant correlation of the maternal mortality ratio with prenatal care coverage, births assisted by skilled health personnel, access to an improved water source, adult literacy rate, primary female enrolment rate, education index, the Gross National Income per capita and the per-capita government expenditure on health. Conclusions Education and an effective and efficient health system, especially during pregnancy and delivery, are strongly related to maternal death. Also, macro-economic factors are related and could be influencing the others.

Hernández Valentín

2009-12-01

306

Patterns of biomedical science production in a sub-Saharan research center  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Research activities in sub-Saharan Africa may be limited to delegated tasks due to the strong control from Western collaborators, which could lead to scientific production of little value in terms of its impact on social and economic innovation in less developed areas. However, the current contexts of international biomedical research including the development of public-private partnerships and research institutions in Africa suggest that scientific activi...

Agnandji Selidji T; Tsassa Valerie; Conzelmann Cornelia; Köhler Carsten; Ehni Hans-Jörg

2012-01-01

307

Gender difference in support for democracy in sub-Saharan Africa: Do social institutions matter?  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Little investigation has been made to explain why women are less likely than are men to support democracy in sub-Saharan Africa. This gender difference in politics has been found in numerous studies and may hinder the much needed legitimation of democracy in this region. This paper addresses the question of whether this observed gender gap is due to the omission of social institutions related to gender inequality, something that affects women's daily life and deprives them of autonomy at home...

Konte, Maty

2014-01-01

308

An estimate of the prevalence of epilepsy in Sub–Saharan Africa: A systematic analysis  

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Full Text Available Epilepsy is a leading serious neurological condition worldwide and has particularly significant physical, economic and social consequences in Sub–Saharan Africa. This paper aims to contribute to the understanding of epilepsy prevalence in this region and how this varies by age and sex so as to inform understanding of the disease characteristics as well as the development of infrastructure, services and policies.

Abigail Paul

2012-12-01

309

Efficient phosphorus application strategies for increased crop production in sub-Saharan West Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Comparable data are lacking from the range of environments found in sub-Saharan West Africa to draw more general conclusions about the relative merits of locally available rockphosphate (RockP) in alleviating phosphorus (P) constraints to crop growth. To fill this gap, a multi-factorial field experiment was conducted over 4 years at eight locations in Niger, Burkina Faso and Togo. These ranged in annual rainfall from 510 to 1300 mm. Crops grown were pearl millet (Pennisetum glaucum L.), sorgh...

Bu?rkert, Andreas; Bationo, Andre?; Piepho, Hans-peter

2001-01-01

310

A national policy for malaria elimination in Swaziland: a first for sub-Saharan Africa  

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Full Text Available Abstract Swaziland is working to be the first country in mainland sub-Saharan Africa to eliminate malaria. The highest level of Swaziland's government recently approved a national elimination policy, which endorses Swaziland's robust national elimination strategic plan. This commentary outlines Swaziland's progress towards elimination as well as the challenges that remain, primarily around securing long-term financial resources and managing imported cases from neighbouring countries.

Kandula Deepika

2011-10-01

311

How can Sub-Saharan Africa turn the China-India threat into an opportunity  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The rise of China and India – the Asian Driver economies – is transforming the global economic, political and social landscape. The challenges posed by their rapid growth and global emergence are increasingly at the centre of strategic debates in the large OECD economies. But what of their impacts on other low income economies in general, and sub-Saharan Africa (SSA) in particular? Perhaps these giant Asian economies, confronted with their own challenges in overcoming endemic and deeply-r...

Kaplinsky, Raphael

2009-01-01

312

The structural anatomy and institutional architecture of inclusive growth in sub-Saharan Africa  

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The distinct features of inclusive growth within the context of sub-Saharan Africa are identified. The anatomy of growth is analysed by exploring the interrelationship among growth, inequality, and poverty. The present growth spell appears to have been relatively inclusive. The recent structural transformation has led to a more normal and desirable migration process. Two alternatives development strategies are described: pro-poor growth and pro-growth poverty reduction. The finding that high ...

Thorbecke, Erik

2014-01-01

313

Technologies for heating, cooling and powering rural health facilities in sub-Saharan Africa  

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This paper examines technical and economic choices for rural electrification in Africa and presents the rationale for trigeneration (capability for electricity, heating, and cooling) in health and education applications. An archetypal load profile for a rural health clinic (25 kWhe/day and 118–139 kWht) is described, and a regional analysis is performed for sub-Saharan Africa by aggregating NASA meteorological data (insolation, temperature, and heating and cooling degree-days) using correla...

Orosz, Matthew; Quoilin, Sylvain; Hemond, Harold

2013-01-01

314

Managed groundwater development for water-supply security in Sub-Saharan Africa: investment priorities  

Scientific Electronic Library Online (English)

Full Text Available SciELO South Africa | Language: English Abstract in english In numerous countries of Sub-Saharan Africa the strategic agenda of the water-sector is undergoing substantial change because of demographic pressure, climate change and economic transformation. Two new policy questions are arising from the need to make better use of available groundwater storage to [...] improve water-supply security:

Stephen, Foster; Albert, Tuinhof; Frank van, Steenbergen.

315

The Disproportionate High Risk of HIV Infection Among the Urban Poor in Sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The link between HIV infection and poverty in sub-Saharan Africa (SSA) is rather complex and findings from previous studies remain inconsistent. While some argue that poverty increases vulnerability, existing empirical evidence largely support the view that wealthier men and women have higher prevalence of HIV. In this paper, we examine the association between HIV infection and urban poverty in SSA, paying particular attention to differences in risk factors of HIV infection between the urban ...

Magadi, Monica A.

2013-01-01

316

Experiences of leadership in health care in sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Leadership is widely regarded as central to effective health-care systems, and resources are increasingly devoted to the cultivation of strong health-care leadership. Nevertheless, the literature regarding leadership capacity building has been developed primarily in the context of high-income settings. Less research has been done on leadership in low-income settings, including sub-Saharan Africa, particularly in health care, with attention to historical, p...

Curry Leslie; Taylor Lauren; Chen Peggy; Bradley Elizabeth

2012-01-01

317

Governance of basic services provision in sub-Saharan Africa and the need to shift gear  

Digital Repository Infrastructure Vision for European Research (DRIVER)

During 1970 to mid 1980s, governments’ policies on basic services in sub-Saharan Africa (SSA) had an almost exclusive focus on directly provided, publicly-funded. This approach coupled with disintegration of the economic structures resulted in steep decline in people’s access to basic services. Recent developments however show that policies and strategies have changed and so is people’s access to the services. Decentralisation within the state and from the state to market and to civil s...

Awortwi, N.; Helmsing, A. H. J.

2007-01-01

318

Resource rents, democracy and corruption: Evidence from Sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We examine the effect of the interaction between resource rents and democracy on corruption for a panel of 29 Sub-Saharan countries during the period from 1985 to 2007. We find that higher resource rents lead to more corruption and that the effect is significantly stronger in less democratic countries. Surprisingly, we also find that higher resource rents lead to fewer internal conflicts and that less democratic countries face not a higher but a lower likelihood of conflicts following an incr...

