WorldWideScience

Sample records for sub-saharan african population

  1. Population Genomics of sub-saharan Drosophila melanogaster: African diversity and non-African admixture.

    Directory of Open Access Journals (Sweden)

    John E Pool

    Full Text Available Drosophila melanogaster has played a pivotal role in the development of modern population genetics. However, many basic questions regarding the demographic and adaptive history of this species remain unresolved. We report the genome sequencing of 139 wild-derived strains of D. melanogaster, representing 22 population samples from the sub-Saharan ancestral range of this species, along with one European population. Most genomes were sequenced above 25X depth from haploid embryos. Results indicated a pervasive influence of non-African admixture in many African populations, motivating the development and application of a novel admixture detection method. Admixture proportions varied among populations, with greater admixture in urban locations. Admixture levels also varied across the genome, with localized peaks and valleys suggestive of a non-neutral introgression process. Genomes from the same location differed starkly in ancestry, suggesting that isolation mechanisms may exist within African populations. After removing putatively admixed genomic segments, the greatest genetic diversity was observed in southern Africa (e.g. Zambia, while diversity in other populations was largely consistent with a geographic expansion from this potentially ancestral region. The European population showed different levels of diversity reduction on each chromosome arm, and some African populations displayed chromosome arm-specific diversity reductions. Inversions in the European sample were associated with strong elevations in diversity across chromosome arms. Genomic scans were conducted to identify loci that may represent targets of positive selection within an African population, between African populations, and between European and African populations. A disproportionate number of candidate selective sweep regions were located near genes with varied roles in gene regulation. Outliers for Europe-Africa F(ST were found to be enriched in genomic regions of locally

  2. Candida antifungal drug resistance in sub-Saharan African populations: A systematic review

    Science.gov (United States)

    Africa, Charlene Wilma Joyce; Abrantes, Pedro Miguel dos Santos

    2017-01-01

    Background: Candida infections are responsible for increased morbidity and mortality rates in at-risk patients, especially in developing countries where there is limited access to antifungal drugs and a high burden of HIV co-infection.  Objectives: This study aimed to identify antifungal drug resistance patterns within the subcontinent of Africa.  Methods: A literature search was conducted on published studies that employed antifungal susceptibility testing on clinical Candida isolates from sub-Saharan African countries using Pubmed and Google Scholar.  Results: A total of 21 studies from 8 countries constituted this review. Only studies conducted in sub-Saharan Africa and employing antifungal drug susceptibility testing were included. Regional differences in Candida species prevalence and resistance patterns were identified.  Discussion: The outcomes of this review highlight the need for a revision of antifungal therapy guidelines in regions most affected by Candida drug resistance.  Better controls in antimicrobial drug distribution and the implementation of regional antimicrobial susceptibility surveillance programmes are required in order to reduce the high Candida drug resistance levels seen to be emerging in sub-Saharan Africa. PMID:28154753

  3. Autosomal resequence data reveal Late Stone Age signals of population expansion in sub-Saharan African foraging and farming populations.

    Directory of Open Access Journals (Sweden)

    Murray P Cox

    Full Text Available BACKGROUND: A major unanswered question in the evolution of Homo sapiens is when anatomically modern human populations began to expand: was demographic growth associated with the invention of particular technologies or behavioral innovations by hunter-gatherers in the Late Pleistocene, or with the acquisition of farming in the Neolithic? METHODOLOGY/PRINCIPAL FINDINGS: We investigate the timing of human population expansion by performing a multilocus analysis of > or = 20 unlinked autosomal noncoding regions, each consisting of approximately 6 kilobases, resequenced in approximately 184 individuals from 7 human populations. We test the hypothesis that the autosomal polymorphism data fit a simple two-phase growth model, and when the hypothesis is not rejected, we fit parameters of this model to our data using approximate Bayesian computation. CONCLUSIONS/SIGNIFICANCE: The data from the three surveyed non-African populations (French Basque, Chinese Han, and Melanesians are inconsistent with the simple growth model, presumably because they reflect more complex demographic histories. In contrast, data from all four sub-Saharan African populations fit the two-phase growth model, and a range of onset times and growth rates is inferred for each population. Interestingly, both hunter-gatherers (San and Biaka and food-producers (Mandenka and Yorubans best fit models with population growth beginning in the Late Pleistocene. Moreover, our hunter-gatherer populations show a tendency towards slightly older and stronger growth (approximately 41 thousand years ago, approximately 13-fold than our food-producing populations (approximately 31 thousand years ago, approximately 7-fold. These dates are concurrent with the appearance of the Late Stone Age in Africa, supporting the hypothesis that population growth played a significant role in the evolution of Late Pleistocene human cultures.

  4. HLA-DRB1 and -DQB1 loci in three west African ethnic groups: genetic relationship with sub-Saharan African and European populations.

    Science.gov (United States)

    Lulli, Patrizia; Mangano, Valentina D; Onori, Annamaria; Batini, Chiara; Luoni, Gaia; Sirima, Bienvenu S; Nebie, Issa; Chessa, Luciana; Petrarca, Vincenzo; Modiano, David

    2009-11-01

    The Fulani of west Africa have been shown to be less susceptible to malaria and to mount a stronger immune response to malaria than sympatric ethnic groups. The analysis of HLA diversity is useful for the assessment of the genetic distance between the Fulani and sympatric populations, which represents the necessary theoretical background for the investigation of genetic determinants of susceptibility to malaria. We assessed the polymorphism of HLA-DRB1 and -DQB1 loci and analyzed the distribution of alleles/haplotypes in Fulani, Mossi, and Rimaibé from Burkina Faso. We then investigated the genetic relationship of these three ethnic groups with other sub-Saharan African populations as well as with Europeans. We confirmed that the Fulani from Burkina Faso are genetically distinct from sympatric Mossi and Rimaibé. Furthermore the Fulani from Burkina Faso are close to those from The Gambia and, intriguingly, share the distribution of specific alleles with east African populations (Amhara and Oromo). It is noteworthy that the HLA-DRB1*04 and -DQB1*02 alleles, which are implicated in the development of several autoimmune diseases, are present at high frequency in the Fulani, suggesting their potential involvement in the enhanced immune reactivity observed in this population.

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

    Directory of Open Access Journals (Sweden)

    de Graft Aikins Ama

    2009-08-01

    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

  6. The Ethics of Introducing GMOs into sub-Saharan Africa: Considerations from the sub-Saharan African Theory of Ubuntu.

    Science.gov (United States)

    Komparic, Ana

    2015-11-01

    A growing number of countries in sub-Saharan Africa are considering legalizing the growth of genetically modified organisms (GMOs). Furthermore, several projects are underway to develop transgenic crops tailored to the region. Given the contentious nature of GMOs and prevalent anti-GMO sentiments in Africa, a robust ethical analysis examining the concerns arising from the development, adoption, and regulation of GMOs in sub-Saharan Africa is warranted. To date, ethical analyses of GMOs in the global context have drawn predominantly on Western philosophy, dealing with Africa primarily on a material level. Yet, a growing number of scholars are articulating and engaging with ethical theories that draw upon sub-Saharan African value systems. One such theory, Ubuntu, is a well-studied sub-Saharan African communitarian morality. I propose that a robust ethical analysis of Africa's agricultural future necessitates engaging with African moral theory. I articulate how Ubuntu may lead to a novel and constructive understanding of the ethical considerations for introducing GMOs into sub-Saharan Africa. However, rather than reaching a definitive prescription, which would require significant engagement with local communities, I consider some of Ubuntu's broader implications for conceptualizing risk and engaging with local communities when evaluating GMOs. I conclude by reflecting on the implications of using local moral theory in bioethics by considering how one might negotiate between universalism and particularism in the global context. Rather than advocating for a form of ethical relativism, I suggest that local moral theories shed light on salient ethical considerations that are otherwise overlooked.

  7. Sub Saharan African Terrorist Groups’ use of the Internet

    Directory of Open Access Journals (Sweden)

    Stewart Bertram

    2014-02-01

    Full Text Available Recent actions by French military forces in Niger and the global prominence of terrorist groups such as Al Shabaab and Boko Haram, have highlighted the growing counter terrorist focus on the countries of Sub Saharan Africa. Additionally in a post Bin Laden world and with the immanent withdrawal of coalition combat troops from Afghanistan, there is the possibility of Africa as a continent becoming the new front in the Global War on Terror ('Mben' et al., 2013. However, it is a mistake to assume that Africa’s story is uniformly one of violence and death. Vibrant cultures and a rugged entrepreneurial spirit have combined with a robust Internet backbone, to create the embryonic emergence of high tech hotspots across Africa. With rising IT literacy levels, more and more Africans are becoming connected to the information super highway on a daily basis (Graham, 2010. A tiny minority of these Africans are terrorists.

  8. Another Failure to Replicate Lynn's Estimate of the Average IQ of Sub-Saharan Africans

    Science.gov (United States)

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

    2010-01-01

    In his comment on our literature review of data on the performance of sub-Saharan Africans on Raven's Progressive Matrices, Lynn (this issue) criticized our selection of samples of primary and secondary school students. On the basis of the samples he deemed representative, Lynn concluded that the average IQ of sub-Saharan Africans stands at 67…

  9. Food shortages in sub-Saharan Africa and population growth.

    Science.gov (United States)

    Munisi, S E

    1982-12-01

    Food problems faced by sub-Saharan African nations center around the widening gap between food needs and availablity. Food shortages are suggested to originate from poor distribution and as a result of natural disasters; not as a consequence of population growth. Imperialism, colonialism, and neocolonial exploitation has encouraged African economic and cultural backwardness; a situation in which high population growth can have grave consequences. Fertility control is promoted by industrialized governments as a means of solving socioeconomic problems. However, fertility control may not be justified in many African nations which experience high infant mortality and labor intensive agriculture. Although the number of people who can be fed in any circumstance is ultimately finite, Africa's situation could be improved. If presently uninhabitable land was made suitable for settlement, land shortage from overpopulation would not be problematic for a long time. Modernization of agricultural practices could have a substantial impact of food production. At present, innovations are largely associated with the production of export crops which has often necessitated food imports. Food aid for relief in emergencies or for support of regions with chronic shortages is appropriate and beneficial, however, in some cases food aid can be detrimental, e.g., by lowering food prices thus burdening small farmers. Food aid tends to create dependency, not self-sufficiency. Malnutrition and hunger are symptoms of underdevelopment. At the policy level, a food and nutrition strategy should include rural development designed to improve income redistribution, agricultural modernization, and measures to influence the production of various foods to ensure a balanced diet, and nutrition and health intervention programs for vulnerable groups. In addition to overall agricultural development, 2 general recommendations are offered: increased production of staple food stuffs and a concentrated effort to

  10. Gender Gaps in Political Participation across Sub-Saharan African Nations

    Science.gov (United States)

    Coffe, Hilde; Bolzendahl, Catherine

    2011-01-01

    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…

  11. Sub-Saharan Africa: population pressures on development.

    Science.gov (United States)

    Goliber, T J

    1985-02-01

    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

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

    Science.gov (United States)

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

    2010-01-01

    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 intelligence.…

  13. Sub-Saharan African Students and Their Experiences in American Higher Education

    Science.gov (United States)

    Osikomaiya, Olujide

    2014-01-01

    The purpose of this research project is to study the experiences of Sub-Saharan African students, who have earned professional degrees from American institutions and are currently living in the United States. Acculturative stressors have been identified by researchers as predictors of loneliness, depression, homesickness, and poor mental health…

  14. Evaluation of Genome Wide Association Study Associated Type 2 Diabetes Susceptibility Loci in Sub Saharan Africans

    Science.gov (United States)

    Adeyemo, Adebowale A.; Tekola-Ayele, Fasil; Doumatey, Ayo P.; Bentley, Amy R.; Chen, Guanjie; Huang, Hanxia; Zhou, Jie; Shriner, Daniel; Fasanmade, Olufemi; Okafor, Godfrey; Eghan, Benjamin; Agyenim-Boateng, Kofi; Adeleye, Jokotade; Balogun, Williams; Elkahloun, Abdel; Chandrasekharappa, Settara; Owusu, Samuel; Amoah, Albert; Acheampong, Joseph; Johnson, Thomas; Oli, Johnnie; Adebamowo, Clement; Collins, Francis; Dunston, Georgia; Rotimi, Charles N.

    2015-01-01

    Genome wide association studies (GWAS) for type 2 diabetes (T2D) undertaken in European and Asian ancestry populations have yielded dozens of robustly associated loci. However, the genomics of T2D remains largely understudied in sub-Saharan Africa (SSA), where rates of T2D are increasing dramatically and where the environmental background is quite different than in these previous studies. Here, we evaluate 106 reported T2D GWAS loci in continental Africans. We tested each of these SNPs, and SNPs in linkage disequilibrium (LD) with these index SNPs, for an association with T2D in order to assess transferability and to fine map the loci leveraging the generally reduced LD of African genomes. The study included 1775 unrelated Africans (1035 T2D cases, 740 controls; mean age 54 years; 59% female) enrolled in Nigeria, Ghana, and Kenya as part of the Africa America Diabetes Mellitus (AADM) study. All samples were genotyped on the Affymetrix Axiom PanAFR SNP array. Forty-one of the tested loci showed transferability to this African sample (p < 0.05, same direction of effect), 11 at the exact reported SNP and 30 others at SNPs in LD with the reported SNP (after adjustment for the number of tested SNPs). TCF7L2 SNP rs7903146 was the most significant locus in this study (p = 1.61 × 10−8). Most of the loci that showed transferability were successfully fine-mapped, i.e., localized to smaller haplotypes than in the original reports. The findings indicate that the genetic architecture of T2D in SSA is characterized by several risk loci shared with non-African ancestral populations and that data from African populations may facilitate fine mapping of risk loci. The study provides an important resource for meta-analysis of African ancestry populations and transferability of novel loci. PMID:26635871

  15. Effective coverage and systems effectiveness for malaria case management in sub-Saharan African countries.

    Directory of Open Access Journals (Sweden)

    Katya Galactionova

    Full Text Available Scale-up of malaria preventive and control interventions over the last decade resulted in substantial declines in mortality and morbidity from the disease in sub-Saharan Africa and many other parts of the world. Sustaining these gains will depend on the health system performance. Treatment provides individual benefits by curing infection and preventing progression to severe disease as well as community-level benefits by reducing the infectious reservoir and averting emergence and spread of drug resistance. However many patients with malaria do not access care, providers do not comply with treatment guidelines, and hence, patients do not necessarily receive the correct regimen. Even when the correct regimen is administered some patients will not adhere and others will be treated with counterfeit or substandard medication leading to treatment failures and spread of drug resistance. We apply systems effectiveness concepts that explicitly consider implications of health system factors such as treatment seeking, provider compliance, adherence, and quality of medication to estimate treatment outcomes for malaria case management. We compile data for these indicators to derive estimates of effective coverage for 43 high-burden Sub-Saharan African countries. Parameters are populated from the Demographic and Health Surveys and other published sources. We assess the relative importance of these factors on the level of effective coverage and consider variation in these health systems indicators across countries. Our findings suggest that effective coverage for malaria case management ranges from 8% to 72% in the region. Different factors account for health system inefficiencies in different countries. Significant losses in effectiveness of treatment are estimated in all countries. The patterns of inter-country variation suggest that these are system failures that are amenable to change. Identifying the reasons for the poor health system performance and

  16. Human population growth offsets climate-driven increase in woody vegetation in sub-Saharan Africa

    DEFF Research Database (Denmark)

    Brandt, Martin Stefan; Rasmussen, Kjeld; Peñuelas, Josep

    2017-01-01

    The rapidly growing human population in sub-Saharan Africa generates increasing demand for agricultural land and forest products, which presumably leads to deforestation. Conversely, a greening of African drylands has been reported, but this has been difficult to associate with changes in woody...... an increase in woody cover largely in drylands, and 11% had a decrease (2,150,000 km2), mostly in humid zones. Increases in woody cover were associated with low population growth, and were driven by increases in CO2 in the humid zones and by increases in precipitation in drylands, whereas decreases in woody...... cover were associated with high population growth. The spatially distinct pattern of these opposing trends reflects, first, the natural response of vegetation to precipitation and atmospheric CO2, and second, deforestation in humid areas, minor in size but important for ecosystem services...

  17. The European Horticulture Market : Opportunities for Sub-Saharan African Exporters

    OpenAIRE

    2005-01-01

    Trade is an essential driver for sustained economic growth, and growth is necessary for poverty reduction. In Sub-Saharan Africa, where three-fourths of the poor live in rural areas, spurring growth and generating income and employment opportunities is critical for poverty reduction strategies. Seventy percent of the population lives in rural areas, where livelihoods are largely dependent ...

  18. Challenging the Concept of ''informal'' in Sub-Saharan African Cities

    DEFF Research Database (Denmark)

    Eskemose Andersen, Jørgen

    2014-01-01

    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...

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

    Science.gov (United States)

    Affinnih, Yahya H

    2002-02-01

    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

  20. The Current Waist Circumference Cut Point Used for the Diagnosis of Metabolic Syndrome in Sub-Saharan African Women Is Not Appropriate

    OpenAIRE

    Crowther, Nigel J.; Norris, Shane A.

    2012-01-01

    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 wer...

  1. Phylogenetic relationships and limb loss in sub-Saharan African scincine lizards (Squamata: Scincidae).

    Science.gov (United States)

    Whiting, Alison S; Bauer, Aaron M; Sites, Jack W

    2003-12-01

    Skinks are the largest family of lizards and are found worldwide in a diversity of habitats. One of the larger and more poorly studied groups of skinks includes members of the subfamily Scincinae distributed in sub-Saharan Africa. Sub-Saharan African scincines are one of the many groups of lizards that show limb reduction and loss, and the genus Scelotes offers an excellent opportunity to look at limb loss in a phylogenetic context. Phylogenetic relationships were reconstructed for a total of 52 taxa representing all subfamilies of skinks as well as other Autarchoglossan families using sequence from six gene regions including; 12S, 16S, and cytochrome b (mitochondrial), as well as alpha-Enolase, 18S, and C-mos (nuclear). The family Scincidae is recovered as monophyletic and is the sister taxon to a (Cordylidae+Xantusiidae) clade. Within skinks the subfamily Acontinae is monophyletic and sister group to all remaining skinks. There is no support for the monophyly of the subfamilies Lygosominae and Scincinae, but sub-Saharan African scincines+Feylinia form a well supported monophyletic group. The monophyly of Scelotes is confirmed, and support is found for two geographic groups within the genus. Reconstructions of ancestral states for limb and digital characters show limited support for the reversal or gain of both digits and limbs, but conservative interpretation of the results suggest that limb loss is common, occurring multiple times throughout evolutionary history, and is most likely not reversible.

