Abstract in english The aim of this study was to show how, in some particular circumstances, a physical marker can be used along with molecular markers in the research of an ancient people movement. A set of five Alu insertions was analysed in 42 subjects from a particular Tunisian group (El Hamma) that has, unlike most of the Tunisian population, a very dark skin, similar to that of sub-Saharans, and in 114 Tunisian subjects (Gabes sample) from the same governorate, but outside the group. O (more) ur results showed that the El Hamma group is genetically midway between sub-Saharan populations and North Africans, whereas the Gabes sample is clustered among North Africans. In addition, The A25 Alu insertion, considered characteristic to sub-Saharan Africans, was present in the El Hamma group at a relatively high frequency. This frequency was similar to that found in sub-Saharans from Nigeria, but significantly different from those found in the Gabes sample and in other North African populations. Our molecular results, consistent with the skin color status, suggest a sub-Saharan origin of this particular Tunisian group.

The Duffy blood group locus, which encodes a chemokine receptor, is characterized by three alleles-FY*A, FY*B, and FY*O. The frequency of the FY*O allele, which corresponds to the absence of Fy antigen on red blood cells, is at or near fixation in most sub-Saharan African populations but is very rar...

Urban mobility is increasingly becoming one of the planning and development issues for cities in the sub-Saharan Africa (SSA) region. Sub-Saharan cities are growing fast, outstripping the current transport infrastructure. Despite the population and spatial growth, many cities are defined by inadequate planning, rapid urbanisation and deteriorating transport infrastructure and services. In most sub-Saharan African countries, modes of urban mobility are highly dependent on income. Transport options are limited. In fact, walking and cycling are often the main means available for the majority of city commuters. Little effort is made to develop a range of transport options or to improve bike or walking paths. Combined with traffic jams, poor governance and the increasing cost of living, public ...

Sub-Saharan Africa suffers by far the greatest malaria burden worldwide and is currently undergoing a profound demographic change, with a growing proportion of its population moving to urban areas. Urbanisation is generally expected to reduce malaria transmission; however the disease still persists in African cities, in some cases at higher levels than in nearby rural areas. Objective. This paper aims to collate and analyse risk factors for urban malaria transmission throughout sub-Saharan Africa and to discuss their implications for control. Methods. A systematic search on malaria and urbanisation was carried out focusing on sub-Saharan Africa. Particular interest was taken in vector breeding sites in urban and periurban areas. Results. A variety of urban vector breeding sites were catalogued, the majority of which were artificial, including urban agriculture, tyre tracks, and ditches. Natural breeding sites varied according to location. Low socioeconomic status was a significant risk factor for malaria, often present in peri-urban areas. A worrying trend was seen in the adaptation of malaria vector species to the urban environment. Urban malaria is highly focused and control programs should reflect this. Conclusion. As urbanisation continues and vector species adapt, continued monitoring and control of urban malaria in sub-Saharan Africa is essential. PMID:23125863

Ankylosing spondylitis (AS) is the prototype for spondyloarthritis primarily affecting young men. Geographic and ethnic variations exist in the prevalence and severity of AS and relate to the wide disparity in the frequency of human leukocyte antigen (HLA)-B27, a major genetic risk factor. The strength of the disease association with HLA-B27 is lower in most Arab populations (25?75?%) than in Western European populations (>90?%), and there is no association in sub-Saharan Africa, where the prevalence of HLA-B27 is <1?%. Other epidemiologic differences between European and African populations are the apparent later age at presentation in sub-Saharan Africa, and the high rate of spondyloarthropathies associated with human immunodeficiency virus infection. Diagnosis of AS is often delayed 8?1...

Previous genetic studies have suggested a history of sub-Saharan African gene flow into some West Eurasian populations after the initial dispersal out of Africa that occurred at least 45,000 years ago. However, there has been no accurate characterization of the proportion of mixture, or of its date. We analyze genome-wide polymorphism data from about 40 West Eurasian groups to show that almost all Southern Europeans have inherited 1%-3% African ancestry with an average mixture date of around 55 generations ago, consistent with North African gene flow at the end of the Roman Empire and subsequent Arab migrations. Levantine groups harbor 4%-15% African ancestry with an average mixture date of about 32 generations ago, consistent with close political, economic, and cultural links with Egypt in the late middle ages. We also detect 3%-5% sub-Saharan African ancestry in all eight of the diverse Jewish populations that we analyzed. For the Jewish admixture, we obtain an average estimated date of about 72 generations. This may reflect descent of these groups from a common ancestral population that already had some African ancestry prior to the Jewish Diasporas. PMID:21533020

Abstract in english A southern Brazilian isolated community of predominantly sub-Saharan African origin, with a total population of 74 individuals and high degree of inbreeding (F = 0.081) was studied. The small sizes of the breeding (35) and effective (21) populations, as well as the very small effective migration rate (4%), suggest a high probability for the occurrence of genetic drift. A sample was typed for fourteen blood genetic systems and most of these systems seem to reveal the found (more) er effect. This evolutionary factor was probably responsible for the absence of some polymorphic alleles frequent in African populations, i.e.: ABO*B, RHD-RHCE*DCe, GPA-GPB*NS (MNSs*NS), GPA-GPB*NS U (MNSs*NSU), HBB*S, HP*2M and ESD*2. The most unusual allele frequency was that for BCHE*A, 0.27, four times higher than its highest estimated frequency and fifty times higher than that those observed in African populations. Considering the allele frequencies of the Sub-Saharan African (A) and European (E) ancestral populations, the population studied can be quantified as containing 97.33% ± 10.41 of A alleles and 2.67% ± 10.41 of E alleles.

Abstract This paper evaluates the effect of access to improved water sources and sanitation on 41 sub-Saharan African (SSA) countries' economic efficiency and growth. For this reason data envelopment analysis (DEA), bootstrap techniques and probabilistic approaches are used. The empirical results indicate that SSA countries' economic efficiency is positively influenced by the access of population both on improved water sources and sanitation. Finally, when the provision of access to improved water sources is provided to more than 50% of the population, the positive effect on countries' economic efficiency is much greater compared with the effect of providing sustainable access to improved sanitation to the same proportion of population.

The Gambia National Cancer Registry (GNCR) is one of the few nationwide population-based cancer registries in sub-Saharan Africa. Most registries in sub-Saharan Africa are limited to cities; therefore, the GNCR is important in providing estimates of cancer incidence in rural Africa. Our study assesses the quality of its data. The methods proposed by Bray and Parkin, and Parkin and Bray (Eur J Cancer 2009;45:747-64) were applied to the registry data from 1990 to 2009 to assess comparability, validity and completeness. The system used for classification and coding of neoplasms followed international standards. The percentage of cases morphologically verified was 18.1% for men and 33.1% for women, and that of death certificate only cases was 6.6 and 3.6%, respectively. Incidence rates in rural regions were lower than in the urban part of the country, except amongst young male adults. Comparison with other West African registries showed that the incidences of liver and uterine cervical cancer were comparable, but those of prostate and breast in The Gambia were relatively low. The overall completeness was estimated at 50.3% using the capture-recapture method. The GNCR applies international standard practices to data collection and handling, providing valuable data on cancer incidence in sub-Saharan Africa. However, the data are incomplete in the rural and elderly populations probably because of health care access and use. PMID:22618962

Paediatric drug formulations of artemisinin combination therapies and pharmacokinetic data supporting their use in African children are urgently needed for the effective treatment of young children suffering from falciparum malaria in sub-Saharan Africa. In this thesis the pharmacokinetic characteri...

AbstractBackground: Celiac disease is an autoimmune disorder that occurs in genetically susceptible individuals in whom the ingestion of dietary gluten induces intestinal mucosa inflammation. Previous studies suggest that celiac disease may either be very rare or underdiagnosed in African and/or African-derived population. Aim: Determine the prevalence of celiac disease in Sub-Saharan African-derived Brazilian communities using serological screening. Subjects and methods: Inhabitants from 10 African-derived communities from Northeastern of Brazil were screened for celiac disease. All sera were tested for endomysial class IgA antibody using indirect immunofluorescence. Results: No positive test for IgA-endomysial was observed in the 860 individuals tested. Conclusion: Our data suggests a lo...

Background.- Despite being a highly prevalent disorder and substantial cause of disability, migraine is understudied in Africa. Moreover, no previous study has investigated the effects of stress and unipolar psychiatric comorbidities on migraine in a sub-Saharan African cohort. Objective.- To evaluate the prevalence of migraine and its association with stress and unipolar psychiatric comorbidities among a cohort of African adults. Methods.- This was a cross-sectional epidemiologic study evaluating 2151 employed adults in sub-Saharan Africa. A standardized questionnaire was used to identify sociodemographic, headache, and lifestyle characteristics of participants. Migraine classification was based on the International Classification of Headache Disorders-2 diagnostic criteria. Depressive, anxiety, and stress symptoms were ascertained with the Patient Health Questionnaire and the Depression Anxiety Stress Scale, respectively. Multivariable logistic regression models were used to estimate adjusted odds ratio (OR) and 95% confidence intervals (CIs). Results.- A total of 9.8% (n?=?212) of study participants fulfilled criteria for migraine (9.8%, 95% CI 8.6-11.1) with a higher frequency among women (14.3%, 95% CI 11.9-16.6) than men (6.9%, 95% CI 5.5-8.3). Similar to predominantly Caucasian migraine cohorts, sub-Saharan African migraineurs were more likely to be younger, have a lower education, and more likely to report a poor health status than non-migraineurs. However, in contrast with historical reports in predominantly Caucasian migraine cohorts, sub-Saharan African migraineurs were less likely to report smoking than non-migraineurs. Participants with moderately severe depressive symptoms had over a 3-fold increased odds of migraine (OR?=?3.36, 95% CI 1.30-8.70) compared with those classified as having minimal or no depressive symptoms, and the odds of migraine increased with increasing severity of depressive symptoms (P trend?anxiety symptoms had increased odds of migraine (OR?=?2.28, 95% CI 1.24-4.21; OR?=?1.77, 95% CI 0.93-3.35; and OR?=?5.39, 95% CI 2.19-13.24, respectively). Finally, those with severe stress had a 3.57-fold increased odds of migraine (OR?=?3.57, 95% CI 1.35-9.46). Conclusion.- Although historically it has been reported that migraine prevalence is greater in Caucasians than African Americans, our study demonstrates a high migraine prevalence among urban-dwelling Ethiopian adults (9.9%) that is comparable with what is typically reported in predominantly Caucasian cohorts. Further, among employed sub-Saharan African adults and similar to predominantly Caucasian populations, migraine is strongly associated with stress and unipolar psychiatric symptoms. The high burden of migraine and its association with stress and unipolar psychiatric symptoms in our study of well-educated and urban-dwelling African adults has important clinical and public health implications pending confirmation in other African populations. PMID:23095087

The frequency distribution of Y-chromosome haplotypes at DNA polymorphism p49/TaqI was studied in a sample of 505 North Africans from Mauritania, Morocco, Algeria, Tunisia, Libya, and Egypt. A particularly high frequency (55.0%) of Y-haplotype 5 (A2, C0, D0, F1, I1) was observed in these populations, with a relative predominance in those of Berber origin. Examination of the relative frequencies of other haplotypes in these populations, mainly haplotype 4 (the "African" haplotype), haplotype 15 (the "European" haplotype), and haplotypes 7 and 8 (the "Near-East" haplotypes), permit useful comparisons with neighboring peoples living in sub-Saharan Africa, Europe, and the Near East. PMID:10885192

OBJECTIVE: Evaluate the process of screening and detection of HIV, HBV, HCV and syphilis in the province of Lleida by determining the proportions of positive results in the different groups during one year. DESIGN: Descriptive, multicentre study of all the serological tests performed in immigrants and natives attended in 2007. SETTING: Province of Lleida (Spain). PARTICIPANTS: 255,410 users. MAIN MEASUREMENTS: Age, sex, country of origin and period of residence in Spain, and the results for HIV, hepatitis B, hepatitis C and syphilis. We calculated the proportions in which a serological test had been requested, and examined the association between the rates of positive tests and the geographical area of origin, and calculated age-adjusted rates taking the age distribution of the native population as the reference. RESULTS: Risk of HBV was 4.6 times higher in immigrants than in natives (11.7 times in sub-Saharan Africans). The rate of positive syphilis tests was three times higher in the immigrant group. For HIV the PR was 2.3 (sub-Saharan Africans 7.4). For hepatitis C the risk was lower in immigrants than in natives (PR=0.4). CONCLUSIONS: Immigrants have a higher probability of testing positive in screening in hepatitis B, syphilis and HIV. The rates differ significantly according to the origin of the immigrant. PMID:23140837

Outside southern Africa little attention has been given to the lively debates, particularly within South Africa, about migration, economic integration, racism/xenophobia and exclusion. After the collapse of apartheid the Southern African Development Community (sadc) developed initiatives on regional co-operation on population movement in a far-reaching 1995 Draft Protocol on Free Movement. However, the post-apartheid South African state was concerned solely with free trade and, with the support of other regional players, managed to halt the Protocol. The processes of neoliberal regional integration, socioeconomic transformations, poverty and inequality, as well as the political turmoil in countries of the sub-Saharan region, have resulted in growth of migration to South Africa. The post-ap...

The processes of genetic admixture determine the haplotype structure and linkage disequilibrium patterns of the admixed population, which is important for medical and evolutionary studies. However, most previous studies do not consider the inherent complexity of admixture processes. Here we proposed two approaches to explore population admixture dynamics, and we demonstrated, by analyzing genome-wide empirical and simulated data, that the approach based on the distribution of chromosomal segments of distinct ancestry (CSDAs) was more powerful than that based on the distribution of individual ancestry proportions. Analysis of 1,890 African Americans showed that a continuous gene flow model, in which the African American population continuously received gene flow from European populations over about 14 generations, best explained the admixture dynamics of African Americans among several putative models. Interestingly, we observed that some African Americans had much more European ancestry than the simulated samples, indicating substructures of local ancestries in African Americans that could have been caused by individuals from some particular lineages having repeatedly admixed with people of European ancestry. In contrast, the admixture dynamics of Mexicans could be explained by a gradual admixture model in which the Mexican population continuously received gene flow from both European and Amerindian populations over about 24 generations. Our results also indicated that recent gene flows from Sub-Saharan Africans have contributed to the gene pool of Middle Eastern populations such as Mozabite, Bedouin, and Palestinian. In summary, this study not only provides approaches to explore population admixture dynamics, but also advances our understanding on population history of African Americans, Mexicans, and Middle Eastern populations. PMID:23103229

Twenty-one X-chromosomal short tandem repeat (STR) loci, including the six clusters of linked markers DXS10148-DXS10135-DXS8378 (Xp22), DXS7132-DXS10079-DXS10074 (Xq12), DXS6801-DXS6809-DXS6789 (Xq21), DXS7424-DXS101 (Xq22), DXS10103-HPRTB-DXS10101 (Xq26), DXS8377-DXS10146-DXS10134-DXS7423 (Xq28) and the loci DXS6800, GATA172D05 and DXS10011 were typed in a population sample from Ivory Coast (n=125; 51 men and 74 women). Allele and haplotype frequencies as well as linkage disequilibrium data for kinship calculations are provided. On the whole, no significant differences in the genetic variability of X-STR markers were observed between Ivorians and other sub-Saharan African populations belonging to the Niger-Kordofanian linguistic group. PMID:21717153

We compared perinatal mortality rates (PMRs) and the risk from certain causes among immigrant and native population in the Valencian Community (Spain). Using data from the Perinatal Mortality Registry, crude and age standardized mortality ratios were obtained in the different groups of mothers. Mortality rate ratios were calculated to compare the causes of death resulting from prematurity, congenital anomalies, infectious diseases and Sudden Infant Death Syndrome between Spanish and foreign women. PMRs were higher among all the immigrant groups compared with the native population, with a statistical significance in Eastern European and sub-Saharan mothers. Neonatal mortality rates in North African and Latin American mothers were similar to those of native women. Babies of immigrant mothers were at a significant higher risk of dying from late infectious diseases and from causes resulting from being premature. More research is needed on the risk factors which contribute to generating differences in our setting. PMID:23054547

Use of alcohol and other psychoactive substances is associated with serious social and public health problems, but the extent of the problem in Sub-Saharan Africa is not well known. We set out to review epidemiological publications on alcohol and other psychoactive substances in Sub-Saharan Africa by performing a systematic search of electronic databases and paper records. Ten Sub-Saharan African countries are among the 22 in the world with the highest increase in per capita alcohol consumption. Cannabis, tobacco, and khat are widely used, and use of cocaine, stimulants, and heroin is increasing. More epidemiological research and implementation and evaluation of interventions is needed. Collaboration between African researchers and those in developed countries could help.? PMID:21314750

Abstract Objectives- Non-physician cataract surgeons (NPCS) provide cataract surgical services in some Sub-Saharan African (SSA) countries. However, their training, placement, legal framework and supervision have not been documented. We sought to do so to inform decision-making regarding future training. Methods- Standard questionnaires were sent to national eye coordinators and other ophthalmologic leaders in Africa to collect information. Face-to-face interviews were conducted at training programmes in Ethiopia, Tanzania and Kenya, and email interviews were conducted with directors at training programmes in the Gambia and Malawi. Results- Responses were provided for 31/39 (79%) countries to which questionnaires were sent. These countries represent about 90% of the population of SSA. Over...

Signals of archaic admixture have been identified through comparisons of the draft Neanderthal and Denisova genomes with those of living humans. Studies of individual loci contributing to these genome-wide average signals are required for characterization of the introgression process and investigation of whether archaic variants conferred an adaptive advantage to the ancestors of contemporary human populations. However, no definitive case of adaptive introgression has yet been described. Here we provide a DNA sequence analysis of the innate immune gene STAT2 and show that a haplotype carried by many Eurasians (but not sub-Saharan Africans) has a sequence that closely matches that of the Neanderthal STAT2. This haplotype, referred to as N, was discovered through a resequencing survey of the...

Background: More than half of all new HIV infections in sub-Saharan African countries, including Uganda, occur among young people between the ages of 15 and 24, the most sexually active period of their lives. Understanding the contextual determinants of sexual behavior in this group is crucial in co...

African tick-bite fever, caused by Rickettsia africae, is the most common tick-borne rickettsiosis in sub-Saharan Africa. Mediterranean spotted fever due to Rickettsia conorii also occurs in the region but is more prevalent in Mediterranean countries. Using microimmunofluorescence, we compared the d...

Human African trypanosomiasis (HAT), also known as sleeping sickness, is a major cause of mortality and morbidity in sub-Saharan Africa. Current therapy with melarsoprol for CNS HAT has unacceptable side-effects with an overall mortality of 5%. This review discusses the issues of diagnosis and stagi...

This paper discusses food security and the African food crisis. By means of data from a survey of over 3000 farm households in eight sub-Saharan countries, the authors conclude that food security requires a broad integration of smallholders in the market. Subsistence orientation does not promote foo...

Rift Valley fever virus (RVFV) (genus Phlebovirus, family Bunyaviridae) has a tripartite negative-strand genome and causes a mosquito-borne disease among humans and livestock in sub-Saharan African and Arabian Peninsula countries. Phlebovirus L, M, and N mRNAs are synthesized from the virus-sense RN...

Climate variation is known to affect human health in developing countries. This paper quantifies the impact of variations in precipitation and temperature on the regional prevalence of diarrhea in children under the age of three in Sub-Saharan Africa. Demographic and Health Survey data for the regions of 14Sub-Saharan African countries are matched at fine resolution with climate data from the Africa Rainfall and Temperature Evaluation System (ARTES) for the period between 1992 and 2001. The results show that shortage of rainfall in the dry season increases the prevalence of diarrhea across Sub-Saharan Africa. Such shortages occur in many regions when rainfall is average and low relative to the long-term average for that month. The results also show that an increase in monthly average maxim...

This report, the most recent of several SSRC projects related to knowledge production, research networks and capacity building in sub-Saharan Africa, concerns the state of collaboration between U.S. and South African higher education institutions around social science research and other areas linked to the extraordinary changes that have (and are) taking place in postapartheid South Africa's higher education system. Since the end of apartheid in 1994, linkages between U.S. and South African higher education institutions and research organizations have proliferated. Recent changes within the South African landscape present new opportunities and challenges to identifying gaps and priorities in research and training. This study represents an effort to better understand the existing terrain of research and training collaboration between the two countries. The goal of the inventory is to identify existing gaps in U.S.-South African collaborations and to contribute to the development of priorities for future collaborative activities. It focuses on collaborations in social science research, capacity building and training in all fields, and activities designed to strengthen historically disadvantaged institutions and extend access to previously excluded populations in South Africa. It is hoped that this study will serve as an important resource for academic institutions in both countries in identifying potential partners and activities and for donor agencies in determining funding priorities. (Contains 9 tables.)

African animal trypanosomosis is a parasitic blood disease transmitted by tsetse flies and is widespread in sub-Saharan Africa. West African taurine breeds have the ability, known as trypanotolerance, to limit parasitaemia and anaemia and remain productive in enzootic areas. Several quantitative trait loci (QTL) underlying traits related to trypanotolerance have been identified in an experimentally infected F(2) population resulting from a cross between taurine and zebu cattle. Although this information is highly valuable, the QTL remain to be confirmed in populations subjected to natural conditions of infection, and the corresponding regions need to be refined. In our study, 360 West African cattle were phenotyped for the packed cell volume control under natural conditions of infection in south-western Burkina Faso. Phenotypes were assessed by analysing data from previous cattle monitored over 2 years in an area enzootic for trypanosomosis. We further genotyped for 64 microsatellite markers mapping within four previously reported QTL on BTA02, BTA04, BTA07 and BTA13. These data enabled us to estimate the heritability of the phenotype using the kinship matrix between individuals computed from genotyping data. Thus, depending on the estimators considered and the method used, the heritability of anaemia control ranged from 0.09 to 0.22. Finally, an analysis of association identified an allele of the MNB42 marker on BTA04 as being strongly associated with anaemia control, and a candidate gene, INHBA, as being close to that marker. PMID:22404348

Lindsay K.L., Gibney E.R. & McAuliffe F.M. (2012) 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. J Hum Nutr Diet. ABSTRACT: 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. PMID:22594552

African pygmy mice (subgenus Nannomys) are a group of small murine rodents that are widespread throughout Sub-Saharan Africa. Although this group has long been recognized for its extensive chromosomal diversity, the highly conserved morphology of its members has made taxonomic assignments problematic. Renewed interest resulting from a series of cytogenetic and molecular investigations has led to the identification of novel patterns of diversification in these rodents that are reviewed herein. These approaches have considerably improved species delimitation and provide tentative diagnostic criteria as well as preliminary phylogenetic relationships that will be refined as more taxa are investigated. Although sparse, ecological data suggest that pygmy mice may exhibit original reproductive traits that deserve further investigation. Chromosomal diversity undoubtedly remains one of the most interesting features of African pygmy mouse biology. They display several karyotypic traits that are rare in mammals: (i) their genomes tolerate the recurrent formation of tandem fusions and sex-autosome translocations, both of which are rare in other mammals due to their highly deleterious effects on fertility; (ii) they exhibit the first case of a whole arm exchange involving an X chromosome, and (iii) two species show novel means of sex chromosome determination - one exhibits XY females, whereas the other harbors populations in which males have no Y chromosome. The diversity of African pygmy mice offers a unique opportunity to study the processes involved in their radiation, and in a broader context, the evolution of sex chromosome determination in mammals.