Arezki, Rabah; Gylfason, Thorvaldur

2011-01-01

319

Building social capital for agricultural innovation : experiences with farmer groups in sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The main objective of this bulletin is to help in laying a stronger foundation for the generation of truly client-driven agricultural innovation systems in sub-Saharan Africa (SSA) in order to facilitate greater efficiency and effectiveness in achieving the overarching agricultural development objectives of sustained productivity gains, improved profitability, and poverty alleviation. Pioneering experiences with the Farmer Research Group (FRG) approach in many parts of SSA show that the build...

Heemskerk, W.; Wennink, B.

2004-01-01

320

Estimating the incidence of colorectal cancer in Sub–Saharan Africa: A systematic analysis  

Directory of Open Access Journals (Sweden)

Full Text Available Nearly two–thirds of annual mortality worldwide is attributable to non–communicable diseases (NCDs, with 70% estimated to occur in low– and middle–income countries (LMIC. Colorectal cancer (CRC accounts for over 600 000 deaths annually, but data concerning cancer rates in LMIC is very poor. This study analyses the data available to produce an estimate of the incidence of colorectal cancer in Sub–Saharan Africa (SSA.

Alice Graham

2012-12-01

 
 
 
 
321

Gendered perspectives on economic growth and development in sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Researchers have linked sub-Saharan Africa's (SSA) poor growth performance in recent decades to several factors, including geography, institutions, and low returns to investment. This literature has not yet integrated the research that identifies linkages between gender, economic development, and growth, however. This paper explores the macro effects of gender, transmitted via the productive sector and in the household, in part due to the tendency for work - paid and unpaid - to be gender-seg...

Seguino, Stephanie; Were, Maureen

2014-01-01

322

Hydrological education and training needs in Sub-Saharan Africa: requirements, constraints and progress  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This paper represents a perspective on the education and training needs related to hydrology and water resources science within the sub-Saharan Africa region and discusses the requirements of the region, some of the relatively recent developments and initiatives and some of the constraints that exist and remain difficult to surmount. The requirements include the development of academic research capacity and technical skill for both the private and public sector at a variety of levels....

Hughes, D. A.

2011-01-01

323

Hydrological education and training needs in sub-Saharan Africa: requirements, constraints and progress  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This paper represents a perspective on the education and training needs related to hydrology and water resources science within the sub-Saharan Africa region and discusses the requirements of the region, some of the relatively recent developments and initiatives and some of the constraints that exist and remain difficult to surmount. The requirements include the development of academic research capacity and technical skill for both the private and public sector at a variety of levels. Some of...

Hughes, D. A.

2012-01-01

324

Role of the U.S. Military in Countering China's Growing Influence in Sub-Saharan Africa.  

Science.gov (United States)

The United States military is the least effective component in countering the growing influence of China in Sub-Saharan Africa and should be a supporting effort to enhance the more important applications of economic, diplomatic and informational power. Di...

B. D. Gordon

2009-01-01

325

Analysis of Africanized honey bee mitochondrial DNA reveals further diversity of origin  

Directory of Open Access Journals (Sweden)

Full Text Available Within the past 40 years, Africanized honey bees spread from Brazil and now occupy most areas habitable by the species Apis mellifera, from Argentina to the southwestern United States. The primary genetic source for Africanized honey bees is believed to be the sub-Saharan honey bee subspecies A. m. scutellata. Mitochondrial markers common in A. m. scutellata have been used to classify Africanized honey bees in population genetic and physiological studies. Assessment of composite mitochondrial haplotypes from Africanized honey bees, using 4 base recognizing restriction enzymes and COI-COII intergenic spacer length polymorphism, provided evidence for a more diverse mitochondrial heritage. Over 25% of the "African" mtDNA found in Africanized populations in Argentina are derived from non-A. m. scutellata sources.

Sheppard Walter S.

1999-01-01

326

Diverging Pathways : Young Female Employment and Entrepreneurship in Sub-Saharan Africa  

DEFF Research Database (Denmark)

Shrinking public sectors and limited opportunities for gaining formal wage employment in the private sector have resulted in entrepreneurship being promoted as a means of generating youth employment. This discourse is being widely promoted within sub-Saharan Africa despite little being known about how best to support youth employment and entrepreneurship. This paper focuses on two of the main trades which young women in sub-Saharan Africa have typically entered: hairdressing and dressmaking. Through drawing on a qualitative case study of hairdressers and seamstresses in Ghana, it is shown how the two professions have fared quite differently in recent years: whereas hairdressing has boomed, dressmaking has been stagnating. The paper shows how these diverging trajectories can be attributed to three related factors. First, globalisation has affected the two trades differently; second, their respective trade associations have reacted differently to the new constraints and opportunities generated by globalisation and their training systems have undergone different degrees of professionalisation; and third, the prestige associated with the two professions has changed affecting the aspirations of young women to enter the professions and the experiences of those that do. As the paper shows, geographers potentially have much to contribute to employment and entrepreneurship debates by providing more contextualised studies which recognise the complex interplay between globalisation, institutions and individuals in particular places and acknowledge the ensuing diverse employment experiences. Such studies are highly relevant for policymakers who are facing the difficult challenge of how to create employment and stimulate entrepreneurship in sub-Saharan Africa.

Langevang, Thilde; Gough, Katherine

2012-01-01

327

Role of pathology in sub-Saharan Africa: An example from Sudan  

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Full Text Available Khalid Dafaallah, Awadelkarim1, Ahmed Abdalla, Mohamedani2, Massimo Barberis31Department of Molecular Biology, National Cancer Institute, 2Department of Pathology, Faculty of Medicine, University of Gezira, Wad Medani, Sudan; 3Department of Pathology, European Institute of Oncology, Milan, ItalyAbstract: In sub-Saharan Africa there is an extreme shortage of pathology services and, when provided, they are of unacceptable standard. Specimen handling and storage are very poor, and render this important aspect of medicinal practice rudimentary. The situation on the ground reflects the full spectrum of the educational, cultural, political, and economical challenges that must be confronted in building basic scientific capabilities in the life sciences, including medicine, in such countries. It is a difficult and often discouraging situation, however, several constructive initiatives have been promoted to address this problem. In this paper we describe the current state of pathology services in sub-Saharan Africa, documenting our experience in Sudan. We also report some of the results obtained by others and our future goals, and propose how pathology-related problems could be addressed in sub-Saharan Africa, by focusing on specific critical points, which may also be considered for other developing countries outside Africa.Keywords: pathology, Africa, networks, standard operative procedures, telepathology

Khalid Dafaallah

2010-05-01

328

Single motherhood and child mortality in sub-Saharan Africa: a life course perspective.  

