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1

A genomic analysis identifies a novel component in the genetic structure of sub-Saharan African populations  

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Studies of large sets of SNP data have proven to be a powerful tool in the analysis of the genetic structure of human populations. In this work, we analyze genotyping data for 2,841 SNPs in 12 Sub-Saharan African populations, including a previously unsampled region of south-eastern Africa (Mozambiqu...

Sikora, Martin; Laayouni, Hafid; Calafell, Francesc; Comas, David; Bertranpetit, Jaume

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CCR5D32 mutation in three Brazilian populations of predominantly Sub-Saharan African ancestry  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english This study reports the frequencies of the CCR5D32 mutation of the beta-chemokine 5 gene and discusses the possible effects of past and recent gene flow in three quilombo remnants (Brazilians communities with anthropological African ancestry whose ancestors were escaped slaves): Rio das Rãs, Mocambo, and São Gonçalo in the northeastern region of Brazil. The CCR5D32 allele frequency of the Mocambo population was significantly higher (5.6%) than that found in the Rio das (more) Rãs (1%) and São Gonçalo (0.9%) populations. These differences may reflect different proportions of parental populations in the founders individuals, a founder-effect and/or different histories of inter-ethnic contact. The frequency of the CCR5D32 allele in the Mocambo sample is similar to that found in those urban Brazilian populations which have a large amount of European genetic input, indicating a European contribution to the gene pool of this population and suggesting that, perhaps since its foundation, Mocambo has had a high level of admixture or experienced a founder-effect.

Carvalho, Mônica W.P.; Leboute, Ana P.M.; Oliveira, Silviene F.; Sousa, Sandra M.B.; Klautau-Guimarães, Maria de Nazaré; Simões, Aguinaldo L.

2004-01-01

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CCR5D32 mutation in three Brazilian populations of predominantly Sub-Saharan African ancestry  

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Full Text Available This study reports the frequencies of the CCR5D32 mutation of the beta-chemokine 5 gene and discusses the possible effects of past and recent gene flow in three quilombo remnants (Brazilians communities with anthropological African ancestry whose ancestors were escaped slaves): Rio das Rãs, Mocambo, and São Gonçalo in the northeastern region of Brazil. The CCR5D32 allele frequency of the Mocambo population was significantly higher (5.6%) than that found in the Rio das Rãs (1%) and São Gonçalo (0.9%) populations. These differences may reflect different proportions of parental populations in the founders individuals, a founder-effect and/or different histories of inter-ethnic contact. The frequency of the CCR5D32 allele in the Mocambo sample is similar to that found in those urban Brazilian populations which have a large amount of European genetic input, indicating a European contribution to the gene pool of this population and suggesting that, perhaps since its foundation, Mocambo has had a high level of admixture or experienced a founder-effect.

Mônica W.P. Carvalho; Ana P.M. Leboute; Silviene F. Oliveira; Sandra M.B. Sousa; Maria de Nazaré Klautau-Guimarães; Aguinaldo L. Simões

2004-01-01

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Cardiovascular disease, diabetes and established risk factors among populations of sub-Saharan African descent in Europe: a literature review  

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Full Text Available Abstract Background Most European countries are ethnically and culturally diverse. Globally, cardiovascular disease (CVD) is the leading cause of death. The major risk factors for CVD have been well established. This picture holds true for all regions of the world and in different ethnic groups. However, the prevalence of CVD and related risk factors vary among ethnic groups. Methods This article provides a review of current understanding of the epidemiology of vascular disease, principally coronary heart disease (CHD), stroke and related risk factors among populations of Sub-Sahara African descent (henceforth, African descent) in comparison with the European populations in Europe. Results Compared with European populations, populations of African descent have an increased risk of stroke, whereas CHD is less common. They also have higher rates of hypertension and diabetes than European populations. Obesity is highly prevalent, but smoking rate is lower among African descent women. Older people of African descent have more favourable lipid profile and dietary habits than their European counterparts. Alcohol consumption is less common among populations of African descent. The rate of physical activity differs between European countries. Dutch African-Suriname men and women are less physically active than the White-Dutch whereas British African women are more physically active than women in the general population. Literature on psychosocial stress shows inconsistent results. Conclusion Hypertension and diabetes are highly prevalent among African populations, which may explain their high rate of stroke in Europe. The relatively low rate of CHD may be explained by the low rates of other risk factors including a more favourable lipid profile and the low prevalence of smoking. The risk factors are changing, and on the whole, getting worse especially among African women. Cohort studies and clinical trials are therefore needed among these groups to determine the relative contribution of vascular risk factors, and to help guide the prevention efforts. There is a clear need for intervention studies among these populations in Europe.

Agyemang Charles; Addo Juliet; Bhopal Raj; de Graft Aikins Ama; Stronks Karien

2009-01-01

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Energy and carbon emissions: sub-Saharan African perspective  

Energy Technology Data Exchange (ETDEWEB)

This paper illustrates the importance of the full involvement of sub-Saharan African countries in the international debate on global climate change despite the relatively minor contribution these nations make to worldwide emissions of greenhouse gases. The paper suggests policies that will allow these African nations to support the growth in energy services required to foster economic development through the use of less carbon-intensive technologies. Such an energy strategy would raise the quality of life of the sub-Saharan African people, and simultaneously restrain the growth of energy-related carbon emissions. Given the necessary infrastructure and political commitment, these countries can overcome the barriers that could prevent the successful implementation of these policies without sacrificing their development goals. 10 refs., 3 tabs.

Davidson, O.R. (Sierra Leone University, Freetown (Sierra Leone))

1993-01-01

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Comparison of different blood pressure indices for the prediction of prevalent diabetic nephropathy in a sub-Saharan African population with type 2 diabetes  

Science.gov (United States)

Background The association between blood pressure (BP) and diabetic kidney diseases in Africans has been less well investigated. We assessed and compared the strength of the association and discriminatory capability of systolic (SBP), diastolic (DBP) BP, pulse pressure (PP) and mean arterial blood pressure (MAP) for nephropathy risk in sub-Saharan Africans with type 2 diabetes. Methods Participants were 420 consecutive individuals (49% men) with type 2 diabetes receiving chronic care in two main referral centres in the two major cities of Cameroon. Logistic regression models were used to compute the odd ratio (OR) and 95% confidence interval (95% CI) for a standard deviation (SD) higher level of SBP (25 mmHg), DBP (13), PP (18) and MAP (16) with nephropathy risk. Discrimination was assessed and compared with c-statistics and relative integrated discrimination improvement (RIDI, %). Results The adjusted OR (95% CI) for nephropathy with each SD higher BP variable were: 1.45 (1.15-1.84) for SBP, 1.33 (1.06-1.66) for DBP, 1.35 (1.06-1.71) for PP and 1.42 (1.13-1.78) for MAP. C-statistic comparison showed no difference in discrimination of models with each of the BP variables (p-values ? 0.69 for c-statistics comparison). However, RIDI statistic always showed and enhancement in models discrimination when other BP variables were replaced with SBP, although such an enhancement was marginal for MAP. Using BP combination modestly improved models? discrimination. Conclusion SBP was the best predictor of prevalent nephropathy in this population, while DBP was the less effective. This may have implication for kidney disease risk stratification and protection.

Choukem, Simeon-Pierre; Dzudie, Anastase; Dehayem, Mesmin; Halle, Marie-Patrice; Doualla, Marie-Solange; Luma, Henry; Kengne, Andre-Pascal

2012-01-01

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Coal in sub-Saharan-African countries undergoing desertification  

Energy Technology Data Exchange (ETDEWEB)

Coal has been reported in 11 of the 16 sub-Saharan countries discussed in this appraisal: Mauritania, Senegal, Mali, Niger, Benin, Nigeria, Cameroon, Central African Republic, Sudan, Ethiopia, and Somalia. No coal occurrences have been reported in Gambia, Togo, Burkina, Chad, and Djibouti but coal may be present within these countries because neighbouring countries do contain coal-bearing rocks. Most of these countries are undergoing desertification. Destruction of forest and shrub lands for fuel is occurring at an increasing rate because of desertification and increasing energy demands. Part of the present and future energy needs of the sub-Saharan region could be met by use of indigenous coal and peat. Nine sedimentary basins have the potential of either coal and/or peat deposits of economic value: 1- Senegal Basin, 2- Taoudeni Basin and Gao Trough, 3- Niger Basin, 4- Chad Basin. 5- Chari Basin, 6- Benue Trough (Depression), 7- Sudan Trough, 8- Plateau and Rift Belt, and 9- Somali Basin. Niger and Nigeria are the only countries in sub-Saharan Africa in which coal is presently being mined as a fuel source for powerplants and domestic use. Peat occurs in the deltas, lower river, and interdunal basin areas of Senegal, Mauritania, and Sudan. The overall objective of these studies is to establish, within the sub-Saharan region, energy independent countries using indigeneous coal and peat resources. These resources have the potential to replace wood and wood charcoal as domestic fuel in the urban centres, as well as producing electrical and industrial energy, thus reducing expensive oil imports and decreasing the rate of deforestation. 31 refs., 16 figs., 1 tab.

Weaver, J.N.; Brownfield, M.E.; Bergin, M.J. (United States Geological Survey, Denver, CO (USA))

1990-01-01

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

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

Naidoo Thijessen; Schlebusch Carina M; Makkan Heeran; Patel Pareen; Mahabeer Rajeshree; Erasmus Johannes C; Soodyall Himla

2010-01-01

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Gender Gaps in Political Participation across Sub-Saharan African Nations  

Science.gov (United States)

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

Coffe, Hilde; Bolzendahl, Catherine

2011-01-01

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Gender Gaps in Political Participation Across Sub-Saharan African Nations.  

UK PubMed Central (United Kingdom)

A substantial literature has studied gender differences in political participation in Western industrialized democracies, but little is known about such gaps in sub-Saharan African nations. Using 2005 Afrobarometer data, this paper presents a systematic investigation of the gender gap in political participation across 18 sub-Saharan African countries. In line with cultural isomorphism, patterns in gender gaps across different types of participation generally mirror those of Western democracies, with small to no gender gaps in registration to vote, but substantial gaps in less institutionalized types of participation. Yet, the remaining large gaps cannot be explained by gender differences in socioeconomic characteristics and political attitudes as suggested in studies on Western industrialized nations. Finally, substantial cross-national differences within the sub-Saharan African are found, substantiating the importance of more fine-grained examinations of variation across sub-Saharan African nations.

Coffe H; Bolzendahl C

2011-06-01

11

Sub-Saharan Africa: population pressures on development.  

Science.gov (United States)

The population of sub-Saharan Africa, estimated at 434 million in 1984, is expected to reach 1.4 billion by 2025. The birth rate, currently 48/1000 population, continues to increase, and the death rate, 17/1000, is declining. Rapid population growth has curtailed government efforts to provide adequate nutrition, preserve the land base essential for future development, meet the demand for jobs, education, and health services, and address overcrowding in urban areas. Low education, rural residence, and low incomes are key contributors to the area's high fertility. Other factors include women's restricted roles, early age at marriage, a need for children as a source of security and support in old age, and limited knowledge of and access to modern methods of contraception. Average desired family size, which is higher than actual family size in most countries, is 6-9 children. Although government leaders have expressed ambivalence toward development of population policies and family planning programs as a result of the identification of such programs with Western aid donors, the policy climat is gradually changing. By mid-1984, at least 13 of the 42 countries in the region had indicated that they consider current fertility rates too high and support government and/or private family planning programs to reduce fertility. In addition, 26 countries in the region provide some government family planning services, usually integrated with maternal and child health programs. However, 10 countries in the region do not support family planning services for any reason. Unfortunately, sub-Saharan Africa has not yet produced a family planning program with a measurable effect on fertility that could serve as a model for other countries in the region. Social and economic change is central to any hope of fertility reduction in sub-Saharan Africa. Lower infant and child mortality rates, rising incomes, higher education, greater economic and social opportunities for women, and increased security would provide a climate more conducive to fertility decline. Given the limited demand, great sensitivity must be shown in implementing family planning programs. PMID:12266940

Goliber, T J

1985-02-01

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Raven's Test Performance of Sub-Saharan Africans: Average Performance, Psychometric Properties, and the Flynn Effect  

Science.gov (United States)

|This paper presents a systematic review of published data on the performance of sub-Saharan Africans on Raven's Progressive Matrices. The specific goals were to estimate the average level of performance, to study the Flynn Effect in African samples, and to examine the psychometric meaning of Raven's test scores as measures of general…

Wicherts, Jelte M.; Dolan, Conor V.; Carlson, Jerry S.; van der Maas, Han L. J.

2010-01-01

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The Average IQ of Sub-Saharan Africans: Comments on Wicherts, Dolan, and van der Maas  

Science.gov (United States)

Wicherts, Dolan, and van der Maas (2009) contend that the average IQ of sub-Saharan Africans is about 80. A critical evaluation of the studies presented by WDM shows that many of these are based on unrepresentative elite samples. We show that studies of 29 acceptably representative samples on tests other than the Progressive Matrices give a…

Lynn, Richard; Meisenberg, Gerhard

2010-01-01

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Plasmodium falciparum mitochondrial genetic diversity exhibits isolation-by-distance patterns supporting a sub-Saharan African origin.  

UK PubMed Central (United Kingdom)

The geographical distribution of single nucleotide polymorphism (SNP) in the mitochondrial genome of the human malaria parasite Plasmodium falciparum was investigated. We identified 88 SNPs in 516 isolates from seven parasite populations in Africa, Southeast Asia and Oceania. Analysis of the SNPs postulated a sub-Saharan African origin and recovered a strong negative correlation between within-population SNP diversity and geographic distance from the putative African origin over Southeast Asia and Oceania. These results are consistent with those previously obtained for nuclear genome-encoded housekeeping genes, indicating that the pattern of inheritance does not substantially affect the geographical distribution of SNPs.

Tanabe K; Jombart T; Horibe S; Palacpac NM; Honma H; Tachibana SI; Nakamura M; Horii T; Kishino H; Mita T

2013-09-01

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[Families in crisis and population policies in Sub-Saharan Africa].  

Science.gov (United States)

During the 3 decades since independence, most sub-Saharan African countries have experienced accelerated demographic growth and increased migration from rural to urban areas. The 2 factors have considerably increased the costs of raising children, who have become more numerous and acquired new needs. In rural areas, families continue to fill much of their children's need for health care and employment. The declining ability of governments beset by economic crises and structural adjustment programs to do so has led some observers to predict that a new demand for smaller families and thus family planning will ensue. But in order for the declarations of intention made to foreign donors with increasing frequency by African governments to lead to significant fertility modifications, a combination of great political will, agreement of families with the new fertility objectives, and accessible family planning infrastructure would be required. Changes of this magnitude are at present difficult to visualize. Most African governments since the 1984 World Population Conference have stated their support of policies to slow demographic growth, but their true attitudes are often ambivalent. Many family planning programs receive only timid official help despite apparent encouragement. Authorities of some small countries concerned about the political implications of population size may hesitate to support family planning, and in all of Africa the desire to limit family size is contrary to deeply held social values. African family planning programs confront both political reticence and the fact that most Africans still consider a large family beneficial, not just through blind adherence to tradition but because for the 70% who support themselves in agriculture a large labor force is essential. Children provide security for the old and infirm. For much of the population, the conditions justifying high fertility in the past--high mortality rates and dependence of production on the available labor force--have changed too little to have caused profound modifications in family size preferences. Fertility surveys in sub-Saharan Africa show that family size desires remain high in most countries. In urban areas, demand for contraception is beginning to appear, but much of it is destined to replace traditional means of spacing that are falling into decline. The obvious potential demand for services from women at the beginning of their reproductive lives and from women lacking permission of their husbands is discouraged by most African family planning programs. Social progress and coercion appear to have been the 2 principal routes to fertility transition in the developing world. Social progress requires improved health and education, goals made more distant by structural adjustment programs. Diminished social investment in sub-Saharan countries appears much more likely to result in increased fertility than in smaller family sizes. PMID:12317456

Locoh, T

1991-12-01

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FINANCIAL DEVELOPMENT AND ECONOMIC GROWTH: THE EXPERIENCE OF 10 SUB-SAHARAN AFRICAN COUNTRIES REVISITED  

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Full Text Available The paper examines the long run and causal relationship between financial developmentand economic growth for ten countries in sub-Saharan Africa. Using the vectorerror correction model (VECM), the study finds that financial development is cointegratedwith economic growth in the selected ten countries in sub-Saharan Africa. That is there isa long run relationship between financial development and economic growth in the selectedsub-Saharan African countries. The results show that financial development Granger causeseconomic growth in Central African Republic, Congo Republic, Gabon, and Nigeria whileeconomic growth Granger causes financial development in Zambia. However, bidirectionalrelationship between financial development and economic growth was found in Kenya, Chad,South Africa, Sierra Leone and Swaziland. The results show the need to develop the financialsector through appropriate regulatory and macroeconomic policies. However, in Zambiaemphasis needs to be placed on economic growth to propel financial development.

Anthony Enisan Akinlo; Tajudeen Egbetunde

2010-01-01

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Revisiting sub-Saharan African countries' drug problems: health, social, economic costs, and drug control policy.  

UK PubMed Central (United Kingdom)

This article takes an international perspective on the drug problem in sub-Saharan Africa. This analysis borrows ideas from physical and economic geography as a heuristic device to conceptualize the global narcoscapes in which drug trafficking occurs. Both the legitimate and the illegal drug trade operate within the same global capitalist system and draw on the same technological innovations and business processes. Central to the paper's argument is evidence that sub-Saharan African countries are now integrated into the political economy of drug consumption due to the spill-over effect. These countries are now minor markets for "hard drugs" as the result of the activities of organizations and individual traffickers that use Africa as a staging point in their trade with Europe and the United States. As a result, sub-Saharan African countries have drug consumption problems that were essentially absent prior to 1980, along with associated health, social, and economic costs. The emerging drug problem has forced African countries to develop their own drug control policy. The sub-Saharan African countries mentioned below vary to some extent in the level of drug use and misuse problems: Burundi, Comoros, Djibouti, Eritrea, Ethiopia, Kenya, Madagascar, Malawi, Mauritius, Mozambique, Reunion, Rwanda, Seychelles, Somalia, Tanzania, Uganda, Zambia, Angola, Cameroon, Central African Republic, Chad, Congo, Congo (Zaire), Equatorial Guinea, Gabon, Sao Tome and Principe, Botswana, Lesotho, Namibia, South Africa, Swaziland, Benin, Burkina Faso, Cape Verde, Cote d'Ivoire, Gambia, Ghana, Guinea, Guinea Bissau, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, and Togo. As part of this effort, African countries are assessing the health, social, and economic costs of drug-use-related problems to pinpoint methods which are both effective and inexpensive, since their budgets for social programs are severely constrained. Many have progressed to the point of adopting anti-drug laws or legislation, or of establishing a drug control agency. They are also cooperating regionally to coordinate drug control measures and working with the Organization of African Unity (OAU). In addition, almost all the sub-Saharan African countries are signatories to all United Nations drug conventions. Since the drug problem in Africa has international origins, it will take concerted international cooperation and coordinated effort to combat the "social cancer" of drugs.

Affinnih YH

2002-02-01

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The African Development Bank, structural adjustment, and child mortality: a cross-national analysis of Sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

We conduct a cross-national analysis to test the hypothesis that African Development Bank (AfDB) structural adjustment adversely impacts child mortality in Sub-Saharan Africa. We use generalized least square random effects regression models and two-step Heckman models that correct for selection bias using data on 35 nations with up to four time points (1990, 1995, 2000, and 2005). We find substantial support for our hypothesis, which indicates that Sub-Saharan African nations that receive an AfDB structural adjustment loan tend to have higher levels of child mortality than Sub-Saharan African nations that do not receive such a loan. This finding remains stable even when controlling for selection bias on whether or not a Sub-Saharan African nation receives an AfDB structural adjustment loan. We conclude by discussing the methodological implications of the article, policy suggestions, and possible directions for future research.

Pandolfelli LE; Shandra JM

2013-01-01

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Valvulopathies in sub-Saharan African children: patterns, humanitarian interventions and cardiac surgical problems.  

Science.gov (United States)

Despite the high burden of rheumatic fever in sub-Saharan African, there is currently no sustained and comprehensive strategy to control the disease. Consequently in this area the number of patients affected by rheumatic valve disease (RVD), most with a surgical indication, is 10-20 fold higher than in industrialised countries and estimates indicate that more than 50% of African RVD patients will die before age 25. In this paper, we review clinical and management issues of RVD in children in sub-Saharan Africa. Severe heart failure and undergrowth are the prevalent presentation of the illness. Severe mitral regurgitation is the commonest rheumatic valvulopathy observed in the first and second decades. Valve repair, the approach of choice, may be associated with unfavourable outcomes in patients with extreme cardiomegaly. In young people, whenever correct anticoagulation may reasonably be achieved, mechanical mitral prostheses should be preferred, even in females. The early deterioration of biologic mitral prostheses strongly suggests limiting their use to those cases in which correct anticoagulation is not feasible. In most sub-Saharan countries, socioeconomic factors strongly limit access to health services and to cardiac surgery in particular. Efforts to overcome these barriers have resulted in humanitarian projects along two patterns: creation of high tech on site health care structures or transfer of children with complex diseases to receive highly specialised cardiac surgical care abroad. We summarise the experience of our programme that followed the latter approach. PMID:22464485

Ferratini, Maurizio; Marianeschi, Stefano; Santoro, Francesco; Vitali, Ettore; Ripamonti, Vittorino; De Maria, Renata; Torri, Anna; Pezzano, Antonio; Moraschi, Andrea; Tavano, Davide; Pesaresi, Marilena; Martinelli, Luigi

2012-03-30

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Valvulopathies in sub-Saharan African children: patterns, humanitarian interventions and cardiac surgical problems.  

UK PubMed Central (United Kingdom)

Despite the high burden of rheumatic fever in sub-Saharan African, there is currently no sustained and comprehensive strategy to control the disease. Consequently in this area the number of patients affected by rheumatic valve disease (RVD), most with a surgical indication, is 10-20 fold higher than in industrialised countries and estimates indicate that more than 50% of African RVD patients will die before age 25. In this paper, we review clinical and management issues of RVD in children in sub-Saharan Africa. Severe heart failure and undergrowth are the prevalent presentation of the illness. Severe mitral regurgitation is the commonest rheumatic valvulopathy observed in the first and second decades. Valve repair, the approach of choice, may be associated with unfavourable outcomes in patients with extreme cardiomegaly. In young people, whenever correct anticoagulation may reasonably be achieved, mechanical mitral prostheses should be preferred, even in females. The early deterioration of biologic mitral prostheses strongly suggests limiting their use to those cases in which correct anticoagulation is not feasible. In most sub-Saharan countries, socioeconomic factors strongly limit access to health services and to cardiac surgery in particular. Efforts to overcome these barriers have resulted in humanitarian projects along two patterns: creation of high tech on site health care structures or transfer of children with complex diseases to receive highly specialised cardiac surgical care abroad. We summarise the experience of our programme that followed the latter approach.

Ferratini M; Marianeschi S; Santoro F; Vitali E; Ripamonti V; De Maria R; Torri A; Pezzano A; Moraschi A; Tavano D; Pesaresi M; Martinelli L

2013-05-01

 
 
 
 
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Conservative treatment of ectopic pregnancy in a sub-Saharan African setting.  

UK PubMed Central (United Kingdom)

In the sub-Saharan African setting, laparotomy for salpingectomy is the common method of treatment for ectopic pregnancy (EP). The objective of this retrospective study was to find out how common EP is treated conservatively in the Yaounde Gynaeco-Obstetric and Paediatric Hospital, Cameroon. Of the 281 patient files analysed, 126 patients (44.8%) were treated conservatively and successfully for EP. Of these, 86 (68.2%) had received conservative surgical treatment while 40 (31.8%) had non-surgical treatment. Salpingostomy was the conservative surgery for 79.1% of the cases. According to the publications available for the sub-Saharan setting, the rate of conservative management of EP at the Yaounde Gynaeco-Obstetric and Paediatric Hospital, Cameroon is high. We recommend that this rate should be improved so that, eventually, the conservative treatment methods of EP become routine.

Foumane P; Mboudou ET; Dohbit JS; Ndingue SM; Tebeu PM; Doh AS

2011-04-01

22

Hepatitis B virus / human immunodeficiency virus co-infection and its hepatocarcinogenic potential in sub-saharan black africans.  

UK PubMed Central (United Kingdom)

CONTEXT: Since the introduction of highly active anti-retroviral regimen for human immunodeficiency virus-1 infection, a significant increase in the incidence of hepatocellular carcinoma has been reported in patients already chronically infected with hepatitis B virus and then given this form of regimen for their retroviral infection. EVIDENCE ACQUISITION: This phenomenon was initially attributed to the far more prolonged survival of those patients who received this new regimen, which provided sufficient time, allowing hepatitis B virus-induced hepatocellular carcinoma to develop. RESULTS: The current belief is that the increased incidence of hepatocellular carcinoma is because of co-infection with the two viruses, one known to be hepatocarcinogenic and the other suspected to increase the carcinogenic potential of the other. Because both hepatitis B virus and human immunodeficiency virus -1 are endemic in the Black population of sub-Saharan Africa and are transmitted in similar ways, as many as 20% of this population are co-infected with the two viruses. In this way, the already high risk of Black African patients developing hepatitis B virus-induced hepatocellular carcinoma is further increased. CONCLUSIONS: The pathogenetic mechanism or mechanisms involved in the carcinogenic interaction between the hepatitis B virus and the human immunodeficiency virus-1 in sub-Saharan Black Africans and other populations co-infected with these viruses have yet to be determined.

Kew MC

2012-10-01

23

Prevalence, awareness, treatment and control of hypertension in a self-selected sub-Saharan African urban population: a cross-sectional study.  

UK PubMed Central (United Kingdom)

OBJECTIVES: Hypertension has been established as a major public health problem in Africa, but its specific contributions to disease burden are still incompletely understood. We report the prevalence and determinants of hypertension, detection, treatment and control rates among adults in major cities in Cameroon. DESIGN: Cross-sectional study. SETTINGS: Community-based multicentre study in major cities in Cameroon. PARTICIPANTS: Participants were self-selected urban dwellers from the Center, Littoral, North-West and West Regions, who attended on 17 May 2011 a screening campaign advertised through mass media. PRIMARY AND SECONDARY OUTCOMES MEASURES: Hypertension defined as systolic (and/or diastolic) blood pressure (BP)??140 (90) mm Hg, or ongoing BP-lowering medications. RESULTS: In all, 2120 participants (1003 women) were included. Among them, 1007 (prevalence rate 47.5%) had hypertension, including 319 (awareness rate 31.7%) who were aware of their status. The prevalence of hypertension increased with age overall and by sex and region. Among aware hypertensive participants, 191 (treatment rate 59.9%) were on regular BP-lowering medication, and among those treated, 47 (controlled rate 24.6%) were at target BP levels (ie, systolic (and diastolic) BP<140 (90) mm Hg). In multivariable logistic regression analysis, male gender, advanced age, parental history of hypertension, diabetes mellitus, elevated waist and elevated body mass index (BMI) were the significant predictors of hypertension. Likewise, male gender, high BMI and physical inactivity were associated with poor control. CONCLUSIONS: High prevalence of hypertension with low awareness, treatment and control were found in this urban population; these findings are significant and alarming with consideration to the various improvements in the access to healthcare and the continuing efforts to educate communities over the last few decades.

Dzudie A; Kengne AP; Muna WF; Ba H; Menanga A; Kouam Kouam C; Abah J; Monkam Y; Biholong C; Mintom P; Kamdem F; Djomou A; Ndjebet J; Wambo C; Luma H; Ngu KB; Kingue S

2012-01-01

24

Prevalence, awareness, treatment and control of hypertension in a self-selected sub-Saharan African urban population: a cross-sectional study  

Science.gov (United States)

Objectives Hypertension has been established as a major public health problem in Africa, but its specific contributions to disease burden are still incompletely understood. We report the prevalence and determinants of hypertension, detection, treatment and control rates among adults in major cities in Cameroon. Design Cross-sectional study. Settings Community-based multicentre study in major cities in Cameroon. Participants Participants were self-selected urban dwellers from the Center, Littoral, North-West and West Regions, who attended on 17 May 2011 a screening campaign advertised through mass media. Primary and secondary outcomes measures Hypertension defined as systolic (and/or diastolic) blood pressure (BP)??140 (90)?mm?Hg, or ongoing BP-lowering medications. Results In all, 2120 participants (1003 women) were included. Among them, 1007 (prevalence rate 47.5%) had hypertension, including 319 (awareness rate 31.7%) who were aware of their status. The prevalence of hypertension increased with age overall and by sex and region. Among aware hypertensive participants, 191 (treatment rate 59.9%) were on regular BP-lowering medication, and among those treated, 47 (controlled rate 24.6%) were at target BP levels (ie, systolic (and diastolic) BP<140 (90)?mm?Hg). In multivariable logistic regression analysis, male gender, advanced age, parental history of hypertension, diabetes mellitus, elevated waist and elevated body mass index (BMI) were the significant predictors of hypertension. Likewise, male gender, high BMI and physical inactivity were associated with poor control. Conclusions High prevalence of hypertension with low awareness, treatment and control were found in this urban population; these findings are significant and alarming with consideration to the various improvements in the access to healthcare and the continuing efforts to educate communities over the last few decades.

Dzudie, Anastase; Kengne, Andre Pascal; Muna, Walinjom F T; Ba, Hamadou; Menanga, Alain; Kouam Kouam, Charles; Abah, Joseph; Monkam, Yves; Biholong, Christian; Mintom, Pierre; Kamdem, Felicite; Djomou, Armel; Ndjebet, Jules; Wambo, Cyrille; Luma, Henry; Ngu, Kathleen Blackett; Kingue, Samuel

2012-01-01

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How can the operating environment for nutrition research be improved in sub-Saharan Africa? The views of African researchers.  

UK PubMed Central (United Kingdom)

Optimal nutrition is critical for human development and economic growth. Sub-Saharan Africa is facing high levels of food insecurity and only few sub-Saharan African countries are on track to eradicate extreme poverty and hunger by 2015. Effective research capacity is crucial for addressing emerging challenges and designing appropriate mitigation strategies in sub-Saharan Africa. A clear understanding of the operating environment for nutrition research in sub-Saharan Africa is a much needed prerequisite. We collected data on the barriers and requirements for conducting nutrition research in sub-Saharan Africa through semi-structured interviews with 144 participants involved in nutrition research in 35 countries in sub-Saharan Africa. A total of 133 interviews were retained for coding. The main barriers identified for effective nutrition research were the lack of funding due to poor recognition by policymakers of the importance of nutrition research and under-utilisation of research findings for developing policy, as well as an absence of research priority setting from within Africa. Current research topics were perceived to be mainly determined by funding bodies from outside Africa. Nutrition researchers argued for more commitment from policymakers at national level. The low capacity for nutrition research was mainly seen as a consequence of insufficient numbers of nutrition researchers, limited skills and a poor research infrastructure. In conclusion, African nutrition researchers argued how research priorities need to be identified by African stakeholders, accompanied by consensus building to enable creating a problem-driven national research agenda. In addition, it was considered necessary to promote interactions among researchers, and between researchers and policymakers. Multidisciplinary research and international and cross-African collaboration were seen as crucial to build capacity in sub-Saharan nutrition research.

Van Royen K; Lachat C; Holdsworth M; Smit K; Kinabo J; Roberfroid D; Nago E; Garimoi Orach C; Kolsteren P

2013-01-01

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How can the operating environment for nutrition research be improved in sub-Saharan Africa? The views of African researchers.  

Science.gov (United States)

Optimal nutrition is critical for human development and economic growth. Sub-Saharan Africa is facing high levels of food insecurity and only few sub-Saharan African countries are on track to eradicate extreme poverty and hunger by 2015. Effective research capacity is crucial for addressing emerging challenges and designing appropriate mitigation strategies in sub-Saharan Africa. A clear understanding of the operating environment for nutrition research in sub-Saharan Africa is a much needed prerequisite. We collected data on the barriers and requirements for conducting nutrition research in sub-Saharan Africa through semi-structured interviews with 144 participants involved in nutrition research in 35 countries in sub-Saharan Africa. A total of 133 interviews were retained for coding. The main barriers identified for effective nutrition research were the lack of funding due to poor recognition by policymakers of the importance of nutrition research and under-utilisation of research findings for developing policy, as well as an absence of research priority setting from within Africa. Current research topics were perceived to be mainly determined by funding bodies from outside Africa. Nutrition researchers argued for more commitment from policymakers at national level. The low capacity for nutrition research was mainly seen as a consequence of insufficient numbers of nutrition researchers, limited skills and a poor research infrastructure. In conclusion, African nutrition researchers argued how research priorities need to be identified by African stakeholders, accompanied by consensus building to enable creating a problem-driven national research agenda. In addition, it was considered necessary to promote interactions among researchers, and between researchers and policymakers. Multidisciplinary research and international and cross-African collaboration were seen as crucial to build capacity in sub-Saharan nutrition research. PMID:23776663

Van Royen, Kathleen; Lachat, Carl; Holdsworth, Michelle; Smit, Karlien; Kinabo, Joyce; Roberfroid, Dominique; Nago, Eunice; Garimoi Orach, Christopher; Kolsteren, Patrick

2013-06-12

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Neorealism and International Subsystems of Small States: Insights from Sub-Saharan African Countries’ Interactions  

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Full Text Available The prevailing wisdom in IR debates finds that neorealism is “the powerful tool” predicting weak states’ behaviour. It has been argued that systemic factors are more likely to explain foreign policy choices of small states if compared to domestic factors. This paper is an exploration of the structural realist hypotheses about small states’ behaviour in the international system. It particularly questions the importance given by neorealism to structural explanations while analysing small states’ behaviour, despite paying little attention to the relativity of smallness. However, the neo-realist hypotheses would become more consistent if tested on smaller states of subsystems crowded by countries considered small in global comparisons. By focusing on smaller states of the Sub-Saharan-African sub-system, this paper argues that neorealist expectations find very little empirical support.

Mughanda Muhindo; Gaetano Calenzo

2011-01-01

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

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

David Olayungbo; Olalekan Yinusa; Anthony Akinlo

2011-01-01

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Topological variability of fingerprint ridge density in a sub-saharan population sample for application in personal identification.  

UK PubMed Central (United Kingdom)

Variability in ridge density in a sub-Saharan population sample was studied by counting ridges in three fingerprint areas (two distal regions, radial and ulnar, and one proximal region) on the epidermal surface of the distal phalanx. Study material was obtained from the fingerprint impressions of 100 male sub-Saharan subjects aged between 18- and 48-years old. The results were compared with those obtained from a Spanish population sample. Sub-Saharan males presented lower ridge density than Spanish males in the distal regions (radial and ulnar) of all fingers, whereas differences in the proximal region were only observed on some fingers. Using the differences observed between these populations, the likelihood ratio for inferring membership of one of the populations from a fingerprint of unknown origin was calculated; therefore, a ridge density of 14 or less for both areas (ulnar and radial), support an origin sub-Saharan versus Spanish population.

Gutiérrez-Redomero E; Quirós JA; Rivaldería N; Alonso MC

2013-05-01

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[The elderly in sub-Saharan Africa: a vulnerable population often ignored in public policy].  

UK PubMed Central (United Kingdom)

Many people and financial institutions believe that the elderly are not a priority in sub-Saharan Africa, a region marked by serious economic, socio-political and health crises. The purpose of this paper is to describe and analyze the assumptions and arguments underlying this view and to demonstrate that the elderly are a vulnerable priority population ignored by all stakeholders and primarily by technical and financial partners. The premise is that development must be viewed as a whole. In addition to improving the living conditions of children, youth and women, efforts to promote development in Africa must also take into account the needs of the elderly. The paper argues that there are four main reasons for focusing on the elderly in sub-Saharan Africa: systemic reasons, ethical/humanitarian reasons, developmental reasons and/or the interests and future of youth and adults.

Berthé A; Berthé-Sanou L; Konaté B; Hien H; Tou F; Drabo M; Badini-Kinda F; Macq J

2013-05-01

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

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

Kanayo Ogujiub; Uche Nwogwugw; Enwere Dik

2011-01-01

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A randomized controlled pilot study of an HIV risk-reduction intervention for sub-Saharan African university students.  

UK PubMed Central (United Kingdom)

This pilot study used a randomized controlled trial to test the efficacy of an HIV risk-reduction intervention for university students in Eastern Cape Province, South Africa. Randomly selected second-year students were randomized to one of two interventions based on social cognitive theory and qualitative research: HIV risk-reduction, targeting sexual-risk behaviors; health-promotion control, targeting health behaviors unrelated to sexual risks. Participants completed behavioral assessments via audio computer-assisted self-interviewing pre-intervention, 6, and 12 months post intervention, with 97.2% retained at 12-month follow-up. Averaged over the 2 follow-ups, HIV risk-reduction intervention participants reported less unprotected vaginal intercourse and more frequent condom use than control participants, with greater efficacy in non-South Africans than South Africans. Positive changes were also observed on theoretical mediators of condom use that the intervention targeted. Interventions based on social cognitive theory integrated with qualitative information from the population may reduce sexual risk behaviors among university students in sub-Saharan Africa.

Heeren GA; Jemmott JB 3rd; Ngwane Z; Mandeya A; Tyler JC

2013-03-01

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Differences in HIV natural history among African and non-African seroconverters in Europe and seroconverters in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

INTRODUCTION: It is unknown whether HIV treatment guidelines, based on resource-rich country cohorts, are applicable to African populations. METHODS: We estimated CD4 cell loss in ART-naïve, AIDS-free individuals using mixed models allowing for random intercept and slope, and time from seroconversion to clinical AIDS, death and antiretroviral therapy (ART) initiation by survival methods. Using CASCADE data from 20 European and 3 sub-Saharan African (SSA) cohorts of heterosexually-infected individuals, aged ?15 years, infected ?2000, we compared estimates between non-African Europeans, Africans in Europe, and Africans in SSA. RESULTS: Of 1,959 (913 non-Africans, 302 Europeans-African origin, 744 SSA), two-thirds were female; median age at seroconversion was 31 years. Individuals in SSA progressed faster to clinical AIDS but not to death or non-TB AIDS. They also initiated ART later than Europeans and at lower CD4 cell counts. In adjusted models, Africans (especially from Europe) had lower CD4 counts at seroconversion and slower CD4 decline than non-African Europeans. Median (95% CI) CD4 count at seroconversion for a 15-29 year old woman was 607 (588-627) (non-African European), 469 (442-497) (European-African origin) and 570 (551-589) (SSA) cells/µL with respective CD4 decline during the first 4 years of 259 (228-289), 155 (110-200), and 199 (174-224) cells/µL (p<0.01). DISCUSSION: Despite differences in CD4 cell count evolution, death and non-TB AIDS rates were similar across study groups. It is therefore prudent to apply current ART guidelines from resource-rich countries to African populations.

Pantazis N; Morrison C; Amornkul PN; Lewden C; Salata RA; Minga A; Chipato T; Jaffe H; Lakhi S; Karita E; Porter K; Meyer L; Touloumi G

2012-01-01

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Socio-demographic and clinical profile of chronic pain with neuropathic characteristics in sub-Saharan African elderly.  

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Data on characteristics of neuropathic pain (NP) in sub-Saharan Africa are scarce, especially in the elderly. We conducted this study to appreciate the socio-demographic and clinical profile of chronic pain (CP) with neuropathic characteristics in sub-Saharan African elderly with musculoskeletal pain. From January to December 2011, we performed a cross-sectional study in all Rheumatology outpatients over 60 years at the Center for Gerontology and Geriatrics, Dakar, Senegal. In this study, we included patients who experienced musculoskeletal pain for 3 months or longer (CP) and with a DN4 score???4 (NP). A complete clinical examination was performed to make the diagnosis of NP 'definite' or 'probable', and to identify the aetiologies of NP. During the study period, 698 outpatients were examined. There were 394 out of the 549 patients over 60 years who reported CP. Among them, 28 patients (7.1%) scored ?4 on the DN4 questionnaire. Female patients, low educational attainment, manual professions, non-workers and diabetes were associated with NP (p?bone metastasis (n?=?1). No aetiology was identified among three patients. Chronic spine diseases associated with radiculopathies and diabetic neuropathy are the main causes of NP, well detected by DN4 questionnaire and clinical examination in Senegalese sub-Saharan African elderly. PMID:23138975

Lekpa, F K; Ndongo, S; Ka, O; Zeba, D; Compaoré, C; Pouye, A; Ka, M M; Diop, T M

2012-11-09

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Access to drinking water and health of populations in Sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

Water is at the center of the plant and animal life, the foundation upon which the health of human settlement and development of civilizations rely on. In tropical regions, 80% of diseases are transmitted either by germs in the water, or by vectors staying in it. In Sub-Saharan Africa, statistics show particularly high levels of unmet needs of populations in access to drinking water in a context of socioeconomic development. For this purpose, this study aims to determine the influence of access to drinking water on the health of populations in Sub-Saharan Africa. Using data from Demographic and Health Surveys (DHS) from Cameroon, Senegal and Chad, it is clear from the descriptive analysis that 60% (Cameroon), and 59% (Chad) of the cases of childhood diarrhea in these two countries are due to the consumption of dirty water. In terms of explanatory analysis, we note that when a household in Cameroon, Senegal or Chad does not have access to drinking water, children under 5 years old residing there are respectively 1.29, 1.27 and 1.03 times more likely to have diarrhea than those residing in households with easy access to drinking water. In view of these results, it is recommended to increase access to drinking water in particular by reducing disparities between the rich and poor people.