The arrival of Europeans in Colonial and post-Colonial times coupled with the forced introduction of sub-Saharan Africans have dramatically changed the genetic background of Venezuela. The main aim of the present study was to evaluate, through the study of mitochondrial DNA (mtDNA) variation, the extent of admixture and the characterization of the most likely continental ancestral sources of present-day urban Venezuelans. We analyzed two admixed populations that have experienced different demographic histories, namely, Caracas (n = 131) and Pueblo Llano (n = 219). The native American component of admixed Venezuelans accounted for 80% (46% haplogroup [hg] A2, 7% hg B2, 21% hg C1, and 6% hg D1) of all mtDNAs; while the sub-Saharan and European contributions made up ?10% each, indicating that Trans-Atlantic immigrants have only partially erased the native American nature of Venezuelans. A Bayesian-based model allowed the different contributions of European countries to admixed Venezuelans to be disentangled (Spain: ?38.4%, Portugal: ?35.5%, Italy: ?27.0%), in good agreement with the documented history. Seventeen entire mtDNA genomes were sequenced, which allowed five new native American branches to be discovered. B2j and B2k, are supported by two different haplotypes and control region data, and their coalescence ages are 3.9 k.y. (95% C.I. 0-7.8) and 2.6 k.y. (95% C.I. 0.1-5.2), respectively. The other clades were exclusively observed in Pueblo Llano and they show the fingerprint of strong recent genetic drift coupled with severe historical consanguinity episodes that might explain the high prevalence of certain Mendelian and complex multi-factorial diseases in this region. PMID:22120584

The Comoros Islands are situated off the coast of East Africa, at the northern entrance of the channel of Mozambique. Contemporary Comoros society displays linguistic, cultural and religious features that are indicators of interactions between African, Middle Eastern and Southeast Asian (SEA) populations. Influences came from the north, brought by the Arab and Persian traders whose maritime routes extended to Madagascar by 700-900 AD. Influences also came from the Far East, with the long-distance colonisation by Austronesian seafarers that reached Madagascar 1500 years ago. Indeed, strong genetic evidence for a SEA, but not a Middle Eastern, contribution has been found on Madagascar, but no genetic trace of either migration has been shown to exist in mainland Africa. Studying genetic diversity on the Comoros Islands could therefore provide new insights into human movement in the Indian Ocean. Here, we describe Y chromosomal and mitochondrial genetic variation in 577 Comorian islanders. We have defined 28 Y chromosomal and 9 mitochondrial lineages. We show the Comoros population to be a genetic mosaic, the result of tripartite gene flow from Africa, the Middle East and Southeast Asia. A distinctive profile of African haplogroups, shared with Madagascar, may be characteristic of coastal sub-Saharan East Africa. Finally, the absence of any maternal contribution from Western Eurasia strongly implicates male-dominated trade and religion as the drivers of gene flow from the North. The Comoros provides a first view of the genetic makeup of coastal East Africa. PMID:20700146

Food security assessment in sub-Saharan Africa requires simultaneous consideration of multiple socio-economic and environmental variables. Early identification of populations at risk enables timely and appropriate action. Since large and widely dispersed populations depend on rainfed agriculture and pastoralism, climate monitoring and forecasting are important inputs to food security analysis. Satellite rainfall estimates (RFE) fill in gaps in station observations, and serve as input to drought index maps and crop water balance models. Gridded rainfall time-series give historical context, and provide a basis for quantitative interpretation of seasonal precipitation forecasts. RFE are also used to characterize flood hazards, in both simple indices and stream flow models. In the future, many African countries are likely to see negative impacts on subsistence agriculture due to the effects of global warming. Increased climate variability is forecast, with more frequent extreme events. Ethiopia requires special attention. Already facing a food security emergency, troubling persistent dryness has been observed in some areas, associated with a positive trend in Indian Ocean sea surface temperatures. Increased African capacity for rainfall observation, forecasting, data management and modelling applications is urgently needed. Managing climate change and increased climate variability require these fundamental technical capacities if creative coping strategies are to be devised. PMID:16433101

Greenhouse gas (GHG) emissions per person from urban waste management activities are greater in sub-Saharan African countries than in other developing countries, and are increasing as the population becomes more urbanised. Waste from urban areas across Africa is essentially dumped on the ground and there is little control over the resulting gas emissions. The clean development mechanism (CDM), from the 1997 Kyoto Protocol has been the vehicle to initiate projects to control GHG emissions in Africa. However, very few of these projects have been implemented and properly registered. A much more efficient and cost effective way to control GHG emissions from waste is to stabilise the waste via composting and to use the composted material as a soil improver/organic fertiliser or as a component of growing media. Compost can be produced by open windrow or in-vessel composting plants. This paper shows that passively aerated open windrows constitute an appropriate low-cost option for African countries. However, to provide an usable compost material it is recommended that waste is processed through a materials recovery facility (MRF) before being composted. The paper demonstrates that material and biological treatment (MBT) are viable in Africa where they are funded, e.g. CDM. However, they are unlikely to be instigated unless there is a replacement to the Kyoto Protocol, which ceases for Registration in December 2012. PMID:22857939

There is little knowledge on the demographic impact of the western wave of the Bantu expansion. Only some predictions could be made based mainly on indirect archaeological, linguistic, and genetic evidences. Apart from the very limited available data on the mitochondrial DNA (mtDNA) side, there are not, however, Y-chromosome studies revealing-if any-the male contribution of western Bantu-farmers. To elucidate the still poorly characterized western Bantu expansion, we analyzed Y-chromosome (25 biallelic polymorphisms and 15 microsatellite markers) and mtDNA (hypervariable control regions I and II and selected coding region RFLPs) variation in a population of 110 individuals from southwest Africa, and compared it with a database of 2,708 Y-chromosome profiles and of 2,565 mtDNAs from all other regions of Africa. This study reveals (1) a dramatic displacement of male and female Khoisan-speaking groups in the southwest, since both the maternal and the paternal genetic pools were composed exclusively by types carried by Bantu-speakers; (2) a clear bias in the admixture process towards the mating of male Europeans with female Sub-Saharan Africans; (3) the assimilation of east African lineages by the southwest (mainly mtDNA-L3f and Y-chromosome-B2a lineages); and (4) signatures of recent male and female gene flow from the southeast into the southwest. The data also indicate that the western stream of the Bantu expansion was a more gradual process than the eastern counterpart, which likely involved multiple short dispersals. PMID:15928903

In this article we provide a theoretical reconstruction of sub-Saharan ethics that we argue is a strong competitor to typical Western approaches to morality. According to our African moral theory, actions are right roughly insofar as they are a matter of living harmoniously with others or honouring communal relationships. After spelling out this ethic, we apply it to several issues in both normative and empirical research into morality. With regard to normative research, we compare and contrast this African moral theory with utilitarianism and Kantianism in the context of several practical issues. With regard to empirical research, we compare and contrast our sub-Saharan ethic with several of Lawrence Kohlberg's views on the nature of morality. Our aim is to highlight respects in which the...

This thesis examines whether urbanization affects GDP per capita positively in Sub-Saharan Africa. Further investigations are done to study how the size of the prime city affects GDP per capita, as well as how the prime city as a percentage of urban population interacts with GDP per capita. The resu...

Schistosomiasis is increasingly encountered among travelers returning from the tropics; signs and symptoms of travelers may differ from those of local populations. During 1993–2005, schistosomiasis was diagnosed in 137 Israeli travelers, most of whom were infected while in sub-Saharan Africa. Clinic...

Signals of archaic admixture have been identified through comparisons of the draft Neanderthal and Denisova genomes with those of living humans. Studies of individual loci contributing to these genome-wide average signals are required for characterization of the introgression process and investigation of whether archaic variants conferred an adaptive advantage to the ancestors of contemporary human populations. However, no definitive case of adaptive introgression has yet been described. Here we provide a DNA sequence analysis of the innate immune gene STAT2 and show that a haplotype carried by many Eurasians (but not sub-Saharan Africans) has a sequence that closely matches that of the Neanderthal STAT2. This haplotype, referred to as N, was discovered through a resequencing survey of the entire coding region of STAT2 in a global sample of 90 individuals. Analyses of publicly available complete genome sequence data show that haplotype N shares a recent common ancestor with the Neanderthal sequence (~80 thousand years ago) and is found throughout Eurasia at an average frequency of ~5%. Interestingly, N is found in Melanesian populations at ~10-fold higher frequency (~54%) than in Eurasian populations. A neutrality test that controls for demography rejects the hypothesis that a variant of N rose to high frequency in Melanesia by genetic drift alone. Although we are not able to pinpoint the precise target of positive selection, we identify nonsynonymous mutations in ERBB3, ESYT1, and STAT2-all of which are part of the same 250 kb introgressive haplotype-as good candidates. PMID:22883142

Greywater is wastewater from baths, sinks and washing machines, accounting for about 60% of the outflow from homes. It contains little pathogens and 90% less nitrogen than toilet water, so does not require the same treatment process. With the increasing demand for freshwater, its use may reduce irrigation water needs, increasing its availability of freshwater for other primary uses. Agriculture is the main water consumer in Africa, which cannot be compromised due to its role in domestic food security and export supplies. The purpose of this paper is to demonstrate findings of the research done on benefits of greywater reuse in some countries, applicable to African countries. In Australia, greywater reuse has reduced freshwater demand, strain on wastewater treatment plants and energy consumption. Aquifer recharge has improved due to increased infiltration flows from greywater uses. In Lebanon, greywater is a valuable resource for encouraging plant growth from nutrients that may otherwise have been wasted. Palestine shares similar climate and water scarcity conditions with most arid sub-Saharan African countries, yet utilizes grey water in production of crops and citrus fruits. Thus use of grey water should be possible in African cities such as Harare, where nearly two thirds of the population rely on agriculture for livelihoods. The problem of blue green algae in sewerage ponds and water reservoirs is significantly reduced by household reuse of grey water in Mexico. Water savings are increased and expenses reduced, as illustrated by the reduction in consumption of municipality freshwater supplies in South African urban areas. Rural communities and schools in Namibia and Egypt have raised funds from grey water reuse in banana plantations. A possible constraint to this strategy could be the unavailability of appropriate technology for primary treatment of grey water before reuse. This strategy may pose health risks where water quality tests are unknown or unavailable but can be overcome through educational campaigns. Supporting data and evidence on safety and benefits of grey water is required to achieve regulatory approval of grey water use.

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 [less than or equal to]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 amlodipine should be increased to 10 mg/day with the possible addition of up to 2 g/day alpha-methyldopa. 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 [greater than or equal to]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 naive 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 alpha-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. PMID:22594907

Fears of the movement of large numbers of people as a result of changes in the environment were first voiced in the 1980s (ref. ). Nearly thirty years later the numbers likely to migrate as a result of the impacts of climate change are still, at best, guesswork. Owing to the high prevalence of rainfed agriculture, many livelihoods in sub-Saharan African drylands are particularly vulnerable to changes in climate. One commonly adopted response strategy used by populations to deal with the resulting livelihood stress is migration. Here, we use an agent-based model developed around the theory of planned behaviour to explore how climate and demographic change, defined by the ENSEMBLES project and the United Nations Statistics Division of the Department of Economic and Social Affairs, combine to influence migration within and from Burkina Faso. The emergent migration patterns modelled support framing the nexus of climate change and migration as a complex adaptive system. Using this conceptual framework, we show that the extent of climate-change-related migration is likely to be highly nonlinear and the extent of this nonlinearity is dependent on population growth; therefore supporting migration policy interventions based on both demographic and climate change adaptation.

Objective. To provide insight into the differential effect of immigration on cesarean section (CS) rates, using Robson classification. Design. A population-based study using birth certificates from the birth registry of 2009. Setting. All births in two of the three Belgian regions excluding Flanders. Population. 37 628 deliveries from Belgian and immigrant mothers from Sub-Saharan Africa, Maghreb and Eastern Europe. Methods. Multivariate analyses using CS as the dependent variable and immigration status as the primary independent variable. Several multivariate logistic regression models were built including medical, anthropometric, socio-economic characteristics, and medical interventions. The impact of analyzing all delivery sites together was tested using mixed-effect analyses. Main Outcome measures. CSs of immigrant subgroups compared to Belgian women. Results. CS rates varied according to immigrant subgroups. Mothers from Sub-Saharan Africa had an adjusted odds ratio of 2.06 (1.62-2.63) for CS compared to Belgian natives. Increased risk for mothers from Sub-Saharan Africa compared to Belgian natives was found among nulliparous and multiparous women without previous CS, and a term, singleton fetus in cephalic position. On the contrary, nulliparous East European mothers with a term singleton fetus in cephalic position in spontaneous labor had an adjusted odds ratio of 0.29 (0.08-0.99) for CS. Conclusions. CS rates currently vary between Robson categories in immigrant subgroups. Immigrant mothers from Sub-Saharan Africa with a term, singleton infant in cephalic position, without previous CS, appear to carry the highest burden. PMID:22994320

South Africa is a privileged member of various global governance clubs. This status is based on its relative economic weight in sub-Saharan Africa and its legacy of ?soft power? derived from the peaceful transition from apartheid to democracy. However, those foundations are waning in the face of the African National Congress (ANC) government?s growing ambivalence towards democratic norms and the relatively rapid growth and development taking place in sub-Saharan Africa. The ANC government?s own policy choices, particularly its emphasis on state-driven economic policy, and the internecine power struggles racking the party have set the country?s economic policy adrift. Thus investor confidence has been undermined at a time of global economic crisis. Taken together, these trends suggest South...

African animal trypanosomiasis, or Nagana, is a debilitating and economically costly disease with a major impact on animal health in sub-Saharan Africa. Trypanosoma vivax, one of the principal trypanosome species responsible for the disease, infects a wide host range including cattle, goats, horses and donkeys and is transmitted both cyclically by tsetse flies and mechanically by other biting flies, resulting in a distribution covering large swathes of South America and much of sub-Saharan Africa. While there is evidence for mating in some of the related trypanosome species, Trypanosoma brucei, Trypanosoma congolense and Trypanosoma cruzi, very little work has been carried out to examine this question in T. vivax. Understanding whether mating occurs in T. vivax will provide insight into th...

Background: Due to intensified measles immunization efforts, measles mortality has decreased substantially worldwide, particularly in Sub-Saharan Africa (SSA). The World Health Organization (WHO) estimated a 92% decrease in measles-related deaths in the WHO AFRO region for the period 2000-2008. Recently, the AFRO region established a measles pre-elimination goal and experts have suggested engaging in a measles eradication campaign at the global level. However, recent large-scale outbreaks in many Sub-Saharan African countries present a challenge to measles control efforts. This paper examines measles immunization and the impact of measles supplemental immunization activities (SIAs) on routine immunization coverage in South Africa (SA). Methods: We reported on immunization coverage trends i...

The northern sub-Saharan African (NSSA) region, bounded by the Sahara, Equator, and the West and East African coastlines, is subjected to intense biomass burning every year during the dry season. This is believed to be one of the drivers of the regional carbon and energy cycles, with serious implications for the water cycle anomalies that probably contribute to drought and desertification. In this presentation, we will discuss a new multi-disciplinary research in the NSSA region, review progress, evaluate preliminary results, and interact with the research and user communities to examine how best to coordinate with other research activities in order to address related environmental issues most effectively.

Human African trypanosomiasis (HAT) and animal African trypanosomiasis (AAT) are significant health concerns throughout much of sub-Saharan Africa. Funding for tsetse fly control operations has decreased since the 1970s, which has in turn limited the success of campaigns to control the disease vector. To maximize the effectiveness of the limited financial resources available for tsetse control, this study develops and analyzes spatially and temporally dynamic tsetse distribution maps of Glossina subgenus Morsitans populations in Kenya from January 2002 to December 2010, produced using the Tsetse Ecological Distribution Model. These species distribution maps reveal seasonal variations in fly distributions. Such variations allow for the identification of "control reservoirs" where fly distributions are spatially constrained by fluctuations in suitable habitat and tsetse population characteristics. Following identification of the control reservoirs, a tsetse management operation is simulated in the control reservoirs using capital and labor control inputs from previous studies. Finally, a cost analysis, following specific economic guidelines from existing tsetse control analyses, is conducted to calculate the total cost of a nationwide control campaign of the reservoirs compared to the cost of a nationwide campaign conducted at the maximum spatial extent of the fly distributions from January 2002 to December 2010. The total cost of tsetse management within the reservoirs sums to $14,212,647, while the nationwide campaign at the maximum spatial extent amounts to $33,721,516. This savings of $19,508,869 represents the importance of identifying seasonally dynamic control reservoirs when conducting a tsetse management campaign, and, in the process, offers an economical means of fly control and disease management for future program planning. PMID:22581989

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.

Objective To determine immigrants? frequency of use of four health services by place of origin and compare it with that of the Spanish population. Methods Based on the 2006 National Health Survey in Spain, we estimated the frequency of use of four health services in men and women from: Spain, Western countries, Eastern Europe, Latin America, North Africa, Sub Saharan Africa and Asia/Oceania. These results were compared with the Spanish population by calculating odds ratios adjusted for age, socioeconomic position, health status, and type of health coverage. Results Immigrant men generally use health services less frequently than Spanish nationals. The main exceptions are Latin American men, who more often use emergency services (OR 1.68, 95% CI 1.41?1.99) and Sub-Saharan men, who use speci...

Human African trypanosomiasis, also known as sleeping sickness, is a neglected disease, and it continues to pose a major threat to 60 million people in 36 countries in sub-Saharan Africa. Transmitted by the bite of the tsetse fly, the disease is caused by protozoan parasites of the genus Trypanosoma and comes in two types: East African human African trypanosomiasis caused by Trypanosoma brucei rhodesiense and the West African form caused by Trypanosoma brucei gambiense. There is an early or hemolymphatic stage and a late or encephalitic stage, when the parasites cross the blood-brain barrier to invade the central nervous system. Two critical current issues are disease staging and drug therapy, especially for late-stage disease. Lumbar puncture to analyze cerebrospinal fluid will remain the...

This paper examines managerial leadership and its cultural and historical foundations in Sub-Saharan Africa (SSA). The analysis is based on existing literature, a qualitative analysis of African media reports, and quantitative results from the Global Leadership and Organizational Behavior Effectiveness (GLOBE) project. The five SSA countries studied were Nigeria, Namibia, Zambia, Zimbabwe, and South Africa (black sample). Results yielded several common themes that characterize SSA leadership patterns across the region. In particular, a common cultural characteristic, ubuntu, was reflected in high levels of group solidarity, paternalistic leadership, and Humane Oriented leadership. Although the negative legacy of colonial dominance has contributed to a culture of corruption, poverty, tribal...

Alcohol prevention strategies for soldiers in sub-Saharan African countries suffer from limited knowledge about soldiers' alcohol consumption patterns. The present study was conducted to understand such patterns in Angolan soldiers, including associated risk and protective factors. From 12 military bases, 568 soldiers completed structured interviews that assessed demographic information, level of alcohol consumption, mental health, social support and religious activity. Logistic regressions were used to determine factors associated with any alcohol intake, problematic drinking, binge drinking and alcohol consumption prior to sexual activity. Nearly 35%% of participants exhibited problematic drinking behaviour on the Alcohol Use Disorders Identification Test. Approximately 26%% reported at ...

Abstract Background: Healthcare workers in Africa managing human immunodeficiency virus (HIV)-infected patients often receive inadequate HIV-specific medical education. The acceptability and feasibility of Web-based distance learning tools to enhance HIV training in Africa have not been extensively evaluated. Materials and Methods: In this prospective observational study, we assessed the feasibility of Web-conferencing to deliver HIV-specific medical training to clinicians supporting HIV care and treatment across 12 Sub-Saharan African countries over a 10-month period. Webinar attendance, technical quality, and participant satisfaction were measured for each Webinar. Demographic details about participants were recorded. Results: Attendance increased from 40 participants in Month 1 to over ...

Background and Objective The HIV/AIDS epidemic in sub-Saharan Africa is decimating populations, deteriorating economies, deepening poverty, and destabilizing traditional social orders. The advent of the U.S. President?s Emergency Plan for AIDS Relief (PEPFAR) made significant supplemental resources available to sub-Saharan national programs for the prevention and treatment of HIV/AIDS, but few programs have demonstrated the capacity to use these resources to increase rapidly in size. In this context, AMPATH, a collaboration of Indiana University School of Medicine, the Moi University School of Medicine, and the Moi Teaching and Referral Hospital in Eldoret, Kenya, is a stunning exception. This report summarizes findings from an assessment of AMPATH staff perceptions of how and why this has...

The C4 grass Zea mays (maize or corn) is the third most important food crop globally after wheat and rice in terms of production and the second most widespread genetically modified (GM) crop, after soybean. Its demand is predicted to increase by 45% by the year 2020. In sub-Saharan Africa, tropical maize has traditionally been the main staple of the diet, 95% of the maize grown is consumed directly as human food and as an important source of income for the resource—poor rural population. However, its growth, development and production are greatly affected by environmental stresses such as drought and salinization. In this respect, food security in tropical sub-Saharan Africa is increasingly dependent on continuous improvement of tropical maize through conventional breeding involving...

Abstract Background. Sub-Saharan Africa experiences an epidemic surge in hypertension. Studies in African Americans led to the recommendation to initiate antihypertensive treatment in Blacks with a diuretic or a low-dose fixed combination including a diuretic. We mounted the Newer versus Older Antihypertensive Agents in African Hypertensive Patients (NOAAH) trial to compare in native African patients a fixed combination of newer drugs, not involving a diuretic, with a combination of older drugs including a diuretic. Methods. Patients aged 30-69 years with uncomplicated hypertension (140-179/90-109 mmHg) and two or fewer associated risk factors are eligible. After a 4-week run-in period off treatment, 180 patients will be randomized to once daily bisoprolol/hydrochlorothiazide 5/6.25 mg or ...