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Single motherhood in sub-Saharan Africa has received surprisingly little attention, although it is widespread and has critical implications for children's well-being. Using survival analysis techniques, we estimate the probability of becoming a single mother over women's life course and investigate the relationship between single motherhood and child mortality in 11 countries in sub-Saharan Africa. Although a mere 5 % of women in Ethiopia have a premarital birth, one in three women in Liberia will become mothers before first marriage. Compared with children whose parents were married, children born to never-married single mothers were significantly more likely to die before age 5 in six countries (odds ratios range from 1.36 in Nigeria to 2.61 in Zimbabwe). In addition, up to 50 % of women will become single mothers as a consequence of divorce or widowhood. In nine countries, having a formerly married mother was associated with a significantly higher risk of dying (odds ratios range from 1.29 in Zambia to 1.75 in Kenya) relative to having married parents. Children of divorced women typically had the poorest outcomes. These results highlight the vulnerability of children with single mothers and suggest that policies aimed at supporting single mothers could help to further reduce child mortality in sub-Saharan Africa. PMID:23839100

Clark, Shelley; Hamplová, Dana

2013-10-01

329

HIV/AIDS mitigation strategies and the State in sub-Saharan Africa – the missing link?  

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Full Text Available Abstract Background The HIV/AIDS pandemic in sub-Saharan Africa is widely recognised as a development disaster threatening poverty reduction, economic growth and not merely a health issue. Its mitigation includes the societal-wide adoption and implementation of specific health technologies, many of which depend on functional institutions and State. Discussion Donor and International Institutions' strategies to mitigate HIV/AIDS in sub-Saharan Africa are premised on a single optimal model of the State, one which focuses on the decentralised delivery of public goods alone (such as healthcare – the service delivery state. The empirical evidence, though sparse, of "successful" and "unsuccessful" sub-Saharan Africa states' performance in mitigating HIV/AIDS does not support this model. Rather, the evidence suggests an alternative model that takes a country context specific approach – encompassing political power, institutional structures and the level of health technology needed. This model draws on the historical experience of East Asian countries' rapid development. Summary For international public health policies to be effective, they must consider a country tailored approach, one that advocates a coordinated strategy designed and led by the State with involvement of wider society specific to each country's particular history, culture, and level of development.

Johnston Deborah

2006-01-01

330

Diet and mortality rates in Sub-Saharan Africa: Stages in the nutrition transition  

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Full Text Available Abstract Background During the last century we have seen wide-reaching changes in diet, nutritional status and life expectancy. The change in diet and physical activity patterns has become known as the nutrition transition. At any given time, a country or region within a country may be at different stages within this transition. This paper examines a range of nutrition-related indicators for countries in Sub-Saharan Africa (SSA and attempts to develop a typical model of a country in transition. Methods Based on the availability of data, 40 countries in SSA were selected for analysis. Data were obtained from the World Health Organisation, Demographic and Health Surveys and the Food and Agriculture Organisation of the United Nations. Multiple linear regression analysis (MLRA was used to explore the determinants of infant mortality. A six point score was developed to identify each country's stage in the nutrition transition. Results MLRA showed that underweight-for-age, protein and the percentage of exclusively breastfed infants were associated with the infant mortality rate (IMR. The majority of countries (n = 26 used in the analysis had nutrition transition scores of zero and one. Most of them had a high prevalence of infant mortality, children that were stunted or underweight-for-age, small percentages of women that were overweight and obese, and low intakes of energy, protein, and fat. Countries with the highest scores include South Africa, Ghana, Gabon, Cape Verde and Senegal which had relatively low IMRs, high levels of obesity/overweight, and low levels of underweight in women, as well as high intakes of energy and fat. These countries display classic signs of a population well established in the nutrition-related non-communicable disease phase of the nutrition transition. Conclusions Countries in SSA are clearly undergoing a nutrition transition. More than half of them are still in the early stage, while a few have reached a point where changes in dietary patterns are affecting health outcomes in a large portion of the population. Those in the early stage of the transition are especially important, since primordial prevention can still be introduced.

Steyn Nelia P

2011-10-01

331

Diet and mortality rates in Sub-Saharan Africa: Stages in the nutrition transition  

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Background During the last century we have seen wide-reaching changes in diet, nutritional status and life expectancy. The change in diet and physical activity patterns has become known as the nutrition transition. At any given time, a country or region within a country may be at different stages within this transition. This paper examines a range of nutrition-related indicators for countries in Sub-Saharan Africa (SSA) and attempts to develop a typical model of a country in transition. Methods Based on the availability of data, 40 countries in SSA were selected for analysis. Data were obtained from the World Health Organisation, Demographic and Health Surveys and the Food and Agriculture Organisation of the United Nations. Multiple linear regression analysis (MLRA) was used to explore the determinants of infant mortality. A six point score was developed to identify each country's stage in the nutrition transition. Results MLRA showed that underweight-for-age, protein and the percentage of exclusively breastfed infants were associated with the infant mortality rate (IMR). The majority of countries (n = 26) used in the analysis had nutrition transition scores of zero and one. Most of them had a high prevalence of infant mortality, children that were stunted or underweight-for-age, small percentages of women that were overweight and obese, and low intakes of energy, protein, and fat. Countries with the highest scores include South Africa, Ghana, Gabon, Cape Verde and Senegal which had relatively low IMRs, high levels of obesity/overweight, and low levels of underweight in women, as well as high intakes of energy and fat. These countries display classic signs of a population well established in the nutrition-related non-communicable disease phase of the nutrition transition. Conclusions Countries in SSA are clearly undergoing a nutrition transition. More than half of them are still in the early stage, while a few have reached a point where changes in dietary patterns are affecting health outcomes in a large portion of the population. Those in the early stage of the transition are especially important, since primordial prevention can still be introduced. PMID:21995618

2011-01-01

332

Patterns of chloroquine use and resistance in sub-Saharan Africa: a systematic review of household survey and molecular data  

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Full Text Available Abstract Background As a result of widespread chloroquine and sulphadoxine-pyrimethamine (SP resistance, 90% of sub-Saharan African countries had adopted policies of artemisinin-based combination therapy (ACT for treatment of uncomplicated malaria by 2007. In Malawi, cessation of chloroquine use was followed by the re-emergence of chloroquine-susceptible malaria. It was expected that introduction of ACT would lead to a return in chloroquine susceptibility throughout Africa, but this has not yet widely occurred. This observation suggests that there is continuing use of ineffective anti-malarials in Africa and that persistent chloroquine-resistant malaria is due to ongoing drug pressure despite national policy changes. Methods To estimate drug use on a national level, 2006-2007 Demographic Health Survey and Multiple Indicator Cluster Survey data from 21 African countries were analysed. Resistance data were compiled by systematic review of the published literature on the prevalence of the Plasmodium falciparum chloroquine resistance transporter polymorphism at codon 76, which causes chloroquine resistance. Results Chloroquine was the most common anti-malarial used according to surveys from 14 of 21 countries analysed, predominantly in West Africa. SP was most commonly reported in two of 21 countries. Among eight countries with longitudinal molecular resistance data, the four countries where the highest proportion of children treated for fever received chloroquine (Uganda, Burkina Faso, Guinea Bissau, and Mali also showed no significant declines in the prevalence of chloroquine-resistant infections. The three countries with low or decreasing chloroquine use among children who reported fever treatment (Malawi, Kenya, and Tanzania had statistically significant declines in the prevalence of chloroquine resistance. Conclusions This study demonstrates that in 2006-2007, chloroquine and SP continued to be used at high rates in many African countries. In countries reporting sustained chloroquine use, chloroquine-resistant malaria persists. In contrast, a low level of estimated chloroquine use is associated with a declining prevalence of chloroquine resistance.