Ntouda J; Sikodf F; Ibrahim M; Abba I

2013-05-01

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Availability of nutritional support services in HIV care and treatment sites in sub-Saharan African countries.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To examine the availability of nutritional support services in HIV care and treatment sites across sub-Saharan Africa. DESIGN: In 2008, we conducted a cross-sectional survey of sites providing antiretroviral therapy (ART) in nine sub-Saharan African countries. Outcomes included availability of: (i) nutritional counselling; (ii) micronutrient supplementation; (iii) treatment for severe malnutrition; and (iv) food rations. Associations with health system indicators were explored using bivariate and multivariate methods. SETTING: President's Emergency Plan for AIDS Relief-supported HIV treatment and care sites across nine sub-Saharan African countries. SUBJECTS: A total of 336 HIV care and treatment sites, serving 467 175 enrolled patients. RESULTS: Of the sites under study, 303 (90 %) offered some form of nutritional support service. Nutritional counselling, micronutrient supplementation, treatment for severe acute malnutrition and food rations were available at 98 %, 64 %, 36 % and 31 % of sites, respectively. In multivariate analysis, secondary or tertiary care sites were more likely to offer nutritional counselling (adjusted OR (AOR): 2.2, 95 % CI 1.1, 4.5). Rural sites (AOR: 2.3, 95 % CI 1.4, 3.8) had increased odds of micronutrient supplementation availability. Sites providing ART for >2 years had higher odds of availability of treatment for severe malnutrition (AOR: 2.4, 95 % CI 1.4, 4.1). Sites providing ART for >2 years (AOR: 1.6, 95 % CI 1.3, 1.9) and rural sites (AOR: 2.4, 95 % CI 1.4, 4.4) had greater odds of food ration availability. CONCLUSIONS: Availability of nutritional support services was high in this large sample of HIV care and treatment sites in sub-Saharan Africa. Further efforts are needed to determine the uptake, quality and effectiveness of these services and their impact on patient and programme outcomes.

Anema A; Zhang W; Wu Y; Elul B; Weiser SD; Hogg RS; Montaner JS; El Sadr W; Nash D

2012-05-01

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

UK PubMed Central (United Kingdom)

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

de Fouchier C; Blanchet A; Hopkins W; Bui E; Ait-Aoudia M; Jehel L

2012-01-01

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

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

Capucine de Fouchier; Alain Blanchet; William Hopkins; Eric Bui; Malik Ait-Aoudia; Louis Jehel

2012-01-01

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

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

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

2007-01-01

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'Migrants from over there' or 'racial minority here'? Sexual networks and prevention practices among sub-Saharan African migrants in France.  

UK PubMed Central (United Kingdom)

Migrants from sub-Saharan Africa bear a disproportionate burden of HIV infection in Europe, with an increasing proportion of them acquiring HIV after migration. This transformation in the epidemic pattern has raised concerns about the sexual mixing and preventive behaviours of migrants. This paper aims at exploring how racial boundaries shape sexual networks and structure prevention practices among migrants from sub-Saharan Africa. Analyses are based on a French survey carried out among 1874 individuals born in sub-Saharan Africa, aged 18-49 and living in Paris and its surroundings. Our results provide evidence of the existence of African sexual networks, over and beyond those of national origin. The intra-African segregation of these sexual networks leads to sexual contacts between migrants from low- and high-HIV prevalence countries, which probably contribute to the development of the epidemic amongst these migrants. Moreover, racially-based perceptions of HIV-related risk seem to produce a specific attitude toward prevention practices as shown by higher rates of condom use among migrant women from sub-Saharan Africa with a partner born outside sub-Saharan Africa. As a consequence, community-based approaches to HIV prevention should take into account the identification of migrants from sub-Saharan Africa as a racial minority and not only focus on national borders.

Marsicano E; Lydié N; Bajos N

2013-08-01

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

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

Ashford C. Chea

2012-01-01

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Management of neural tube defects in a Sub-Saharan African country: the situation in Yaounde, Cameroon.  

UK PubMed Central (United Kingdom)

BACKGROUND: Neural tube defect is a serious disabling but preventable congenital malformation with an incidence of 1.99 per 1000 births in Yaounde [A.K. Njamnshi, V. d e P. Djientcheu, A. Lekoubou, M. Guemse, M.T. Obama, R. Mbu, S. Takongmo, I. Kago. Neural tube defects are rare among black Americans but not in Sub-Saharan black Africans: The case of Yaounde-Cameroon. Journal of the Neurological Sciences 2008; 270: 13-17]. The management requires highly qualified personnel and a significant social cost. The aim of this study was to evaluate the management of neural tube defect in a resource-limited developing Sub-Saharan nation like Cameroon. METHODS: We reviewed all patients with neural tube defects admitted in the neonatology unit of the Mother and Child Center (Chantal Biya Foundation Yaounde) between January 1st 2000 and December 31st 2006. RESULTS: Sixty-nine (69) patients were enrolled. There was a male predominance (69.57%) in the sample. Myelomeningomecele represented 68.11% of cases, followed by encephalocele (27.54%) and meningocele (4.35%). Antenatal ultrasound examinations were done in 27 cases (32.8%). The prenatal diagnosis was made only in 8 cases. No medical abortion was performed in any of these cases. Medical abortion is illegal in Cameroon (except in certain specific situations) as well as other Sub-Saharan African countries. Hydrocephalus was diagnosed in 40.02% of cases. As most of the patients (62.32%) could not afford modern treatment, only 26.09% of them were operated at birth. The rest sought traditional and other forms of treatment, due to poverty or cultural beliefs. Eight patients (11.59%) died before surgery. Surgery consisted of local closure alone (40%) or local closure associated to CSF shunting (60%). The complications were wound dehiscence (13.69%), shunt infection (1.37%), meningitis (1.37%) and iatrogenic pulmonary oedema (1.37%). CONCLUSION: Neural tube defects are the most frequent and disabling malformations in neonates in the Sub-Saharan African paediatric environment. Prenatal management and outcome at birth are limited by poverty and cultural beliefs. Prevention is possible and may be better than palliative care in developing countries.

de Paul Djientcheu V; Njamnshi AK; Wonkam A; Njiki J; Guemse M; Mbu R; Obama MT; Takongmo S; Kago I; Tetanye E; Tietche F

2008-12-01

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

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

Robinson Rachel

2011-01-01

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Blood pressure variables and prevalent electrocardiographic left ventricular hypertrophy in sub-Saharan African individuals with type 2 diabetes.  

UK PubMed Central (United Kingdom)

BACKGROUND: The aim of the present study was to investigate whether brachial blood pressure (BP) variables (systolic BP [SBP], diastolic BP [DBP], pulse [PP] and mean arterial pressure [MAP]) are similar determinants of prevalent electrocardiographic left ventricular hypertrophy (LVH) in sub-Saharan Africans with type 2 diabetes (T2D). METHODS: The study included 420 individuals (49% men) with T2D who were receiving chronic care in two main referral centers in the two major cities (Douala and Yaounde) of Cameroon. Logistic regression models were used to estimate the odds ratio (OR) and 95% confidence intervals (CI) for a standard deviation (SD) higher level of SBP (25 mmHg), DBP (13), PP (18) and MAP (20) with the risk of LVH. Discrimination was assessed and compared with c-statistics and relative integrated discrimination improvement (RIDI; %). RESULTS: The multivariable adjusted OR (95% CI) for prevalent LVH with each SD higher pressure variable was 1.61 (1.22-2.11) for SBP, 1.27 (0.99-1.63) for DBP, 1.62 (1.23-2.15) for PP and 1.44 (1.11-1.87) for MAP. Comparison of c-statistics revealed no difference in the discrimination power of models with each of the BP variables (P > 0.09). However, RIDI showed enhanced discrimination in the models when other BP variables were replaced with PP. However, this enhancement was marginal for SBP. Using BP combinations modestly improved discrimination. CONCLUSIONS: The best predictors of prevalent LVH in the present study population were PP and SBP, whereas DBP was the least effective predictor. These findings have implications for cardiovascular risk stratification and monitoring of risk-reducing therapies.

Dzudie A; Choukem SP; Dehayem MY; Kengne AP

2012-12-01

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Representing an "Authentic Ethnic Identity": Experiences of Sub-Saharan African Musicians in an Eastern German City  

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Full Text Available This paper focuses on how Sub-Saharan Africans present themselves as musicians in Chemnitz, an Eastern German town of around 200,000 citizens that is situated on the periphery of existing immigrant musicians' networks in Europe. Generally, immigration to Chemnitz has been rather limited; the quota of foreign nationals is 2.9 % for the whole city. I will explore what purposes Sub-Saharan African music and dance performances serve in this context both for the majority society as well as for the immigrants, individually and as a community. In so doing, I use a case study on the yearly local "intercultural festival" and analyze what kind of local power structures, institutional and informal, economic and political, influence the Nigerian cultural association's festival performance. This analysis shows how immigrant networks or associations relate to expectations and ascriptions of "authenticity" in a small-scale city. With its focus on the local situation and its effects on the representation of immigrant groups, this paper builds on the work that Nina Glick Schiller and Ayse Caglar (2006, 2009) have done on the importance of locality for research on migration and immigrant incorporation.

Inken Carstensen-Egwuom

2011-01-01

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Phylogeography and population genetics of the maize stalk borer Busseola fusca (Lepidoptera, Noctuidae) in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

The population genetics and phylogeography of African phytophagous insects have received little attention. Some, such as the maize stalk borer Busseola fusca, display significant geographic differences in ecological preferences that may be congruent with patterns of molecular variation. To test this, we collected 307 individuals of this species from maize and cultivated sorghum at 52 localities in West, Central and East Africa during the growing season. For all collected individuals, we sequenced a fragment of the mitochondrial cytochrome b. We tested hypotheses concerning the history and demographic structure of this species. Phylogenetic analyses and nested clade phylogeographic analyses (NCPA) separated the populations into three mitochondrial clades, one from West Africa, and two--Kenya I and Kenya II--from East and Central Africa. The similar nucleotide divergence between clades and nucleotide diversity within clades suggest that they became isolated at about the same time in three different refuges in sub-Saharan Africa and have similar demographic histories. The results of mismatch distribution analyses were consistent with the demographic expansion of these clades. Analysis of molecular variance (amova) indicated a high level of geographic differentiation at different hierarchical levels. NCPA suggested that the observed distribution of haplotypes at several hierarchical levels within the three major clades is best accounted for by restricted gene flow with isolation by distance. The domestication of sorghum and the introduction of maize in Africa had no visible effect on the geographic patterns observed in the B. fusca mitochondrial genome.

Sezonlin M; Dupas S; Le Rü B; Le Gall P; Moyal P; Calatayud PA; Giffard I; Faure N; Silvain JF

2006-02-01

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Review of the sylvatic cycle of African swine fever in sub-Saharan Africa and the Indian ocean.  

UK PubMed Central (United Kingdom)

African swine fever (ASF) is a major limiting factor for pig production in most of the countries in Sub-Saharan Africa and the Indian Ocean. In the absence of vaccine, a good understanding of the ecology and epidemiology of the disease is fundamental to implement effective control measures. In selected countries of Southern and East Africa, the association between Ornithodoros moubata ticks and warthogs has been described in detail in the literature. However, for many other countries in the region, information related to the sylvatic cycle is lacking or incomplete. In West African countries, for instance, the role of wild pigs in the epidemiology of ASF has never been demonstrated and the existence and potential impact of a sylvatic cycle involving an association between soft ticks and warthogs is questionable. In other countries, other wild pig species such as the bushpigs (Potamochoerus spp.) can also be asymptomatically infected by the virus but their role in the epidemiology of the disease is unclear and might differ according to geographic regions. In addition, the methods and techniques required to study the role of wild hosts in ASF virus (ASFV) epidemiology and ecology are very specific and differ from the more traditional methods to study domestic pigs or other tick species. The aim of this review is (i) to provide a descriptive list of the methodologies implemented to study the role of wild hosts in African swine fever, (ii) to compile the available knowledge about the sylvatic cycle of ASFV in different regions of Sub-Saharan Africa and the Indian Ocean in addition to the one that has been described for East and Southern Africa, and (iii) to discuss current methodologies and available knowledge in order to identify new orientations for further field and experimental surveys.

Jori F; Vial L; Penrith ML; Pérez-Sánchez R; Etter E; Albina E; Michaud V; Roger F

2013-04-01

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Review of the sylvatic cycle of African swine fever in sub-Saharan Africa and the Indian ocean.  

Science.gov (United States)

African swine fever (ASF) is a major limiting factor for pig production in most of the countries in Sub-Saharan Africa and the Indian Ocean. In the absence of vaccine, a good understanding of the ecology and epidemiology of the disease is fundamental to implement effective control measures. In selected countries of Southern and East Africa, the association between Ornithodoros moubata ticks and warthogs has been described in detail in the literature. However, for many other countries in the region, information related to the sylvatic cycle is lacking or incomplete. In West African countries, for instance, the role of wild pigs in the epidemiology of ASF has never been demonstrated and the existence and potential impact of a sylvatic cycle involving an association between soft ticks and warthogs is questionable. In other countries, other wild pig species such as the bushpigs (Potamochoerus spp.) can also be asymptomatically infected by the virus but their role in the epidemiology of the disease is unclear and might differ according to geographic regions. In addition, the methods and techniques required to study the role of wild hosts in ASF virus (ASFV) epidemiology and ecology are very specific and differ from the more traditional methods to study domestic pigs or other tick species. The aim of this review is (i) to provide a descriptive list of the methodologies implemented to study the role of wild hosts in African swine fever, (ii) to compile the available knowledge about the sylvatic cycle of ASFV in different regions of Sub-Saharan Africa and the Indian Ocean in addition to the one that has been described for East and Southern Africa, and (iii) to discuss current methodologies and available knowledge in order to identify new orientations for further field and experimental surveys. PMID:23142551

Jori, F; Vial, L; Penrith, M L; Pérez-Sánchez, R; Etter, E; Albina, E; Michaud, V; Roger, F

2012-11-08

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Gestational age-related changes in the peripheral blood cell composition of sub-Saharan African women.  

UK PubMed Central (United Kingdom)

Gestational age-related changes in the cellular composition of peripheral blood have not been described in sub-Saharan African settings. We conducted longitudinal cohort studies in Beninese and Tanzanian mothers with quantification of peripheral blood mononuclear cell-types ex vivo using flow cytometry. Between the second trimester and delivery the frequency of CD4(+) T cells declined significantly, contrasting with a non-significant increase in CD8(+) T cells, but no changes in T-regulatory, NK or NKT cell frequencies. Antigen-presenting cell profiles were also unaltered, although non-significant trends were evident. These changes resemble in some respects those reported during pregnancies in developed countries, but differ in others.

Ibitokou S; Brutus L; Vianou B; Oesterholt M; Massougbodji A; Deloron P; Troye-Blomberg M; Fievet N; Luty AJ

2013-06-01

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An assessment of the potential of drylands in eight sub-Saharan African countries to produce bioenergy feedstocks.  

UK PubMed Central (United Kingdom)

This paper synthesizes lessons learnt from research that aimed to identify land in the dryland regions of eight sub-Saharan African study countries where bioenergy feedstocks production has a low risk of detrimental environmental and socio-economic effects. The methodology involved using geographical information systems (GISs) to interrogate a wide range of datasets, aerial photograph and field verification, an extensive literature review, and obtaining information from a wide range of stakeholders. The GIS work revealed that Africa's drylands potentially have substantial areas available and agriculturally suitable for bioenergy feedstocks production. The other work showed that land-use and biomass dynamics in Africa's drylands are greatly influenced by the inherent 'disequilibrium' behaviour of these environments. This behaviour challenges the sustainability concept and perceptions regarding the drivers, nature and consequences of deforestation, land degradation and other factors. An assessment of the implications of this behaviour formed the basis for the practical guidance suggested for bioenergy feedstock producers and bioenergy policy makers.

Watson HK; Diaz-Chavez RA

2011-04-01

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

Directory of Open Access Journals (Sweden)

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

Novignon Jacob; Nonvignon Justice

2012-01-01

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

UK PubMed Central (United Kingdom)

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

Biddlecom A; Gregory R; Lloyd CB; Mensch BS

2008-12-01

53

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

Science.gov (United States)

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

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

2008-12-01

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Methylenetetrahydrofolate Reductase (MTHFR) from Mediterranean to Sub-Saharan Areas  

Digital Repository Infrastructure Vision for European Research (DRIVER)

There are differences in the allele frequency of MTHFR polymorphism between Western and African population. The aim of this study is to determinate the prevalence of MTHFR C677T and A1298C polymorphisms in young and old people living in different areas from Mediterranean to sub-Saharan areas. The ob...

Rosa Chillemi; Andrea Angius; Ivana Persico; Alessandro Sassu; Dionigio A. Prodi; Salvatore Musumeci

55

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

Scientific Electronic Library Online (English)

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

Velandia Torres, Carlos Roberto; Lacassagne, Marie-Françoise

2012-09-01

56

Financial Implications of Male Circumcision Scale-Up for the Prevention of HIV and Other Sexually Transmitted Infections in a Sub-Saharan African Community.  

UK PubMed Central (United Kingdom)

BACKGROUND: The financial implications of male circumcision (MC) scale-up in sub-Saharan Africa associated with reduced HIV have been evaluated. However, no analysis has incorporated the expected reduction of a comprehensive set of other sexually transmitted infections including human papillomavirus, herpes simplex virus type 2, genital ulcer disease, bacterial vaginosis, and trichomoniasis. METHODS: A Markov model tracked a dynamic population undergoing potential MC scale-up, as individuals experienced MC procedures, procedure-related adverse events, and MC-reduced sexually transmitted infections and accrued any associated costs. Rakai, Uganda, was used as a prototypical rural sub-Saharan African community. Monte Carlo microsimulations evaluated outcomes under 4 alternative scale-up strategies to reach 80% MC coverage among men aged 15 to 49 years, in addition to a baseline strategy defined by current MC rates in central Uganda. Financial outcomes included direct medical expenses only and were evaluated over 5 and 25 years. Costs were discounted to the beginning of each period, coinciding with the start of MC scale-up, and expressed in US$2012. RESULTS: Cost savings from infections averted by MC vary from US$197,531 after 5 years of a scale-up program focusing on adolescent/adult procedures to more than US$13 million after 25 years, under a strategy incorporating increased infant MCs. Over a 5-year period, reduction in HIV contributes to 50% of cost savings, and for 25 years, this contribution rises to nearly 90%. CONCLUSIONS: Sexually transmitted infections other than HIV contribute to cost savings associated with MC scale-up. Previous analyses, focusing exclusively on the financial impact through averted HIV, may have underestimated true cost savings by 10% to 50%.

Kacker S; Frick KD; Quinn TC; Gray RH; Tobian AA

2013-07-01

57

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

Directory of Open Access Journals (Sweden)

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

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

2009-01-01

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The current waist circumference cut point used for the diagnosis of metabolic syndrome in sub-Saharan African women is not appropriate.  

UK PubMed Central (United Kingdom)

The waist circumference cut point for diagnosing the metabolic syndrome in sub-Saharan African subjects is based on that obtained from studies in European populations. The aim of this study was to measure the prevalence of obesity and related metabolic disorders in an urban population of African females, a group at high risk for such diseases, and to determine the appropriate waist cut point for diagnosing the metabolic syndrome. Anthropometry and fasting lipid, glucose and insulin levels were measured in a cohort of 1251 African females participating in the Birth to Twenty cohort study in Soweto, Johannesburg. The waist circumference cut points for diagnosing metabolic syndrome (as defined using the new harmonised guidelines), insulin resistance, dysglycaemia, hypertension and dyslipidaemia were obtained using receiver operator characteristic curve analysis. The prevalence of obesity, type 2 diabetes and metabolic syndrome were 50.1%, 14.3% and 42.1%, respectively. The appropriate waist cut point for diagnosing metabolic syndrome was found to be 91.5 cm and was similar to the cuts points obtained for detecting increased risk of insulin resistance (89.0 cm), dysglycaemia (88.4 cm), hypertension (90.1 cm), hypo-high density lipoproteinaemia (87.6 cm) and hyper-low density lipoproteinaemia (90.5 cm). The present data demonstrates that urban, African females have a high prevalence of obesity and related disorders and the waist cut point currently recommended for the diagnosis of the metabolic syndrome (80.0 cm) in this population should be increased to 91.5 cm. This latter finding demonstrates a clear ethnic difference in the relationship between abdominal adiposity and metabolic disease risk. The similar waist cut points identified for the detection of the individual components of the metabolic syndrome and related cardiovascular risk factors demonstrates that the risk for different metabolic diseases increases at the same level of abdominal adiposity suggesting a common aetiological pathway.

Crowther NJ; Norris SA

2012-01-01

59

Women's and men's fertility preferences and contraceptive behaviors by HIV status in 10 sub-Saharan African countries.  

Science.gov (United States)

This article draws on biomarker data from Demographic and Health Surveys (2003-2007) in 10 sub-Saharan African countries to examine differences in fertility preferences and contraceptive behaviors by HIV status for women and men, taking into account whether or not they probably know their HIV status. The objective is to determine if there are common patterns in the associations between these variables across several countries. Women's and men's fertility preferences and contraceptive behaviors are relatively similar across HIV status and probable knowledge of that status. However, two consistent differences emerge in some of the countries: HIV-positive women who probably know their status are less likely to want more children and are more likely to be using male condoms than women who are HIV-negative and probably know it. A similar association is observed for men for condom use but not for limiting childbearing. Other factors unrelated to HIV status seem to be shaping women's and men's unmet demand for contraception and use of methods other than the condom. PMID:21861606

Bankole, Akinrinola; Biddlecom, Ann E; Dzekedzeke, Kumbutso

2011-08-01

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Women's and men's fertility preferences and contraceptive behaviors by HIV status in 10 sub-Saharan African countries.  

UK PubMed Central (United Kingdom)

This article draws on biomarker data from Demographic and Health Surveys (2003-2007) in 10 sub-Saharan African countries to examine differences in fertility preferences and contraceptive behaviors by HIV status for women and men, taking into account whether or not they probably know their HIV status. The objective is to determine if there are common patterns in the associations between these variables across several countries. Women's and men's fertility preferences and contraceptive behaviors are relatively similar across HIV status and probable knowledge of that status. However, two consistent differences emerge in some of the countries: HIV-positive women who probably know their status are less likely to want more children and are more likely to be using male condoms than women who are HIV-negative and probably know it. A similar association is observed for men for condom use but not for limiting childbearing. Other factors unrelated to HIV status seem to be shaping women's and men's unmet demand for contraception and use of methods other than the condom.

Bankole A; Biddlecom AE; Dzekedzeke K

2011-08-01

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

Directory of Open Access Journals (Sweden)

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

Leo J. de Haan

2010-01-01

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Influence of migration on characteristics of type 2 diabetes in sub-Saharan Africans.  

UK PubMed Central (United Kingdom)

AIM: This study compared the clinical and biochemical characteristics and microvascular complications found in three groups of type 2 diabetes (T2D) patients: Africans living in Africa; African immigrants living in France; and Caucasians living in France. METHODS: Diagnosed T2D Africans living in Cameroon (n=100) were compared with 98 African migrants diagnosed with T2D after having moved to France, and a group of 199 T2D Caucasian patients living in France. All underwent clinical and biochemical evaluations, and all were assessed for microvascular complications. RESULTS: The median duration of stay of the migrants in France was 15years before being diagnosed with diabetes. Despite similar durations of diagnosis, they were 8.9years younger at the time of diagnosis than Africans living in Cameroon (P<0.001). Caucasians and African immigrants in France had lower HbA1c values than Africans in Cameroon (P<0.001); they were also more aggressively treated for hypertension and dyslipidaemia and, therefore, had significantly lower blood pressure levels and better lipid profiles. Diabetic nephropathy and retinopathy rates were higher in Cameroon than in the two other groups. After adjusting for age, diabetes duration, HbA1c, hypertension and other covariates, only the prevalence of diabetic nephropathy (OR: 5.61, 95% CI: 2.32-13.53; P<0.0001) was higher in Cameroon compared with those living in France. CONCLUSION: Our results suggest that Africans who emigrate to France may develop diabetes earlier than those staying in their home country. However, the latter may be a reflection of late diagnosis of diabetes. Also, the less adequate diabetes and hypertension control in the latter would explain their higher rates of nephropathy. Large-scale cohorts are now warranted to substantiate these observations.

Choukem SP; Fabreguettes C; Akwo E; Porcher R; Nguewa JL; Bouche C; Kaze FF; Kengne AP; Vexiau P; Mbanya JC; Sobngwi E; Gautier JF

2013-09-01

63

Gene copy number variations in breast cancer of Sub-Saharan African women.  

UK PubMed Central (United Kingdom)

The goal of this study was CGH array profiling of breast cancer from Malian women in order to define differences with those from USA. CGH array was performed in 28 samples, 17 with a triple negative phenotype. The profiles were compared to those of 106 tumors from USA. 6 chromosomal regions (6p21, 9q34, 11q13, 12q24, 17q25 and 22q12.1-22q13.1) were identified with a significant higher rate of copy number alterations. These regions contain several genes of interest including BCR. FISH and IHC confirmed that BCR was amplified and overexpressed particularly in triple negative tumors. Finally, 5 regions presented a high level of amplification in two or more samples, including 2 regions located between 9p22.3-9p23 and 9p23-9p24.1. This study confirms that breast cancers from African women present biological differences with those from USA. Larger studies are needed to go further in the identification of therapeutic targets that would be specific to African women.

Ly M; Valent A; Diallo G; Penault-Lorca F; Dumke K; Marty V; Viehl P; Lazar V; Job B; Richon C; Scott V; Diallo DA; Bernaudin JF; Andre F

2013-06-01

64

Low frequency of mutated methylenetetrahydrofolate reductase 677C-->T and 1298A-->C genetics single nucleotide polymorphisms (SNPs) in Sub-Saharan populations.  

UK PubMed Central (United Kingdom)

5,10-Methylenetetrahydrofolate reductase (MTHFR) and methionine synthase (MTR) are two of the key enzymes in the folate/vitamin B12-dependent remethylation of homocysteine to methionine. The frequencies of MTHFR single nucleotide polymorphisms (SNPs), 677C-->T, 1298A-->C, 1317T-->C and of MTR, 2756A-->G, have been widely studied in Caucasians, but they have never been reported simultaneously in a large population from Sub-Saharan Africa. Presently, we report the prevalence of these SNPs and their relationship to homocysteine in 240 subjects recruited in West Africa. The frequencies of the mutant genotypes 677TT (0.8%) and 1298CC (2%) were lower than that usually observed in Caucasians, while the frequency of the mutant 1317CC was higher (16%). We formed a systematic association of the mutated MTHFR 677C-->T SNP with a 1298A/1317T common haplotype. The MTHFR mutant genotype 677TT was associated with an intermediate hyperhomocysteinemia (92.4 +/- 6.0 micromol/l) higher than that described in Caucasians. The 2756A-->G SNP in the MTR was similarly distributed in Africans compared to Caucasians. In conclusion, the MTHFR 677TTor 1298CC genotypes are much rarer in Africans than in Caucasians. The 677TT low frequency may be related to the high effect of this mutation on homocysteine metabolism in the environmental conditions of this African region.

Adjalla CE; Amouzou EK; Sanni A; Abdelmouttaleb I; Chabi NW; Namour F; Soussou B; Guéant JL

2003-08-01

65

Low frequency of mutated methylenetetrahydrofolate reductase 677C-->T and 1298A-->C genetics single nucleotide polymorphisms (SNPs) in Sub-Saharan populations.  

Science.gov (United States)

5,10-Methylenetetrahydrofolate reductase (MTHFR) and methionine synthase (MTR) are two of the key enzymes in the folate/vitamin B12-dependent remethylation of homocysteine to methionine. The frequencies of MTHFR single nucleotide polymorphisms (SNPs), 677C-->T, 1298A-->C, 1317T-->C and of MTR, 2756A-->G, have been widely studied in Caucasians, but they have never been reported simultaneously in a large population from Sub-Saharan Africa. Presently, we report the prevalence of these SNPs and their relationship to homocysteine in 240 subjects recruited in West Africa. The frequencies of the mutant genotypes 677TT (0.8%) and 1298CC (2%) were lower than that usually observed in Caucasians, while the frequency of the mutant 1317CC was higher (16%). We formed a systematic association of the mutated MTHFR 677C-->T SNP with a 1298A/1317T common haplotype. The MTHFR mutant genotype 677TT was associated with an intermediate hyperhomocysteinemia (92.4 +/- 6.0 micromol/l) higher than that described in Caucasians. The 2756A-->G SNP in the MTR was similarly distributed in Africans compared to Caucasians. In conclusion, the MTHFR 677TTor 1298CC genotypes are much rarer in Africans than in Caucasians. The 677TT low frequency may be related to the high effect of this mutation on homocysteine metabolism in the environmental conditions of this African region. PMID:12964809

Adjalla, Charles E; Amouzou, Emile K; Sanni, Ambaliou; Abdelmouttaleb, Idrissia; Chabi, Nicodème W; Namour, Fares; Soussou, Batoma; Guéant, Jean-Louis

2003-08-01

66

Improving health information systems for decision making across five sub-Saharan African countries: Implementation strategies from the African Health Initiative.  

UK PubMed Central (United Kingdom)

BACKGROUND: Weak health information systems (HIS) are a critical challenge to reaching the health-related Millennium Development Goals because health systems performance cannot be adequately assessed or monitored where HIS data are incomplete, inaccurate, or untimely. The Population Health Implementation and Training (PHIT) Partnerships were established in five sub-Saharan African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) to catalyze advances in strengthening district health systems. Interventions were tailored to the setting in which activities were planned. COMPARISONS ACROSS STRATEGIES: All five PHIT Partnerships share a common feature in their goal of enhancing HIS and linking data with improved decision-making, specific strategies varied. Mozambique, Ghana, and Tanzania all focus on improving the quality and use of the existing Ministry of Health HIS, while the Zambia and Rwanda partnerships have introduced new information and communication technology systems or tools. All partnerships have adopted a flexible, iterative approach in designing and refining the development of new tools and approaches for HIS enhancement (such as routine data quality audits and automated troubleshooting), as well as improving decision making through timely feedback on health system performance (such as through summary data dashboards or routine data review meetings). The most striking differences between partnership approaches can be found in the level of emphasis of data collection (patient versus health facility), and consequently the level of decision making enhancement (community, facility, district, or provincial leadership). DISCUSSION: Design differences across PHIT Partnerships reflect differing theories of change, particularly regarding what information is needed, who will use the information to affect change, and how this change is expected to manifest. The iterative process of data use to monitor and assess the health system has been heavily communication dependent, with challenges due to poor feedback loops. Implementation to date has highlighted the importance of engaging frontline staff and managers in improving data collection and its use for informing system improvement. Through rigorous process and impact evaluation, the experience of the PHIT teams hope to contribute to the evidence base in the areas of HIS strengthening, linking HIS with decision making, and its impact on measures of health system outputs and impact.

Mutale W; Chintu N; Amoroso C; Awoonor-Williams K; Phillips J; Baynes C; Michel C; Taylor A; Sherr K

2013-01-01

67

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

Despite being one of the highest aid recipient regions, the growth performance in Sub-Saharan Africa (SSA) has been rather disappointing. In this paper, we answer two questions. 1) Is there any significant impact of foreign aid on economic growth? 2) Is grant more effective than loans in pr...

Anupam Das; Syeed Khan

68

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

UK PubMed Central (United Kingdom)

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

Kawooya MG

2012-01-01

69

The impacts of oil price fluctuations on the economy of sub-Saharan African countries, importers of oil products  

International Nuclear Information System (INIS)

[en] This work comprises three parts. The first part aims at presenting the energy situation of sub-Saharan African (SSA) countries grouped in five regions. Because of the demographic pressure and of the petroleum shocks, the commercial energy consumption is growing up rapidly and the energy prices are high for the end-users (because the energy is imported and paid in dollars, and the fiscality share is increased by governments in the case of prices drop in the international market). The important problem of wood fuel is considered, together with the energy-economic growth relations and the determining factors of the energy demand in SSA. Some econometric relations are tested. The second part analyzes the mechanisms generated by petroleum shocks and counter-shocks, and stresses first on the transfers induced by these fluctuations. Then, it presents some macro-economical models which try to integrate the effects of a petroleum shock and makes some calculations based on a decomposition of imports and exports global and partial coefficients. Some important conclusions are inferred from this study: 1 - the second petroleum shock strikes more seriously the oil importing SSA countries because they do not benefit from a favorable international context, like during the first shock (also because the second shock is accompanied by a dollar shock); 2 - the absence of symmetry in oil shocks-counter-shocks; 3 - the crisis of SSA countries is not only of petroleum origin but is also linked with the drop of the export incomes (which itself is partially explained by the impact of petroleum shocks on the industrialized economies), with their bad insertion in the world economy, and with unsuitable domestic economies. The third part proposes some solutions to attenuate the energy and economical difficulties of these countries. It is necessary to implement an energy planning mainly based on the mastery of the demand and on a better management of local resources. The policies of stabilization and of structural adjustment are also presented with their effects on the different sectors. (J.S.)

1997-01-01

70

Ankylosing spondylitis in sub-Saharan Africa.  

Science.gov (United States)

Ankylosing spondylitis (AS) represents a chronic inflammatory bone disease of the axial skeleton that manifests as chronic back pain and progressive stiffness of the spine. It characteristically affects young adults with a peak age of onset between 20-30 years. In contrast to Western Europe and North America, the disease is rare in Sub-Saharan Africa where the majority of the population is HLA-B27 negative. Even in some African populations where HLA-B27 is prevalent (for example, in Gambia and Senegal, where 3-6% of the general population has HLA-B27), the disease is also said to be rare. However, some other genetic markers may be involved in the causation of AS in the HLA-B27 negative population, and when it occurs in this subgroup of patients it has a similar manifestation with HLA-B27 negative white patients and these patients rarely develop anterior uveitis. The clinical presentation of the disease in Africa is generally milder; most affected individuals do not have a family history of AS, the patients are older at onset of the disease, and the majority of them lack extra-articular manifestations such as anterior uveitis compared with the situation in Western Europe and North America. In conclusion, AS in sub-Saharan Africa seems to represent a subgroup of the disease, which may open the window to a greater understanding of the pathophysiology of the condition. PMID:19581245

Belachew, D A; Sandu, N; Schaller, B; Guta, Z

2009-07-01

71

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

Directory of Open Access Journals (Sweden)

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

Samba Michel Cyrille

2010-01-01

72

A literature review of the impact of HIV and AIDS on the role of the elderly in the sub-Saharan African community  

Directory of Open Access Journals (Sweden)

Full Text Available The status of older adults in Africa occupies a small but rapidly expanding share of the global literature on ageing. The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) pandemic has generated a new focus on the changing role of the elderly in communities that have been affected. In sub-Saharan Africa, where millions are projected to be infected with HIV and about two million deaths are recorded annually amongst the traditionally productive adults, such loss of parents and breadwinners means children and the elderly have had to take up unusual responsibilities. A literature review on the elderly and HIV and AIDS provided the data analysed for this article. Access to databases was mainly via EBSCO (www.ebsco.co), which allowed searches in major databases and search engines useful in an academic setting for finding and accessing articles in health and health-related academic journals, repositories and archived reports. Results showed that the AIDS pandemic has direct and indirect effects which have manifested in a set of interrelated social, economic and psychological dimensions that could ultimately impact on the health and well-being of the elderly. It is concluded that more needs to be done to articulate the knowledge base of the impact of HIV and AIDS in order to inform social, economic and political policies for the purpose of alleviating the problems that the pandemic is wreaking on the elderly African population.OpsommingDie status van ouer volwassenes in Afrika beklee’n klein, maar vinnig groeiende deel van die globale verouderings literatuur. Die menslike immuniteitsgebreksvirus (MIV) en verworwe immuniteitsgebreksindroom (VIGS) pandemie het ‘n nuwe fokus op die veranderende rol van bejaardes in die gemeenskap wat deur VIGS beïnvloed word, gegenereer. In sub-Sahara Afrika waar na beraming miljoene geïnfekteer word met MIV, met sowat twee miljoen sterftes jaarliks gerekordeer onder die tradisoneel produktiewe volwassenes, word daar van die kinders en bejaardes verwag om ongewone verantwoordelikhede op hulle te neem as gevolg van die verlies aan ouers of broodwinners. ‘n Literatuuroorsig wat handel oor bejaardes en MIV en VIGS het die geanaliseerde data voorsien vir hierdie artikel. Toegang tot die databasis was meestal deur EBSCO (www.ebsco.co) wat soektog toegelaat het tot groot databasisse en soekenjins wat bruikbaar in die akademiese opset is en die vind van artikels aangaande gesondheid, gesondheidverwante akademiese joernale en argief verslae. Bevindings toon dat die VIGS pandemie direkte en indirekte effekte het. Hierdie effekte manifisteer in ‘n stel sosiaal verwante, ekonomiese en psigologiese dimensies wat ten einde ‘n impak op die gesondheid en welstand van bejaardes het. Daar is tot die gevolgtrekking gekom dat meer gedoen moet word om die kennis basis van MIV en VIGS te artikuleer om die sosiale, ekonomiese en politiese beleid in kennis te stel, om sodoende die resulterende probleme van MIV en VIGS op die bejaarde Afrika populasie te verlig.How to cite this article: Lekalakala-Mokgele,E., 2011, ‘A literature review of the impact of HIV and AIDS on the role of the elderly in the sub-Saharan African Community’, Health SA Gesondheid 16(1), Art. #564, 6 pages. http://dx.doi.org/10:4102/hsag.v16i1.564

Eucebious Lekalakala- Mokgele

2011-01-01

73

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

International Nuclear Information System (INIS)

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

2011-01-01

74

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

Directory of Open Access Journals (Sweden)

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

RICHARD INGWE

2012-01-01

75

Saving-Investment Correlation and Capital Mobility in Sub-Saharan African Countries: A reappraisal through inward and outward capital flows’ correlation.  

Directory of Open Access Journals (Sweden)

Full Text Available Normal 0 false false false EN-US ZH-CN X-NONE Normal 0 false false false EN-US ZH-CN X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:SimSun; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} This paper analyses the Feldstein-Horioka puzzle in 15 sub-Saharan African countries accounting for the correlation between inward and outward capital flows. Applying both cross section and panel data analysis, we show that our results are consistent with previous studies related to developing countries.  More interesting, we confirm, for sub-Saharan African countries, the recent hypothesis of Georgepoulos and Hejazi (2009) that the Feldstein-Horioka home bias is unrelated to the correlation between inward and outward capital flows for developing countries. But for Sub-Saharan African countries, rather than a negative and insignificant coefficient of the interaction between the saving rate and the correlation between inward and outward capital flows, our results indicate that this estimate is positive and insignificant for our sample.  We argue that this result is a consequence of the very weak simultaneity in capital flows for these countries.  Therefore, we finish our paper by proposing some policy recommendations in order to reverse this tendency.

Michel Cyrille Samba; Yu Yan

2010-01-01

76

Prevalence of HIV infection in conflict-affected and displaced people in seven sub-Saharan African countries: a systematic review.  

UK PubMed Central (United Kingdom)

BACKGROUND: Violence and rape are believed to fuel the HIV epidemic in countries affected by conflict. We compared HIV prevalence in populations directly affected by conflict with that in those not directly affected and in refugees versus the nearest surrounding host communities in sub-Saharan African countries. METHODS: Seven countries affected by conflict (Democratic Republic of Congo, southern Sudan, Rwanda, Uganda, Sierra Leone, Somalia, and Burundi) were chosen since HIV prevalence surveys within the past 5 years had been done and data, including original antenatal-care sentinel surveillance data, were available. We did a systematic and comprehensive literature search using Medline and Embase. Only articles and reports that contained original data for prevalence of HIV infection were included. All survey reports were independently evaluated by two epidemiologists to assess internationally accepted guidelines for HIV sentinel surveillance and population-based surveys. Whenever possible, data from the nearest antenatal care and host country sentinel site of the neighbouring countries were presented. 95% CIs were provided when available. FINDINGS: Of the 295 articles that met our search criteria, 88 had original prevalence data and 65 had data from the seven selected countries. Data from these countries did not show an increase in prevalence of HIV infection during periods of conflict, irrespective of prevalence when conflict began. Prevalence in urban areas affected by conflict decreased in Burundi, Rwanda, and Uganda at similar rates to urban areas unaffected by conflict in their respective countries. Prevalence in conflict-affected rural areas remained low and fairly stable in these countries. Of the 12 sets of refugee camps, nine had a lower prevalence of HIV infection, two a similar prevalence, and one a higher prevalence than their respective host communities. Despite wide-scale rape in many countries, there are no data to show that rape increased prevalence of HIV infection at the population level. INTERPRETATION: We have shown that there is a need for mechanisms to provide time-sensitive information on the effect of conflict on incidence of HIV infection, since we found insufficient data to support the assertions that conflict, forced displacement, and wide-scale rape increase prevalence or that refugees spread HIV infection in host communities.

Spiegel PB; Bennedsen AR; Claass J; Bruns L; Patterson N; Yiweza D; Schilperoord M

2007-06-01

77

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

DEFF Research Database (Denmark)

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

Meyrowitsch, Dan Wolf; Pedersen, Erling MØller

2011-01-01

78

Human Leukocyte Antigen Variants B*44 and B*57 Are Consistently Favorable during Two Distinct Phases of Primary HIV-1 Infection in Sub-Saharan Africans with Several Viral Subtypes?†  

Digital Repository Infrastructure Vision for European Research (DRIVER)

As part of an ongoing study of early human immunodeficiency virus type 1 (HIV-1) infection in sub-Saharan African countries, we have identified 134 seroconverters (SCs) with distinct acute-phase (peak) and early chronic-phase (set-point) viremias. SCs with class I human leukocyte antigen (HLA) varia...

Tang, Jianming; Cormier, Emmanuel; Gilmour, Jill; Price, Matthew A.; Prentice, Heather A.; Song, Wei; Kamali, Anatoli

79

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

Directory of Open Access Journals (Sweden)

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

Isabella Aboderin

2010-01-01

80

Epidemiology of imported malaria give support to the hypothesis of 'long-term' semi-immunity to malaria in sub-Saharan African migrants living in France.  

UK PubMed Central (United Kingdom)

BACKGROUND: Short-term semi-immunity to malaria in sub-Saharan African migrants who have recently arrived in non-endemic countries results in less severe imported malaria. Our aim was to investigate the factors associated with imported malaria that would favour the hypothesis of a 'long-term' semi-immunity to malaria in adult travellers of sub-Saharan origin living in France and visiting family or relatives in their country of origin (VFR group). METHOD: The epidemiological, clinical and biological characteristics of imported Plasmodium falciparum malaria in VFR were compared with those of travellers of European origin (TEO). Newly arrived African migrants and European expatriates were excluded. RESULTS: This retrospective study included 106 adult VFR (30%) and 240 adult TEO (70%) with imported P. falciparum malaria treated at the University Hospital Center of Bordeaux between 2000 and 2007. The main regions visited were West Africa (58%) and Central Africa (34%). P. falciparum was associated with severe malaria in 8% of patients (VFR 3% vs. TEO 11%), of which two TEO died. In univariate analysis, the factors associated with P. falciparum malaria in VFR vs. TEO were: female sex, younger age, less frequent use of mosquito nets, poor compliance with chemoprophylaxis, less severe malaria without death, less severe thrombocytopenia and a tendency towards a lower level of parasitaemia and higher haemoglobinaemia. In multivariate analysis, the only factor to be independently associated with P. falciparum malaria in VFR compared to TEO was less frequent severe malaria. CONCLUSIONS: Our results give support to the hypothesis of 'long-term' semi-immunity to malaria in VFR living in France.