With the expansion of access to HIV testing and antiretroviral therapy in sub-Saharan Africa, questions have emerged if stigma remains a useful concept for understanding the effects of AIDS. There is, however, a paucity of research on how HIV-positive Africans—especially African men—experience living with AIDS. This paper addresses this gap and draws on findings from ethnographic fieldwork in 2004 and 2009 with a support group for HIV-positive men in Kampala, Uganda. The paper demonstrates that stigma is central to how men in this context coped with HIV and AIDS, and it provides a conceptual framework that links men’s experiences of AIDS stigma to conceptions of masculinity. In so doing, findings highlight both the possibilities and challenges of involving African men more fully in HIV prevention.

ABSTRACT: BACKGROUND: Neglected tropical diseases (NTDs) are a group of chronic parasitic diseases and related conditions that are the most common diseases among the 2.7 billion people globally living on less than US$2 per day. In response to the growing challenge of NTDs, Ethiopia is preparing to launch a NTD Master Plan. The purpose of this review is to underscore the burden of NTDs in Ethiopia, highlight the state of current interventions, and suggest ways forward. RESULTS: This review indicates that NTDs are significant public health problems in Ethiopia. From the analysis reported here, Ethiopia stands out for having the largest number of NTD cases following Nigeria and the Democratic Republic of Congo. Ethiopia is estimated to have the highest burden of trachoma, podoconiosis and cutaneous leishmaniasis in sub-Saharan Africa (SSA), the second highest burden in terms of ascariasis, leprosy and visceral leishmaniasis, and the third highest burden of hookworm. Infections such as schistosomiasis, trichuriasis, lymphatic filariasis and rabies are also common. A third of Ethiopians are infected with ascariasis, one quarter is infected with trichuriasis and one in eight Ethiopians lives with hookworm or is infected with trachoma. However, despite these high burdens of infection, the control of most NTDs in Ethiopia is in its infancy. In terms of NTD control achievements, Ethiopia reached the leprosy elimination target of 1 case/10,000 population in 1999. No cases of human African trypanosomiasis have been reported since 1984. Guinea worm eradication is in its final phase. The Onchocerciasis Control Program has been making steady progress since 2001. A national blindness survey was conducted in 2006 and the trachoma program has kicked off in some regions. Lymphatic Filariasis, podoconiosis and rabies mapping are underway. CONCLUSION: Ethiopia bears a significant burden of NTDs compared to other SSA countries. To achieve success in integrated control of NTDs, integrated mapping, rapid scale up of interventions and operational research into co implementation of intervention packages will be crucial. PMID:23095679

Indigenous sub-Saharan societies have, over the millennia, lived and socialised within the unwritten `?rules'? of the `?Ubuntu'? or similar philosophies that emphasises holistic `?humanness'?, and which is a form of `?social responsibility'?. This article looks into some relevant social responsibility aspects of medical education in the South African context, with particular emphasis on how these aspects have been addressed. Apartheid was, by its very nature, incompatible with social responsibility for the majority of South Africans, but one medical school that was a non-complicit product of apartheid succeeded in fulfilling a socially responsible mission. Thus, this article implicitly identifies what South Africa, Africa and the global Health Professions Education community could learn fr...

Data on social representations of world history have been collected everywhere in the world except sub-Saharan Africa. Two studies using open-ended data involving university students from six African countries fill this gap. In Study 1, nominations from Cape Verde and Mozambique for the most important events in world history in the past 1000 years were dominated by war and politics, recency effects, and Western-centrism tempered by African sociocentrism on colonization and independence. The first three findings replicated previous research conducted in other parts of the world, but the last pattern contrasted sharply with European data. Study 2 employed a novel method asking participants how they would begin the narration of world history, and then to describe a major transition to the pre...

Women from high-mortality settings in sub-Saharan Africa can remain at risk for adverse maternal outcomes even after migrating to low-mortality settings. To conceptualise underlying socio-cultural factors, we assume a `maternal migration effect' as pre-migration influences on pregnant women’s post-migration care-seeking and consistent utilisation of available care. We apply the `three delays' framework, developed for low-income African contexts, to a high-income western scenario, and aim to identify delay-causing influences on the pathway to optimal facility treatment. We also compare factors influencing the expectations of women and maternal health providers during care encounters. In 2005-2006, we interviewed 54 immigrant African women and 62 maternal providers in greater London, ...

Human African trypanosomiasis, or sleeping sickness, is caused by the protozoan parasites Trypanosoma brucei rhodesiense or Trypanosoma brucei gambiense, and is a major cause of systemic and neurological disability throughout sub-Saharan Africa. Following early-stage disease, the trypanosomes cross the blood–brain barrier to invade the central nervous system leading to the encephalitic, or late stage, infection. Treatment of human African trypanosomiasis currently relies on a limited number of highly toxic drugs, but untreated, is invariably fatal. Melarsoprol, a trivalent arsenical, is the only drug that can be used to cure both forms of the infection once the central nervous system has become involved, but unfortunately, this drug induces an extremely severe post-treatment reacti...

This paper reports the first evidence of the presence of bacteria, other than the three previously described as symbionts, Wigglesworthia glossinidia, Wolbachia, and Sodalis glossinidius, in the midgut of Glossina palpalis palpalis, the tsetse fly, a vector of the chronic form of human African trypanosomiasis in sub-Saharan African countries. Based on the morphological, nutritional, physiological, and phylogenetic results, we identified Enterobacter, Enterococcus, and Acinetobacter spp. as inhabitants of the midgut of the tsetse fly from Angola. Enterobacter spp. was the most frequently isolated. The role of these bacteria in the gut, in terms of vector competence of the tsetse fly, is discussed, as is the possibility of using these bacteria to produce in situ trypanolytic molecules.

Abstract in spanish OBJETIVO : Medir la desigualdad en cuanto a la riqueza de cada país con respecto a las carencias en la cobertura del servicio sanitario de los indicadores de salud materno-infantil en el África subsahariana y cuantificar su contribución a las carencias de cobertura en los servicios sanitarios nacionales. MÉTODOS: A través de la Encuesta sobre Salud y Demografía de 2000-2008 se obtuvieron los datos de cobertura de los servicios sanitarios materno-infantiles en 28 pa? (more) ?ses del África subsahariana. Para cada uno de los países se determinaron las carencias de cobertura nacional para un índice de cobertura global de servicios sanitarios y para indicadores de servicios sanitarios individuales. Los datos se separaron además en las carencias de cobertura para el quintil más rico (por ejemplo, la proporción del quintil que carecía del servicio sanitario necesario) y el riesgo atribuible a la población (una medida absoluta de la desigualdad en cuanto a riqueza de cada país). RESULTADO: En 26 países, la desigualdad nacional en cuanto a la riqueza, constituyó más de un cuarto de las carencias de cobertura total del país. Si se redujera dicha desigualdad, estas carencias disminuirían entre un 16% y un 56%, dependiendo del país. En cuanto a los indicadores de servicios sanitarios individuales, la desigualdad en cuanto a riqueza fue más palpable en servicios como la asistencia profesional al parto y la asistencia prenatal, y menos destacada en la planificación familiar, la vacunación contra el sarampión, la recepción de una tercera dosis de la vacuna contra la difteria, la tos ferina y el tétano y en el tratamiento de infecciones respiratorias agudas en niños menores de 5 años. CONCLUSIÓN: La contribución de la desigualdad en cuanto a riqueza en las carencias de cobertura de servicios sanitarios materno-infantiles varía en cada país y según el servicio sanitario, por lo que necesita intervenciones específicas para cada caso. Las normativas específicas son las más adecuadas cuando se producen casos de marcada desigualdad en cuanto a riqueza dentro de un país, y los enfoques globales, para aquellos países con unas carencias de cobertura de servicios elevadas en todos los quintiles de población. Abstract in english OBJECTIVE: To measure within-country wealth-related inequality in the health service coverage gap of maternal and child health indicators in sub-Saharan Africa and quantify its contribution to the national health service coverage gap. METHODS: Coverage data for child and maternal health services in 28 sub-Saharan African countries were obtained from the 2000-2008 Demographic Health Survey. For each country, the national coverage gap was determined for an overall health se (more) rvice coverage index and select individual health service indicators. The data were then additively broken down into the coverage gap in the wealthiest quintile (i.e. the proportion of the quintile lacking a required health service) and the population attributable risk (an absolute measure of within-country wealth-related inequality). FINDINGS: In 26 countries, within-country wealth-related inequality accounted for more than one quarter of the national overall coverage gap. Reducing such inequality could lower this gap by 16% to 56%, depending on the country. Regarding select individual health service indicators, wealth-related inequality was more common in services such as skilled birth attendance and antenatal care, and less so in family planning, measles immunization, receipt of a third dose of vaccine against diphtheria, pertussis and tetanus and treatment of acute respiratory infections in children under 5 years of age. CONCLUSION: The contribution of wealth-related inequality to the child and maternal health service coverage gap differs by country and type of health service, warranting case-specific interventions. Targeted policies are most appropriate where high within-country wealth-related inequality exists, and whole-population approaches, where the health-service coverage gap is high in all quintiles.

Objective To evaluate the cost-effectiveness of introducing the RTS,S malaria vaccine into the Expanded Programme on Immunization (EPI) in Sub-Saharan Africa (SSA), the contributions of different sources of uncertainty, and the associated expected value of perfect information (EVPI). Methods Vaccination was simulated in populations of 100,000 people at 10 different entomological inoculation rates (EIRs), using an existing stochastic model and a 10-year time horizon. Incremental cost-effectiveness ratios (ICERs) and EVPI were computed from weighted averages of outputs using two different assignments of the EIR distribution in 2007. Uncertainty was evaluated by resampling of epidemiological, vaccination, and health systems model parameters. Results Health benefits were predicted consistently...

We describe the main statistics from a database on electricity supply and consumption by region for the developing countries for the period 1980--1986. The regions covered are Northeast Asia, Southeast Asia, South Asia, Middle East North Africa, Sub-Saharan Africa, and Latin America Caribbean. The variables in the database are population; installed generating capacity, disaggregated by plant type into thermal, hydro, and nuclear; electricity generation, disaggregated by source into coal, oil, gas, hydro, and nuclear; and electricity consumption, disaggregated by sector into industry, residential, commercial, transportation, agriculture. The database is presented at the end of the report.

Knowledge and technology transfer to African laboratories and farmers is an important objective for achieving food security and sustainable crop production on the sub-Saharan African continent. Cassava (Manihot esculenta Crantz) is a vital source of calories for more than a billion people in developing countries, and its potential industrial use for starch and bioethanol in the tropics is increasingly being recognized. However, cassava production remains constrained by the susceptibility of the crop to several biotic and abiotic stresses. For more than a decade, biotechnology has been considered an attractive tool to improve cassava as it substantially circumvents the limitations of traditional breeding, which is particularly time-consuming and tedious because of the high heterozygosity of the crop. A major constraint to the development of biotechnological approaches for cassava improvement has been the lack of an efficient and robust transformation and regeneration system. Despite some success achieved in genetic modification of the model cassava cultivar Tropical Manihot Series (TMS), TMS 60444, in some European and U.S. laboratories, the lack of a reproducible and robust protocol has not allowed the establishment of a routine transformation system in sub-Saharan Africa. In this study, we optimized a robust and efficient protocol developed at ETH Zurich to successfully establish transformation of a commercially cultivated South African landrace, T200, and compared this with the benchmark model cultivar TMS 60444. Results from our study demonstrated high transformation rates for both T200 (23 transgenic lines from 100 friable embryogenic callus (FEC) clusters) compared with TMS 60444 (32 transgenic lines from 100 FEC clusters). The success in transforming landraces or farmer-preferred cultivars has been limited, and the high transformation rate of an industry-preferred landrace in this study is encouraging for a feasible transformation program for cassava improvement in South Africa (SA), which can potentially be extended to other countries in southern Africa. The successful establishment of a robust cassava transformation and regeneration system in SA demonstrates the relevance of technology transfer to sub-Saharan Africa and highlights the importance of developing suitable and reliable techniques before their transfer to laboratories offering less optimal conditions. PMID:22683498

Abstract in spanish Las noticias sobre los conflictos bélicos acaecidos en varios países del África subsahariana durante los años noventa han suscitado preocupación por la posibilidad de que las divisiones étnicas y el solapo de grupos religiosos y raciales den lugar a un aumento de las desigualdades interétnicas en materia de salud y supervivencia en toda la región, sobre todo entre los niños. Paradójicamente, no se ha llevado a cabo ningún estudio sistemático de las desigualdad (more) es étnicas en lo tocante a la supervivencia infantil entre los países de la región. En este artículo se utilizan datos reunidos en los años noventa en 11 países (República Centroafricana, Côte d’Ivoire, Ghana, Kenya, Malí, Namibia, Níger, Rwanda, Senegal, Uganda y Zambia) para determinar si han existido desigualdades étnicas, y en caso afirmativo si se han ampliado, en materia de mortalidad infantil en el África subsahariana desde los años ochenta. En cada país el interés se centró en uno o dos grupos que, como consecuencia de su situación geográfica, hubiesen podido presentar un estado de salud y unas probabilidades de supervivencia distintos del resto de la población nacional. Entre los factores considerados para intentar explicar las posibles desigualdades en supervivencia infantil entre los grupos étnicos cabe citar el dato de si habitan o no en la principal ciudad del país, la situación económica de la unidad familiar, el nivel educativo y el estado nutricional de las madres, el uso de servicios modernos de salud maternoinfantil, en particular de inmunización, y las pautas de fecundidad y migración. Los resultados muestran una notable coherencia. En los 11 países se observaron diferencias significativas entre los grupos étnicos en lo tocante a la probabilidad de fallecer durante la lactancia o antes de los cinco años. Hasta 1992, los niños de las mujeres ashanti en Ghana y de las tutsi en Rwanda tenían un 20% menos de probabilidades de fallecer que los otros niños ghaneses y rwandeses. Los niños de Baoulé, en Côte d’Ivoire, los djerma-songhai en el Níger y los baganda en Uganda presentaban un riesgo de morir antes de los cinco años inferior en más de un tercio al de los niños de otros grupos étnicos de su país. Las diferencias de supervivencia eran especialmente marcadas en Kenya. Entre los niños kalenjin, el riesgo de fallecer antes de los cinco años equivalía a la mitad del correspondiente a otros niños no kikuyu, pese a que habitan casi exclusivamente en zonas rurales. Al mismo tiempo, el riesgo de los kikuyu, predominantemente urbanos, de morir antes de los cinco años era un 65% más bajo entre los lactantes, y un 74% más bajo entre los niños menores de cinco años. Los lactantes y los niños pequeños bemba presentaban una mortalidad notablemente mayor en Zambia. El análisis multifactorial muestra que las diferencias de mortalidad infantil entre etnias están estrechamente relacionadas con las desigualdades económicas en muchos países, y quizá también con el diferente uso que los países de la región del Sahel hacen de los servicios de salud infantil. Las disparidades económicas que están en la base de la desigual mortalidad infantil pueden estar relacionadas con el entorno geográfico habitual de los grupos en los países, pero no son un resultado directo de su distinta radicación en la ciudad principal del país. La robustez y la coherencia de los resultados de este estudio justifican que la noción de etnicidad pase al primer plano de los análisis y teorías de la mortalidad infantil en África que incorporan consideraciones sociales, no sólo epidemiológicas. Además, teniendo en cuenta la ventaja que supone haber estudiado grupos étnicos relativamente pequeños y claramente definidos, en comparación con la mayoría de la población nacional, con arreglo a indicadores fundamentales del bienestar - supervivencia infantil, educación, vivienda, etc. -, los resultados llevan a pensar que muchos países del África subsahariana, aun en un contexto de pobreza generalizada, presentan desigualdades sociales en grado similar a países de otras regiones del mundo. Abstract in english Accounts by journalists of wars in several countries of sub-Saharan Africa in the 1990s have raised concern that ethnic cleavages and overlapping religious and racial affiliations may widen the inequalities in health and survival among ethnic groups throughout the region, particularly among children. Paradoxically, there has been no systematic examination of ethnic inequality in child survival chances across countries in the region. This paper uses survey data collected i (more) n the 1990s in 11 countries (Central African Republic, Côte d’Ivoire, Ghana, Kenya, Mali, Namibia, Niger, Rwanda, Senegal, Uganda, and Zambia) to examine whether ethnic inequality in child mortality has been present and spreading in sub-Saharan Africa since the 1980s. The focus was on one or two groups in each country which may have experienced distinct child health and survival chances, compared to the rest of the national population, as a result of their geographical location. The factors examined to explain potential child survival inequalities among ethnic groups included residence in the largest city, household economic conditions, educational attainment and nutritional status of the mothers, use of modern maternal and child health services including immunization, and patterns of fertility and migration. The results show remarkable consistency. In all 11 countries there were significant differentials between ethnic groups in the odds of dying during infancy or before the age of 5 years. Multivariate analysis shows that ethnic child mortality differences are closely linked with economic inequality in many countries, and perhaps with differential use of child health services in countries of the Sahel region. Strong and consistent results in this study support placing the notion of ethnicity at the forefront of theories and analyses of child mortality in Africa which incorporate social, and not purely epidemiological, considerations. Moreover, the typical advantage of relatively small, clearly defined ethnic groups, as compared to the majority in the national population, according to fundamental indicators of wellbeing - child survival, education, housing, and so forth - suggests that many countries in sub-Saharan Africa, despite their widespread poverty, are as marked by social inequality as are countries in other regions in the world.

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

Achieving sustainable food security in Sub-Saharan Africa is one of the main challenges facing African governments and the international community. The 2007?2008 food crisis and ongoing chronic hunger problems clearly demonstrate that millions of people on the continent, including in relatively stable countries such as Kenya, are dangerously vulnerable to economic, political and climatic shocks that threaten food availability and accessibility. At the heart of the strategies to build resilience and tackle food insecurity is the need for effective institutional and policy frameworks that can support local innovations while taking into account the biophysical, social and economic constraints within which rural livelihoods operate. The papers included in this Special Issue of Food Security su...

While the central thrust of Michael Lipton's work has been the crucial role of productivity gains in small farm agriculture for rural poverty reduction, in many sub-Saharan African countries this desirable outcome has stubbornly refused to materialise, and growing numbers of rural poor people are found persistently to fail to secure even minimal acceptable levels of food consumption. A social protection policy response is to target social cash transfers to the chronic extreme poor. This article focuses on the level of cash transfers relative to income differences between households in the bottom half of the income distribution, and the social tensions that arise from beneficiary selection and exclusion. It is found that cash transfers to target groups such as 'the poorest 10 per cent' or t...

Abstract Sub-Saharan Africa bears the brunt of the HIV epidemic, which is fueled by the many ethical, social, and political complexities that make up Africa. In turn, the pandemic has also caused many ethical, social, and political complexities that Africa now grapples with. Being infected with HIV is highly complex and challenging. Regrettably, gender inequality is still pervasive in Africa. The response by African leaders to the pandemic has been, on the whole, shamefully lethargic. For Africa to win its war against HIV/AIDS, a paradigm shift is required from the perspective of its socio-political context. What is called for is positive political will that will address all aspects of the social determinants of AIDS. What is also required is that Ubuntu is embraced meaningfully.

The adoption of artemisinin-based combination therapy, together with other malaria control strategies, has played a significant role in reducing the burden of malaria in many endemic countries. The artemisinin-based combination therapy artemether-lumefantrine (AL; Coartem(®), Novartis Pharma AG, Basel, Switzerland) has demonstrated consistently high efficacy and safety for over a decade. Currently deployed as a first- or second-line treatment in most sub-Saharan African countries, its extensive use is endorsed by a lack of reported parasite resistance in Africa to date. With a focus on patient needs, AL offers a tailored formulation for infants and children, and packaging solutions to promote adherence. Working towards malaria elimination, innovative strategies using AL, such as treatment of asymptomatic carriers, will be of interest. AL has the potential to continue playing an important role in saving lives. PMID:22554131

High-quality and reliable laboratory services are important components of effective and well-functioning health systems. Accurate, reliable and timely medical laboratory testing is crucial to patient care and disease surveillance. Unfortunately, in many sub-Saharan African countries, medical laboratory systems are adversely affected by the unavailability of medical laboratories, poor laboratory infrastructure and lack of well-trained personnel [1]. Quality in the laboratory is only achieved in a systematic way through the implementation of a quality management system. The results of the study showed that approximately 60?% of the 78 respondents were unaware of the requirements of ISO 15189:2007. A trial of proficiency testing, termed ?blind proficiency testing?, was carried out in which 19...

Sub-Saharan African countries are being strongly urged to enhance their rice production, because their rice consumption and importation rates have been rapidly increasing in recent years. Areas planted to rice in Africa are classified agro-ecologically into rainfed upland, rainfed lowland, and irrigated. Rainfed lowland includes extensive areas of unexploited land that has great potential for the promotion of rice growing. For the unexploited rainfed lowlands of Ghana, we have been studying the development of low-cost rice-farming systems that require no large-scale irrigation or land reclamation. For such systems, it is important to select suitable areas where water for rice farming can be obtained naturally; floodwaters offer promise for this purpose. Delineation and mapping of floodwate...

Purpose The supraclavicular skin is thin and pliable; it closely resembles that of the neck and facial skin, making it the perfect source of tissue for neck and orofacial reconstructions. The author sought to provide a concise compilation of the use of the supraclavicular artery flap, including surgical landmarks, modifications, uses, common complications, and anomalies, and experience with the use of the flap in a sub-Saharan African country. Materials and Methods A literature search was performed on the Internet and PubMed for anatomic and clinical studies/reports in the English language on the supraclavicular artery flap with a minimum of 10 subjects and sufficient data on postoperative complications. Results Five anatomic studies (2 of which included clinical cases) and 12 clinical ser...

Sub-Saharan Africa has one of the highest levels of teenage pregnancies in the world. In spite of that, there is paucity of empirical research on causes of teenage pregnancies in African countries. This paper investigates the determinants of teenage pregnancies based on a case study of Busia District in Kenya. The data are from a household survey conducted in 1998/1999. Empirical results indicate that girls' education level has significant influence on the probability of teenage birth, with non-schooling adolescents and those with primary school level education being more vulnerable. Among the variables used as proxies for access to sex education, availability of church forums that educate adolescents about sex and family life issues reduce probability of teenage pregnancy. Age is positive...