  2. Confirmation of the potential usefulness of two human beta globin pseudogene markers to estimate gene flows to and from sub-Saharan Africans.

    Science.gov (United States)

    Ciminelli, Bianca Maria; Pompei, Fiorenza; Relucenti, Michela; Lum, J Koji; Simporé, Jacques; Spedini, Gabriella; Martínez-Labarga, Cristina; Pardo, Miguel G

    2002-04-01

    Two polymorphic sites, -107 and -100 with respect to the "cap" site of the human beta globin pseudogene, recently discovered in our laboratory, turned out to have an ethnically complementary distribution. The first site is polymorphic in Europeans, North Africans, Indians (Hindu), and Oriental Asians, and monomorphic in sub-Saharan Africans. Conversely, the second site is polymorphic in sub-Saharan African populations and monomorphic in the aforementioned populations. Here we report the gene frequencies of these two polymorphic sites in nine additional populations (Egyptians, Spaniards, Japanese, Chinese, Filipinos, Vietnamese, Africans from Togo and from Benin, and Pygmies), confirming their ethnospecificity and, through the analysis of these two markers in Oromo and Amhara of Ethiopia (two mixed populations), their usefulness in genetic admixture studies. Moreover, we studied another marker polymorphic in sub-Saharan African populations only, a TaqI restriction fragment length polymorphism located in the same region as the present markers, demonstrating the absence of linkage disequilibrium between it and the -100 site, so that we can exclude that the information they provide is redundant.

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

    Directory of Open Access Journals (Sweden)

    Kathleen Van Royen

    Full Text Available 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.

  4. Population Health Science: A Core Element of Health Science Education in Sub-Saharan Africa.

    Science.gov (United States)

    Hiatt, Robert A; Engmann, Natalie J; Ahmed, Mushtaq; Amarsi, Yasmin; Macharia, William M; Macfarlane, Sarah B; Ngugi, Anthony K; Rabbani, Fauziah; Walraven, Gijs; Armstrong, Robert W

    2017-04-01

    Sub-Saharan Africa suffers an inordinate burden of disease and does not have the numbers of suitably trained health care workers to address this challenge. New concepts in health sciences education are needed to offer alternatives to current training approaches.A perspective of integrated training in population health for undergraduate medical and nursing education is advanced, rather than continuing to take separate approaches for clinical and public health education. Population health science educates students in the social and environmental origins of disease, thus complementing disease-specific training and providing opportunities for learners to take the perspective of the community as a critical part of their education.Many of the recent initiatives in health science education in sub-Saharan Africa are reviewed, and two case studies of innovative change in undergraduate medical education are presented that begin to incorporate such population health thinking. The focus is on East Africa, one of the most rapidly growing economies in sub-Saharan Africa where opportunities for change in health science education are opening. The authors conclude that a focus on population health is a timely and effective way for enhancing training of health care professionals to reduce the burden of disease in sub-Saharan Africa.

  5. Comparative analysis of iron homeostasis in sub-Saharan African children with sickle cell disease and their unaffected siblings

    Directory of Open Access Journals (Sweden)

    Selma eGomez

    2016-02-01

    Full Text Available Iron is an essential trace element subject to tight regulation to ensure adequate running of biological processes. In sub-Saharan Africa where hemoglobinopathies are common, iron homeostasis is likely to be impaired by these conditions. Here we assessed and compared key serum proteins associated with iron metabolism between sub-Saharan African children with sickle cell disease (SCD and their unaffected siblings. Complete blood counts and serum concentrations of four key proteins involved in iron regulation (ferritin, transferrin, sTfR and hepcidin were measured for 73 children with SCD and 68 healthy siblings in Benin, West Africa. We found significant differences in concentration of transferrin, sTfR and ferritin between the two groups. Hepcidin concentrations were found at unusually high concentrations but did not differ among the two groups. We found a significant negative correlation between hepcidin levels and both MCH and MCV in the SCD group and report that sTfR concentrations show a correlation with MCV and MHC in opposite directions in the two groups. These results highlight the unusually high levels of hepcidin in the Beninese population and the patterns of differential iron homeostasis taking place under sickle cell disease status. These results lay the foundation for a systematic evaluation of the underlying mechanisms deregulating iron homeostasis in populations with SCD or high prevalence of iron deficiency.

  6. Raven’s test performance of sub-Saharan Africans: average performance, psychometric properties, and the Flynn Effect

    NARCIS (Netherlands)

    Wicherts, J.M.; Dolan, C.V.; Carlson, J.S.; van der Maas, H.L.J.

    2010-01-01

    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

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

    Science.gov (United States)

    Kreamer, David K; Usher, Brent

    2010-01-01

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

  8. Learning-by-Exporting Versus Self-Selection: New Evidence for 19 Sub-Saharan African Countries

    NARCIS (Netherlands)

    Foster-McGregor, N.; Isaksson, A.; Kaulich, F.

    2015-01-01

    We examine learning-by-exporting effects of manufacturing and services firms in 19 sub-Saharan African countries. Comparing several outlier-robust estimators, our results provide evidence for positive effects in the manufacturing sector when using the MM estimator, but not in the services sector.

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

    NARCIS (Netherlands)

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

    1990-01-01

    Sum.: The economic policy of structural adjustment, which was initiated in most African countries during the 1980s, posed a serious threat to agricultural marketing boards in sub-Saharan Africa. Two elements of structural adjustment were particularly ominous: 'privatization' threatened the continued

  10. Stakeholder roles for fostering ambidexterity in Sub-Saharan African agricultural netchains for the emergence of multi-stakeholder cooperatives

    NARCIS (Netherlands)

    Pérez Perdomo, S.A.; Farrow, A.; Trienekens, J.H.; Omta, S.W.F.

    2015-01-01

    The Sub-Saharan African smallholder agricultural sector faces multiple and usually complex challenges, which can potentially be overcome by collective action. Smallholder farmers and other value chain stakeholders can tackle temporal, structural and contextual challenges by joining multi-level innov

  11. Another failure to replicate Lynn’s estimate of the average IQ of sub-Saharan Africans

    NARCIS (Netherlands)

    Wicherts, J.M.; Dolan, C.V.; Carlson, J.S.; van der Maas, H.L.J.

    2010-01-01

    In his comment on our literature review of data on the performance of sub-Saharan Africans on Raven's Progressive Matrices, Lynn (this issue) criticized our selection of samples of primary and secondary school students. On the basis of the samples he deemed representative, Lynn concluded that the av

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

    Directory of Open Access Journals (Sweden)

    Olusanya Bolajoko O

    2010-01-01

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

  13. Engaging black sub-Saharan African communities and their gatekeepers in HIV prevention programs: Challenges and strategies from England

    Directory of Open Access Journals (Sweden)

    Mathew Nyashanu

    2016-12-01

    Full Text Available Objective: HIV infection is a sensitive issue in black communities [Serrant-Green L. Black Caribbean men, sexual health decisions and silences. Doctoral thesis. Nottingham School of Nursing, University of Nottingham; 2004]. Statistics show black sub-Saharan African (BSSA communities disproportionately constitute two-thirds of people with HIV [Heath Protection Agency. Health protection report: latest infection reports-GOV.UK; 2013]. African communities constitute 30% of people accessing HIV treatment in the United Kingdom yet represent less than 1% of the population [Health Protection Agency. HIV in the United Kingdom: 2012 report; 2012], [Department of Health. DVD about FGM. 2012. Available from fgm@dh.gsi.gov.uk.]. This article explores the sociocultural challenges in engaging BSSA communities in HIV prevention programs in England and possible strategies to improve their involvement. Methods: Twelve focus group discussions and 24 semistructured interviews were conducted in a 2-year period with participants from the BSSA communities and sexual health services in the West Midlands, England. The research was supported by the Ubuntu scheme, a sexual health initiative working with African communities in Birmingham, England. Results: Ineffective engagement with African communities can hinder the effectiveness of HIV prevention programs. Skills and strategies sensitive to BSSA culture are important for successful implementation of prevention programs. HIV prevention programs face challenges including stigma, denial, and marginalized views within BSSA communities. Conclusion: Networking, coordination, and cultural sensitivity training for health professionals are key strategies for engaging BSSA communities in HIV prevention programs.

  14. Tuberculosis and HIV control in sub-Saharan African prisons: "thinking outside the prison cell".

    Science.gov (United States)

    Reid, Stewart E; Topp, Stephanie M; Turnbull, Eleanor R; Hatwiinda, Sisa; Harris, Jennifer B; Maggard, Katie R; Roberts, Sarah T; Krüüner, Annika; Morse, Jill C; Kapata, Nathan; Chisela, Chileshe; Henostroza, German

    2012-05-15

    Tuberculosis is one of the fastest-growing epidemics in prison populations in sub-Saharan Africa (SSA), constituting a threat to both inmates and the wider community. Various factors have contributed to the breakdown of tuberculosis control in prison facilities in SSA, including slow and insensitive diagnostics, failing prison infrastructure, inadequate funding, and weak prevention and treatment interventions for human immunodeficiency virus (HIV). In this article, we describe the challenges inherent in current approaches to tuberculosis control in prisons and consider the alternatives. We argue that although improved implementation of conventional tuberculosis control activities is necessary, considerable investment in a broader range of public health interventions, including infrastructure and staffing upgrades, cutting-edge tuberculosis diagnostics, and combination prevention for HIV, will be equally critical. This combination response to tuberculosis in prisons will be essential for tackling existing and nascent prison tuberculosis epidemics and will require high-level political support and financing.

  15. Phylogeographical Structure in Mitochondrial DNA of Legume Pod Borer (Maruca vitrata Population in Tropical Asia and Sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Malini Periasamy

    Full Text Available This study was undertaken to assess the genetic diversity and host plant races of M. vitrata population in South and Southeast Asia and sub-Saharan Africa. The cytochrome c oxidase subunit 1 (cox1 gene was used to understand the phylogenetic relationship of geographically different M. vitrata population, but previous studies did not include population from Southeast Asia, the probable center of origin for Maruca, and from east Africa. Extensive sampling was done from different host plant species in target countries. Reference populations from Oceania and Latin America were used. An amplicon of 658 bp was produced by polymerase chain reaction, and 64 haplotypes were identified in 686 M. vitrata individuals. Phylogenetic analysis showed no difference among the M. vitrata population from different host plants. However, the results suggested that M. vitrata has formed two putative subspecies (which cannot be differentiated based on morphological characters in Asia and sub-Saharan Africa, as indicated by the high pairwise FST values (0.44-0.85. The extremely high FST values (≥ 0.93 of Maruca population in Latin America and Oceania compared to Asian and African population seem to indicate a different species. On the continental or larger geographical region basis, the genetic differentiation is significantly correlated with the geographical distance. In addition, two putative species of Maruca, including M. vitrata occur in Australia, Indonesia and Papua New Guinea. The negative Tajima's D and Fu's FS values showed the recent demographic expansion of Maruca population. The haplotype network and Automatic Barcode Gap Discovery analyses confirmed the results of phylogenetic analysis. Thus, this study confirmed the presence of three putative Maruca species, including one in Latin America, one in Oceania (including Indonesia and M. vitrata in Asia, Africa and Oceania. Hence, the genetic differences in Maruca population should be carefully considered

  16. Phylogeographical Structure in Mitochondrial DNA of Legume Pod Borer (Maruca vitrata) Population in Tropical Asia and Sub-Saharan Africa.

    Science.gov (United States)

    Periasamy, Malini; Schafleitner, Roland; Muthukalingan, Krishnan; Ramasamy, Srinivasan

    2015-01-01

    This study was undertaken to assess the genetic diversity and host plant races of M. vitrata population in South and Southeast Asia and sub-Saharan Africa. The cytochrome c oxidase subunit 1 (cox1) gene was used to understand the phylogenetic relationship of geographically different M. vitrata population, but previous studies did not include population from Southeast Asia, the probable center of origin for Maruca, and from east Africa. Extensive sampling was done from different host plant species in target countries. Reference populations from Oceania and Latin America were used. An amplicon of 658 bp was produced by polymerase chain reaction, and 64 haplotypes were identified in 686 M. vitrata individuals. Phylogenetic analysis showed no difference among the M. vitrata population from different host plants. However, the results suggested that M. vitrata has formed two putative subspecies (which cannot be differentiated based on morphological characters) in Asia and sub-Saharan Africa, as indicated by the high pairwise FST values (0.44-0.85). The extremely high FST values (≥ 0.93) of Maruca population in Latin America and Oceania compared to Asian and African population seem to indicate a different species. On the continental or larger geographical region basis, the genetic differentiation is significantly correlated with the geographical distance. In addition, two putative species of Maruca, including M. vitrata occur in Australia, Indonesia and Papua New Guinea. The negative Tajima's D and Fu's FS values showed the recent demographic expansion of Maruca population. The haplotype network and Automatic Barcode Gap Discovery analyses confirmed the results of phylogenetic analysis. Thus, this study confirmed the presence of three putative Maruca species, including one in Latin America, one in Oceania (including Indonesia) and M. vitrata in Asia, Africa and Oceania. Hence, the genetic differences in Maruca population should be carefully considered while designing

  17. A Systematic Review of Tobacco Smoking Prevalence and Description of Tobacco Control Strategies in Sub-Saharan African Countries; 2007 to 2014.

    Directory of Open Access Journals (Sweden)

    Rachel Brathwaite

    Full Text Available To systematically review current smoking prevalence among adults in sub-Saharan Africa from 2007 to May 2014 and to describe the context of tobacco control strategies in these countries.Five databases, Medline, Embase, Africa-wide Information, Cinahl Plus, and Global Health were searched using a systematic search strategy. There were no language restrictions.26 included studies measured current smoking prevalence in nationally representative adult populations in sub-Saharan African countries.Study details were independently extracted using a standard datasheet. Data on tobacco control policies, taxation and trends in prices were obtained from the Implementation Database of the WHO FCTC website.Studies represented 13 countries. Current smoking prevalence varied widely ranging from 1.8% in Zambia to 25.8% in Sierra Leone. The prevalence of smoking was consistently lower in women compared to men with the widest gender difference observed in Malawi (men 25.9%, women 2.9%. Rwanda had the highest prevalence of women smokers (12.6% and Ghana had the lowest (0.2%. Rural, urban patterns were inconsistent. Most countries have implemented demand-reduction measures including bans on advertising, and taxation rates but to different extents.Smoking prevalence varied widely across sub-Saharan Africa, even between similar country regions, but was always higher in men. High smoking rates were observed among countries in the eastern and southern regions of Africa, mainly among men in Ethiopia, Malawi, Rwanda, and Zambia and women in Rwanda and rural Zambia. Effective action to reduce smoking across sub-Saharan Africa, particularly targeting population groups at increased risk remains a pressing public health priority.

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

    Directory of Open Access Journals (Sweden)

    Nikos Pantazis

    Full Text Available 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.

  19. Malthusian factors as proximal drivers of human population crisis at Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Mauricio eLima

    2015-11-01

    Full Text Available There is a growing interest and concern for understanding the interaction among human population growth and the sustainability of natural resources. In fact, many agrarian societies experienced an increasing frequency of wars, famines and epidemics during the periods of resource depletion. People from Sub-Saharan Africa (SSA have suffered the demographic consequences of famines, civil wars and political instabilities during the last fifty years.. Almost half of the countries of Sub-Saharan Africa have undergone some form of demographic crisis over the past fifty years. Our analysis indicate that despite that environmental conditions were positively correlated with crop production across SSA, Malthusian factors correlated inversely with cultivation intensity, which in turn translated into a higher magnitude of depopulation suffered during the past fifty years. In this paper, we provide empirical evidence that population collapses in SSA during the last fifty years have been multifactorial, although more closely associated with Malthusian factors as proximal drivers. Other proximal drivers such as economic indicators, political stability and environmental determinants did not explain as much variance as Malthusian forces, suggesting that explanations of collapse magnitude in SSA are embedded in a complex multi-causal chain, in which demographic factors may play a modulating role yet to be explored in more depth.

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

    Directory of Open Access Journals (Sweden)

    Capucine de Fouchier

    2012-12-01

    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.

  1. Researching the Link Between Biomass Burning and Drought Across the Northern Sub-Saharan African Savanna/Sahel Belt

    Science.gov (United States)

    Ichoku, Charles; Ellison, Luke

    2012-01-01

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

  2. Signatures of adaptation in human invasive Salmonella Typhimurium ST313 populations from sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Chinyere K Okoro

    2015-03-01

    Full Text Available Two lineages of Salmonella enterica serovar Typhimurium (S. Typhimurium of multi-locus sequence type ST313 have been linked with the emergence of invasive Salmonella disease across sub-Saharan Africa. The expansion of these lineages has a temporal association with the HIV pandemic and antibiotic usage. We analysed the whole genome sequence of 129 ST313 isolates representative of the two lineages and found evidence of lineage-specific genome degradation, with some similarities to that observed in S. Typhi. Individual ST313 S. Typhimurium isolates exhibit a distinct metabolic signature and modified enteropathogenesis in both a murine and cattle model of colitis, compared to S. Typhimurium outside of the ST313 lineages. These data define phenotypes that distinguish ST313 isolates from other S. Typhimurium and may represent adaptation to a distinct pathogenesis and lifestyle linked to an-immuno-compromised human population.

  3. Analysis of a grid ionospheric vertical delay and its bounding errors over West African sub-Saharan region

    Science.gov (United States)

    Abe, O. E.; Otero Villamide, X.; Paparini, C.; Radicella, S. M.; Nava, B.

    2017-02-01

    Investigating the effects of the Equatorial Ionization Anomaly (EIA) ionosphere and space weather on Global Navigation Satellite Systems (GNSS) is very crucial, and a key to successful implementation of a GNSS augmentation system (SBAS) over the equatorial and low-latitude regions. A possible ionospheric vertical delay (GIVD, Grid Ionospheric Vertical Delay) broadcast at a Ionospheric Grid Point (IGP) and its confidence bounds errors (GIVE, Grid Ionospheric Vertical Error) are analyzed and compared with the ionospheric vertical delay estimated at a nearby user location over the West African Sub-Saharan region. Since African sub-Saharan ionosphere falls within the EIA region, which is always characterized by a disturbance in form of irregularities after sunset, and the disturbance is even more during the geomagnetically quiet conditions unlike middle latitudes, the need to have a reliable ionospheric threat model to cater for the nighttime ionospheric plasma irregularities for the future SBAS user is essential. The study was done during the most quiet and disturbed geomagnetic conditions on October 2013. A specific low latitude EGNOS-like algorithm, based on single thin layer model, was engaged to simulate SBAS message in the study. Our preliminary results indicate that, the estimated GIVE detects and protects a potential SBAS user against sampled ionospheric plasma irregularities over the region with a steep increment in GIVE to non-monitored after local sunset to post midnight. This corresponds to the onset of the usual ionospheric plasma irregularities in the region. The results further confirm that the effects of the geomagnetic storms on the ionosphere are not consistent in affecting GNSS applications over the region. Finally, this paper suggests further work to be investigated in order to improve the threat integrity model activity, and thereby enhance the availability of the future SBAS over African sub-Saharan region.