Pistone T; Diallo A; Mechain M; Receveur MC; Malvy D

2013-08-01

 
 
 
 
81

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

Directory of Open Access Journals (Sweden)

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

Anupam Das; Syeed Khan

2011-01-01

82

Quality Assurance in Sub-Saharan Africa  

Science.gov (United States)

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

Materu, Peter; Righetti, Petra

2010-01-01

83

Sexual behavior, knowledge and information sources of very young adolescents in four sub-Saharan African countries.  

Science.gov (United States)

Adolescents are a key target group for HIV and pregnancy prevention efforts, yet very little is known about the youngest adolescents: those under age 15. New survey data from 12-14 year olds in Burkina Faso, Ghana, Malawi and Uganda are used to describe their sexual activity, knowledge about HIV, STIs and pregnancy prevention, and sources of sexual and reproductive health information, including sex education in schools. Results show that very young adolescents are already beginning to be sexually active and many believe their close friends are sexually active. They have high levels of awareness but little in-depth knowledge about pregnancy and HIV prevention. Multiple information sources are used and preferred by very young adolescents. Given their needs for HIV, STI and pregnancy prevention information that is specific and practical and considering that the large majority are attending school in most countries in Sub-Saharan Africa, school-based sex education is a particularly promising avenue for reaching adolescents under age 15. PMID:18458739

Bankole, Akinrinola; Biddlecom, Ann; Guiella, Georges; Singh, Susheela; Zulu, Eliya

2007-12-01

84

The Average IQ of Sub-Saharan Africans Assessed by the Progressive Matrices: A Reply to Wicherts, Dolan, Carlson & van der Maas  

Science.gov (United States)

|Wicherts, Dolan, Carlson & van der Maas (WDCM) (2010) contend that the average IQ in sub-Saharan Africa is about 76 in relation to a British mean of 100 and sd of 15. This result is achieved by including many studies of unrepresentative elite samples. Studies of acceptably representative samples indicate a sub-Saharan Africa IQ of approximately…

Lynn, Richard

2010-01-01

85

The Average IQ of Sub-Saharan Africans Assessed by the Progressive Matrices: A Reply to Wicherts, Dolan, Carlson & van der Maas  

Science.gov (United States)

Wicherts, Dolan, Carlson & van der Maas (WDCM) (2010) contend that the average IQ in sub-Saharan Africa is about 76 in relation to a British mean of 100 and sd of 15. This result is achieved by including many studies of unrepresentative elite samples. Studies of acceptably representative samples indicate a sub-Saharan Africa IQ of approximately…

Lynn, Richard

2010-01-01

86

HIV and kidney disease in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

A wide clinical spectrum of renal diseases affects individuals with HIV. These conditions include acute kidney injury, electrolyte and acid-base disturbances, HIV-associated glomerular disease, acute-on-chronic renal disease and adverse side effects related to treatment of HIV. Studies employing varying criteria for diagnosis of kidney disease have reported a variable prevalence of these diseases in patients with HIV in sub-Saharan Africa: 6% in South Africa, 38% in Nigeria, 26% in Côte d'Ivoire, 28% in Tanzania, 25% in Kenya, 20-48.5% in Uganda and 33.5% in Zambia. Results from these studies also suggest that a broader spectrum of histopathological lesions in HIV-associated kidney disease exists in African populations than previously thought. Strategies to prevent or retard progression to end-stage renal disease of HIV-associated kidney conditions should include urinalysis and measurement of kidney function of all people with HIV at presentation. Renal replacement in the form of dialysis and transplantation should be implemented as appropriate. This Review focuses on the available evidence of renal diseases in patients with HIV infection in sub-Saharan Africa and offers practical guidelines to treat these conditions that also take into consideration challenges and obstacles that are specific to sub-Saharan Africa.

Fabian J; Naicker S

2009-10-01

87

HIV and kidney disease in sub-Saharan Africa.  

Science.gov (United States)

A wide clinical spectrum of renal diseases affects individuals with HIV. These conditions include acute kidney injury, electrolyte and acid-base disturbances, HIV-associated glomerular disease, acute-on-chronic renal disease and adverse side effects related to treatment of HIV. Studies employing varying criteria for diagnosis of kidney disease have reported a variable prevalence of these diseases in patients with HIV in sub-Saharan Africa: 6% in South Africa, 38% in Nigeria, 26% in Côte d'Ivoire, 28% in Tanzania, 25% in Kenya, 20-48.5% in Uganda and 33.5% in Zambia. Results from these studies also suggest that a broader spectrum of histopathological lesions in HIV-associated kidney disease exists in African populations than previously thought. Strategies to prevent or retard progression to end-stage renal disease of HIV-associated kidney conditions should include urinalysis and measurement of kidney function of all people with HIV at presentation. Renal replacement in the form of dialysis and transplantation should be implemented as appropriate. This Review focuses on the available evidence of renal diseases in patients with HIV infection in sub-Saharan Africa and offers practical guidelines to treat these conditions that also take into consideration challenges and obstacles that are specific to sub-Saharan Africa. PMID:19776781

Fabian, June; Naicker, Saraladevi

2009-10-01

88

Sensitivity and specificity of typhoid fever rapid antibody tests for laboratory diagnosis at two sub-Saharan African sites.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To evaluate three commercial typhoid rapid antibody tests for Salmonella Typhi antibodies in patients suspected of having typhoid fever in Mpumalanga, South Africa, and Moshi, United Republic of Tanzania. METHODS: The diagnostic accuracy of Cromotest(®) (semiquantitative slide agglutination and single tube Widal test), TUBEX(®) and Typhidot(®) was assessed against that of blood culture. Performance was modelled for scenarios with pretest probabilities of 5% and 50%. FINDINGS: In total 92 patients enrolled: 53 (57.6%) from South Africa and 39 (42.4%) from the United Republic of Tanzania. Salmonella Typhi was isolated from the blood of 28 (30.4%) patients. The semiquantitative slide agglutination and single-tube Widal tests had positive predictive values (PPVs) of 25.0% (95% confidence interval, CI: 0.6-80.6) and 20.0% (95% CI: 2.5-55.6), respectively. The newer typhoid rapid antibody tests had comparable PPVs: TUBEX(®), 54.1% (95% CI: 36.9-70.5); Typhidot(®) IgM, 56.7% (95% CI: 37.4-74.5); and Typhidot(®) IgG, 54.3% (95% CI: 36.6-71.2). For a pretest probability of 5%, PPVs were: TUBEX(®), 11.0% (95% CI: 6.6-17.9); Typhidot(®) IgM, 9.1% (95% CI: 5.8-14.0); and Typhidot(®) IgG, 11.0% (6.3-18.4). For a pretest probability of 50%, PPVs were: TUBEX(®), 70.2% (95% CI: 57.3-80.5); Typhidot(®) IgM, 65.6% (95% CI: 54.0-75.6); and Typhidot(®) IgG, 70.0% (95% CI: 56.0-81.1). CONCLUSION: Semiquantitative slide agglutination and single-tube Widal tests performed poorly. TUBEX(®) and Typhidot(®) may be suitable when pretest probability is high and blood cultures are unavailable, but their performance does not justify deployment in routine care settings in sub-Saharan Africa.

Keddy KH; Sooka A; Letsoalo ME; Hoyland G; Chaignat CL; Morrissey AB; Crump JA

2011-09-01

89

Epidemiology of hepatocellular carcinoma in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

Published incidences of hepatocellular carcinoma in the Black population of sub-Saharan Africa underestimate the true incidence of the tumor because of the many instances in which hepatocellular carcinoma is either not definitively diagnosed or is not recorded in a cancer registry. Despite this, it is manifestly evident that the tumor occurs commonly and is a major cause of cancer deaths in Black African peoples living in the sub-continent, particularly in those living in rural areas. 46,000 new cases of hepatocellular carcinoma have been recorded to be diagnosed in sub-Saharan Africa each year, and age-standardized incidences of the tumor as high as 41.2/100,000 persons/year have been documented. The highest incidence of hepatocellular carcinoma has been recorded in Mozambique. The tumor occurs at a young age in rural dwelling and, to a lesser extent, urban dwelling Black Africans. It is also more common in men than women, particularly in the younger patients. Cirrhosis co-exists with hepatocellular carcinoma in about 60% of patients and is equally common in the two sexes. The tumor is not only common in the Black African population, it also carries an especially grave prognosis, with about 93% of the patients dying within 12 months of the onset of symptoms. Caucasians living in the sub-continent have a low incidence of hepatocellular carcinoma and it occurs at an older age.

Kew MC

2013-03-01

90

Metabolic profile of sub-Saharan African patients presenting with first-ever-in-lifetime stroke: association with insulin resistance.  

UK PubMed Central (United Kingdom)

BACKGROUND: To assess the pattern of metabolic profile associated with first stroke episode in a hospital setting in Cameroon. METHODS: All patients admitted for first-ever-in-lifetime stroke over a 6-month period were eligible for inclusion in the study. The 84% participation rate yielded 57 of 68 patients between 16 and 85 years of age. Fifty-seven control subjects were selected to match patients included for age range, sex, and known hypertension and diabetes. We measured fasting serum glucose, insulin, and lipids in controls and in patients between days 3 and 7 after admission. RESULTS: Total cholesterol was comparable in patients and controls (172.6 ± 39.5 v 175.4 ± 49.7 mg/dL; P = .75), as were triglycerides (129.4 ± 56.1 v 122.4 ± 60.7 mg/dL; P = .53). high-density lipoprotein cholesterol (HDL-C) levels were lower in patients than in controls (37.4 ± 20.6 v 50.2 ± 18.0 mg/dL; P = .001), with comparable levels of low-density lipoprotein cholesterol (LDL-C; 109.4 ± 43.0 v 100.7 ± 48.8 mg/dL; P = .32). The LDL-C/HDL-C ratio was higher in patients compared to controls (4.0 ± 3.0 v 2.3 ± 1.7; P = .0001), as was the total cholesterol/HDL-C ratio (5.9 ± 3.5 v 3.9 ± 1.8; P = .0001). Compared to controls, stroke patients had higher fasting insulin levels (5.9 ± 5.4 v 2.3 ± 3.2 IU/mL; P < .001) and higher insulin resistance as measured by the homeostatic model assessment of insulin resistance (1.9 ± 2.2 v 0.7 ± 1.0; P = .001). CONCLUSIONS: Stroke is associated with markers of insulin resistance, low serum levels of HDL, and high total cholesterol/HDL ratio in this African population. Studies with a larger sample size and cohort designs are warranted to explore the causal pathways, persistence of these abnormalities, and population-specific cut points.

Sobngwi E; Kengne AP; Balti EV; Fezeu L; Nouthe B; Djiogue S; Njamen D; Gautier JF; Unwin NC; Mbanya JC

2012-11-01

91

A Review on Aflatoxin Contamination and Its Implications in the Developing World : a Sub-Saharan African Perspective  

DEFF Research Database (Denmark)

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

Gnonlonfin, G J B; Hell, K

2013-01-01

92

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

UK PubMed Central (United Kingdom)

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

Kabiru CW; Izugbara CO; Beguy D

2013-01-01

93

Energy Security and Sub-Saharan Africa  

Directory of Open Access Journals (Sweden)

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

Emily Meierding

2012-01-01

94

[Depression in Sub-Saharan Africa].  

Science.gov (United States)

We now have a better knowledge of the specific features of depression in sub-Saharan Africa. Anthropologically speaking, the Western model is irrelevant. Depression in sub-Saharan Africa involves the relationship of the subject to himself or others in a mode specific to African cultures. Ignoring this fact can lead to simplistic ethnocentrism. From a clinical standpoint, depressive illness characterized by somatic manifestations, delusions of persecution, and anxiety are increasingly uncommon. As African societies modernize, these traditional forms are being gradually supplanted by states with symptoms and prognoses more like those observed in industrialized countries. Hybrid depressive syndromes are now the most widespread. Epidemiologically the notion widely held only a few decades ago that depression is a rare occurrence in Africa has now been dispelled. Many studies have been conducted to determine the exact incidence, age distribution, and sex ratio but more precise data is still needed. This investigation will require improvement in screening and diagnostic methods which must be not only suitable for clinical use but also adaptable to local conditions. This is also true with regard to management which has the same goals as anywhere else in the world. Treatment facilities are different in urban and rural areas but care is often dispensed in unconventional settings and may be combined with traditional methods. Drug availability is limited by problems involving supply and cost. This explains why electro-convulsive therapy which was introduced into sub-Saharan Africa long ago still plays a major role in the treatment of depression. PMID:9791599

Perez, S; Junod, A

1998-01-01

95

[Depression in Sub-Saharan Africa  

UK PubMed Central (United Kingdom)

We now have a better knowledge of the specific features of depression in sub-Saharan Africa. Anthropologically speaking, the Western model is irrelevant. Depression in sub-Saharan Africa involves the relationship of the subject to himself or others in a mode specific to African cultures. Ignoring this fact can lead to simplistic ethnocentrism. From a clinical standpoint, depressive illness characterized by somatic manifestations, delusions of persecution, and anxiety are increasingly uncommon. As African societies modernize, these traditional forms are being gradually supplanted by states with symptoms and prognoses more like those observed in industrialized countries. Hybrid depressive syndromes are now the most widespread. Epidemiologically the notion widely held only a few decades ago that depression is a rare occurrence in Africa has now been dispelled. Many studies have been conducted to determine the exact incidence, age distribution, and sex ratio but more precise data is still needed. This investigation will require improvement in screening and diagnostic methods which must be not only suitable for clinical use but also adaptable to local conditions. This is also true with regard to management which has the same goals as anywhere else in the world. Treatment facilities are different in urban and rural areas but care is often dispensed in unconventional settings and may be combined with traditional methods. Drug availability is limited by problems involving supply and cost. This explains why electro-convulsive therapy which was introduced into sub-Saharan Africa long ago still plays a major role in the treatment of depression.

Perez S; Junod A

1998-01-01

96

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

Energy Technology Data Exchange (ETDEWEB)

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

Azoumah, Y.; Yamegueu, D.; Ginies, P.; Coulibaly, Y.; Girard, P. [Laboratoire Energie Solaire et Economie d' Energie (LESEE), Fondation 2iE, 01 BP 594, Ouagadougou 01 (Burkina Faso)

2011-01-15

97

Molecular typing of the pneumococcus and its application in epidemiology in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

Molecular typing of the pneumococcus has played a crucial role in understanding the epidemiology of the organism. However, most of what is known about molecular epidemiology of the pneumococcus pertains to the developed world. The brunt of pneumococcal infections is borne by sub-Saharan African countries, which makes epidemiological monitoring of the pneumococcus essential in this region of the world. This review paper focuses on molecular typing of the pneumococcus and what is known about epidemiology of the organism in sub-Saharan Africa based on the various typing methods. Several molecular typing methods are available for typing the pneumococcus and the major ones include multilocus sequence typing (MLST), multilocus enzyme electrophoresis (MLEE), serotyping and DNA fingerprinting methods such as pulsed field gel electrophoresis (PFGE) and amplified fragment length polymorphism (AFLP). Currently, MLST is the most suitable method for typing the pneumococcus. The pneumococcal population structure in sub-Saharan Africa appears to be quite different from that of the developed world, and pneumococcal serotype 1 related to the ST 618 clone and clones of the ST 217 clonal complex are responsible for outbreaks in sub-Saharan Africa.

Donkor ES

2013-01-01

98

THE CONTRIBUTION OF SUB-SAHARAN AFRICAN STRAINS TO THE PHYLOGENY OF CYANOBACTERIA: FOCUSING ON THE NOSTOCACEAE (NOSTOCALES, CYANOBACTERIA)  

UK PubMed Central (United Kingdom)

To date, phylogenies have been based on known gene sequences accessible at GenBank, and the absence of many cyanobacterial lineages from collections and sequence databases has hampered their classification. Investigating new biotopes to isolate more genera and species is one way to enrich strain collections and subsequently enhance gene sequence databases. A polyphasic approach is another way of improving our understanding of the details of cyanobacterial classification. In this work, we have studied phylogenetic relationships in strains isolated from freshwater bodies in Senegal and Burkina Faso to complement existing morphological and genetic databases. By comparing 16S rDNA sequences of African strains to those of other cyanobacteria lineages, we placed them in the cyanobacterial phylogeny and confirmed their genus membership. We then focused on the Nostocaceae family by concatenated analysis of four genes (16S rDNA, hetR, nifH, and rpoC1 genes) to characterize relationships among Anabaena morphospecies, in particular, Anabaena sphaerica var. tenuis G. S. West. Using a polyphasic approach to the Nostocaceae family, we demonstrate that A. sphaerica var. tenuis is more closely related to Cylindrospermospsis/Raphidiopsis than to other planktonic Anabaena/Aphanizomenon. On the basis of phylogeny and morphological data, we propose that these three significantly different clusters should be assigned to three genera.

Thomazeau Sole?ne; Houdan-Fourmont Aude; Coute? Alain; Duval Charlotte; Couloux Arnaud; Rousseau Florence; Bernard Ce?cile

2010-06-01

99

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

Background: To date no validated instrument in the French language exists to screen for posttraumatic stress disorder (PTSD) in survivors of torture and organized violence. Objective: The aim of this study is to adapt and validate the Harvard Trauma Questionnaire (HTQ) to this population. Method: Th...

Capucine de Fouchier; Alain Blanchet; William Hopkins; Eric Bui; Malik Ait-Aoudia; Louis Jehel

100

Measuring the integration of staple food markets in Sub-Saharan Africa: Heterogeneous infrastructure and cross border trade in the East African community  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This analysis employs cointegration methods and semiparametric regression in order to assess the integration of maize markets and the factors determining national and cross-national transmission of price signals in Sub-Saharan Africa. We use a rich dataset of 16 series of wholesale maize prices betw...

Ihle, Rico; von Cramon-Taubadel, Stephan; Zorya, Sergiy

 
 
 
 
101

Reconsidering the Evidence Base, Considering the Rural: Aiming for a Better Understanding of the Education and Training Needs of Sub-Saharan African teachers  

Science.gov (United States)

|Providing basic education for all children by 2015 is one of the world's major educational objectives and teachers are crucial to achieving this. This article argues that not enough attention has been paid to the specific training needs of teachers in rural areas. Focusing on Sub-Saharan Africa it argues (i) that large-scale statistical data…

Buckler, Alison

2011-01-01

102

Metabolic syndrome in type 2 diabetes: comparative prevalence according to two sets of diagnostic criteria in sub-Saharan Africans.  

UK PubMed Central (United Kingdom)

BACKGROUND: Available definition criteria for metabolic syndrome (MS) have similarities and inconsistencies. The aim of this study was to determine the prevalence of MS in a group of Cameroonians with type 2 diabetes, according to the International Diabetes Federation (IDF) and the National Cholesterol Education Programme Adult Treatment Panel III (NCEP-ATP III) criteria, and to assess the concordance between both criteria, and the implications of combining them. METHODS: We collected clinical and biochemical data for 308 patients with type 2 diabetes (men 157) at the National Obesity Center of the Yaounde Central Hospital, Cameroon. Concordance was assessed with the use of the Kappa statistic. RESULTS: Mean age (standard deviation) was 55.8 (10.5) years and the median duration of diagnosed diabetes (25th-75th percentiles) was 3?years (0.5-5.0), similarly among men and women. The prevalence of MS was 71.7% according to the IDF criteria and 60.4% according to NCEP-ATP III criteria. The prevalence was significantly higher in women than in men independently of the criteria used (both p?population and in women. CONCLUSIONS: The IDF and NCEP-ATP III criteria do not always diagnose the same group of diabetic individuals with MS and combining them merely increases the yield beyond that provided by the IDF definition alone. This study highlights the importance of having a single unifying definition for MS in our setting.

Kengne AP; Limen SN; Sobngwi E; Djouogo CF; Nouedoui C

2012-01-01

103

Incidence and predictors of death, retention, and switch to second-line regimens in antiretroviral- treated patients in sub-Saharan African Sites with comprehensive monitoring availability.  

UK PubMed Central (United Kingdom)

BACKGROUND: Antiretroviral treatment programs in sub-Saharan Africa have high rates of early mortality and loss to follow-up. Switching to second-line regimens is often delayed because of limited access to laboratory monitoring. METHODS: Retrospective analysis was performed of a cohort of adults who initiated a standard first-line antiretroviral treatment at 5 public sector sites in 3 African countries. Monitoring included routine CD4 cell counts, human immunodeficiency virus RNA measures, and records of whether appointments were kept. Incidence and predictors of death, loss to follow-up, and switch to second-line regimens were analyzed by time-to-event approaches. RESULTS: A total of 3749 patients were analyzed; at baseline, 37.1% were classified as having World Health Organization disease stage 3 or 4, and the median CD4 cell count was 192 cells/mL. First-line regimens were nevirapine based in 96.5% of patients; 17.7% of patients attended <95% of their drug pickup appointments. During 4545 person-years of follow-up, mortality was 8.6 deaths per 100 person-years and was predicted by lower baseline CD4 cell count, lower hemoglobin level, and lower body mass index (calculated as weight in kilograms divided by the square of height in meters); more-advanced clinical stage of infection; male sex; and more missed drug pickup appointments. Dropouts (which accrued at a rate of 2.1 dropouts per 100 person-years) were predicted by a lower body mass index, more missed visits and missed drug pickup appointments, and later calendar year. Incidence of switches to second-line regimens was 4.9 per 100 person-years; increased hazards were observed with lower CD4 cell count and earlier calendar year at baseline. In patients who switched, virological failure was predicted by combined clinical and CD4 criteria with 74% sensitivity and 30% specificity. CONCLUSIONS: In an antiretroviral treatment program employing comprehensive monitoring, the probability of switching to second-line therapy was limited. Regular pickup of medication was a predictor of survival and was also strongly predictive of patient retention.

Palombi L; Marazzi MC; Guidotti G; Germano P; Buonomo E; Scarcella P; Doro Altan A; Zimba Ida V; San Lio MM; De Luca A

2009-01-01

104

Nuclear receptor-mediated induction of CYP450 by antiretrovirals: functional consequences of NR1I2 (PXR) polymorphisms and differential prevalence in whites and sub-Saharan Africans.  

UK PubMed Central (United Kingdom)

BACKGROUND: Antiretroviral therapy including HIV protease inhibitors and nonnucleoside reverse transcriptase inhibitors can both inhibit and induce expression of cytochrome P450s, potentially leading to drug interactions. However, information is lacking on the impact of genetic polymorphism on this interaction. METHODS: This study examines the prevalence of 33 polymorphisms in NR1I2 (pregnane X receptor [PXR]), CYP3A4, and CYP2B6 in 1013 white and sub-Saharan African patients with HIV; explores the inductive ability of 16 antiretrovirals on CYP3A4 and CYP2B6 promoter activity through nuclear receptors PXR and constitutive androstane receptor (CAR); and evaluates the influence of naturally occurring PXR genetic variants on antiretroviral activation. RESULTS: Seventeen polymorphisms were present at different frequencies between the two ethnicities. Darunavir, fosamprenavir, lopinavir, nelfinavir, tipranavir, efavirenz, and abacavir increased CYP3A4 and/or CYP2B6 promoter activity, some through constitutive androstane receptor but mainly through PXR. Addition of low-dose ritonavir enhanced levels of CYP promoter activity for several protease inhibitors. Some PXR variants displayed lower fosamprenavir- and lopinavir-induced CYP3A4 promoter activity than the PXR reference sequence, whereas efavirenz and nelfinavir induction was unchanged. CONCLUSIONS: The presence of NR1I2 polymorphisms can alter the induction of CYP3A4 and CYP2B6 promoter activity, potentially adding to the unpredictable nature of antiretroviral drug interactions. These polymorphisms differ in prevalence between whites and sub-Saharan Africans.

Svärd J; Spiers JP; Mulcahy F; Hennessy M

2010-12-01

105

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

Energy Technology Data Exchange (ETDEWEB)

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

Sebitosi, A.B. [Department of Electrical Engineering, University of Cape Town, Private Bag Rondebosch 7701, Cape Town (South Africa)]. E-mail: bsebitos@ebe.uct.ac.za; Pillay, P. [Clarkson University, Potsdam, NY 13699, USA (United States); Khan, M.A. [Department of Electrical Engineering, University of Cape Town, Private Bag Rondebosch 7701, Cape Town (South Africa)

2006-06-15

106

Issues Related to Higher Education in Sub-Saharan Africa. World Bank Staff Working Papers No. 780.  

Science.gov (United States)

|Higher education in Sub-Saharan African countries is examined. Attention is directed to the development of higher education in sub-Saharan African countries since the early 1960s, as well as criticisms currently directed at the sector, and the economic and budgetary environment for resource allocation. The labor market for African college…

Hinchliffe, Keith

107

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

Energy Technology Data Exchange (ETDEWEB)

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

Azoumah, Y., E-mail: yao.azoumah@2ie-edu.or [Laboratoire Energie Solaire et Economie d' Energie (LESEE), Fondation 2iE, 01 BP 594, Ouagadougou 01 (Burkina Faso); Yamegueu, D.; Ginies, P.; Coulibaly, Y.; Girard, P. [Laboratoire Energie Solaire et Economie d' Energie (LESEE), Fondation 2iE, 01 BP 594, Ouagadougou 01 (Burkina Faso)

2011-01-15

108

Blindness and visual impairment due to age-related cataract in sub-Saharan Africa: a systematic review of recent population-based studies.  

UK PubMed Central (United Kingdom)

AIM: We aimed to evaluate age-related cataract as a contributor to blindness and visual impairment (VI) in sub-Saharan Africa (SSA). METHODS: A systematic review of population-based studies published between 2000 and October 2012. Prevalence and proportions of blindness and VI due to cataract, cataract surgical coverage (CSC), per cent intraocular lens (IOL) implantation and visual outcomes of surgery in accordance with WHO criteria were ascertained. RESULTS: Data from 17 surveys (subjects mostly aged ?50-years-old) from 15 different countries in SSA were included, comprising 96 402 people. Prevalence of blindness (presenting visual acuity <3/60 in better eye) ranged from 0.1% in Uganda to 9.0% in Eritrea, and the proportion of total blindness due to cataract ranged between 21% and 67%. Cataract was the principal cause of blindness and VI in 15 and 14 studies, respectively. There was a strong positive correlation between good visual outcomes and IOL use (R=0.69, p=0.027). Considerable inter-study heterogeneity was evident in CSC and visual outcomes following surgery, and between 40% and 100% of operations had used IOL. CONCLUSIONS: Cataract represents the principal cause of blindness and VI and should remain a priority objective for eye care in SSA. However, the prevalence of blindness and VI due to cataract was variable and may reflect differences in the availability of cataract surgical programmes and cataract incidence.

Bastawrous A; Dean WH; Sherwin JC

2013-10-01

109

Strategy for ESD in Sub-Saharan Africa  

Science.gov (United States)

|The UNESCO Regional Office for Education in Africa has spearheaded development of a draft regional strategy for the implementation of the UNDESD in sub-Saharan Africa. The strategy aims to harmonize implementation of ESD; broaden public awareness; promote an education system that enhances African culture, especially when it contributes to…

Paden, Mary

2007-01-01

110

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

Directory of Open Access Journals (Sweden)

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

Fotso Jean-Christophe; Ezeh Alex; Madise Nyovani; Ciera James

2007-01-01

111

Comparison of HIV Prevalence Estimates from Antenatal Care Surveillance and Population-Based Surveys in Sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Objective: To compare HIV seroprevalence estimates obtained from antenatal care (ANC) sentinel surveillance surveys in Ethiopia, Kenya, Malawi, Tanzania and Uganda with those from population-based demographic and health surveys (DHS) and AIDS indicator surveys (AIS). Methods: Geographical informatio...

Mishra, V; Hong, R; Montana, Livia Sydel

112

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

Science.gov (United States)

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

Trudeau, Edouard J. C.

113

Microarray-based maps of copy-number variant regions in European and sub-Saharan populations.  

Science.gov (United States)

The genetic basis of phenotypic variation can be partially explained by the presence of copy-number variations (CNVs). Currently available methods for CNV assessment include high-density single-nucleotide polymorphism (SNP) microarrays that have become an indispensable tool in genome-wide association studies (GWAS). However, insufficient concordance rates between different CNV assessment methods call for cautious interpretation of results from CNV-based genetic association studies. Here we provide a cross-population, microarray-based map of copy-number variant regions (CNVRs) to enable reliable interpretation of CNV association findings. We used the Affymetrix Genome-Wide Human SNP Array 6.0 to scan the genomes of 1167 individuals from two ethnically distinct populations (Europe, N=717; Rwanda, N=450). Three different CNV-finding algorithms were tested and compared for sensitivity, specificity, and feasibility. Two algorithms were subsequently used to construct CNVR maps, which were also validated by processing subsamples with additional microarray platforms (Illumina 1M-Duo BeadChip, Nimblegen 385K aCGH array) and by comparing our data with publicly available information. Both algorithms detected a total of 42669 CNVs, 74% of which clustered in 385 CNVRs of a cross-population map. These CNVRs overlap with 862 annotated genes and account for approximately 3.3% of the haploid human genome.We created comprehensive cross-populational CNVR-maps. They represent an extendable framework that can leverage the detection of common CNVs and additionally assist in interpreting CNV-based association studies. PMID:21179565

Vogler, Christian; Gschwind, Leo; Röthlisberger, Benno; Huber, Andreas; Filges, Isabel; Miny, Peter; Auschra, Bianca; Stetak, Attila; Demougin, Philippe; Vukojevic, Vanja; Kolassa, Iris-Tatjana; Elbert, Thomas; de Quervain, Dominique J-F; Papassotiropoulos, Andreas

2010-12-16

114

Methylenetetrahydrofolate Reductase (MTHFR) from Mediterranean to Sub-Saharan Areas  

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

Rosa Chillemi; Andrea Angius; Ivana Persico; Alessandro Sassu; Dionigio A. Prodi; Salvatore Musumeci

2006-01-01

115

Integration of Highly Qualified Sub-Saharan Immigrants in Prague  

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

Andrea Gerstnerová

2011-01-01

116

Home-based palliative care in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

Palliative care within sub-Saharan African remains relatively new, with one service delivery model used being home-based care (HBC), a well-established mode of care provision within the HIV/AIDS context. The integration of palliative care into HBC services is a major advance in increasing its accessibility in the region. However, challenges exist to the provision of palliative services through HBC, especially for nurses, and these challenges, along with some of the responses to them, are discussed.

Downing J; Powell RA; Mwangi-Powell F

2010-05-01

117

Glaucoma drainage implant surgery--an evidence-based update with relevance to sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

Glaucoma represents a leading cause of preventable vision loss in Sub-Saharan Africa. Recent studies evaluating outcomes of glaucoma drainage implant (GDI) surgery suggest an important role for this approach in the African patient population. The Tube Versus Trabeculectomy study demonstrated a higher success rate with non-valved GDI surgery compared to trabeculectomy with mitomycin C after five years. The Ahmed Baerveldt Comparison study showed no difference in surgical failure rates between the Ahmed Glaucoma Valve and the Baerveldt Glaucoma Implant (BGI) but better intraocular pressure outcomes with the BGI at one year. The Ahmed Versus Baerveldt study demonstrated a lower failure rate for the BGI, but also a requirement for more post-operative interventions. Further study of GDI surgery in the Sub-Saharan Africa is necessary to determine its optimal place in the treatment paradigm for glaucoma patients in the region.

Aminlari AE; Scott IU; Aref AA

2013-04-01

118

Underdeveloped ICT areas in Sub-Saharan Africa  

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

Alfonso AVILA

2009-01-01

119

Patterns of HIV-1 drug resistance after first-line antiretroviral therapy (ART) failure in 6 sub-Saharan African countries: implications for second-line ART strategies.  

UK PubMed Central (United Kingdom)

BACKGROUND: Human immunodeficiency virus type 1 (HIV-1) drug resistance may limit the benefits of antiretroviral therapy (ART). This cohort study examined patterns of drug-resistance mutations (DRMs) in individuals with virological failure on first-line ART at 13 clinical sites in 6 African countries and predicted their impact on second-line drug susceptibility. METHODS: A total of 2588 antiretroviral-naive individuals initiated ART consisting of different nucleoside reverse transcriptase inhibitor (NRTI) backbones (zidovudine, stavudine, tenofovir, or abacavir, plus lamivudine or emtricitabine) with either efavirenz or nevirapine. Population sequencing after 12 months of ART was retrospectively performed if HIV RNA was >1000 copies/mL. The 2010 International Antiviral Society-USA list was used to score major DRMs. The Stanford algorithm was used to predict drug susceptibility. RESULTS: HIV-1 sequences were generated for 142 participants who virologically failed ART, of whom 70% carried ?1 DRM and 49% had dual-class resistance, with an average of 2.4 DRMs per sequence (range, 1-8). The most common DRMs were M184V (53.5%), K103N (28.9%), Y181C (15.5%), and G190A (14.1%). Thymidine analogue mutations were present in 8.5%. K65R was frequently selected by stavudine (15.0%) or tenofovir (27.7%). Among participants with ?1 DRM, HIV-1 susceptibility was reduced in 93% for efavirenz/nevirapine, in 81% for lamivudine/emtricitabine, in 59% for etravirine/rilpivirine, in 27% for tenofovir, in 18% for stavudine, and in 10% for zidovudine. CONCLUSIONS: Early failure detection limited the accumulation of resistance. After stavudine failure in African populations, zidovudine rather than tenofovir may be preferred in second-line ART. Strategies to prevent HIV-1 resistance are a global priority.

Hamers RL; Sigaloff KC; Wensing AM; Wallis CL; Kityo C; Siwale M; Mandaliya K; Ive P; Botes ME; Wellington M; Osibogun A; Stevens WS; Rinke de Wit TF; Schuurman R

2012-06-01

120

Challenges of Neonatal Surgery in Sub-Saharan Africa  

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Full Text Available In the last few decades, a better understanding of neonatal physiology and advances in technology and neonatal intensive care have improved the safety and out come of neonatal surgery in developed countries. In sub-Saharan African, however, neonatal surgery is still bedeviled by a myriad of problems, making newborn surgery to be attended by unacceptable morbidity and mortality. The problems range from lack of awareness and late presentation, through shortage of relevant personnel and lack of appropriate equipments and facilities to poor financing for neonatal surgical services. The quality of neonatal surgical service is a measure of the quality of paediatric surgical service provided by any centre. Efforts need to be made by all stakeholders to improve neonatal services in sub-Saharan Africa. Neonates require and certainly deserve the highest level of surgical care.

Ameh EA

2004-01-01

 
 
 
 
121

Human Leukocyte Antigen Variants B*44 and B*57 Are Consistently Favorable during Two Distinct Phases of Primary HIV-1 Infection in Sub-Saharan Africans with Several Viral Subtypes?†  

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As part of an ongoing study of early human immunodeficiency virus type 1 (HIV-1) infection in sub-Saharan African countries, we have identified 134 seroconverters (SCs) with distinct acute-phase (peak) and early chronic-phase (set-point) viremias. SCs with class I human leukocyte antigen (HLA) variants B*44 and B*57 had much lower peak viral loads (VLs) than SCs without these variants (adjusted linear regression beta values of ?1.08 ± 0.26 log10 [mean ± standard error] and ?0.83 ± 0.27 log10, respectively; P < 0.005 for both), after accounting for several nongenetic factors, including gender, age at estimated date of infection, duration of infection, and country of origin. These findings were confirmed by alternative models in which major viral subtypes (A1, C, and others) in the same SCs replaced country of origin as a covariate (P ? 0.03). Both B*44 and B*57 were also highly favorable (P ? 0.03) in analyses of set-point VLs. Moreover, B*44 was associated with relatively high CD4+ T-cell counts during early chronic infection (P = 0.02). Thus, at least two common HLA-B variants showed strong influences on acute-phase as well as early chronic-phase VL, regardless of the infecting viral subtype. If confirmed, the identification of B*44 as another favorable marker in primary HIV-1 infection should help dissect mechanisms of early immune protection against HIV-1 infection.

Tang, Jianming; Cormier, Emmanuel; Gilmour, Jill; Price, Matthew A.; Prentice, Heather A.; Song, Wei; Kamali, Anatoli; Karita, Etienne; Lakhi, Shabir; Sanders, Eduard J.; Anzala, Omu; Amornkul, Pauli N.; Allen, Susan; Hunter, Eric; Kaslow, Richard A.

2011-01-01

122

From Chaos to Cohesion: A Regional Approach to Security, Stability, and Development in Sub-Saharan Africa.  

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Conflicts and extremism are almost certain to continue to rise in Africa, especially with instability resulting from the cascade of unrest across North Africa and the Middle East, the burgeoning youth bulge in Sub-Saharan Africa, African mercenaries, risi...

D. E. Chido

2013-01-01

123

Social, behavioural, and intervention research among people of Sub-Saharan African origin living with HIV in the UK and Europe: literature review and recommendations for intervention.  

UK PubMed Central (United Kingdom)

Africans are the second largest group affected by HIV in Western Europe after men who have sex with men (MSM). This review describes and summarises the literature on social, behavioural, and intervention research among African communities affected by HIV in the UK and other European countries in order to make recommendations for future interventions. We conducted a keyword search using Embase, Medline and PsychInfo, existing reviews, 'grey literature', as well as expert working group reports. A total of 138 studies met our inclusion criteria; 31 were published in peer-reviewed journals, 107 in the grey literature. All peer-reviewed studies were observational or "descriptive," and none of them described HIV interventions with African communities. However, details of 36 interventions were obtained from the grey literature. The review explores six prominent themes in the descriptive literature: (1) HIV testing; (2) sexual lifestyles and attitudes; (3) gender; (4) use of HIV services; (5) stigma and disclosure (6) immigration status, unemployment and poverty. Although some UK and European interventions are addressing the needs of African communities affected by HIV, more resources need to be mobilised to ensure current and future interventions are targeted, sustainable, and rigorously evaluated.

Prost A; Elford J; Imrie J; Petticrew M; Hart GJ

2008-03-01

124

Epidemiology of ischaemic heart disease in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

BACKGROUND: The epidemiology of ischaemic heart disease (IHD) in sub-Saharan Africa (SSA) remains largely enigmatic. Major obstacles to our understanding of the condition include lack of reliable health statistics, particularly cause-specific mortality data, inadequate diagnostic capabilities, shortage of physicians and cardiologists, and misguided opinions. METHODS: This review of the epidemiology of ischaemic heart disease in sub-Saharan Africa involved a systematic bibliographic MEDLINE search of published data on IHD in SSA over the past century. Search words included epidemiology, ischaemic (coronary) heart disease, myocardial infarction, cardiovascular risk factors and sub-Saharan Africa. Selected data are presented on the prevalence of cardiovascular risk factors and mortality from ischaemic heart disease from different countries representing the main regions of the continent. RESULTS: Although IHD in SSA remains relatively uncommon, its prevalence is predicted to rise in the next two decades due to the rising prevalence of risk factors, especially hypertension, diabetes, overweight and obesity, physical inactivity, increased tobacco use and dyslipidaemia. It is estimated that age-standardised mortality rates for IHD will rise by 27% in African men and 25% in women by 2015, and by 70 and 74%, respectively by 2030. CONCLUSION: Ischaemic heart disease remains relatively uncommon in SSA, despite an increasing prevalence of risk factors, but its incidence is rising. The pace and direction of economic development, rates of urbanisation, and changes in life expectancy resulting from the impact of pre-transitional diseases and violence will be major determinants of the IHD epidemic in SSA. The best window of opportunity for prevention of the emerging epidemic of ischaemic heart disease in sub-Saharan Africa is now.

Onen CL

2013-03-01

125

The Political Economy Of Urban Food Security In Sub-Saharan Africa  

UK PubMed Central (United Kingdom)

Sub-Saharan African cities in the late 1990s face a daunting set of problemsincluding rapid growth, increasing poverty, deteriorating infrastructure, and inadequatecapacity for service provision. However, even as a renewed debate is shaping up aroundissues of urban development, there is little attention given to the question of urban foodsecurity and nutrition. Whereas in the 1970s and 1980s, urban food problems in Africacommanded political attention, the nature of urban food insecurity in the 1990s is suchthat it has tended to lose political importance. This is largely because in the 1970s, theproblem was one of outright food shortages and rapid price changes that affected largeportions of the urban population simultaneously. The impact of structural adjustment,continued rapid growth, and an increase in urban poverty make food insecurity in the1990s primarily a problem of access by the urban poor. Under circumstances where theurban poor spend a very large portion of their total income on food, urban poverty rapidlytranslates food insecurity. The lack of formal safety nets, and the shifting of responsibilityfor coping with food insecurity away from the state towards the individual and householdlevel has tended to atomize and muffle any political response to this new urban foodinsecurity.This paper briefly reviews urban food insecurity and generates a set of empiricalquestions for an analysis of food and livelihood security in contemporary urban SubSaharanAfrica, and then examines historical and contemporary evidence from Kampala,Uganda, and Accra, Ghana, to suggest some tentative conclusions.CONTENTSAcknowledgments .................................................... iv1.

Fcnd Discussion; Paper No

126

Developmental State and Economic Development: Prospects for Sub-Saharan Africa  

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Full Text Available This paper will argue that the demonization of sub-Saharan African state proposed and enacted by neoliberal institutions during and since the era of structural adjustment has no historical foundations. In making this argument, the history of development thinking prior to and after World War II will be analyzed to show that the state was and continues to be instrumental in economic development. Finally, drawing on the contributions of heterodox development economists, prospects for re-integrating the sub-Saharan African state to bolster economic development will be assessed by drawing on the development experiences of East Asia’s high performing economies.

Richard B. Dadzie

2012-01-01

127

Predicting trends in HIV-1 sexual transmission in sub-Saharan Africa through the Drug Resource Enhancement Against AIDS and Malnutrition model: antiretrovirals for 5 reduction of population infectivity, incidence and prevalence at the district level.  