Sub-Saharan Africa has experienced substantial urbanisation and land degradation processes over the past three decades. Using multi-source satellite imagery combined with geographical and demographic data, this study's aims were to analyse the extent of land cover changes (LCC) and identifying major landscape transformation processes (LTP) and their drivers for four West African cities in Mali, Burkina-Faso, Nigeria and Niger. A common classification scheme was used for a visual interpretation of Corona images from the 1960s and an automated classification of Landsat scenes from 1986, 2000/2001 and 2009. Based on a postclassification comparison LCC were summarized and related to the demographic trends of the past 50 years. Map changes were calculated from 1986 to 2009 to depict LTP (urbani...

Prisons have long been associated with rapid transmission of infectious diseases. The HIV/AIDS epidemic in sub-Saharan Africa (SSA) has fuelled the spread of TB and HIV in prisons. The poor living conditions and ineffective health services in prisons in SSA are a major breeding ground of Mycobacterium tuberculosis (Mtb). The spread of TB between prisoners, prison staff and visitors and the emergence of drug-resistant TB in prisons now poses a threat to control efforts of national TB programmes in SSA. Accurate data required to develop appropriate interventions to tackle the ominous problem of TB in African prisons are scanty and unreliable. The health of prisoners is by default a neglected political issue. This article reviews the available literature on TB and drug-resistant TB in prisons...

Migration of skilled health workers from sub-Saharan African countries has significantly increased in this century, with most countries becoming sources of migrants. Despite the growing problem of health worker migration for the effective functioning of health care systems there is a remarkable paucity and incompleteness of data. Hence, it is difficult to determine the real extent of migration from, and within, Africa, and thus develop effective forecasting or remedial policies. This global overview and the most comprehensive data indicate that the key destinations remain the USA and the UK, and that major sources are South Africa and Nigeria, but in both contexts there is now greater diversity. Migrants move primarily for economic reasons, and increasingly choose health careers because th...

High-quality and reliable laboratory services are important components of effective and well-functioning health systems. Accurate, reliable and timely medical laboratory testing is crucial to patient care and disease surveillance. Unfortunately, in many sub-Saharan African countries, medical laboratory systems are adversely affected by the unavailability of medical laboratories, poor laboratory infrastructure and lack of well-trained personnel [1]. Quality in the laboratory is only achieved in a systematic way through the implementation of a quality management system. The results of the study showed that approximately 60 % of the 78 respondents were unaware of the requirements of ISO 15189:2007. A trial of proficiency testing, termed ?blind proficiency testing?, was carried out in which 19...

Neandertals, the closest evolutionary relatives of present-day humans, lived in large parts of Europe and western Asia before disappearing 30,000 years ago. We present a draft sequence of the Neandertal genome composed of more than 4 billion nucleotides from three individuals. Comparisons of the Neandertal genome to the genomes of five present-day humans from different parts of the world identify a number of genomic regions that may have been affected by positive selection in ancestral modern humans, including genes involved in metabolism and in cognitive and skeletal development. We show that Neandertals shared more genetic variants with present-day humans in Eurasia than with present-day humans in sub-Saharan Africa, suggesting that gene flow from Neandertals into the ancestors of non-Africans occurred before the divergence of Eurasian groups from each other. PMID:20448178

During the past century, several epidemics of human African trypanosomiasis, a deadly disease caused by the protist Trypanosoma brucei, have afflicted sub-Saharan Africa. Over 10-000 new victims are reported each year, with hundreds of thousands more at risk. As current drug treatments are either highly toxic or ineffective, novel trypanocides are urgently needed. The T.brucei galactose synthesis pathway is one potential therapeutic target. Although galactose is essential for T.brucei survival, the parasite lacks the transporters required to intake galactose from the environment. UDP-galactose 4--epimerase (TbGalE) is responsible for the epimerization of UDP-glucose to UDP-galactose and is therefore of great interest to medicinal chemists. Using molecular dynamics simulations, we investiga...

Although the Kimberley Process Certificate Scheme has considerably reduced the flow of conflict diamonds from 4% to less than 1%, other forms of illicit diamonds are estimated at 20% of global production. While scholars and policy makers have given considerable attention to illicit mining and smuggling (with some success), illicit exploitation still hinders revenue generation that is needed for economic growth and development in Sub-Saharan African (SSA) countries heavily reliant on alluvial minerals. Based on surveys of 240 households in four diamondiferous chiefdoms in Kono District in Sierra Leone, key informant interviews, focus groups and secondary data, and drawing from the actor-oriented approach and Le Billon (Fuelling war: natural resources and armed conflict. London, Internationa...

Summary Outbreaks of African swine fever (ASF) have been reported in the past from several countries in sub-Saharan Africa. The aim of this study was to genotype ASF viruses (ASFVs) from the 2008 outbreak in Morogoro and Dar es Salaam regions of Tanzania. Tissue samples from domestic pigs that died as a result of severe haemorrhagic disease were collected and analysed with PCR and genome sequencing methods using ASFV-specific primer sets. Nucleotide sequence data were obtained for the B646L (p72), E183L (p54) and the variable region of the B602L gene sequences. Phylogenetic analyses based on DNA sequences showed that the 2008 Tanzanian isolates belonged to p72 genotype XV and clustered together with those derived from the 2001 outbreak in Tanzania. Analysis of the tetrameric amino acid rep...

Abstract Aim The Kakamega Forest, western Kenya, has been biogeographically assigned to both lowland and montane forest biomes, or has even been considered to be unique. Most frequently it has been linked with the Guineo-Congolian rain forest block. The present paper aims to test six alternative hypotheses of the zoogeographical relationships between this forest remnant and other African forests using reptiles as a model group. Reptiles are relatively slow dispersers, compared with flying organisms (Aves and Odonata) on which former hypotheses have been based, and may thus result in a more conservative biogeographical analysis. Location Kakamega Forest, Kenya, Sub-Saharan Africa. Methods The reptile diversity of Kakamega Forest was evaluated by field surveys and data from literature resour...

Purpose. Malawi is a sub-Saharan African nation with a severe HIV epidemic. The quality of life (QoL) has never been investigated among people living with HIV and AIDS (PLWHA) in Malawi. This study examines the QoL and associated factors including life needs among PLWHA at different stages of their illness in the northern region of Malawi. Methods. Survey analysis of consecutive outpatient participants receiving highly active antiretroviral therapy at the Rainbow Clinic and non-HIV patients receiving care at the affiliated Mzuzu Central Hospital during a one-month period was performed. Laboratory testing and clinical diagnosis were used to determine HIV status, determine CD4 count, and classify WHO clinical stage. A total of 267 HIV-infected patients and 598 non-HIV participants completed ...

The African sub-continent (Sub-Saharan Africa) is a vast continent of mangroves and deserts, rainforests, mountains and, miles upon thousands of miles of flat wooded plains. It is a continent whose people rely directly on its basic natural resources--land, water, soils, animals and vegetation--for their day-to-day subsistence and development. The effects of environmental degradation have taught bilateral and multilateral agencies, non-governmental organizations (NGOs), and national governments harsh lessons about the critical importance of natural resources management to food security and development. The report examines the role of NGO's as resource stewards and explores the relationship between NGO's and donors in the environmental field, with particular reference to experiences from the Natural Resources Management Support Project for Africa and from the literature. Practical guidelines for enhancing the effectiveness of donor- collaboration are suggested. Annexes present case studies of Cameroon, Madagascar, and Mali.

Human African trypanosomiasis (HAT) is a parasitic disease affecting sub-Saharan Africa. The parasites are able to traverse the blood-brain barrier (BBB), which marks stage 2 (S2) of the disease. Delivery of anti-parasitic drugs across the BBB is key to treating S2 effectively and the difficulty in achieving this goal is likely to be a reason why some drugs require highly intensive treatment regimes to be effective. This study aimed to investigate not only the drug transport mechanisms utilised by nifurtimox at the BBB, but also the impact of nifurtimox-eflornithine combination therapy (NECT) and other anti-HAT drug combination therapies (CTs) on radiolabelled-nifurtimox delivery in an in vitro model of drug accumulation and the human BBB, the hCMEC/D3 cell line. We found that nifurtimox a...

Human African trypanosomiasis (HAT), or sleeping sickness, is a major threat to human health throughout sub-Saharan Africa. Almost always fatal if untreated or inadequately treated, a commonly used drug for treating late-stage HAT, and the only drug for late-stage Trypanosoma brucei rhodesiense, is intravenous melarsoprol, which kills 5% of patients receiving it. Melarsoprol cyclodextrin inclusion complexes have been tested in a highly reliable mouse model of HAT. These complexes increase the oral bioavailability of melarsoprol making them effective orally and both curative and nontoxic in doses that are equivalent to those of intravenous melarsoprol. It is argued that a small clinical trial of this drug in HAT is justified to potentially improve the outcome of patients with late-stage rhodesiense disease. PMID:22704910

Abstract The African stem borer, Busseola fusca (Fuller) (Lepidoptera: Noctuidae), is an important pest of maize and sorghum in sub-Saharan Africa. As in many other lepidopteran insects, the ability of B. fusca to recognize and colonize a variety of plants is based on the interaction between its sensory systems and the physical and chemical characteristics of its immediate environment. In this study, we tried to identify the behavioural steps of B. fusca leading to host selection and oviposition. Three Poaceae species commonly cultivated in Kenya for human consumption and animal forage were used in this study: the two most preferred hosts, maize (Zea mays L.) and sorghum [Sorghum bicolor (L.) Moench], and one non-preferred host, Napier grass (Pennisetum purpureum Schumach). Wind tunnel obs...

There is widespread interest in the impacts of climate change on agriculture in Sub-Saharan Africa (SSA), and on the most effective investments to assist adaptation to these changes, yet the scientific basis for estimating production risks and prioritizing investments has been quite limited. Here we show that by combining historical crop production and weather data into a panel analysis, a robust model of yield response to climate change emerges for several key African crops. By mid-century, the mean estimates of aggregate production changes in SSA under our preferred model specification are - 22, - 17, - 17, - 18, and - 8% for maize, sorghum, millet, groundnut, and cassava, respectively. In all cases except cassava, there is a 95% probability that damages exceed 7%, and a 5% probability that they exceed 27%. Moreover, countries with the highest average yields have the largest projected yield losses, suggesting that well-fertilized modern seed varieties are more susceptible to heat related losses.

ABSTRACT: INTRODUCTION: The epidemic of HIV in sub-Saharan Africa varies significantly across countries in the region with high prevalence in Southern Africa and Nigeria. Cancer is increasingly identified as a complication of HIV infection with higher incidence and mortality in this group than in the general population. Without cancer prevention strategies, improved cancer treatment alone would be an insufficient response to this increasing burden among people living with HIV (PLHIV). Although previous studies have noted low levels of awareness of cancers in sub-Saharan Africa none has examined the knowledge and perceptions of cancer among beneficiaries of a large PEPFAR program in Nigeria. METHODS: Focus group discussions (FGD) and Key Informant Interviews (KII) were carried out in 4 high volume tertiary care institutions that offer HIV care and treatment in Nigeria. FGD and KII assessed participants' knowledge of cancer, attitudes towards cancer risk and cancer screening practices. RESULTS: The mean age of participants was 38 years. Most participants had heard about cancer and considered it a fatal disease but displayed poor knowledge of the causes and of AIDs associated cancers. PLHIV in Nigeria expressed attitudes of fear, denial and disbelief as to their perceived cancer risk. Some of the participants had heard about cancer screening but very few participants had been screened. CONCLUSION: Our findings of poor knowledge of cancer among PLHIV in Nigeria indicate the need for health care providers and the government to intervene by developing primary cancer prevention strategies for this population. PMID:23098099

The vast majority of patients with Parkinson's disease (PD) in sub-Saharan Africa are undiagnosed and untreated with impaired quality of life and markedly increased mortality rates. PD is a progressive neurodegenerative disorder that becomes increasingly common as people age. Diagnosis remains predominantly clinical based on motor symptoms: tremor, rigidity, bradykinesia and postural instability. In developed countries, it is well recognized and very few patients will not be diagnosed and treated. However, in developing countries, such as those in sub-Saharan Africa, evidence suggests that most patients are undiagnosed, and even if they are diagnosed, they do not have access to sustainable, affordable, drug treatment and medical supervision. There is a lack of awareness, both within the general population and also among healthcare professionals, and many patients seek help from traditional healers. Even if they are diagnosed, treatment is often too expensive, and supplies are sporadic. There is a great need to increase awareness of PD within the general population and the fact that the symptoms are treatable. Education of healthcare workers about PD is also important, but a major challenge is there are few doctors and even fewer neurologists. Awareness raising and training will be to no avail, unless the problem of an affordable, reliable supply of drug treatment can be tackled. PMID:22650168

ABSTRACT: BACKGROUND: Trypanosomosis, a protozoal disease affecting livestock, transmitted by Glossina (tsetse) flies is a major constraint to agricultural production in Sub-Saharan Africa. It is accepted that utilization of the native trypanotolerance exhibited in some of the African cattle breeds to improve trypanotolerance of more productive but susceptible breeds, will offer a cost effective and sustainable solution to the problem. The success of this approach is based on the premise that quantitative trait loci previously identified under relatively controlled situations confer useful trypanotolerance under natural field situations. As part of a study to authenticate this hypothesis, a population of 192 cattle, consisting of six batches of N'Dama and Kenya-Boran backcross animals [(N'Dama x Kenya-Boran) x Kenya-Boran] born over the period 2002 to 2006 was constructed. Some of the batches also included pure Kenya-Boran cattle, or N'Dama x Kenya- Boran F1 animals. Each batch was exposed as yearlings to natural field trypanosomosis challenge over a period of about one year; the entire challenge period extending from December 2003 to June 2007. Performance of the animals was evaluated by weekly or biweekly measurements of body weight, packed blood cell volume (PCV), parasitemia score, and number of trypanocide treatments. From these basic data, 49 phenotypes were constructed reflecting dynamics of body weight, packed cell volume (PCV) and parasitemia under challenge. RESULTS: Females were distinctly more trypanotolerant than males. F1, backcross and pure Kenya- Boran animals ranked in that order with respect to trypanotolerance. Overall batch effects were highly significant (p<0.001) for most traits, and were generally more significant than the gender or genetic type effects. The superior trypanotolerance of the F1 animals was expressed in all three components of animal defense strategies against pathogens: Avoidance resistance, and tolerance. CONCLUSIONS: The results show that trypanotolerance derived from the N'Dama is expressed under field conditions; and that the trait is primarily additive in nature, being expressed in heterozygous condition and in a three-quarters Boran genetic background. The results further, underscore the complexity of the trait in the field manifesting all three host disease-control strategies, and show the importance of gender and local environmental conditions in determining response to challenge. PMID:23075408

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

Greater than 80% of malaria-related mortality occurs in sub-Saharan Africa due to infections with Plasmodium falciparum. The majority of P. falciparum-related mortality occurs in immune-naïve infants and young children, accounting for 18% of all deaths before five years of age. Clinical manifestations of severe falciparum malaria vary according to transmission intensity and typically present as one or more life-threatening complications, including: hyperparasitemia; hypoglycemia; cerebral malaria; severe malarial anemia (SMA); and respiratory distress. In holoendemic transmission areas, SMA is the primary clinical manifestation of severe childhood malaria, with cerebral malaria occurring only in rare cases. Mortality rates from SMA can exceed 30% in pediatric populations residing in holoendemic transmission areas. Since the vast majority of the morbidity and mortality occurs in immune-naïve African children less than five years of age, with SMA as the primary manifestation of severe disease, this review will focus primarily on the innate immune mechanisms that govern malaria pathogenesis in this group of individuals. The pathophysiological processes that contribute to SMA involve direct and indirect destruction of parasitized and non-parasitized red blood cells (RBCs), inefficient and/or suppression of erythropoiesis, and dyserythropoiesis. While all of these causal etiologies may contribute to reduced hemoglobin (Hb) concentrations in malaria-infected individuals, data from our laboratory and others suggest that SMA in immune-naïve children is characterized by a reduced erythropoietic response. One important cause of impaired erythroid responses in children with SMA is dysregulation in the innate immune response. Phagocytosis of malarial pigment hemozoin (Hz) by monocytes, macrophages, and neutrophils is a central factor for promoting dysregulation in innate inflammatory mediators. As such, the role of P. falciparum-derived Hz (PfHz) in mediating suppression of erythropoiesis through its ability to cause dysregulation in pro- and anti-inflammatory cytokines, growth factors, chemokines, and effector molecules is discussed in detail. An improved understanding of the etiological basis of suppression of erythropoietic responses in children with SMA may offer the much needed therapeutic alternatives for control of this global disease burden. PMID:7123238

Abstract The multimammate rat, Mastomys natalensis Smith 1834, is a dominant species in agro-ecosystems in Sub-Saharan Africa, but adapts quickly to changes in non-agricultural landscape, particularly woodlands and forests. In this study we report on reproduction and population dynamics of M. natalensis in deforested high elevation localities in the Usambara Mountains, north-east Tanzania. We conducted Capture-Mark-Recapture studies in 2002-2004, and established that reproduction of M. natalensis takes place in the extended wet season between February and June, and the population density peaks in June-August. Reproduction cease in July to January and population density drops from July onwards. Reproduction and population density fluctuations are linked to the duration and amount of rainfal...

APOBEC3B, a gene involved in innate response, exhibits insertion-deletion polymorphism across world populations. We observed the insertion allele to be nearly fixed in malaria endemic regions of sub-Saharan Africa as well as populations with high malaria incidence in the past. This prompted us to investigate the possible association of the polymorphism with falciparum malaria. We studied the distribution of APOBEC3B, in 25 diverse Indian populations comprising of 500 samples and 176 severe or non-severe Plasmodium falciparum patients and 174 ethnically-matched uninfected individuals from a P. falciparum endemic and a non-endemic region of India. The deletion frequencies ranged from 0% to 43% in the Indian populations. The frequency of the insertion allele strikingly correlated with the end...

Although the leaves of Kigelia africana are used to make a palm-nut soup which is consumed mainly by lactating women in many parts of sub-Saharan Africa, little is known about the nutrient qualities of this underutilized and underappreciated plant food. Leaves of Kigelia africana, called "sausage tree" in English and "nufuten" in the Twi language of Ghana, were collected in Kumasi and analyzed for their content of nutritionally important fatty acids, amino acids, minerals, and trace elements. The dried leaves contained 1.62% fatty acids, of which ?-linolenic acid and linolenic acid accounted for 44% and 20%, respectively, of the total. Protein accounted for 12.6% of the dry weight and, except for lysine, its overall essential amino acid profile compared favorably to a World Health Organization protein standard for school children. Kigelia leaf contained considerable amounts of many essential elements, including calcium (7,620 ?g/g), iron (161 ?g/g), magnesium (2,310 ?g/g), manganese (14.6 ?g/g), zinc (39.9 ?g/g), and chromium (0.83 ?g/g); selenium, however, was not detected. These data indicate that Kigelia africana leaf compares favorably with many other commonly-consumed green leafy vegetables such as spinach and provides a rational basis for promoting the conservation and propagation of the plant and encouraging its wider use in the diets of populations in sub-Saharan Africa. PMID:21883090

Pre-colonial traditional societies in Sub-Saharan Africa were mostly oral societies whose languages were not written. In the African context, especially, it was clear that the mostly oral traditions of these societies' languages were neither being appreciated nor promoted as media of communication, or means of education by the invading Europeans. As such, for the European powers that were in control of African life in the colonial relationships, only written literature (in colonial languages) was to be regarded as meaningful literature. The point presented in this essay is not to "radically and irrationally" blame the historical and current impositions of European languages and cultures for everything that is wrong with the old continent. It is simply to suggest that if the language of development, the standards of development, the history of development as well as the social-psychology of development are all imported via the expressive and descriptive platforms that are both ontologically and existentially alienating, the results cannot bode well for Africans and others in similar intersections of historiographies and their actualities. (Contains 1 note.)

The adequacy and safety of blood transfusion in sub-Saharan Africa is the subject of much concern, yet there have been very few studies of its history. An overview of that record finds that transfusions were first reported in Africa (sub-Saharan and excluding South Africa) in the early 1920s, and organized transfusion practices were established before the Second World War. Blood transfusion grew rapidly after 1945, along with the construction of new hospitals and expanded health services in Africa. Significant differences existed between colonial powers in the organization of transfusion services, but these converged after independence as their use continued to grow and decentralized and hospital-based practices were adopted. It was only after the oil crisis in the mid-1970s that health spending declined and the collection, testing, and transfusion of blood began to level off. Thus, when the AIDS crisis hit transfusion services, they were already struggling to meet the needs of patients. At this time, foreign assistance as well as the World Health Organization and the League of Red Cross Societies helped respond to both the immediate problem of testing blood, and for some countries, support existed for the broader reorganization of transfusion. Overall, the history shows that transfusion was adopted widely and quickly, limited mainly by the availability of knowledgeable doctors and hospital facilities. There was less resistance than expected by Africans to receive transfusions, and the record shows a remarkable flexibility in obtaining blood. The dangers of disease transmission were recognized from an early date but were balanced against the potential lifesaving benefits of transfusion. PMID:22981696

Summary Plasmodium falciparum is distributed throughout the tropics and is responsible for an estimated 230 million cases of malaria every year, with a further 1.4 billion people at risk of infection [1-3]. Little is known about the genetic makeup of P. falciparum populations, despite variation in genetic diversity being a key factor in morbidity, mortality, and the success of malaria control initiatives. Here we analyze a worldwide sample of 519 P. falciparum isolates sequenced for two housekeeping genes (63 single nucleotide polymorphisms from around 5000 nucleotides per isolate). We observe a strong negative correlation between within-population genetic diversity and geographic distance from sub-Saharan Africa (R2 = 0.95) over Africa, Asia, and Oceania. In contrast, regional variation i...