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

    Directory of Open Access Journals (Sweden)

    Robinson Rachel

    2011-09-01

    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

  5. Barriers to early presentation and diagnosis of breast cancer among African women living in sub-Saharan Africa

    Science.gov (United States)

    Akuoko, Cynthia Pomaa; Armah, Ernestina; Sarpong, Theresa; Quansah, Dan Yedu; Amankwaa, Isaac

    2017-01-01

    Background Breast cancer (BC) has been described as the leading cause of cancer deaths among women especially in the developing world including sub Saharan Africa (SSA). Delayed presentation and late diagnosis at health facilities are parts of the contributing factors of high BC mortality in Africa. This review aimed to appraise the contributing factors to delayed breast cancer presentation and diagnosis among SSA women. Methods Five databases encompassing medical and social sciences were systematically searched using predefined search terms linked with breast cancer presentation and diagnosis and sub Saharan Africa. Reference lists of relevant papers were also hand searched. Quality of quantitative and qualitative articles were assessed using the National Institute of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and the Critical Appraisal Skills Programme (CASP) quality appraisal checklist. Thematic analysis was used to synthesize the qualitative studies to integrate findings. Results Fourteen (14) quantitative studies, two (2) qualitative studies and one (1) mixed method study merited inclusion for analysis. This review identified low knowledge of breast cancer among SSA women. This review also found lack of awareness of early detection treatment, poor perception of BC, socio-cultural factors such as belief, traditions and fear as factors impacting African women’s health seeking behavior in relation to breast cancer. Conclusion Improving African women’s knowledge and understanding will improve behaviors related to breast cancer and facilitate early presentation and detection and enhance proper management and treatment of breast cancer. PMID:28192444

  6. Consequences of neglect: analysis of the sub-Saharan African snake antivenom market and the global context.

    Directory of Open Access Journals (Sweden)

    Nicholas I Brown

    Full Text Available BACKGROUND: The worldwide neglect of immunotherapeutic products for the treatment of snakebite has resulted in a critical paucity of effective, safe and affordable therapy in many Third World countries, particularly in Africa. Snakebite ranks high among the most neglected global health problems, with thousands of untreated victims dying or becoming permanently maimed in developing countries each year because of a lack of antivenom-a treatment that is widely available in most developed countries. This paper analyses the current status of antivenom production for sub-Saharan African countries and provides a snapshot of the global situation. METHODS: A global survey of snake antivenom products was undertaken in 2007, involving 46 current and former antivenom manufacturers. Companies producing antivenom for use in sub-Saharan Africa were re-surveyed in 2010 and 2011. RESULTS: The amount of antivenom manufactured for sub-Saharan Africa increased between 2007 and 2010/11, however output and procurement remained far below that required to treat the estimated 300,000-500,000 snakebite victims each year. Variable potency and inappropriate marketing of some antivenoms mean that the number of effective treatments available may be as low as 2.5% of projected needs. Five companies currently market antivenom for sale in Africa; three others have products in the final stages of development; and since 2007 one has ceased production indefinitely. Most current antivenom producers possess a willingness and capacity to raise output. However inconsistent market demand, unpredictable financial investment and inadequate quality control discourage further production and threaten the viability of the antivenom industry. CONCLUSION: Financial stimulus is urgently needed to identify and develop dependable sources of high-grade antivenoms, support current and emerging manufacturers, and capitalise on existing unutilised production capacity. Investing to ensure a consistent

  7. Review: Joseph Patrick Ganahl, Corruption, Good Governance, and the African State: A Critical Analysis of the Political-Economic Foundations of Corruption in Sub-Saharan Africa (2013

    Directory of Open Access Journals (Sweden)

    Reinhart Kößler

    2015-01-01

    Full Text Available Review of the monograph:Joseph Patrick Ganahl, Corruption, Good Governance, and the African State: A Critical Analysis of the Political-Economic Foundations of Corruption in Sub-Saharan Africa, Potsdam: Potsdam University Press, 2013, ISBN 9783869562483, 300 pp.

  8. Timescales of transformational climate change adaptation in sub-Saharan African agriculture

    Science.gov (United States)

    Rippke, Ulrike; Ramirez-Villegas, Julian; Jarvis, Andy; Vermeulen, Sonja J.; Parker, Louis; Mer, Flora; Diekkrüger, Bernd; Challinor, Andrew J.; Howden, Mark

    2016-06-01

    Climate change is projected to constitute a significant threat to food security if no adaptation actions are taken. Transformation of agricultural systems, for example switching crop types or moving out of agriculture, is projected to be necessary in some cases. However, little attention has been paid to the timing of these transformations. Here, we develop a temporal uncertainty framework using the CMIP5 ensemble to assess when and where cultivation of key crops in sub-Saharan Africa becomes unviable. We report potential transformational changes for all major crops during the twenty-first century, as climates shift and areas become unsuitable. For most crops, however, transformation is limited to small pockets (banana is transformation more widespread (~30% area for maize and banana, 60% for beans). We envisage three overlapping adaptation phases to enable projected transformational changes: an incremental adaptation phase focused on improvements to crops and management, a preparatory phase that establishes appropriate policies and enabling environments, and a transformational adaptation phase in which farmers substitute crops, explore alternative livelihoods strategies, or relocate. To best align policies with production triggers for no-regret actions, monitoring capacities to track farming systems as well as climate are needed.

  9. Estimating the hypothetical dual health impact and cost-effectiveness of the Woman’s Condom in selected sub-Saharan African countries

    Directory of Open Access Journals (Sweden)

    Mvundura M

    2015-03-01

    Full Text Available Mercy Mvundura, Neeti Nundy, Maggie Kilbourne-Brook, Patricia S Coffey Technology Solutions Global Program, PATH, Seattle, WA, USA Background: Female condoms are the only currently available woman-initiated option that offers dual protection from pregnancy and sexually transmitted infections, including HIV. The Woman’s Condom is a new female condom designed to provide dual protection and to be highly pleasurable and acceptable. Objective: We sought to estimate the potential dual health impact and cost-effectiveness of a Woman’s Condom distribution program in 13 sub-Saharan African countries with HIV prevalence rates >4% among adults aged 15–49 years. We used two separate, publicly available models for this analysis, the Impact 2 model developed by Marie Stopes International and the Population Services International disability-adjusted life years (DALY calculator program. We estimated the potential numbers of pregnancies and DALYs averted when the Woman’s Condom is used as a family planning method and the HIV infections and DALYs averted when it is used as an HIV prevention method. Results: Programming 100,000 Woman’s Condoms in each of 13 countries in sub-Saharan Africa during a 1-year period could potentially prevent 194 pregnancies and an average of 21 HIV infections in each country. When using the World Health Organization CHOosing Interventions that are Cost-Effective (WHO-CHOICE criteria as a threshold to infer the potential cost-effectiveness of the Woman’s Condom, we found that the Woman’s Condom would be considered cost-effective. Conclusion: This was a first and successful attempt to estimate the impact of dual protection of female condoms. The health impact is greater for the use of the Woman’s Condom as an HIV prevention method than for contraception. Dual use of the Woman’s Condom increases the overall health impact. The Woman’s Condom was found to be very cost-effective in all 13 countries in our sample. Keywords

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

    Directory of Open Access Journals (Sweden)

    Degboe Arnold N

    2009-09-01

    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

  11. Cholera Incidence and Mortality in Sub-Saharan African Sites during Multi-country Surveillance.

    Directory of Open Access Journals (Sweden)

    Delphine Sauvageot

    2016-05-01

    Full Text Available Cholera burden in Africa remains unknown, often because of weak national surveillance systems. We analyzed data from the African Cholera Surveillance Network (www.africhol.org.During June 2011-December 2013, we conducted enhanced surveillance in seven zones and four outbreak sites in Togo, the Democratic Republic of Congo (DRC, Guinea, Uganda, Mozambique and Cote d'Ivoire. All health facilities treating cholera cases were included. Cholera incidences were calculated using culture-confirmed cholera cases and culture-confirmed cholera cases corrected for lack of culture testing usually due to overwhelmed health systems and imperfect test sensitivity. Of 13,377 reported suspected cases, 34% occurred in Conakry, Guinea, 47% in Goma, DRC, and 19% in the remaining sites. From 0-40% of suspected cases were aged under five years and from 0.3-86% had rice water stools. Within surveillance zones, 0-37% of suspected cases had confirmed cholera compared to 27-38% during outbreaks. Annual confirmed incidence per 10,000 population was <0.5 in surveillance zones, except Goma where it was 4.6. Goma and Conakry had corrected incidences of 20.2 and 5.8 respectively, while the other zones a median of 0.3. During outbreaks, corrected incidence varied from 2.6 to 13.0. Case fatality ratios ranged from 0-10% (median, 1% by country.Across different African epidemiological contexts, substantial variation occurred in cholera incidence, age distribution, clinical presentation, culture confirmation, and testing frequency. These results can help guide preventive activities, including vaccine use.

  12. Cholera Incidence and Mortality in Sub-Saharan African Sites during Multi-country Surveillance

    Science.gov (United States)

    Sauvageot, Delphine; Njanpop-Lafourcade, Berthe-Marie; Akilimali, Laurent; Anne, Jean-Claude; Bidjada, Pawou; Bompangue, Didier; Bwire, Godfrey; Coulibaly, Daouda; Dengo-Baloi, Liliana; Dosso, Mireille; Orach, Christopher Garimoi; Inguane, Dorteia; Kagirita, Atek; Kacou-N’Douba, Adele; Keita, Sakoba; Kere Banla, Abiba; Kouame, Yao Jean-Pierre; Landoh, Dadja Essoya; Langa, Jose Paulo; Makumbi, Issa; Miwanda, Berthe; Malimbo, Muggaga; Mutombo, Guy; Mutombo, Annie; NGuetta, Emilienne Niamke; Saliou, Mamadou; Sarr, Veronique; Senga, Raphael Kakongo; Sory, Fode; Sema, Cynthia; Tante, Ouyi Valentin; Gessner, Bradford D.; Mengel, Martin A.

    2016-01-01

    Background Cholera burden in Africa remains unknown, often because of weak national surveillance systems. We analyzed data from the African Cholera Surveillance Network (www.africhol.org). Methods/ Principal findings During June 2011–December 2013, we conducted enhanced surveillance in seven zones and four outbreak sites in Togo, the Democratic Republic of Congo (DRC), Guinea, Uganda, Mozambique and Cote d’Ivoire. All health facilities treating cholera cases were included. Cholera incidences were calculated using culture-confirmed cholera cases and culture-confirmed cholera cases corrected for lack of culture testing usually due to overwhelmed health systems and imperfect test sensitivity. Of 13,377 reported suspected cases, 34% occurred in Conakry, Guinea, 47% in Goma, DRC, and 19% in the remaining sites. From 0–40% of suspected cases were aged under five years and from 0.3–86% had rice water stools. Within surveillance zones, 0–37% of suspected cases had confirmed cholera compared to 27–38% during outbreaks. Annual confirmed incidence per 10,000 population was <0.5 in surveillance zones, except Goma where it was 4.6. Goma and Conakry had corrected incidences of 20.2 and 5.8 respectively, while the other zones a median of 0.3. During outbreaks, corrected incidence varied from 2.6 to 13.0. Case fatality ratios ranged from 0–10% (median, 1%) by country. Conclusions/Significance Across different African epidemiological contexts, substantial variation occurred in cholera incidence, age distribution, clinical presentation, culture confirmation, and testing frequency. These results can help guide preventive activities, including vaccine use. PMID:27186885

  13. Bibliometric Assessment of European and Sub-Saharan African Research Output on Poverty-Related and Neglected Infectious Diseases from 2003 to 2011.

    Directory of Open Access Journals (Sweden)

    J Gabrielle Breugelmans

    2015-08-01

    Full Text Available The European & Developing Countries Clinical Trials Partnership (EDCTP is a partnership of European and sub-Saharan African countries that aims to accelerate the development of medical interventions against poverty-related diseases (PRDs. A bibliometric analysis was conducted to 1 measure research output from European and African researchers on PRDs, 2 describe collaboration patterns, and 3 assess the citation impact of clinical research funded by EDCTP.Disease-specific research publications were identified in Thomson Reuters Web of Science using search terms in titles, abstracts and keywords. Publication data, including citation counts, were extracted for 2003-2011. Analyses including output, share of global papers, normalised citation impact (NCI, and geographical distribution are presented. Data are presented as five-year moving averages. European EDCTP member countries accounted for ~33% of global research output in PRDs and sub-Saharan African countries for ~10% (2007-2011. Both regions contributed more to the global research output in malaria (43.4% and 22.2%, respectively. The overall number of PRD papers from sub-Saharan Africa increased markedly (>47% since 2003, particularly for HIV/AIDS (102% and tuberculosis (TB (81%, and principally involving Southern and East Africa. For 2007-2011, European and sub-Saharan African research collaboration on PRDs was highly cited compared with the world average (NCI in brackets: HIV/AIDS 1.62 (NCI: 1.16, TB 2.11 (NCI: 1.06, malaria 1.81 (NCI: 1.22, and neglected infectious diseases 1.34 (NCI: 0.97. The NCI of EDCTP-funded papers for 2003-2011 was exceptionally high for HIV/AIDS (3.24, TB (4.08 and HIV/TB co-infection (5.10 compared with global research benchmarks (1.14, 1.05 and 1.35, respectively.The volume and citation impact of papers from sub-Saharan Africa has increased since 2003, as has collaborative research between Europe and sub-Saharan Africa. >90% of publications from EDCTP

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

    Directory of Open Access Journals (Sweden)

    Johannes Engelken

    2014-02-01

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

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

    Science.gov (United States)

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

    2014-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Nigel J Crowther

    Full Text Available 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

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

    Science.gov (United States)

    Crowther, Nigel J; Norris, Shane A

    2012-01-01

    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

  18. THE MAGNITUDE AND DETERMINANTS OF CAPITAL FLIGHT - THE CASE FOR 6 SUB-SAHARAN AFRICAN COUNTRIES

    NARCIS (Netherlands)

    HERMES, N; LENSINK, R

    1992-01-01

    Most studies treat capital flight as an exclusively Latin American problem. This paper estimates capital flight for six African countries and shows that the emphasis on Latin American capital flight is not correct. It appears that the burden of capital flight is also important for many African count

  19. "It's my secret": fear of disclosure among sub-Saharan African migrant women living with HIV/AIDS in Belgium.

    Directory of Open Access Journals (Sweden)

    Agnes Ebotabe Arrey

    Full Text Available Patients with HIV not only have to deal with the challenges of living with an incurable disease but also with the dilemma of whether or not to disclose their status to their partners, families and friends. This study explores the extent to which sub-Saharan African (SSA migrant women in Belgium disclose their HIV positive status, reasons for disclosure/non-disclosure and how they deal with HIV disclosure. A qualitative study consisting of interviews with twenty-eight SSA women with HIV/AIDS was conducted. Thematic content analysis was employed to identify themes as they emerged. Our study reveals that these women usually only disclose their status to healthcare professionals because of the treatment and care they need. This selective disclosure is mainly due to the taboo of HIV disease in SSA culture. Stigma, notably self-stigma, greatly impedes HIV disclosure. Techniques to systematically incorporate HIV disclosure into post-test counseling and primary care services are highly recommended.

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

    Directory of Open Access Journals (Sweden)

    Crichton Joanna

    2010-06-01

    adverse events experienced and the proportion reporting drunkenness. Conclusions We find an association between experience of adverse childhood events and drunkenness among adolescents in four sub-Saharan African countries. The complex impacts of adverse childhood experiences on young people's development and behavior may have an important bearing on the effectiveness of interventions geared at reducing alcohol dependence among the youth.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-12-17

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

  2. PEPFAR Funding and Reduction in HIV Infection Rates in 12 Focus Sub-Saharan African Countries: A Quantitative Analysis

    Directory of Open Access Journals (Sweden)

    Roger J. Chin, MA, MPA

    2015-04-01

    Full Text Available Background: HIV and AIDS continue to have a calamitous effect on individuals living on the continent of Africa. U.S. President George W. Bush implemented the President’s Emergency Plan for AIDS Relief (PEPFAR with the objective of committing approximately $15 billion from 2004 through 2008 to assist with the reduction of the HIV pandemic worldwide. The majority of the PEPFAR policy and funding focused on 12 countries in sub-Saharan Africa: Botswana, Cote d’Ivoire, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, and Zambia. The policy question this research paper seeks to analyze is whether the PEPFAR funding (as a % of Gross Domestic Product (GDP allocated to the 12 countries in Africa had any effect on the decrease of HIV infection rates of males and females between the ages of 15 and 49. Methods: A fixed-effects panel regression analysis was conducted to determine if this association exists. This study examined the 12 African countries that received PEPFAR funding over the years 2002 to 2010; even though PEPFAR was only active from 2004 through 2008, this research included two years prior and two years after this timeframe in order to better estimate the effect of PEPFAR funding on HIV reduction. Results: The results illustrate that on average, ceteris paribus, for every 1 percentage point increase in PEPFAR funding per GDP a country received, the country’s HIV infection rate decreased by 0.355 percentage points. Conclusions and Global Health Implications: While the empirical findings in this study suggested that the correlation between PEPFAR funding and HIV reduction is statistically significant, the practical significance is perhaps less obvious. Arguably, the reduction rate should be higher given the extent of funding targeted to this project. The conclusion of this research provides suggestions on future research and the policy implications of PEPFAR.

  3. Mesoscale Modeling of Smoke Particles Distribution and Their Radiative Feedback over Northern Sub-Saharan African Region

    Science.gov (United States)

    Yue, Y.; Wang, J.; Ichoku, C. M.; Ellison, L.

    2015-12-01

    Stretching from southern boundary of Sahara to the equator and expanding west to east from Atlantic Ocean coasts to the India Ocean coasts, the northern sub-Saharan African (NSSA) region has been subject to intense biomass burning. Comprised of savanna, shrub, tropical forest and a number of agricultural crops, the extensive fires burn belt covers central and south of NSSA during dry season (from October to March) contributes to one of the highest biomass burning rate per km2 in the world. Due to smoke particles' absorption effects of solar radiation, they can modify the surface and atmosphere temperature and thus change atmospheric stability, height of the boundary layer, regional atmospheric circulation, evaporation rate, cloud formation, and precipitation. Hence, smoke particles emitted from biomass burning over NSSA region has a significant influence to the air quality, weather and climate variability. In this study, the first version of this Fire Energetics and Emissions Research (FEER.v1) emissions of several smoke constituents including light-absorbing organic carbon (OC) and black carbon (BC) are applied to a state-of-science meteorology-chemistry model as NOAA Weather Research and Forecasting Model with Chemistry (WRF-Chem). We analyzed WRF-Chem simulations of surface and vertical distribution of various pollutants and their direct radiative effects in conjunction with satellite observation data from Moderate Resolution Imaging Spectroradiometer (MODIS) and Cloud-Aerosol Lidar data with Orthogonal Polarization (CALIPSO) to strengthen the importance of combining space measured emission products like FEER.v1 emission inventory with mesoscale model over intense biomass burning region, especially in area where ground-based air-quality and radiation-related observations are limited or absent.