UK PubMed Central (United Kingdom)

BACKGROUND: The use of antiretrovirals to reduce the incidence of human immunodeficiency virus (HIV) infection has been evaluated in mathematical models as potential strategies for curtailing the epidemic. Cohort data from the Drug Resource Enhancement Against AIDS and Malnutrition (DREAM) Program was used to generate a realistic model for the HIV epidemic in sub-Saharan Africa. METHODS: Two combined stochastic models were developed: patient and epidemic models. Models were combined using virus load as a parameter of infectivity. DREAM data that assessed patient care in Mozambique and Malawi were used to generate measures of infectivity, survival, and adherence. The Markov chain prediction model was used for the analysis of disease progression in treated and untreated patients. A partnership model was used to assess the probability that an infected individual would transmit HIV. RESULTS: Data from 26565 patients followed up from January 2002 through July 2009 were analyzed with the model; 63% of patients were female, the median age was 35 years, and the median observation time was 25 months. In the model, a 5-fold reduction in infectivity (from 1.6% to 0.3%) occurred within 3 years when triple ART was used. The annual incidence of HIV infection declined from 7% to 2% in 2 years, and the prevalence was halved, from 12% to 6%, in 11 years. Mortality in HIV-infected individuals declined by 50% in 5 years. A cost analysis demonstrated economic efficiency after 4 years. CONCLUSIONS: Our model, based on patient data, supports the hypothesis that treatment of all infected individuals translates into a drastic reduction in incident HIV infections. A targeted implementation strategy with massive population coverage is feasible in sub-Saharan Africa.

Palombi L; Bernava GM; Nucita A; Giglio P; Liotta G; Nielsen-Saines K; Orlando S; Mancinelli S; Buonomo E; Scarcella P; Altan AM; Guidotti G; Ceffa S; Haswell J; Zimba I; Magid NA; Marazzi MC

2012-07-01

128

Home-based palliative care in sub-Saharan Africa.  

Science.gov (United States)

Palliative care within sub-Saharan African remains relatively new, with one service delivery model used being home-based care (HBC), a well-established mode of care provision within the HIV/AIDS context. The integration of palliative care into HBC services is a major advance in increasing its accessibility in the region. However, challenges exist to the provision of palliative services through HBC, especially for nurses, and these challenges, along with some of the responses to them, are discussed. PMID:20463514

Downing, Julia; Powell, Richard A; Mwangi-Powell, Faith

2010-05-01

129

Analysis of paternal lineages in Brazilian and African populations  

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Full Text Available The present-day Brazilian population is a consequence of the admixture of various peoples of very different origins, namely, Amerindians, Europeans and Africans. The proportion of each genetic contribution is known to be very heterogeneous throughout the country. The aim of the present study was to compare the male lineages present in two distinct Brazilian populations, as well as to evaluate the African contribution to their male genetic substrate. Thus, two Brazilian population samples from Manaus (State of Amazon) and Ribeirão Preto (State of São Paulo) and three African samples from Guinea Bissau, Angola and Mozambique were typed for a set of nine Y chromosome specific STRs. The data were compared with those from African, Amerindian and European populations. By using Y-STR haplotype information, low genetic distances were found between the Manaus and Ribeirão Preto populations, as well as between these and others from Iberia. Likewise, no significant distances were observed between any of the African samples from Angola, Mozambique and Guinea Bissau. Highly significant Rst values were found between both Brazilian samples and all the African and Amerindian populations. The absence of a significant Sub-Saharan African male component resulting from the slave trade, and the low frequency in Amerindian ancestry Y-lineages in the Manaus and Ribeirão Preto population samples are in accordance with the accentuated gender asymmetry in admixture processes that has been systematically reported in colonial South American populations.

Mónica Carvalho; Pedro Brito; Virgínia Lopes; Lisa Andrade; Mª João Anjos; Francisco Corte Real; Leonor Gusmão

2010-01-01

130

Iron status, malaria parasite loads and food policies: evidence from sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

This brief article investigates the consequences of improving children's iron status for malaria parasite loads by analyzing data from Cote d'Ivoire, Zambia, and Tanzania; the treatment of iron deficiencies has been argued to flare up malaria in under-nourished populations. The data from a randomized controlled trial in Cote d'Ivoire showed statistically insignificant effects of the consumption of iron-fortified biscuits on children's malaria parasite loads. Second, nutrient intakes data from Zambia showed insignificant correlations and associations between children's iron and folate intakes and malaria parasite loads. Third, malaria parasite loads did not change significantly for Tanzanian children receiving anthelmintic treatment; malaria loads were lower for older children and for those using bed nets. Overall, the evidence from sub-Saharan African countries suggests that small improvements in iron status achieved via suitable food policies are unlikely to have detrimental effects for children's malaria parasite loads.

Bhargava A

2013-01-01

131

Peer Effects and Textbooks in Primary Education: Evidence from Francophone Sub-Saharan Africa  

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As opposed to many other school inputs, textbooks have frequently been demonstrated to significantly foster student achievement. Using the rich data set provided by the 'Program on the Analysis of Education Systems' (PASEC) for five francophone, sub-Saharan African countries, this paper goes beyond ...

Frölich, Markus; Michaelowa, Katharina

132

Peer effects and textbooks in primary education : Evidence from francophone sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

As opposed to many other school inputs, textbooks have frequently been demonstrated to significantly foster student achievement. Using the rich data set provided by the 'Program on the Analysis of Education Systems' (PASEC) for five francophone, sub-Saharan African countries, this paper goes beyond ...

Frölich, Markus; Michaelowa, Katharina

133

Neurocysticercosis in sub-Saharan Africa: a review of prevalence, clinical characteristics, diagnosis, and management.  

UK PubMed Central (United Kingdom)

Neurocysticercosis has been recognized as a major cause of secondary epilepsy worldwide. So far, most of the knowledge about the disease comes from Latin America and the Indian subcontinent. Unfortunately, in sub-Saharan Africa the condition was neglected for a long time, mainly owing to the lack of appropriate diagnostic tools. This review therefore focuses on the prevalence of neurocysticercosis in sub-Saharan Africa, the clinical picture with emphasis on epilepsy, as well as the diagnosis and treatment of neurocysticercosis and its related epilepsy/epileptic seizures in African resource-poor settings.

Winkler AS

2012-09-01

134

Molecular evidence for five distinct Bemisia tabaci (Homoptera: Aleyrodidae) geographic haplotypes associated with cassava plants in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

The Bemisia tabaci (Gennadius) complex contains the only known whitefly vector of plant-infecting begomoviruses, which are the causal agents of mosaic diseases of cassava in Africa and India. Widespread phenotypic variability, together with the absence of definitive morphological taxonomic characters for this whitefly complex, has confounded both the systematics and the study of its virus vector biology. Substantial genetic variability and phylogeographical relationships have been shown for phenotypic, but morphologically identical, variants of B. tabaci based on the mitochondrial (mt) cytochrome oxidase I (COI) sequence, leading to the suggestion that they represent a species complex. Here, phylogenetic relationships were explored, using the mtCOI sequence (780 bp) as a molecular marker, for B. tabaci collected from cassava plants in southern and western Africa, including Cameroon, Zambia, Mozambique, Zimbabwe, Swaziland, and South Africa. Maximum likelihood analyses of mtCOI sequences revealed that most B. tabaci examined were placed into one of three subgroups within the major sub-Saharan African clade, which also contains previously reported populations indigenous to Malawi and Uganda, and collectively shared on overall nucleotide (nt) identity at 88.9-99.7%. Two other reference populations, the monophagous Benin haplotype from Asystasia spp. and a B. tabaci from cassava in the Ivory Coast (IC), were the most divergent outliers of the sub-Saharan clade, each representing the only member of their respective clade (I and V), at the present time. Members of the sub-Saharan clade associated with cassava had as their closest relatives haplotypes I and II of the Mediterranean-Northern Africa clade, with which they shared a collective 84.2-92.9% nt identity (not including the IC cassava reference haplotype). In contrast, the sub-Saharan African clade diverged from the Americas and Southeast Asia/Far East clades at 79.7-85.1 and 77.5-84.9%, respectively. Within the sub-Saharan clade, subclade II contained B. tabaci from Zambia, Mozambique, South Africa, and Swaziland at 95-99% identity. The sub-Saharan subcluster III contained haplotypes from southern and western Africa. Counter to the otherwise phylogeographical relationships observed for cassava-associated B. tabaci from southern Africa, one and two populations from Cameroon (okra) and Zimbabwe (cassava), respectively, grouped with the major Mediterranean-North Africa clade, together with their closest relative associated with okra from IC, are included here as a reference sequence for the first time, with which they collectively formed a new, third subclade. Thus, phylogenetic analysis of B. tabaci mtCOI haplotypes examined thus far from the African continent has revealed five major cassava-associated haplotypes, which grouped primarily based on extant geography, with the exception of one and two collections from Cameroon and Zimbabwe, respectively. Hypotheses explaining the potential distributions of haplotypes are discussed.

Berry SD; Fondong VN; Rey C; Rogan D; Fauquet CM; Brown JK

2004-07-01

135

Where to deploy pre-exposure prophylaxis (PrEP) in sub-Saharan Africa?  

UK PubMed Central (United Kingdom)

OBJECTIVE: Two randomised controlled trials showed that pre-exposure prophylaxis (PrEP) reduces HIV transmission between heterosexual men and women. We model the potential impact on transmission and cost-effectiveness of providing PrEP in sub-Saharan Africa. METHODS: We use a deterministic, compartmental model of HIV transmission to evaluate the potential of a 5-year PrEP intervention targeting the adult population of 42 sub-Saharan African countries. We examine the incremental impact of adding PrEP at pre-existing levels of male circumcision and antiretroviral therapy (ART). The base case assumes efficacy of 68%; adherence at 80%; country coverage at 10% of the HIV-uninfected adult population; and annual costs of PrEP and ART at US$200 and US$880 per person, respectively. RESULTS: After 5 years, 390 000 HIV infections (95% UR 190 000 to 630 000) would be prevented, 24% of these in South Africa. HIV infections averted per 100 000 people (adult) would range from 500 in Lesotho to 10 in Somalia. Incremental cost-effectiveness would be US$5800/disability-adjusted life year (DALY) (95% UR 3100 to 13500). Cost-effectiveness would range from US$500/DALY in Lesotho to US$44 600/DALY in Eritrea. CONCLUSIONS: In a general adult population, PrEP is a high-cost intervention which will have maximum impact and be cost-effective only in countries that have high levels of HIV burden and low levels of male circumcision in the population. Hence, PrEP will likely be most effective in Southern Africa as a targeted intervention added to existing strategies to control the HIV pandemic.

Verguet S; Stalcup M; Walsh JA

2013-08-01

136

Effect of HIV infection on pregnancy-related mortality in sub-Saharan Africa: secondary analyses of pooled community-based data from the network for Analysing Longitudinal Population-based HIV/AIDS data on Africa (ALPHA).  

UK PubMed Central (United Kingdom)

BACKGROUND: Model-based estimates of the global proportions of maternal deaths that are in HIV-infected women range from 7% to 21%, and the effects of HIV on the risk of maternal death is highly uncertain. We used longitudinal data from the Analysing Longitudinal Population-based HIV/AIDS data on Africa (ALPHA) network to estimate the excess mortality associated with HIV during pregnancy and the post-partum period in sub-Saharan Africa. METHODS: The ALPHA network pooled data gathered between June, 1989 and April, 2012 in six community-based studies in eastern and southern Africa with HIV serological surveillance and verbal-autopsy reporting. Deaths occurring during pregnancy and up to 42 days post partum were defined as pregnancy related. Pregnant or post-partum person-years were calculated for HIV-infected and HIV-uninfected women, and HIV-infected to HIV-uninfected mortality rate ratios and HIV-attributable rates were compared between pregnant or post-partum women and women who were not pregnant or post partum. FINDINGS: 138,074 women aged 15-49 years contributed 636,213 person-years of observation. 49,568 women had 86,963 pregnancies. 6760 of these women died, 235 of them during pregnancy or the post-partum period. Mean prevalence of HIV infection across all person-years in the pooled data was 17.2% (95% CI 17.0-17.3), but 60 of 118 (50.8%) of the women of known HIV status who died during pregnancy or post partum were HIV infected. The mortality rate ratio of HIV-infected to HIV-uninfected women was 20.5 (18.9-22.4) in women who were not pregnant or post partum and 8.2 (5.7-11.8) in pregnant or post-partum women. Excess mortality attributable to HIV was 51.8 (47.8-53.8) per 1000 person-years in women who were not pregnant or post partum and 11.8 (8.4-15.3) per 1000 person-years in pregnant or post-partum women. INTERPRETATION: HIV-infected pregnant or post-partum women had around eight times higher mortality than did their HIV-uninfected counterparts. On the basis of this estimate, we predict that roughly 24% of deaths in pregnant or post-partum women are attributable to HIV in sub-Saharan Africa, suggesting that safe motherhood programmes should pay special attention to the needs of HIV-infected pregnant or post-partum women. FUNDING: Wellcome Trust, Health Metrics Network (WHO).

Zaba B; Calvert C; Marston M; Isingo R; Nakiyingi-Miiro J; Lutalo T; Crampin A; Robertson L; Herbst K; Newell ML; Todd J; Byass P; Boerma T; Ronsmans C

2013-05-01

137

Estimating the impact of expanded access to antiretroviral therapy on maternal, paternal and double orphans in sub-Saharan Africa, 2009-2020  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background HIV/AIDS has orphaned 11.6 million children in sub-Saharan Africa. Expanded antiretroviral therapy (ART) use may reduce AIDS orphanhood by decreasing adult mortality and population-level HIV transmission. Methods We modeled two scenarios to measure the impact of adult ART use on the incidence of orphanhood in 10 sub-Saharan African countries, from 2009 to 2020. Demographic model data inputs were obtained from cohort studies, UNAIDS, UN Population Division, WHO and the US Census Bureau. Results Compared to current rates of ART uptake, universal ART access averted 4.37 million more AIDS orphans by year 2020, including 3.15 million maternal, 1.89 million paternal and 0.75 million double orphans. The number of AIDS orphans averted was highest in South Africa (901.71 thousand) and Nigeria (839.01 thousand), and lowest in Zimbabwe (86.96 thousand) and Côte d'Ivoire (109.12 thousand). Conclusion Universal ART use may significantly reduce orphanhood in sub-Saharan Africa.

Anema Aranka; Au-Yeung Christopher G; Joffres Michel; Kaida Angela; Vasarhelyi Krisztina; Kanters Steve; Montaner Julio SG; Hogg Robert S

2011-01-01

138

Cutaneous T-cell lymphoma in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

The incidence and economic burden of cancer in sub-Saharan Africa is increasing, and innovative strategies are needed to improve prevention and care in this population. This article uses a case of cutaneous T-cell lymphoma in Uganda to propose guidelines for the diagnosis and treatment of this disease in resource-limited settings. These guidelines were developed from the consensus opinion of specialists at the Uganda Cancer Institute and Fred Hutchinson Cancer Research Center as part of an established collaboration. Areas for future investigation that can improve the care of patients in this region are identified.

Ulrickson M; Okuku F; Walusansa V; Press O; Kalungi S; Wu D; Kambugu F; Casper C; Orem J

2013-03-01

139

Epilepsy in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

Over 10 million people in Africa have epilepsy of which most have no access to appropriate treatment. Epilepsy in Africa is different- the incidence is higher, and the causes and cultural attitudes towards it differ. This article examines the epidemiology, causes and treatment of epilepsy in sub-Saharan Africa and looks at the challenges to improve access to treatment and potential solutions and the implications for neurologists in more developed countries.

Prevett M

2013-02-01

140

People Who Inject Drugs, HIV Risk, and HIV Testing Uptake in Sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

Dramatic rises in injection drug use (IDU) in sub-Saharan Africa account for increasingly more infections in a region already overwhelmed by the HIV epidemic. There is no known estimate of the number of people who inject drugs (PWID) in the region, or the associated HIV prevalence in PWID. We reviewed literature with the goal of describing high-risk practices and exposures in PWID in sub-Saharan Africa, as well as current HIV prevention activities aimed at drug use. The literature search looked for articles related to HIV risk, injection drug users, stigma, and HIV testing in sub-Saharan Africa. This review found evidence demonstrating high rates of HIV in IDU populations in sub-Saharan Africa, high-risk behaviors of the populations, lack of knowledge regarding HIV, and low HIV testing uptake. There is an urgent need for action to address IDU in order to maintain recent decreases in the spread of HIV in sub-Saharan Africa.

Asher AK; Hahn JA; Couture MC; Maher K; Page K

2013-11-01

 
 
 
 
141

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

UK PubMed Central (United Kingdom)

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

Byrne N

2007-03-01

142

Inequities in the Global Health Workforce: The Greatest Impediment to Health in Sub-Saharan Africa  

Directory of Open Access Journals (Sweden)

Full Text Available Health systems played a key role in the dramatic rise in global life expectancy that occurred during the 20th century, and have continued to contribute enormously to the improvement of the health of most of the world’s population. The health workforce is the backbone of each health system, the lubricant that facilitates the smooth implementation of health action for sustainable socio-economic development. It has been proved beyond reasonable doubt that the density of the health workforce is directly correlated with positive health outcomes. In other words, health workers save lives and improve health. About 59 million people make up the health workforce of paid full-time health workers world-wide. However, enormous gaps remain between the potential of health systems and their actual performance, and there are far too many inequities in the distribution of health workers between countries and within countries. The Americas (mainly USA and Canada) are home to 14% of the world’s population, bear only 10% of the world’s disease burden, have 37% of the global health workforce and spend about 50% of the world’s financial resources for health. Conversely, sub-Saharan Africa, with about 11% of the world’s population bears over 24% of the global disease burden, is home to only 3% of the global health workforce, and spends less than 1% of the world’s financial resources on health. In most developing countries, the health workforce is concentrated in the major towns and cities, while rural areas can only boast of about 23% and 38% of the country’s doctors and nurses respectively. The imbalances exist not only in the total numbers and geographical distribution of health workers, but also in the skills mix of available health workers. WHO estimates that 57 countries world wide have a critical shortage of health workers, equivalent to a global deficit of about 2.4 million doctors, nurses and midwives. Thirty six of these countries are in sub-Saharan Africa. They would need to increase their health workforce by about 140% to achieve enough coverage for essential health interventions to make a positive difference in the health and life expectancy of their populations. The extent causes and consequences of the health workforce crisis in Sub-Saharan Africa, and the various factors that influence and are related to it are well known and described. Although there is no “magic bullet” solution to the problem, there are several documented, tested and tried best practices from various countries. The global health workforce crisis can be tackled if there is global responsibility, political will, financial commitment and public-private partnership for country-led and country-specific interventions that seek solutions beyond the health sector. Only when enough health workers can be trained, sustained and retained in sub-Saharan African countries will there be meaningful socio-economic development and the faintest hope of attaining the Millennium Development Goals in the sub-continent.

Stella C. E. Anyangwe; Chipayeni Mtonga

2007-01-01

143

Nutrition and the commoditization of food in sub-Saharan Africa.  

Science.gov (United States)

During the past decade, Africa, more than any other continent, has been associated with famine and malnutrition. The Sahelian drought of the early 1970s, the Wollo and Karamoja famines and most recently, mass starvation in Ethiopia, have followed one another in rapid succession. The term 'food crisis' continually crops up in the popular and academic press. An increasing number of researchers probe possible causes; many seek a systemic reason for the present situation. One working hypothesis is that increasing commoditization of food has undermined Africa's food systems. This paper does not purport to prove or disprove this. Less ambitiously, its aim is to draw attention to inter-relationships between commoditization and physical and social aspects of African food systems, tracing their possible effects on the nutritional status of the African population. In so doing, some of the complexities of developing food production and consumption in the transition from peasant societies to more urban-based national economies become evident. The paper is divided into three main parts: a discussion of conceptual categories and general background information about sub-Saharan African food zones and commodity and factor markets; a review of literature on rural food availability and nutrition; and a review of urban food availability and nutrition. PMID:2648597

Bryceson, D F

1989-01-01

144

Nutrition and the commoditization of food in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

During the past decade, Africa, more than any other continent, has been associated with famine and malnutrition. The Sahelian drought of the early 1970s, the Wollo and Karamoja famines and most recently, mass starvation in Ethiopia, have followed one another in rapid succession. The term 'food crisis' continually crops up in the popular and academic press. An increasing number of researchers probe possible causes; many seek a systemic reason for the present situation. One working hypothesis is that increasing commoditization of food has undermined Africa's food systems. This paper does not purport to prove or disprove this. Less ambitiously, its aim is to draw attention to inter-relationships between commoditization and physical and social aspects of African food systems, tracing their possible effects on the nutritional status of the African population. In so doing, some of the complexities of developing food production and consumption in the transition from peasant societies to more urban-based national economies become evident. The paper is divided into three main parts: a discussion of conceptual categories and general background information about sub-Saharan African food zones and commodity and factor markets; a review of literature on rural food availability and nutrition; and a review of urban food availability and nutrition.

Bryceson DF

1989-01-01

145

Analysis of pharmacogenetic traits in two distinct South African populations  

Directory of Open Access Journals (Sweden)

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

Ikediobi Ogechi; Aouizerat Bradley; Xiao Yuanyuan; Gandhi Monica; Gebhardt Stefan; Warnich Louise

2011-01-01

146

Sub-Saharan hydroelectric power development potential  

International Nuclear Information System (INIS)

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

1991-01-01

147

SOVEREIGNTY OF STATES IN THE POST COLD WAR ERA: IMPLICATIONS FOR SUB-SAHARAN AFRICA  

Directory of Open Access Journals (Sweden)

Full Text Available The United Nations (UN) was founded to ‘to save succeeding generations from the scourge of war’.1 However, the post-independence history of sub-Saharan Africa has demonstrated that the international community, or lack of an international society, has so far been unable to protect the African continent from this ‘scourge’, or indeed from itself. A number of reasons may be suggested for this, including the organisation of the international community into a number of sovereign independent states, the inability of some of these territorial sovereignties to act and function as states, the formal political and economic crisis and marginalisation of especially sub-Saharan Africa, and finally the history of the continent. Accordingly, this article has two major objectives. The article will illustrate how state failure and intrastate asymmetric warfare alters and undermines the Westphalian concept of state in sub-Saharan Africa. Furthermore it attempts to show that the way in which the concept of ‘national sovereignty’ is understood is changing, and that this might have instrumental implications for future interstate relations in sub-Saharan Africa.

Thomas Jørgenson

2012-01-01

148

Challenges in biobank governance in Sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

BACKGROUND: Biological sample and data transfer within and out of Africa is steeped in controversy With the H3Africa project now aiming to establish biobanks in Africa, it is essential that there are ethical and legal governance structures in place to oversee the operation of these biobanks. Such governance is essential to ensuring that donors are protected, that cultural perspectives are respected and that researchers have a ready availability of ethically sourced biological samples. METHODS: A literature review of all legislation, regulations, guidelines and standard operating procedures on informed consent, confidentiality and the transfer of biological samples amongst countries in Sub-Saharan Africa was conducted. In addition, an examination of the websites of departments of health and national ethics committees was performed. Researchers and research ethics scholars in the field in various African countries were contacted for assistance. A literature review of all studies examining participants views on issues related to biobanking in Africa was carried out and five separate studies were found. RESULTS: It was found that biobanking guidelines differ substantially across Sub-Saharan Africa regarding biobanking and often conflicted across borders. This has the potential to negatively impact collaboration. Furthermore, the guidelines in place often do not recognise the ethical difficulties arising from the transfer of biological samples and are unsuitable to regulate biobanks. Additionally, there is insufficient research into the views of research participants and stakeholders on the use of biological /samples. CONCLUSION: Collaboration is necessary to ensure the success of biobanking projects in Africa. To achieve this, there should be some harmonization of guidelines across Africa which would aid in transferring biological samples across borders. These guidelines should reflect the unique ethical issues arising out of the storage and secondary uses of biological samples. Finally, further research into the views of research participants is necessary. Such studies should aid in the drafting of any new harmonization guidelines.

Staunton C; Moodley K

2013-09-01

149

LPG market in sub Saharan Africa  

International Nuclear Information System (INIS)

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

1999-01-01

150

Adolescent childbearing in sub-Saharan Africa  

Directory of Open Access Journals (Sweden)

Full Text Available This article examines whether increased years of schooling exercised a consistent impact on delayed childbearing in sub-Saharan Africa. Data were drawn from Demographic and Health Surveys conducted in eight countries over the period 1987-1999. Multiple logistic regressions were used to assess trends and determinants in the probability of first birth during adolescence. Girls' education from about the secondary level onwards was found to be the only consistently significant covariate. No effect of community aggregate education was discernible, after controlling for urbanity and other individual-level variables. The results reinforce previous findings that improving girls' education is a key instrument for raising ages at first birth, but suggest that increases in schooling at lower levels alone bear only somewhat on the prospects for fertility decline among adolescents.

Gupta Neeru; Mahy Mary

2003-01-01

151

Religious and cultural traits in HIV/AIDS epidemics in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

BACKGROUND: The pandemic of HIV/AIDS in sub-Saharan Africa and the rise of epidemics in Asia to the previously unforeseen level are likely to have global social, economic, and political impacts. In this emergency, it is vital to reappraise the weight of powerful religious and cultural factors in spreading the disease. The role of Islam in shaping values, norms, and public policies in North African states is to be appreciated for the lowest HIV prevalence in their populations. Yet, the place of religion in prevention of the disease diffusion is not fully understood nor worldwide acknowledged by the primary decision makers. Another topic, which has received little attention to date, despite the abundance of literature concerning the unfortunate Africa's anti-AIDS campaign, is an issue of colonial past. METHODS: To better comprehend the share of both traits in diverse spread of HIV in sub-Saharan Africa, we studied the correlation between Muslim and Christian proportions in the state's population and HIV rate. RESULTS: By this method, Muslim percentage came out as a potential predictor of HIV prevalence in a given state. In another approach, most subcontinental countries were clustered by colocalization and similarity in their leading religion, colonial past, and HIV seroprevalence starting from barely noticeable (0.6 - 1.2%, for Mauritania, Senegal, Somalia, and Niger) and low levels (1.9 - 4.8%, for Mali, Eritrea, Djibouti, Guinea, Guinea-Bissau, Burkina-Faso, and Chad) for Muslim populated past possessions of France and Italy, in the northern part of the subcontinent. Former territories of France, Belgium, Portugal, and the UK formed two other groups of the countries nearing the equator with Catholic prevailing (Democratic Republic of Congo, Republic of Congo, Rwanda, Gabon, and Burundi) or mixed populations comprising Christian, Muslim, and indigenous believers (Benin, Ghana, Uganda, Togo, Angola, Nigeria, Liberia, Kenya, Cameroon, Côte d'Ivoire, and Sierra-Leone), which covered the HIV prevalence range from 1.9% to 7%. Albeit being traced by origin to the central part of the continent, HIV has reached the highest rates in the South, particularly Malawi (14.2%), Zambia (16.5%), South Africa (21.5%), Zimbabwe (24.6%), Lesotho (28.9%), Botswana (37.3%), and Swaziland (38.8%)-all former British colonies with dominating Christian population. CONCLUSION: In the group ranking list, a distinct North to South oriented incline in HIV rates related to prevailing religion and previous colonial history of the country was found, endorsing the preventive role of the Islam against rising HIV and the increased vulnerability to menace in states with particular colonial record.

Velayati AA; Bakayev V; Bahadori M; Tabatabaei SJ; Alaei A; Farahbood A; Masjedi MR

2007-10-01

152

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

This article assesses the current technical and economic potential of three bioenergy production systems (cassava ethanol, jatropha oil and fuelwood) in semi-arid and arid regions of eight sub-Saharan African countries. The results indicate that the availability of land for energy production ranges ...

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

153

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

Energy Technology Data Exchange (ETDEWEB)

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

NONE

2012-02-15

154

The national determinants of deforestation in sub-Saharan Africa.  

Science.gov (United States)

For decades, the dynamics of tropical deforestation in sub-Saharan Africa (SSA) have defied easy explanation. The rates of deforestation have been lower than elsewhere in the tropics, and the driving forces evident in other places, government new land settlement schemes and industrialized agriculture, have largely been absent in SSA. The context and causes for African deforestation become clearer through an analysis of new, national-level data on forest cover change for SSA countries for the 2000-2005 period. The recent dynamic in SSA varies from dry to wet biomes. Deforestation occurred at faster rates in nations with predominantly dry forests. The wetter Congo basin countries had lower rates of deforestation, in part because tax receipts from oil and mineral industries in this region spurred rural to urban migration, declines in agriculture and increased imports of cereals from abroad. In this respect, the Congo basin countries may be experiencing an oil and mineral fuelled forest transition. Small farmers play a more important role in African deforestation than they do in southeast Asia and Latin America, in part because small-scale agriculture remains one of the few livelihoods open to rural peoples. PMID:23878341

Rudel, Thomas K

2013-07-22

155

The national determinants of deforestation in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

For decades, the dynamics of tropical deforestation in sub-Saharan Africa (SSA) have defied easy explanation. The rates of deforestation have been lower than elsewhere in the tropics, and the driving forces evident in other places, government new land settlement schemes and industrialized agriculture, have largely been absent in SSA. The context and causes for African deforestation become clearer through an analysis of new, national-level data on forest cover change for SSA countries for the 2000-2005 period. The recent dynamic in SSA varies from dry to wet biomes. Deforestation occurred at faster rates in nations with predominantly dry forests. The wetter Congo basin countries had lower rates of deforestation, in part because tax receipts from oil and mineral industries in this region spurred rural to urban migration, declines in agriculture and increased imports of cereals from abroad. In this respect, the Congo basin countries may be experiencing an oil and mineral fuelled forest transition. Small farmers play a more important role in African deforestation than they do in southeast Asia and Latin America, in part because small-scale agriculture remains one of the few livelihoods open to rural peoples.

Rudel TK

2013-01-01

156

Exploring changes in open defecation prevalence in sub-Saharan Africa based on national level indices.  

UK PubMed Central (United Kingdom)

BACKGROUND: In sub-Saharan Africa, it is estimated that 215 million people continue to engage in open defecation. This practice facilitates the transmission of diarrheal diseases - one of the leading causes of mortality in children under 5 in sub-Saharan Africa. The main purpose of this study is to: estimate changes in open defecation prevalence between 2005 and 2010 across countries in sub-Saharan Africa; examine the association between national level indices and changes in open defecation prevalence; and assess how many countries can achieve 'open defecation free status' by 2015. METHODS: After applying selection criteria, this study analyzed country-level data for 34 sub-Saharan African countries. Seven country-level indices were collected: 1) presence of a national sanitation policy; 2) budget line for sanitation; 3) budget allocated to sanitation; 4) annual per capita GDP; 5) GDP growth; 6) implementation of total sanitation approaches; and 7) per capita aid disbursement for water supply and sanitation. The relationships between these country-level indices and the change in open defecation from 2005 to 2010 were investigated using Wilcoxon Signed-Rank test and Spearman's rank correlation test. RESULTS: Only 3 countries (i.e. Ethiopia, Angola and Sao Tome and Principe) decreased open defecation by 10% or more between 2005 and 2010. No significant associations were observed between the change in open defecation prevalence and all of national level indices except per capita aid disbursement. Per capita aid disbursement for water and sanitation was positively associated with a reduction in open defecation (p-value?=?0.02) for a subset of 29 low-income countries from 2005 to 2010. Only one country in our analysis, Angola, is on track to end open defecation by 2015 based on their performance between 2000 and 2010. CONCLUSIONS: Most of the national level indices, including a country's economic status, were not associated with the change in the open defecation prevalence. Based on current trends, the goal of ending open defecation in the majority of sub-Saharan African countries by 2015 will not be achieved. Our findings may be limited by the exploratory nature of this analysis, and future research is required to identify and characterize national level factors specific to reducing open defecation in sub-Saharan Africa.

Galan DI; Kim SS; Graham JP

2013-01-01

157

The Impacts of Technology Adoption on Smallholder Agricultural Productivity in Sub-Saharan Africa: A Review  

Directory of Open Access Journals (Sweden)

Full Text Available This paper is a review article on the impacts of technology adoption on agricultural productivity in smallholder agriculture in the sub-Saharan African region. The use of agricultural technologies determines how the increase in agricultural output impacts on poverty levels and environmental degradation. Experience and evidence from countries within and around the sub-Saharan African region indicate that returns to agricultural technology development could be very high and far reaching. The factors affecting technology adoption are assets, income, institutions, vulnerability, awareness, labour, and innovativeness by smallholder farmers. Technologies that require few assets, have a lower risk premium, and are less expensive have a higher chance of being adopted by smallholder farmers. There are certain traditional smallholder agricultural technologies in sub-Saharan Africa that also have their own merits. Some of these technologies are more efficient in their use of scarce production resources than modern technologies. Modern researchers should therefore seek to understand the rationale behind traditional smallholder farmer behaviour in technology use. This will make their future technological interventions in smallholder agriculture more effective.

Washington Muzari; Wirimayi Gatsi; Shepherd Muvhunzi

2012-01-01

158

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

DEFF Research Database (Denmark)

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

Kluth, Michael Friederich

2013-01-01

159

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

UK PubMed Central (United Kingdom)

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

Kernif T; Djerbouh A; Mediannikov O; Ayach B; Rolain JM; Raoult D; Parola P; Bitam I

2012-12-01

160

Does the Orphan Disadvantage "Spill Over?" An analysis of whether living in an area with a higher concentration of orphans is associated with children's school enrollment in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

BACKGROUND: Despite considerable concern regarding the social consequences of sub-Saharan Africa's high orphan prevalence, no research investigates how living in a community densely populated with orphans is more broadly associated with children's-including nonorphans'-acquisition of human capital. OBJECTIVE: We provide a new look at the implications of widespread orphanhood in sub-Saharan Africa by examining whether living in an area with a high concentration of orphans is associated with children's likelihood of school enrollment. METHODS: We use data from the Demographic and Health Survey (DHS) and the Multiple Indicators Cluster Survey (MICS) to estimate multilevel logistic regression models to assess whether living in a setting with a higher concentration of orphans is associated with school enrollment among 383,010 children in 336 provinces in 34 sub-Saharan African countries. RESULTS: Orphan concentration has a curvilinear association with children's school enrollment in western and eastern Africa: the initially positive association becomes negative at higher levels. In central and southern Africa, orphan concentration has a positive linear association with children's school enrollment. CONCLUSION: In western and eastern Africa, the negative association between living in a setting more densely populated with orphans and children's school enrollment provides suggestive evidence that the orphan disadvantage "spills over" in the communities most heavily affected. Conversely, in central and southern Africa, the positive association between living in a setting more densely populated with orphans and children's school enrollment highlights the resiliency of these relatively wealthier communities with high levels of orphans. Although longitudinal research is needed to confirm these findings and clarify the underlying mechanisms, this study lays the groundwork for a new body of research aimed at understanding the broader social implications of widespread orphanhood in sub-Saharan Africa.

Smith-Greenaway E; Heckert J

2013-06-01

 
 
 
 
161

Modelling HIV/AIDS epidemics in sub-Saharan Africa using seroprevalence data from antenatal clinics  

Directory of Open Access Journals (Sweden)

Full Text Available OBJECTIVE: To improve the methodological basis for modelling the HIV/AIDS epidemics in adults in sub-Saharan Africa, with examples from Botswana, Central African Republic, Ethiopia, and Zimbabwe. Understanding the magnitude and trajectory of the HIV/AIDS epidemic is essential for planning and evaluating control strategies. METHODS: Previous mathematical models were developed to estimate epidemic trends based on sentinel surveillance data from pregnant women. In this project, we have extended these models in order to take full advantage of the available data. We developed a maximum likelihood approach for the estimation of model parameters and used numerical simulation methods to compute uncertainty intervals around the estimates. FINDINGS: In the four countries analysed, there were an estimated half a million new adult HIV infections in 1999 (range: 260 to 960 thousand), 4.7 million prevalent infections (range: 3.0 to 6.6 million), and 370 thousand adult deaths from AIDS (range: 266 to 492 thousand). CONCLUSION: While this project addresses some of the limitations of previous modelling efforts, an important research agenda remains, including the need to clarify the relationship between sentinel data from pregnant women and the epidemiology of HIV and AIDS in the general population.

Salomon Joshua A.; Murray Christopher J.L.

2001-01-01

162

Neoliberal Globalization and the Politics of Migration in Sub-Saharan Africa  

Directory of Open Access Journals (Sweden)

Full Text Available Over the last few decades, many states in sub-Saharan Africa have adopted draconian anti-migrant policies, leaving refugees and migrants vulnerable to violence, harassment, and economic exploitation. These policies represent a shift from the relatively hospitable attitude shown by many African nations in the immediate post-colonial period. Explanations at the local level do not adequately explain the pervasiveness of these changes or why many developing states are now replicating the migration discourse and practices of the global north. Drawing on scholarship and data from a number of states in the region, including Tanzania, Kenya, Ghana, and South Africa, this paper argues that owing to the widespread implementation of neoliberal economic policies, these states are now subject to many of the same incentives and constraints that operate in the developed north. As a result, political parties and business elites have used national migration policy as an instrument for enhancing their political and economic positions. Insofar as neoliberal globalization continues to exacerbate inequality within the developing world, the harsh measures taken by governments of developing countries against their refugee and migrant populations are likely to increase. It is therefore important that scholars of migration and human rights begin to reassess the prevailing, nearly exclusive emphasis in many globalization studies on the dehumanizing policies and exploitation of southern migrants by states in the global north, as such an emphasis risks obscuring the emergence of more complex patterns of migration and anti-migrant practices in the developing world.

Saul Tobias

2012-01-01

163

The Altruistic Motive of Remittances: A Panel Data Analysis of Economies in Sub Saharan Africa  

Directory of Open Access Journals (Sweden)

Full Text Available Remittances have become an important source of foreign exchange earnings in many countries as migrants continue to send income to relatives at home. However, the main motives for sending remittances remain controversial. This paper examines the relative importance of the socio-political and economic determinants of remittance inflow using an unbalance panel data of 36 economies in the Sub Saharan African Region in an attempt to assess the altruistic motive of remittance inflow. The results using a random effect estimation technique show that altruism is important for remitting, as the per capita income differential between host and home country and the age dependency ratio are positive and statistically significant. The level of per capita income of the home country is also found to be negative and statistically significant which also supports the altruistic motive of remittances. The results further suggest that the development of the financial sector and the proportion of Catholics in the population will encourage remittance inflow. These results are robust to the different specifications and estimation methodology.

Dobdinga Cletus Fonchamnyo

2012-01-01

164

Epidemiology of glaucoma in sub-saharan Africa: prevalence, incidence and risk factors.  

UK PubMed Central (United Kingdom)

PURPOSE: The purpose of this study is to review the epidemiology of different types of glaucoma relevant to Sub-Saharan Africa (SSA) and to discuss the evidence regarding the risk factors for onset and progression of glaucoma, including risk factors for glaucoma blindness. METHODS: Electronic databases (PubMed, MedLine, African Journals Online- AJOL) were searched using the full text, Medical Subject Headings (MeSH) terms, author(s) and title to identify publications since 1982 in the following areas: population-based glaucoma prevalence and incidence studies in SSA and in African-derived black populations outside Africa; population-based prevalence and incidence of blindness and visual impairment studies in SSA including rapid assessment methods, which elucidate the glaucoma-specific blindness prevalence; studies of risk factors for glaucoma; and publications that discussed public health approaches for the control of glaucoma in Africa. RESULTS: Studies highlighted that glaucoma in SSA is a public health problem and predominantly open-angle glaucoma. It is the second-leading cause of blindness, has a high prevalence, an early onset and progresses more rapidly than in Caucasians. These factors are further compounded by poor awareness and low knowledge about glaucoma even by persons affected by the condition. CONCLUSION: Glaucoma care needs to be given high priority in Vision 2020 programs in Africa. Many questions remain unanswered and there is a need for further research in glaucoma in SSA in all aspects especially epidemiology and clinical care and outcomes involving randomized controlled trials. Genetic and genome-wide association studies may aid identification of high-risk groups. Social sciences and qualitative studies, health economics and health systems research will also enhance public health approaches for the prevention of blindness due to glaucoma.

Kyari F; Abdull MM; Bastawrous A; Gilbert CE; Faal H

2013-04-01

165

Challenges confronting the health workforce in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

Sub-Saharan Africa and the international health community face a daunting challenge to deal with an extraordinary disease burden and improve the health status of Africans. Despite decades of effort to provide effective, equitable and affordable health care services, the health indices of Africans have stagnated and in some instances have deteriorated. Africa is the only continent that has not fully benefited from recent advances in biomedical sciences that brought health tools and technologies to tackle most of the disease burden. The emergence of the HIV/AIDS epidemic has confounded the health scene and posed further challenges. Several factors are responsible for this state of affairs: macro factors, that represent the broader socio-cultural environment that impact on health, and micro factors, which are largely health sector specific. There is increasing recognition that the major limiting factor to improved health outcomes is not lack of financial resources or health technologies but the lack of implementation capacity which depends on the presence of a functional health system. The drivers and architects of this are health workers, 'the most important of the health system's input'. The Commission on Macroeconomics and Health advocates a greatly increased investment in health rising in low income countries to a per capita expenditure of US $34 per year and states that the problem in implementing this recommendation is not difficulty in raising funds but the capacity of the health sector itself to absorb the increased flow. Yet, until fairly recently sufficient attention has not been directed to the role of the health workforce. The failure to develop and deploy an appropriate and motivated health workforce, and the environment necessary for the workforce to perform optimally is clearly a critical determinant of the health status of Africans. This paper summarizes key issues facing the workforce and outlines a framework to develop strategies to address them.

Habte D; Dussault G; Dovlo D

2004-01-01

166

Mycotoxins in food systems in Sub Saharan Africa: A review.  