Venkatesan Meera

2011-05-01

333

Is gold mining a bane or a blessing in Sub-Saharan Africa: The case of Ghana  

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Full Text Available Mining is one of the controversial industries, all over the world, particularly in sub-Saharan African countries. This is because the industry is fraught with lots of institutional and socio-economic contradictions, which is characterized by large multi-national companies. Mining in Ghana’s western region, where gold is mainly exploited, presents different situations with greater expectations for community development. In all, a total of 102 household questionnaires and key informant interviews were administered and conducted in the three selected communities respectively. In Ghana, host communities to multinational companies have lived on their edges, typified by abject poverty, state of despondency and sometimes, productive resources dispossession. These, the study found out to be contrary to what should be expected from the assertion of gold mining; which connotes wealth creation and development. Using a qualitative and quantitative research design in three selected communities: Tarkwa, Damang and Prestea in the Western region of Ghana, we examine these paradoxes in the context of the relationships between mining companies and the socio-economic implications of livelihoods and survival of these communities.

Divine Odame Appiah

2012-12-01

334

Coastal ocean research in sub-Saharan Africa: towards operational oceanography using satellites, in situ measurements and numerical models  

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Sub-Saharan Africa is greatly influenced by major western boundary currents of the Indian Ocean, Agulhas Current and the Somali Current (for six months of the year), and the major eastern boundary upwelling current systems of the Atlantic Ocean, with their concomitant nu-trient rich upwelling ecosystems which support large fisheries: the Benguela Upwelling System and the Canary Upwelling System. The location of the tip of placecountry-regionSouth Africa is unique in the world oceans, since it is such the only place where a warm western boundary current can interact with a cold upwelling ecosystem. In addition, the Agulhas Current is unique in that it retroflects 80% of its large volume flux back into the placeIndian Ocean. The interocean transport of warm thermocline water from the Indian to the placeAtlantic ocean is of global importance. Satellite observations of temperature, chlorophyll, sea surface height, and wind and waves have elucidated many of these first order processes. Numerical ocean models forced and constrained by satellite measurements are being increasingly used to place operational oceanography on a sound footing. Partnerships with African and northern hemisphere collaborators (e.g. the new Norwegian Nansen-Tutu Centre for Marine Research, PlaceNamePrinceton PlaceTypeUniversity) will enhance operational oceanography around placeAfrica to the benefit of all its inhabitants. All of the above aspects will be discussed, with specific examples of local innovative space borne techniques.

Shillington, Frank

335

Role and outcomes of community health workers in HIV care in sub-Saharan Africa: a systematic review  

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Introduction: The provision of HIV treatment and care in sub-Saharan Africa faces multiple challenges, including weak health systems and attrition of trained health workers. One potential response to overcome these challenges has been to engage community health workers (CHWs). Methodology: A systematic literature search for quantitative and qualitative studies describing the role and outcomes of CHWs in HIV care between inception and December 2012 in sub-Saharan Africa was performed in the fo...

Mwai, Grace W.; Gitau Mburu; Kwasi Torpey; Peter Frost; Nathan Ford; Janet Seeley

2013-01-01

336

Policy options of agricultural biotechnology R&D in Sub-Saharan Africa: key issues and aspects  

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This paper reviews the status of Agricultural Biotechnology in Sub-Saharan Africa. It addresses the potential economic benefits to Sub-Saharan Africa and the effect biotechnology policies may have on growth, production and poverty reduction. The extent to which agricultural biotechnology will compound or mitigate the constraints faced by smallholders/subsistence farmers is also discussed. The status of crop biotechnology research worldwide is reviewed and the influence of intellectual propert...

Yawson, Robert M.; Yawson, Ivy

2008-01-01

337

Agreement between clinicians' and care givers' assessment of intelligence in Nigerian children with intellectual disability: 'ratio IQ' as a viable option in the absence of standardized 'deviance IQ' tests in sub-Saharan Africa  

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Full Text Available Abstract Background There may be need to assess intelligent quotient (IQ scores in sub-Saharan African children with intellectual disability, either for the purpose of educational needs assessment or research. However, modern intelligence scales developed in the western parts of the world suffer limitation of widespread use because of the influence of socio-cultural variations across the world. This study examined the agreement between IQ scores estimation among Nigerian children with intellectual disability using clinicians' judgment based on International Classification of Diseases, tenth Edition (ICD - 10 criteria for mental retardation and caregivers judgment based on 'ratio IQ' scores calculated from estimated mental age in the context of socio-cultural milieu of the children. It proposed a viable option of IQ score assessment among sub-Saharan African children with intellectual disability, using a ratio of culture-specific estimated mental age and chronological age of the child in the absence of standardized alternatives, borne out of great diversity in socio-cultural context of sub-Saharan Africa. Methods Clinicians and care-givers independently assessed the children in relation to their socio-cultural background. Clinicians assessed the IQ scores of the children based on the ICD - 10 diagnostic criteria for mental retardation. 'Ratio IQ' scores were calculated from the ratio of estimated mental age and chronological age of each child. The IQ scores as assessed by the clinicians were then compared with the 'ratio IQ' scores using correlation statistics. Results A total of forty-four (44 children with intellectual disability were assessed. There was a significant correlation between clinicians' assessed IQ scores and the 'ratio IQ' scores employing zero order correlation without controlling for the chronological age of the children (r = 0.47, df = 42, p = 0.001. First order correlation controlling for the chronological age of the children showed higher correlation score between clinicians' assessed IQ scores and 'ratio IQ' scores (r = 0.75, df = 41, p = 0.000. Conclusion Agreement between clinicians' assessed IQ scores and 'ratio IQ' scores was good. 'Ratio IQ' test would provide a viable option of assessing IQ scores in sub-Saharan African children with intellectual disability in the absence of culture-appropriate standardized intelligence scales, which is often the case because of great diversity in socio-cultural structures of sub-Saharan Africa.

Aguocha Chinyere M

2009-09-01

338

The movement ecology of the straw-colored fruit bat, Eidolon helvum, in sub-Saharan Africa assessed by stable isotope ratios.  