  4. Alcohol consumption and breast cancer risk among women in three sub-Saharan African countries.

    Directory of Open Access Journals (Sweden)

    Frank Qian

    Full Text Available BACKGROUND: Alcohol drinking is linked to the development of breast cancer. However, there is little knowledge about the impact of alcohol consumption on breast cancer risk among African women. METHODS: We conducted a case-control study among 2,138 women with invasive breast cancer and 2,589 controls in Nigeria, Cameroon, and Uganda from 1998 to 2013. A structured questionnaire was used to collect information on alcohol consumption, defined as consuming alcoholic beverages at least once a week for six months or more. Logistic regression was used to estimate adjusted odds ratio (aOR and 95% confidence interval (CI. RESULTS: Among healthy controls, the overall alcohol consumption prevalence was 10.4%, and the prevalence in Nigeria, Cameroon, and Uganda were 5.0%, 34.6%, and 50.0%, respectively. Cases were more likely to have consumed alcohol (aOR = 1.62, 95% CI: 1.33-1.97. Both past (aOR = 1.54; 95% CI: 1.19-2.00 and current drinking (aOR = 1.71; 95% CI: 1.30-2.23 were associated with breast cancer risk. A dose-response relationship was observed for duration of alcohol drinking (P-trend <0.001, with 10-year increase of drinking associated with a 54% increased risk (95% CI: 1.29-1.84. CONCLUSION: We found a positive relationship between alcohol consumption and breast cancer risk, suggesting that this modifiable risk factor should be addressed in breast cancer prevention programs in Africa.

  5. Acute care needs in a rural Sub-Saharan African Emergency Centre: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Usha Periyanayagam

    2012-12-01

    Conclusions: This pilot study describes the patient population, resource and training needs of a rural Emergency Centre in SSA. It demonstrates that acute care providers will be required to evaluate a wide variety of patient complaints, effectively utilise laboratory and radiologic testing, and perform numerous focused treatments and therapies. Specialised training programmes, such as GECC’s ECP programme, are needed to create providers able to provide high quality, lifesaving care.

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

    Science.gov (United States)

    Kawooya, Michael G

    2012-01-01

    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.

  7. Training for Rural Radiology and Imaging in Sub-Saharan Africa: Addressing the Mismatch Between Services and Population

    Directory of Open Access Journals (Sweden)

    Michael G Kawooya

    2012-01-01

    Full Text Available 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.

  8. The key challenge of corporate governance of firms: Empirical evidence from Sub-Saharan African anglophone (SSAA) countries

    OpenAIRE

    Afolabi, Adeoye Amuda

    2013-01-01

    This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University. Motivation:In the Sub-Saharan Africa countries there are several factors contributing to the collapse of firms. Most firms have failed due to poor corporate governance practices. The recent collapse of some firms in the financial and non-financial sectors in the Sub-region shows that there are challenges hindering effective corporate governance of firms in the Subregion. Consequently, this...

  9. Ketosis-prone type 2 diabetes in patients of sub-Saharan African origin: clinical pathophysiology and natural history of beta-cell dysfunction and insulin resistance.

    Science.gov (United States)

    Mauvais-Jarvis, Franck; Sobngwi, Eugène; Porcher, Raphaël; Riveline, Jean-Pierre; Kevorkian, Jean-Philippe; Vaisse, Christian; Charpentier, Guillaume; Guillausseau, Pierre-Jean; Vexiau, Patrick; Gautier, Jean-François

    2004-03-01

    Nonautoimmune ketosis-prone diabetic syndromes are increasingly frequent in nonwhite populations. We have characterized a cohort of patients of sub-Saharan African origin who had ketosis-prone type 2 diabetes (n = 111), type 1 diabetes (n = 21), and type 2 diabetes (n = 88) and were admitted to a hospital for management of uncontrolled diabetes. We compared epidemiological, clinical, and metabolic features at diabetes onset and measured insulin secretion (glucagon-stimulated C-peptide) and insulin action (short intravenous insulin tolerance test) during a 10-year follow-up. Ketosis-prone type 2 diabetes shows a strong male predominance, stronger family history, higher age and BMI, and more severe metabolic decompensation than type 1 diabetes. In ketosis-prone type 2 diabetes, discontinuation of insulin therapy with development of remission of insulin dependence is achieved in 76% of patients (non-insulin dependent), whereas only 24% of patients remain insulin dependent. During evolution, ketosis-prone type 2 diabetes exhibit specific beta-cell dysfunction features that distinguish it from type 1 and type 2 diabetes. The clinical course of non-insulin-dependent ketosis-prone type 2 diabetes is characterized by ketotic relapses followed or not by a new remission. Progressive hyperglycemia precedes and is a strong risk factor for ketotic relapses (hazard ratio 38). The probability for non-insulin-dependent ketosis-prone type 2 diabetes to relapse is 90% within 10 years, of whom approximately 50% will become definitively insulin dependent. Insulin sensitivity is decreased in equal proportion in both ketosis-prone type 2 diabetes and type 2 diabetes, but improves significantly in non-insulin-dependent ketosis-prone type 2 diabetes, only after correction of hyperglycemia. In conclusion, ketosis-prone type 2 diabetes can be distinguished from type 1 diabetes and classical type 2 diabetes by specific features of clinical pathophysiology and also by the natural history of

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

    Science.gov (United States)

    Benza, Magdalena

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

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

    LENUS (Irish Health Repository)

    Lindsay, K L

    2012-12-01

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

  12. Sensitization to common aeroallergens in a population of young adults in a sub-Saharan Africa setting: a cross-sectional study

    OpenAIRE

    2016-01-01

    Background Sensitization to aeroallergens increases the risk of developing asthma or allergic rhinitis. Data on sensitization to airborne allergens in the general population in sub-Saharan Africa are lacking. The aim of this study was to determine the prevalence and determinants of sensitization to common aeroallergens in a population of young adults. Methods A cross-sectional study was conducted among students of the Faculty of Medicine and Pharmaceutical Sciences of the University of Douala...

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

    DEFF Research Database (Denmark)

    Pantazis, Nikos; Morrison, Charles; Amornkul, Pauli N

    2012-01-01

    It is unknown whether HIV treatment guidelines, based on resource-rich country cohorts, are applicable to African populations.......It is unknown whether HIV treatment guidelines, based on resource-rich country cohorts, are applicable to African populations....

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

    DEFF Research Database (Denmark)

    Meyrowitsch, Dan Wolf; Pedersen, Erling Møller; Alifrangis, Michael

    2011-01-01

    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 programme...

  15. Quality Assurance in Sub-Saharan Africa

    Science.gov (United States)

    Materu, Peter; Righetti, Petra

    2010-01-01

    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.…

  16. Sub-Saharan Africa's media and neocolonialism.

    Science.gov (United States)

    Domatob, J K

    1988-01-01

    Given the heavy Western metropolitan bias of the media in sub-Saharan Africa, the ideology of neocolonialism continues to exert a dominant influence on economic, social, political, and cultural life. This neocolonial influence is further reinforced by advertising that champions a consumerist culture centered around Western goods. The capital of multinational firms plays a crucial role in the strategy of media imperialism. The dramatic growth of monopolies and the creation of military-industrial-information conglomerates in the 1970s and 1980s have been reflected in the international exchange of information and the interlinkage of mass communication systems in sub-Saharan Africa. Another media strategy that reinforces neocolonialism is the use of satellite communication. If cultural autonomy is defined as sub-Saharan Africa's capacity to decide on the allocation of its environmental resources, then cultural synchronization is a massive threat to that autonomy. Few African nations have the resources or expertise necessary to design, establish, or maintain communication systems that could accurately reflect their own culture. Nonetheless, there are some policy options. Personnel can be trained to respect African values and to recognize the dangers of neocolonial domination. The production of indigenous programs could reduce the media's foreign content. The incorporation of traditional drama and dance in the media could enhance this process. Above all, a high degree of planning is necessary if sub-Saharan African states intend to tackle the media and its domination by neocolonialist ideology.

  17. The state, refugees and migration in sub-Saharan Africa.

    Science.gov (United States)

    Akokpari, J K

    1998-01-01

    Migration and refugee movements could significantly decline in sub-Saharan African countries. However, countries must redistribute meager resources equitably and engage in environmental protection. Refugee and migrant populations have increased in sub-Saharan Africa during 1969-95, from 700,000 to 6.8 million. This study examined the causes of migration and the implications for host countries. Doornbos (1990) identifies the root problem as the partisan nature of African politics and the incapacity to manage ecological degradation. The African state is wholly or partially responsible for the creation of conflicts. Examples abound in Zaire, South Africa, Sudan, Rwanda, Burundi, Somalia, Ethiopia, Liberia, Congo, and Chad. State partisanship is also evident in Angola, Mozambique, Uganda, and Sierra Leone. An estimated 10 million Africans, in 1985, left their homes due to wars, government repression, or the inability of land to support them. In 1994, USAID estimated that 11.6 million Africans in 10 countries were threatened by famine from drought. Environmental degradation has generated conflicts. Africa's marginalized economy results in recession, unemployment, inflation, and distributional conflicts. Democratization has brought conflicts between the state, civil society, and exiles. Refugees face homelessness, poverty, emotional distress, inadequate food, and disease. Host countries face security threats, pressure on limited resources, rebellions from refugees and their involvement with foreign mercenaries, local conflicts between native and refugee populations, and environmental degradation from refugees.

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

    Science.gov (United States)

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

    2007-12-01

    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.

  19. 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)

    Lynn, Richard

    2010-01-01

    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…

  20. Accelerating investments in power in sub-Saharan Africa

    Science.gov (United States)

    Eberhard, Anton; Gratwick, Katharine; Morello, Elvira; Antmann, Pedro

    2017-02-01

    Private sector investments in African power generation play an increasingly important role in addressing the continent's electricity supply shortages. Our analysis of investment trends in sub-Saharan Africa reveals some key success factors.

  1. Inequalities in maternal health care utilization in sub-Saharan African countries: a multiyear and multi-country analysis.

    Directory of Open Access Journals (Sweden)

    Nazmul Alam

    Full Text Available To assess social inequalities in the use of antenatal care (ANC, facility based delivery (FBD, and modern contraception (MC in two contrasting groups of countries in sub-Saharan Africa divided based on their progress towards maternal mortality reduction. Six countries were included in this study. Three countries (Ethiopia, Madagascar, and Uganda had 4.5% average annual reduction rate while another three (Cameroon, Zambia, and Zimbabwe had >550 MMR in 2010 with only <1.5% average annual reduction rate. All of these countries had at least three rounds of Demographic and Health Surveys (DHS before 2012. We measured rate ratios and differences, as well as relative and absolute concentration indices in order to examine within-country geographical and wealth-based inequalities in the utilization of ANC, FBD, and MC. In the countries which have made sufficient progress (i.e. Ethiopia, Madagascar, and Uganda, ANC use increased by 8.7, 9.3 and 5.7 percent, respectively, while the utilization of FBD increased by 4.7, 0.7 and 20.2 percent, respectively, over the last decade. By contrast, utilization of these services either plateaued or decreased in countries which did not make progress towards reducing maternal mortality, with the exception of Cameroon. Utilization of MC increased in all six countries but remained very low, with a high of 40.5% in Zimbabwe and low of 16.1% in Cameroon as of 2011. In general, relative measures of inequalities were found to have declined overtime in countries making progress towards reducing maternal mortality. In countries with insufficient progress towards maternal mortality reduction, these indicators remained stagnant or increased. Absolute measures for geographical and wealth-based inequalities remained high invariably in all six countries. The increasing trend in the utilization of maternal care services was found to concur with a steady decline in maternal mortality. Relative inequality declined overtime in countries

  2. Skilled Birth Attendants: who is who? A descriptive study of definitions and roles from nine Sub Saharan African countries.

    Directory of Open Access Journals (Sweden)

    Adetoro Adegoke

    Full Text Available BACKGROUND: Availability of a Skilled Birth Attendant (SBA during childbirth is a key indicator for MDG5 and a strategy for reducing maternal and neonatal mortality in Africa. There is limited information on how SBAs and their functions are defined. The aim of this study was to map the cadres of health providers considered SBAs in Sub Saharan Africa (SSA; to describe which signal functions of Essential Obstetric Care (EmOC they perform and assess whether they are legislated to perform these functions. METHODS AND FINDINGS: Key personnel in the Ministries of Health, teaching institutions, referral, regional and district hospitals completed structured questionnaires in nine SSA countries in 2009-2011. A total of 21 different cadres of health care providers (HCP were reported to be SBA. Type and number of EmOC signal functions reported to be provided, varied substantially between cadres and countries. Parenteral antibiotics, uterotonic drugs and anticonvulsants were provided by most SBAs. Removal of retained products of conception and assisted vaginal delivery were the least provided signal functions. Except for the cadres of obstetricians, medical doctors and registered nurse-midwives, there was lack of clarity regarding signal functions reported to be performed and whether they were legislated to perform these. This was particularly for manual removal of placenta, removal of retained products and assisted vaginal delivery. In some countries, cadres not considered SBA performed deliveries and provided EmOC signal functions. In other settings, cadres reported to be SBA were able to but not legislated to perform key EmOC signal functions. CONCLUSIONS: Comparison of cadres of HCPs reported to be SBA across countries is difficult because of lack of standardization in names, training, and functions performed. There is a need for countries to develop clear guidelines defining who is a SBA and which EmOC signal functions each cadre of HCP is expected to

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

    Science.gov (United States)

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

    2013-12-01

    Nearly 80% of countries in sub-Saharan Africa (SSA) face problems of nitrogen (N) scarcity, which together with poverty causes food insecurity and malnutrition. The Alliance for a Green Revolution in Africa has set a goal of increasing fertilizer use in the region six-fold by 2015. While there is substantial evidence that greater N fertilizer use will improve crop yields, it could lead to increased N leaching and elevated nitrate (NO3-) concentrations in surface water and groundwater reservoirs. However, it is unclear what the magnitude of impacts will be in SSA given historically low nutrient additions (of less than 5 kg N/ha/yr), highly degraded soils (due to years of nutrient and soil organic matter depletion), and a wide range of soil types on which increased fertilizer use is occurring. Current estimates of N dynamics and balances in SSA agriculture now rely on data from other regions with different soil types, soil fertility, and land management practices. To understand the influence of increased fertilizer use on water quality requires data from representative areas in SSA. Experimental maize plots were established in a randomized complete block design in both western Kenya (clayey soil) and mid-western Tanzania (sandy soil). Plots were amended with 0, 50, 75, and 200 kg N/ha/yr as mineral fertilizer. Tension lysimeters were installed at three depths in each treatment, and water was collected throughout the maize growing season. Soil water solutions were analyzed for NO3--N. Flow through the soil column at each soil depth, was modeled using VS2DT, a variably saturated flow and solute transport model, and water flux values were multiplied by measured NO3--N concentrations to estimate seasonal N leaching flux. Soil texture was a major driver of N losses, altering both the pathways and magnitude of losses. Clayey soils in western Kenya show an enormous potential for loss of NO3--N immediately following the onset of rains as they trigger high rates of N

  4. Early Diagnosis of HIV Infection in Infants - One Caribbean and Six Sub-Saharan African Countries, 2011-2015.

    Science.gov (United States)

    Diallo, Karidia; Kim, Andrea A; Lecher, Shirley; Ellenberger, Dennis; Beard, R Suzanne; Dale, Helen; Hurlston, Mackenzie; Rivadeneira, Molly; Fonjungo, Peter N; Broyles, Laura N; Zhang, Guoqing; Sleeman, Katrina; Nguyen, Shon; Jadczak, Steve; Abiola, Nadine; Ewetola, Raimi; Muwonga, Jérémie; Fwamba, Franck; Mwangi, Christina; Naluguza, Mary; Kiyaga, Charles; Ssewanyana, Isaac; Varough, Deyde; Wysler, Domercant; Lowrance, David; Louis, Frantz Jean; Desinor, Olbeg; Buteau, Josiane; Kesner, Francois; Rouzier, Vanessa; Segaren, Nat; Lewis, Tessa; Sarr, Abdoulaye; Chipungu, Geoffrey; Gupta, Sundeep; Singer, Daniel; Mwenda, Reuben; Kapoteza, Hilary; Chipeta, Zawadi; Knight, Nancy; Carmona, Sergio; MacLeod, William; Sherman, Gayle; Pillay, Yogan; Ndongmo, Clement B; Mugisa, Bridget; Mwila, Annie; McAuley, James; Chipimo, Peter J; Kaonga, Wezi; Nsofwa, Dailess; Nsama, Davy; Mwamba, Fales Zulu; Moyo, Crispin; Phiri, Clement; Borget, Marie-Yolande; Ya-Kouadio, Leonard; Kouame, Abo; Adje-Toure, Christiane A; Nkengasong, John

    2016-11-25

    Pediatric human immunodeficiency virus (HIV) infection remains an important public health issue in resource-limited settings. In 2015, 1.4 million children aged HIV (including 170,000 infants born in 2015), with the vast majority living in sub-Saharan Africa (1). In 2014, 150,000 children died from HIV-related causes worldwide (2). Access to timely HIV diagnosis and treatment for HIV-infected infants reduces HIV-associated mortality, which is approximately 50% by age 2 years without treatment (3). Since 2011, the annual number of HIV-infected children has declined by 50%. Despite this gain, in 2014, only 42% of HIV-exposed infants received a diagnostic test for HIV (2), and in 2015, only 51% of children living with HIV received antiretroviral therapy (1). Access to services for early infant diagnosis of HIV (which includes access to testing for HIV-exposed infants and clinical diagnosis of HIV-infected infants) is critical for reducing HIV-associated mortality in children aged HIV testing services for early infant diagnosis was assessed. During 2011-2015, the total number of HIV diagnostic tests performed among HIV-exposed infants within 6 weeks after birth (tests for early infant diagnosis of HIV), as recommended by the World Health Organization (WHO) increased in all seven countries (Cote d'Ivoire, the Democratic Republic of the Congo, Haiti, Malawi, South Africa, Uganda, and Zambia); however, in 2015, the rate of testing for early infant diagnosis among HIV-exposed infants was HIV positivity among those tested declined in all seven countries, with three countries (Cote d'Ivoire, the Democratic Republic of the Congo, and Uganda) reporting >50% decline. The most common challenges for access to testing for early infant diagnosis included difficulties in specimen transport, long turnaround time between specimen collection and receipt of results, and limitations in supply chain management. Further reductions in HIV mortality in children can be achieved through

  5. U.S. Trade and Investment Relationship with Sub-Saharan Africa: The African Growth and Opportunity Act

    Science.gov (United States)

    2009-07-24

    3 A. Hoeffler, “The Augmented Solow Model and the African Growth Debate,” CSAE, University of Oxford...On November 4, 2002, then-USTR Robert B. Zoellick notified Congress that negotiations would be initiated with the members of the Southern African

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

    Science.gov (United States)

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

    2013-11-01

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

  7. U.S. Trade and Investment Relationship with Sub-Saharan Africa: The African Growth and Opportunity Act and Beyond

    Science.gov (United States)

    2008-10-28

    CRS-3 3 A. Hoeffler, “The Augmented Solow Model and the African Growth Debate,” CSAE, University of Oxford, March 2000. 4 For a further discussion of...initiatives by the international community. Observers, such as World Bank president Robert Zoellick, acknowledge that the debt relief initiative has...Southern African Customs Union FTA (SACU).56 On November 4, 2002, USTR Robert B. Zoellick notified Congress that negotiations would be initiated with

  8. Admixture into and within sub-Saharan Africa.

    Science.gov (United States)

    Busby, George Bj; Band, Gavin; Si Le, Quang; Jallow, Muminatou; Bougama, Edith; Mangano, Valentina D; Amenga-Etego, Lucas N; Enimil, Anthony; Apinjoh, Tobias; Ndila, Carolyne M; Manjurano, Alphaxard; Nyirongo, Vysaul; Doumba, Ogobara; Rockett, Kirk A; Kwiatkowski, Dominic P; Spencer, Chris Ca

    2016-06-21

    Similarity between two individuals in the combination of genetic markers along their chromosomes indicates shared ancestry and can be used to identify historical connections between different population groups due to admixture. We use a genome-wide, haplotype-based, analysis to characterise the structure of genetic diversity and gene-flow in a collection of 48 sub-Saharan African groups. We show that coastal populations experienced an influx of Eurasian haplotypes over the last 7000 years, and that Eastern and Southern Niger-Congo speaking groups share ancestry with Central West Africans as a result of recent population expansions. In fact, most sub-Saharan populations share ancestry with groups from outside of their current geographic region as a result of gene-flow within the last 4000 years. Our in-depth analysis provides insight into haplotype sharing across different ethno-linguistic groups and the recent movement of alleles into new environments, both of which are relevant to studies of genetic epidemiology.