Science.gov (United States)

Mycotoxins, toxic secondary metabolites of fungi are now recognised as major cause of food intoxications in Sub Saharan Africa (SSA). Aflatoxins, the most important of the group have been implicated in acute aflatoxicoses, carcinogenicity, growth retardation, neonatal jaundice and immunological suppression in SSA. The hot and humid tropical climate provides ideal condition for growth of toxigenicAspergillus spp, making food contamination to be widespread in SSA, with maize and groundnuts being the most contaminated. The available data suggests that cassava products (the most important African food) are not prone to aflatoxin contamination. Recent data on ochratoxin A produced by species ofAspergillus on grains have indicated the necessity for it to be monitored in SSA. Fumonisins represent the most importantFusarium mycotoxins in SSA, and surveillance data indicate very high contamination rates of almost 100% in maize samples from West Africa. Limited information exists on the occurrence of trichothecenes, while the data currently available suggest that zearalenone contamination seems not to be a problem in SSA. The strategies under investigation to mitigate the mycotoxin problem in SSA include education of the people on the danger of consuming mouldy foods, pre and post harvest management strategies with emphasis on biological control, use of plant products to arrest fungal growth during storage, enterosorbent clay technology, and the search for traditional techniques that could reduce/detoxify mycotoxins during food processing. PMID:23605662

Bankole, S; Schollenberger, M; Drochner, W

2006-09-01

167

Extra-couple HIV transmission in sub-Saharan Africa: a mathematical modelling study of survey data.  

UK PubMed Central (United Kingdom)

BACKGROUND: The proportion of heterosexual HIV transmission in sub-Saharan Africa that occurs within cohabiting partnerships, compared with that in single people or extra-couple relationships, is widely debated. We estimated the proportional contribution of different routes of transmission to new HIV infections. As plans to use antiretroviral drugs as a strategy for population-level prevention progress, understanding the importance of different transmission routes is crucial to target intervention efforts. METHODS: We built a mechanistic model of HIV transmission with data from Demographic and Health Surveys (DHS) for 2003-2011, of 27,201 cohabiting couples (men aged 15-59 years and women aged 15-49 years) from 18 sub-Saharan African countries with information about relationship duration, age at sexual debut, and HIV serostatus. We combined this model with estimates of HIV survival times and country-specific estimates of HIV prevalence and coverage of antiretroviral therapy (ART). We then estimated the proportion of recorded infections in surveyed cohabiting couples that occurred before couple formation, between couple members, and because of extra-couple intercourse. FINDINGS: In surveyed couples, we estimated that extra-couple transmission accounted for 27-61% of all HIV infections in men and 21-51% of all those in women, with ranges showing intercountry variation. We estimated that in 2011, extra-couple transmission accounted for 32-65% of new incident HIV infections in men in cohabiting couples, and 10-47% of new infections in women in such couples. Our findings suggest that transmission within couples occurs largely from men to women; however, the latter sex have a very high-risk period before couple formation. INTERPRETATION: Because of the large contribution of extra-couple transmission to new HIV infections, interventions for HIV prevention should target the general sexually active population and not only serodiscordant couples. FUNDING: US National Institutes of Health, US National Science Foundation, and J S McDonnell Foundation.

Bellan SE; Fiorella KJ; Melesse DY; Getz WM; Williams BG; Dushoff J

2013-05-01

168

Readmission and death after an acute heart failure event: predictors and outcomes in sub-Saharan Africa: results from the THESUS-HF registry.  

UK PubMed Central (United Kingdom)

AIMS: Contrary to elderly patients with ischaemic-related acute heart failure (AHF) typically enrolled in North American and European registries, patients enrolled in the sub-Saharan Africa Survey of Heart Failure (THESUS-HF) were middle-aged with AHF due primarily to non-ischaemic causes. We sought to describe factors prognostic of re-admission and death in this developing population. METHODS AND RESULTS: Prognostic models were developed from data collected on 1006 patients enrolled in THESUS-HF, a prospective registry of AHF patients in 12 hospitals in nine sub-Saharan African countries, mostly in Nigeria, Uganda, and South Africa. The main predictors of 60-day re-admission or death in a model excluding the geographic region were a history of malignancy and severe lung disease, admission systolic blood pressure, heart rate and signs of congestion (rales), kidney function (BUN), and echocardiographic ejection fraction. In a model including region, the Southern region had a higher risk. Age and admission sodium levels were not prognostic. Predictors of 180-day mortality included malignancy, severe lung disease, smoking history, systolic blood pressure, heart rate, and symptoms and signs of congestion (orthopnoea, peripheral oedema and rales) at admission, kidney dysfunction (BUN), anaemia, and HIV positivity. Discrimination was low for all models, similar to models for European and North American patients, suggesting that the main factors contributing to adverse outcomes are still unknown. CONCLUSION: Despite the differences in age and disease characteristics, the main predictors for 6 months mortality and combined 60 days re-admission and death are largely similar in sub-Saharan Africa as in the rest of the world, with some exceptions such as the association of the HIV status with mortality.

Sliwa K; Davison BA; Mayosi BM; Damasceno A; Sani M; Ogah OS; Mondo C; Ojji D; Dzudie A; Kouam Kouam C; Suliman A; Schrueder N; Yonga G; Ba SA; Maru F; Alemayehu B; Edwards C; Cotter G

2013-09-01

169

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

UK PubMed Central (United Kingdom)

Indigenous fruits constitute an important part in human diets in many sub-Saharan African countries, particularly in the rural areas and during droughts. In order to promote and expand the utilization of these fruits, knowledge on their nutritional composition is essential. This review presents the results of a literature research of the nutritional composition of 10 selected indigenous fruits from sub-Saharan Africa. Species were selected due to their current importance and future potential for nutrition, processing and cash income generation. Compositional data were compiled and mean values of components per species were calculated. Most papers were compiled for Adansonia digitata (26) and Dacryodes edulis (16), followed by Tamarindus indica (10), Balanites aegyptiaca (9), Sclerocarya birrea (9), Ziziphus mauritiana (9), Vitex doniana (7) and Irvingia gabonensis (5) and least for Uapaca kirkiana (3) and Syzygium guineense (3). Fruits were found to be mainly analysed for macronutrients and minerals. Vitamins - apart from vitamin C - were rarely reported. Substantial compositional differences were found among as well as within the different fruit species. The results of this study emphasize the need for generating more high quality data for a wider spectrum of components of the selected indigenous fruits in sub-Saharan Africa.

Stadlmayr B; Charrondière UR; Eisenwagen S; Jamnadass R; Kehlenbeck K

2013-04-01

170

Assessing and forecasting groundwater development costs in Sub-Saharan Africa  

Scientific Electronic Library Online (English)

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

Xenarios, Stefanos; Pavelic, Paul

2013-01-01

171

Trichinella infections in animals and humans in sub-Saharan Africa: a review.  

UK PubMed Central (United Kingdom)

The aim of this review is to provide information on Trichinella infection in humans, livestock and wildlife in sub-Saharan Africa mainly focusing on geographical distribution of species/genotypes, biology, host range, life cycles and to identify research gaps. Trichinella britovi, Trichinella nelsoni and Trichinella zimbabwensis and one genotype (Trichinella T8) are known to occur in sub-Saharan Africa. Distinct geographic ranges with overlapping of some taxa in some areas have been observed. Genetic variants of T. nelsoni has been reported to occur among parasites originating from Eastern and Southern Africa and sequence heterogeneity also occurs among T. zimbabwensis isolates originating from different regions of Zimbabwe and South Africa. Field observations so far indicate that sylvatic Trichinella infections in the region are common in carnivores (mammals and reptiles) and to a lesser extent in omnivores. Cannibalism, scavenging and predation appear to be the most important routes of transmission and maintenance of the sylvatic cycles of the Trichinella taxa. To date, human trichinellosis has been documented in only four sub-Saharan countries (8.7%, 4/46). Bushpigs and warthogs have been the source of human infection with T. britovi and T. nelsoni being the aetiological agents. An increase in bushmeat trade and the creation of Transfrontier Conservation Areas (TFCAs) may have increased the risk of human trichinellosis in the region. With the creation of TFCAs in the region, sampling of wildlife hosts from protected areas of most sub-Sahara African countries is required to fully map the distribution of Trichinella species/genotypes in this region. More structured field surveys are still needed to determine the sylvatic host distribution of the different Trichinella taxa. Biological data of the Trichinella taxa in both wild and domestic animals of sub-Saharan Africa is very limited and further research is required.

Mukaratirwa S; La Grange L; Pfukenyi DM

2013-01-01

172

Trichinella infections in animals and humans in sub-Saharan Africa: a review.  

Science.gov (United States)

The aim of this review is to provide information on Trichinella infection in humans, livestock and wildlife in sub-Saharan Africa mainly focusing on geographical distribution of species/genotypes, biology, host range, life cycles and to identify research gaps. Trichinella britovi, Trichinella nelsoni and Trichinella zimbabwensis and one genotype (Trichinella T8) are known to occur in sub-Saharan Africa. Distinct geographic ranges with overlapping of some taxa in some areas have been observed. Genetic variants of T. nelsoni has been reported to occur among parasites originating from Eastern and Southern Africa and sequence heterogeneity also occurs among T. zimbabwensis isolates originating from different regions of Zimbabwe and South Africa. Field observations so far indicate that sylvatic Trichinella infections in the region are common in carnivores (mammals and reptiles) and to a lesser extent in omnivores. Cannibalism, scavenging and predation appear to be the most important routes of transmission and maintenance of the sylvatic cycles of the Trichinella taxa. To date, human trichinellosis has been documented in only four sub-Saharan countries (8.7%, 4/46). Bushpigs and warthogs have been the source of human infection with T. britovi and T. nelsoni being the aetiological agents. An increase in bushmeat trade and the creation of Transfrontier Conservation Areas (TFCAs) may have increased the risk of human trichinellosis in the region. With the creation of TFCAs in the region, sampling of wildlife hosts from protected areas of most sub-Sahara African countries is required to fully map the distribution of Trichinella species/genotypes in this region. More structured field surveys are still needed to determine the sylvatic host distribution of the different Trichinella taxa. Biological data of the Trichinella taxa in both wild and domestic animals of sub-Saharan Africa is very limited and further research is required. PMID:23041114

Mukaratirwa, Samson; La Grange, Louis; Pfukenyi, Davies M

2012-10-05

173

[Will climate and demography have a major impact on malaria in sub-Saharan Africa in the next 20 years?  

UK PubMed Central (United Kingdom)

The purpose of this review of the literature is to present factors possibly affecting the spread of malaria in sub-Saharan Africa over the next 20 years. Malaria is a vector-borne disease that depends on environmental and human constraints. The main environmental limitations involve susceptibility of the vector (mosquitoes of the Anopheles genus) and parasite (Plasmodium falciparum) to climate. Malaria is a stable, endemic disease over most of the African continent. Climatic change can only affect a few regions on the fringes of stable zones (e.g. altitude areas or Sahel) where malaria is an unstable, epidemic disease. Higher temperatures could induce a decrease of malaria transmission in regions of the Sahel or an increase in the highlands. The extent of these overall trends will depend on the unpredictable occurrence of major meteorological phenomenon as well as on human activities affecting the environment that could lead to dramatic but limited outbreaks in some locations. The most influential human factors could be runaway demographic growth and urban development. Estimations based on modeling studies indicate that urbanization will lead to a 53.5% drop in exposure to malaria by 2030. However this reduction could be less than expected because of adaptation of Anopheles gambiae and An. arabiensis, the main vectors of malaria in sub-Saharan Africa, to the urban environment as well as increasing vector resistance to insecticides. Another unforeseeable factor that could induce unexpected malaria epidemics is mass migration due to war or famine. Finally immunosuppressive illnesses (e.g. HIV and malnutrition) could alter individual susceptibility to malaria. Social constraints also include human activities that modify land use. In this regard land use (e.g. forest clearance and irrigation) is known to influence the burden of malaria that is itself dependent on local determinants of transmission. Overall the most important social constraint for the population will be access to malarial prevention and implementation action to control this scourge.

Saugeon C; Baldet T; Akogbeto M; Henry MC

2009-04-01

174

Sexually transmitted infections in an African migrant population in Portugal: A baseline study  

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Full Text Available Background: For geographical and recent historic reasons, Portugal is a gateway and home for immigration from sub-Saharan countries. Misconceptions related to these populations often lead to consider them as high-frequency clusters for dissemination of sexually transmitted infections (STIs). Epidemiological evidence-based data is needed to elucidate these issues and baseline prevalence studies are the starting point for this.Methodology: A prospective study was conducted in 220 African migrants (171 men and 49 women), recently arrived in Portugal, at the time of their first consultation. The presence of STIs was evaluated using a clinical syndromic approach and biological confirmation for gonorrhoea, Chlamydia trachomatis genital infection, syphilis, Hepatitis B and Human Immunodeficiency Virus (HIV) infection.Results: Global prevalence of the targeted infections were 1.8% for gonorrhoea, 0 % for Chlamydia infection, 4.1% for Syphilis, 5.9% for HBsAg presence and 7.3% for HIV infection. Globally, 16.4% of the studied persons had at least one sexually transmitted infection.Conclusions: We concluded that prevalence rates encountered in this population is similar to that of non-migrant Portuguese populations with a high risk for sexually transmitted diseases. Therefore migration from sub-Saharan Africa doesn’t seem to constitute a particularly critical isolated factor for public health risk of STIs in the community.

Luis Távora-Tavira, Rosa Teodósio, Jorge Seixas, Emília Prieto, Rita Castro, Filomena Exposto, Jorge Atouguia

2007-01-01

175

Reproductive inequality in sub-Saharan Africa: differentials versus concentration.  

UK PubMed Central (United Kingdom)

Within developing countries, our understanding of reproductive inequality-how fertility is distributed within a population-has been shaped largely by studies of fertility differentials, a practical but partial-information measure. In this study, we examine whether exclusive reliance on differentials biases this understanding. Findings based on recent data from sub-Saharan Africa show bias. We find that historical and especially cross-country comparisons can yield substantially different conclusions about the magnitude and even the direction of inequality patterns and trends, depending on whether differentials or fuller-information measures are used. For instance, the fertility differentials associated with education have remained relatively stable as national fertility has fallen, but inequality (as calculated by a fuller measure) has increased. Such results underscore the value of complementing existing studies of fertility differentials with analyses based on fuller-information measures. The analyses also show how change in differential fertility behavior and in the educational composition of national populations has shaped recent variations in reproductive inequality in the region.

Giroux SC; Eloundou-Enyegue PM; Lichter DT

2008-09-01

176

[African population in history].  

Science.gov (United States)

The growth rate of the African population has been fluctuating throughout history, affected by political, social, and economic events. 6000 years ago, the majority of the population was based in North Africa, because farming had been developed there. However, between the 11th and the 16th centuries, there was a constant decline in the population of that region, due to invasions from Europe and the black plague. During the same period, the population in the area south of the Sahara grew rapidly, as people there had gone into the iron tool period and farming had been developed. From the 16th to the mid-17th Century, population growth was considerable in Africa; more people had learned the technology of irrigation, corn and potatoes had been introduced from South America, and colonialism was not yet an issue. From the mid-17th to the mid-19th Century, there was no growth, due to the slave trade and wars between tribes. One estimate sets the direct and indirect loss during this period, as a result of the slave trade, at 100 million people. From the 1850s to the end of World War I, population growth started up again, chiefly influenced by the fact that the slave trade had essentially come to a half and modern medical care had become available on the continent. However, in central Africa, the region which suffered the worst blow from the slave trade, growth was very slow, while in East Africa the population was declining because of wars between colonists and natives, as well as natural disasters. Increases in population during this period were a result of immigration from Europe and India. From the end of World War I to the present, growth has been rapid, given improvements in medical services and standards of living, while most of the former colonies became independent after the 1950s. Consequently, almost all African countries are under great pressure now with regard to their populations. PMID:12159345

Yang, S

1984-11-29

177

[Malaria and HIV infection in subSaharan Africa: another match made in hell?].  

UK PubMed Central (United Kingdom)

Malaria and HIV are the most important infections in subSaharan Africa, in terms of the morbidity and mortality they cause. Current data suggest a possible interaction between the two diseases. Cellular immunodeficiency due to HIV infection might increase the frequency and severity of malaria, as local populations in endemic areas become less resistant. Likewise, the onset and repetition of malaria episodes might activate HIV replication and thus decrease the number of CD4 lymphocytes and accelerate the disease course. Despite their geographical coincidence, the epidemiological profiles of malaria and HIV differ considerably. The entanglement of these two diseases has epidemiological, clinical and therapeutic consequences in subSaharan Africa that raise concerns that HIV with malaria, as with tuberculosis, is a match made in Hell.

Aoussi EF; Tanon KA; Ehui E; Ouattara SI; Inwoley KA; Adoubryn KD; Eholié SP; Bissagnéné E

2011-07-01

178

The effects of public and private health care expenditure on health status in sub-Saharan Africa: new evidence from panel data analysis.  

UK PubMed Central (United Kingdom)

UNLABELLED: BACKGROUND: Health care expenditure has been low over the years in developing regions of the world. A majority of countries in these regions, especially sub-Saharan Africa (SSA), rely on donor grants and loans to finance health care. Such expenditures are not only unsustainable but also inadequate considering the enormous health care burden in the region. The objectives of this study are to determine the effect of health care expenditure on population health status and to examine the effect by public and private expenditure sources. METHODS: The study used panel data from 1995 to 2010 covering 44 countries in SSA. Fixed and random effects panel data regression models were fitted to determine the effects of health care expenditure on health outcomes. RESULTS: The results show that health care expenditure significantly influences health status through improving life expectancy at birth, reducing death and infant mortality rates. Both public and private health care spending showed strong positive association with health status even though public health care spending had relatively higher impact. CONCLUSION: The findings imply that health care expenditure remains a crucial component of health status improvement in sub-Saharan African countries. Increasing health care expenditure will be a significant step in achieving the Millennium Development Goals. Further, policy makers need to establish effective public-private partnership in allocating health care expenditures.

Novignon J; Olakojo SA; Nonvignon J

2012-01-01

179

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

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

Young Fiona; Critchley Julia A; Johnstone Lucy K; Unwin Nigel C

2009-01-01

180

Plio-Pleistocene history and phylogeography of Acacia senegal in dry woodlands and savannahs of sub-Saharan tropical Africa: evidence of early colonisation and recent range expansion.  

UK PubMed Central (United Kingdom)

Drylands are extensive across sub-Saharan Africa, socio-economically and ecologically important yet highly sensitive to environmental changes. Evolutionary history, as revealed by contemporary intraspecific genetic variation, can provide valuable insight into how species have responded to past environmental and population changes and guide strategies to promote resilience to future changes. The gum arabic tree (Acacia senegal) is an arid-adapted, morphologically diverse species native to the sub-Saharan drylands. We used variation in nuclear sequences (internal transcribed spacer (ITS)) and two types of chloroplast DNA (cpDNA) markers (PCR-RFLP, cpSSR) to study the phylogeography of the species with 293 individuals from 66 populations sampled across its natural range. cpDNA data showed high regional and rangewide haplotypic diversity (h(T(cpSSR))=0.903-0.948) and population differentiation (G(ST(RFLP))=0.700-0.782) with a phylogeographic pattern that indicated extensive historical gene flow via seed dispersal. Haplotypes were not restricted to any of the four varieties, but showed significant geographic structure (G(ST(cpSSR))=0.392; R(ST)=0.673; R(ST)>R(ST) (permuted)), with the major division separating East and Southern Africa populations from those in West and Central Africa. Phylogenetic analysis of ITS data indicated a more recent origin for the clade including West and Central African haplotypes, suggesting range expansion in this region, possibly during the Holocene humid period. In conjunction with paleobotanical evidence, our data suggest dispersal to West Africa, and across to the Arabian Peninsula and Indian subcontinent, from source populations located in the East African region during climate oscillations of the Plio-Pleistocene.

Odee DW; Telford A; Wilson J; Gaye A; Cavers S

2012-12-01

 
 
 
 
181

The contribution of international health volunteers to the health workforce in sub-Saharan Africa  

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Full Text Available Abstract Background In this paper, we aim to quantify the contribution of international health volunteers to the health workforce in sub-Saharan Africa and to explore the perceptions of health service managers regarding these volunteers. Methods Rapid survey among organizations sending international health volunteers and group discussions with experienced medical officers from sub-Saharan African countries. Results We contacted 13 volunteer organizations having more than 10 full-time equivalent international health volunteers in sub-Saharan Africa and estimated that they employed together 2072 full-time equivalent international health volunteers in 2005. The numbers sent by secular non-governmental organizations (NGOs) is growing, while the number sent by development NGOs, including faith-based organizations, is mostly decreasing. The cost is estimated at between US$36 000 and US$50 000 per expatriate volunteer per year. There are trends towards more employment of international health volunteers from low-income countries and of national medical staff. Country experts express more negative views about international health volunteers than positive ones. They see them as increasingly paradoxical in view of the existence of urban unemployed doctors and nurses in most countries. Creating conditions for employment and training of national staff is strongly favoured as an alternative. Only in exceptional circumstances is sending international health volunteers viewed as a defendable temporary measure. Conclusion We estimate that not more than 5000 full-time equivalent international health volunteers were working in sub-Saharan Africa in 2005, of which not more than 1500 were doctors. A distinction should be made between (1) secular medical humanitarian NGOs, (2)development NGOs, and (3) volunteer organizations, as Voluntary Service Overseas (VSO) and United Nations volunteers (UNV). They have different views, undergo different trends and are differently appreciated by government officials. International health volunteers contribute relatively small numbers to the health workforce in sub-Saharan Africa, and it seems unlikely that they will do more in the future. In areas where they play a role, their contribution to service delivery is sometimes very significant.

Laleman Geert; Kegels Guy; Marchal Bruno; Van der Roost Dirk; Bogaert Isa; Van Damme Wim

2007-01-01

182

Reproductive health and family planning needs among HIV-infected women in Sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Review key topics and recent literature regarding reproductive health and family planning needs for HIV-infected women in Sub-Saharan Africa. METHODS: Electronic searches performed in PubMed, JSTOR, and Web of Science; identified articles reviewed for inclusion. FINDINGS: Most HIV-infected women in Sub-Saharan Africa bear children, and access to antiretroviral therapy may increase childbearing desires and/or fertility, resulting in greater need for contraception. Most contraceptive options can be safely and effectively used by HIV-infected women. Unmet need for contraception is high in this population, with 66- 92% of women reporting not wanting another child (now or ever), but only 20-43% using contraception. During pregnancy and delivery, HIV-infected women need access to prevention of mother-to-child transmission (PMTCT) services, a skilled birth attendant, and quality post-partum care to prevent HIV infection in the infant and maximize maternal health. Providers may lack resources as well as appropriate training and support to provide such services to women with HIV. Innovations in biomedical and behavioral interventions may improve reproductive healthcare for HIV-infected women, but in Sub-Saharan Africa, models of integrating HIV and PMTCT services with family planning and reproductive health services will be important to improve reproductive outcomes. CONCLUSIONS: HIV-infected women in Sub-Saharan Africa have myriad needs related to reproductive health, including access to high-quality family planning information and options, high-quality pregnancy care, and trained providers. Integrated services that help prevent unintended pregnancy and optimize maternal and infant health before, during and after pregnancy will both maximize limited resources as well as provide improved reproductive outcomes.

Sarnquist CC; Rahangdale L; Maldonado Y

2013-03-01

183

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

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

Brian-Vincent IKEJIAKU

2009-01-01

184

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

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

E. Jane Morris

2011-01-01

185

Waist circumference does not predict circulating adiponectin levels in sub-Saharan women  

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Full Text Available Abstract Background Because of previously reported ethnic differences in determinants and markers of obesity and related metabolic disorders, we sought to investigate circulating levels of adiponectin and their correlates in a sub-Saharan African (sSA) population. Subjects and Methods We studied 70 non-diabetic volunteers (33M/37F) living in Yaoundé, Cameroon, aged 24–69 yr, with BMI 20–42 kg/m2. In all participants we measured waist circumference and total body fat by bioimpedance, and obtained a fasting venous blood sample for measurement of plasma glucose, serum insulin and adiponectin concentrations. We performed a euglycaemic hyperinsulinaemic clamp in 1/4 subjects, and HOMAIR was used as surrogate of fasting insulin sensitivity index since it best correlates to clamp measurements. Results Males had lower adiponectin levels than females (8.8 ± 4.3 vs. 11.8 ± 5.5 ?g/L). There was no significant correlation between adiponectin and total body fat (rs = -0.03; NS), whereas adiponectin was inversely correlated with waist circumference (rs = -0.39; p = 0.001). Adiponectin correlated negatively with insulin resistance (rs = -0.35; p = 0.01). In a regression analysis using fasting adiponectin concentration as the dependent variable, and age, HOMAIR, waist circumference, and fat mass as predictors, waist circumference (? = -3.30; p = 0.002), fat mass (? = -2.68; p = 0.01), and insulin resistance (? = -2.38; p = 0.02) but not age (? = 1.11; p = 0.27) were independent predictors of adiponectin. When considering gender, these relations persisted with the exception of waist circumference in females. Conclusion Adiponectin correlates in this study population are comparable to those observed in Caucasians with the exception of waist circumference in women. The metabolic significance of waist circumference is therefore questioned in sSA women.

Sobngwi Eugène; Effoe Valery; Boudou Philippe; Njamen Dieudonné; Gautier Jean-François; Mbanya Jean-Claude

2007-01-01

186

Women's empowerment and ideal family size: an examination of DHS empowerment measures in Sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

CONTEXT: The Demographic and Health Survey (DHS) program collects data on women's empowerment, but little is known about how these measures perform in Sub-Saharan African countries. It is important to understand whether women's empowerment is associated with their ideal number of children and ability to limit fertility to that ideal number in the Sub-Saharan African context. METHODS: The analysis used couples data from DHS surveys in four Sub-Saharan African countries: Guinea, Mali, Namibia and Zambia. Women's empowerment was measured by participation in household decision making, attitudes toward wife beating and attitudes toward refusing sex with one's husband. Multivariable linear regression was used to model women's ideal number of children, and multivariable logistic regression was used to model women's odds of having more children than their ideal. RESULTS: In Guinea and Zambia, negative attitudes toward wife beating were associated with having a smaller ideal number of children (beta coefficients, -0.5 and -0.3, respectively). Greater household decision making was associated with a smaller ideal number of children only in Guinea (beta coefficient, -0.3). Additionally, household decision making and positive attitudes toward women's right to refuse sex were associated with elevated odds of having more children than desired in Namibia and Zambia, respectively (odds ratios, 2.3 and 1.4); negative attitudes toward wife beating were associated with reduced odds of the outcome in Mali (0.4). CONCLUSIONS: Women's empowerment--as assessed using currently available measures--is not consistently associated with a desire for smaller families or the ability to achieve desired fertility in these Sub-Saharan African countries. Further research is needed to determine what measures are most applicable for these contexts.

Upadhyay UD; Karasek D

2012-06-01

187

[Sociocultural aspects of albinism in Sub-Saharan Africa: mutilations and ritual murders committed in east Africa (Burundi and Tanzania)  

UK PubMed Central (United Kingdom)

This report presents an overview of the many sociocultural prejudices confronting albinos and their parents in Sub-Saharan Africa at each stage of life (infancy, adolescence, and adulthood). The birth of an albino child to two black parents has always been an enigma for African peoples. French-speaking and English-speaking populations in Central, East and South African countries have invented numerous myths to account for this event. Albinos are believed to possess good and evil magical powers. On the white magic side, some organs are believed to confer luck, health, and prosperity. For this reason albinos in Tanzania and Burundi are still in 2008 prey to ritual murders and mutilations to obtain various body parts such as arms, legs, and genitals for preparation of amulets. This barbaric and iniquitous practice has been severely condemned by authorities in both countries as well as by the European Parliament. To end these atrocities disseminating accurate medical information explaining the genetic basis of albinism will be necessary to eliminate ignorance and superstition.

Aquaron R; Djatou M; Kamdem L

2009-10-01

188

Pharmacogenomics of warfarin in populations of African descent.  

UK PubMed Central (United Kingdom)

Warfarin is the most commonly prescribed oral anticoagulant worldwide despite its narrow therapeutic index and the notorious inter- and intra-individual variability in dose required for the target clinical effect. Pharmacogenetic polymorphisms are major determinants of warfarin pharmacokinetic and dynamics and included in several warfarin dosing algorithms. This review focuses on warfarin pharmacogenomics in sub-Saharan peoples, African Americans and admixed Brazilians. These 'Black' populations differ in several aspects, notably their extent of recent admixture with Europeans, a factor which impacts on the frequency distribution of pharmacogenomic polymorphisms relevant to warfarin dose requirement for the target clinical effect. Whereas a small number of polymorphisms in VKORC1 (3673G > A, rs9923231), CYP2C9 (alleles *2 and *3, rs1799853 and rs1057910, respectively) and arguably CYP4F2 (rs2108622), may capture most of the pharmacogenomic influence on warfarin dose variance in White populations, additional polymorphisms in these, and in other, genes (e.g. CALU rs339097) increase the predictive power of pharmacogenetic warfarin dosing algorithms in the Black populations examined. A personalized strategy for initiation of warfarin therapy, allowing for improved safety and cost-effectiveness for populations of African descent must take into account their pharmacogenomic diversity, as well as socio-economical, cultural and medical factors. Accounting for this heterogeneity in algorithms that are 'friendly' enough to be adopted by warfarin prescribers worldwide requires gathering information from trials at different population levels, but demands also a critical appraisal of racial/ethnic labels that are commonly used in the clinical pharmacology literature but do not accurately reflect genetic ancestry and population diversity.

Suarez-Kurtz G; Botton MR

2013-02-01

189

Developing and Deploying OERs in sub-Saharan Africa: Building on the Present  

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Full Text Available Open educational resources (OERs) have the potential to reduce costs, improve quality, and increase access to educational opportunities. OER development and deployment is one path that could contribute to achieving education for all. This article builds on existing information and communication technology (ICT) implementation plans in Africa and on the experiences of organizations and initiatives such as the African Virtual University (AVU), OER Africa, the South African Institute of Distance Education (SAIDE), and the Teacher Education in Sub-Saharan Africa (TESSA) Project, to present one view of the benefits, challenges, and steps that could be taken to realize the potential of OERs in sub-Saharan Africa. Thus, the article focuses on the factors necessary for creating and sustaining a vision for OER development and deployment; developing and distributing resources with an open license; improving technology infrastructure and reducing the cost of Internet access; establishing communities of educational collaborators; sustaining involvement in the OER initiative; producing resources in interoperable and open formats; establishing and maintaining the quality of OERs; providing local context to address national and regional needs and conditions; informing the public about OERs; and taking the initiative to build on the knowledge, skills, and experiences of others. In order to assist educators and decision makers, links to a variety of resources are provided.

Clayton R. Wright; Sunday A. Reju

2012-01-01

190

Factors associated to infant mortality in Sub-Saharan Africa  

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Full Text Available Half of the 10 million children who die annually in the world are from Sub-Saharan Africa (SSA). The reasons are known, but lack of will and resources avoid the development of sustainable policies. Associated factors to the high infant mortality rate (IMR) in SSA have been investigated in this research. An ecological multi-group study was designed comparing rates within SSA. The dependent variable is the IMR and health services, economic and development indicators are the independent variables. Information and data sources were WHO, World Bank, UNICEF and UNDP (1997-2007). IMR mean value is 92.2 (per 1000 live births) and a relationship with several of the factors could be observed. In the bi-variate analysis direct relationship was observed with maternal mortality rate and an inverse relationship was observed with prenatal care coverage, births assisted by skilled health personnel, gross national income per capita, per capita government expenditure on health, social security expenditure, adult literacy rate, net primary school enrolment rate, population with access to safe drinking water (in urban and rural areas) and with population with access to basic sanitation in rural areas. In the multi-variate analysis IMR had an inverse relationship with children under 5 years with diarrhoea who receive oral re-hydration, with social security expenditure as percentage of general government expenditure on health and with per capita government expenditure on health. The situation in SSA would change if their inhabitants received education and information to demand more equitable polices and better investments from their governments.

Pablo Viguera Ester; Alberto Torres; José M. Freire; Valentín Hernández; Ángel Gil

2011-01-01

191

Diabetes in Sub Saharan Africa 1999-2011: Epidemiology and public health implications. a systematic review  

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Full Text Available Abstract Background Diabetes prevalence is increasing globally, and Sub-Saharan Africa is no exception. With diverse health challenges, health authorities in Sub-Saharan Africa and international donors need robust data on the epidemiology and impact of diabetes in order to plan and prioritise their health programmes. This paper aims to provide a comprehensive and up-to-date review of the epidemiological trends and public health implications of diabetes in Sub-Saharan Africa. Methods We conducted a systematic literature review of papers published on diabetes in Sub-Saharan Africa 1999-March 2011, providing data on diabetes prevalence, outcomes (chronic complications, infections, and mortality), access to diagnosis and care and economic impact. Results Type 2 diabetes accounts for well over 90% of diabetes in Sub-Saharan Africa, and population prevalence proportions ranged from 1% in rural Uganda to 12% in urban Kenya. Reported type 1 diabetes prevalence was low and ranged from 4 per 100,000 in Mozambique to 12 per 100,000 in Zambia. Gestational diabetes prevalence varied from 0% in Tanzania to 9% in Ethiopia. Proportions of patients with diabetic complications ranged from 7-63% for retinopathy, 27-66% for neuropathy, and 10-83% for microalbuminuria. Diabetes is likely to increase the risk of several important infections in the region, including tuberculosis, pneumonia and sepsis. Meanwhile, antiviral treatment for HIV increases the risk of obesity and insulin resistance. Five-year mortality proportions of patients with diabetes varied from 4-57%. Screening studies identified high proportions (> 40%) with previously undiagnosed diabetes, and low levels of adequate glucose control among previously diagnosed diabetics. Barriers to accessing diagnosis and treatment included a lack of diagnostic tools and glucose monitoring equipment and high cost of diabetes treatment. The total annual cost of diabetes in the region was estimated at US$67.03 billion, or US$8836 per diabetic patient. Conclusion Diabetes exerts a significant burden in the region, and this is expected to increase. Many diabetic patients face significant challenges accessing diagnosis and treatment, which contributes to the high mortality and prevalence of complications observed. The significant interactions between diabetes and important infectious diseases highlight the need and opportunity for health planners to develop integrated responses to communicable and non-communicable diseases.

Hall Victoria; Thomsen Reimar W; Henriksen Ole; Lohse Nicolai

2011-01-01

192

Improvement of pathology in sub-Saharan Africa.  

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In the coming decades, cancer will be a major clinical and public health issue in sub-Saharan Africa. However, clinical and public health infrastructure and services in many countries are not positioned to deal with the growing cancer burden. Pathology is a core service required to serve many needs related to cancer in sub-Saharan Africa. Cancer diagnosis, treatment, and research all depend on adequate pathology. Pathology is also necessary for cancer registration, which is needed to accurately estimate cancer incidence and mortality. Cancer registry data directly guide policy-makers' decisions for cancer control and the allocation of clinical and public health services. Despite the centrality of pathology in many components of cancer care and control, countries in sub-Saharan Africa have at best a tenth of the pathology coverage of that in high-income countries. Equipment, processes, and services are lacking, and there is a need for quality assurance for the definition and implementation of high-quality, accurate diagnosis. Training and advocacy for pathology are also needed. We propose approaches to improve the status of pathology in sub-Saharan Africa to address the needs of patients with cancer and other diseases.

Adesina A; Chumba D; Nelson AM; Orem J; Roberts DJ; Wabinga H; Wilson M; Rebbeck TR

2013-04-01

193

Peculiarities of the Digital Divide in Sub-Saharan Africa  

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

Mutula, Stephen M.

2005-01-01

194

The EU's Military Operations in Sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This report deals with four selected EU military operations in Sub-Saharan Africa. It includes an analysis the operations from a neorealist perspective and a normative power perspective. In the neorealist perspective France seems to be the main actor in the operations, because of their colonial past...

Deis, Nadia; Jansler, Nicklas

195

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

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

Fatch W. Kalembo; Du Yukai; Maggie Zgambo; Qiu Jun

2012-01-01

196

Rapid urban malaria appraisal (RUMA) in sub-Saharan Africa  

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

Wang Shr-Jie; Lengeler Christian; Smith Thomas A; Vounatsou Penelope; Cissé Guéladio; Diallo Diadie A; Akogbeto Martin; Mtasiwa Deo; Teklehaimanot Awash; Tanner Marcel

2005-01-01

197

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2011-07-01

198

Public opinion and support for government AIDS policies in sub-Saharan Africa.  

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Based on data from Afrobarometer's 2008-2009 public opinion surveys in 20 sub-Saharan African states, this article examines the extent of support for government AIDS policies. While many international and nongovernmental organizations have criticized African governments for failing to implement comprehensive HIV/AIDS policies, survey data shows that citizens have generally positive assessments of their governments' responses. The findings demonstrate that support for a government's AIDS policies arises less from demographic characteristics and more from experiences with and perceptions of the government's capabilities. In particular, those in better economic circumstances and those who approve of the president's job performance show particularly strong support for their government's AIDS policies. This may suggest that leaders are exhibiting the political will necessary to implement holistic AIDS policies and receiving support for them, but it may also suggest respondents are not differentiating between support for the government as a whole and support for particular policy areas. PMID:22133585

Youde, Jeremy

2011-11-17

199

Public opinion and support for government AIDS policies in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

Based on data from Afrobarometer's 2008-2009 public opinion surveys in 20 sub-Saharan African states, this article examines the extent of support for government AIDS policies. While many international and nongovernmental organizations have criticized African governments for failing to implement comprehensive HIV/AIDS policies, survey data shows that citizens have generally positive assessments of their governments' responses. The findings demonstrate that support for a government's AIDS policies arises less from demographic characteristics and more from experiences with and perceptions of the government's capabilities. In particular, those in better economic circumstances and those who approve of the president's job performance show particularly strong support for their government's AIDS policies. This may suggest that leaders are exhibiting the political will necessary to implement holistic AIDS policies and receiving support for them, but it may also suggest respondents are not differentiating between support for the government as a whole and support for particular policy areas.

Youde J

2012-01-01

200

End of life care in sub-Saharan Africa: a systematic review of the qualitative literature  

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Full Text Available Abstract Background End of life (EoL) care in sub-Saharan Africa still lacks the sound evidence-base needed for the development of effective, appropriate service provision. It is essential to make evidence from all types of research available alongside clinical and health service data, to ensure that EoL care is ethical and culturally appropriate. This article aims to synthesize qualitative research on EoL care in sub-Saharan Africa to inform policy, practice and further research. It seeks to identify areas of existing research; describe findings specifically relevant to the African context; and, identify areas lacking evidence. Methods Relevant literature was identified through eight electronic databases: AMED, British Nursing Index & Archive, CINAHL, EMBASE, IBSS, MEDLINE, PsycINFO, and the Social Sciences Citation Index; and hand searches. Inclusion criteria were: published qualitative or mixed-method studies in sub-Saharan Africa, about EoL care. Study quality was assessed using a standard grading scale. Relevant data including findings and practice recommendations were extracted and compared in tabular format. Results Of the 407 articles initially identified, 51 were included in the qualitative synthesis. Nineteen came from South Africa and the majority (38) focused on HIV/AIDS. Nine dealt with multiple or unspecified conditions and four were about cancer. Study respondents included health professionals, informal carers, patients, community members and bereaved relatives. Informal carers were typically women, the elderly and children, providing total care in the home, and lacking support from professionals or the extended family. Twenty studies focused on home-based care, describing how programmes function in practice and what is needed to make them effective. Patients and carers were reported to prefer institutional care but this needs to be understood in context. Studies focusing on culture discussed good and bad death, culture-specific approaches to symptoms and illness, and the bereavement process. Conclusions The data support or complement the findings from quantitative research. The review prompts a reconsideration of the assumption that in Africa the extended family care for the sick, and that people prefer home-based care. The review identifies areas relevant for a research agenda on socio-cultural issues at the EoL in sub-Saharan Africa.

Gysels Marjolein; Pell Christopher; Straus Lianne; Pool Robert

2011-01-01

 
 
 
 
201

Experiences of leadership in health care in sub-Saharan Africa  

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

Curry Leslie; Taylor Lauren; Chen Peggy; Bradley Elizabeth

2012-01-01

202

The paediatric surgeon and his working conditions in Francophone sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

BACKGROUND: This study described the current conditions of work of paediatric surgeons in Francophone sub-Saharan Africa (FSSA) and set the debate at the level of the humanist thinking in medicine. PATIENTS AND METHODS: This was a multicentre study from 1 st May to 30 th October 2008. The African Society of paediatric surgeons' directory was used to identify paediatric surgeons in the Francophone's countries in Sub Saharan Africa. The parameters studied were number of surgeons per country, means of training, working conditions, remunerations, needs for continuous training and the research. RESULTS: A total of 41 paediatric surgeons (68.33%) responded. The average number of paediatric surgeons per country was 5. The means of training included government scholarships among 7 paediatric surgeons (17.07%), scholarship from a non-governmental organisations in 14 (34.15%) and self-sponsorships in 20 (48.78%). The average salary was 450 Euros (€) (range: 120-1 400 Euros). Most of the paediatric surgeons (68.29%) had internet services for continuous update courses and research. Thirty six paediatric surgeons (87.80%) had no subscription to specialised scientific journals. CONCLUSION: The paediatric surgeon in FSSA faces many problems related to his working and living conditions that may have a negative impact on their competences.

Gnassingbé K; Tekou H; da Silva-Anoma S; Akakpo-Numado GK; Aguehounde C; Dick R; Bankole R; Abarchi H; Wandaogo A; Ouattara O; Kouame DB; N'Doye M

2011-09-01

203

Assessing sub-Saharan Erythrina for efficacy: traditional uses, biological activities and phytochemistry.  

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The genus Erythrina comprises more than 100 species, widely distributed in tropical and subtropical areas. In Africa, 31 wild species and 14 cultivated species have been described. In sub-Saharan Africa, Erythrina species are used to treat frequent parasitic and microbial diseases, inflammation, cancer, wounds. The rationale of these traditional uses in African traditional medicine was established by screening several species for biological activities. Promising activities were found against bacteria, parasites (Plasmodium), human and phytopathogenic fungi, some of which were multidrug resistant (MDR) micro organisms. Some species also exhibited antioxidant, anti-inflammatory activities and enzymes inhibitory properties. Most of the species chemically investigated were reported to contain flavanones, prenylated isoflavones, isoflavanones and pterocarpans. Some phytochemicals (vogelin B, vogelin C, isowightcone, abyssinin II, derrone) were the active principles as antibacterials, antifungals, antiplasmodials and inhibitors of enzyme borne diseases (PTP1B, HIV protease, DGAT). This review highlights the important role of Erythrina species as sources of lead compounds or new class of phytotherapeutic agents for fighting against major public health (MDR infections, cancer, diabetes, obesity) in sub-Saharan Africa. PMID:22097091

Kone, Witabouna Mamidou; Solange, Kakou-Ngazoa E; Dosso, Mireille

2011-05-15

204

Assessing sub-Saharan Erythrina for efficacy: traditional uses, biological activities and phytochemistry.  