Background Since 2000, R&D financing for global health has increased significantly, with innovative proposals for further increases. However, although venture capital (VC) funding has fostered life sciences businesses across the developed world, its application in the developing world and particularly in Africa is relatively new. Is VC feasible in the African context, to foster the development and application of local health innovation? As the most industrially advanced African nation, South Africa serves as a test case for life sciences venture funding. This paper analyzes Bioventures, the first VC company focused on life sciences investment in sub-Saharan Africa. The case study method was used to analyze the formation, operation, and investment support of Bioventures, and to suggest lessons for future health venture funds in Africa that aim to develop health-oriented innovations. Discussion The modest financial success of Bioventures in challenging circumstances has demonstrated a proof of concept that life sciences VC can work in the region. Beyond providing funds, support given to investees included board participation, contacts, and strategic services. Bioventures had to be proactive in finding and supporting good health R&D. Due to the fund’s small size, overhead and management expenses were tightly constrained. Bioventures was at times unable to make follow-on investments, being forced instead to give up equity to raise additional capital, and to sell health investments earlier than might have been optimal. With the benefit of hindsight, the CFO of Bioventures felt that partnering with a larger fund might benefit similar future funds. Being better linked to market intelligence and other entrepreneurial investors was also seen as an unmet need. Summary BioVentures has learned lessons about how the traditional VC model might evolve to tackle health challenges facing Africa, including how to raise funds and educate investors; how to select, value, and support investments; and how to understand the balance between financial and social returns. The experience of the fund suggests that future health funds targeting ailments of the poor might require investors that accept health benefits as part of their overall “return.” Learning from Bioventures may help develop health innovation funding for sub-Saharan African that has combined health, financial, and economic development impacts. PMID:17734859

The devastating consequences of HIV/AIDS have caused untold harm and human suffering globally. Over 33 million people worldwide are estimated to be living with HIV and AIDS and a majority of these are in sub-Saharan Africa. Women and children are more infected particularly in sub-Saharan countrie...

African trypanosomiasis is still a major health problem in many sub-Saharan countries in Africa. We investigated the effects of three preparations of Panax ginseng, Panax notoginseng, isolated ginsenosides, and the polyacetylene panaxynol on Trypanosoma brucei brucei and the human cancer cell line HeLa. Hexane extracts and the pure panaxynol were toxic and at the same time highly selective against T. b. brucei, whereas methanol extracts and 12 isolated ginsenosides were significantly less toxic and showed only weak selectivity. Panaxynol was cytotoxic against T. b. brucei at the concentration of 0.01?µg/mL with a selectivity index of 858, superior even to established antitrypanosomal drugs. We suggest that the inhibition of trypanothione reductase, which is only found in trypanosomes, might explain the observed selectivity. The high selectivity together with a cytotoxic concentration in the range of the bioavailability makes panaxynol and other polyacetylenes in general very promising lead compounds for the treatment of African trypanosomiasis. Copyright © 2012 John Wiley & Sons, Ltd. PMID:22473703

Human African trypanosomiasis, endemic to sub-Saharan Africa, is invariably fatal if untreated. Its causative agent is the protozoan parasite Trypanosoma brucei. Eflornithine is used as a first line treatment for human African trypanosomiasis, but there is a risk that resistance could thwart its use, even when used in combination therapy with nifurtimox. Eflornithine resistant trypanosomes were selected in vitro and subjected to biochemical and genetic analysis. The resistance phenotype was verified in vivo. Here we report the molecular basis of resistance. While the drug's target, ornithine decarboxylase, was unaltered in resistant cells and changes to levels of metabolites in the targeted polyamine pathway were not apparent, the accumulation of eflornithine was shown to be diminished in resistant lines. An amino acid transporter gene, TbAAT6 (Tb927.8.5450), was found to be deleted in two lines independently selected for resistance. Ablating expression of this gene in wildtype cells using RNA interference led to acquisition of resistance while expression of an ectopic copy of the gene introduced into the resistant deletion lines restored sensitivity, confirming the role of TbAAT6 in eflornithine action. Eflornithine resistance is easy to select through loss of a putative amino acid transporter, TbAAT6. The loss of this transporter will be easily identified in the field using a simple PCR test, enabling more appropriate chemotherapy to be administered. PMID:19753472

In the past decade, the telecommunication and Information and Communication Technology (ICT) industry has grown very fast with increasing appetites for modern value added services and gadgets which function without any break, delay or interferences. Currently, total worldwide mobile subscription have grown to 5.3 billion and mobile internet subscription to 2 billion at the end of 2010, and these numbers are expected to double within five years (1). The growth trend in Africa is not different. It is expectation that the mobile subscriber base will rise to 1 billion at the end of 2010 (2). This growth therefore requires more reliable and sustainable energy for effective operation. However, about nearly 1.6 billion people in the world do not have access to electricity and about 99 percent of this figure is from developing countries. This shows that about 1.3 billion people from Sub-Saharan African do not have access to the grid electricity (3). This paper looks at energy consumption of telecommunication and ICT in African countries, the potentials of introducing renewable energy into telecommunication and ICT sector in Africa especially in the rural communities. It is expected that, the deployment of renewable energy will provide a reliable and sustainable power supply, in the Telecom/ICT industry thereby making access to ICT much easier and at a lesser cost.

Human African trypanosomiasis is an infectious disease which has resulted in the deaths of thousands of people in Sub-Saharan Africa. Two subspecies of the protozoan parasite Trypanosoma brucei are the causative agents of the infection, whereby T. b. gambiense leads to chronic development of the disease and T. b. rhodesiense establishes an acute form, which is fatal within months or even weeks. Current chemotherapy treatment is complex, since special drugs have to be used for the different development stages of the disease, as well as for the parasite concerned. Melarsoprol is the only approved drug for effectively treating both subspecies of human African trypanosomiasis in its advanced stage, however, the drug's potency is constrained due to an unacceptable side effect: encephalopathy, which develops in one out of every 20 patients who are treated with the drug. In addition to the deleterious treatment with melarsoprol, the number of drug-resistant strains of T. brucei supp. increases. Mechanisms of drug resistance have been elucidated and involve decreased drug import through the loss of the purine transporter P2 as well as enhanced drug export, mediated by a multidrug resistance-associated protein called TbMRPA. Thereby, the medical treatment with the available chemotherapeutics becomes exceedingly difficult. A promising strategy for research into new drugs and moreover, to overcome drug resistance, are compounds derived from natural sources. This study provides an overview of the recently discovered small molecules with trypanocidal activity against T. b. gambiense and T. b. rhodesiense. In addition, former promising compounds are touched upon. PMID:18813846

Access to modern energy services is still low in developing countries and this lack of access affects in particular the Least Developed Countries (LDCs) and sub-Saharan Africa. The large majority of population in the Logone Valley at the border between Chad and Cameroon still relies on wood fuel burnt in smoky and inefficient fireplaces for cooking. The promotion of wood saving stoves locally produced and appropriate for the traditional cooking practices has been implemented by an international cooperation project. Two stove models were compared to the traditional 3-stone fire and a gas stove by Water Boiling Tests and Controlled Cooking Tests. The results showed significant fuel savings thanks to the use of the improved stoves. Data collected during the tests, crossed with information abo...

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-Guer...

Abstract Considering that current newborn/infant hearing screening (NHS) instruments were designed primarily for use in developed countries, this study set out to ascertain the potential effects of higher ambient noise levels on transient-evoked otoacoustic emissions (TEOAE) in sub-Saharan Africa. Data was drawn from two hospital-based and community-based NHS programs in Lagos, Nigeria, with a total screened population of 11 893 infants. Two automated TEOAE screening devices-Echo-Screen and ECHOCHECK-were available for this study. Ambient noise levels ranged from 61.0-90.5 dBA in the hospital wards and 55.6-82.5 dBA in the community health centers. One TEOAE model could not be activated at the prevailing noise levels. No significant pattern was observed in average noise levels and overall ...

The aim of the present work was to study the origin of paternal and maternal lineages in Guinea-Bissau population, inferred by phylogeographic analyses of mtDNA and Y chromosome defined haplogroups. To determine the male lineages present in Guinea-Bissau, 33 unrelated males were typed using a PCR-SNaPshot multiplex based method including 24 Y-SNPs, which characterize the main haplogroups in sub-Saharan Africa and Western Europe. In the same samples, 17 Y-STRs (included in the YFiler kit, Applied Biosystems) were additionally typed. The most frequent lineages observed were E1b1a (xE1b1a4,7)-M2 (68%) and E1a-M33 (15%). The European haplogroup R1b1-P25 was represented with a frequency of 12%. The two hypervariable mtDNA regions were sequenced in 79 unrelated individuals from Guinea-Bissau, an...

Abstract Background: Sub-Saharan Africa bears an inordinate burden of human immunodeficiency virus (HIV) infection/acquired immune deficiency syndrome (AIDS). Reports have shown increased prevalence of clustering of cardiovascular risk factors referred to as metabolic syndrome in treatment-na?ve patients and patients on highly active antiretroviral therapy (HAART). In view of the fact that metabolic syndrome is a heterogeneous disorder with substantial variability in the prevalence and component traits within and across populations and the dearth of publications on the prevalence and clinical correlates of metabolic syndrome in people living with HIV/AIDS (PLWHA) in Nigeria, this study was carried out to determine the prevalence and clinical correlates of metabolic syndrome among an HIV-in...

Like many countries in sub-Saharan Africa, Tanzania faces considerable challenges in meeting the future energy demands of its rapidly growing urban population without depleting its forests. Nonindustrial charcoal production generates large emissions of greenhouse gases (GHG) in the form of CO"2 from forest degradation and methane from oxidation in traditional kilns. On a global scale, the GHG emissions from cement production are of considerable magnitude and are increasing rapidly. In this study, the impact of converting sawmill residues into charcoal briquettes and charcoal powder in Tanzania was assessed, using a cradle-to-grave approach. Furthermore, the net effects on GHG of substituting more GHG-intensive fuels with these charcoal products were evaluated. Replacing coal in cement manu...

Decades ago, discussion of an impending global pandemic of obesity was thought of as heresy. But in the 1970s, diets began to shift towards increased reliance upon processed foods, increased away-from-home food intake, and increased use of edible oils and sugar-sweetened beverages. Reductions in physical activity and increases in sedentary behavior began to be seen as well. The negative effects of these changes began to be recognized in the early 1990s, primarily in low- and middle-income populations, but they did not become clearly acknowledged until diabetes, hypertension, and obesity began to dominate the globe. Now, rapid increases in the rates of obesity and overweight are widely documented, from urban and rural areas in the poorest countries of sub-Saharan Africa and South Asia to po...

The University of Chicago and the University of Ibadan in Nigeria have partnered to exchange innovative insights into the sexual and reproductive health of disadvantaged populations in Chicago and Nigeria. Youth in both Chicago and Nigeria face disproportionately high rates of mortality and morbidity due to poor sexual and reproductive health. Traditional models have fallen short of the needs of these youth, so the University of Chicago is seeking to reframe and retool adolescent sexual health education. Game Changer Chicago is an initiative that incorporates digital storytelling, new media, and game design to conduct workshops with youth around issues of sexuality and emotional health. Based on the success of storytelling and digital media programs in Nigeria and the success of Game Changer Chicago, we believe this model holds promise for implementation in Nigeria and other sub-Saharan countries PMID:22916551

Poaching and habitat destruction across sub-Saharan Africa brought the black rhinoceros (Diceros bicornis) close to extinction. Over the past few decades, however, one of four subspecies, D. b. bicornis, has experienced a significant population increase as a consequence of its protection within Etosha National Park (ENP), Namibia. We report here on the level and spatial distribution of black rhinoceros genetic diversity within ENP. Using nine microsatellite loci, genetic variation was assessed from 144 individuals. Our results are consistent with the observation of lower levels of genetic diversity in D. b. bicornis, when compared to D. b. michaeli, but greater diversity when compared to D. b. minor. We also showed that ENP?s black rhino genetic diversity is well represented in Waterberg N...

A substantial proportion of HIV-1 infected individuals in sub-Saharan Africa are in stable relationships with HIV-1 uninfected partners, and HIV-1 serodiscordant couples thus represent an important target population for HIV-1 prevention. Couple-based HIV-1 testing and counseling facilitates identification of HIV-1 serodiscordant couples, counseling about risk reduction, and referrals to HIV-1 treatment, reproductive health services, and support services. Maximizing HIV-1 prevention for HIV-1 serodiscordant couples requires a combination of strategies, including counseling about condoms, sexual risk, fertility, contraception, and the clinical and prevention benefits of antiretroviral therapy (ART) for the HIV-1-infected partner; provision of clinical care and ART for the HIV-1-infected part...

BACKGROUND: Tuberculosis (TB) accounts of much of the morbidity and mortality associated with HIV. We evaluate the cost-effectiveness of different strategies to actively screen for TB disease in HIV positive individuals, where isoniazid preventative therapy (IPT) is given to those screening negative, and use value of information analysis (VOI) to identify future research priorities. METHODOLOGY/ PRINCIPAL FINDINGS: We built an individual sampling model to investigate the costs (2010 US Dollars) and consequences of screening for TB, and providing TB treatment or IPT in adults testing HIV positive in Sub-Saharan Africa. A systematic review and meta-analysis was conducted to assess performance of the nine different TB screening strategies evaluated. Probabilistic sensitivity analysis was conducted to incorporate decision uncertainty, and expected value of perfect information for the entire model and for groups of parameters was calculated. Screening all HIV infected individuals with sputum microscopy was the least costly strategy, with other strategies not cost-effective at WHO recommended thresholds. Screening those with TB symptoms with sputum microscopy and CXR would be cost-effective at a threshold ICER of $7,800 per quality-adjusted life year (QALY), but associated with significant uncertainty. VOI analysis suggests further information would be of value. CONCLUSIONS/ SIGNIFICANCE: Resource-constrained countries in sub-Saharan Africa wishing to scale up TB preventative services in their HIV infected populations should consider expanding laboratory facilities to enable increased screening for TB with sputum microscopy, whilst improved estimates of the TB prevalence in the population to be screened are needed, as it may influence the optimal strategy. PMID:22291958

Abstract in spanish OBJETIVO: La circuncisión masculina reduce el riesgo de contagio del VIH en un 60% aproximadamente. Se están implantando servicios de circuncisión masculina en poblaciones seleccionadas del África subsahariana, al tiempo que se planifican nuevas intervenciones. Un motivo serio de preocupación es la duda sobre si es posible practicar la circuncisión masculina en condiciones seguras a un gran número de varones adultos en los países en desarrollo. MÉTODOS: Este estu (more) dio prospectivo se llevó a cabo en el distrito de Bungoma, Kenya, donde la circuncisión masculina es una práctica generalizada. Mediante un método de muestreo por conglomerados en dos etapas se seleccionó a hombres jóvenes que deseaban someterse a circuncisión, tradicional o médica. Durante los meses de julio y agosto de 2004, 1007 varones fueron entrevistados a los 30-89 días de la intervención. Veinticuatro hombres fueron objeto de observación durante la circuncisión y a los 3, 8, 30 y 90 días de la misma, y 298 fueron sometidos a exploración clínica pasados 45-89 días tras la intervención. Se entrevistó asimismo a 21 prácticos tradicionales y 20 profesionales médicos para evaluar su experiencia y grado de adiestramiento, y se hicieron inventarios de los establecimientos de salud para determinar el estado del instrumental y los suministros necesarios para realizar las circuncisiones de forma segura. RESULTADOS: De 443 hombres circuncidados por el método tradicional, 156 (35,2%) sufrieron eventos adversos, frente a 99 de los 559 (17,7%) sometidos a circuncisión médica (razón de posibilidades (OR): 2,53; intervalo de confianza del 95%: 1,89-3,38). Hemorragias e infecciones fueron los efectos adversos más comunes, pero se observaron también casos de desgarro, torsión y disfunción eréctil. Los participantes tenían entre 5 y 21 años, y la mitad de ellos eran sexualmente activos antes de la circuncisión. Prácticos y profesionales carecían de los conocimientos y preparación necesarios, y la mayoría de los centros de salud no disponían del instrumental y los suministros adecuados. CONCLUSIÓN: Habrá que desplegar un gran esfuerzo de capacitación y abundantes recursos en el África subsahariana antes de poder pasar a fomentar resueltamente la circuncisión masculina como medio de prevención de la infección por VIH. Dos de cada tres hombres africanos han sido circuncidados, la mayoría por prácticos tradicionales o no preparados y en entornos informales. El tema de la seguridad de la circuncisión no debe ser ignorado en las comunidades donde es ya ampliamente practicada. Abstract in english OBJECTIVE: Male circumcision reduces the risk of HIV acquisition by approximately 60%. Male circumcision services are now being introduced in selected populations in sub-Saharan Africa and further interventions are being planned. A serious concern is whether male circumcision can be provided safely to large numbers of adult males in developing countries. METHODS: This prospective study was conducted in the Bungoma district, Kenya, where male circumcision is universally pr (more) actised. Young males intending to undergo traditional or clinical circumcision were identified by a two-stage cluster sampling method. During the July-August 2004 circumcision season, 1007 males were interviewed 30-89 days post- circumcision. Twenty-four men were directly observed during and 3, 8, 30 and 90 days post-circumcision, and 298 men underwent clinical exams 45-89 days post-procedure. Twenty-one traditional and 20 clinical practitioners were interviewed to assess their experience and training. Inventories of health facilities were taken to assess the condition of instruments and supplies necessary for performing safe circumcisions. FINDINGS: Of 443 males circumcised traditionally, 156 (35.2%) experienced an adverse event compared with 99 of 559 (17.7%) circumcised clinically (odds ratio: 2.53; 95% confidence interval: 1.89-3.38). Bleeding and infection were the most common adverse effects, with excessive pain, lacerations, torsion and erectile dysfunction also observed. Participants were aged 5 to 21 years and half were sexually active before circumcision. Practitioners lacked knowledge and training. Proper instruments and supplies were lacking at most health facilities. CONCLUSION: Extensive training and resources will be necessary in sub-Saharan Africa before male circumcision can be aggressively promoted for HIV prevention. Two-thirds of African men are circumcised, most by traditional or unqualified practitioners in informal settings. Safety of circumcision in communities where it is already widely practised must not be ignored.

Objective To determine maternal risk factors for stillbirth among pregnant HIV-infected women in sub-Saharan Africa. Design Prospective cohort study nested within a micronutrient trial. At enrollment, maternal sociodemographic, obstetric, immunologic, clinical, and nutritional variables were measured. Women were followed through monthly clinic visits until delivery. Multivariate predictors of stillbirth were identified in Poisson regression models. Setting Antenatal clinic in a tertiary care hospital in urban Dar es Salaam, Tanzania. Population N = 1,078 women enrolled between 12 and 27 weeks of gestation. Main outcome measures Stillbirth (delivery of dead baby ? 28 weeks’ gestation), fresh stillbirth, and macerated stillbirth. Results Among 1,017 singleton pregnancies, there were 49 stillbirths, yielding a stillbirth risk of 50.0 per 1,000 deliveries (95% Confidence Interval(CI) = 37.2, 65.6). Of stillbirths with known type, 53.7% were fresh and 46.3% macerated. In multivariate analyses, baseline measures of late ( ? 21 weeks’ gestation) study entry (Relative Risk (RR) = 2.13, 95% CI = 1.17, 3.87), CD3 count ? 1,179 cells/ml (RR = 2.15, 95% CI = 1.16, 4.01), stillbirth history (RR = 3.53, 95% CI = 1.30, 9.59), primiparity (RR = 3.65, 95% CI = 1.83, 7.29), and syphilis infection (RR = 2.06, 95% CI = 1.09, 3.88) predicted increased stillbirth risk. Late study entry, illiteracy, stillbirth history, primiparity, CD3 count ? 1,179 cells/ml, gonorrhea infection, and previous hospitalization predicted increased risk of fresh stillbirth, while living alone and syphilis infection predicted increased risk of macerated stillbirth. Conclusions Applying antenatal screening and preventive tools for the socioeconomic, obstetric, immunologic, and clinical risk factors identified may assist in reducing the high incidence of stillbirth among HIV-infected women in urban sub-Saharan Africa. PMID:16199546

Abstract in spanish La lucha contra el SIDA plantea numerosos retos en todo el mundo, lo que hace temer a muchos que sea muy difícil, si no imposible, ganar esa batalla. Uganda ha demostrado que una estrategia de lucha precoz, coherente y multisectorial permite reducir tanto la prevalencia como la incidencia de la infección por el VIH. A partir de sólo dos casos de SIDA en 1982, la epidemia de Uganda se propagó hasta dar lugar a 2 millones de casos acumulados de infección por el VIH a f (more) inales de 2000. El Programa de Lucha contra el SIDA establecido en 1987 en el Ministerio de Salud articuló una respuesta nacional que se extendió con el tiempo a otros sectores de interés bajo la coordinación de la Comisión de Uganda para el SIDA. La respuesta nacional consistió en introducir nuevas políticas, alianzas más amplias, una mayor capacidad institucional de atención e investigación, educación en materia de salud pública para propiciar cambios de comportamiento, una gestión reforzada de las enfermedades de transmisión sexual (ETS), mejoras en los servicios de transfusión sanguínea, servicios de atención y apoyo para las personas con VIH/SIDA, y un sistema de vigilancia para controlar la evolución de la epidemia. Tras una década de lucha en esos frentes, Uganda se convirtió en octubre de 1996 en el primer país africano que informó de una tendencia a la baja de los casos de infección por el VIH, y desde entonces la prevalencia ha seguido disminuyendo. El Medical Research Council del Reino Unido y el Instituto de Investigaciones Virológicas de Uganda han puesto de relieve una disminución de la incidencia de infección por el VIH en la población general en los distritos de Kyamulibwa y Masaka. Otros estudios repetidos posteriores sobre los conocimientos, actitudes, comportamientos y prácticas han revelado cambios positivos en los principales indicadores de prevención. Los datos llevan a pensar que la respuesta nacional integrada aquí descrita, unida al resuelto compromiso político conseguido en su apoyo, está en el origen de la disminución observada. Otros países del África subsahariana podrían lograr resultados similares con ese tipo de medidas. A la vista del éxito cosechado, resulta inaceptable no adoptar como mínimo tales medidas. Abstract in english The fight against HIV/AIDS poses enormous challenges worldwide, generating fears that success may be too difficult or even impossible to attain. Uganda has demonstrated that an early, consistent and multisectoral control strategy can reduce both the prevalence and the incidence of HIV infection. From only two AIDS cases in 1982, the epidemic in Uganda grew to a cumulative 2 million HIV infections by the end of 2000. The AIDS Control Programme established in 1987 in the Mi (more) nistry of Health mounted a national response that expanded over time to reach other relevant sectors under the coordinating role of the Uganda AIDS Commission. The national response was to bring in new policies, expanded partnerships, increased institutional capacity for care and research, public health education for behaviour change, strengthened sexually transmitted disease (STD) management, improved blood transfusion services, care and support services for persons with HIV/AIDS, and a surveillance system to monitor the epidemic. After a decade of fighting on these fronts, Uganda became, in October 1996, the first African nation to report declining trends in HIV infection. Further decline in prevalence has since been noted. The Medical Research Council (UK) and the Uganda Virus Research Institute have demonstrated declining HIV incidence rates in the general population in the Kyamulibwa in Masaka Districts. Repeat knowledge, attitudes, behaviour and practice studies have shown positive changes in the priority prevention indicators. The data suggest that a comprehensive national response supported by strong political commitment may be responsible for the observed decline. Other countries in sub-Saharan Africa can achieve similar results by these means. Since success is possible, anything less is unacceptable.