  9. Investments in blood safety improve the availability of blood to underserved areas in a sub-saharan african country

    NARCIS (Netherlands)

    Pitman, J.P.; Wilkinson, R.L.; Basavaraju, S.V.; Von Finckenstein, B.G.; Sibinga, C.T.H.; Marfin, A.; Postma, M.J.; Mataranyika, M.N.; Tobias, J.L.

    2014-01-01

    Background: Since 2004, several African countries, including Namibia, have received assistance from the U.S. President's Emergency Plan for AIDS Relief (PEPFAR). Aims: Gains have been documented in the safety and number of collected units in these countries, but the distribution of blood has not bee

  10. HIV and tuberculosis in prisons in sub-Saharan Africa.

    Science.gov (United States)

    Telisinghe, Lilanganee; Charalambous, Salome; Topp, Stephanie M; Herce, Michael E; Hoffmann, Christopher J; Barron, Peter; Schouten, Erik J; Jahn, Andreas; Zachariah, Rony; Harries, Anthony D; Beyrer, Chris; Amon, Joseph J

    2016-09-17

    Given the dual epidemics of HIV and tuberculosis in sub-Saharan Africa and evidence suggesting a disproportionate burden of these diseases among detainees in the region, we aimed to investigate the epidemiology of HIV and tuberculosis in prison populations, describe services available and challenges to service delivery, and identify priority areas for programmatically relevant research in sub-Saharan African prisons. To this end, we reviewed literature on HIV and tuberculosis in sub-Saharan African prisons published between 2011 and 2015, and identified data from only 24 of the 49 countries in the region. Where data were available, they were frequently of poor quality and rarely nationally representative. Prevalence of HIV infection ranged from 2·3% to 34·9%, and of tuberculosis from 0·4 to 16·3%; detainees nearly always had a higher prevalence of both diseases than did the non-incarcerated population in the same country. We identified barriers to prevention, treatment, and care services in published work and through five case studies of prison health policies and services in Zambia, South Africa, Malawi, Nigeria, and Benin. These barriers included severe financial and human-resource limitations and fragmented referral systems that prevent continuity of care when detainees cycle into and out of prison, or move between prisons. These challenges are set against the backdrop of weak health and criminal-justice systems, high rates of pre-trial detention, and overcrowding. A few examples of promising practices exist, including routine voluntary testing for HIV and screening for tuberculosis upon entry to South African and the largest Zambian prisons, reforms to pre-trial detention in South Africa, integration of mental health services into a health package in selected Malawian prisons, and task sharing to include detainees in care provision through peer-educator programmes in Rwanda, Zimbabwe, Zambia, and South Africa. However, substantial additional investments are

  11. Intracontinental spread of human invasive Salmonella Typhimurium pathovariants in sub-Saharan Africa.

    Science.gov (United States)

    Okoro, Chinyere K; Kingsley, Robert A; Connor, Thomas R; Harris, Simon R; Parry, Christopher M; Al-Mashhadani, Manar N; Kariuki, Samuel; Msefula, Chisomo L; Gordon, Melita A; de Pinna, Elizabeth; Wain, John; Heyderman, Robert S; Obaro, Stephen; Alonso, Pedro L; Mandomando, Inacio; MacLennan, Calman A; Tapia, Milagritos D; Levine, Myron M; Tennant, Sharon M; Parkhill, Julian; Dougan, Gordon

    2012-11-01

    A highly invasive form of non-typhoidal Salmonella (iNTS) disease has recently been documented in many countries in sub-Saharan Africa. The most common Salmonella enterica serovar causing this disease is Typhimurium (Salmonella Typhimurium). We applied whole-genome sequence-based phylogenetic methods to define the population structure of sub-Saharan African invasive Salmonella Typhimurium isolates and compared these to global Salmonella Typhimurium populations. Notably, the vast majority of sub-Saharan invasive Salmonella Typhimurium isolates fell within two closely related, highly clustered phylogenetic lineages that we estimate emerged independently ∼52 and ∼35 years ago in close temporal association with the current HIV pandemic. Clonal replacement of isolates from lineage I by those from lineage II was potentially influenced by the use of chloramphenicol for the treatment of iNTS disease. Our analysis suggests that iNTS disease is in part an epidemic in sub-Saharan Africa caused by highly related Salmonella Typhimurium lineages that may have occupied new niches associated with a compromised human population and antibiotic treatment.

  12. Extended gene diversity at the FMR1 locus and neighbouring CA repeats in a sub-Saharan population

    Energy Technology Data Exchange (ETDEWEB)

    Chiurazzi, Genuardi, M.; Neri, G. [Instituto di Genetica Medica, Roma (Italy)] [and others

    1996-07-12

    We report on the allele distributions in a normal black African population at two microsatellite loci neighbouring the FRAXA locus and at the CGG repeat in the 5{prime} end of the FMR1 gene, which causes the fragile X syndrome. The CGG repeat distribution was found to be similar to that of other ethnic groups, as well as to that of other non-human primates, possibly predicting a comparable prevalence of fragile X in Africa. Significant linkage disequilibrium has been observed between fragile X mutations and alleles of the DXS548 and FRAXAC1 loci in European and Asian populations, and some founder chromosomes may be extremely old. Those associated with FRAXAC1-A and DXS548-2 alleles are not present in the Asian fragile X samples. We searched for these alleles and their frequency in the well defined Bamileke population of Cameroon. All previously described alleles and some new ones were found in this sample, supporting the hypothesis of their pre-existence and subsequent loss in Asian populations. Finally, the heterozygosity of the Bamileke sample was significantly higher at both marker loci and comparable to that of Europeans at the CGG repeat, confirming the notion that genetic diversity is greater in Africans than in other groups and supporting the view that evolution of modern man started in Africa. 31 refs., 1 fig., 1 tab.

  13. Obesity and type 2 diabetes in sub-Saharan Africans - Is the burden in today's Africa similar to African migrants in Europe? : The RODAM study

    NARCIS (Netherlands)

    Agyemang, Charles; Meeks, Karlijn; Beune, Erik; Owusu-Dabo, Ellis; Mockenhaupt, Frank P; Addo, Juliet; de Graft Aikins, Ama; Bahendeka, Silver; Danquah, Ina; Schulze, Matthias B; Spranger, Joachim; Burr, Tom; Agyei-Baffour, Peter; Amoah, Stephen K; Galbete, Cecilia; Henneman, Peter; Klipstein-Grobusch, Kerstin; Nicolaou, Mary; Adeyemo, Adebowale; van Straalen, Jan; Smeeth, Liam; Stronks, Karien

    2016-01-01

    BACKGROUND: Rising rates of obesity and type 2 diabetes (T2D) are impending major threats to the health of African populations, but the extent to which they differ between rural and urban settings in Africa and upon migration to Europe is unknown. We assessed the burden of obesity and T2D among Ghan

  14. Energy Security and Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Emily Meierding

    2013-02-01

    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.

  15. [Depression in Sub-Saharan Africa].

    Science.gov (United States)

    Perez, S; Junod, A

    1998-01-01

    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.

  16. Use of the World Health Organization’s Medical Eligibility Criteria for Contraceptive Use Guidance in sub-Saharan African Countries: A Cross-Sectional Study

    Science.gov (United States)

    Chen, Melissa J; Gaffield, Mary E; Kiarie, James

    2016-01-01

    ABSTRACT Given recent updates to the postpartum contraception recommendations in the fifth edition of the Medical Eligibility Criteria for Contraceptive Use (MEC), published by the World Health Organization (WHO), the purpose of this qualitative study was to assess the extent to which national family planning policies in sub-Saharan African countries are in agreement with the WHO MEC, particularly with regard to postpartum contraceptive use. WHO headquarters sent questionnaires to country-level focal points to complete with their Ministry of Health counterparts. Between February and May 2016, 23 of 32 (72%) surveys were completed. All respondents reported that their countries had used the MEC document in the past, with most reporting that they had used the guidance as a reference (n = 20, 87%), for training purposes (n = 19, 83%), to change clinical practices (n = 17, 74%), and to develop national policies (n = 16, 70%). While many respondents (16, 70%) indicated their countries already include immediate postpartum intrauterine device insertion among breastfeeding women in their family planning policies, few reported currently allowing use of progestogen-only pills (n = 8, 35%) or implants (n = 8, 35%) during the immediate postpartum period (i.e., less than 48 hours after delivery) for breastfeeding women. A higher percentage of respondents indicated their countries allowed breastfeeding women the option of progestogen-only pills (n = 16, 70%) and implants (n = 13, 57%) between 48 hours and 6 weeks postpartum. Findings from this baseline assessment suggest that many countries may benefit from training and policy formulation support to adapt both new WHO MEC updates as well as existing recommendations from previous MEC revisions into national family planning guidelines. PMID:27688720

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

    Directory of Open Access Journals (Sweden)

    Kabiru Caroline W

    2013-02-01

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

  18. Monitoring Sub-Saharan African physician migration and recruitment post-adoption of the WHO code of practice: temporal and geographic patterns in the United States.

    Science.gov (United States)

    Tankwanchi, Akhenaten Benjamin Siankam; Vermund, Sten H; Perkins, Douglas D

    2015-01-01

    Data monitoring is a key recommendation of the WHO Global Code of Practice on the International Recruitment of Health Personnel, a global framework adopted in May 2010 to address health workforce retention in resource-limited countries and the ethics of international migration. Using data on African-born and African-educated physicians in the 2013 American Medical Association Physician Masterfile (AMA Masterfile), we monitored Sub-Saharan African (SSA) physician recruitment into the physician workforce of the United States (US) post-adoption of the WHO Code of Practice. From the observed data, we projected to 2015 with linear regression, and we mapped migrant physicians' locations using GPS Visualizer and ArcGIS. The 2013 AMA Masterfile identified 11,787 active SSA-origin physicians, representing barely 1.3% (11,787/940,456) of the 2013 US physician workforce, but exceeding the total number of physicians reported by WHO in 34 SSA countries (N = 11,519). We estimated that 15.7% (1,849/11,787) entered the US physician workforce after the Code of Practice was adopted. Compared to pre-Code estimates from 2002 (N = 7,830) and 2010 (N = 9,938), the annual admission rate of SSA émigrés into the US physician workforce is increasing. This increase is due in large part to the growing number of SSA-born physicians attending medical schools outside SSA, representing a trend towards younger migrants. Projection estimates suggest that there will be 12,846 SSA migrant physicians in the US physician workforce in 2015, and over 2,900 of them will be post-Code recruits. Most SSA migrant physicians are locating to large urban US areas where physician densities are already the highest. The Code of Practice has not slowed the SSA-to-US physician migration. To stem the physician "brain drain", it is essential to incentivize professional practice in SSA and diminish the appeal of US migration with bolder interventions targeting primarily early-career (age ≤ 35) SSA physicians.

  19. Sub-Saharan Africa’s Lagging Development

    Directory of Open Access Journals (Sweden)

    Katja Vintar Mally

    2009-12-01

    Full Text Available Sub-Saharan Africa is a very diverse region with extensive natural wealth, great human potential, and a rich history. However, the majority of its countries are among the poorest in the world and about half of its 800 million inhabitants live in extreme poverty. Sub-Saharan Africa produces only 1.5% of the world’s GDP and its share in world trade has fallen from 6% in 1980 to 2% today. The region’s exports remain dominated by primary goods (fuels, ores, and agricultural products. The roots of the region’s economic weakness lie variously in the past colonial relationships with European countries and in unjust global trade patterns as well as in misuse of power by ruling political elites in the post-independence era. Numerous civil wars and other conflicts have fragmented the sub-Saharan countries into many factions and parties fighting for domination. The region is lagging behind developed countries because of corruption, lack of infrastructure, weakness of its institutions, heavy indebtedness, lack of education and health services, and unfavorable natural conditions, among other factors. Subsistence agriculture is the source of livelihood for most Africans. Nevertheless, average yields per hectare are low and heavily dependent on climatic conditions. Compared to urban areas (except for slums, people living in rural areas have worse infrastructure and are further from achieving the UN’s Millennium Development Goals. The recent increase in food prices is threatening the limited progress in reducing hunger and malnutrition (28% of children under age five are underweight and particularly vulnerable to infectious diseases. Little progress has been made in reducing child and maternal mortality; mortality rates remain the highest in the world. In the previous decade, life expectancy in sub-Saharan countries has fallen due to the spread of HIV/AIDS and it still remains below fifty. In addition, many negative socioeconomic effects are the result

  20. Changing HIV treatment eligibility under health system constraints in sub-Saharan Africa: investment needs, population health gains, and cost-effectiveness

    Science.gov (United States)

    Hontelez, Jan A.C.; Chang, Angela Y.; Ogbuoji, Osondu; de Vlas, Sake J.; Bärnighausen, Till; Atun, Rifat

    2016-01-01

    Objective: We estimated the investment needs, population health gains, and cost-effectiveness of different policy options for scaling-up prevention and treatment of HIV in the 10 countries that currently comprise 80% of all people living with HIV in sub-Saharan Africa (Ethiopia, Kenya, Malawi, Mozambique, Nigeria, South Africa, Tanzania, Uganda, Zambia, and Zimbabwe). Design: We adapted the established STDSIM model to capture the health system dynamics: demand-side and supply-side constraints in the delivery of antiretroviral treatment (ART). Methods: We compared different scenarios of supply-side (i.e. health system capacity) and demand-side (i.e. health seeking behavior) constraints, and determined the impact of changing guidelines to ART eligibility at any CD4+ cell count within these constraints. Results: Continuing current scale-up would require US$178 billion by 2050. Changing guidelines to ART at any CD4+ cell count is cost-effective under all constraints tested in the model, especially in demand-side constrained health systems because earlier initiation prevents loss-to-follow-up of patients not yet eligible. Changing guidelines under current demand-side constraints would avert 1.8 million infections at US$208 per life-year saved. Conclusion: Treatment eligibility at any CD4+ cell count would be cost-effective, even under health system constraints. Excessive loss-to-follow-up and mortality in patients not eligible for treatment can be avoided by changing guidelines in demand-side constrained systems. The financial obligation for sustaining the AIDS response in sub-Saharan Africa over the next 35 years is substantial and requires strong, long-term commitment of policy-makers and donors to continue to allocate substantial parts of their budgets. PMID:27367487

  1. Meningitis in HIV-positive patients in sub-Saharan Africa: a review

    Directory of Open Access Journals (Sweden)

    Jennifer A Veltman

    2014-10-01

    Full Text Available Introduction: Meningitis is one of the leading causes of death among patients living with HIV in sub-Saharan Africa. There is no widespread tracking of the incidence rates of causative agents among patients living with HIV, yet the aetiologies of meningitis are different than those of the general population. Methods: We reviewed the scientific literature published in PubMed to determine the incidence rates of meningitis among hospitalized people living with HIV in sub-Saharan Africa and report our findings from seven studies across sub-Saharan Africa. Results: We found high rates of cryptococcal meningitis (19–68%. Tuberculous meningitis was lower (1–36%, although some centres included possible cases as “other” meningitis; therefore, this may not be a true representation of the total cases. Pyogenic meningitis ranged from 6 to 30% and “other” meningitis ranged from 7 to 28% of all reported cases of meningitis. Mortality rates ranged from 25 to 68%. This review describes the most common aetiologies and provides practical diagnostic, treatment and prevention considerations as they apply to the individual living with HIV in sub-Saharan Africa. Conclusions: Diagnosis is often limited, and wider availability of accurate and low-cost laboratory diagnostics is desperately needed for prompt diagnosis and initiation of appropriate treatment. Wider acceptance and adoption of available preventative modalities can decrease the incidence of potentially fatal central nervous system infections in African patients living with HIV.

  2. mtDNA variability in two Bantu-speaking populations (Shona and Hutu) from Eastern Africa: implications for peopling and migration patterns in sub-Saharan Africa.