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Flying foxes (Pteropodidae) are key seed dispersers on the African continent, yet their migratory behavior is largely unknown. Here, we studied the movement ecology of the straw-colored fruit bat, Eidolon helvum, and other fruit bats by analyzing stable isotope ratios in fur collected from museum specimens. In a triple-isotope approach based on samples of two ecologically similar non-migratory pteropodids, we first confirmed that a stable isotope approach is capable of delineating between geographically distinct locations in Sub-Saharan Africa. A discriminant function analysis assigned 84% of individuals correctly to their capture site. Further, we assessed how well hydrogen stable isotope ratios (?(2)H) of fur keratin collected from non-migratory species (n = 191 individuals) records variation in ?(2)H of precipitation water in sub-Saharan Africa. Overall, we found positive, negative and no correlations within the six studied species. We then developed a reduced major axis regression equation based on individual data of non-migratory species to predict where potentially migratory E. helvum (n = 88) would come from based on their keratin ?(2)H. Across non-migratory species, ?(2)H of keratin and local water correlated positively. Based on the isoscape origin model, 22% of E. helvum were migratory, i.e. individuals had migrated over at least 250 km prior to their capture. Migratory individuals came from locations at a median distance of about 860 km from the collection site, four even from distances of at least 2,000 km. Ground-truthing of our isoscape origin model based on keratin ?(2)H of extant E. helvum (n = 76) supported a high predictive power of assigning the provenance of African flying foxes. Our study highlights that stable isotope ratios can be used to explain the migratory behavior of flying foxes, even on the isotopically relatively homogenous African continent, and with material collected by museums many decades or more than a century ago. PMID:23029206

Ossa, Gonzalo; Kramer-Schadt, Stephanie; Peel, Alison J; Scharf, Anne K; Voigt, Christian C

2012-01-01

339

Heart Surgery Practice in Sub Saharan Africa: Single Nigerian Institutional Midterm Results and Challenges  

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Full Text Available Background: The majority of prospective cardiac surgical patients in sub Saharan Africa lack access to open heart surgery. We reviewed our midterm results to identify the obstacles to growth and challenges with sustainability. Methods: Records of patients undergoing heart surgery at LASUTH from December 2004 to March 2006 were retrospectively reviewed for clinical and outcome data. Results: Twenty four patients age 10-50, mean 28.0 +/? 10.49 years and 13 (54.2% males underwent surgery. 12 (50.0% patients had mechanical valve replacements, 11 (45.8% closure of septal defects and 1 (4.2% left atrial myxoma resection. Logistic euroscore for valve patients was 5.81 +/? 4.74 while observed mortality was 8.3% (1/12. Overall 30 days operative mortality was 8.3% (2/24 and major morbidity 4.2% (1/24. Patients with septal defects closure stopped clinic visits within a year. Valve patients follow up was complete in 90.1% with mean duration of 55.2 +/? 15.3 months. Late events occurred only in females with mitral valve replacements. The 5-year freedom from thromboembolism and bleeding was 74.0% and survival 82.0% in valve patients. Conclusion: Despite limited resources heart surgery can safely be performed with good outcomes by trained local personnel under supervision of visiting foreign teams until they are proficient to operate independently. Patients with less complex congenital defects have excellent postsurgical outcomes, while patients with rheumatic valve replacement are subject to ongoing valve related morbidity and mortality therefore require lifetime follow up. Choice of prosthetic valve for the mostly indigent and poorly educated population remains a challenge. We now prefer stented tissue valve despite its known limitations, in child bearing age females desirous of childbirth and others unlikely to comply with anticoagulation regimen. Barriers to sustainability include poor infrastructures, few skilled manpower, inadequate funding and restricted patient access due to inability to pay without third party insurance or government Medicaid.

Jonathan O. Nwiloh

2014-03-01

340

Population divergence in East African coelacanths.  

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The coelacanth, Latimeria chalumnae, occurs at the Eastern coast of Africa from South Africa up to Kenya. It is often referred to as a living fossil mainly because of its nearly unchanged morphology since the Middle Devonian. As it is a close relative to the last common ancestor of fish and tetrapods, molecular studies mostly focussed on their phylogenetic relationships. We now present a population genetic study based on 71 adults from the whole known range of the species. Despite an overall low genetic diversity, there is evidence for divergence of local populations. We assume that originally the coelacanths at the East African Coast derived from the Comoros population, but have since then diversified into additional independent populations: one in South Africa and another in Tanzania. Unexpectedly, we find a split of the Comoran coelacanths into two sympatric subpopulations. Despite its undeniably slow evolutionary rate, the coelacanth still diversifies and is therefore able to adapt to new environmental conditions. PMID:22677282

Lampert, Kathrin P; Fricke, Hans; Hissmann, Karen; Schauer, Jürgen; Blassmann, Katrin; Ngatunga, Benjamin P; Schartl, Manfred

2012-06-01

 
 
 
 
341

Effects of Natural Selection and Gene Conversion on the Evolution of Human Glycophorins Coding for MNS Blood Polymorphisms in Malaria-Endemic African Populations  

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Malaria has been a very strong selection pressure in recent human evolution, particularly in Africa. Of the one million deaths per year due to malaria, more than 90% are in sub-Saharan Africa, a region with high levels of genetic variation and population substructure. However, there have been few studies of nucleotide variation at genetic loci that are relevant to malaria susceptibility across geographically and genetically diverse ethnic groups in Africa. Invasion of erythrocytes by Plasmodium falciparum parasites is central to the pathology of malaria. Glycophorin A (GYPA) and B (GYPB), which determine MN and Ss blood types, are two major receptors that are expressed on erythrocyte surfaces and interact with parasite ligands. We analyzed nucleotide diversity of the glycophorin gene family in 15 African populations with different levels of malaria exposure. High levels of nucleotide diversity and gene conversion were found at these genes. We observed divergent patterns of genetic variation between these duplicated genes and between different extracellular domains of GYPA. Specifically, we identified fixed adaptive changes at exons 3–4 of GYPA. By contrast, we observed an allele frequency spectrum skewed toward a significant excess of intermediate-frequency alleles at GYPA exon 2 in many populations; the degree of spectrum distortion is correlated with malaria exposure, possibly because of the joint effects of gene conversion and balancing selection. We also identified a haplotype causing three amino acid changes in the extracellular domain of glycophorin B. This haplotype might have evolved adaptively in five populations with high exposure to malaria.

Ko, Wen-Ya; Kaercher, Kristin A.

2011-01-01

342

The multiplicity of malaria transmission: a review of entomological inoculation rate measurements and methods across sub-Saharan Africa  

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Full Text Available Abstract Plasmodium falciparum malaria is a serious tropical disease that causes more than one million deaths each year, most of them in Africa. It is transmitted by a range of Anopheles mosquitoes and the risk of disease varies greatly across the continent. The "entomological inoculation rate" is the commonly-used measure of the intensity of malaria transmission, yet the methods used are currently not standardized, nor do they take the ecological, demographic, and socioeconomic differences across populations into account. To better understand the multiplicity of malaria transmission, this study examines the distribution of transmission intensity across sub-Saharan Africa, reviews the range of methods used, and explores ecological parameters in selected locations. It builds on an extensive geo-referenced database and uses geographical information systems to highlight transmission patterns, knowledge gaps, trends and changes in methodologies over time, and key differences between land use, population density, climate, and the main mosquito species. The aim is to improve the methods of measuring malaria transmission, to help develop the way forward so that we can better assess the impact of the large-scale intervention programmes, and rapid demographic and environmental change taking place across Africa.