Human African Trypanosomiasis (HAT),which is also known as sleeping sickness, is a major cause of death and disability in 36 countries in sub-Saharan Africa. The disease is caused by the protozoan parasite of the Trypanosoma genus which is transmitted by the bite of the tsetse fly. The two types of HAT, the East African form due to Trypanosoma b.rhodesiensei (T. b.rhodesiensi) and the West African form due to T. b.gambiense, differ in their tempo of infection but in both cases the disease is always fatal if untreated. As well as multiple systemic features seen in the early (haemolymphatic) stage of disease, the late (encephalitic stage) stage, is associated with a wide range of neurological features including neuropsychiatric, motor and sensory abnormalities. Accurate staging of the disease is absolutely essential because of the potentially fatal complications of melarsoprol treatment of late-stage disease, the most important of which is a severe post-treatment reactive encephalopathy (PTRE) the pathogenesis of which is not fully understood. However, there is not a universal consensus as to how late-stage disease should be diagnosed using CSF criteria, and this has been very problematic in HAT. A more recent alternative drug for late stage gambiense disease is eflornithine (DFMO). There is a pressing need for a non-toxic oral drug for both early and late stage disease that would obviate many of the problems of staging, and various possible strategies to achieve this goal are currently underway. However, control of the disease will also require more effective measures of reducing man/fly contact and also the allocation of much greater financial and infrastructural resources than are currently available in Africa. PMID:16541214

The prevalences of antibodies reactive with Coxiella burnetti, Rickettsia conorii, and Rickettsia typhi were determined by indirect fluorescent antibody testing of sera from seven African countries. The seroprevalences of antibodies reactive with C. burnetti and R. conorii in countries from North Africa were similar to those reported from southern Europe. In countries of sub-Saharan Africa, the seroprevalence of antibodies reactive with C. burnetti varied greatly; the generally higher figures for West Africa, where stock breeding is prominent, suggested that domestic animals might be the main reservoirs of infection. The prevalence of antibodies to the recently described species Rickettsia africae was higher than that reported for spotted fever-group rickettsiae from elsewhere in the world and paralleled the distribution of Amblyomma species. Western blot results suggested that the antibodies detected were more likely to be reactive with R. africae than with R. conorii, the main vector of which (Rhipicephalus species) rarely feeds on humans. The seroprevalences of antibodies reactive with R. typhi were higher in coastal regions, where Rattus norvegicus--the natural host of the vector Xenopsylla--is more prevalent, than in inland areas. PMID:8589132

Sub-Saharan African countries are at an increased risk of the effects of global warming. Unfortunately they have the least capacity to adapt to its untoward effects. We studied public awareness of global warming, its perceived causes, effects and prevention in Kano city, northern Nigeria. Structured questionnaires were administered on a cross section of 181 adults in Kano eliciting their awareness of global warming, as well as perceived causes, effects and ways of prevention. Of the 181 respondents, 132 (72.9%) were aware of global warming mainly from electronic media (44.4%), the Internet (20.5%) and schools (18.7%). They mostly attributed it to air pollution (99.2%), use of fossil fuels (97.7%), toxic waste (78.0%) and chlorofluorocarbons (73.5%). Perceived effects of global warming include extremes of ambient temperature (97.7%), increased disease outbreaks (92.4%), floods (68.2%), droughts (51.5%) and loss of species (50.0%). Respondents opined that global warming could be prevented by using renewable sources of energy such as the sun (53.8%), massive tree planting (44.7%) and phasing out of old automobiles (43.2%). A significantly higher proportion of males, younger and educated respondents were aware of global warming. The high awareness about global warming needs to be reinforced through use of media to encourage advocacy and community action towards preventing global warming and ensuring environmental sustainability.

In 2006, WHO alerted the world to a global health workforce crisis, demonstrated through critical shortages of health workers, primarily in Sub-Saharan Africa (WHO in World Health Report, 2006). The objective of our study was to assess, in a participative way, the educational needs for public health and health workforce development among potential trainees and training institutions in nine French-speaking African countries. A needs assessment was conducted in the target countries according to four approaches: (1) Review at national level of health challenges. (2) Semi-directed interviews with heads of relevant training institutions. (3) Focus group discussions with key-informants. (4) A questionnaire-based study targeting health professionals identified as potential trainees. A needs assessment showed important public health challenges in the field of health workforce development among the target countries (e.g. unequal HRH distribution in the country, ageing of HRH, lack of adequate training). It also showed a demand for education and training institutions that are able to offer a training programme in health workforce development, and identified training objectives and core competencies useful to potential employers and future trainees (e.g. leadership, planning/evaluation, management, research skill). In combining various approaches our study was able to show a general demand for health managers who are able to plan, develop and manage a nation's health workforce. It also identified specific competencies that should be developed through an education and training program in public health with a focus on health workforce development. PMID:22453358

Indigenous forest degradation is regarded as one of the most important environmental issues facing Sub-Saharan Africa and South Africa in particular. We tested the utility of the unique band settings of the recently launched South African satellite, SumbandilaSat in characterising forest fragmentation in a fragile rural landscape in Dukuduku, northern KwaZulu-Natal. The AISA Eagle hyperspectral image was resampled to the band settings of SumbandilaSat and SPOT 5 (green, red and near infrared bands only) for comparison purposes. Variogram analysis and the red edge shift were used to quantify forest heterogeneity and stress levels, respectively. Results showed that the range values from variograms can quantify differences in spatial heterogeneity across landscapes. The study has also shown that the unique band settings of SumbandilaSat provide additional information for quantifying stress in vegetation as compared to SPOT image data. This is critical in light of the fact that stress levels in vegetation have previously been quantified using hyperspectral sensors, which are more expensive and do not cover large areas as compared to SumbandilaSat satellite. The study moves remote sensing a step closer to operational monitoring of indigenous forests.

Several species of haematophagous tsetse flies (genus Glossina) are vectors for trypanosomes, the parasitic protozoans that cause Human African Trypanosomiasis (HAT). Although there was a reduced incidence of HAT in the mid 1960s, decreased disease surveillance has led to a resurgence of HAT in sub-Saharan Africa. Despite being efficient vectors for HAT transmission, the prevalence of G. morsitans infection by trypanosomes in the wild is surprisingly minimal. The precise mechanisms by which G. morsitans remain refractory to trypanosome infection are largely unknown although it has been demonstrated that G. morsitans mounts a strong immune response to invading pathogens. This study identifies G. morsitans immune-related CLIP domain serine proteases and their inhibitors, serine protease inhibitors (serpin) genes. It further establishes their evolutionary relationships with counterparts in Drosophila melanogaster, Anopheles gambiae, Bombyx mori, Manduca sexta and Culex quinquefasciatus. Multiple sequence alignments show conservation of most secondary structure elements for both CLIPs and serpins. Amino acid composition of the serpin reactive site loop (RSL) indicates that the G. morsitans serpins act through an inhibitory mechanism to the target serine protease. Similar to D. melanogaster and unlike A. gambiae, the transcriptome data suggest that G. morsitans does not contain gene expansions in their CLIP-domain serine protease and serpin families. The presence of alternatively spliced variants in the G. morsitans serpins transcriptome data mirrors that of the D. melanogaster transcriptome. PMID:21055483

Human African trypanosomiasis (HAT) is a disease caused by the protozoan parasite Trypanosoma brucei, the causative agent of sleeping sickness that is still endemic in well defined regions of sub-Saharan Africa. Co-infections with this human pathogen and human immunodeficiency virus (HIV) are not uncommon, but their potential interaction has been little studied. The organo-arsenical drug melarsoprol has been widely used for the treatment of late stage trypanosomiasis since the early 1950s and is still widely used despite very serious adverse effects. Because arsenic trioxide, another trivalent arsenical structurally related to melarsoprol, has been shown to markedly increase HIV replication in dendritic cells (DCs), we tested the effect of melarsoprol on virus replication in various primary human immune cell types, including DCs. We show here that this medicinal drug stimulates the replication of several strains of HIV-1, specifically in monocyte-derived DCs, and also renders such cells susceptible to HIV-2 infection. The drug acts mainly through an increase in the efficacy of the reverse transcription process, and this effect is mediated, at least partly, by an inhibition of expression of the cellular restriction factor APOBEC3G. These observations raise concerns about the harmful effect that melarsoprol might exert on the natural history of HIV in co-infected patients and on virus transmission. PMID:21763506

Rubiaceae family is a large family of 630 genera and about 13000 species found worldwide, especially in tropical and warm regions. These plants are not only ornamental but they are also used in African folk medicine to treat several diseases. Based on online published data and library bibliographic research, we herein reported accumulated information related to their traditional usages in sub-Saharan traditional medicine, their chemical composition and the screened pharmacological activities. Indeed, more than 60 species are used for more than 70 medicinal indications including malaria, hepatitis, eczema, oedema, cough, hypertension, diabetes and sexual weakness. Through biological screening following leads supplied with traditional healers, many of these plants exhibited antimalarial, antimicrobial, antihypertension, antidiabetic, antioxidant and anti-inflammatory activities. Bioactive compounds including indole alkaloids, terpenoids and anthraquinones have been isolated from these bioguided fractionation studies. It is evidence that great attention has been paid to species such as Nauclea latifolia, Morinda lucida, Mitragyna inermis and Crossopteryx febrifuga; however, several compounds should be waiting to be discovered since none of these plants has been systematically investigated for its biochemical composition. According the current global health context with the recrudescence of HIV, much effort should be oriented towards this virus when screening Rubiaceae. PMID:21870639

Same-sex practices are stigmatized in much of sub-Saharan Africa. Cross-sectional relationships between discrimination, access to and use of health care services, and HIV knowledge among men who have sex with men (MSM) were assessed in Malawi, Namibia, and Botswana. A survey and HIV screening were used to explore these variables and the prevalence of HIV. Overall, 19% of men screened positive for HIV infection. Ninety-three percent knew HIV is transmitted through anal sex with men, however, only 67% had ever received information of how to prevent this transmission. Few (17%) reported ever disclosing same sex practices to a health professional and 19% reported ever being afraid to seek health care. Men reported ever been denied health care services (5%) and 21% had ever been blackmailed because of their sexuality. Strong associations were observed between experiences of discrimination and fear of seeking health care services. Characterizing the relationship between stigma and health care seeking practices and attitudes can inform the development and implementation of HIV interventions for African MSM. PMID:21153432

About 20 years after initial calls for the introduction of user fees in health systems in sub-Saharan Africa, a growing coalition is advocating for their removal. Several African countries have abolished user fees for health care for some or all of their citizens. However, fee-for-service health care delivery remains a primary health care funding model in many countries in sub-Saharan Africa. Although the impact of user fees on utilization of health services and household finances has been studied extensively, further research is needed to characterize the multi-faceted health and social problems associated with charging user fees. This ethnographic study aims to identify consequences of user fees on gender inequality, food insecurity, and household decision-making for a group of women living in poverty. Ethnographic life history interviews were conducted with 24 women in Yirimadjo, Mali in 2007. Purposive sampling selected participants across a broad socio-economic spectrum. Semi-structured interviews addressed participants' past medical history, socio-economic status, social and family history, and access to health care. Interview transcripts were coded using the guiding analytical framework of structural violence. Interviews revealed that user fees for health care not only decreased utilization of health services, but also resulted in delayed presentation for care, incomplete or inadequate care, compromised food security and household financial security, and reduced agency for women in health care decision making. The effects of user fees were amplified by conditions of poverty, as well as gender and health inequality; user fees in turn reinforced the inequalities created by those very conditions. The qualitative data reveal multi-faceted health and socioeconomic effects of user fees, and illustrate that user fees for health care may impact quality of care, health outcomes, food insecurity, and gender inequality, in addition to impacting health care utilization and household finances. As many countries consider user fee abolition policies, these findings indicate the need to create a broader evaluation framework-one that can measure the health and socioeconomic impacts of user fee polices and of their removal. PMID:22883255

Human immunodeficiency virus (HIV) is primarily transmitted through heterosexual intercourse and women in Sub-Saharan Africa are disproportionately affected. Correlates of protective immunity and mucosal factors influencing sexual HIV transmission need to be identified as they may serve as critical ...

Abelmoschus esculentus (Malvaceae), Hibiscus acetosella (Malvaceae), Manihot esculenta Crantz (Euphorbiaceae) and Pteridium aquilinum (Dennstaedtiaceae) leaves are currently consumed as vegetables by migrants from sub-Saharan Africa living in Western Europe and by the people in the origin countries,...

Floods and associated landslides are one of the most widespread natural .... After passing through the Philippines and traversing the South China Sea, Xangsane .... CNN later reported that the flash ... monitoring over Sub-Saharan Africa.

... any cuts or sores. • HIV can spread through blood transfusion during surgery if any of the blood is ... be extremely rare to get HIV through a blood transfusion in the United States. In sub-Saharan Africa, ...

The expansion of the Bantu-speaking people (EBSP) during the past 3000-5000 years is an event of great importance in the history of humanity. Anthropology, archaeology, linguistics and, in recent decades, genetics have been used to elucidate some of the events and processes involved. Although it is generally accepted that the EBSP has its origin in the so-called Bantu Homeland situated in the area of the border between Nigeria and the Grassfields of Cameroon, and that it followed both western and eastern routes, much less is known about the number and dates of those expansions, if more than one. Mitochondrial, Y-chromosome and autosomal DNA analyses have been carried out in attempts to understand the demographic events that have taken place. There is an increasing evidence that the expansion was a more complex process than originally thought and that neither a single demographic event nor an early split between western and eastern groups occurred. In this study, we analysed unique event polymorphism and short tandem repeat variation in non-recombining Y-chromosome haplogroups contained within the E1b1a haplogroup, which is exclusive to individuals of recent African ancestry, in a large, geographically widely distributed, set of sub-Saharan Africans (groups=43, n=2757), all of whom, except one Nilo-Saharan-speaking group, spoke a Niger-Congo language and most a Bantu tongue. Analysis of diversity and rough estimates of times to the most recent common ancestors of haplogroups provide evidence of multiple expansions along eastern and western routes and a late, exclusively eastern route, expansion.European Journal of Human Genetics advance online publication, 15 August 2012; doi:10.1038/ejhg.2012.176. PMID:22892538

Human African trypanosomiasis (HAT) or sleeping sickness is a major public health problem in 36 sub-Saharan African countries and is caused by Trypanosoma brucei gambiense and T. b. rhodesiense. About 25,000 new cases of the disease are reported annually, and around 50 million people are classed as at risk of contracting the disease. Until now; the only effective drug available for treatment of advanced HAT was the trypanocide melarsoprol. The mortality rate of melarsoprol treated patients is 1-5%. Megazol is a nitroimidazole derivative shown to be effective in vitro against T. b. brucei with an EC50 of 0.01 micrograms.ml-1. When this compound was tested for its in vivo activity in T. b. brucei infected Swiss mice, it was shown to cure the acute disease. However, megazol alone did not cause cure of mice carrying a subacute infection with involvement of the central nervous system (CNS). Combined suramin and megazol treatment did prove effective and the mice were shown to have remission without further relapse from the CNS. The study of three megazol derivatives is also described here. Substitution of a bromine, methyl or trifluoromethyl moiety at the 4 position of the imidazole ring abolished trypanocidal activity both in vivo and in vitro. Intermediates of megazol synthesis (imidazole sulfoxide and imidazole sulfone) were also tested, but were shown not to be active. It is thought that megazol trypanocidal effect may be due to the triggering of radical production by the compound, which have toxic effects on the trypanosomes metabolism. In depth study of megazol is needed to fully elucidate its pharmacokinetics and to precisely pin down its mode of action. PMID:8610542

African swine fever (ASF) is caused by a large and highly pathogenic DNA virus, African swine fever virus (ASFV), which provokes severe economic losses and expansion threats. Presently, no specific protection or vaccine against ASF is available, despite the high hazard that the continued occurrence of the disease in sub-Saharan Africa, the recent outbreak in the Caucasus in 2007, and the potential dissemination to neighboring countries, represents. Although virus entry is a remarkable target for the development of protection tools, knowledge of the ASFV entry mechanism is still very limited. Whereas early studies have proposed that the virus enters cells through receptor-mediated endocytosis, the specific mechanism used by ASFV remains uncertain. Here we used the ASFV virulent isolate Ba71, adapted to grow in Vero cells (Ba71V), and the virulent strain E70 to demonstrate that entry and internalization of ASFV includes most of the features of macropinocytosis. By a combination of optical and electron microscopy, we show that the virus causes cytoplasm membrane perturbation, blebbing and ruffles. We have also found that internalization of the virions depends on actin reorganization, activity of Na(+)/H(+) exchangers, and signaling events typical of the macropinocytic mechanism of endocytosis. The entry of virus into cells appears to directly stimulate dextran uptake, actin polarization and EGFR, PI3K-Akt, Pak1 and Rac1 activation. Inhibition of these key regulators of macropinocytosis, as well as treatment with the drug EIPA, results in a considerable decrease in ASFV entry and infection. In conclusion, this study identifies for the first time the whole pathway for ASFV entry, including the key cellular factors required for the uptake of the virus and the cell signaling involved. PMID:22719252

Background Sleeping sickness, also called human African trypanosomiasis, is transmitted by the tsetse, a blood-sucking fly confined to sub-Saharan Africa. The form of the disease in West and Central Africa is carried mainly by species of tsetse that inhabit riverine woodland and feed avidly on humans. In contrast, the vectors for the East and Southern African form of the disease are usually savannah species that feed mostly on wild and domestic animals and bite humans infrequently, mainly because the odours produced by humans can be repellent. Hence, it takes a long time to catch many savannah tsetse from people, which in turn means that studies of the nature of contact between savannah tsetse and humans, and the ways of minimizing it, have been largely neglected. Methodology/Principal Findings The savannah tsetse, Glossina morsitans morsitans and G. pallidipes, were caught from men in the Mana Pools National park of Zimbabwe. Mostly the catch consisted of young G. m. morsitans, with little food reserve. Catches were increased by 4–8 times if the men were walking, not stationary, and increased about ten times more if they rode on a truck at 10 km/h. Catches were unaffected if the men used deodorant or were baited with artificial ox odour, but declined by about 95% if the men were with an ox. Surprisingly, men pursuing their normal daily activities were bitten about as much when in or near buildings as when in woodland. Catches from oxen and a standard ox-like trap were poor indices of the number and physiological state of tsetse attacking men. Conclusion/Significance The search for new strategies to minimize the contact between humans and savannah tsetse should focus on that occurring in buildings and vehicles. There is a need to design a man-like trap to help to provide an index of sleeping sickness risk. PMID:12662344

This qualitative case study assesses the impact of a three-year Hilton Foundation-supported, Sisters Leadership Development Initiative (SLDI) in five African nations. The goal was to evaluate the SLDI program for increasing leadership capacities of 340 women in Kenya, Uganda, Tanzania, Ghana and Nigeria. The purpose of this study was to determine the program effectiveness, by observing the changes it effected in trainees and their communities. Another purpose was to assess the pedagogical practices used by both international (USA) and local (African) instructors to deliver instruction that directly applied to the trainees' workplaces. Also, the study evaluated the sustainability strategies in place to support trainee projects and future leadership programs. The design of evaluation is drawn from the theoretical perspectives elucidated by transformational leadership theory (Bass, 1985), diffusion of innovation theory (Rogers, 2003) and "culture software of the mind" (Hofstede & Hofstede, 2005). The methodology consisted on-site, data collection in Africa through in-depth interviews, site-visits observations, field notes, program document analysis, and informal conversations with subjects. The sample consisted of 45 interviewees, including 32 trainees drawn from the five sub-Saharan countries, ten instructors--four from East Africa, three from West Africa and the United States respectively, and three regional administrators. Results indicate that the program goals were attained, significant impact was evident in the trainees' adaptation of new leadership styles and models in their workplaces, innovative projects they implemented and measurable economic benefits realized Utilizing local and international instructors enhanced instruction by affording intercultural cross-fertilization. This study illustrates how the design of leadership programs can confirm the creation of innovative practice for effective organizational management in the developing nations. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.

Mastomys natalensis is the major pest rodent in sub-Saharan Africa. In this study, population genetic techniques were used to gain new insights into its dispersal behaviour, a critical parameter in pest management. Using 11 microsatellites, 272 individuals from a 300 ha area in Tanzania were genotyped. Genetic diversity was high, with no isolation by distance and little differentiation between field plots far apart, indicating a large effective population size and high dispersal rates in agreement with ecological observations. On the other hand, genetic differentiation between nearby field plots, isolation by distance within a single field plot and kin clustering were also observed. This apparent contradiction may be explained by yearly founder effects of a small number of breeding individuals per square area, which is consistent with the presence of linkage disequilibrium. An alternative, not mutually exclusive explanation is that there are both dispersing and sedentary animals in the population. The low-density field plots were characterized by low relatedness and small genetic distances to other field plots, indicating a high turnover rate and negative density-dependent dispersal. In one field plot female-biased dispersal was observed, which may be related to inbreeding avoidance or female competition for resources. Most juveniles appeared to be local recruits, but they did not seem to stay in their native area for more than two months. Finally, possible implications for pest management are discussed.

Samples of 162 impala antelope (Aepyceros melampus) from throughout its distribution range in sub-Saharan Africa were surveyed using eight polymorphic microsatellite loci. Furthermore, 155 previously published mitochondrial DNA (mtDNA) sequences from the same localities were reanalyzed. Two subspecies of impala are presently recognized-the isolated black-faced impala (Aepyceros melampus petersi) in southwest Africa and the common impala (Aepyceros melampus melampus) abundant in southern and east Africa. All tests performed indicated significant genetic differentiation at the subspecific level. Furthermore, individual-based analyses split the common impala subspecies into two distinct genetic groups, conforming with regional geographic affiliation to southern or east Africa. This was supported by assignment tests, genetic distance measures, pairwise values, and analysis of molecular variance. We suggest that the presence of such previously unknown regional structuring within the subspecies reflects a pattern of colonization from a formerly large panmictic population in southern Africa toward east Africa. This scenario was supported by a progressive decline in population diversity indices toward east Africa and a significant increase in the quantity /(1 - ). Both microsatellite and mtDNA data indicated a genetic distinctiveness of the Samburu population in Kenya.

Population linkage disequilibrium occurs as a consequence of mutation, selection, genetic drift, and population substructure produced by admixture of genetically distinct ethnic populations. African American and Hispanic ethnic groups have a history of significant gene flow among parent groups, whic...