    Science.gov (United States)

    Castrì, Loredana; Tofanelli, Sergio; Garagnani, Paolo; Bini, Carla; Fosella, Xenia; Pelotti, Susi; Paoli, Giorgio; Pettener, Davide; Luiselli, Donata

    2009-10-01

    In this study, we report novel data on mitochondrial DNA in two of the largest eastern Bantu-speaking populations, the Shona from Zimbabwe and the Hutu from Rwanda. The goal is to evaluate the genetic relationships of these two ethnic groups with other Bantu-speaking populations. Moreover, by comparing our data with those from other Niger-Congo speaking populations, we aim to clarify some aspects of evolutionary and demographic processes accompanying the spread of Bantu languages in sub-Saharan Africa and to test if patterns of genetic variation fit with models of population expansion based on linguistic and archeological data. The results indicate that the Shona and Hutu are closely related to the other Bantu-speaking populations. However, there are some differences in haplogroup composition between the two populations, mainly due to different genetic contributions from neighboring populations. This result is confirmed by estimates of migration rates which show high levels of gene flow not only between pairs of Bantu-speaking populations, but also between Bantu and non-Bantu speakers. The observed pattern of genetic variability (high genetic homogeneity and high levels of gene flow) supports a linguistic model suggesting a gradual spread of Bantu-speakers, with strong interactions between the different lines of Bantu-speaker descent, and is also in agreement with recent archeological findings. In conclusion, our data emphasize the role that population admixture has played at different times and to varying degrees in the dispersal of Bantu languages.

  3. Blood Component Use in a Sub-Saharan African Country : Results of a 4-Year Evaluation of Diagnoses Associated With Transfusion Orders in Namibia

    NARCIS (Netherlands)

    Pitman, John P.; Wilkinson, Robert; Liu, Yang; von Finckenstein, Bjorn; Sibinga, Cees Th. Smit; Lowrance, David W.; Marfin, Anthony A.; Postma, Maarten J.; Mataranyika, Mary; Basavaraju, Sridhar V.

    2015-01-01

    National blood use patterns in sub-Saharan Africa are poorly described. Although malaria and maternal hemorrhage remain important drivers of blood demand across Africa, economic growth and changes in malaria, HIV/AIDS, and noncommunicable disease epidemiology may contribute to changes in blood deman

  4. Perception, experience, and indigenous knowledge of climate change and variability: the case of Accra, a sub-Saharan African city

    Science.gov (United States)

    Codjoe, Samuel N.A.; Owusu, George; Burkett, Virginia

    2014-01-01

    Several recent international assessments have concluded that climate change has the potential to reverse the modest economic gains achieved in many developing countries over the past decade. The phenomenon of climate change threatens to worsen poverty or burden populations with additional hardships, especially in poor societies with weak infrastructure and economic well-being. The importance of the perceptions, experiences, and knowledge of indigenous peoples has gained prominence in discussions of climate change and adaptation in developing countries and among international development organizations. Efforts to evaluate the role of indigenous knowledge in adaptation planning, however, have largely focused on rural people and their agricultural livelihoods. This paper presents the results of a study that examines perceptions, experiences, and indigenous knowledge relating to climate change and variability in three communities of metropolitan Accra, which is the capital of Ghana. The study design is based on a three-part conceptual framework and interview process involving risk mapping, mental models, and individual stressor cognition. Most of the residents interviewed in the three communities of urban Accra attributed climate change to the combination of deforestation and the burning of firewood and rubbish. None of the residents associated climate change with fossil fuel emissions from developed countries. Numerous potential adaptation strategies were suggested by the residents, many of which have been used effectively during past drought and flood events. Results suggest that ethnic residential clustering as well as strong community bonds in metropolitan Accra have allowed various groups and long-settled communities to engage in the sharing and transmission of knowledge of weather patterns and trends. Understanding and building upon indigenous knowledge may enhance the design, acceptance, and implementation of climate change adaptation strategies in Accra and

  5. Symptom Clusters in People Living with HIV Attending Five Palliative Care Facilities in Two Sub-Saharan African Countries: A Hierarchical Cluster Analysis.

    Directory of Open Access Journals (Sweden)

    Katrien Moens

    Full Text Available Symptom research across conditions has historically focused on single symptoms, and the burden of multiple symptoms and their interactions has been relatively neglected especially in people living with HIV. Symptom cluster studies are required to set priorities in treatment planning, and to lessen the total symptom burden. This study aimed to identify and compare symptom clusters among people living with HIV attending five palliative care facilities in two sub-Saharan African countries.Data from cross-sectional self-report of seven-day symptom prevalence on the 32-item Memorial Symptom Assessment Scale-Short Form were used. A hierarchical cluster analysis was conducted using Ward's method applying squared Euclidean Distance as the similarity measure to determine the clusters. Contingency tables, X2 tests and ANOVA were used to compare the clusters by patient specific characteristics and distress scores.Among the sample (N=217 the mean age was 36.5 (SD 9.0, 73.2% were female, and 49.1% were on antiretroviral therapy (ART. The cluster analysis produced five symptom clusters identified as: 1 dermatological; 2 generalised anxiety and elimination; 3 social and image; 4 persistently present; and 5 a gastrointestinal-related symptom cluster. The patients in the first three symptom clusters reported the highest physical and psychological distress scores. Patient characteristics varied significantly across the five clusters by functional status (worst functional physical status in cluster one, p<0.001; being on ART (highest proportions for clusters two and three, p=0.012; global distress (F=26.8, p<0.001, physical distress (F=36.3, p<0.001 and psychological distress subscale (F=21.8, p<0.001 (all subscales worst for cluster one, best for cluster four.The greatest burden is associated with cluster one, and should be prioritised in clinical management. Further symptom cluster research in people living with HIV with longitudinally collected symptom data to

  6. North African populations carry the signature of admixture with Neandertals.

    Directory of Open Access Journals (Sweden)

    Federico Sánchez-Quinto

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

  7. Apparent variation in Neanderthal admixture among African populations is consistent with gene flow from Non-African populations.

    Science.gov (United States)

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

    2013-01-01

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

  8. Ethiopia: between Sub-Saharan Africa and western Eurasia.

    Science.gov (United States)

    Lovell, A; Moreau, C; Yotova, V; Xiao, F; Bourgeois, S; Gehl, D; Bertranpetit, J; Schurr, E; Labuda, D

    2005-05-01

    Ethiopia is central to population genetic studies investigating the out of Africa expansion of modern humans, as shown by Y chromosome and mtDNA studies. To address the level of genetic differentiation within Ethiopia, and its relationship to Sub-Saharan Africa and Eurasia, we studied an 8 kb segment of the X-chromosome from 72 chromosomes from the Amhara, Oromo and Ethiopian Jews, and compared these results with 804 chromosomes from Middle Eastern, African, Asian and European populations, and 22 newly typed Saharawi. Within Ethiopia the two largest ethnic groups, the Amhara and Oromo, were not found to be statistically distinct, based on an exact test of haplotype frequencies. The Ethiopian Jews appear as an admixed population, possibly of Jewish origin, though the data remain equivocal. There is evidence of a close relationship between Ethiopian and Yemenite Jews, likely a result of indirect gene flow. Within an African and Eurasian context, the distribution of alleles of a variable T(n) repeat, and the spread of haplotypes containing Africa-specific alleles, provide evidence of a genetic continuity from Sub-Saharan Africa to the Near East, and furthermore suggest that a bottleneck occurred in Ethiopia associated with an out of Africa expansion. Ethiopian genetic heterogeneity, as evidenced by principal component analysis of haplotype frequencies, most likely resulted from periods of subsequent admixture. While these results are from the analysis of one locus, we feel that in association with data from other marker systems they add a complementary perspective on the history of Ethiopia.

  9. 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)

    Madise Nyovani

    2007-08-01

    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.

  10. Soil Degradation-Induced Decline in Productivity of Sub-Saharan African Soils: The Prospects of Looking Downwards the Lowlands with the Sawah Ecotechnology

    Directory of Open Access Journals (Sweden)

    Sunday E. Obalum

    2012-01-01

    Full Text Available The paper provides an insight into the problem of land degradation in Sub-Saharan Africa, with emphasis on soil erosion and its effect on soil quality and productivity, and proposes a lowland-based rice-production technology for coping with the situation. Crop yields are, in addition to the degree of past and current erosion, determined by a number of interacting variables. This, coupled with the generally weak database on erosion-induced losses in crop yield in spite of the region’s high vulnerability to erosion, makes it difficult to attain a reliable inference on the cause-effect relationship between soil loss and productivity. Available data suggest, however, that the region is at risk of not meeting up with the challenges of agriculture in this 21st century. Based on the few studies reviewed, methodology appears to have an overwhelming influence on the erosion-productivity response, whereas issues bordering on physical environment and soil affect the shape of the response curve. We argue that the sawah ecotechnology has the potential of countering the negative agronomic and environmental impacts of land degradation in Sub-Saharan Africa. This is a farmer-oriented, low-cost system of managing soil, water, and nutrient resources for enhancing lowland rice productivity and realizing Green Revolution in the region.

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

    Directory of Open Access Journals (Sweden)

    Christian Vogler

    Full Text Available 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.

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

    Science.gov (United States)

    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

    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.

  13. In Pursuit of the African PhD: A Critical Survey of Emergent Policy Issues in Select Sub-Saharan African Nations, Ethiopia, Ghana and South Africa

    Science.gov (United States)

    Molla, Tebeje; Cuthbert, Denise

    2016-01-01

    After decades of decline, African higher education is now arguably in a new era of revival. With the prevalence of knowledge economy discourse, national governments in Africa and their development partners have increasingly aligned higher education with poverty reduction plans and strategies. Research capacity has become a critical development…

  14. 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)

    Trudeau, Edouard J. C.

    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…

  15. Dutch research on environment and development in Sub-Saharan Africa

    NARCIS (Netherlands)

    L.J. de Haan (Leo); P. Ton (Peter)

    1994-01-01

    textabstractThis paper was written at the request of the Werkgemeenschap Afrika (Netherlands African Studies Association). lts main objective is to present a review of recent Dutch research on environmental issues in Sub-Saharan Africa.

  16. Impact of human schistosomiasis in sub-Saharan Africa.

    Science.gov (United States)

    Adenowo, Abiola Fatimah; Oyinloye, Babatunji Emmanuel; Ogunyinka, Bolajoko Idiat; Kappo, Abidemi Paul

    2015-01-01

    Schistosomiasis, a neglected tropical disease of poverty ranks second among the most widespread parasitic disease in various nations in sub-Saharan Africa. Neglected tropical diseases are causes of about 534,000 deaths annually in sub-Saharan Africa and an estimated 57 million disability-adjusted life-years are lost annually due to the neglected tropical diseases. The neglected tropical diseases exert great health, social and financial burden on economies of households and governments. Schistosomiasis has profound negative effects on child development, outcome of pregnancy, and agricultural productivity, thus a key reason why the "bottom 500 million" inhabitants of sub-Saharan Africa continue to live in poverty. In 2008, 17.5 million people were treated globally for schistosomiasis, 11.7 million of those treated were from sub-Saharan Africa. This enervating disease has been successfully eradicated in Japan, as well as in Tunisia. Morocco and some Caribbean Island countries have made significant progress on control and management of this disease. Brazil, China and Egypt are taking steps towards elimination of the disease, while most sub-Saharan countries are still groaning under the burden of the disease. Various factors are responsible for the continuous and persistent transmission of schistosomiasis in sub-Saharan Africa. These include climatic changes and global warming, proximity to water bodies, irrigation and dam construction as well as socio-economic factors such as occupational activities and poverty. The morbidity and mortality caused by this disease cannot be overemphasized. This review is an exposition of human schistosomiasis as it affects the inhabitants of various communities in sub-Sahara African countries. It is hoped this will bring a re-awakening towards efforts to combat this impoverishing disease in terms of vaccines development, alternative drug design, as well as new point-of-care diagnostics.

  17. Emigration dynamics in Sub-Saharan Africa.

    Science.gov (United States)

    Adepoju, A

    1995-01-01

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

  18. Sub-Saharan Africa and the Paperless Society.

    Science.gov (United States)

    Olden, Anthony

    1987-01-01

    Considers the relevance for sub-Saharan Africa of electronic information systems in terms of the segments of the population that would benefit from such services, as opposed to a broader library role of advancing literacy to the general population. (Author/CLB)

  19. Blood component use in a sub-Saharan African country: results of a 4-year evaluation of diagnoses associated with transfusion orders in Namibia.

    Science.gov (United States)

    Pitman, John P; Wilkinson, Robert; Liu, Yang; von Finckenstein, Bjorn; Smit Sibinga, Cees Th; Lowrance, David W; Marfin, Anthony A; Postma, Maarten J; Mataranyika, Mary; Basavaraju, Sridhar V

    2015-01-01

    National blood use patterns in sub-Saharan Africa are poorly described. Although malaria and maternal hemorrhage remain important drivers of blood demand across Africa, economic growth and changes in malaria, HIV/AIDS, and noncommunicable disease epidemiology may contribute to changes in blood demand. We evaluated indications for blood use in Namibia, a country in southern Africa, using a nationally representative sample and discuss implications for the region. Clinical and demographic data related to the issuance of blood component units in Namibia were reviewed for a 4-year period (August 1, 2007-July 31, 2011). Variables included blood component type, recipient age and sex, and diagnosis. Diagnoses reported by clinicians were reclassified into International Statistical Classification of Diseases, 10th Revision categories. Multiple imputation methods were used to complete a data set missing age, sex or diagnosis data. Descriptive analyses were conducted to describe indications for transfusions and use of red blood cells (RBCs), platelets, and plasma. A total of 39,313 records accounting for 91,207 blood component units were analyzed. The median age of Namibian transfusion recipients was 45 years (SD, ±19). A total of 78,660 RBC units were issued in Namibia during the study period. Red blood cells transfused for "unspecified anemia" accounted for the single largest category of blood issued (24,798 units). Of the overall total, 38.9% were for diseases of the blood and blood-forming organs (D50-D89). Infectious disease (A00-B99), pregnancy (O00-O99), and gastrointestinal (K20-K93) accounted for 14.8%, 11.1%, and 6.1% of RBC units issued, respectively. Although a specific diagnosis of malaria accounted for only 2.7% of pediatric transfusions, an unknown number of additional transfusions for malaria may have been categorized by requesting physicians as unspecified anemia and counted under diseases of blood forming organs. During the study period, 9751 units of fresh

  20. Infectious Diseases in Sub-Saharan Immigrants to Spain.

    Science.gov (United States)

    Serre Delcor, Núria; Maruri, Begoña Treviño; Arandes, Antoni Soriano; Guiu, Isabel Claveria; Essadik, Hakima Ouaarab; Soley, Mateu Espasa; Romero, Israel Molina; Ascaso, Carlos

    2016-04-01

    Immigrants may be carriers of infectious diseases because of the prevalence of these diseases in their country of origin, exposure during migration, or conditions during resettlement, with this prevalence being particularly high in sub-Saharan Africans. We performed a retrospective review of 180 sub-Saharan immigrants screened for infectious diseases at an International Health Center from January 2009 to December 2012. At least one pathogenic infectious disease was diagnosed in 72.8% patients: 60.6% latent tuberculosis infection, 36.8% intestinal parasites (intestinal protozoa or helminths), 28.1% helminths, 14.8% hepatitis B surface antigen positive, 1.2% anti-hepatitis C virus positive, 1.2% human immunodeficiency virus-positive, and 1.2% malaria. Coinfections were present in 28.4%. There was significant association between eosinophilia (absolute count or percentage) or hyper-IgE and the presence of helminths (P< 0.001). Relative eosinophilia and hyper-IgE were better indicators of helminth infection than absolute eosinophilia, particularly for schistosomiasis and strongyloidiasis. We found a high prevalence of infectious diseases in sub-Saharan immigrants, which could lead to severe health problems (in the absence of prompt treatment), representing a high cost to the public health system and possible transmission in the host country. Accurate screening and tailored protocols for infectious diseases are recommended in sub-Saharan immigrants.

  1. The role of partners’ educational attainment in the association between HIV and education amongst women in seven sub-Saharan African countries

    Directory of Open Access Journals (Sweden)

    Guy Harling

    2016-02-01

    Full Text Available Introduction: Individuals’ educational attainment has long been considered as a risk factor for HIV. However, little attention has been paid to the association between partner educational attainment and HIV infection. Methods: We conducted cross-sectional analysis of young women (aged 15–34 in 14 Demographic and Health Surveys from seven sub-Saharan Africa (SSA countries with generalized HIV epidemics. We measured the degree of similarity in educational attainment (partner homophily in 75,373 partnerships and evaluated the correlation between homophily and female HIV prevalence at the survey cluster level. We then used logistic regression to assess whether own and partner educational attainment was associated with HIV serostatus amongst 38,791 women. Results: Educational attainment was positively correlated within partnerships in both urban and rural areas of every survey (Newman assortativity coefficients between 0.09 and 0.44, but this correlation was not ecologically associated with HIV prevalence. At the individual level, larger absolute differences between own and partner educational attainment were associated with significantly higher HIV prevalence amongst women. This association was heterogeneous across countries, but not between survey waves. In contrast to other women, for those aged 25–34 who had secondary or higher education, a more-educated partner was associated with lower HIV prevalence. Conclusions: HIV prevalence amongst women in SSA is associated not only with one's own education but also with that of one's partner. These findings highlight the importance of understanding how partners place individuals at risk of infection and suggest that HIV prevention efforts may benefit from considering partner characteristics.

  2. Investigating the Impacts of Surface Temperature Anomalies Due to Wildfires in Northern Sub-Saharan Africa

    Science.gov (United States)

    Gabbert, T.; Ichoku, C. M.; Matsui, T.; Capehart, W. J.

    2014-12-01

    The northern Sub-Saharan African region (NSSA) is an area of intense study due to the recent severe droughts that have dire consequences on the population, which relies mostly on rainfed agriculture for its food supply. This region's weather and hydrologic cycle are very complex and are dependent on the West African Monsoon. Different regional processes affect the West African Monsoon cycle and variability. One of the areas of current investigation is the water cycle response to the variability of land surface characteristics. Land surface characteristics are often altered in NSSA due to agricultural practices, grazing, and the fires that occur during the dry season. To better understand the effects of biomass burning on the hydrologic cycle of the sub-Saharan environment, an interdisciplinary team sponsored by NASA is analyzing potential feedback mechanisms due to the fires. As part of this research, this study focuses on the effects of land surface changes, particularly albedo and skin temperature, that are influenced by biomass burning. Surface temperature anomalies can influence the initiation of convective rainfall and surface albedo is linked to the absorption of solar radiation. To capture the effects of fire perturbations on the land surface, NASA's Unified Weather and Research Forecasting (NU-WRF) model coupled with NASA's Land Information System (LIS) is being used to simulate some of the fire-induced surface temperature anomalies and other environmental processes. In this presentation, we will report the strategy for these simulations, and show some preliminary results.

  3. Avian influenza: potential impact on sub-Saharan military populations with high rates of human immunodeficiency virus/acquired immunodeficiency syndrome.