Kelly-Hope Louise A

2009-01-01

343

Plasmodium falciparum msp1, msp2 and glurp allele frequency and diversity in sub-Saharan Africa  

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Full Text Available Abstract Background The efficacy of anti-malarial drugs is assessed over a period of 28-63 days (depending on the drugs' residence time following initiation of treatment in order to capture late failures. However, prolonged follow-up increases the likelihood of new infections depending on transmission intensity. Therefore, molecular genotyping of highly polymorphic regions of Plasmodium falciparum msp1, msp2 and glurp loci is usually carried out to distinguish recrudescence (true failures from new infections. This tool has now been adopted as an integral part of anti-malarial efficacy studies and clinical trials. However, there are concerns over its utility and reliability because conclusions drawn from molecular typing depend on the genetic profile of the respective parasite populations, but this profile is not systematically documented in most endemic areas. This study presents the genetic diversity of P. falciparum msp1, msp2 and glurp markers in selected sub-Saharan Africa countries with varying levels of endemicity namely Malawi, Tanzania, Uganda, Burkina Faso and São Tomé. Methods A total 780 baseline (Day 0 blood samples from children less than seven years, recruited in a randomized controlled clinical trials done between 1996 and 2000 were genotyped. DNA was extracted; allelic frequency and diversity were investigated by PCR followed by capillary electrophoresis for msp2 and fragment sizing by a digitalized gel imager for msp1 and glurp. Results and Conclusion Plasmodium falciparum msp1, msp2 and glurp markers were highly polymorphic with low allele frequencies. A total of 17 msp1 genotypes [eight MAD20-, one RO33- and eight K1-types]; 116 msp2 genotypes [83 3D7 and 33 FC27- types] and 14 glurp genotypes were recorded. All five sites recorded very high expected heterozygosity (HE values (0.68 - 0.99. HE was highest in msp2 locus (HE = 0.99, and lowest for msp1 (HE = 0.68 (P msp1, msp2 and glurp in malaria clinical trials in sub-Saharan Africa to discriminate new from recrudescent infections.

Snounou Georges

2011-04-01

344

Pattern of presentation of idiopathic polypoidal choroidal vasculopathy in Ibadan, Sub-Saharan Africa  

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Full Text Available TS Oluleye, Y Babalola Retina and Vitreous Unit, Department of Ophthalmology, University of Ibadan and University College Hospital, Ibadan, Nigeria Background: Idiopathic polypoidal choroidal vasculopathy is an abnormal choroidal vascular pathology similar to age-related macular degeneration. It may present with sudden visual loss from hemorrhagic retinal pigment epithelial detachment and breakthrough vitreous hemorrhage or with chronic recurrent episodes. The condition is not uncommon in the retina clinic at the University College Hospital, Ibadan, Sub-Saharan Africa. This study presents the pattern of presentation in Ibadan. Methods: We review all cases of idiopathic polypoidal choroidal vasculopathy seen from 2007 to 2012 in the retina clinic at the University College Hospital, Ibadan, to determine the major pattern of presentations, available treatment modalities, and visual outcomes. Results: Ten cases were seen during the study period. Their mean age was 58 years, with a male to female ratio of 1:4. The most common presenting complaint was sudden visual loss. Major examination findings were retinal pigment epithelial detachment, orange subretinal lesions, and breakthrough vitreous hemorrhage. The modalities of treatment available included vitrectomy to clear vitreous hemorrhage. Intravitreal bevacizumab reduced the height of the pigment epithelial detachment and cleared vitreous hemorrhage. Thermal laser was applied for extrafoveal lesions. Two patients with subfoveal lesions were referred abroad for photodynamic therapy. Visual outcome showed significant improvement in vitrectomized patients who presented with vitreous hemorrhage. Presenting vision of hand motion and light perception improved to vision ranging from counting fingers to 6/12 after vitrectomy. Conclusion: Idiopathic polypoidal choroidal vasculopathy may not be uncommon in Sub-Saharan Africa. A high index of suspicion is warranted in the diagnosis so as to provide timely intervention. Keywords: idiopathic polypoidal choroidal vasculopathy, retinal pigment epithelial detachment, presentations, Sub-Saharan Africa

Oluleye TS

2013-07-01

345

Essays on social protection and poverty transmission in Sub-Saharan Africa  

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The present Ph.D. dissertation deals with the analysis of micro data from developing countries. In particular, the underlying theme is the analysis of social protection and poverty transmission in Sub-Saharan Africa studied in different contexts (i.e. urban slums and rural villages) and at different levels (i.e. local and national samples). The thesis consists of three papers, each corresponding to a chapter. The first one focuses on the risk factors leading children to street life in Zambia...

Strobbe, Francesco

2010-01-01

346

Terrorism and Africa: on the danger of further attacks in Sub-Saharan Africa  

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"The attacks in Mombasa of November 2002 have drawn attention to a region of the world that had been considered a minor stage in the fight against terrorism following September 11, namely sub-Saharan Africa. The alliance against terrorism previously limited its efforts in this area to preventing al-Qaida fighters from finding refuge in the Horn of Africa. What seemed to have been forgotten was that the first monstrous attacks by al-Qaida took place in East Africa. In 1998, the US embassies in...

Mair, Stefan

2003-01-01

347

Policies, Programmes and Institutions of Water Sector in Sub-Saharan Africa  

International Nuclear Information System (INIS)

Meaningful investment in the water sector can easily increase food production and productivity of human resources and thus stimulate economic growth, human and environmental health. The author indicates that, the Mar del Plata Action Plan (1977), the New Delhi Statement (1990), Dublin Statement (1991)and the Agenda 21 Chapter 18 of UNCED (1992) emphasise the urgent need for integrated, sustainable water resources management. The publication looks at the policy development in the water sector, the disparities in the allocation of water supplies in the urban and the rural areas, the importance of water in the development of the industrial sector and how to manage the demand for water in sub-Saharan Africa

348

Antiretroviral therapy in sub-Saharan Africa: adherence lessons from tuberculosis and leprosy.  