UK PubMed Central (United Kingdom)

The genus Erythrina comprises more than 100 species, widely distributed in tropical and subtropical areas. In Africa, 31 wild species and 14 cultivated species have been described. In sub-Saharan Africa, Erythrina species are used to treat frequent parasitic and microbial diseases, inflammation, cancer, wounds. The rationale of these traditional uses in African traditional medicine was established by screening several species for biological activities. Promising activities were found against bacteria, parasites (Plasmodium), human and phytopathogenic fungi, some of which were multidrug resistant (MDR) micro organisms. Some species also exhibited antioxidant, anti-inflammatory activities and enzymes inhibitory properties. Most of the species chemically investigated were reported to contain flavanones, prenylated isoflavones, isoflavanones and pterocarpans. Some phytochemicals (vogelin B, vogelin C, isowightcone, abyssinin II, derrone) were the active principles as antibacterials, antifungals, antiplasmodials and inhibitors of enzyme borne diseases (PTP1B, HIV protease, DGAT). This review highlights the important role of Erythrina species as sources of lead compounds or new class of phytotherapeutic agents for fighting against major public health (MDR infections, cancer, diabetes, obesity) in sub-Saharan Africa.

Kone WM; Solange KN; Dosso M

2011-05-01

205

Evaluating the Impact of ICT-tools on Health Care Delivery in Sub-Saharan Hospitals.  

UK PubMed Central (United Kingdom)

This research explores to what extent Information and Communication Technology (ICT)-based information management methods can help to improve efficiency and effectiveness of health services in sub-Saharan hospitals and how clinical information can be made available for secondary use enabling non-redundant reporting of health- and care performance indicators. In the course of a 6 years research effort between 2006 and 2012, it was demonstrated that patient identification, financial management and structured reporting improved dramatically after implementation of well adapted ICT-tools in a set of 19 African health facilities. Real-time financial management metrics helped hospitals to quickly identify fraudulent practices and defective invoicing procedures. Out-patient case load significantly increased compared to the national average, average length of stay has been shortened in 15 of 19 health facilities and global hospital mortality decreased. Hospital workforce-evaluated impact of hospital information system implementation on local working conditions and quality of care was very positive. It was demonstrated that local sub-Saharan health professionals strongly believe in the importance of health information systems.

Verbeke F; Karara G; Nyssen M

2013-01-01

206

The blood supply in Sub-Saharan Africa: Needs, challenges, and solutions.  

UK PubMed Central (United Kingdom)

Sub-Saharan Africa (SSA) is burdened with a growing population and poor health care resources. Transfusion medicine is uniquely affected for SSA as a result of a combination of factors which put tremendous pressure on the blood supply. In this review, we consider these factors including: malaria, sickle cell anemia, transfusion medicine infrastructure, and past transfusion medicine policies including those which are tied to foreign aid, such as a VNRD-only practice. We also consider how SSA can overcome some of these hurdles to achieve a safe and adequate blood supply for its people through the advent of new vaccines, medications, infrastructure development, policy changes, and education.

Lund TC; Hume H; Allain JP; McCullough J; Dzik W

2013-07-01

207

[Premature fertility in Sub-Saharan Africa].  

Science.gov (United States)

Results of research and intervention programs have convinced a majority of African decision makers of the desirability of reducing the number of births to very young mothers. But many families, especially in rural areas, continue to value early marriage and childbearing. In Niger, for example, the 1992 Demographic and Health Survey indicated that 47% of women currently aged 20-24 years had entered a union before the age of 15 and 87% by the age of 18. 53% had children before they reached 18. Early pregnancy within marriage is seldom regarded as a problem, and is often welcomed by the girl as a proof of fecundity. Attitudes toward premarital pregnancy, on the other hand, depend greatly on the social context. In Islamic areas, where all premarital sexual relations are frowned upon, families favor very early marriage as a means of preventing extramarital pregnancy. In groups undergoing transition to modern norms, pregnancy is viewed as a problem when it interrupts the mother's school attendance, and mothers are subjected to stigmatizing and moralistic sanctions. A more objective approach is to consider the social and health implications of early pregnancy rather than viewing it as the transgression of a norm. Health studies have clearly demonstrated the dangers of pregnancy for adolescents who have not achieved their full growth and the risks of illegal abortion. Motherhood is a great handicap to training and employment of young girls. Family planning programs have made avoidance of early pregnancy a priority. The Demographic and Health Surveys and other studies over the past fifteen years have greatly increased knowledge of adolescent fertility and of entry into adult life including marriage, but some confusion persists regarding the concept of adolescent fertility. Statistical data should distinguish between very young mothers and those over about 18 years, when most have reached physiological maturity. The marital status of the young mother should also be taken into account. Most African countries with data available from more than one survey appear to have experienced a trend toward decline in the number of very early marriages and pregnancies. Such declines as have occurred are probably the result of urbanization and school attendance rather than any specific policy measure. Programs targeted to adolescents should distinguish between the risks of early pregnancy and of premarital fertility. Increased attention should be directed to rural women who marry and have children at very young ages. PMID:12178204

Locoh, T

1994-01-01

208

IPPs in Sub-Saharan Africa: Determinants of success  

Energy Technology Data Exchange (ETDEWEB)

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

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

2011-09-15

209

Greenhouse gas emissions in Sub-Saharan Africa  

Energy Technology Data Exchange (ETDEWEB)

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

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

1990-11-01

210

Vaccination for typhoid fever in Sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

New data on the epidemiologic, clinical and microbiologic aspects of typhoid fever in sub-Saharan Africa call for new strategies and new resources to bring the regional epidemic under control. Areas with endemic disease at rates approaching those in south Asia have been identified; large, prolonged and severe outbreaks are occurring more frequently; and resistance to antimicrobial agents, including fluoroquinolones is increasing. Surveillance for typhoid fever is hampered by the lack of laboratory resources for rapid diagnosis, culture confirmation and antimicrobial susceptibility testing. Nonetheless, in 2010, typhoid fever was estimated to cause 725 incident cases and 7 deaths per 100,000 person years in sub-Saharan Africa. Efforts for prevention and outbreak control are challenged by limited access to safe drinking water and sanitation and by a lack of resources to initiate typhoid immunization. A comprehensive approach to typhoid fever prevention including laboratory and epidemiologic capacity building, investments in water, sanitation and hygiene and reconsideration of the role of currently available vaccines could significantly reduce the disease burden. Targeted vaccination using currently available typhoid vaccines should be considered as a short- to intermediate-term risk reduction strategy for high-risk groups across sub-Saharan Africa.

Slayton RB; Date KA; Mintz ED

2013-04-01

211

Effect of variable transmission rate on the dynamics of HIV in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

BACKGROUND: The cause of the high HIV prevalence in sub-Saharan Africa is incompletely understood, with heterosexual penile-vaginal transmission proposed as the main mechanism. Heterosexual HIV transmission has been estimated to have a very low probability; but effects of cofactors that vary in space and time may substantially alter this pattern. METHODS: To test the effect of individual variation in the HIV infectiousness generated by co-infection, we developed and analyzed a mathematical sexual network model that simulates the behavioral components of a population from Malawi, as well as the dynamics of HIV and the co-infection effect caused by other infectious diseases, including herpes simplex virus type-2, gonorrhea, syphilis and malaria. RESULTS: The analysis shows that without the amplification effect caused by co-infection, no epidemic is generated, and HIV prevalence decreases to extinction. But the model indicates that an epidemic can be generated by the amplification effect on HIV transmission caused by co-infection. CONCLUSION: The simulated sexual network demonstrated that a single value for HIV infectivity fails to describe the dynamics of the epidemic. Regardless of the low probability of heterosexual transmission per sexual contact, the inclusion of individual variation generated by transient but repeated increases in HIV viral load associated with co-infections may provide a biological basis for the accelerated spread of HIV in sub-Saharan Africa. Moreover, our work raises the possibility that the natural history of HIV in sub-Saharan Africa cannot be fully understood if individual variation in infectiousness is neglected.

Cuadros DF; Crowley PH; Augustine B; Stewart SL; García-Ramos G

2011-01-01

212

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

Directory of Open Access Journals (Sweden)

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

Andre Pascal Kengne; Anastase Dzudie; Eugene Sobngwi

2008-01-01

213

Importance of ethnicity, CYP2B6 and ABCB1 genotype for efavirenz pharmacokinetics and treatment outcomes: a parallel-group prospective cohort study in two sub-Saharan Africa populations.  

UK PubMed Central (United Kingdom)

OBJECTIVES: We evaluated the importance of ethnicity and pharmacogenetic variations in determining efavirenz pharmacokinetics, auto-induction and immunological outcomes in two African populations. METHODS: ART naïve HIV patients from Ethiopia (n?=?285) and Tanzania (n?=?209) were prospectively enrolled in parallel to start efavirenz based HAART. CD4+ cell counts were determined at baseline, 12, 24 and 48 weeks. Plasma and intracellular efavirenz and 8-hydroxyefvairenz concentrations were determined at week 4 and 16. Genotyping for common functional CYP2B6, CYP3A5, ABCB1, UGT2B7 and SLCO1B1 variant alleles were done. RESULT: Patient country, CYP2B6*6 and ABCB1 c.4036A>G (rs3842A>G) genotype were significant predictors of plasma and intracellular efavirenz concentration. CYP2B6*6 and ABCB1 c.4036A>G (rs3842) genotype were significantly associated with higher plasma efavirenz concentration and their allele frequencies were significantly higher in Tanzanians than Ethiopians. Tanzanians displayed significantly higher efavirenz plasma concentration at week 4 (p<0.0002) and week 16 (p?=?0.006) compared to Ethiopians. Efavirenz plasma concentrations remained significantly higher in Tanzanians even after controlling for the effect of CYP2B6*6 and ABCB1 c.4036A>G genotype. Within country analyses indicated a significant decrease in the mean plasma efavirenz concentration by week 16 compared to week 4 in Tanzanians (p?=?0.006), whereas no significant differences in plasma concentration over time was observed in Ethiopians (p?=?0.84). Intracellular efavirenz concentration and patient country were significant predictors of CD4 gain during HAART. CONCLUSION: We report substantial differences in efavirenz pharmacokinetics, extent of auto-induction and immunologic recovery between Ethiopian and Tanzanian HIV patients, partly but not solely, due to pharmacogenetic variations. The observed inter-ethnic variations in efavirenz plasma exposure may possibly result in varying clinical treatment outcome or adverse event profiles between populations.

Ngaimisi E; Habtewold A; Minzi O; Makonnen E; Mugusi S; Amogne W; Yimer G; Riedel KD; Janabi M; Aderaye G; Mugusi F; Bertilsson L; Aklillu E; Burhenne J

2013-01-01

214

[African agriculture faced with global changes: researches and innovations based on ecological sciences].  

UK PubMed Central (United Kingdom)

In the context of environmental and socio-economic changes, the agriculture of Sub-Saharan African countries will have to ensure food security of the population, while reducing its environmental footprint. The biophysical and social systems of agricultural production are complex. Innovative agricultural practices will be based on an intensification of ecological processes that determine the functioning of the soil-plant system, farmers' fields and agro-ecosystems. This ecological engineering approach is useful to take up the challenge of Sub-Saharan agricultures in the future, as shown in researches conducted by IESOL International Joint Lab "Intensification of agricultural soils in West Africa" (ISRA, UCAD, TU, OU, INERA, IRD).

Masse D; Ndour Badiane Y; Hien E; Akpo LÉ; Assigbetsé K; Bilgo A; Diédhiou I; Hien V; Lardy L

2013-05-01

215

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

UK PubMed Central (United Kingdom)

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

Uchudi J; Magadi M; Mostazir M

2012-05-01

216

The impact of HIV-1 on the malaria parasite biomass in adults in sub-Saharan Africa contributes to the emergence of antimalarial drug resistance  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background HIV-related immune-suppression increases the risk of malaria (infection, disease and treatment failure) and probably the circulating parasite biomass, favoring the emergence of drug resistance parasites. Methods The additional malaria parasite biomass related to HIV-1 co-infection in sub-Saharan Africa was estimated by a mathematical model. Parasite biomass was computed as the incidence rate of clinical malaria episodes multiplied by the number of parasites circulating in the peripheral blood of patients at the time symptoms appear. A mathematical model estimated the influence of HIV-1 infection on parasite density in clinical malaria by country and by age group, malaria transmission intensity and urban/rural area. In a multivariate sensitivity analysis, 95% confidence intervals (CIs) were calculated using the Monte Carlo simulation. Results The model shows that in 2005 HIV-1 increased the overall malaria parasite biomass by 18.0% (95%CI: 11.6–26.9). The largest relative increase (134.9–243.9%) was found in southern Africa where HIV-1 prevalence is the highest and malaria transmission unstable. The largest absolute increase was found in Zambia, Malawi, the Central African Republic and Mozambique, where both malaria and HIV are highly endemic. A univariate sensitivity analysis shows that estimates are sensitive to the magnitude of the impact of HIV-1 infection on the malaria incidence rates and associated parasite densities. Conclusion The HIV-1 epidemic by increasing the malaria parasite biomass in sub-Saharan Africa may also increase the emergence of antimalarial drug resistance, potentially affecting the health of the whole population in countries endemic for both HIV-1 and malaria.

Van geertruyden Jean-Pierre; Menten Joris; Colebunders Robert; Korenromp Eline; D'Alessandro Umberto

2008-01-01

217

Programme science research on medical male circumcision scale-up in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

Three randomised trials demonstrate that voluntary medical male circumcision (MMC) reduces male HIV acquisition by 50-60%, and post-trial surveillance has shown that the effects are long lasting. Scale-up of services has been initiated in 14 high-priority sub-Saharan African countries with high rates of HIV and low prevalence of MMC. However, circumcision coverage in the region remains low. Challenges to MMC rollout include suboptimal demand among higher-risk men, the need to expand access and reduce costs of MMC through personnel task shifting and task sharing, assuring and maintaining a high quality of service provision, and the testing and introduction of non-surgical devices. In addition, early infant male circumcision has not been adequately evaluated in Africa. Here, we describe challenges to implementation and discuss the ongoing and future role of implementation and programme science in addressing such challenges.

Gray RH; Wawer MJ; Kigozi G

2013-08-01

218

The adjustment of curricula in veterinary faculties in sub-Saharan Africa.  

Science.gov (United States)

A survey was conducted by questionnaire to assess the current undergraduate curricula in the veterinary faculties of sub-Saharan Africa. The survey also examined how such curricula are adjusted for crucial developments in the veterinary field, such as privatisation, decentralisation and globalisation, with the increasing risk of transboundary diseases. The results demonstrate that most of these faculties face serious shortages, both in their budgets and of qualified personnel. Most faculties do not have formal feedback systems to allow former graduates to contribute to periodic reviews of the curricula. Although some north-south and south-south collaboration exists among African veterinary faculties, more intensive regional collaboration at both undergraduate and postgraduate level would allow optimal use of the available funds and human resources. The creation of a regional veterinary council and a committee of deans would be an excellent step forward in ensuring internationalisation and harmonisation of veterinary education and establishing a regional accreditation system. PMID:15200112

de Deken, R; Obwolo, M J; Thys, E; Geerts, S

2004-04-01

219

The adjustment of curricula in veterinary faculties in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

A survey was conducted by questionnaire to assess the current undergraduate curricula in the veterinary faculties of sub-Saharan Africa. The survey also examined how such curricula are adjusted for crucial developments in the veterinary field, such as privatisation, decentralisation and globalisation, with the increasing risk of transboundary diseases. The results demonstrate that most of these faculties face serious shortages, both in their budgets and of qualified personnel. Most faculties do not have formal feedback systems to allow former graduates to contribute to periodic reviews of the curricula. Although some north-south and south-south collaboration exists among African veterinary faculties, more intensive regional collaboration at both undergraduate and postgraduate level would allow optimal use of the available funds and human resources. The creation of a regional veterinary council and a committee of deans would be an excellent step forward in ensuring internationalisation and harmonisation of veterinary education and establishing a regional accreditation system.

de Deken R; Obwolo MJ; Thys E; Geerts S

2004-04-01

220

Programme science research on medical male circumcision scale-up in sub-Saharan Africa.  

Science.gov (United States)

Three randomised trials demonstrate that voluntary medical male circumcision (MMC) reduces male HIV acquisition by 50-60%, and post-trial surveillance has shown that the effects are long lasting. Scale-up of services has been initiated in 14 high-priority sub-Saharan African countries with high rates of HIV and low prevalence of MMC. However, circumcision coverage in the region remains low. Challenges to MMC rollout include suboptimal demand among higher-risk men, the need to expand access and reduce costs of MMC through personnel task shifting and task sharing, assuring and maintaining a high quality of service provision, and the testing and introduction of non-surgical devices. In addition, early infant male circumcision has not been adequately evaluated in Africa. Here, we describe challenges to implementation and discuss the ongoing and future role of implementation and programme science in addressing such challenges. PMID:23698513

Gray, Ronald H; Wawer, Maria J; Kigozi, Godfrey

2013-05-22

 
 
 
 
221

Celiac Disease: A Challenging Disease Uneasy to Diagnose in Sub-Saharan Africa  

Directory of Open Access Journals (Sweden)

Full Text Available AIM: Celiac disease is rarely described in sub-Saharan Africa.METHODS: From a series of 17 cases diagnosed between 2005and 2007 in Djibouti, we describe our diagnosis an managementdifficulties.RESULTS: African ethnics represented 64.7%. Sex ratio (F/M) is1.4, mean age 82 months, associated diseases in 47%. Anti-gliadine,anti-endomysium and anti-transglutaminase antibodies were positivein 100%, 66.6% and 100%. Upper digestive tract endoscopy wasrealized 4 times. Eleven patients (64.7%) began gluten free diet, 7recovered. Two patients died (11.7%).CONCLUSION: CD is difficult to diagnose for technical reasons.GFD is successful thanks to parental continuous medical education.

Diallo Ibrahima; Coton Thierry

2013-01-01

222

Power, politics and rehabilitation in sub-Saharan Africa: from the personal to the political.  

UK PubMed Central (United Kingdom)

This article discusses the complexities of facilitating community-based rehabilitation in resource-poor contexts in Sub-Saharan Africa. It does so through a reflection on the book Able-Bodied: Scenes from a Curious Life, written by Leslie Swartz, a South African expert on disability in the context of international development. Swartz uses his own personal experiences as son of a disabled father as a springboard for reflections on his long involvement in the often-fraught areas of disability research and activism. He pays particular attention to the way in which emotions shape the struggles around expertise and power that bedevil disability identity politics. In particular, his work highlights how the complex dynamics of race, class and disability undermine the effectiveness of the movement.

Campbell C

2011-01-01

223

Family planning outcomes and primary school attendance in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

This study examines the relationship between women's family planning outcomes and primary school enrollment among their 8-11-year-old children. We analyze household- and wider-context-level data for 103,000 children in 30 sub-Saharan African countries. Negative associations with school enrollment are found for those who have short preceding or succeeding birth intervals, a young sibling, or a mother who is pregnant. These findings remain unchanged after controlling for socioeconomic and demographic characteristics. Analysis of interaction effects shows that many associations with family planning outcomes depend on the context in which the household is living, revealing the importance of a situation-specific approach. Findings indicate that helping families improve their pregnancy planning will increase children's schooling opportunities and lead to more effective use of household and community resources.

Longwe A; Smits J

2012-06-01

224

Status epilepticus in sub-Saharan Africa: New findings.  

UK PubMed Central (United Kingdom)

Status epilepticus (SE) is common in sub-Saharan Africa, particularly in children. Most cases in children are caused by infections, particularly malaria in endemic areas. The outcome is worse than in the West, probably because of delays in initiating treatment, and lack of skills and facilities for the management of SE. However some of the causes, for example, falciparum malaria, offer challenges in the diagnosis and the treatment of SE. Exposure to falciparum malaria increases the risk of SE. Much of the SE in Africa could be prevented by reducing the incidence of infections. The outcome could be improved through education, development of locally appropriate guidelines, and provision of appropriate facilities.

Newton CR; Kariuki SM

2013-09-01

225

International Food Security: Insufficient Efforts by Host Governments and Donors Threaten Progress to Halve Hunger in Sub-Saharan Africa by 2015  

Canada Institute for Scientific and Technical Information (Canada)

Persistent food insecurity in sub-Saharan Africa is primarily due to several factors, including low agricultural productivity, limited rural development, government policy disincentives, and the impact of poor health on the agricultural workforce. Additional factors, including rising global commodity prices and climate change, will likely further exacerbate food insecurity in the region. The gap between the average grain yield in sub- Saharan Africa compared with the rest of the world's developing countries has widened over the years, and, by 2006, the yield in sub-Saharan Africa was only about 40 percent of that of the rest of the world s developing countries. Low agricultural productivity is due, in part, to the limited use of agricultural inputs, such as fertilizer and improved seed varieties, and the lack of modern farming practices. Poor roads and lack of access to credit make it difficult for farmers to effectively participate in local and regional markets to increase their income. Moreover, some government policies, such as high taxation on agriculture, have a negative impact on agricultural production and food security. For example, Tanzanian farmers must pay about 55 taxes, levies, and fees to sell their agricultural products, equivalent to 50 percent of the price the farmers receive. Poor health also exacerbates food insecurity in sub-Saharan Africa through its adverse impact on the agricultural workforce, according to panels in the four countries we visited. For example, the human immunodeficiency virus (HIV) has taken a heavy toll on the population and agricultural production of sub-Saharan Africa, because two thirds of those in the world who have HIV live in that region. In addition, rising global commodity prices and climate change will likely further exacerbate food insecurity in sub- Saharan Africa.

2008-01-01

226

The role of the healthcare sector in the prevention of sexual violence against sub-Saharan transmigrants in Morocco: a study of knowledge, attitudes and practices of healthcare workers.  

UK PubMed Central (United Kingdom)

BACKGROUND: Sub-Saharan transmigrants in Morocco are extremely vulnerable to sexual violence. From a public health perspective, the healthcare system is globally considered an important partner in the prevention of sexual violence. The aim of this study is twofold. In a first phase, we aimed to identify the current role and position of the Moroccan healthcare sector in the prevention of sexual violence against sub-Saharan transmigrants. In a second phase, we wanted these results and available guidelines to be the topic of a participatory process with local stakeholders in order to formulate recommendations for a more desirable prevention of sexual violence against sub-Saharan transmigrants by the Moroccan healthcare sector. METHODS: Knowledge, attitudes and practices of healthcare workers in Morocco concerning sexual violence against sub-Saharan transmigrants and its prevention were firstly explored in semi-structured interviews after which they were discussed in a participatory process resulting in the formulation of recommendations. RESULTS: All participants (n=24) acknowledged the need for desirable prevention of sexual violence against transmigrants. Furthermore, important barriers in tertiary prevention practices, i.e. psychosocial and judicial referral and long-term follow-up, and in secondary prevention attitudes, i.e. active identification of victims were identified. Moreover, existing services for Moroccan victims of sexual violence currently do not address the sub-Saharan population. Thus, transmigrants are bound to rely on the aid of civil society. CONCLUSIONS: This research demonstrates the low accessibility of existing Moroccan services for sub-Saharan migrants. In particular, there is an absence of prevention initiatives addressing sexual violence against the sub-Saharan transmigrant population. Although healthcare workers do wish to develop prevention initiatives, they are dealing with structural difficulties and a lack of expertise. Recommendations adapted to the context of sub-Saharan transmigrants in Morocco are suggested.

van den Ameele S; Keygnaert I; Rachidi A; Roelens K; Temmerman M

2013-01-01

227

Cataract Incidence in Sub-Saharan Africa: What does Mathematical Modeling tell us about Geographic Variations and Surgical Needs?  

UK PubMed Central (United Kingdom)

Abstract Purpose: To apply a previously described mathematical model, designed to estimate cataract incidence from age-specific prevalence, to Rapid Assess of Avoidable Blindness survey data from Sub-Saharan Africa in order to estimate the incidence of cataract and therefore surgical needs. Methods: All Rapid Assessment of Avoidable Blindness surveys from Sub-Saharan Africa were identified. A previously developed mathematical model, designed to estimate the incidence of operable cataract was applied to those (27/32) meeting the inclusion criteria. Results: Incidence varied significantly across the continent with the result that cataract surgery rate targets required to eliminate cataract vary too. When variation in age structure is also taken into account, the cataract surgery rate needed to eliminate cataract visual impairment at the level of 6/18 ranges from 1200-4500 surgeries per year per million population. Conclusions: This is important evidence of significant variation in the incidence of cataract within Sub-Saharan Africa. The variation may be related to genetic or cultural variations on the continent and has important implications for planning services.

Lewallen S; Courtright P; Etya'ale D; Mathenge W; Schmidt E; Oye J; Clark A; Williams T

2013-10-01

228

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

Scientific Electronic Library Online (English)

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

Gentil García, Isabel

2012-09-01

229

Health needs and public health functions addressed in scientific publications in Francophone sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To describe the reporting of public health research in Francophone sub-Saharan Africa (FSA). STUDY DESIGN: A bibliometric research study of scientific public health publications in FSA, which includes 24 countries and approximately 260 million people. METHODS: Two researchers analysed original articles published in 2007 in the medical or social sciences fields and indexed in Scopus. At least one co-author of articles had to be based in FSA. The analysis focused on research field, public health function (WHO classification), FSA country author's affiliation, language, journal type and global burden of disease (WHO classification). RESULTS: Of 1047 articles retrieved by the search, 212 were from the public health field. The number of articles per country varied from 0 to 36. Public health functions examined were health service research (24.5%), health monitoring (27.4%), prevention (15%) and legislation (0.5%). The distribution of health needs described in the articles was close to that of the WHO data for Africa for 2004: infectious and parasitic diseases (70% vs 54%), maternal and perinatal conditions (15% vs 17%), non-communicable diseases (15.6% vs 21%), and injuries (0.5% vs 8%). CONCLUSION: The areas reported in published articles from sub-Saharan Africa reflect the health needs distribution in Africa; however, the number of publications is low, particularly for prevention. In light of the current focus on evidence-based public health, this study questions whether the international scientific community adequately considers the expertise and perspectives of African researchers and professionals.

Benie-Bi J; Cambon L; Grimaud O; Kivits J; Alla F

2013-06-01

230

78 FR 22260 - Sub-Saharan Africa Advisory Committee of the Export-Import Bank of the United States (Ex-Im Bank...  

Science.gov (United States)

...EXPORT-IMPORT BANK Sub-Saharan Africa Advisory Committee of the Export-Import...Special Meeting SUMMARY: The Sub-Saharan Africa Advisory Committee was established by...financial commitments in Sub- Saharan Africa under the loan, guarantee, and...

2013-04-15

231

Effectiveness of antiretroviral therapy among HIV-infected children in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

Assessment of antiretroviral treatment programmes for HIV-infected children in sub-Saharan Africa is important to enable the development of effective care and improve treatment outcomes. We review the effectiveness of paediatric antiretroviral treatment programmes in sub-Saharan Africa and discuss the implications of these findings for the care and treatment of HIV-infected children in this region. Available reports indicate that programmes in sub-Saharan Africa achieve treatment outcomes similar to those in North America and Europe. However, progress in several areas is required to improve the care of HIV-infected children in sub-Saharan Africa. The findings emphasise the need for low-cost diagnostic tests that allow for earlier identification of HIV infection in infants living in sub-Saharan Africa, improved access to antiretroviral treatment programmes, including expansion of care into rural areas, and the integration of antiretroviral treatment programmes with other health-care services, such as nutritional support.

Sutcliffe CG; van Dijk JH; Bolton C; Persaud D; Moss WJ

2008-08-01

232

Improving Data Concerning Women's Empowerment in Sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

This study assesses the utility of Demographic and Health Survey (DHS) questions regarding women's empowerment in the context of sub-Saharan Africa. We examine the use of, and need for improvements to, women's empowerment data in Ghana, Mozambique, Senegal, and Uganda. Drawing on interviews conducted among gender and health experts and on context-specific literature, our findings reveal that although DHS data are widely used, data needs remain in five areas: economic empowerment, knowledge of legal rights and recourse, participation in decisionmaking, attitudes and social norms, and adolescent girls. We recommend that Demographic and Health Surveys be modified-for example, through adding specific survey items-to fulfill some but not all of these emerging women's empowerment data needs. We also suggest that other surveys fill known gaps and that data users carefully consider the meaning and relative weight of the women's empowerment items according to the cultural context in which the data are collected.

Heckert J; Fabic MS

2013-09-01

233

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background There may be need to assess intelligent quotient (IQ) scores in sub-Saharan African children with intellectual disability, either for the purpose of educational needs assessment or research. However, modern intelligence scales developed in the western parts of th...

Bakare Muideen O; Ubochi Vincent N; Okoroikpa Ifeoma N; Aguocha Chinyere M; Ebigbo Peter O

234

78 FR 24744 - Postponement Notice of Open Special Meeting of the Sub-Saharan Africa Advisory Committee of the...  

Science.gov (United States)

...Open Special Meeting of the Sub-Saharan Africa Advisory Committee of the Export-Import...Ex-Im Bank) SUMMARY: The Sub-Saharan Africa Advisory Committee was established by...financial commitments in Sub- Saharan Africa under the loan, guarantee, and...

2013-04-26

235

Hospital management practices and availability of surgery in sub-saharan Africa: a pilot study of three hospitals.  

UK PubMed Central (United Kingdom)

BACKGROUND: Sub-Saharan Africa has a high surgical burden of disease but performs a disproportionately low volume of surgery. Closing this surgical gap will require increased surgical productivity of existing systems. We examined specific hospital management practices in three sub-Saharan African hospitals that are associated with surgical productivity and quality. METHODS: We conducted 54 face-to-face, structured interviews with administrators, clinicians, and technicians at a teaching hospital, district hospital, and religious mission hospital across two countries in sub-Saharan Africa. Questions focused on recommended general management practices within five domains: goal setting, operations management, talent management, quality monitoring, and financial oversight. Records from each interview were analyzed in a qualitative fashion. Each hospital's management practices were scored according to the degree of implementation of the management practices (1 = none; 3 = some; 5 = systematic). RESULTS: The mission hospital had the highest number of employees per 100 beds (226), surgeons per operating room (3), and annual number of operations per operating room (1,800). None of the three hospitals had achieved systematic implementation of management practices in all 14 measures. The mission hospital had the highest total management score (44/70 points; average = 3.1 for each of the 14 measures). The teaching and district hospitals had statistically significantly lower management scores (average 1.3 and 1.1, respectively; p < .001). CONCLUSIONS: It is possible to meaningfully assess hospital management practices in low resource settings. We observed substantial variation in implementation of basic management practices at the three hospitals. Future research should focus on whether enhancing management practices can improve surgical capacity and outcomes.

Funk LM; Conley DM; Berry WR; Gawande AA

2013-11-01

236

Hospital Management Practices and Availability of Surgery in Sub-Saharan Africa: A Pilot Study of Three Hospitals.  

UK PubMed Central (United Kingdom)

BACKGROUND: Sub-Saharan Africa has a high surgical burden of disease but performs a disproportionately low volume of surgery. Closing this surgical gap will require increased surgical productivity of existing systems. We examined specific hospital management practices in three sub-Saharan African hospitals that are associated with surgical productivity and quality. METHODS: We conducted 54 face-to-face, structured interviews with administrators, clinicians, and technicians at a teaching hospital, district hospital, and religious mission hospital across two countries in sub-Saharan Africa. Questions focused on recommended general management practices within five domains: goal setting, operations management, talent management, quality monitoring, and financial oversight. Records from each interview were analyzed in a qualitative fashion. Each hospital's management practices were scored according to the degree of implementation of the management practices (1 = none; 3 = some; 5 = systematic). RESULTS: The mission hospital had the highest number of employees per 100 beds (226), surgeons per operating room (3), and annual number of operations per operating room (1,800). None of the three hospitals had achieved systematic implementation of management practices in all 14 measures. The mission hospital had the highest total management score (44/70 points; average = 3.1 for each of the 14 measures). The teaching and district hospitals had statistically significantly lower management scores (average 1.3 and 1.1, respectively; p < .001). CONCLUSIONS: It is possible to meaningfully assess hospital management practices in low resource settings. We observed substantial variation in implementation of basic management practices at the three hospitals. Future research should focus on whether enhancing management practices can improve surgical capacity and outcomes.

Funk LM; Conley DM; Berry WR; Gawande AA

2013-08-01

237

The social and gender context of HIV disclosure in sub-Saharan Africa: a review of policies and practices.  

UK PubMed Central (United Kingdom)

This paper reviews the legal and policy context of HIV disclosure in sub-Saharan Africa, as well as what is known about rates, consequences and social context of disclosure, with special attention to gender issues and the role of health services. Persistent rates of nondisclosure by those diagnosed with HIV raise difficult ethical, public health and human rights questions about how to protect the medical confidentiality, health and well-being of people living with HIV on the one hand, and how to protect partners and children from HIV transmission on the other. Both globally and within the sub-Saharan African region, a spate of recent laws, policies and programmes have tried to encourage or - in some cases - mandate HIV disclosure. These policies have generated ethical and policy debates. While there is consensus that the criminalization of transmission and nondisclosure undermines rights while serving little public health benefit, there is less clarity about the ethics of third party notification, especially in resource-constrained settings. Despite initiatives to encourage voluntary HIV disclosure and to increase partner testing in sub-Saharan Africa, health workers continue to grapple with difficult challenges in the face of nondisclosure, and often express a need for more guidance and support in this area. A large body of research indicates that gender issues are key to HIV disclosure in the region, and must be considered within policies and programmes. Taken as a whole, this evidence suggests a need for more attention to the challenges and dilemmas faced by both clients and providers in relation to HIV disclosure in this region and for continued efforts to consider the perspectives and rights of all those affected.

Bott S; Obermeyer CM

2013-07-01

238

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

Directory of Open Access Journals (Sweden)

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

Labonté Ronald; Packer Corinne; Klassen Nathan

2006-01-01

239

Environmental impact assessment practices in the sub-Saharan Africa: cases from Kenya  

Energy Technology Data Exchange (ETDEWEB)

The aim for this research is to review environmental impact assessment (EIA) practices in sub-Saharan Africa, drawing upon appropriate theoretical and methodological work on EIA. This study uses a comparative evaluation method to examine the extent of environmental impact assessment (EIA) in project analysis. It uses site and services low cost housing projects from Kenya. The research has three major components: (1) review of environmental practice in Sub-Saharan Africa through literature review and case studies; (2) review of general literature on EIA as practiced by international agencies and developed countries; and (3) formulation of more suitable guidelines for EIA procedures in Sub-Saharan Africa.

Ngunjiri, P.G.

1987-01-01

240

Factors affecting job satisfaction and retention of medical laboratory professionals in seven countries of Sub-Saharan Africa  

Science.gov (United States)

Effective implementation and sustainability of quality laboratory programmes in Sub-Saharan Africa relies on the development of appropriate staff retention strategies. Assessing the factors responsible for job satisfaction and retention is key for tailoring specific interventions aiming at improving the overall impact of health programmes. A survey was developed to assess these factors among 224 laboratorians working in the laboratory programme the University of Maryland implemented in seven Sub-Saharan African countries. Lack of professional development was the major reason for leaving the previous job for 28% of interviewees who changed jobs in the past five years. Professional development/training opportunities was indicated by almost 90% (195/224) of total interviewees as the most important or a very important factor for satisfaction at their current job. Similarly, regular professional development/opportunities for training was the highest rated incentive to remain at their current job by 80% (179/224). Laboratory professionals employed in the private sector were more likely to change jobs than those working in the public sector (P = 0.002). The findings were used for developing specific strategies for human resources management, in particular targeting professional development, aiming at improving laboratory professionals within the University of Maryland laboratory programme and hence its long-term sustainability.

2013-01-01

 
 
 
 
241

Effect of concurrent sexual partnerships on rate of new HIV infections in a high-prevalence, rural South African population: a cohort study.  

UK PubMed Central (United Kingdom)

BACKGROUND: Concurrent sexual partnerships are widely believed to be one of the main drivers of the HIV epidemic in sub-Saharan Africa. This view is supported by theoretical models predicting that increases in prevalence of concurrent partnerships could substantially increase the rate of spread of the disease. However, the effect of concurrent partnerships on HIV incidence has not been appropriately tested in a sub-Saharan African setting. METHODS: For this population-based cohort study, we used data from the Africa Centre demographic surveillance site in KwaZulu-Natal, South Africa, to try to find support for the concurrency hypothesis. We used a moving-window approach to construct estimates of the geographical variation in reported concurrent and lifetime partners in sexually active men aged 15-55 years (n=2153) across the study area. We then followed up 7284 HIV-negative women (?15 years of age) in the population and quantified the effect of the sexual behaviour profiles of men in the surrounding local community on a woman's hazard of HIV acquisition. FINDINGS: During 5 years' follow-up, 693 new female HIV infections occurred (incidence 3.60 cases per 100 person-years). We identified substantial intercommunity heterogeneity in the estimated point-prevalence of partnership concurrency (range 4.0-76.3%; mean 31.5%) and mean number of lifetime sexual partners (3.4-12.9; mean 6.3) in sexually active men in this population. After adjustment for individual-level sexual behaviour and demographic, socioeconomic, and environmental factors associated with HIV acquisition, mean lifetime number of partners of men in the immediate local community was predictive of hazard of HIV acquisition in women (adjusted hazard ratio [HR] 1.08, 95% CI 1.03-1.14, p=0.004), whereas a high prevalence of partnership concurrency in the same local community was not associated with any increase in risk of HIV acquisition (adjusted HR 1.02, 95% CI 0.95-1.09, p=0.556). INTERPRETATION: We find no evidence to suggest that concurrent partnerships are an important driver of HIV incidence in this typical high-prevalence rural African population. Our findings suggest that in similar hyperendemic sub-Saharan African settings, there is a need for straightforward, unambiguous messages aimed at the reduction of multiple partnerships, irrespective of whether those partnerships overlap in time. FUNDING: US National Institute of Child Health and Human Development; Wellcome Trust.

Tanser F; Bärnighausen T; Hund L; Garnett GP; McGrath N; Newell ML

2011-07-01

242

AIDS in sub-Saharan Africa: implications for health education.  

UK PubMed Central (United Kingdom)

This paper reviews the current epidemiologic status of AIDS in sub-Saharan Africa, focusing on what is currently understood about the distinctive features of heterosexual transmission in young men, women, and children. Epidemiologic data show that AIDS is transmitted primarily through heterosexual vaginal intercourse. Heterosexual transmission is highlighted both as the principal mode of spread of AIDS in east, central, and southern Africa and as the primary focus for AIDS education and control of the epidemic. The transmission of AIDS, like that of other sexually transmissible diseases, results from sexual behaviors that are rooted in social and cultural values that are not easily changed. The primary risk factors--including multiple sex partners, prostitution, and unprotected intercourse--are examined. The perceived obstacles to control of the epidemic include unfavorable government reactions to the epidemic, poor public knowledge, prevailing sexual attitudes, and reluctance to use condoms. These and other immediate and competing risk factors like unemployment and poverty combine to complicate the task of AIDS education.

Gwede C; McDermott RJ

1992-01-01

243

Oil and natural gas in sub-Saharan Africa  

Energy Technology Data Exchange (ETDEWEB)

Intensive oil prospection efforts are going on in Africa. The author of this article sets South Africa aside and studies three zones: the east coast, central Africa and the west coast -particularly the Gulf of Guinea. The vast Ethiopia-Kenya sedimentary zone has given disappointing results despite quite important prospection efforts; nevertheless, there are some encouraging signs for oil and especially for gas in Ethiopia and in Somalia. In central Africa two types of basins with oil potential can be distinguished: the ''grabens'' and the ''interior'' or ''intratonic'' basins. It seems that the best results have been achieved in Sudan. The hydrocarbon producing region on the West Africa coast is limited to the Gulf of Guinea. By far the main producer is Nigeria. The first authentic discovery in sub-Saharan Africa was made in Angola in 1955 by the Belgian Petrofina Company; this was the Benfica deposit. Gabon and Angola began producing at about the same time as Nigeria. Gabon's production reached a culminating point between 1975 and 1977 and it's only due to strictly technical causes that its production in 1982 attained the level of 1972. Elf Gabon is the main producer, but a dozen other oil companies are engaged in prospection. Shell and Gulf are producers.

Mainguy, M.

1984-01-30

244

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

Science.gov (United States)

Jean-Pierre Allain and colleagues argue that, while unintended, the foreign aid provided for blood transfusion services in sub-Saharan Africa has resulted in serious negative outcomes, which requires reflection and rethinking. PMID:22984355

Ala, Fereydoun; Allain, Jean-Pierre; Bates, Imelda; Boukef, Kamel; Boulton, Frank; Brandful, James; Dax, Elizabeth M; El Ekiaby, Magdy; Farrugia, Albert; Gorlin, Jed; Hassall, Oliver; Lee, Helen; Loua, André; Maitland, Kathryn; Mbanya, Dora; Mukhtar, Zainab; Murphy, William; Opare-Sem, Ohene; Owusu-Ofori, Shirley; Reesink, Henk; Roberts, David; Torres, Oscar; Totoe, Grace; Ullum, Henrik; Wendel, Silvano

2012-09-11

245

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

DEFF Research Database (Denmark)

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

Muchie, Mammo

2000-01-01

246

Contribution of legume nitrogen fixation to sustainable agriculture in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

Grain legumes fix about 15-210 kg N ha-1 seasonally in Africa, and therefore feature prominently in the cropping systems of traditional farmers. However, increased exploitation of this biological N is constrained by various environmental and nutritional factors, including the cropping patterns used. An evaluation of traditional cropping systems in Africa shows that crop rotation involving legume and cereal monocultures is by far more sustainable than intercropping, the most dominant cultural practice in the continent. Tree legumes also fix about 43-581 kg N ha-1 y-1, making their leaf prunings an important component of sustainability in agroforestry and alley cropping systems. In a single year, the prunings of Sesbania sesban can provide up to a hectare of cereal crop, up to 448 kg N, 31.4 kg P, 125 kg K, 114 kg Ca and 27.3 kg Mg, thus making the foliage of this legume the "ideal" fertilizer. Clearly, achieving sustainable yields in Sub-Saharan Africa would require a deeper understanding of how fixed N in legume residues is managed in the soil environment, in addition to expanding the use of neglected African food legumes, which exhibit considerable drought resistance and nitrate tolerance. In Africa, where soil moisture often limits yields, research on neglected, symbiotic native legumes with NO3- and drought-tolerant traits would constitute a sound basis for increased sustainable production.