    Science.gov (United States)

    Feldman, Robert L; Nickell, Kent

    2007-07-01

    Several sub-Saharan militaries have large percentages of troops with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome. With the arrival of avian influenza in Africa, the potential exists that some of those soldiers might also become infected with H5N1, the virus responsible for the disease. Two possible scenarios have been postulated regarding how such a coinfection of HIV and H5N1 might present. (1) Soldiers already weakened by HIV/acquired immunodeficiency syndrome rapidly succumb to H5N1. The cause of death is a "cytokine storm," essentially a runaway inflammatory response. (2) The weakened immune system prevents the cytokine storm from occurring; however, H5N1 is still present, replicating, and being shed, leading to the infection of others. A cytokine storm is particularly dangerous for individuals of military age, as evidenced by the large number of soldiers who died during the 1918 influenza epidemic. If large numbers of sub-Saharan soldiers suffer a similar fate from avian influenza, then military and political instability could develop.

  4. Cesarean section in sub-Saharan Africa.

    Science.gov (United States)

    Harrison, Margo S; Goldenberg, Robert L

    2016-01-01

    Cesarean section is an essential maternal healthcare service. Its role in labor and delivery care in low- and middle-income countries is complex; in many low-resource settings it is underutilized in the most needy of populations and overused by the less needy, without clear methods to ensure that universal access is available. Additionally, even if universal access were available, it is not evident that these countries would have the capacity or the finances to appropriate meet demand for the procedure, or that patients would want to utilize the care. This review summarizes the literature and illustrates the complicated relationship that cesarean section, which is rapidly on the rise around the world, has with individuals, communities, and nations in sub-Saharan Africa.

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

    Directory of Open Access Journals (Sweden)

    Christopher R. Frei

    2011-07-01

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

  6. Risk perception and communication in sub-Saharan Africa.

    Science.gov (United States)

    Dodoo, Alexander; Hugman, Bruce

    2012-11-01

    In this narrative review, a brief summary of theoretical approaches to risk perception is followed by an analysis of some of the special factors influencing risk perception and risk communication in sub-Saharan Africa. Examples of recent and emergent local medicines and vaccine controversies in several countries are given along with evidence and analysis of how they were managed. These demonstrate, among other things, the extent to which ethnic, religious and cultural issues influence popular perception, and the power of rumour and anecdote in shaping public opinion and official responses to events. Where safety monitoring systems exist, they are in their infancy, with limited capacity for data collection, credible scientific review, effective public communication and robust crisis management. Although increasing democratic freedoms, including less restricted media, and evolving health systems are addressing the challenges and give hope for further progress, there are still deep and intractable issues that inhibit transparent and effective risk communication and stand in the way of African populations comprehending medicines and their risks in safer and more balanced ways. Some proposals for future change and action are offered, including the pursuit of a deeper understanding of local and national values, assumptions and beliefs that drive risk perception; tailoring public health planning and communications to specifically-targeted regions and populations; strengthening of safety surveillance and data-collection systems; giving higher priority to medicines safety issues in healthcare training and public education.

  7. Evaluating evidence-based health care teaching and learning in the undergraduate human nutrition; occupational therapy; physiotherapy; and speech, language and hearing therapy programs at a sub-Saharan African academic institution

    Science.gov (United States)

    Rohwer, Anke; Young, Taryn

    2017-01-01

    Background It is important that all undergraduate healthcare students are equipped with evidence-based health care (EBHC) knowledge and skills to encourage evidence-informed decision-making after graduation. We assessed EBHC teaching and learning in undergraduate human nutrition (HN); occupational therapy (OT); physiotherapy (PT); and speech, language and hearing therapy (SPLH) programs at a sub-Saharan African university. Methods We used methodological triangulation to obtain a comprehensive understanding of EBHC teaching and learning: (1) through a document review of module guides, we identified learning outcomes related to pre-specified EBHC competencies; we conducted (2) focus group discussions and interviews of lecturers to obtain their perspectives on EBHC and on EBHC teaching and learning; and we (3) invited final year students (2013) and 2012 graduates to complete an online survey on EBHC attitudes, self-perceived EBHC competence, and their experience of EBHC teaching and learning. Results We reviewed all module outlines (n = 89) from HN, PT and SLHT. The OT curriculum was being revised at that time and could not be included. Six lecturers each from HN and OT, and five lecturers each from PT and SLHT participated in the focus groups. Thirty percent (53/176) of invited students responded to the survey. EBHC competencies were addressed to varying degrees in the four programs, although EBHC teaching and learning mostly occurred implicitly. Learning outcomes referring to EBHC focused on enabling competencies (e.g., critical thinking, biostatistics, epidemiology) and were concentrated in theoretical modules. Key competencies (e.g., asking questions, searching databases, critical appraisal) were rarely addressed explicitly. Students felt that EBHC learning should be integrated throughout the four year study period to allow for repetition, consolidation and application of knowledge and skills. Lecturers highlighted several challenges to teaching and practising

  8. The food production and consumption balance in sub-Saharan Africa under different SSPs, from 2010 to 2050

    Science.gov (United States)

    Wada, Y.; Luan, Y.; Fischer, G.; Sun, L.; Shi, P.

    2015-12-01

    Forcing with the population growth and consequently increasing food requirement, food security in sub-Saharan Africa is one of the most emergent and challenging issues. The purposes of this work are 1) what's the future food requirement and their food security status in each sub-Saharan African countries? What is the distance from current and future food security status, corresponding to the food requirement, to the targeted food security status? 2) To what extent Sub-Saharan countries could meet their present and future food requirement, and whether they have potential to improve their food insecurity status on currently cultivated land? 3) Whether or, if there have, how the pressures on land resources from meeting the food requirements? To figure those questions out, we firstly use socio-economic pathways datasets, and historical food diet pattern classification to forecast the 2010-2050 food commodity and feed calories demand per country. A new food security indicator, which considered the influences of both the food energy and quality intake, was used to evaluate the food insecurity status and the distances to different targeted statuses of the specific country. The latest Global Agro-Ecological Zones (GAEZ) databases were used to estimate the current and future crop yield gap and crop potential production. For current to future scenario analysis, we considered population growth, dietary change, climate change, agricultural input level, and target food security status. Then the balance of food requirement with the current and potential crop production was analyzed for different scenarios. Land requirements were calculated for meeting those food requirements, and the pressures on land resources are evaluated. Our works are hoping to provide scientific-based evidences for policy recommendations for local government to tackle food insecurity problems in Sub-Saharan Africa.

  9. Association of HIV and ART with cardiometabolic traits in sub-Saharan Africa

    DEFF Research Database (Denmark)

    Dillon, David G; Gurdasani, Deepti; Riha, Johanna;

    2013-01-01

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

  10. Tourism and microcredit for sustainable community development in Sub-Saharan Africa

    NARCIS (Netherlands)

    Hoeve ten, Marieke

    2009-01-01

    Poverty reduction is one of the main Millennium Development Goals (United Nations, 2000). Sub-Saharan Africa is the region with the highest prevalence of poverty. Almost half the population lives in extreme poverty (Chen & Ravillion, 2004; UN, 2005). Pove

  11. Effective Defense Support for Public Diplomacy (DSPD) with a Sub-Saharan Africa Target Audience: A Case Study of the African Crisis Response Force Proposal

    Science.gov (United States)

    2008-12-01

    Proquest and Torpedo Ultra database searches of the world news media. Each instance of defense support for the bid from its announcement in...2939-306, ABI/INFORM Global Database , (Document ID: 10235242) (accessed May 11, 2008). 64 George Gedda and Associated Press Writer, "African...Technical Information Center, 1989). 73 Redie Bereketeab, Eritrea: The Making of a Nation (Trenton, NJ: Red Sea Press, 2007), 48; Clement E. Adibe and David

  12. Sub-Saharan Africa Report

    Science.gov (United States)

    2007-11-02

    South Africans, he said, distruct the media imensely. He said black South Africans had little romanticism about the African experience. /9738 CSO...issue. If (C1C) considers the matter so urgent that they want to close the theatres next week, then they must do it." Meanwhile, the council decided

  13. U.S. Geological Survey Studies of Energy Resources in Sub-Saharan Africa

    Science.gov (United States)

    ,

    1997-01-01

    The U.S. Government and the American public need access to information on energy resources in sub-Saharan Africa.Sub-Saharan Africa (mostly Nigeria) produces 5 percent of the world's oil, while supplying the United States with 15 percent of our imports (Energy Information Administration). In the next 10 years, sub-Saharan oil and gas will become increasingly more important to the export market. New discoveries in offshore provinces of West Africa ensure a bright future for the region. Projections indicate that increased oil production in sub-Saharan Africa will far outpace the growth of intraregional consumption, providing greater quantities of oil for export (Forman, 1996). Also, West Africa, although a marginal supplier of liquefied natural gas (LNG) today, will become an important LNG source to the international market by the year 2000 (Oil & Gas Journal, 1996). The United States needs up-to-date information about petroleum resources and the energy balance within the region to predict the future role of sub-Saharan Africa as a major oil and gas exporter. The data required to generate the needed information are often disseminated in archives of oil companies and African geologic surveys, or in obscure publications. For these reasons, the U.S. Geological Survey is collecting data on sub-Saharan energy and constructing a regional energy bibliography. The team of geoscientists will assure that this information is available quickly and from a scientifically based, objective view point.

  14. Management of Sickle Cell Disease: A Review for Physician Education in Nigeria (Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Ademola Samson Adewoyin

    2015-01-01

    Full Text Available Sickle cell disease (SCD predominates in sub-Saharan Africa, East Mediterranean areas, Middle East, and India. Nigeria, being the most populous black nation in the world, bears its greatest burden in sub-Saharan Africa. The last few decades have witnessed remarkable scientific progress in the understanding of the complex pathophysiology of the disease. Improved clinical insights have heralded development and establishment of disease modifying interventions such as chronic blood transfusions, hydroxyurea therapy, and haemopoietic stem cell transplantation. Coupled with parallel improvements in general supportive, symptomatic, and preventive measures, current evidence reveals remarkable appreciation in quality of life among affected individuals in developed nations. Currently, in Nigeria and other West African states, treatment and control of SCD are largely suboptimal. Improved knowledge regarding SCD phenotypes and its comprehensive care among Nigerian physicians will enhance quality of care for affected persons. This paper therefore provides a review on the aetiopathogenesis, clinical manifestations, and management of SCD in Nigeria, with a focus on its local patterns and peculiarities. Established treatment guidelines as appropriate in the Nigerian setting are proffered, as well as recommendations for improving care of affected persons.

  15. Prevalence and correlates of bacterial vaginosis in different sub-populations of women in sub-Saharan Africa: a cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Vicky Jespers

    Full Text Available Clinical development of vaginally applied products aimed at reducing the transmission of HIV and other sexually transmitted infections, has highlighted the need for a better characterisation of the vaginal environment. We set out to characterise the vaginal environment in women in different settings in sub-Saharan Africa.A longitudinal study was conducted in Kenya, Rwanda and South-Africa. Women were recruited into pre-defined study groups including adult, non-pregnant, HIV-negative women; pregnant women; adolescent girls; HIV-negative women engaging in vaginal practices; female sex workers; and HIV-positive women. Consenting women were interviewed and underwent a pelvic exam. Samples of vaginal fluid and a blood sample were taken and tested for bacterial vaginosis (BV, HIV and other reproductive tract infections (RTIs. This paper presents the cross-sectional analyses of BV Nugent scores and RTI prevalence and correlates at the screening and the enrolment visit.At the screening visit 38% of women had BV defined as a Nugent score of 7-10, and 64% had more than one RTI (N. gonorrhoea, C. trachomatis, T. vaginalis, syphilis and/or Candida. At screening the likelihood of BV was lower in women using progestin-only contraception and higher in women with more than one RTI. At enrolment, BV scores were significantly associated with the presence of prostate specific antigen (PSA in the vaginal fluid and with being a self-acknowledged sex worker. Further, sex workers were more likely to have incident BV by Nugent score at enrolment.Our study confirmed some of the correlates of BV that have been previously reported but the most salient finding was the association between BV and the presence of PSA in the vaginal fluid which is suggestive of recent unprotected sexual intercourse.

  16. China-Africa Health Development Initiatives: Benefits and Implications for Shaping Innovative and Evidence-informed National Health Policies and Programs in Sub-saharan African Countries

    Science.gov (United States)

    Tambo, Ernest; Ugwu, Chidiebere E.; Guan, Yayi; Wei, Ding; Xiao-Ning; Xiao-Nong, Zhou

    2016-01-01

    Background and Introduction: This review paper examines the growing implications of China’s engagement in shaping innovative national initiatives against infectious diseases and poverty control and elimination in African countries. It seeks to understand the factors and enhancers that can promote mutual and innovative health development initiatives, and those that are necessary in generating reliable and quality data for evidence-based contextual policy, priorities and programs. Methods: We examined the China-Africa health cooperation in supporting global health agenda on infectious diseases such as malaria, schistosomiasis, Ebola, TB, HIV/AIDS, neglected tropical diseases (NTDs) prevention, control and elimination spanning a period of 10 years. We reviewed referenced publications, global support data, and extensive sources related to and other emerging epidemics and infectious diseases of poverty, programs and interventions, health systems development issues, challenges, opportunities and investments. Published literature in PubMed, Scopus, Google Scholar, Books and web-based peer-reviewed journal articles, government annual reports were assessed from the first Forum on China-Africa Cooperation (FOCAC) in November 2006 to December 2015 Third Ministerial conferences. Results: Our findings highlight current shared public health challenges and emphasize the need to nurture, develop and establish effective, functional and sustainable health systems capacity to detect and respond to all public health threats and epidemic burdens, evidence-based programs and quality care outcomes. China’s significant health diplomacy emphasizes the importance of health financing in establishing health development commitment and investment in improving the gains and opportunities, importantly efficiency and value health priorities and planning. Conclusions and Global Health Implications: Strengthening China-Africa health development agenda towards collective commitment and investment

  17. Cross-sectional observational assessment of quality of newborn care immediately after birth in health facilities across six sub-Saharan African countries

    Science.gov (United States)

    de Graft-Johnson, Joseph; Vesel, Linda; Rosen, Heather E; Rawlins, Barbara; Abwao, Stella; Mazia, Goldy; Bozsa, Robert; Mwebesa, Winifrede; Khadka, Neena; Kamunya, Rosemary; Getachew, Ashebir; Tibaijuka, Gaudiosa; Rakotovao, Jean Pierre; Tekleberhan, Alemnesh

    2017-01-01

    Objective To present information on the quality of newborn care services and health facility readiness to provide newborn care in 6 African countries, and to advocate for the improvement of providers' essential newborn care knowledge and skills. Design Cross-sectional observational health facility assessment. Setting Ethiopia, Kenya, Madagascar, Mozambique, Rwanda and Tanzania. Participants Health workers in 643 facilities. 1016 health workers were interviewed, and 2377 babies were observed in the facilities surveyed. Main outcome measures Indicators of quality of newborn care included (1) provision of immediate essential newborn care: thermal care, hygienic cord care, and early and exclusive initiation of breast feeding; (2) actual and simulated resuscitation of asphyxiated newborn infants; and (3) knowledge of health workers on essential newborn care, including resuscitation. Results Sterile or clean cord cutting instruments, suction devices, and tables or firm surfaces for resuscitation were commonly available. 80% of newborns were immediately dried after birth and received clean cord care in most of the studied facilities. In all countries assessed, major deficiencies exist for essential newborn care supplies and equipment, as well as for health worker knowledge and performance of key routine newborn care practices, particularly for immediate skin-to-skin contact and breastfeeding initiation. Of newborns who did not cry at birth, 89% either recovered on their own or through active steps taken by the provider through resuscitation with initial stimulation and/or ventilation. 11% of newborns died. Assessment of simulated resuscitation using a NeoNatalie anatomic model showed that less than a third of providers were able to demonstrate ventilation skills correctly. Conclusions The findings shared in this paper call attention to the critical need to improve health facility readiness to provide quality newborn care services and to ensure that service providers have

  18. The environmental challenges in Sub-Saharan Africa.

    Science.gov (United States)

    Mabogunje, A L

    1995-05-01

    Countries in sub-Saharan Africa are doing some rethinking, after decades of development that have resulted in continued poverty, international indebtedness, environmental degradation, and inappropriate Western models. Technological innovations, institutional developments, and family planning are key inputs. Development should shift to a focus on elimination of widespread poverty. Past development strategies in an African context of ample resources have harmed the environment without improving the average person's standard of living. Knowledge about Africa's environment and environmental degradation is inadequate. Recent studies have found, contrary to popular belief, that small shareholders made considerable investments in resource-based capital, which protected their farms from major environmental deterioration and negative impacts of intensification. In Nigeria field studies found that rising demand for fuelwood did not lead to greater deforestation or desertification. Severe degradation has occurred in places where density of population is greater than 500 persons per sq. km, where the land is physically or biologically vulnerable, and where socioeconomic conditions interfere with application of conservation measures. Reduced well-being and reduced food capacity is attributed to land tenure arrangements, misguided macroeconomic policies, and inadequate infrastructure. The issues of development, environment, and population are complex. Sustainable development is possible with appropriate investment priorities that will provide needed infrastructure, services, and education. Urban areas need safe water, solid waste disposal, and spatial planning to relieve congested spaces. Rural areas should focus on health education and basic sanitation. Regulatory measures and conservation measures are also important. Institutional development that promotes democracy, expands individual property rights, and increases the knowledge base offers the most hope for alleviating

  19. Contemporary issues on the epidemiology and antiretroviral adherence of HIV-infected adolescents in sub-Saharan Africa: a narrative review

    Directory of Open Access Journals (Sweden)

    Olurotimi A Adejumo

    2015-09-01

    Full Text Available Introduction: Adolescents are a unique and sometimes neglected group in the planning of healthcare services. This is the case in many parts of sub-Saharan Africa, where more than eight out of ten of the world's HIV-infected adolescents live. Although the last decade has seen a reduction in AIDS-related mortality worldwide, largely due to improved access to effective antiretroviral therapy (ART, AIDS remains a significant contributor to adolescent mortality in sub-Saharan Africa. Although inadequate access to ART in parts of the subcontinent may be implicated, research among youth with HIV elsewhere in the world suggests that suboptimal adherence to ART may play a significant role. In this article, we summarize the epidemiology of HIV among sub-Saharan African adolescents and review their adherence to ART, emphasizing the unique challenges and factors associated with adherence behaviour. Methods: We conducted a comprehensive search of online databases for articles, relevant abstracts, and conference reports from meetings held between 2010 and 2014. Our search terms included “adherence,” “compliance,” “antiretroviral use” and “antiretroviral adherence,” in combination with “adolescents,” “youth,” “HIV,” “Africa,” “interventions” and the MeSH term “Africa South of the Sahara.” Of 19,537 articles and abstracts identified, 215 met inclusion criteria, and 148 were reviewed. Discussion: Adolescents comprise a substantial portion of the population in many sub-Saharan African countries. They are at particular risk of HIV and may experience worse outcomes. Although demonstrated to have unique challenges, there is a dearth of comprehensive health services for adolescents, especially for those with HIV in sub-Saharan Africa. ART adherence is poorer among older adolescents than other age groups, and psychosocial, socio-economic, individual, and treatment-related factors influence adherence behaviour among adolescents

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

    Directory of Open Access Journals (Sweden)

    Petria M. Theron

    2013-11-01

    Full Text Available On the 2012 Corruption Perceptions Index of Transparency International, 89.6%of Sub-Saharan African countries received scores below 50, where a score of zero signifies that the country is highly corrupt and a score of 100 declares a country free of corruption. From these results, it seems as if Sub-Saharan African countries are quite vulnerable to corruption. In this article, the question whether certain traits in the Sub-Saharan African culture such as communalism, gift giving and a shame culture could in some situations influence people’s perception of, and their possible openness towards, certain forms of corruption was investigated. The research showed that cultural traits do influence people’s behaviour and that there are certain traits in the Sub-Saharan African culture that might sanction corruption. In response to these findings, some preliminary suggestions were proposed as to how Christians living in Africa could evaluate their cultural practices in the light of God’s Word and from a reformed theological paradigm. Instead of succumbing to the pressure posed by their culture to participate in immoral or corrupt activities, they could contribute to a moral regeneration on the African continent.