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Declining drug costs and increases in international donor interest are leading to greater availability of antiretroviral treatment programmes for persons living with the human immunodeficiency virus in parts of sub-Saharan Africa. Ensuring adequate adherence to antiretroviral drug therapy is one of the principal challenges facing successful implementation in Africa, where 70% of the world's infected persons live. Tuberculosis and leprosy are two diseases of global importance whose control programmes can provide important lessons for developing antiretroviral drug adherence strategies. This paper examines various approaches used in tuberculosis and leprosy control which could help enhance adherence to antiretroviral therapy in resource-limited settings. PMID:15537453

Reid, S E; Reid, C A; Vermund, S H

2004-11-01

349

An analysis of off grid electrical systems in rural Sub-Saharan Africa  

International Nuclear Information System (INIS)

The decade leading up to the end of the last millennium saw systematic unbundling and privatisation of power utility companies in Sub-Saharan Africa. The new profit driven entrepreneurs have swiftly moved to consolidate in urban enclaves and put paid to any remote hope for future rural electrification. Consequently, rural communities have resorted to fending for themselves by adapting to off grid electrification. Most of these emerging installations are individual isolated units. This paper looks at various off gird electric system configurations in rural Kenya and suggests ways in which they could be reconfigured to be more energy efficient

350

Coal and peat in the sub-Saharan region of Africa: alternative energy options?  

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Coal and peat are essentially unused and in some cases unknown in sub-Saharan Africa. However, they might comprise valuable alternative energy sources in some or all of the developing nations of the region. The 11 countries considered in this appraisal reportedly contain coal and peat. On the basis of regional geology, another five countries might also contain coal-bearing rocks. If the resource potential is adequate, coal and peat might be utilized in a variety of ways including substituting for fuelwood, generating electricity, supplying process heat for local industry and increasing agricultural productivity. -from Author

Weaver, J.N.; Landis, E.R.

1990-01-01

351

African-American mitochondrial DNAs often match mtDNAs found in multiple African ethnic groups  

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Full Text Available Abstract Background Mitochondrial DNA (mtDNA haplotypes have become popular tools for tracing maternal ancestry, and several companies offer this service to the general public. Numerous studies have demonstrated that human mtDNA haplotypes can be used with confidence to identify the continent where the haplotype originated. Ideally, mtDNA haplotypes could also be used to identify a particular country or ethnic group from which the maternal ancestor emanated. However, the geographic distribution of mtDNA haplotypes is greatly influenced by the movement of both individuals and population groups. Consequently, common mtDNA haplotypes are shared among multiple ethnic groups. We have studied the distribution of mtDNA haplotypes among West African ethnic groups to determine how often mtDNA haplotypes can be used to reconnect Americans of African descent to a country or ethnic group of a maternal African ancestor. The nucleotide sequence of the mtDNA hypervariable segment I (HVS-I usually provides sufficient information to assign a particular mtDNA to the proper haplogroup, and it contains most of the variation that is available to distinguish a particular mtDNA haplotype from closely related haplotypes. In this study, samples of general African-American and specific Gullah/Geechee HVS-I haplotypes were compared with two databases of HVS-I haplotypes from sub-Saharan Africa, and the incidence of perfect matches recorded for each sample. Results When two independent African-American samples were analyzed, more than half of the sampled HVS-I mtDNA haplotypes exactly matched common haplotypes that were shared among multiple African ethnic groups. Another 40% did not match any sequence in the database, and fewer than 10% were an exact match to a sequence from a single African ethnic group. Differences in the regional distribution of haplotypes were observed in the African database, and the African-American haplotypes were more likely to match haplotypes found in ethnic groups from West or West Central Africa than those found in eastern or southern Africa. Fewer than 14% of the African-American mtDNA sequences matched sequences from only West Africa or only West Central Africa. Conclusion Our database of sub-Saharan mtDNA sequences includes the most common haplotypes that are shared among ethnic groups from multiple regions of Africa. These common haplotypes have been found in half of all sub-Saharan Africans. More than 60% of the remaining haplotypes differ from the common haplotypes at a single nucleotide position in the HVS-I region, and they are likely to occur at varying frequencies within sub-Saharan Africa. However, the finding that 40% of the African-American mtDNAs analyzed had no match in the database indicates that only a small fraction of the total number of African haplotypes has been identified. In addition, the finding that fewer than 10% of African-American mtDNAs matched mtDNA sequences from a single African region suggests that few African Americans might be able to trace their mtDNA lineages to a particular region of Africa, and even fewer will be able to trace their mtDNA to a single ethnic group. However, no firm conclusions should be made until a much larger database is available. It is clear, however, that when identical mtDNA haplotypes are shared among many ethnic groups from different parts of Africa, it is impossible to determine which single ethnic group was the source of a particular maternal ancestor based on the mtDNA sequence.

Jackson Fatimah

2006-10-01

352

Urbanization Drift and Obesity Epidemic in Sub-Saharan Africa: A Review of the Situation in Nigeria.  

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Full Text Available The growing trend of obesity worldwide and in sub-Saharan Africa can be linked to theurbanization drift experienced in recent years both in developed and developing countrieslike Nigeria, at four pivotal points namely: physical activity level, socio-economic status(SES, nutritional and psychosocial factors. Literature search was done usingMedline/PubMed and Google Scholar for published studies on the urbanization rate, andthe prevalence of overweight and obesity in Nigeria. The socio-demographic determinantsof obesity among adults in the Nigerian population were female gender, marriage, lowphysical activity level, positive family history, urban area of residence and age ? 40 years.Obesity was more prevalent among women of low SES living in the urban area than thoseof high SES. Also overweight and obesity was more prevalent among young children (girlsthan boys living in an urban than rural area and attending private than public schools. Inorder to prevent a higher trend of obesity in future, more of awareness/attitudinalreorientation programmes need to be created by health based action groups incollaboration with government agencies on perception, risky lifestyles and culturesassociated with excessive weight gain.

E.E Akpan

2013-06-01

353

Facing up to programmatic challenges created by the HIV/AIDS epidemic in sub-Saharan Africa.  

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Three decades after the emergence of HIV, we have made great strides in our response to the epidemic, from prevention of transmission to testing and treatment. However, it is still common in high-prevalence settings for people to not know their HIV status, and estimates are that globally, a mere 36% of those eligible for treatment are receiving it. On top of this, for every person with HIV entering treatment, two more are infected. The operational obstacles to overcoming the challenges and fully implementing proven strategies are numerous. The operational research and implementation sciences aim to provide a sound basis for how to maximize the use of limited resources by investigating the best models to deliver services and implement programmes in various settings and contexts. In this special issue, the Journal of the International AIDS Society intends to highlight some of the operational and programmatic challenges that are faced in sub-Saharan Africa, home to the largest population living with HIV. Our hope is that readers gain insight into some of the challenges associated with the HIV/AIDS epidemic and a changing environment in the region, and become familiar with some applications of operational research and implementation science in HIV healthcare settings. PMID:21967757

Heidari, Shirin; Harries, Anthony D; Zachariah, Rony

2011-01-01

354

Brain drain in sub-Saharan Africa: contributing factors, potential remedies and the role of academic medical centres.  