Adoption of information and communication technologies and access to the Internet is expanding in Africa, but because of the rapid growth elsewhere, a Digital Divide between Africa and the rest of the world exists, and the gap is growing. In many sub-Saharan African countries, education and research sector suffer some of the worst deficiencies in access to the Internet, despite progress in development of NRENs National Research and Education (cyber) Networks. By contrast, it is widely acknowledged in policy statements from the African Union, the UN, and others that strength in this very sector provides the key to meeting and sustaining Millennium Development Goals. Developed countries with effective cyber-capabilities proclaim the benefits to rich and poor alike arising from the Information Revolution. This is but a dream for many scientists in African institutions. As the world of science becomes increasingly Internet-dependent, so they become increasingly isolated. eGY-Africa is a bottom-up initiative by African scientists and their collaborators to try to reduce this Digital Divide by a campaign of advocacy for better institutional facilities. Four approaches are being taken. The present status of Internet services, problems, and plans are being mapped via a combination of direct measurement of Internet performance (the PingER Project) and a questionnaire-based survey. Information is being gathered on policy statements and initiatives aimed at reducing the Digital Divide, which can be used for arguing the case for better Internet facilities. Groups of concerned scientists are being formed at the national, regional levels in Africa, building on existing networks as much as possible. Opinion in the international science community is being mobilized. Finally, and perhaps most important of all, eGY-Africa is seeking to engage with the many other programs, initiatives, and bodies that share the goal of reducing the Digital Divide either as a direct policy objective, or indirectly as a means to an end, such as the development of an indigenous capability in science and technology for national development. The expectation is that informed opinion from the scientific community at the institutional, national, and international levels can be used to influence the decision makers and donors who are in a position to deliver better Internet capabilities.

Human African trypanosomiasis, or sleeping sickness, is caused by the protozoan parasites Trypanosoma brucei rhodesiense or Trypanosoma brucei gambiense, and is a major cause of systemic and neurological disability throughout sub-Saharan Africa. Following early-stage disease, the trypanosomes cross the blood-brain barrier to invade the central nervous system leading to the encephalitic, or late stage, infection. Treatment of human African trypanosomiasis currently relies on a limited number of highly toxic drugs, but untreated, is invariably fatal. Melarsoprol, a trivalent arsenical, is the only drug that can be used to cure both forms of the infection once the central nervous system has become involved, but unfortunately, this drug induces an extremely severe post-treatment reactive encephalopathy (PTRE) in up to 10% of treated patients, half of whom die from this complication. Since it is unlikely that any new and less toxic drug will be developed for treatment of human African trypanosomiasis in the near future, increasing attention is now being focussed on the potential use of existing compounds, either alone or in combination chemotherapy, for improved efficacy and safety. The kynurenine pathway is the major pathway in the metabolism of tryptophan. A number of the catabolites produced along this pathway show neurotoxic or neuroprotective activities, and their role in the generation of central nervous system inflammation is well documented. In the current study, Ro-61-8048, a high affinity kynurenine-3-monooxygenase inhibitor, was used to determine the effect of manipulating the kynurenine pathway in a highly reproducible mouse model of human African trypanosomiasis. It was found that Ro-61-8048 treatment had no significant effect (P = 0.4445) on the severity of the neuroinflammatory pathology in mice during the early central nervous system stage of the disease when only a low level of inflammation was present. However, a significant (P = 0.0284) reduction in the severity of the neuroinflammatory response was detected when the inhibitor was administered in animals exhibiting the more severe, late central nervous system stage, of the infection. In vitro assays showed that Ro-61-8048 had no direct effect on trypanosome proliferation suggesting that the anti-inflammatory action is due to a direct effect of the inhibitor on the host cells and not a secondary response to parasite destruction. These findings demonstrate that kynurenine pathway catabolites are involved in the generation of the more severe inflammatory reaction associated with the late central nervous system stages of the disease and suggest that Ro-61-8048 or a similar drug may prove to be beneficial in preventing or ameliorating the PTRE when administered as an adjunct to conventional trypanocidal chemotherapy. PMID:19339256

In the western Sahel and many other regions of sub-Saharan Africa, wild edible plants contribute significantly to human diets, not only during periods when cereal staples are scarce, but also when they are readily available. Although there have been published reports regarding the nutrient contents of these plant foods, little attention has been devoted to their content of antinutrients such as calcium chelators and inhibitors of the pancreas-derived proteases, trypsin and chymotrypsin, which are required for the efficient digestion and absorption of dietary proteins. In this study, aqueous extracts of 61 different leaves, seeds, fruits and flowers of edible plants gathered in the Republic of Niger were analyzed for their content of trypsin inhibitory substances using alpha-N-benzoyl-DL-arginine-p-nitroanilide as the substrate and bovine trypsin as the enzyme source. Twelve of these plant foods contained more antitrypsin activity than soybeans (1.34-8.18 vs. 1.32 microg trypsin inhibited/mg dry weight). Boiling for 3 min did not inactivate the antitrypsin activity in most of the plant extracts. These data confirm that more than half of the wild edible plant foods widely consumed by various populations who inhabit the western Sahel contain significant quantities of heat-stable trypsin inhibitor that could possibly compromise the bioavailability of proteins present in the diets of these populations. PMID:11086876

This paper starts with a quick overview of the energy situation in the Sub-Saharan West-Africa and then mainly focus on the rural areas in the Sahel. Information on energy matters is here scattered and not treated with the necessary importance. The present CO{sub 2}/capita emissions are shown. The average value for the Sahel countries 0.13 ton CO{sub 2}/capita or far lower than the global sustainable level. It is a factor of 30 less than the global average. There is plenty of room for an increase of CO{sub 2} emissions from the Sahelian countries, the question is how to increase energy consumption in a way people can afford. The consumption of fossil fuels in the Sahelian countries is extremely low and only 3-5% of the population have access to electricity. More than 80% of the energy consumption is covered by biomass, a resource under pressure. Until now only a very small share of the investment and development effort has been to the traditional energy sector. The focus should now be on the energy services needed to create development in all sectors especially in the rural areas, where decentral solar electricity generation is a feasible option, and on management of forestation efforts by local populations. The terms traditional and modern energy should be abandoned and since all sectiors need energy, a multi sectorial approach is needed. The necessary technological research should be supported and pilot projects started. (ARW) 18 refs.

In this volume, scholars working on African politics and African international relations address major issues in contemporary Africa in the context of globalization. The basic and original image of sub-Saharan Africa was that of chromic marginalization in globalizing world. However, as Bayart proposed in the name of “paradigm of extraversion,” there is an alternative image that Africans have utilized their external relations (dependencies) in their favor for long time in their relations with the other world. It is in this interactive manner that Africa and Africans have transformed themselves. It is these multi-dimensional changes on which the authors of articles in this volume focus.This introductory article consists of five sections including brief introduction of each contribution. At first, the old and new issue of nation and state in the context of Africa since colonial period is reexamined. As Mamdani coined the concept of “bifurcated state,” colonial state was by nature dualdimensional despotism. This type of despotism is still observed in Africa in such way as “failed states” like Sudan and Zimbabwe in contemporary period. Also it is possible to point out that nation-building is still unaccomplished “modern” project in Africa.Second, transformation of conflicts in global context is mentioned. The concept of “conflict” has been often reevaluated in its applicability to describe “new wars.” Alternative concepts like complex political emergencies and emerging political complex was proposed by Duffield to describe the new situation of “conflicts.” In fact, “conflict phenomena” has been deeply transformed in the post-cold war era due to involvement of a variety of actors.Third section focuses on emerging regionalism in Africa. It was in 2002 that African Union (AU) was established on the new principle of “intervention instead of indifference” to humanitarian disasters on the continent. New Partnership for African Development (NEPAD), which is a new vision and strategic framework for African development, was also adopted for the purpose of coping with the current challenges facing the African continent. Despite these new initiatives, it remains to be seen if these new organizations and frameworks become effective to sort out a variety of issues on the continent.Fourthly, change of political regimes in the name of democratization in Africa has been critically evaluated and labeled in such ways as “pseudodemocracy,” “virtual democracy,” and even “semi-authoritarianism.” In this context, democratization is considered to include not only political pluralism and elections but also development of civil society, constitutionalism and so on. Decentralization is also regarded as important component of democratization and improvement of governance from below. Even so, it is still necessary to evaluate roles of a variety of components in its relation to democratization in Africa.Lastly, instead of marginalization, Africa became a place of engagement of a variety of outside actors, because of the regional war on terrorism and richness of natural resources. In this context one of the most prominent engagements comes from China and India in recent days, which clearly has great interest in African mineral resources. In 2005, G8 also declared its new and heavy involvement in Africa to get rid of chronic poverty in Africa. This is recognized as a “new struggle for Africa,” in which various interaction will cause new political and economic trajectory of this continent. In these ways, Africa will be somehow transformed in the coming years in this obviously interdependent and interconnected world.   

Extensive monocultures are often believed to be more vulnerable to attacks by insect pests than crops in a heterogeneous landscape. In monocultures the insect pests find abundant resources when the crops are in the susceptible stage and they migrate or enter diapause when the crop is removed. For rodents, escaping from temporarily poor conditions is relatively more difficult, and therefore we predicted that a population of rodent pests in a monoculture with synchronised periods of absence of the field crop, would do less well when compared with a population in a heterogeneous landscape. The multimammate mouse (Mastomys natalensis) is a major pest in rural areas throughout sub-Saharan Africa. It appears difficult to control since it has an opportunistic diet and the capacity for explosive population growth. We compared demographic rates between a population in an extensive maize monoculture and a population in a mixed landscape of smaller maize fields. We used data from a 4-year monthly capture-recapture study. Time series of abundance estimates for the two sites showed remarkable synchrony. Timing and duration of reproduction were comparable, although more females were observed to mature in the mosaic compared to the monoculture. The probability of capture was higher in the mosaic structured grid for both the subadult and adult part of the population. The model selection procedure demonstrated that a model without an effect of habitat in both survival and seniority received most support from the data. No differences in the multimammate mouse demography between the monoculture and mosaic structured habitat were observed which had a substantial impact on population dynamics. This means that rodent management options in both agricultural systems could focus on the same aspects of rodent ecology.

Poverty and food security are endemic issues in much of sub-Saharan Africa. To eradicate extreme poverty and hunger in the region remains a key Millennium Development Goal. Many African governments have pursued economic reforms and agricultural policy interventions in order to accelerate economic growth that reduces poverty faster. Agricultural policy regimes in Zambia in the last 50 years (1964–2008) are examined here to better understand their likely impact on food security and poverty, with an emphasis on the political economy of maize subsidy policies. The empirical work draws on secondary sources and an evaluation of farm household data from three villages in the Kasama District of Zambia from 1986/87 and 1992/93 to estimate a two-period econometric model to examine the impact on household welfare in a pre- and post-reform period. The analysis shows that past interventions had mixed effects on enhancing the production of food crops such as maize. While such reforms were politically popular, it did not necessarily translate into household-level productivity or welfare gains in the short term. The political economy of reforms needs to respond to the inherent diversity among the poor rural and urban households. The potential of agriculture to generate a more pro-poor growth process depends on the creation of new market opportunities that most benefit the rural poor. The state should encourage private sector investments for addressing infrastructure constraints to improve market access and accelerate more pro-poor growth through renewed investments in agriculture, rural infrastructure, gender inclusion, smarter subsidies and regional food trade. However, the financing of such investments poses significant challenges. There is a need to address impediments to the effective participation of public private investors to generate more effective poverty reduction and hunger eradication programmes. This article also explores the opportunities for new public–private investments through South–South cooperation and Asia-driven growth for reducing poverty in Zambia. PMID:22213879

Background Human African trypanosomiasis (HAT), a parasitic protozoal disease, is caused primarily by two subspecies of Trypanosoma brucei. HAT is a re-emerging disease and currently threatens millions of people in sub-Saharan Africa. Many affected people live in remote areas with limited access to health services and, therefore, rely on traditional herbal medicines for treatment. Methods A molecular docking study has been carried out on phytochemical agents that have been previously isolated and characterized from Nigerian medicinal plants, either known to be used ethnopharmacologically to treat parasitic infections or known to have in-vitro antitrypanosomal activity. A total of 386 compounds from 19 species of medicinal plants were investigated using in-silico molecular docking with validated Trypanosoma brucei protein targets that were available from the Protein Data Bank (PDB): Adenosine kinase (TbAK), pteridine reductase 1 (TbPTR1), dihydrofolate reductase (TbDHFR), trypanothione reductase (TbTR), cathepsin B (TbCatB), heat shock protein 90 (TbHSP90), sterol 14?-demethylase (TbCYP51), nucleoside hydrolase (TbNH), triose phosphate isomerase (TbTIM), nucleoside 2-deoxyribosyltransferase (TbNDRT), UDP-galactose 4? epimerase (TbUDPGE), and ornithine decarboxylase (TbODC). Results This study revealed that triterpenoid and steroid ligands were largely selective for sterol 14?-demethylase; anthraquinones, xanthones, and berberine alkaloids docked strongly to pteridine reductase 1 (TbPTR1); chromenes, pyrazole and pyridine alkaloids preferred docking to triose phosphate isomerase (TbTIM); and numerous indole alkaloids showed notable docking energies with UDP-galactose 4? epimerase (TbUDPGE). Polyphenolic compounds such as flavonoid gallates or flavonoid glycosides tended to be promiscuous docking agents, giving strong docking energies with most proteins. Conclusions This in-silico molecular docking study has identified potential biomolecular targets of phytochemical components of antitrypanosomal plants and has determined which phytochemical classes and structural manifolds likely target trypanosomal enzymes. The results could provide the framework for synthetic modification of bioactive phytochemicals, de novo synthesis of structural motifs, and lead to further phytochemical investigations. PMID:16012738

The parasitic disease human African trypanomiasis (HAT), also known as sleeping sickness, is a highly neglected fatal condition endemic in sub-Saharan Africa, which is poorly treated with medicines that are toxic, no longer effective or very difficult to administer. New, safe, effective and easy-to-use treatments are urgently needed. Many nitroimidazoles possess antibacterial and antiprotozoal activity and examples such as tinidazole are used to treat trichomoniasis and guardiasis, but concerns about toxicity including genotoxicity limit their usefulness. Fexinidazole, a 2-substituted 5-nitroimidazole rediscovered by the Drugs for Neglected Diseases initiative (DNDi) after extensive compound mining of public and pharmaceutical company databases, has the potential to become a short-course, safe and effective oral treatment, curing both acute and chronic HAT. This paper describes the genotoxicity profile of fexinidazole and its two active metabolites, the sulfoxide and sulfone derivatives. All the three compounds are mutagenic in the Salmonella/Ames test; however, mutagenicity is either attenuated or lost in Ames Salmonella strains that lack one or more nitroreductase(s). It is known that these enzymes can nitroreduce compounds with low redox potentials, whereas their mammalian cell counterparts cannot, under normal conditions. Fexinidazole and its metabolites have low redox potentials and all mammalian cell assays to detect genetic toxicity, conducted for this study either in vitro (micronucleus test in human lymphocytes) or in vivo (ex vivo unscheduled DNA synthesis in rats; bone marrow micronucleus test in mice), were negative. Thus, fexinidazole does not pose a genotoxic hazard to patients and represents a promising drug candidate for HAT. Fexinidazole is expected to enter Phase II clinical trials in 2012. PMID:22539226

Background Studies in developed countries have shown highly active antiretroviral therapy (HAART) decreases incidence of severe opportunistic diseases (ODs) in HIV-infected patients beyond what is expected from CD4 changes. Objective To estimate the independent impact of HAART on reducing ODs and mortality in Côte d’Ivoire. Methods Within 2 longitudinal studies of HIV-infected adults (1996–2003), we identified time on cotrimoxazole alone and HAART plus cotrimoxazole. WHO stage 3–4 defining events and severe malaria were divided into those preventable and not preventable with cotrimoxazole. Incidence of ODs by CD4 stratum was estimated using incidence density analysis. CD4 at time of OD was estimated using linear interpolation. Using Poisson regression, we estimated the effect of HAART on OD incidence and mortality by CD4 stratum. Results Four hundred forty-six and 135 adults were followed during 6,216 and 3,412 person-months in the cotrimoxazole alone and HAART plus cotrimoxazole periods. There was a CD4-independent risk reduction for ODs and mortality during the HAART plus cotrimoxazole period compared to cotrimoxazole alone, which varied by time on HAART, CD4 stratum, and OD type. It was mainly seen after 6 months on HAART, and for ODs not preventable by cotrimoxazole. The HAART effect differed significantly by CD4 stratum (p=0.02), but was significant in all strata after 6 months on HAART. Conclusions In these sub-Saharan African adults, HAART initiation reduced ODs and mortality beyond what was expected through the HAART-induced CD4 increase. Further studies should examine practical implications of this independent “HAART effect” on clinical outcomes in patients on HAART.

Human African trypanosomiasis (HAT), or sleeping sickness, results from infection with the protozoan parasites Trypanosoma brucei (T. b.) gambiense or T. b. rhodesiense and is invariably fatal if untreated. There are 60 million people at risk from the disease throughout sub-Saharan Africa. The infection progresses from the haemolymphatic stage where parasites invade the blood, lymphatics and peripheral organs, to the late encephalitic stage where they enter the central nervous system (CNS) to cause serious neurological disease. The trivalent arsenical drug melarsoprol (Arsobal) is the only currently available treatment for CNS-stage T. b. rhodesiense infection. However, it must be administered intravenously due to the presence of propylene glycol solvent and is associated with numerous adverse reactions. A severe post-treatment reactive encephalopathy occurs in about 10% of treated patients, half of whom die. Thus melarsoprol kills 5% of all patients receiving it. Cyclodextrins have been used to improve the solubility and reduce the toxicity of a wide variety of drugs. We therefore investigated two melarsoprol cyclodextrin inclusion complexes; melarsoprol hydroxypropyl-?-cyclodextrin and melarsoprol randomly-methylated-?-cyclodextrin. We found that these compounds retain trypanocidal properties in vitro and cure CNS-stage murine infections when delivered orally, once per day for 7-days, at a dosage of 0.05 mmol/kg. No overt signs of toxicity were detected. Parasite load within the brain was rapidly reduced following treatment onset and magnetic resonance imaging showed restoration of normal blood-brain barrier integrity on completion of chemotherapy. These findings strongly suggest that complexed melarsoprol could be employed as an oral treatment for CNS-stage HAT, delivering considerable improvements over current parenteral chemotherapy. PMID:21909447

Maize streak virus (MSV; family Geminiviridae, genus Mastrevirus), the causal agent of maize streak disease, ranks amongst the most serious biological threats to food security in subSaharan Africa. Although five distinct MSV strains have been currently described, only one of these - MSV-A - causes severe disease in maize. Due primarily to their not being an obvious threat to agriculture, very little is known about the 'grass-adapted' MSV strains, MSV-B, -C, -D and -E. Since comparing the genetic diversities, geographical distributions and natural host ranges of MSV-A with the other MSV strains could provide valuable information on the epidemiology, evolution and emergence of MSV-A, we carried out a phylogeographical analysis of MSVs found in uncultivated indigenous African grasses. Amongst the 83 new MSV genomes presented here, we report the discovery of six new MSV strains (MSV-F to -K). The non-random recombination breakpoint distributions detectable with these and other available mastrevirus sequences partially mirror those seen in begomoviruses, implying that the forces shaping these breakpoint patterns have been largely conserved since the earliest geminivirus ancestors. We present evidence that the ancestor of all MSV-A variants was the recombinant progeny of ancestral MSV-B and MSV-G/-F variants. While it remains unknown whether recombination influenced the emergence of MSV-A in maize, our discovery that MSV-A variants may both move between and become established in different regions of Africa with greater ease, and infect more grass species than other MSV strains, goes some way towards explaining why MSV-A is such a successful maize pathogen. PMID:18753214

Cassava is the major source of calories for more than 250 million Sub-Saharan Africans, however, it has the lowest protein-to-energy ratio of any major staple food crop in the world. A cassava-based diet provides less than 30% of the minimum daily requirement for protein. Moreover, both leaves and roots contain potentially toxic levels of cyanogenic glucosides. The major cyanogen in cassava is linamarin which is stored in the vacuole. Upon tissue disruption linamarin is deglycosylated by the apolplastic enzyme, linamarase, producing acetone cyanohydrin. Acetone cyanohydrin can spontaneously decompose at pHs >5.0 or temperatures >35°C, or is enzymatically broken down by hydroxynitrile lyase (HNL) to produce acetone and free cyanide which is then volatilized. Unlike leaves, cassava roots have little HNL activity. The lack of HNL activity in roots is associated with the accumulation of potentially toxic levels of acetone cyanohydrin in poorly processed roots. We hypothesized that the over-expression of HNL in cassava roots under the control of a root-specific, patatin promoter would not only accelerate cyanogenesis during food processing, resulting in a safer food product, but lead to increased root protein levels since HNL is sequestered in the cell wall. Transgenic lines expressing a patatin-driven HNL gene construct exhibited a 2-20 fold increase in relative HNL mRNA levels in roots when compared with wild type resulting in a threefold increase in total root protein in 7 month old plants. After food processing, HNL overexpressing lines had substantially reduced acetone cyanohydrin and cyanide levels in roots relative to wild-type roots. Furthermore, steady state linamarin levels in intact tissues were reduced by 80% in transgenic cassava roots. These results suggest that enhanced linamarin metabolism contributed to the elevated root protein levels. PMID:21799761

There are remarkably few contemporary, population-based studies of intestinal nematode infection for sub-Saharan Africa. This paper presents a comprehensive epidemiological analysis of hookworm infection intensity in a rural Ugandan community. Demographic, kinship, socioeconomic and environmental data were collected for 1,803 individuals aged six months to 85 years in 341 households in a cross-sectional community survey. Hookworm infection was assessed by faecal egg count. Spatial variation in the intensity of infection was assessed using a Bayesian negative binomial spatial regression model and the proportion of variation explained by host additive genetics (heritability) and common domestic environment was estimated using genetic variance component analysis. Overall, the prevalence of hookworm was 39.3%, with the majority of infections (87.7%) of light intensity (

Tungiasis (sand flea disease) is caused by the penetration of females of Tunga penetrans into the skin of the feet. Within 2 weeks of penetration the burrowed flea increases its volume by a factor of 2,000. This is paralleled by intense inflammation of the surrounding tissue. Acute and chronic inflammation leads to the development of painful and debilitating clinical pathology. This results in impaired physical fitness and mobility. The social implications of tungiasis-associated morbidity are multifold. Children with tungiasis are teased and ridiculed, adults feel ashamed and stigmatized. There is anecdotal evidence that tungiasis negatively affects educational achievements. Impaired mobility and physical fitness will have a negative impact on household economics. Sand flea disease is common in resource-poor communities in South America and in sub-Saharan Africa with prevalence in the general population of up to 60%. In East Africa, it has re-emerged in epidemic dimensions in recent years. Hitherto, no effective drug treatment has been at hand. Traditional treatment, i.e., the manipulation of burrowed sand fleas with blunt and inappropriate instruments may facilitate the transmission of blood-derived pathogens. Prevention is feasible through regular application of a repellent based on coconut oil. Owing to its strong association with poverty, sand flea disease would be an excellent starting point for a community-based fight against rural poverty. PMID:22941398

It is estimated that over 90% of children infected with human immunodeficiency virus (HIV) live in the developing world and particularly in sub-Saharan Africa. Pulmonary disease is the most common clinical feature of acquired immunodeficiency syndrome (AIDS) in infants and children causing the most morbidity and mortality, and is the primary cause of death in 50% of cases. Children with lung disease are surviving progressively longer because of earlier diagnosis and antiretroviral treatment and, therefore, thoracic manifestations have continued to change and unexpected complications are being encountered. It has been reported that 33% of HIV-positive children have chronic changes on chest radiographs by the age of 4 years. Lymphocytic interstitial pneumonitis is common in the paediatric HIV population and is responsible for 30-40% of pulmonary disease. HIV-positive children also have a higher incidence of pulmonary malignancies, including lymphoma and pulmonary Kaposi sarcoma. Immune reconstitution inflammatory syndrome is seen after highly active antiretroviral treatment. Complications of pulmonary infections, aspiration and rarely interstitial pneumonitis are also seen. This review focuses on the imaging findings of non-infective chronic pulmonary disease. (orig.)