Dakora FD; Keya SO

1997-06-01

247

Sub-Saharan Rubiaceae: a review of their traditional uses, phytochemistry and biological activities.  

UK PubMed Central (United Kingdom)

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.

Karou SD; Tchacondo T; Ilboudo DP; Simpore J

2011-02-01

248

Sub-Saharan Rubiaceae: a review of their traditional uses, phytochemistry and biological activities.  

Science.gov (United States)

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

Karou, Simplice D; Tchacondo, Tchadjobo; Ilboudo, Denise P; Simpore, Jacques

2011-02-01

249

Effects of the number and age of siblings on educational transitions in sub-saharan Africa.  

UK PubMed Central (United Kingdom)

Studies examining the link between number of siblings and level of education attained by children in Africa have produced mixed results. This study draws on Demographic and Health Survey data from 26 sub-Saharan African countries and employs a multilevel multiprocess model that controls for time-invariant unobserved mother-level characteristics. We find indications that having younger siblings increases the likelihood of entering primary school; however, once a child is enrolled, having pre-school aged siblings is negatively associated with educational progression. Having a greater number of siblings older than age 15 increases the likelihood of primary-school entry and completion but has no effect on subsequent educational transitions. Some positive effects of having a greater number of siblings who are aged 6-15 are also observed. Girls are more adversely affected by having young siblings than are boys, but they benefit more than do boys from having siblings who are older than age 15. On the whole, the effects are not very strong, however.

Kravdal O; Kodzi I; Sigle-Rushton W

2013-09-01

250

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

Scientific Electronic Library Online (English)

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

Dzvimbo, Kuzvinetsa Peter; Moloi, Kholeka Constance

2013-01-01

251

Eurasian and African mitochondrial DNA influences in the Saudi Arabian population  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Genetic studies of the Arabian Peninsula are scarce even though the region was the center of ancient trade routes and empires and may have been the southern corridor for the earliest human migration from Africa to Asia. A total of 120 mtDNA Saudi Arab lineages were analyzed for HVSI/II sequences and for haplogroup confirmatory coding diagnostic positions. A phylogeny of the most abundant haplogroup (preHV)1 (R0a) was constructed based on 13 whole mtDNA genomes. Results The Saudi Arabian group showed greatest similarity to other Arabian Peninsula populations (Bedouin from the Negev desert and Yemeni) and to Levantine populations. Nearly all the main western Asia haplogroups were detected in the Saudi sample, including the rare U9 clade. Saudi Arabs had only a minority sub-Saharan Africa component (7%), similar to the specific North-African contribution (5%). In addition, a small Indian influence (3%) was also detected. Conclusion The majority of the Saudi-Arab mitochondrial DNA lineages (85%) have a western Asia provenance. Although the still large confidence intervals, the coalescence and phylogeography of (preHV)1 haplogroup (accounting for 18 % of Saudi Arabian lineages) matches a Neolithic expansion in Saudi Arabia.

Abu-Amero Khaled K; González Ana M; Larruga Jose M; Bosley Thomas M; Cabrera Vicente M

2007-01-01

252

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

Directory of Open Access Journals (Sweden)

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

Reid Stephen J; Mash Robert; Downing Raymond V; Moosa Shabir

2011-01-01

253

Condom use for preventing STI/HIV and unintended pregnancy among young men in Sub-Saharan Africa.  

Science.gov (United States)

The condom is the only known method that provides simultaneous protection against unplanned pregnancy and some sexually transmitted infections (STIs), including HIV, among sexually active people. Using data from the Demographic and Health Surveys from 18 Sub-Saharan African countries, this study examined condom use and reasons for using the method at last intercourse among sexually active young men aged 15 to 29. Most young men were aware of the condom (73%-98%), but its use at last intercourse was quite variable, ranging from 6% in Madagascar to 74% in Namibia. In 10 countries, more young men reportedly used condoms for preventing STIs alone than they did for preventing pregnancy alone. In 6 countries, at least one third of the users used the method for both purposes. Use of the condom at last intercourse was associated with union status, education, residence, and exposure to television in at least two thirds of the countries. PMID:19477720

Bankole, Akinrinola; Singh, Susheela; Hussain, Rubina; Oestreicher, Gabrielle

2008-09-09

254

Condom use for preventing STI/HIV and unintended pregnancy among young men in Sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

The condom is the only known method that provides simultaneous protection against unplanned pregnancy and some sexually transmitted infections (STIs), including HIV, among sexually active people. Using data from the Demographic and Health Surveys from 18 Sub-Saharan African countries, this study examined condom use and reasons for using the method at last intercourse among sexually active young men aged 15 to 29. Most young men were aware of the condom (73%-98%), but its use at last intercourse was quite variable, ranging from 6% in Madagascar to 74% in Namibia. In 10 countries, more young men reportedly used condoms for preventing STIs alone than they did for preventing pregnancy alone. In 6 countries, at least one third of the users used the method for both purposes. Use of the condom at last intercourse was associated with union status, education, residence, and exposure to television in at least two thirds of the countries.

Bankole A; Singh S; Hussain R; Oestreicher G

2009-03-01

255

Plan for supporting natural resources management in sub-Saharan Africa: Regional environmental strategy for the Africa bureau  

Energy Technology Data Exchange (ETDEWEB)

USAID's plan for combatting environmental degradation in sub-Saharan Africa through natural resource management (NRM) is presented. USAID will focus its efforts on two problem areas: soil degradation due to unsustainable agricultural practices, and loss of tropical forests and other critical habitats. The subregions targeted are: arid and semi-arid tropics, tropical highlands, the country of Madagascar, and the humid tropical forest of the Congo Basin. The plan divides African countries into three categories. In Category I countries, USAID would implement comprehensive programs. Programs in Category II countries would focus more limited resources on a single technical priority. Category III countries generally have only small humanitarian and or political programs, and will not undertake bilateral NRM programs. Annexes include a detailed framework for organizing country NRM programs.

1992-05-01

256

Shortage of healthcare workers in sub-Saharan Africa: a nephrological perspective.  

UK PubMed Central (United Kingdom)

AIMS: The paper assesses the lack of healthcare workers, the consequences, and possible solutions. MATERIALS AND METHODS: Review of existing literature and global health reports. RESULTS: The 47 countries of sub-Saharan Africa have a critical shortage of healthcare workers, the deficit amounting to 2.4 million doctors and nurses. There are 2 doctors and 11 nursing/midwifery personnel per 10,000 population, compared with 19 doctors and 49 nursing/midwifery personnel per 10,000 for the Americas, and 32 doctors and 78 nursing/midwifery personnel per 10,000 for Europe. And, whereas there are 28 doctors and 87 nurses/midwifery personnel per 10,000 in high income regions of the world, there are only 5 doctors and 11 nurses/ midwifery personnel per 10,000 in low income regions. The shortage of nephrologists in Africa, and especially sub-Saharan Africa, remains a critical issue, with many countries having < 1 nephrologist per million population; some have no nephrologists at all. The USA, UK, Canada and Australia have benefitted considerably from the migration of nurses and doctors over the past half century. Opportunities for training as well as employment have attracted doctors from many countries to these developed countries. Since 2006, new legislation in the UK has limited the inflow of health workers. Developing countries are also beginning to take steps to mitigate the problem of health worker loss and are developing strategies to both train increasing numbers of different cadres of healthcare worker and also to retain those already working in these countries. CONCLUSIONS: The forces of globalization are tending to increase the worldwide movement of all types of professionals, including those working in health care. It is this lack of health workers in developing countries that has been such a major constraint in limiting progress on initiatives such as the HIV "3 by 5" and Millennium Development Goals. More specifically, lack of resources, both human and financial, in developing countries has hampered nephrology programs both in the detection and prevention of chronic kidney disease and in the ability of doctors, nurses and other nephrological personnel to provide acute/chronic dialysis and transplantation.

Naicker S; Eastwood JB; Plange-Rhule J; Tutt RC

2010-11-01

257

Cultural phylogeography of the Bantu Languages of sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

There is disagreement about the routes taken by populations speaking Bantu languages as they expanded to cover much of sub-Saharan Africa. Here, we build phylogenetic trees of Bantu languages and map them onto geographical space in order to assess the likely pathway of expansion and test between dispersal scenarios. The results clearly support a scenario in which groups first moved south through the rainforest from a homeland somewhere near the Nigeria-Cameroon border. Emerging on the south side of the rainforest, one branch moved south and west. Another branch moved towards the Great Lakes, eventually giving rise to the monophyletic clade of East Bantu languages that inhabit East and Southeastern Africa. These phylogenies also reveal information about more general processes involved in the diversification of human populations into distinct ethnolinguistic groups. Our study reveals that Bantu languages show a latitudinal gradient in covering greater areas with increasing distance from the equator. Analyses suggest that this pattern reflects a true ecological relationship rather than merely being an artefact of shared history. The study shows how a phylogeographic approach can address questions relating to the specific histories of certain groups, as well as general cultural evolutionary processes.

Currie TE; Meade A; Guillon M; Mace R

2013-07-01

258

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

Directory of Open Access Journals (Sweden)

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

Oladimeji Idowu Oladele

2011-01-01

259

Challenging the Concept of the informal in Sub-Saharan Cities : The case of Maxaquene A  

DEFF Research Database (Denmark)

Current definitions of urbanity lead to claims that a large proportion (75% according to UN Habitat) of Sub-Saharan Africa’s (SSA) urban population is housed in ‘informal’ settlements with almost all new housing stock provided ‘informally’ in contradiction to the “formal” that is defined as planned and regulated by the state. In most cases in SSA cities urban development has no professional assistance in the form of architects or engineers, and what is characterised as ‘disorder’, as is the case with informal urbanisation, is considered as undesirable, inappropriate, dangerous, unhealthy and un-modern (Folkers 2009, Hardoy 1990, Jenkins 2011, Nielsen 2008, Nguluma 2003, Mitlin, D. 2004, Koolhaas 2006). In 2003 the UN adopted a new terminology for what over decades used to be labelled as ‘informal’-, ‘squatter’-, ‘illegal’-, ‘unplanned’-, ‘spontaneous’ settlements, “shanty towns” with the term “slum” (UN habitat 2003). However, defining what slum implies is complex and this author consider the term as prejudiced and not covering the diversity most informal settlements represents Further the term stigmatises a remarkable share of any city population in SSA (Huchzermeyer 2011, Davis 2007, Harber 2011, Garau 2005).

Eskemose Andersen, JØrgen

260

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

UK PubMed Central (United Kingdom)

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

Chersich MF; Luchters S; Ntaganira I; Gerbase A; Lo YR; Scorgie F; Steen R

2013-01-01

 
 
 
 
261

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

Directory of Open Access Journals (Sweden)

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

Matthew F Chersich; Stanley Luchters; Innocent Ntaganira; Antonio Gerbase; Ying-Ru Lo; Fiona Scorgie; Richard Steen

2013-01-01

262

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

Scientific Electronic Library Online (English)

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

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

2012-01-01

263

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

UK PubMed Central (United Kingdom)

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

King DP; Madi M; Mioulet V; Wadsworth J; Wright CF; Valdazo-González B; Ferris NP; Knowles NJ; Hammond J

2012-01-01

264

Prevalence, incidence and risk factors for anogenital warts in Sub Saharan Africa: a systematic review and meta analysis.  

UK PubMed Central (United Kingdom)

INTRODUCTION: The quadrivalent HPV vaccine is highly effective in primary prevention of anogenital warts (AGWs). However, there is lack of systematic review in the literature of the epidemiology of AGWs in Sub Saharan Africa (SSA). OBJECTIVE: To review the prevalence, incidence and risk factors for AGWs in SSA prior to the introduction of HPV vaccination programs. METHODS: PubMed/MEDLINE, Africa Index Medicus and HINARI websites were searched for peer reviewed English language published medical literature on AGWs from January 1, 1984 to June 30, 2012. Relevant additional references cited in published papers were also evaluated for inclusion. For inclusion, the article had to meet the following criteria (1) original studies with estimated prevalence and/or incidence rates among men and/or women (2) detailed description of the study population (3) clinical or self-reported diagnosis of AGWs (4) HPV genotyping of histologically confirmed AGWs. The final analysis included 40 studies. Data across different studies were synthesized using descriptive statistics for various subgroups of females and males by geographical area. A meta - analysis of relative risk was conducted for studies that had data reported by HIV status. RESULTS: The prevalence rates of clinical AGWs among sex workers and women with sexually transmitted diseases (STDs) or at high risk of sexually transmitted infection (STIs) range from 3.3% - 10.7% in East, 2.4% - 14.0% in Central and South, and 3.5% - 10.5% in West African regions. Among pregnant women, the prevalence rates range from 0.4% - 3.0% in East, 0.2% - 7.3% in Central and South and 2.9% in West African regions. Among men, the prevalence rates range from 3.5% - 4.5% in East, 4.8% - 6.0% in Central and South and 4.1% to 7.0% in West African regions. In all regions, the prevalence rates were significantly higher among HIV+ than HIV- women with an overall summary relative risk of 1.62 (95% CI: 143-1.82).The incidence rates range from 1.1 - 2.7 per 100 person-years among women and 1.4 per 100 person years among men. Incidence rate was higher among HIV+ (3.0 per 100 person years) and uncircumcised men (1.7 per 100 person-years) than circumcised men (1.3 per 100 person-years).HIV positivity was a risk factor for AGWs among both men and women. Other risk factors in women include presence of abnormal cervical cytology, co-infection with HPV 52, concurrent bacteria vaginoses and genital ulceration. Among men, other risk factors include cigarette smoking and lack of circumcision. CONCLUSIONS: AGWs are common among selected populations particularly HIV infected men and women. However, there is need for population-based studies that will guide policies on effective prevention, treatment and control of AGWs.

Banura C; Mirembe FM; Orem J; Mbonye AK; Kasasa S; Mbidde EK

2013-01-01

265

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

DEFF Research Database (Denmark)

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

Neerinckx, Simon B; Peterson, Andrew T

2008-01-01

266

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

UK PubMed Central (United Kingdom)

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

Cardoso LA

2012-12-01

267

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

Directory of Open Access Journals (Sweden)

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

D. McKeever

2010-01-01

268

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

International Nuclear Information System (INIS)

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

2005-01-01

269

Geographic variation of hypertension in sub-saharan Africa: a case study of South Africa.  

UK PubMed Central (United Kingdom)

BACKGROUND: Hypertension is of public health importance in sub-Saharan Africa, with considerable underdiagnosis, poor management, and lack of community-wide preventive strategies. We examined the geographic variation of hypertension at the province level in South Africa, while accounting for individual-level risk factors such as sociodemographics, lifestyle, and cardiovascular comorbidities. METHODS: Our analysis was based on the South African Demographic and Health Survey, including 13,596 men and women aged 15 years and over. Individual data were collected on lifestyle habits and cardiovascular comorbidities, but were aggregated to the nine country's provinces. We used a Bayesian geo-additive mixed model to map the geographic distribution of hypertension at the province level, accounting for individual risk factors. RESULTS: The overall prevalence of hypertension (blood pressure ?140/90 mmHg or self-reported diagnosis or on medication) was 30.4%. In multivariate Bayesian geo-additive models, current smokers (odds ratio [OR] and 95% credible region [CR]: 1.14 [1.03, 1.26]), current drinkers (1.17 [1.05, 1.29]), people reporting sleep problems (1.16 [1.02, 1.31]), and participants with prevalent cardiovascular comorbidities, such as type 2 diabetes (2.49 [1.92, 3.13]), were significantly associated with a higher prevalence of hypertension. There was a striking variation in hypertension prevalence across provinces, the highest being in North West (1.33 [1.14, 1.61]), Free State (1.32 [1.08, 1.68]) and Northern Cape (1.30 [1.02, 1.55]), the lowest in Limpopo (0.68 [0.56, 0.84]). CONCLUSIONS: This study showed distinct geographic patterns in hypertension prevalence in South Africa, suggesting the potential role of socioeconomic, nutritional, and environmental factors at the province level, beyond individual-level risk factors in this setting.

Kandala NB; Tigbe W; Manda SO; Stranges S

2013-03-01

270

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

Directory of Open Access Journals (Sweden)

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

Philip Woodhouse

2012-01-01

271

[Hepatitis B virus (HBV) infection in Sub-Saharan immigrants in Almeria (Spain)].  

UK PubMed Central (United Kingdom)

INTRODUCTION: There is scant information available in Spain regarding virological markers and clinical status in Sub-Saharan patients infected with HVB. METHODS: A cross-sectional and retrospective study of virological markers and clinical status of HBV infection in 510 adult patients from Sub-Saharan Africa, not co-infected with HIV, most of them from West Africa countries. RESULTS: A total of 90.8% of patients had markers of HBV infection and 137 (26.9%) were HBsAg positive. Among patients with HBsAg positive, 55.9% were chronic inactive carriers. The predominant genotype was E. CONCLUSIONS: The study shows a high prevalence of both markers of HBV infection and of chronic hepatitis B in immigrants from Sub-Saharan Africa.

Salas J; Vázquez J; Cabezas T; Lozano AB; Cabeza I

2011-02-01

272

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

Directory of Open Access Journals (Sweden)

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

Logie Dorothy E; Harding Richard

2005-01-01

273

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

Directory of Open Access Journals (Sweden)

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

Uthman Olalekan A; Lawoko Stephen; Moradi Tahereh

2009-01-01

274

Eutrophication and nutrient release in urban areas of sub-Saharan Africa--a review.  

UK PubMed Central (United Kingdom)

Eutrophication is an increasing problem in sub-Saharan Africa (SSA), and, as a result, the ecological integrity of surface waters becomes compromised, fish populations become extinct, toxic cyanobacteria blooms are abundant, and oxygen levels reduce. In this review we establish the relationship between eutrophication of fresh inland surface waters in SSA and the release of nutrients in their mega-cities. Monitoring reports indicate that the population of mega-cities in SSA is rapidly increasing, and so is the total amount of wastewater produced. Of the total amounts produced, at present, less than 30% is treated in sewage treatment plants, while the remainder is disposed of via onsite sanitation systems, eventually discharging their wastewater into groundwater. When related to the urban water balance of a number of SSA cities, the total amount of wastewater produced may be as high as 10-50% of the total precipitation entering these urban areas, which is considerable, especially since in most cases, precipitation is the most important, if not only the 'wastewater diluting agent' present. The most important knowledge gaps include: (1) the fate and transport mechanisms of nutrients (N and P) in soils and aquifers, or, conversely, the soil aquifer treatment characteristics of the regoliths, which cover a large part of SSA, (2) the effect of the episodic and largely uncontrolled removal of nutrients stored at urban surfaces by runoff from precipitation on nutrient budgets in adjacent lakes and rivers draining the urban areas, and (3) the hydrology and hydrogeology within the urban area, including surface water and groundwater flow patterns, transport velocities, dynamics of nutrient transport, and the presence of recharge and discharge areas. In order to make a start with managing this urban population-related eutrophication, many actions are required. As a first step, we suggest to start systematically researching the key areas identified above.

Nyenje PM; Foppen JW; Uhlenbrook S; Kulabako R; Muwanga A

2010-01-01

275

Preexposure prophylaxis will have a limited impact on HIV-1 drug resistance in sub-Saharan Africa: a comparison of mathematical models.  

UK PubMed Central (United Kingdom)

BACKGROUND:: Preexposure prophylaxis (PrEP) with tenofovir and emtricitabine can prevent new HIV-1 infections, but there is a concern that use of PrEP could increase HIV drug resistance resulting in loss of treatment options. We compared standardized outcomes from three independent mathematical models simulating the impact of PrEP on HIV transmission and drug resistance in sub-Saharan African countries. METHODS:: All models assume that people using PrEP receive an HIV test every 3-6 months. The models vary in structure and parameter choices for PrEP coverage, effectiveness of PrEP (at different adherence levels) and the rate with which HIV drug resistance emerges and is transmitted. RESULTS:: The models predict that the use of PrEP in conjunction with antiretroviral therapy will result in a lower prevalence of HIV than when only antiretroviral therapy is used. With or without PrEP, all models suggest that HIV drug resistance will increase over the next 20 years due to antiretroviral therapy. PrEP will increase the absolute prevalence of drug resistance in the total population by less than 0.5% and amongst infected individuals by at most 7%. Twenty years after the introduction of PrEP, the majority of drug-resistant infections is due to antiretroviral therapy (50-63% across models), whereas 40-50% will be due to transmission of drug resistance, and less than 4% to the use of PrEP. CONCLUSION:: HIV drug resistance resulting from antiretroviral therapy is predicted to far exceed that resulting from PrEP. Concern over drug resistance should not be a reason to limit the use of PrEP.

van de Vijver DA; Nichols BE; Abbas UL; Boucher CA; Cambiano V; Eaton JW; Glaubius R; Lythgoe K; Mellors J; Phillips A; Sigaloff KC; Hallett TB

2013-08-01

276

Burden of end-stage renal disease in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

AIMS: To review prevalence, causes and management of end-stage renal disease (ESRD) in sub-Saharan Africa (SSA). MATERIALS AND METHODS: Review of literature and data. RESULTS: Approximately 70% of the least developed countries of the world are in SSA. Rapid urbanization is occurring in many parts of the continent, contributing to overcrowding and poverty. While infections and parasitic diseases are still the leading cause of death in Africa, non-communicable diseases are coming to the forefront. There is a continuing "brain drain" of healthcare workers (physicians and nurses) from Africa to more affluent regions. There are large rural areas of Africa that have no health professionals to serve these populations. There are no nephrologists in many parts of SSA; the numbers vary from 0.5 per million population (pmp) in Kenya to 0.6 pmp in Nigeria, 0.7 pmp in Sudan and 1.1 pmp in South Africa. Chronic kidney disease affects mainly young adults aged 20 - 50 years in SSA and is primarily due to hypertension and glomerular diseases. HIV- related glomerular disease often presents late, with patients requiring dialysis. Diabetes mellitus affects 9.4 million people in Africa. The prevalence of diabetic nephropathy is estimated to be 6 - 16% in SSA. The current dialysis treatment rate is < 20 pmp (and nil in many countries of SSA), with in-center hemodialysis the modality of RRT for the majority. Transplantation is carried out in a few SSA countries: South Africa, Nigeria, Mauritius and Ghana, with most of the transplants being living donor transplants, except in South Africa where the majority are from deceased donors. CONCLUSION: Chronic kidney disease care is especially challenging in SSA, with large numbers of ESRD patients, inadequate facilities, funding and support.

Naicker S

2010-11-01

277

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

Science.gov (United States)

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

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

2011-01-01

278

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

DEFF Research Database (Denmark)

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

Nygaard, Ivan; Bindner, Henrik W.

2009-01-01

279

Filariasis in Sub-Saharan Immigrants Attended in a Health Area of Southern Spain: Clinical and Epidemiological Findings.  

UK PubMed Central (United Kingdom)

Filariasis is still an endemic disease in several countries worldwide. Patients with mansonellosis result in only relatively mild symptoms, but these infections could produce many visits to health care providers. In Spain, this infection is imported due to the increase of immigrant population reaching our country during last years. The health area of the Hospital of Poniente has a rate of immigrants around to 20 %, with a high percentage coming from sub-Saharan countries, being Mansonella perstans the main filarial infection in the majority of cases. In the protocol for the immigrants, it has been included the diagnosis of filarial infections in order to treat them. This manuscript describes epidemiological and clinical aspects of patients with this kind of infection.

Cobo F; Cabezas-Fernández MT; Salas-Coronas J; Cabeza-Barrera MI; Vázquez-Villegas J; Soriano-Pérez MJ

2013-07-01

280

Reconstructing Sub-Saharan, Mayan, and Other Prehistoric Civilizations in Mathematical Macro-Theory of Civilizations  

CERN Document Server

A study of the Great Zimbabwe Sub-Saharan civilization, Mayan civilization and other prehistoric civilizations within the framework of a mathematical macro theory of civilizations. We show these isolated and early civilizations conform to the general mathematical theory of civilizations in detail.

Blaha, S

2003-01-01

 
 
 
 
281

State of business ethics and field of teaching, training and research in Sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This article provides a comparative summary of the findings of the survey of Business Ethics as field of Teaching, Training and Reserach across the four sub-regions in Sub-Saharan Africa ( Western Africa, Southern Africa, Eastern Africa and Francophone Africa). The article commences with a discussio...

Rossouw, Deon

282

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

We examine the effect of the interaction between resource rents and democracy on corruption for a panel of 29 Sub-Saharan countries during the period from 1985 to 2007. We find that higher resource rents lead to more corruption and that the effect is significantly stronger in less democratic countri...

Arezki, Rabah; Gylfason, Thorvaldur

283

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

Scientific Electronic Library Online (English)

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

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

2012-01-01

284

Sub-Saharan Africa's Mothers, Newborns, and Children: Where and Why Do They Die?  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In the first article in a series on maternal, newborn, and child health in sub-Saharan Africa, Joy Lawn and colleagues outline where and why deaths among mothers and children occur and what known interventions can be employed to prevent these deaths.

Kinney, Mary V.; Kerber, Kate J.; Black, Robert E.; Cohen, Barney; Nkrumah, Francis; Coovadia, Hoosen; Nampala, Paul Michael

285

Household Composition among Elders in Sub-Saharan Africa in the Context of HIV/AIDS  

Science.gov (United States)

Cross-sectional and repeated surveys from household components of Demographic and Health Surveys in sub-Saharan Africa were examined to determine whether household composition indicators for older adults (N = 52,573), involving offspring and grandchildren, correlated with national levels of AIDS mortality. One in 4 was living with a grandchild…

Zimmer, Zachary

2009-01-01

286

The double challenge of adapting to climate change while accelerating development in sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Accelerating economic growth and social development is necessary to reduce the vulnerability and enhance the adaptive capacity of sub-Saharan Africa to cope with the consequences of predicted unfavorable future climate. This requires major investments and policy reforms to induce a needed radical tr...

Hassan, Rashid M.

287

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

UK PubMed Central (United Kingdom)

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

Fasinu P; Orisakwe OE

2013-01-01

288

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

Scientific Electronic Library Online (English)

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

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

2012-01-01

289

Conflict, disasters and no jobs: Reasons for international migration from Sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Sub-Saharan Africa (SSA) has the highest growth rate in net international migration in the world. The reasons for this migration are investigated in this paper. First, a survey of the literature on the profile and determinants of international migration in SSA is given. Second, panel data on 45 coun...

Naudé, Wim

290

Enhancing global control of alcohol to reduce unsafe sex and HIV in sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Sub-Saharan Africa carries a massive dual burden of HIV and alcohol disease, and these pandemics are inextricably linked. Physiological and behavioural research indicates that alcohol independently affects decision-making concerning sex, and skills for negotiating condoms and thei...

Chersich Matthew F; Rees Helen V; Scorgie Fiona; Martin Greg

291

Challenges in disclosure of adverse events and errors in surgery; perspectives from sub-Saharan Africa  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Surgery in sub-Saharan Africa is widely known to be done against a background of poverty and illiteracy, late presentation with complicated pathologies, and a desperate lack of infrastructure. In addition, patient autonomy and self determination are highly flavored by cultural practices and religiou...

Ibrahim, Abdulrasheed; Garba, Ekundayo Stephen; Asuku, Malachy Eneye

292

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

Modern biotechnology, including the application of transgenic techniques to produce Genetically Modified Organisms (GMOs), can play a significant role in increasing agricultural production in a sustainable way, but its products need to be tailored for the developing world. In sub-Saharan Africa, the...

E. Jane Morris

293

HIV-1 drug resistance in antiretroviral-naive individuals in sub-Saharan Africa after rollout of antiretroviral therapy: a multicentre observational study.  

UK PubMed Central (United Kingdom)

BACKGROUND: There are few data on the epidemiology of primary HIV-1 drug resistance after the roll-out of antiretroviral treatment (ART) in sub-Saharan Africa. We aimed to assess the prevalence of primary resistance in six African countries after ART roll-out and if wider use of ART in sub-Saharan Africa is associated with rising prevalence of drug resistance. METHODS: We did a cross-sectional study in antiretroviral-naive adults infected with HIV-1 who had not started first-line ART, recruited between 2007 and 2009 from 11 regions in Kenya, Nigeria, South Africa, Uganda, Zambia, and Zimbabwe. We did population-based sequencing of the pol gene on plasma specimens with greater than 1000 copies per mL of HIV RNA. We identified drug-resistance mutations with the WHO list for transmitted resistance. The prevalence of sequences containing at least one drug-resistance mutation was calculated accounting for the sampling weights of the sites. We assessed the risk factors of resistance with multilevel logistic regression with random coefficients. FINDINGS: 2436 (94.1%) of 2590 participants had a pretreatment genotypic resistance result. 1486 participants (57.4%) were women, 1575 (60.8%) had WHO clinical stage 3 or 4 disease, and the median CD4 count was 133 cells per ?L (IQR 62-204). Overall sample-weighted drug-resistance prevalence was 5.6% (139 of 2436; 95% CI 4.6-6.7), ranging from 1.1% (two of 176; 0.0-2.7) in Pretoria, South Africa, to 12.3% (22 of 179; 7.5-17.1) in Kampala, Uganda. The pooled prevalence for all three Ugandan sites was 11.6% (66 of 570; 8.9-14.2), compared with 3.5% (73 of 1866; 2.5-4.5) for all other sites. Drug class-specific resistance prevalence was 2.5% (54 of 2436; 1.8-3.2) for nucleoside reverse-transcriptase inhibitors (NRTIs), 3.3% (83 of 2436; 2.5-4.2) for non-NRTIs (NNRTIs), 1.3% (31 of 2436; 0.8-1.8) for protease inhibitors, and 1.2% (25 of 2436; 0.7-1.7) for dual-class resistance to NRTIs and NNRTIs. The most common drug-resistance mutations were K103N (43 [1.8%] of 2436), thymidine analogue mutations (33 [1.6%] of 2436), M184V (25 [1.2%] of 2436), and Y181C/I (19 [0.7%] of 2436). The odds ratio for drug resistance associated with each additional year since the start of the ART roll-out in a region was 1.38 (95% CI 1.13-1.68; p=0.001). INTERPRETATION: The higher prevalence of primary drug resistance in Uganda than in other African countries is probably related to the earlier start of ART roll-out in Uganda. Resistance surveillance and prevention should be prioritised in settings where ART programmes are scaled up. FUNDING: Ministry of Foreign Affairs of the Netherlands.

Hamers RL; Wallis CL; Kityo C; Siwale M; Mandaliya K; Conradie F; Botes ME; Wellington M; Osibogun A; Sigaloff KC; Nankya I; Schuurman R; Wit FW; Stevens WS; van Vugt M; de Wit TF

2011-10-01

294

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

UK PubMed Central (United Kingdom)

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

Agnandji ST; Tsassa V; Conzelmann C; Köhler C; Ehni HJ

2012-01-01

295

Differences by sex in the prevalence of diabetes mellitus, impaired fasting glycaemia and impaired glucose tolerance in sub-Saharan Africa: a systematic review and meta-analysis  

Science.gov (United States)

Abstract Objective To assess differences between men and women in the prevalence of diabetes mellitus, impaired fasting glycaemia and impaired glucose tolerance in sub-Saharan Africa. Methods In September 2011, the PubMed and Web of Science databases were searched for community-based, cross-sectional studies providing sex-specific prevalences of any of the three study conditions among adults living in parts of sub-Saharan Africa (i.e. in Eastern, Middle and Southern Africa according to the United Nations subregional classification for African countries). A random-effects model was then used to calculate and compare the odds of men and women having each condition. Findings In a meta-analysis of the 36 relevant, cross-sectional data sets that were identified, impaired fasting glycaemia was found to be more common in men than in women (OR: 1.56; 95% confidence interval, CI: 1.20–2.03), whereas impaired glucose tolerance was found to be less common in men than in women (OR: 0.84; 95% CI: 0.72–0.98). The prevalence of diabetes mellitus – which was generally similar in both sexes (OR: 1.01; 95% CI: 0.91–1.11) – was higher among the women in Southern Africa than among the men from the same subregion and lower among the women from Eastern and Middle Africa and from low-income countries of sub-Saharan Africa than among the corresponding men. Conclusion Compared with women in the same subregions, men in Eastern, Middle and Southern Africa were found to have a similar overall prevalence of diabetes mellitus but were more likely to have impaired fasting glycaemia and less likely to have impaired glucose tolerance.

Yatsuya, Hiroshi; Kawaguchi, Leo; Aoyama, Atsuko

2013-01-01

296

Differences by sex in the prevalence of diabetes mellitus, impaired fasting glycaemia and impaired glucose tolerance in sub-Saharan Africa: a systematic review and meta-analysis.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To assess differences between men and women in the prevalence of diabetes mellitus, impaired fasting glycaemia and impaired glucose tolerance in sub-Saharan Africa. METHODS: In September 2011, the PubMed and Web of Science databases were searched for community-based, cross-sectional studies providing sex-specific prevalences of any of the three study conditions among adults living in parts of sub-Saharan Africa (i.e. in Eastern, Middle and Southern Africa according to the United Nations subregional classification for African countries). A random-effects model was then used to calculate and compare the odds of men and women having each condition. FINDINGS: In a meta-analysis of the 36 relevant, cross-sectional data sets that were identified, impaired fasting glycaemia was found to be more common in men than in women (OR: 1.56; 95% confidence interval, CI: 1.20-2.03), whereas impaired glucose tolerance was found to be less common in men than in women (OR: 0.84; 95% CI: 0.72-0.98). The prevalence of diabetes mellitus - which was generally similar in both sexes (OR: 1.01; 95% CI: 0.91-1.11) - was higher among the women in Southern Africa than among the men from the same subregion and lower among the women from Eastern and Middle Africa and from low-income countries of sub-Saharan Africa than among the corresponding men. CONCLUSION: Compared with women in the same subregions, men in Eastern, Middle and Southern Africa were found to have a similar overall prevalence of diabetes mellitus but were more likely to have impaired fasting glycaemia and less likely to have impaired glucose tolerance.

Hilawe EH; Yatsuya H; Kawaguchi L; Aoyama A

2013-09-01

297

Susceptibility of bacterial isolates from community-acquired infections in sub-Saharan Africa and Asia to macrolide antibiotics.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To review the literature on the susceptibility of common community pathogens in sub-Saharan Africa and Asia to the macrolide antibiotics. METHODS: Inclusion criteria required that isolates were collected since 2004 to ensure results were of contemporary relevance. The data were aggregated by region, age group and sterility of site of culture sample. RESULTS: A total of 51 studies were identified, which reported the macrolide antimicrobial susceptibilities of common bacterial pathogens isolated since 2004. In general, there was less macrolide resistance in African than in Asian isolates. Most African studies reported high levels of macrolide susceptibility in Streptococcus pneumoniae, whereas most Chinese studies reported high levels of resistance. There was very little information available for Gram-negative organisms. CONCLUSIONS: Susceptibility of the pneumococcus to macrolides in SSA remains high in many areas, and good activity of azithromycin has been shown against Salmonellae spp. in Asia. In urban areas where high antibiotic consumption is prevalent, there was evidence of increased resistance to macrolides. However, there is no information on susceptibility from large areas in both continents.

Lubell Y; Turner P; Ashley EA; White NJ

2011-10-01

298

Smoking prevalence and its impacts on lung cancer mortality in Sub-Saharan Africa: An epidemiological study.  

UK PubMed Central (United Kingdom)

BACKGROUND: Reliable mortality data are sparse for developing countries. Furthermore, risk factor prevalence information is hardly available and thus not taken into consideration when estimating mortality. METHODS: The authors used a validated, statistical model combined with representative smoking prevalence from WHO STEPS surveys to estimate lung cancer mortality for six Sub-Saharan African countries (Benin, Malawi, Mozambique, Niger, Sierra Leone, Swaziland). Results were compared to a reference database (GLOBOCAN). Using different smoking prevalence scenarios, future lung cancer deaths were estimated. RESULTS: The prevalence of current moderate smoking among males ranged from 8.7% to 34.6%. Prevalence was much lower among females. For all countries considered, our mortality estimates were higher than GLOBOCAN estimates that do not consider prevalence: Overall, we estimated 2405 lung cancer deaths for 2008 compared to 531 deaths estimated by GLOBOCAN. Up to 2030, lung cancer deaths are expected to increase in general and by over 100% in Benin and Niger. Even under the assumption of decrease in smoking prevalence, lung cancer mortality will rise. CONCLUSION: On the bases of detailed smoking prevalence information, our findings implicate a higher lung cancer burden in low income countries. The epidemiologic transition in African low-income countries alludes to the need for targeted health prevention efforts.

Winkler V; Ott JJ; Cowan M; Becher H

2013-09-01

299

The disproportionate high risk of HIV infection among the urban poor in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

The link between HIV infection and poverty in sub-Saharan Africa (SSA) is rather complex and findings from previous studies remain inconsistent. While some argue that poverty increases vulnerability, existing empirical evidence largely support the view that wealthier men and women have higher prevalence of HIV. In this paper, we examine the association between HIV infection and urban poverty in SSA, paying particular attention to differences in risk factors of HIV infection between the urban poor and non-poor. The study is based on secondary analysis of data from the Demographic and Health Surveys from 20 countries in SSA, conducted during 2003-2008. We apply multilevel logistic regression models, allowing the urban poverty risk factor to vary across countries to establish the extent to which the observed patterns are generalizable across countries in the SSA region. The results reveal that the urban poor in SSA have significantly higher odds of HIV infection than their urban non-poor counterparts, despite poverty being associated with a significantly lower risk among rural residents. Furthermore, the gender disparity in HIV infection (i.e. the disproportionate higher risk among women) is amplified among the urban poor. The paper confirms that the public health consequence of urban poverty that has been well documented in previous studies with respect to maternal and child health outcomes does apply to the risk of HIV infection. The positive association between household wealth and HIV prevalence observed in previous studies largely reflects the situation in the rural areas where the majority of the SSA populations reside.

Magadi MA

2013-06-01

300

Cytochrome P450 pharmacogenetics in African populations.  

UK PubMed Central (United Kingdom)

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

Alessandrini M; Asfaha S; Dodgen TM; Warnich L; Pepper MS

2013-05-01

 
 
 
 
301

Cytochrome P450 pharmacogenetics in African populations.  

Science.gov (United States)

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

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

2013-04-16

302

Science-based health innovation in sub-Saharan Africa  

Directory of Open Access Journals (Sweden)

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

Al-Bader Sara; Masum Hassan; Simiyu Ken; Daar Abdallah S; Singer Peter A

2010-01-01

303

Science-based health innovation in sub-Saharan Africa.  

Science.gov (United States)

In recent years emerging markets such as India, China, and Brazil have developed appropriate business models and lower-cost technological innovations to address health challenges locally and internationally. But it is not well understood what capabilities African countries, with their high disease burden, have in science-based health innovation.This gap in knowledge is addressed by this series in BMC International Health and Human Rights. The series presents the results of extensive on-the-ground research in the form of four country case studies of health and biotechnology innovation, six studies of institutions within Africa involved in health product development, and one study of health venture funds in Africa. To the best of our knowledge it is the first extensive collection of empirical work on African science-based health innovation.The four country cases are Ghana, Rwanda, Tanzania and Uganda. The six case studies of institutions are A to Z Textiles (Tanzania), Acorn Technologies (South Africa), Bioventures venture capital fund (South Africa), the Malagasy Institute of Applied Research (IMRA; Madagascar), the Kenyan Medical Research Institute (KEMRI; Kenya), and Niprisan's development by Nigeria's National Institute for Pharmaceutical Research and Development and Xechem (Nigeria).All of the examples highlight pioneering attempts to build technological capacity, create economic opportunities, and retain talent on a continent significantly affected by brain drain. They point to the practical challenges for innovators on the ground, and suggest potentially helpful policies, funding streams, and other support systems.For African nations, health innovation represents an opportunity to increase domestic capacity to solve health challenges; for international funders, it is an opportunity to move beyond foreign aid and dependency. The shared goal is creating self-sustaining innovation that has both health and development impacts. While this is a long-term strategy, this series shows the potential of African-led innovation, and indicates how it might balance realism against opportunity. There is ample scope to learn lessons more systematically from cases like those we discuss; to link entrepreneurs, scientists, funders, and policy-makers into a network to share opportunities and challenges; and ultimately to better support and stimulate African-led health innovation. PMID:21144069

Al-Bader, Sara; Masum, Hassan; Simiyu, Ken; Daar, Abdallah S; Singer, Peter A

2010-12-13

304

Spatial Clustering of All-Cause and HIV-Related Mortality in a Rural South African Population (2000-2006).  

UK PubMed Central (United Kingdom)

BACKGROUND: Sub-Saharan Africa bears a disproportionate burden of HIV infection. Knowledge of the spatial distribution of HIV outcomes is vital so that appropriate public health interventions can be directed at locations most in need. In this regard, spatial clustering analysis of HIV-related mortality events has not been performed in a rural sub-Saharan African setting. METHODOLOGY AND RESULTS: Kulldorff's spatial scan statistic was used to identify HIV-related and all-cause mortality clusters (p<0.05) in a population-based demographic surveillance survey in rural KwaZulu Natal, South Africa (2000-2006). The analysis was split pre (2000-2003) and post (2004-2006) rollout of antiretroviral therapy, respectively. Between 2000-2006 a total of 86,175 resident individuals ?15 years of age were under surveillance and 5,875 deaths were recorded (of which 2,938 were HIV-related) over 343,060 person-years of observation (crude all-cause mortality rate 17.1/1000). During both time periods a cluster of high HIV-related (RR?=?1.46/1.51, p?=?0.001) and high all-cause mortality (RR?=?1.35/1.38, p?=?0.001) was identified in peri-urban communities near the National Road. A consistent low-risk cluster was detected in the urban township in both time periods (RR?=?0.60/0.39, p?=?0.003/0.005) and in the first time period (2000-2003) a large cluster of low HIV-related and all-cause mortality in a remote rural area was identified. CONCLUSIONS: HIV-related and all-cause mortality exhibit strong spatial clustering tendencies in this population. Highest HIV-related mortality and all-cause mortality occurred in the peri-urban communities along the National Road and was lowest in the urban township and remote rural communities. The geography of HIV-related mortality corresponded closely to the geography of HIV prevalence, with the notable exception of the urban township where high HIV-related mortality would have been expected on the basis of the high HIV prevalence. Our results suggest that HIV treatment and care programmes should be strengthened in easy-to-reach high density, peri-urban populations near National Roads where both HIV-related and all-cause mortality are highest.