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A double jeopardy exists in resource-limited settings (RLS) in sub-Saharan Africa (SSA): there are a disproportionately greater number of acutely ill patients, but a paucity of healthcare workers (HCW) to care for them. SSA has 25% of the global disease burden but only 3% of the world's HCW. Thirty-two SSA countries do not meet the WHO minimum of 23 HCW per 10000 population. Contributing factors include insufficient supply, inadequate distribution and migration. Potential remedies include international workforce policies, non-governmental organisations, national and international medical organisations' codes of conduct, inter-country collaborations, donor-directed policies and funding to train more people in-country, and health system strengthening and task-shifting. Collaborations among academic institutions from resource-rich and poor countries can help address HCW supply, distribution and migration. It is now opportune to harness bright, committed people from academic centres in resource-rich and poor settings to create long-term, collaborative relationships focused on training, clinical skills and locally relevant research endeavours, who mutually strive for HCW retention, less migration, and ultimately sufficient HCW to provide optimal care in all RLS. PMID:22962319

Kasper, Jennifer; Bajunirwe, Francis

2012-11-01

355

Facing up to programmatic challenges created by the HIV/AIDS epidemic in sub-Saharan Africa  

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Full Text Available Abstract Three decades after the emergence of HIV, we have made great strides in our response to the epidemic, from prevention of transmission to testing and treatment. However, it is still common in high-prevalence settings for people to not know their HIV status, and estimates are that globally, a mere 36% of those eligible for treatment are receiving it. On top of this, for every person with HIV entering treatment, two more are infected. The operationa obstacles to overcoming the challenges and fully implementing proven strategies are numerous. The operational research and implementation sciences aim to provide a sound basis for how to maximize the use of limited resources by investigating the best models to deliver services and implement programmes in various settings and contexts. In this special issue, the Journal of the International AIDS Society intends to highlight some of the operational and programmatic challenges that are faced in sub-Saharan Africa, home to the largest population living with HIV. Our hope is that readers gain insight into some of the challenges associated with the HIV/AIDS epidemic and a changing environment in the region, and become familiar with some applications of operational research and implementation science in HIV healthcare settings.

Heidari Shirin

2011-07-01

356

A global approach to the management of EMR (Electronic Medical Records of patients with HIV/AIDS in Sub-Saharan Africa: the experience of DREAM Software  

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Full Text Available Abstract Background The DREAM Project operates within the framework of the national health systems of several sub-Saharan African countries and aims to introduce the essential components of an integrated strategy for the prevention and treatment of HIV/AIDS. The project is intended to serve as a model for a wide-ranging scale-up in the response to the epidemic. This paper aims to show DREAM's challenges and the solutions adopted. One of the solutions is the efficient management of the clinical data regarding the treatment of the patients and epidemiological analyses. Methods Specific software for the management of the patients' EMR has been created within the DREAM programme in order to deal with the challenges deriving from the context in which DREAM operates. Setting up a computer infrastructure in health centres, providing a power supply, as well as managing the data and the project resources efficiently and reliably, are some of the questions that have been analysed in this study. Results Over the years this software has proved that it is able to respond to the need for efficient management of the clinical data and organization of the health centres. Today it is used in 10 countries in sub-Saharan Africa by thousands of professionals and by now it has reached its fourth version. The medical files of over 73,000 assisted patients are managed by this software and the data collected with it have become essential for the epidemiological research that is carried out to improve the effectiveness of the therapy. Conclusion Sub-Saharan Africa is the region hardest hit by HIV and AIDS in the world. However, the resources and responses adopted so far, to confront the epidemic, have at times been rather minimalist. The DREAM project has faced the battle against the epidemic by equipping itself with qualitative standards comparable to Western ones. The experience of DREAM has revealed that it is indeed possible to guarantee levels of excellence in developing countries, also in the sphere of ICT (Information and Communication Technology, thus making the intervention even more effective and contributing to bridging the digital divide.

Peroni Marco

2009-09-01

357

HIV/AIDS and young age widowhood in sub-Saharan Africa.  

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This article investigates a probable hidden consequence of high rates of HIV infection and AIDS deaths-an apparently rising proportion of women aged below 50 years who are widowed. It is assumed that young widows who remain unmarried and are sexually active may widely disseminate HIV infection if they are seropositive and do not use condoms. Data from eight nationally representative social surveys in sub-Saharan Africa are analyzed. Four of the surveys are from countries with high HIV prevalence rates (about 10% of adults are HIV positive) and the other four surveys are from countries with relatively low prevalence rates (about 2% of adults are HIV positive). The proportion of young widows in six countries with relevant data are calculated and compared over time. The results show that the proportion of young widows is higher in countries with high HIV prevalence rates than in countries with low prevalence rates. Moreover, while the proportion of young widows decreased in countries with low HIV prevalence rates, the proportion increased in high-prevalence countries. The implications of these results for research policy in Sub-Saharan Africa are discussed. PMID:14998284

Adetunji, J A

2001-01-01

358

The economics of renewable energy expansion in rural Sub-Saharan Africa  

International Nuclear Information System (INIS)

Accelerating development in Sub-Saharan Africa will require massive expansion of access to electricity-currently reaching only about one third of households. This paper explores how essential economic development might be reconciled with the need to keep carbon emissions in check. We develop a geographically explicit framework and use spatial modeling and cost estimates from recent engineering studies to determine where stand-alone renewable energy generation is a cost effective alternative to centralized grid supply. Our results suggest that decentralized renewable energy will likely play an important role in expanding rural energy access. However, it will be the lowest cost option for a minority of households in Africa, even when likely cost reductions over the next 20 years are considered. Decentralized renewables are competitive mostly in remote and rural areas, while grid connected supply dominates denser areas where the majority of households reside. These findings underscore the need to decarbonize the fuel mix for centralized power generation as it expands in Africa. - Research highlights: ? Expansion of electricity access in Sub-Saharan Africa remains a development priority. ? Low carbon options are important to reduce GHG emissions growth and avoid lock-ins. ? Spatially explicit cost modeling guides choice of supply options. ? Decentralized renewables are lowest cost for a significant minority of households. ? Grid supply remains attractive, suggesting focus on decarbonizing centralized supply.

359

Biofuels development in Sub-Saharan Africa: Are the policies conducive?  

International Nuclear Information System (INIS)

This paper analyses national, regional and international biofuels policies and strategies to assess whether these policies promote or undermine the development of biofuels sector in Africa. Despite having a huge comparative advantage in land, labour and good climatic conditions favourable for the growing of energy crops, few countries in Sub-Saharan Africa have included biofuels strategies in their energy or national development policies. Further results show that while developed countries commit huge financial resources for research, technology development and the provision of tax-incentives to both producers and consumers, there is little government support for promoting biofuels in Africa. Although the consequences of biofuels on food supply remain uncertain, the mandatory blending of biofuels with fossil fuels by industrialized countries will create demand for land in Africa for the growing of energy crops for biofuels. This paper urgently calls upon national governments in Sub-Saharan Africa to develop appropriate strategies and regulatory frameworks to harness the potential economic opportunities from biofuels sector development, while protecting the environment and rural communities from the adverse effects of land alienation from the mainstream agriculture towards the growing of energy crops for biofuels at the expense of traditional food crops.