Finger millet (Eleusine coracana) is a subsistence crop grown in Sub-Saharan Africa and the Indian Sub-continent. Fusarium species occurring on this crop have not been reported. Approximately 13% of the Fusarium isolates recovered from finger millet growing at three different locations in eastern Uganda belong to Fusarium verticillioides, and could produce up to 18,600?µg/g of total fumonisins when cultured under laboratory conditions. These strains are all genetically unique, based on AFLP analyses, and form fertile perithecia when crossed with the standard mating type tester strains for this species. All but one of the strains is female-fertile and mating-type segregates 13:20 Mat-1:Mat-2. Three new sequences of the gene encoding translation elongation factor 1-?? were found within the population. These results indicate a potential health risk for infants who consume finger millet gruel as a weaning food, and are consistent with the hypothesis that F. verticillioides originated in Africa and not in the Americas, despite its widespread association with maize grown almost anywhere worldwide. PMID:22916825

Migration is known to increase the risk of heterosexual transmission of human immunodeficiency virus (HIV) in sub-Saharan Africa, but little attention has been paid to fresh graduates of tertiary institutions who are on migration for compulsory national assignment in Nigeria. In July and August 2004, a survey was conducted on sexually active men (n = 344) and women (n = 373) to investigate determinants of condom use during national service. Sixty-eight percent of men and 41% of women reported condom use at last intercourse before the survey. For both men and women, condom use was common if they had one or more regular sex partners and if they were purchasing condoms. In addition, women's condom use was predicted by being single and having intention to use condoms in next intercourse. The findings further showed that there was high risk of HIV transmission in the sample population as consistent condom use was 15% for men and 4% for women. Twelve percent of men and 8% of women reported STI diagnoses in the last 12 months before the survey. Four percent of men and 2% of women reported they already had HIV diagnoses. Only 1% of men and 2% of women reported they would receive voluntary HIV test if offered free by the government. The study findings suggest the need to extend the existing condom social marketing services in the country to the youth on national service and promote condom education messages among them prior to commencing national service. PMID:16997898

In recent years, the unregulated increase of the population in coastal areas of developing countries has become source of concern for both water supply and quality control. In the region of Dakar (Senegal), approximately 80% of water resources come from groundwater reservoirs, which are increasingly affected by anthropogenic pressures. The identification of the main sources of pollution, and thus the aquifer vulnerability, is essential to provide a sound basis for the implementation of long-term geochemically based water management plans in this sub-Saharan area. With this aim, a hydrochemical and isotopic survey on 26 wells was performed in the so-called Peninsula of Cap-Vert. Results show that seawater intrusion represents the main process affecting groundwater chemical characteristics. Nitrates often exceed the World Health Organization drinking water limits: stable isotopes of dissolved nitrate (?¹?N and ?¹?O) indicate urban sewage and fertilizers as a major source of contamination. Results depict a complex situation in which groundwater is affected by direct and indirect infiltration of effluents, mixing with seawater and freshening processes from below. Besides the relevance of the investigation at a regional level, it represents a basis for decision-making processes in an integrated water resources management and in the planning of similar monitoring strategies for other urban coastal regions. PMID:20300838

Somalis currently constitute the largest Sub-Saharan community in Canada and as such have greatly contributed to the transformation of the immigrant population of this country. Although there is a growing body of research on the Somali community in Canada, the question of how the first generation of Somali Canadians experiences aging and transmits its values and attitudes in this regard to younger generations has yet to be explored. The goal of the present study is precisely to understand how male and female Somali seniors living in Canada perceive and experience aging from a cross-cultural perspective. A total of 17 Somali elders (9 women and 8 men) took part in two focus group discussions. Results of the interpretative content analysis revealed that, regardless of the cultural context, both Somali men and women foster quite a positive view of the notion of aging. However, as Somali migrants, men were more critical than women in regards to the challenges of aging in Canada. Results are discussed in light of previous studies on aging, ageism and culture. PMID:22941417

ABSTRACT: BACKGROUND: The ability of different obesity indices to predict cardiovascular risk is still debated in youth and few data are available in sub Saharan Africa. We compared the associations between several indices of obesity and cardiovascular risk factors (CVRFs) in late adolescence in the Seychelles. METHODS: We measured body mass index (BMI), waist circumference, waist/hip ratio (WHiR), waist/height ratio (WHtR) and percent fat mass (by bioimpedance) and 6 CVRFs (blood pressure, LDL-cholesterol, HDL-cholesterol, triglycerides, fasting blood glucose and uric acid) in 423 youths aged 19--20 years from the general population. RESULTS: The prevalence of overweight/obesity and several CVRFs was high, with substantial sex differences. Except for glucose in males and LDL-cholesterol in females, all obesity indices were associated with CVRFs. BMI consistently predicted CVRFs at least as well as the other indices. Linear regression on BMI had standardized regression coefficients of 0.25-0.36 for most CVRFs (p=2 CVRFs compared to 74% of male and 46% of female overweight subjects (BMI >P90). CONCLUSION: There was an elevated prevalence of obesity and of several CVRFs in youths in Seychelles. BMI predicted single or combined CVRFs at least as well as other simple obesity indices. PMID:23134594

Hispanic/Latino populations possess a complex genetic structure that reflects recent admixture among and potentially ancient substructure within Native American, European, and West African source populations. Here, we quantify genome-wide patterns of SNP and haplotype variation among 100 individuals...

abubakari a-r, jones mc, lauder w, kirk a, anderson j & devendra d (2011)-Journal of Nursing and Healthcare of Chronic Illness3, 245-256-Associations between knowledge, illness perceptions, self-management and metabolic control of type 2 diabetes among African and European-origin patients Aims.- Using Leventhal-s Common-sense self-regulation model, this study investigated associations between illness perceptions, self-management and metabolic-control outcomes for diabetes among European and African-origin patients with type 2 diabetes. Background.- Compared to the general populations of their host countries, African-origin populations in the diaspora are disproportionately affected by diabetes and its microvascular complications. However, comparatively little is known about how African-ori...

Woody biomass constitutes the main domestic fuel in many parts of Africa. The need for more definitive data on this resource was perceived at a Household Energy Seminar held by the World Bank Energy Sector Management Assistance Program (ESMAP) in Harare, Zimbabwe, in February 1988. The present project was conceived as a result. It is a first attempt to produce an analysis by type of land cover of the woody biomass present in Sub-Saharan. On examining the energy balance for most Sub-Saharan countries, one is struck by the dominance of woodfuel, including fuelwood and charcoal. (Copyright (c) 1994 The International Bank for Reconstruction and Development/The World Bank.)

Abstract in spanish OBJETIVO: Determinar la participación en las actividades suplementarias de inmunización (ASI) contra la poliomielitis en el África subsahariana entre los usuarios y no usuarios de los servicios de inmunización sistemática, así como entre los usuarios que se atuvieron o no al calendario de vacunación antipoliomielítica oral (OPV). MÉTODOS:Los datos se obtuvieron a través de encuestas de hogares en países del África subsahariana en los que la poliomielitis no es (more) endémica. Los usuarios del servicio de inmunización sistemática fueron niños (con edades inferiores a cinco años) que disponían de una tarjeta sanitaria con sus antecedentes de vacunación; los no usuarios fueron niños que nunca habían tenido una tarjeta sanitaria. Se consideró que los usuarios cumplían con el calendario de vacunación OPV si, al iniciar la campaña, sus tarjetas sanitarias reflejaban que habían recibido las dosis OPV obligatorias. La regresión logística midió las relaciones existentes entre la participación en las ASI, el uso de ambos servicios de inmunización sistemática y la conformidad con la OPV sistemática entre los usuarios. RESULTADOS: Los datos de 21 ASI realizadas entre 1999 y 2010 en 15 países diferentes reunieron los criterios de inclusión. De manera global, la participación en las ASI fue de entre el 70,2% y el 96,1%, y fue sistemáticamente menor entre lactantes que entre niños con edades comprendidas entre uno y cuatro años. En los análisis ajustados, la participación entre los usuarios de los servicios de inmunización sistemática fue superior al 85% en 12 ASI, mientras que la participación de no usuarios fue superior al 85% en solo cinco ASI. En 18 de las actividades suplementarias de inmunización, la participación fue mayor entre usuarios (P Abstract in english OBJECTIVE: To determine participation in polio supplementary immunization activities (SIAs) in sub-Saharan Africa among users and non-users of routine immunization services and among users who were compliant or non-compliant with the routine oral poliovirus vaccine (OPV) immunization schedule. METHODS: Data were obtained from household-based surveys in non-polio-endemic sub-Saharan African countries. Routine immunization service users were children (aged (more) d ever had a health card containing their vaccination history; non-users were children who had never had a health card. Users were considered compliant with the OPV routine immunization schedule if, by the SIA date, their health card reflected receipt of required OPV doses. Logistic regression measured associations between SIA participation and use of both routine immunization services and compliance with routine OPV among users. FINDINGS: Data from 21 SIAs conducted between 1999 and 2010 in 15 different countries met inclusion criteria. Overall SIA participation ranged from 70.2% to 96.1%. It was consistently lower among infants than among children aged 1-4 years. In adjusted analyses, participation among routine immunization services users was > 85% in 12 SIAs but non-user participation was > 85% in only 5 SIAs. In 18 SIAs, participation was greater among users (P

In today's interconnected and global society, socially responsive learning is an integral part of educational excellence. This book encourages socially responsive learning by showing the reader how to use traditional African folk tales and quality children's books, young adult novels, classic literature, and film media about Africa as the mode for examining diversity, equity, and human rights issues in high school and university classrooms. Each Novel Guide chapter in this unique and remarkable resource offers the following features to provoke critical thinking and challenge students to become socially responsive learners: (1) An overview of the novels and activities how those activities are aligned with standards; (2) An exploration of each novel's social and historical context; (3) About the author descriptions and plot summaries; (4) "Making Connections" question sets; (5) A critical exploration of themes; (6) "Teacher Talk" questioning strategies; (7) Cross-curricular activities; and (8) A "Making-A-Difference Project." The literature explored in this book helps students and teachers to expand not only their concept of global issues and awareness of what is at stake when various kinds of injustice are ignored, but also how they may become activists on the global scene, citizens who can make a positive difference in the world. After a Foreword (Allan Stratton) and Preface ("Teaching Human Rights in the Era of Globalization," Jacqueline N. Glasgow and Linda J. Rice), this book is divided into five parts. Part I: Getting Started, contains the following chapters: (1) Rationale for Using Novel Guides to Explore African Life and Culture Through Literature (Jacqueline N. Glasgow and Linda J. Rice); and (2) Building Students' Background Knowledge of African Life and Culture (Jacqueline N. Glasgow and Linda J. Rice). Part II: Novel Guides to Explore the Arab World in Northern Africa, contains the following chapters: (3) Life in Sudan: From Slavery to Freedom (JacquelineN. Glasgow); and (4) The Struggle of Arab Women to Lead Self-Determining Lives (Jacqueline N. Glasgow). Part III: Novel Guides to Explore the Life and Culture of People in Central Regions of Africa, contains: (5) Voices Resisting Colonial Rule in Nigeria (Jacqueline N. Glasgow); (6) Conflicts in Rituals and Politics in Kenya (Linda J. Rice); (7) Rites of Passage for Young Girls in the Central Regions of Africa (Jacqueline N. Glasgow); and (8) Connections and Communication across the Continents: From Ethiopia to the United States (Alexa L. Sandmann). Part IV: Novel Guides to Explore the Life and Culture of People in Sub-Saharan Africa, contains the following chapters: (9) Exploitation Through Child Labor and Animal Poaching in 19th-Century South Africa (Linda J. Rice); (10) Racial Tensions, Injustice, and Harmony in South African Literature (Linda J. Rice); (11) The Struggles for Human Rights in the Young Adult Literature of South Africa (Jacqueline N. Glasgow); (12) Life and Literature in Botswana: Resolving Cultural Conflicts to Create a Better World (Jacqueline N. Glasgow); and (13) Cultural Conflicts and Choices for Education of Young Women in Pre- and Post-Colonial Zimbabwe (Jacqueline N. Glasgow and Kara Haas). Part V: Resources to Explore Africa Through Film, Children's Literature, and the Oral Tradition, contains the final chapters: (14) Using Film Media as Visual Text for Studying the Rwandan Genocide (Ruth McClain); (15) Children's Literature as a Means of Exploring African Life (Allison L. Baer); and (16) Exploring the African Oral Tradition: From Proverbs to Folk Tales (Jacqueline N. Glasgow). (Contains author and subject indexes.)

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.

An outline of the current challenges in sustainable development facing the African energy sector was presented. Emphasis was placed on the necessity of providing adequate training to African decision-makers. Two important challenges face the African continent. The first is the improvement of the energy situation in rural Africa, which accounts for approximately 75 per cent of the continent`s population. The second is to increase cooperation in energy matters within the continent`s countries. 8 refs.

Background Malaria is a leading cause of mortality, particularly in sub-Saharan African children. Prompt and efficacious treatment is important as patients may progress within a few hours to severe and possibly fatal disease. Chlorproguanil-dapsone-artesunate (CDA) was a promising artemisinin-based combination therapy (ACT), but its development was prematurely stopped because of safety concerns secondary to its associated risk of haemolytic anaemia in glucose-6-phosphate dehydrogenase (G6PD)-deficient individuals. The objective of the study was to assess whether CDA treatment and G6PD deficiency are risk factors for a post-treatment haemoglobin drop in African children <5?years of age with uncomplicated malaria. Methods This case–control study was performed in the context of a larger multicentre randomized clinical trial comparing safety and efficacy of four different ACT in children with uncomplicated malaria. Children, who after treatment experienced a haemoglobin drop ?2?g/dl (cases) within the first four days (days 0, 1, 2, and 3), were compared with those without an Hb drop (controls). Cases and controls were matched for study site, sex, age and baseline haemoglobin measurements. Data were analysed using a conditional logistic regression model. Results G6PD deficiency prevalence, homo- or hemizygous, was 8.5% (10/117) in cases and 6.8% (16/234) in controls (p?=?0.56). The risk of a Hb drop ?2?g/dl was not associated with either G6PD deficiency (adjusted odds ratio (AOR): 0.81; p?=?0.76) or CDA treatment (AOR: 1.28; p?=?0.37) alone. However, patients having both risk factors tended to have higher odds (AOR: 11.13; p?=?0.25) of experiencing a Hb drop ?2?g/dl within the first four days after treatment, however this finding was not statistically significant, mainly because G6PD deficient patients treated with CDA were very few. In non-G6PD deficient individuals, the proportion of cases was similar between treatment groups while in G6PD-deficient individuals, haemolytic anaemia occurred more frequently in children treated with CDA (56%) than in those treated with other ACT (29%), though the difference was not significant (p?=?0.49). Conclusion The use of CDA for treating uncomplicated malaria may increase the risk of haemolytic anaemia in G6PD-deficient children. PMID:19818174

It is 40 years since Coombs (1967) first drew attention to the World Education Crisis, and specifically problems in the educational systems of countries in the developing world. Today, many of these problems remain, and are most visible in the educational systems of countries in sub-Saharan Africa. A large number of children remain out of school and for those who do enrol, less than half complete the primary education cycle. More worrying is the fact that those who do complete primary schooling leave with unacceptably low levels of knowledge and skills. The problems of access to education, and the quality of learning opportunities and learning outcomes are unevenly spread between rural and urban areas, better- and worse-off constituencies, and between boys and girls. This raises questions about the nature of the state and its commitment to equality and equity for all. The chapters in this volume argue that quality, equity and democratic accountability are inseparable objectives in the quest to strengthen and improve educational systems in the developing world. Between them they highlight the specific problems of quality, equity and democratic accountability in a number of African educational systems, and provide useful insights into ongoing work by national governments and international donor agencies to remedy these shortcomings. Contents include: Introduction (David Johnson and William Beinart); The Challenge of Learning: Improving the Quality of Basic Education in Sub-Sahara Africa (Andriaan M. Verspoor); Improving the Quality of Education in Nigeria: A Comparative Evaluation of Recent Policy Imperatives (David Johnson); Education and Democracy in The Gambia: Reflections on the Position of Development Projects in a Small African State (Michele Schweisfurth); International and Comparative Research and the Quality of Education: Learning from the Primary School Management Project in Kenya (Michael Crossley); Remaking the Nation: Changing Masculinities and Education in South Africa (Elaine Unterhalter); Redressing School Inequalities in the Eastern Cape, South Africa (Anthony Lemon); Language, Literacy and Equality: minority language communities in the Cameroon (Barbara Trudell); and Gatherers of Knowledge: Namibian Khoisan Healers and their World of Possibilities (Chris Low.)

Most of the nations of sub-Saharan Africa (SSA), with the notable exceptions of South Africa and a few others, fall into the category of 'least developed countries' (LDCs), typically with per-capita GDP below USD 2,000. LDCs are characterised by industrial sectors that provide only a small proportion of GDP. Although the contribution of agriculture to GDP also appears low, most people in these countries depend largely on agriculture for survival. Poverty levels-the fraction of people with an income below 1 USD per day-are in general above 40%. While provision of basic services like clean water and sanitation is improving in many LDCs, access to modern forms of energy like electricity and gas remains extremely low. The low level of economic development determines the low level of energy consumption, and also the forms of energy used. Sub-Saharan Africa has one of the world's lowest per-capita consumption rates of modern energy, and even this is declining, since the rate of electrification cannot keep pace with population increase. The low level of electrification is due to a number of factors including poverty in general, a highly-dispersed rural population, a low degree of industrialisation, a historically inefficient energy sector, and difficulties in accessing capital to finance the development of modern energy sources. For LDCs throughout this region the major part of energy is used in households. By far the largest part of this energy is used for cooking and comes from traditional biomass such as firewood, charcoal and agricultural waste, which supplies as much as 95% of all energy consumed in some countries, and an average of 81% for the whole SSA region. The major developmental challenges for all the countries in the region may be expressed in terms of the Millennium Development Goals (MDGs). Although there is no specific MDG for energy, it is now widely accepted that access to energy contributes, and is indeed essential to the achievement of all the MDGs. Thus, access to clean, affordable and reliable energy is a prerequisite for the countries of SSA, not only for household uses like cooking, heating and lighting, but also for industry and agriculture, social services and transport. It is through the productive use of energy, in the broadest sense including energy for education, health and other social services, as well as for income-generating activities, that these populations can be helped out of poverty to lead rich and fulfilling lives. With regard to the climate change problem, the LDCs of SSA contribute very little to global greenhouse gas emissions, and this is likely to remain the case into the foreseeable future. The overriding issue is how to provide increased energy for development. While the emission of greenhouse gases like CO{sub 2} is not the main driver for energy policy in SSA, it would be wise even at this stage to replace high-carbon fuels with low-carbon alternatives such as natural gas, and to include CO{sub 2}-free renewable energy, as long as these solutions are close to being economically competitive. In such cases, carbon financing schemes such as the Clean Development Mechanism (CDM) might provide supplementary funding for new energy developments. Two main challenges are apparent in the energy sector: 1) How to provide access to clean, modern energy to growing populations, often in dispersed rural settlements, as well as social services and growing industries. 2) How to ensure a reliable and stable energy supply, in the wake of recent energy shortages. These have been caused by, for example, water shortages in hydropower-dependent countries such as Ghana and Tanzania, rising oil prices, and the recent power shortfall in South Africa, which has seriously affected neighbouring countries to the north. (au)

Despite the higher incidence of end stage renal disease (ESRD) among African Americans, whites in the United States population have a higher prevalence of chronic kidney disease. This may be due, in part, to a faster rate of progression to ESRD among African Americans with kidney disease. Anemia i...

This paper reviews the evidence on some of the major trends in economic development at a global level and assess their influence on food, nutrition and health. Food and nutrition are themselves broad topics, and each is influenced by a myriad of local and international forces, making them both interesting and important, but also challenging in their complexity. It is especially difficult to deal with such a vast and complicated terrain in such a short paper, and one must inevitably deal only superficially with a number of complex areas. This paper will review a number of key forces for change in the global system, with a focus on the implications of each for food and nutrition. Each area is central to the experience of economic, social and political development, particularly in the period since 1945, and each is tied in various ways with that complex and interrelated set of changes that we call globalisation. Seven key factors will be explored: global population growth, leading to strong pressures on world availability of arable land and food; increasing integration in the global economy, as measured through such things as trade, financial flows and information exchanges, and with specific implications for the food industry and for trade in food products; growing gaps between rich and poor countries; similar increases in disparities between rich and poor segments within individual countries; the rapid growth of cities in the developing world, resulting in massive challenges for the food supply systems of many nations; the growth within some countries, for example in a number of Asian countries, of a "new middle class" with distinctive patterns of consumption; and, high levels of population movements between countries resulting in the creation of significant communities of immigrants in a number of nations. Examples will be drawn from the two regions familiar to the author, Asia and Sub-Saharan Africa, but with a particular emphasis on East Asia. PMID:15228985