Namosha E; Sartorius B; Tanser F

2013-01-01

305

Vesical Schistosomiasis With Terminal Hematuria in Sub-Saharan Patients.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To know the characteristics of vesical schistosomiasis caused by schistosoma hematobium in immigrant patients. MATERIAL AND METHODS: The retrospective study of 41 cases microbiologically diagnosed in our hospital over the last 16 years is presented. Data was collected on origin, age, presentation form, diagnostic tests and treatment. RESULTS: All were African patients whose ages ranged from 4 to 32 years and who had terminal macroscopic hematuria. Most of the patients (85%) were men. In all of the cases, diagnosis was by a urinary microbiological study and in one case, cystoscopy with a biopsy of a typical vesical lesion. Terminal hematuria is the most representative clinical sign. They were treated with praziquantel. CONCLUSIONS: The epidemiology and intermittent terminal hematuria in African patients should lead to the suspicion of vesical schistosomiasis as the first diagnostic option. Urinary microbiological study is a rapid, non-invasive, test with high diagnostic yield that would avoid performing invasive studies. Its simple treatment assures high level of compliance and consequent efficacy.

Pereira J; Calleja E; Marne C; Borque A

2013-10-01

306

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

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

Sheppard Walter S.; Rinderer Thomas E.; Garnery Lionel; Shimanuki Hachiro

1999-01-01

307

Influence of HLA alleles on shedding of Kaposi sarcoma-associated herpesvirus in saliva in an African population.  

UK PubMed Central (United Kingdom)

BACKGROUND: Kaposi sarcoma-associated herpesvirus (KSHV) is endemic in sub-Saharan Africa. Infection in childhood involves mother-to-child transmission and transmission between siblings or other close contacts. Large amounts of viral DNA in saliva have been linked to transmission from mother to child. To investigate factors contributing to the shedding of KSHV in the saliva of mothers in rural South Africa, we sequenced the HLA-A alleles of 448 mothers and the HLA-DRB1 alleles of 363 mothers and compared their HLA types with viral loads in saliva. METHODS: Viral load was quantified with real-time polymerase chain reaction on DNA extracted from saliva. HLA-A and HLA-DRB1 allele groups were determined by sequencing-based typing. RESULTS: We found that 2 HLA-A alleles, A*6801 and A*4301, and 1 HLA-DRB1 allele group, DRB1*04, were associated with shedding of KSHV in saliva. KSHV could be detected more frequently in mothers carrying at least 1 copy of HLA-A*6801 or HLA-A*4301, and higher viral loads were found in HLA-A*68- and HLA-DRB1*04-carrying mothers. CONCLUSIONS: These findings could suggest that 2 HLA-A alleles, A*6801 and A*4301, and 1 HLA-DRB1 allele group, DRB1*04, that are more frequent in African populations might be associated with an impaired control of KSHV and, hence, increased shedding in saliva.

Alkharsah KR; Dedicoat M; Blasczyk R; Newton R; Schulz TF

2007-03-01

308

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

DEFF Research Database (Denmark)

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

Lund, Henrik Hautop

2012-01-01

309

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

DEFF Research Database (Denmark)

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

Adisa, Femi; Isabalija, Stephen R.

310

Factoring quality laboratory diagnosis into the malaria control agenda for sub-saharan Africa.  

UK PubMed Central (United Kingdom)

Abstract. Recent progress in malaria control in sub-Saharan Africa has been achieved primarily through provision of insecticide-treated nets, indoor residual spraying, and antimalarial drugs. Although these interventions are important, proper case identification and accurate measurement of their impact depend on quality diagnostic testing. Current availability of diagnostic testing for malaria in sub-Saharan Africa is inadequate to support disease management, prevention programs, and surveillance needs. Challenges faced include a dearth of skilled workforce, inadequate health systems infrastructure, and lack of political will. A coordinated approach to providing pre-service clinical and laboratory training together with systems that support a scale-up of laboratory services could provide means not only for effective malaria case management but also, management of non-malaria febrile illnesses, disease surveillance, and accurate control program evaluation. A synthesis of the challenges faced in ensuring quality malaria testing and how to include this information in the malaria control and elimination agenda are presented.

Aidoo M

2013-09-01

311

Challenges in disclosure of adverse events and errors in surgery; perspectives from sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

Surgery in sub-Saharan Africa is widely known to be done against a background of poverty and illiteracy, late presentation with complicated pathologies, and a desperate lack of infrastructure. In addition, patient autonomy and self determination are highly flavored by cultural practices and religious beliefs. Any of these factors can influence the pattern and disclosure of adverse events and errors. The impact of these in the relationships between surgeons and patients, and between health institutions and patients must be considered as it may affect disclosure and response to errors. This article identifies the peculiar socioeconomic and cultural challenges that may hinder disclosure and proposes strategies for instituting disclosure of errors and adverse events services in Sub-Saharan Africa.

Ibrahim A; Garba ES; Asuku ME

2012-01-01

312

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

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

Alvarez Jose; Gil Ruth; Hernández Valentín; Gil Angel

2009-01-01

313

Diabetic retinopathy in sub-Saharan Africa: meeting the challenges of an emerging epidemic.  

UK PubMed Central (United Kingdom)

BACKGROUND: Sub-Saharan Africa faces an epidemic of diabetes. Diabetes causes significant morbidity including visual loss from diabetic retinopathy, which is largely preventable. In this resource-poor setting, health systems are poorly organized to deliver chronic care with multiple system involvement. The specific skills and resources needed to manage diabetic retinopathy are scarce. The costs of inaction for individuals, communities and countries are likely to be high. DISCUSSION: Screening for and treatment of diabetic retinopathy have been shown to be effective, and cost-effective, in resource-rich settings. In sub-Saharan Africa, clinical services for diabetes need to be expanded with the provision of effective, integrated care, including case-finding and management of diabetic retinopathy. This should be underpinned by a high quality evidence base accounting for differences in diabetes types, resources, patients and society in Africa. Research must address the epidemiology of diabetic retinopathy in Africa, strategies for disease detection and management with laser treatment, and include health economic analyses. Models of care tailored to the local geographic and social context are most likely to be cost effective, and should draw on experience and expertise from other continents. Research into diabetic retinopathy in Africa can drive the political agenda for service development and enable informed prioritization of available health funding at a national level. Effective interventions need to be implemented in the near future to avert a large burden of visual loss from diabetic retinopathy in the continent. SUMMARY: An increase in visual loss from diabetic retinopathy is inevitable as the diabetes epidemic emerges in sub-Saharan Africa. This could be minimized by the provision of case-finding and laser treatment, but how to do this most effectively in the regional context is not known. Research into the epidemiology, case-finding and laser treatment of diabetic retinopathy in sub-Saharan Africa will highlight a poorly met need, as well as guide the development of services for that need as it expands.

Burgess PI; Msukwa G; Beare NA

2013-01-01

314

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

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

Kunene Simon; Phillips Allison A; Gosling Roly D; Kandula Deepika; Novotny Joseph M

2011-01-01

315

Information and Communication Technologies and Poverty Reduction in Developing Countries : the Case of Sub Saharan Africa countries  

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Full Text Available There is a growing interest in using Information and Communication Technologies (ICTs) to support poverty reduction efforts and strategies in the framework of the Millennium Development Goals (MDGs). These interest ended up revealing how much the Poverty Reduction Strategy Papers (PRSPs) of many african nations have underestimated the importance of ICTs as a development tool. The fact that so little was mentionned about the use of ICTs for poverty alleviation and creation of employment highlighted the confusion, and uncertainty of decision makers. At the country level, ICT is still to be effectively integrated into national poverty alleviation and development strategies. The question then is how ICTs can help achieve those objectives. How can ICTs be used as tools to fight against poverty? Poverty is widely recognized as multidimensional, encompassing food security, health, education, rights, security and dignity, amongst others as stressed by Bachelor and al in a model showing the intricate linkages between ICTs and most PRSP goals. The link between ICTs and poverty reduction strategy is therefore not that obvious. Although, researchers and development partners involved in poverty alleviation recognize more easily the linkage between ICT and poverty reduction strategies. In any case, it is a prerequisite to have a conducive environment and country readiness for ICTs implementation. Unfortunately, in many Sub-Saharan Africa countries, there is not yet a clear and effective policy and strategy for the use of ICT.

Lot Tcheeko; Marcellin Ndong Ntah

2006-01-01

316

Prices of antihypertensive medicines in sub-Saharan Africa and alignment to WHO's model list of essential medicines.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To investigate compliance of National Essential Medicines Lists (NEMLs) with the WHO Essential Medicines List (WHO/EML) in 2007 and to compare prices of antihypertensive drugs in and between 13 sub-Saharan African countries. METHODOLOGY: Data on NEMLs and drug prices were collected from 65 public and 65 private pharmacies (five of each per country). Prices were compared with the International Drug Price Indicator Guide (IDPIG). The cost of drug treatment within a country was calculated using defined daily doses (DDD) and between countries using DDD prices adjusted for purchasing power parity-based gross domestic product per capita. RESULTS: All surveyed countries had a NEML. However, none of these lists were in complete alignment with the 2007 WHO/EML, and 38% had not been updated in the last 5 years. Surveyed medicines were cheaper when on the NEMLs; they were also cheaper in public than in private pharmacies. Prices varied greatly per medicine. A large majority of the public prices were higher than those indicated by the IDPIG. Overall, hydrochlorothiazide is the cheapest drug. CONCLUSION: There are substantial differences in NEML composition between the 13 countries. The proportion of NEMLs not regularly updated was double the global United Nations estimates. Prices of WHO/EML-advised drugs differ greatly between drugs and for each drug within and between countries. In general, the use of drugs on the NEML improves financial accessibility, and these drugs should be prescribed preferentially.

Twagirumukiza M; Annemans L; Kips JG; Bienvenu E; Van Bortel LM

2010-03-01

317

Can social inclusion policies reduce health inequalities in sub-Saharan Africa?--A rapid policy appraisal.  

UK PubMed Central (United Kingdom)

The global resurgence of interest in the social determinants of health provides an opportunity for determined action on unacceptable and unjust health inequalities that exist within and between countries. This paper reviews three categories of social inclusion policies: cash-transfers; free social services; and specific institutional arrangements for programme integration in six selected countries--Botswana, Mozambique, South Africa, Ethiopia, Nigeria, and Zimbabwe. The policies were appraised as part of the Social Exclusion Knowledge Network (SEKN) set up under the auspices of the World Health Organization's Commission on Social Determinants of Health. The paper highlights the development landscape in sub-Saharan Africa and presents available indicators of the scale of inequity in the six countries. A summary of the policies appraised is presented, including whether or what the impact of these policies has been on health inequalities. Cross-cutting benefits include poverty alleviation, notably among vulnerable children and youths, improved economic opportunities for disadvantaged households, reduction in access barriers to social services, and improved nutrition intake. The impact of these benefits, and hence the policies, on health status can only be inferred. Among the policies reviewed, weaknesses or constraints were in design and implementation. The policy design weaknesses include targeting criteria, their enforcement and latent costs, inadequate participation of the community and failure to take the cultural context into account. A major weakness of most policies was the lack of a monitoring and evaluation system, with clear indicators that incorporate system responsiveness. The policy implementation weaknesses include uneven regional implementation with rural areas worst affected; inadequate or poor administrative and implementation capacity; insufficient resources; problems of fraud and corruption; and lack of involvement of civil servants, exacerbating implementation capacity problems. The key messages to sub-Saharan African governments include: health inequalities must be measured; social policies must be carefully designed and effectively implemented addressing the constraints identified; monitoring and evaluation systems need improvement; and participation of the community needs to be encouraged through conducive and enabling environments. There is a need for a strong movement by civil society to address health inequalities and to hold governments accountable for improved health and reduced health inequalities.

Rispel LC; de Sousa CA; Molomo BG

2009-08-01

318

Single Motherhood and Child Mortality in Sub-Saharan Africa: A Life Course Perspective.  

UK PubMed Central (United Kingdom)

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

Clark S; Hamplová D

2013-07-01

319

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

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

Khalid Dafaallah; Awadelkarim; Ahmed Abdalla; et al

2010-01-01

320

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

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

Mohiddin Abdu; Johnston Deborah

2006-01-01

 
 
 
 
321

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

UK PubMed Central (United Kingdom)

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

Clark S; Hamplová D

2013-10-01

322

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

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

Abrahams Zulfa; Mchiza Zandile; Steyn Nelia P

2011-01-01

323

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

UK PubMed Central (United Kingdom)

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

Abrahams Z; McHiza Z; Steyn NP

2011-01-01

324

A review of generalist and specialist community health workers for delivering adolescent health services in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

CONCLUSIONS: This review found that innovative service delivery approaches, such as those potentially offered by CHWs, for adolescents in sub-Saharan Africa are lacking, CHW programs have proliferated despite the absence of high quality evaluations, rigorous studies to establish the comparative effectiveness of generalist versus specialist CHW programs are needed, and further investigation of the role of CHWs in providing adolescent health services in sub-Saharan Africa is warranted.

Koon AD; Goudge J; Norris SA

2013-10-01

325

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

UK PubMed Central (United Kingdom)

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

Kelly-Hope LA; McKenzie FE

2009-01-01

326

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

UK PubMed Central (United Kingdom)

BACKGROUND: The efficacy of anti-malarial drugs is assessed over a period of 28-63 days (depending on the drugs' residence time) following initiation of treatment in order to capture late failures. However, prolonged follow-up increases the likelihood of new infections depending on transmission intensity. Therefore, molecular genotyping of highly polymorphic regions of Plasmodium falciparum msp1, msp2 and glurp loci is usually carried out to distinguish recrudescence (true failures) from new infections. This tool has now been adopted as an integral part of anti-malarial efficacy studies and clinical trials. However, there are concerns over its utility and reliability because conclusions drawn from molecular typing depend on the genetic profile of the respective parasite populations, but this profile is not systematically documented in most endemic areas. This study presents the genetic diversity of P. falciparum msp1, msp2 and glurp markers in selected sub-Saharan Africa countries with varying levels of endemicity namely Malawi, Tanzania, Uganda, Burkina Faso and São Tomé. METHODS: A total 780 baseline (Day 0) blood samples from children less than seven years, recruited in a randomized controlled clinical trials done between 1996 and 2000 were genotyped. DNA was extracted; allelic frequency and diversity were investigated by PCR followed by capillary electrophoresis for msp2 and fragment sizing by a digitalized gel imager for msp1 and glurp. RESULTS AND CONCLUSION: Plasmodium falciparum msp1, msp2 and glurp markers were highly polymorphic with low allele frequencies. A total of 17 msp1 genotypes [eight MAD20-, one RO33- and eight K1-types]; 116 msp2 genotypes [83 3D7 and 33 FC27- types] and 14 glurp genotypes were recorded. All five sites recorded very high expected heterozygosity (HE) values (0.68 - 0.99). HE was highest in msp2 locus (HE=0.99), and lowest for msp1 (HE=0.68) (P<0.0001). The genetic diversity and allelic frequency recorded were independent of transmission intensity (P=0.84, P=0.25 respectively. A few genotypes had particularly high frequencies; however the most abundant showed only a 4% probability that a new infection would share the same genotype as the baseline infection. This is unlikely to confound the distinction of recrudescence from new infection, particularly if more than one marker is used for genotyping. Hence, this study supports the use of msp1, msp2 and glurp in malaria clinical trials in sub-Saharan Africa to discriminate new from recrudescent infections.

Mwingira F; Nkwengulila G; Schoepflin S; Sumari D; Beck HP; Snounou G; Felger I; Olliaro P; Mugittu K

2011-01-01

327

The relationship of living arrangements and depressive symptoms among older adults in sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

BACKGROUND: Older adults in sub-Saharan Africa are increasingly facing the twin challenges of reduced support from their adult children and taking on new roles caring for orphans and vulnerable children. How these changes affect the mental health of older adults is largely unknown. METHODS: We use data from the 2002-2003 World Health Surveys for 15 countries in sub-Saharan Africa to examine whether older adults who may be lacking adequate support through living alone or in skipped-generation households are at an increased risk of depressive symptoms compared to those living with at least one working-age adult. Using meta-regression, we also examine whether heterogeneity across countries in the prevalence of depressive symptoms or in the association between living arrangements and depressive symptoms is associated with HIV/AIDS prevalence and national economic status. RESULTS: The pooled prevalence of depressive symptoms among older adults was 9.2%. Older adults living alone had a 2.3% point higher predicted prevalence of depressive symptoms compared to individuals living with at least one working-age adult (95% confidence interval: 0.2%, 4.4%). None of the country characteristics examined explained heterogeneity across countries in the relationship between living arrangements and depressive symptoms. However, there was some evidence suggesting a positive association between depressive symptom prevalence and the severity of a country's HIV/AIDS epidemic. CONCLUSION: As depressive symptoms are known to be predictive of poor quality of life and increased mortality, it is important to address how health and social policies can be put in place to mitigate the potentially detrimental effects of solitary living on the mental health of older persons in sub-Saharan Africa.

McKinnon B; Harper S; Moore S

2013-01-01

328

Drivers and deterrents of facility delivery in sub-Saharan Africa: a systematic review.  

Science.gov (United States)

While the most important factors associated with facility-based delivery (FBD) have been explored within individual countries in Africa, no systematic review has explored the factors associated with FBD across sub-Saharan Africa. A systematic search of the peer-reviewed literature was conducted to identify articles published in English from 1/1995-12/2011 that reported on original research conducted entirely or in part in sub-Saharan Africa and included a primary outcome variable of FBD, delivery location, or skilled birth attendance (SBA). Out of 1,168 citations identified, 65 met inclusion criteria. 62 of 65 were cross-sectional, and 58 of 65 relied upon household survey data. Fewer than two-thirds (43) included multivariate analyses. The factors associated with facility delivery were categorized as maternal, social, antenatal-related, facility-related, and macro-level factors. Maternal factors were the most commonly studied. This may be a result of the overwhelming reliance on household survey data - where maternal sociodemographic factors are likely to be well-represented and non-maternal factors may be less consistently and accurately represented. Multivariate analysis suggests that maternal education, parity / birth order, rural / urban residence, household wealth / socioeconomic status, distance to the nearest facility, and number of antenatal care visits were the factors most consistently associated with FBD. In conclusion, FBD is a complex issue that is influenced by characteristics of the pregnant woman herself, her immediate social circle, the community in which she lives, the facility that is closest to her, and context of the country in which she lives. Research to date has been dominated by analysis of cross-sectional household survey data. More research is needed that explores regional variability, examines longitudinal trends, and studies the impact of interventions to boost rates of facility delivery in sub-Saharan Africa. PMID:23962135

Moyer, Cheryl A; Mustafa, Aesha

2013-08-20

329

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

Directory of Open Access Journals (Sweden)

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

Oluleye TS; Babalola Y

2013-01-01

330

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

Energy Technology Data Exchange (ETDEWEB)

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

Sebitosi, A.B. [Department of Electrical Engineering, University of Cape Town, Private Bag Rondebosch 7701, Cape Town (South Africa)]. E-mail: bsebitos@ebe.uct.ac.za; Pillay, P. [Clarkson University, Potsdam, NY 13699, USA (United States); Khan, M.A. [Department of Electrical Engineering, University of Cape Town, Private Bag Rondebosch 7701, Cape Town (South Africa)

2006-06-15

331

Central Bank Independence and Inflation Targeting: Monetary Policy Framework for Sub-saharan Africa  

Directory of Open Access Journals (Sweden)

Full Text Available Open system-holistic family view of the macroeconomic sector sees collaborations and policy coordination between the monetary and fiscal subsystems fundamental and inalienable in the holistic family-macroeconomic sector. Full independence (isolation) of the monetary subsystem from the fiscal subsystem is outlandish. The optimal point of independence shifts each time the system adapts to environmental factors but continues to lie between zero and full independence in the continuum of independence. This holistic view best describes the behaviour of modern macroeconomic sector in an ever increasingly globalized-digitalized economy. Sub-Saharan Africa can also inflation target by suitably embracing the prescribed monetary policy framework.

Oyedokun Agbeja

2007-01-01

332

Maternal education is associated with reduced female disadvantages in under-five mortality in sub-Saharan Africa and southern Asia.  

UK PubMed Central (United Kingdom)

BACKGROUND: The male:female (M:F) mortality ratio for under-five mortality varies considerably across and within societies. Maternal education has been linked to better outcomes for girls, but the evidence is mixed. We examined how the M:F ratio for under-five mortality varies by maternal education in sub-Saharan Africa and southern Asia. METHODS: We used recent Demographic and Health Surveys from 31 sub-Saharan African and 4 southern Asian countries. M:F mortality ratios were determined using information on 49 769 deaths among 521 551 children. We estimate M:F ratios for under-five (month 0-59), neonatal (month 0), post-neonatal (month 1-11) and child mortality (month 12-59) by maternal education while controlling for demographic and household characteristics. M:F ratios for under-five mortality and child mortality are compared with more 'gender neutral' thresholds (of 1.25 and 1.17, respectively) estimated on the basis of the Human Mortality Database. RESULTS: In sub-Saharan Africa, the M:F ratio for under-five mortality is 1.09 [95% confidence interval (CI) 1.06-1.13] among non-educated mothers, 1.14 (95% CI 1.09-1.19) among mothers with some primary education and 1.25 (95% CI 1.16-1.34) among mothers with some secondary or more education. For southern Asia, the ratios are 0.88 (95% CI 0.82-0.95), 1.10 (95% CI 0.97-1.25) and 1.13 (95% CI 1.02-1.26), respectively. The M:F ratio for child mortality also shows an educational gradient in both regions, with the M:F ratio being lower among non-educated mothers. In southern Asia, the M:F ratio for child mortality is particularly low among mothers with no education, M:F ratio = 0.54 (95% CI 0.41-0.72). CONCLUSIONS: Among mothers with more education, the difference in the mortality chances of boys and girls more closely resembles a 'gender neutral' situation than among women with no or little education. Girls benefit both in absolute and relative terms from having a more educated mother.

Monden CW; Smits J

2013-02-01

333

Benign proliferative breast diseases among female patients at a sub-Saharan Africa tertiary hospital: a cross sectional study.  

UK PubMed Central (United Kingdom)

BACKGROUND: Non-cancerous diseases of the breast have assumed increasing importance because of the public awareness of breast cancer. These benign diseases are a recognized important risk factor for later breast cancer which can develop in either breast. The risk estimate of these benign breast diseases has not been well established in sub Saharan Africa. Women with benign proliferative or atypical breast lesions have a two- fold risk of developing breast cancer in western populations. The purpose of this study therefore was to determine the prevalence of proliferative disease ( BPBD) with and without atypia among Ugandan Black women. METHODS: A cross-sectional descriptive study conducted at Mulago Hospital Breast Clinic between January 2012 and June 2012; 208 women aged 12 years and above with palpable breast lumps were screened. Fine needle aspiration biopsies were taken for cytological examination. RESULTS: Of the 208 women with benign breast lumps screened, 195 were recruited in the study. The prevalence of BPBD was 18% (35/195). BPBD with atypia was 5.6% (11/195). The mean age and body mass index (BMI) were 28.4 years and 23.26 kg/m2 respectively. The commonest lesions were fibroadenomas for 57%, (111/195), and fibrocystic change were 21% (40/195). Most BPBD with atypia lesions were in the fibrocystic category. CONCLUSIONS: Benign proliferative breast diseases are common, found mostly among premenopausal women. A significant proportion of BPBD had atypical proliferation. An accurate breast cancer risk estimate study for BPBD is recommended.

Okoth C; Galukande M; Jombwe J; Wamala D

2013-01-01

334

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

Directory of Open Access Journals (Sweden)

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

Ekpenyong C.E.; Akpan E.E

2013-01-01

335

Comparing the Effectiveness of Informal and Formal Institutions in Sustainable Common Pool Resources Management in Sub-Saharan Africa  

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Full Text Available This article compares the effectiveness of informal and formal institutions for sustainable common pool resources (CPRs) management in Sub-Saharan Africa and investigates the social, political and demographic conditions that influence the institutions? effectiveness. By focusing on publications addressing micro-level CPR management, a comprehensive literature review was conducted. Articles were grouped, based on the main themes of the study, including types of institutions and conditions that influence their effectiveness. A qualitative meta-analysis was conducted using a deductive coding approach. The results revealed that informal institutions have contributed to sustainable CPR management by creating a suitable environment for joint decision-making, enabling exclusion at low cost for CPR users and using locally agreed sanctions. Although the published evidence suggested less support to formal institutions under decentralised governmental reforms, they played an important role in implementing technologies for sustainable CPR management. Conditions that influence the effectiveness of both types of institutions include high population growth on limited CPRs, the growing scarcity of CPRs due to land use change and the lack of human and financial capacities. Improving the conditions that hinder the contributions of both types of institutions is crucial to enhance the institutions? effectiveness in sustainable CPR management. Moreover, policies and development interventions should strengthen the involvement of well-functioning informal institutions in decision-making so that sustainable CPR management can be achieved.

Yami Mastewal; Vogl Christian; Hauser Michael

2009-01-01

336

Developing the agenda for European Union collaboration on non-communicable diseases research in Sub-Saharan Africa  

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Full Text Available Abstract Background Health research is increasing in Africa, but most resources are currently chanelled towards infectious diseases and health system development. While infectious diseases remain a heavy burden for some African countries, non-communicable diseases (NCDs) account for more than half of all deaths globally and WHO predicts 27% increase in NCDs in Africa over the next decade. We present findings of a European-Africa consultation on the research agenda for NCDs. Methods A workshop was held in Yaoundé, Cameroon, organized by the Network for the Coordination and Advancement of Sub-Saharan Africa-European Union Science and Technology Cooperation (CAAST-Net). Drawing on initial presentations, a small expert group from academic, clinical, public-health and administrative positions considered research needs in Africa for cardiovascular disease, cancer and diabetes. Results Research in Africa can draw from different environmental and genetic characteristics to understand the causes of the disease, while economic and social factors are important in developing relevant strategies for prevention and treatment. The suggested research needs include better methods for description and recording, clinical studies, understanding cultural impacts, prevention strategies, and the integrated organisation of care. Specific fields proposed for research are listed. Conclusions Our paper contributes to transparency in the process of priority-setting for health research in Africa. Although the European Union Seventh Framework Research Programme prioritises biomedical and clinical research, research for Africa should also address broader social and cultural research and intervention research for greatest impact. Research policy leaders in Africa must engage national governments and international agencies as well as service providers and research communities. None can act effectively alone. Bringing together the different stakeholders, and feeding the results through to the European Union research programme is a valuable contribution of CAAST-Net.

McCarthy Mark; Maher Dermot; Ly Adama; Ndip Agbor

2010-01-01

337

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

Energy Technology Data Exchange (ETDEWEB)

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

Jumbe, Charles B.L., E-mail: charlesjumbe@bunda.unima.m [University of Malawi, Centre for Agricultural Research and Development, Bunda College, P.O. Box 219, Lilongwe (Malawi); Msiska, Frederick B.M., E-mail: frederickmsiska@yahoo.co [Ministry of Agriculture and Food Security, P.O. Box 30134, Lilongwe 3 (Malawi); Madjera, Michael, E-mail: michael.madjera@onlinehome.d [Evangelical Church in Middle Germany, P.O. Box 1424, 39004 Magdeburg (Germany)

2009-11-15

338

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

Energy Technology Data Exchange (ETDEWEB)

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

Jumbe, Charles B.L. [University of Malawi, Centre for Agricultural Research and Development, Bunda College, P.O. Box 219, Lilongwe (Malawi); Msiska, Frederick B.M. [Ministry of Agriculture and Food Security, P.O. Box 30134, Lilongwe 3 (Malawi); Madjera, Michael [Evangelical Church in Middle Germany, P.O. Box 1424, 39004 Magdeburg (Germany)

2009-11-15

339

Strengthening health systems through HIV monitoring and evaluation in Sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

PURPOSE OF REVIEW: In this review, we describe the challenges faced by using clinical cohorts to perform Monitoring and Evaluation (M&E) and the possible solutions for increasing and strengthening health systems in low-income and middle-income countries. RECENT FINDINGS: HIV scale-up has facilitated the transition from paper-based medical records to electronic medical records at hundreds of sites in most of the countries in sub-Saharan Africa and the implementation of national HIV databases. However, National M&E systems in resource-limited settings tend to be chronically challenged by persistently incomplete reporting and inaccurate data, which undermines their usefulness. In low-income and middle-income countries, new information technologies such as Web-based systems and mobile phone networks are expanding rapidly. Their use will improve data quality and, therefore, reduce participant dropout and improve reporting rates. These systems have the potential to allow real time access to summary reports and to integrate data from other settings such as maternal and infant health clinics. SUMMARY: The efforts to address the AIDS pandemic in sub-Saharan Africa will require enhanced information systems. Stronger systems are needed to deliver primary healthcare for those with and without HIV, and it is also essential to build and take advantage of synergies across health information systems.

Ekouevi DK; Karcher S; Coffie PA

2011-07-01

340

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

International Nuclear Information System (INIS)

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

2009-01-01

 
 
 
 
341

The bioethanol industry in sub-Saharan Africa: history, challenges, and prospects.  

UK PubMed Central (United Kingdom)

Recently, interest in using bioethanol as an alternative to petroleum fuel has been escalating due to decrease in the availability of crude oil. The application of bioethanol in the motor-fuel industry can contribute to reduction in the use of fossil fuels and in turn to decreased carbon emissions and stress of the rapid decline in crude oil availability. Bioethanol production methods are numerous and vary with the types of feedstock used. Feedstocks can be cereal grains (first generation feedstock), lignocellulose (second generation feedstock), or algae (third generation feedstock) feedstocks. To date, USA and Brazil are the leading contributors to global bioethanol production. In sub-Saharan Africa, bioethanol production is stagnant. During the 1980s, bioethanol production has been successful in several countries including Zimbabwe, Malawi, and Kenya. However, because of numerous challenges such as food security, land availability, and government policies, achieving sustainability was a major hurdle. This paper examines the history and challenges of bioethanol production in sub-Saharan Africa (SSA) and demonstrates the bioethanol production potential in SSA with a focus on using bitter sorghum and cashew apple juice as unconventional feedstocks for bioethanol production.

Deenanath ED; Iyuke S; Rumbold K

2012-01-01

342

Pedagogical Renewal for Quality Universal Primary Education: Overview of Trends in Sub-Saharan Africa  

Science.gov (United States)

This article assumes that pedagogical renewal and teacher development are two sides of the same coin, and that the achievement of a universal primary education that is equitable and of acceptable quality in Sub-Saharan Africa will depend to a large extent on both. The need for pedagogical renewal stems from the evidence that (i) teaching is arguably the strongest school-level determinant of student achievement; (ii) teaching effect on student learning is reportedly higher in Sub-Saharan Africa than it is in high-income countries; (iii) learning achievement is considerably lower in the sub-continent's schools; and (iv) the kind of teaching that takes place in these schools confines students to a passive role and only fosters lower order skills. An overview of experiences with pedagogical renewal highlights the challenges involved in adopting open-ended instructional practices on the sub-continent. It further points to bilingual education as one of the most promising strategies. Regardless of the route taken for renewing pedagogy, the professional development of teacher educators/trainers must be considered a critical enabling condition.

Dembélé, Martial; Lefoka, Pulane

2007-11-01

343

Factoring quality laboratory diagnosis into the malaria control agenda for sub-saharan Africa.  

Science.gov (United States)

Abstract. Recent progress in malaria control in sub-Saharan Africa has been achieved primarily through provision of insecticide-treated nets, indoor residual spraying, and antimalarial drugs. Although these interventions are important, proper case identification and accurate measurement of their impact depend on quality diagnostic testing. Current availability of diagnostic testing for malaria in sub-Saharan Africa is inadequate to support disease management, prevention programs, and surveillance needs. Challenges faced include a dearth of skilled workforce, inadequate health systems infrastructure, and lack of political will. A coordinated approach to providing pre-service clinical and laboratory training together with systems that support a scale-up of laboratory services could provide means not only for effective malaria case management but also, management of non-malaria febrile illnesses, disease surveillance, and accurate control program evaluation. A synthesis of the challenges faced in ensuring quality malaria testing and how to include this information in the malaria control and elimination agenda are presented. PMID:24006294

Aidoo, Michael

2013-09-01

344

Male circumcision for HIV prevention: current evidence and implementation in sub-Saharan Africa  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Heterosexual exposure accounts for most HIV transmission in sub-Saharan Africa, and this mode, as a proportion of new infections, is escalating globally. The scientific evidence accumulated over more than 20 years shows that among the strategies advocated during this period for HIV prevention, male circumcision is one of, if not, the most efficacious epidemiologically, as well as cost-wise. Despite this, and recommendation of the procedure by global policy makers, national implementation has been slow. Additionally, some are not convinced of the protective effect of male circumcision and there are also reports, unsupported by evidence, that non-sex-related drivers play a major role in HIV transmission in sub-Saharan Africa. Here, we provide a critical evaluation of the state of the current evidence for male circumcision in reducing HIV infection in light of established transmission drivers, provide an update on programmes now in place in this region, and explain why policies based on established scientific evidence should be prioritized. We conclude that the evidence supports the need to accelerate the implementation of medical male circumcision programmes for HIV prevention in generalized heterosexual epidemics, as well as in countering the growing heterosexual transmission in countries where HIV prevalence is presently low.

Wamai Richard G; Morris Brian J; Bailis Stefan A; Sokal David; Klausner Jeffrey D; Appleton Ross; Sewankambo Nelson; Cooper David A; Bongaarts John; de Bruyn Guy; Wodak Alex D; Banerjee Joya

2011-01-01

345

Perceptions of prenatal and obstetric care in Sub-Saharan Africa.  

UK PubMed Central (United Kingdom)

BACKGROUND: The maternal mortality ratio in Sub-Saharan Africa remains high, despite progress in reducing maternal mortality in other parts of the world. OBJECTIVE: To explore the perceptions of women and communities to identify barriers to the uptake of obstetric services. SEARCH STRATEGY: A systematic review of qualitative studies exploring perceptions of pregnancy and obstetric services, with thematic synthesis of the included studies. SELECTION CRITERIA: Qualitative studies reporting findings from focus group discussions and in-depth interviews between 1996 and 2009 were included. DATA COLLECTION AND ANALYSIS: Thematic synthesis involved collating and reviewing quotations taken directly from included studies. Themes were generated and clustered for analysis. MAIN RESULTS: Twenty-seven studies were included and 6 major themes identified: perceptions of healthcare workers; perceptions of the hospital environment; cultural perceptions of women; cultural perceptions of pregnancy; perceptions of traditional birth attendants and traditional healers; and role of the community in pregnancy and birth. CONCLUSION: Community attitudes regarding cultural beliefs and interactions with healthcare providers were identified as barriers to the utilization of healthcare services during pregnancy in Sub-Saharan Africa. These prevent engagement with prenatal care and timely use of medical services. Addressing the barriers will be seminal to the success of any healthcare intervention.

Brighton A; D'Arcy R; Kirtley S; Kennedy S

2013-03-01

346

Swine Influenza in Sub-Saharan Africa - Current Knowledge and Emerging Insights.  

UK PubMed Central (United Kingdom)

Pigs have been associated with several episodes of influenza outbreaks in the past and are considered to play a significant role in the ecology of influenza virus. The recent 2009 pandemic influenza A/H1N1 virus originated from swine and not only did it cause widespread infection in humans, but was also transmitted back to swine in Asia, Europe and America. What may be the prevailing situation in Africa, particularly in sub-Saharan Africa, with respect to the circulation of classical swine or pandemic influenza? The ecology of influenza viruses, as well as the epidemiology of human or animal influenza, is poorly understood in the region. In particular, little is known about swine influenza in Africa despite the relevance of this production in the continent and the widespread pig husbandry operations in urban and rural areas. In this review, the gap in the knowledge of classical and pandemic swine influenza is attributed to negligence of disease surveillance, as well as to the economic and public health impact that the disease may cause in sub-Saharan Africa. However, emerging serological and virological evidence of swine influenza virus in some countries in the region underscores the importance of integrated surveillance to better understand the circulation and epidemiology of swine influenza, a disease of global economic and public health importance.

Meseko C; Olaleye D; Capua I; Cattoli G

2013-07-01

347

Regulation and policy initiatives for sustainable energy in sub-Saharan Africa. Chapter 1  

International Nuclear Information System (INIS)

Environmental change and sustainable development present a challenge for all nations. Developed countries have to dismantle and change historic practice before progressing, whereas developing countries can move directly to new technology and new institutional frameworks. This chapter seeks to identify trends in energy supply and use that both improve sustainability and provide opportunities for commerce and industry. Worldwide experience is studied for application in sub-Saharan Africa (abbreviated as 'Africa' henceforward). Such application is central to UNIDO's programmes in energy and environment. These programmes consider both the supply and the demand sides, by the provision of energy for industry, use of renewable energy resources and improved industrial energy end-use efficiency. Key factors are de-linking intensity of energy use from economic growth and reducing environmental damage from energy supply and use The background for this chapter is 'Sustainable Energy Regulation and Policy-making for Africa', a set of 20 training-modules produced for UNIDO and REEEP (the Renewable Energy and Energy Efficiency Partnership). The modules will be used by governments, regulatory offices and industry in Africa for stimulating policy and commercial development in renewable energy and energy efficiency. Of particular relevance is the general trend to more liberalized electricity supplies, as regulated within new legislation. Within each country, institutional frameworks can be changed and improved for the benefit of both citizens and commerce alike. There is a common trend worldwide to include institutional mechanisms for the increase of renewable energy generation and the efficient use of energy within regulatory legislation, e.g. (Harrington et al., 2007). Government involvement and ministerial regulation is most common for electricity. In all countries, the introductory stages of electricity supply have been strongly influenced by national and local government action and ownership. However, once initiated, an established market economy, involving many competitive private companies, should produce electricity at less cost to the consumer and the nation, than if wholly owned and operated by government. Such improvement requires a carefully constructed legal framework, especially because there are many monopoly aspects of electricity supply. The administration and control of the legal objectives requires jurisdiction, usually by the appointment of a Regulator with a specialist and independent staff. Thus, hand-in-hand with the liberalization of energy supplies is the requirement for regulation. Since 1990, liberalization of energy supply, especially of electricity, has been introduced throughout Europe. The main actions have been at national level; consequently, individual national policies and methods dominate. Nevertheless, having an integrated European electricity grid encourages commonality throughout Europe. Associated with liberalization is the growth of private company participation and hence the need for legally enforceable regulation by a Regulator. The pattern of development in Europe is similar to many other world regions including North America. However, European electricity supply is older and the population more concentrated than in most other regions, therefore the opportunity for structured liberalization came first in Europe. Consequently, the European experience is important for formulating policy elsewhere, including Africa. However, without competition from several private companies for each contract, liberalization may well fail to deliver the improved services and reduced energy tariffs expected; chapter three considers such experience. Coincidentally with the trend to energy supply liberalization, has come the need for renewable energy supplies and increased energy efficiency. This change is promoted by several factors, including: sustainable development, new technology, reduced emissions and climate change. New technology enables improvements in the efficient generation and use of energy, thus bri ngin

2007-01-01

348

A decade of research involving men who have sex with men in sub-Saharan Africa: current knowledge and future directions.  

UK PubMed Central (United Kingdom)

It has been just over 10 years since the first large behavioral survey of men who have sex with men (MSM) was implemented in Senegal in 2001. Since then, behavioral and/or HIV prevalence surveys have been conducted in over 14 other countries in sub-Saharan Africa. Current available evidence and review have established that HIV prevalence among MSM in these countries are significantly higher than corresponding general populations, that MSM engage in sexual risk behaviors that place them and sexual partners at higher risk, and that issues of discrimination and stigmatization inhibit HIV interventions for MSM. This paper summarizes the existing knowledge, describes limitations of this evidence, and proposes new and enhanced research approaches to fulfill needed gaps to inform national HIV responses for MSM populations.

Muraguri N; Temmerman M; Geibel S

2012-01-01

349

From bulldozing to housing rights: reducing vulnerability and improving health in African slums.  

Science.gov (United States)

Forced evictions heighten vulnerability among slum dwellers who already face multiple risks of ill health. They constitute a well-documented violation of economic and social rights and are reaching epidemic proportions in sub-Saharan Africa as economic globalization creates and strengthens incentives for forced evictions. We describe evictions in the slums of four African metropolitan areas: Accra (Ghana), Lagos (Nigeria), Luanda (Angola) and Nairobi (Kenya). We survey diverse strategies used in responding to forced evictions and outline the challenges and barriers encountered. We conclude that the international human rights framework offers an important approach for protecting the health of vulnerable populations. PMID:23549705

Mohindra, Katia S; Schrecker, Ted

2013-03-01

350

From bulldozing to housing rights: reducing vulnerability and improving health in African slums.  

UK PubMed Central (United Kingdom)

Forced evictions heighten vulnerability among slum dwellers who already face multiple risks of ill health. They constitute a well-documented violation of economic and social rights and are reaching epidemic proportions in sub-Saharan Africa as economic globalization creates and strengthens incentives for forced evictions. We describe evictions in the slums of four African metropolitan areas: Accra (Ghana), Lagos (Nigeria), Luanda (Angola) and Nairobi (Kenya). We survey diverse strategies used in responding to forced evictions and outline the challenges and barriers encountered. We conclude that the international human rights framework offers an important approach for protecting the health of vulnerable populations.

Mohindra KS; Schrecker T

2013-03-01

351

Why Are Women Less Democratic Than Men? Evidence from Sub-Saharan African Countries  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A substantial literature has examined the determinants of support for democracy and although existing work has found a gender gap in democratic attitudes, there have been no attempts to explain it. In this paper we try to understand why females are less supportive of democracy than males in a number...

García-Peñalosa, Cecilia; Konte, Maty