  1. Sub-Saharan Africa Report.

    Science.gov (United States)

    2007-11-02

    colored banners, all hand-sewn flags, hung from a structure made of wood and vines . One could see the major African leaders, past or present, Nkrumah...the SLPMB espe- cially vis-a-vis the development needs and the so- cio-economic well- being of the peo- ple in the produce plantation areas

  2. Sub-Saharan African Report, No. 2806

    Science.gov (United States)

    2007-11-02

    34’ Portugal’s top 10 export categories are wood pulp , leather footwear, gum resin, cork or cork stoppers, olive oil, agglomerated cork for decorative use...analytical studies for the Angolan Paper and Pulp Company and the Angolan Textile Enterprise (ENTEX), and has provided technical assistance and training...the seeds is poor and they are not received in time. In the livestock sector, campaigns to vaccinate cattle have been launched, and poultry and hog

  3. Multidimensional Measurement of Poverty among Women in Sub-Saharan Africa

    Science.gov (United States)

    Batana, Yele Maweki

    2013-01-01

    Since the seminal work of Sen, poverty has been recognized as a multidimensional phenomenon. The recent availability of relevant databases renewed the interest in this approach. This paper estimates multidimensional poverty among women in fourteen Sub-Saharan African countries using the Alkire and Foster multidimensional poverty measures, whose…

  4. Corporate boards and ownership structure: Evidence from Sub-Saharan Africa

    NARCIS (Netherlands)

    Munisi, Gibson; Hermes, Niels; Randoy, Trond

    2014-01-01

    This study examines the relationship between board structure and ownership structure for firms listed on the stock exchanges of twelve Sub-Saharan African countries, using data for the period 2006–2009. We find that ownership concentration, foreign ownership and managerial ownership are negatively a

  5. Tax Mobilization in Sub-Saharan Africa: The Impact of Tax and Business Law Reforms

    OpenAIRE

    BERTINELLI, Luisito; Bourgain, Arnaud

    2016-01-01

    This paper contributes to measuring the influence of business (and tax) law reforms on sub-Saharan African countries tax mobilization ability. Relying on a new business law reform indicator, our results validate the significant impact of corporate law modernization on governmental revenue, and unearth a complementary effect between business and tax law reforms.

  6. The Dynamics of Job Creation and Job Destruction: Is Sub-Saharan Africa Different?

    NARCIS (Netherlands)

    A.S. Bedi (Arjun Singh); A. Shiferaw (Admasu)

    2009-01-01

    textabstractThe Dynamics of Job Creation and Job Destruction: Is Sub-Saharan Africa Different? This paper analyzes the creation, destruction and reallocation of jobs in order to understand the micro-dynamics of aggregate employment change in African manufacturing. The nature and magnitude of gross j

  7. Sub-Saharan Africa betwixt and between : rural livelihood practices and policies

    NARCIS (Netherlands)

    Bryceson, Deborah Fahy

    1999-01-01

    Drawing on research findings emanating from the De-Agrarianisation and Rural Employment (DARE) Research Programme, coordinated by the African Studies Centre, Leiden, this paper compares changing economic and social patterns in a wide variety of rural settlements in sub-Saharan Africa. Recently emerg

  8. Challenges in malaria control in sub-Saharan Africa: the vaccine perspective

    DEFF Research Database (Denmark)

    Lusingu, John P A; Von Seidlein, Lorenz

    2008-01-01

    of these interventions. The emergence of resistance against drugs and insecticides requires in response a steady stream of new interventions. Up to the beginning of this millennium, most sub-Saharan African countries have been using chloroquine (CQ) as the first-line antimalarial drug, which had to be replaced...

  9. Sub-Saharan Africa Report

    Science.gov (United States)

    1987-04-07

    sources said they included: —Mr Johan Rupert, " crown prince" of the Rembrandt empire and son of Dr Anton Rupert. His name has been mentioned ever...South African physicists, engineers and technicians. This impressive scientific and technological achievement crowns 10 years of intense effort by...well as in the coal-fired power stations in South Africa. The mullite- zirconia ceramic material under development at the NIMR has an advantage in

  10. Prices of second-line antiretroviral treatment for middle-income countries inside versus outside sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Bryony Simmons

    2014-11-01

    Full Text Available Introduction: Antiretrovirals are available at low prices in sub-Saharan Africa, but these prices may not be consistently available for middle-income countries in other regions with large HIV epidemics. Over 30% of HIV infected people live in countries outside sub-Saharan Africa. Several key antiretrovirals are still on patent, with generic production restricted. We assessed price variations for key antiretroviral drugs inside versus outside sub-Saharan Africa. Methods: HIV drug prices used in national programmes (2010–2014 were extracted from the WHO Global Price Reporting Mechanism database for all reporting middle-income countries as classified by the World Bank. Treatment costs (branded and generic were compared for countries inside sub-Saharan Africa versus those outside. Five key second-line antiretrovirals were analysed: abacavir, atazanavir, darunavir, lopinavir/ritonavir, raltegravir. Results: Prices of branded antiretrovirals were significantly higher outside sub-Saharan Africa (p<0.001, adjusted for year of purchase (see Table 1. For example, the median (interquartile range price of darunavir from Janssen was $732 (IQR $732-806 per person-year in sub-Saharan Africa versus $4689 (IQR $4075-5717 in non-African middle-income countries, an increase of 541%. However, when supplied by generic companies, most antiretrovirals were similarly priced between countries in sub-Saharan Africa and other regions. Conclusions: Pharmaceutical companies are selling antiretrovirals to non-African middle-income countries at prices 74–541% higher than African countries with similar gross national incomes. However, generic companies are selling most of these drugs at similar prices across regions. Mechanisms to ensure fair pricing for patented antiretrovirals across both African and non-African middle-income countries need to be improved, to ensure sustainable treatment access.

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

    Science.gov (United States)

    Byrne, Neville

    2007-03-01

    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.

  12. Sub-Saharan Africa Report

    Science.gov (United States)

    2007-11-02

    cultivation , the purpose being to lessen the effects of the famine that is threatening the bulk of the Mozambican population. The first task carried...coconut trees and a grove of 2,000 orange, tangerine , lemon, and other fruit trees. Although no technician is assigned to the site, it receives...sellers, a habit she claimed she had just cultivated .’ She said that even with their combined salaries, they still find it difficult to cope

  13. The States of Sub Saharan Africa on the way to the Global Information Society

    Directory of Open Access Journals (Sweden)

    Konstantin A. Pantserev

    2010-12-01

    Full Text Available The paper devotes to the problem of overcoming of the digital divide in the Sub Saharan African States. On the example of Kenya the author speaks about the comparative success of the development of the information technologies in Africa and in turn underlines the most significant obstacles on the way of African states to the global information society and suggests the means how to overcome them.

  14. Sub-Saharan Africa Report

    Science.gov (United States)

    2007-11-02

    34kimbongue," with little or no nutritional value, the population wanders around the mountains in search of a tuber considered to be highly...Africa’s harvest and livestock yields are lower than the rest of the world’s—even lower than Zimbabwe’s—because extra competition for existing...PW he met his Moses." A surfer points out that had Mr Hendricksc been in a yacht or a boat and dipped’ his feet in the water at the same point

  15. Increasing sustainable cataract services in sub-Saharan Africa: an experimental initiative

    Directory of Open Access Journals (Sweden)

    Sasipriya M Karumanchi

    2015-04-01

    Full Text Available To begin to meet the need for cataract surgery in sub-Saharan Africa, the cataract surgical rate (CSR should be at least 2,000 to 3,000; i.e. there should be 2,000-3,000 cataract operations per million population, per year. The current levels are below 1,000 (and often much lower. Sub-Saharan Africa poses a unique set of challenges: low population density; inadequate transportation systems that inhibit access; big differences in wealth; and a shortage of eye care resources (which are usually concentrated in larger cities. Additional issues relate to productivity, the supply chain and the quality of outcomes, all of which contribute to the low cataract surgical rates. It is in this context that the Hilton Foundation sought to enhance cataract surgical services in sub-Saharan Africa, through the Hilton Cataract Initiative.

  16. Power sector reform and distributed generation in sub-Saharan Africa

    DEFF Research Database (Denmark)

    Turkson, J.K.; Wohlgemuth, N.

    2001-01-01

    As part of the current liberalisation process sweeping sub-Saharan Africa, power sectors across the region are being scrutinised and restructured. A critical aspect of the reform is improving access to electricity by large segments of the population. Many in the continent are, therefore...... of the world might be transferable to the countries of sub-Saharan Africa is assessed. The paper concludes by investigating the prospects for distributed generation in power sector reform in sub-Saharan Africa, arguing that though lessons from other parts of the world will be helpful, they cannot be all......,looking at the issue of distributed generation as opposed to grid extension and the role of renewable energy in this process. The purpose of this paper is to inform this discussion by two means. First, after examining the concept of distributed - or decentralised - generation in a region where urban population is...

  17. Perception of Genetic Testing for Deafness and Factors Associated with Interest in Genetic Testing Among Deaf People in a Selected Population in Sub-Saharan Africa.

    Science.gov (United States)

    Adedokun, Babatunde O; Yusuf, Bidemi O; Lasisi, J Taye; Jinadu, A A; Sunmonu, M T; Ashanke, A F; Lasisi, O Akeem

    2015-12-01

    Understanding the perceptions of genetic testing by members of the deaf community may help in planning deafness genetics research, especially so in the context of strong adherence to cultural values as found among native Africans. Among Yorubas in Nigeria, deafness is perceived to be caused by some offensive actions of the mother during pregnancy, spiritual attack, and childhood infections. We studied attitudes towards, and acceptance of genetic testing by the deaf community in Nigeria. Structured questionnaires were administered to individuals sampled from the Vocational Training Centre for the Deaf, the religious Community, and government schools, among others. The main survey items elicited information about the community in which the deaf people participate, their awareness of genetic testing, whether or not they view genetic testing as acceptable, and their understanding of the purpose of genetic testing. There were 150 deaf participants (61.3 % males, 38.7 % females) with mean age of 26.7 years ±9.8. A majority of survey respondents indicated they relate only with other members of the deaf community (78 %) and reported believing genetic testing does more good than harm (79.3 %); 57 % expressed interest in genetic testing. Interest in genetic testing for deafness or in genetic testing in pregnancy was not related to whether respondents relate primarily to the deaf or to the hearing community. However, a significantly higher number of male respondents and respondents with low education reported interest in genetic testing.

  18. The Perplex of Deforestation in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    A.W Yalew

    2015-09-01

    Full Text Available Deforestation has been a complex phenomenon to study in sub-Saharan Africa. The average annual deforestation rate in the region is by far higher than the world average. What causes and drives deforestation in the region are debated to date. The present paper is motivated by this debate. It attempts to test whether the maintained hypotheses on the causes of deforestation can give answer to the problem in sub-Saharan Africa. It used average cross-national data of forty eight countries in the region. The data are retrieved from international sources. The Spearman’s rank correlation coefficients between two deforestation indicators and five often-cited causes of deforestation were computed. The role of public forest ownership, share of forest and agricultural products in total exports, and the year of forest laws enacted are also discussed. However, it finds no clear, strong, and systematic pattern to argue that population density, rural population, rural poverty, industrial logging for exports, economic growth, late enactment of forest laws, and public ownership of forests are underlying causes of deforestation in the region. The trends of forestland in Rwanda and Zimbabwe vividly present the finding. Therefore, future studies related to the topic in the region shall focus on sub-national panel data.

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

    Directory of Open Access Journals (Sweden)

    Chipayeni Mtonga

    2007-06-01

    .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.

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

    Science.gov (United States)

    Bryceson, D F

    1989-01-01

    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.

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

    Science.gov (United States)

    Monekosso, G L

    2014-08-01

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

  2. Current Status of Norovirus Infections in Children in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Samuel Munalula Munjita

    2015-01-01

    Full Text Available Noroviruses are a leading cause of acute sporadic gastroenteritis worldwide. In Sub-Saharan Africa, information regarding norovirus infections in children is scarce. A systematic review of studies performed between 1993 and June 2015 was conducted to establish the genotypic distribution and prevalence of norovirus infections in children (≤17 in Sub-Saharan Africa. Analysis of data from 19 studies involving 8,399 samples from children with symptomatic and nonsymptomatic gastroenteritis revealed prevalence of 12.6% (range 4.6% to 32.4%. The prevalence of norovirus infections was higher in symptomatic children (14.2% than asymptomatic children (9.2%. Genogroup II (GII was the most prevalent genogroup accounting for 76.4% of all the reported norovirus infections. The rest of the infections were GI (21.7% and GI/GII (1.9%. The most common genotypes were GII.4 (65.2%, GI.7 (33.3%, and GI.3 (21.3%. These statistics were calculated from studies carried out in 12 out of 48 Sub-Saharan African countries. Therefore, more studies involving several countries are required to determine fully the epidemiology of noroviruses and their contribution to childhood diarrhoea in Sub-Saharan Africa.

  3. MIGRATION OF WOMEN FROM SUB-SAHARAN AFRICA TO EUROPE: THE ROLE OF HIGHLY SKILLED WOMEN

    Directory of Open Access Journals (Sweden)

    Camilla Spadavecchia

    2013-10-01

    Full Text Available This contribution aims to analyze Sub-Saharan women’s migration with a special focus on highly skilled women in order to create a framework to better understand the different factors shaping migration patterns, such as the push and pull factors, the increase of flows and the complexity associated with them. In recent years the number of female Sub-Saharan migrants has grown at a rate much higher than the global average. In fact, in 2010 alone the number of female African migrants was 47.2% (World Bank, 2012, showing an increase of 5.2% since the 1960’s when women constituted 42% of the total migration from Sub-Saharan Africa. The feminization of migration flows from Sub-Saharan Africa (SSA in recent years has also witnessed a diversification of the flows. One specific segment on the rise is labor migration, specifically, highly skilled migration, especially for tertiary students and physicians and nurses. The study explores social geography and the geography of migration. The author considers two dimensions of analysis: women’s migration patterns from SSA (with a special focus on the impacts of the flows and highly skilled migration from SSA.

  4. The genetics of East African populations: a Nilo-Saharan component in the African genetic landscape.

    Science.gov (United States)

    Dobon, Begoña; Hassan, Hisham Y; Laayouni, Hafid; Luisi, Pierre; Ricaño-Ponce, Isis; Zhernakova, Alexandra; Wijmenga, Cisca; Tahir, Hanan; Comas, David; Netea, Mihai G; Bertranpetit, Jaume

    2015-01-01

    East Africa is a strategic region to study human genetic diversity due to the presence of ethnically, linguistically, and geographically diverse populations. Here, we provide new insight into the genetic history of populations living in the Sudanese region of East Africa by analysing nine ethnic groups belonging to three African linguistic families: Niger-Kordofanian, Nilo-Saharan and Afro-Asiatic. A total of 500 individuals were genotyped for 200,000 single-nucleotide polymorphisms. Principal component analysis, clustering analysis using ADMIXTURE, FST statistics, and the three-population test were used to investigate the underlying genetic structure and ancestry of the different ethno-linguistic groups. Our analyses revealed a genetic component for Sudanese Nilo-Saharan speaking groups (Darfurians and part of Nuba populations) related to Nilotes of South Sudan, but not to other Sudanese populations or other sub-Saharan populations. Populations inhabiting the North of the region showed close genetic affinities with North Africa, with a component that could be remnant of North Africans before the migrations of Arabs from Arabia. In addition, we found very low genetic distances between populations in genes important for anti-malarial and anti-bacterial host defence, suggesting similar selective pressures on these genes and stressing the importance of considering functional pathways to understand the evolutionary history of populations.

  5. Democratic consolidation in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Ángel Pérez González

    2001-12-01

    Full Text Available The contributions made by theory on democratic consolidation in Eastern Europe are also pertinent to analysis of processes of democratization and democratic consolidation in other areas, such as sub-Saharan Africa. The parameters of analysis highlight the importance of a strong state (organized, with legitimated institutions and a structured society (whether multiethnic or not as necessary conditions for democratization. On the assumption that the colonizing powers basically used two models –the French assimilationist model and the British indirect government model– the study of how these conditions were fulfilled in various sub-Saharan states leads to two conclusions: the first, the possibility of a process of democratization in those states where European (French colonization produced a total assimilation of the colonized society, including above all the colonizer’s political values; and the second, the possibility of processes of democratization in states produced by British colonization where the indigenous structures and those of the metropolis were superimposed, a phenomenon which allowed the application of democratic values by legitimated local institutions.

  6. History of blood transfusion in sub-saharan Africa.

    Science.gov (United States)

    Schneider, William H

    2013-01-01

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

  7. The Case for Investing in Secondary Education in Sub-Saharan Africa (SSA): Challenges and Opportunities

    Science.gov (United States)

    Fredriksen, Birger; Fossberg, Camilla Helgø

    2014-01-01

    Over the next two decades, sub-Saharan Africa will face substantial pressure to expand its secondary education system. This is driven by the current low development of secondary education compared to other world regions, continued rapid population growth, the increase in the enrollment and completion rates at the primary education level, and the…

  8. Agronomic biofortification of crops to fight hidden hunger in sub-Saharan Africa

    NARCIS (Netherlands)

    Valença, de A.W.; Bake, A.; Brouwer, I.D.; Giller, K.E.

    2017-01-01

    Micronutrient deficiencies or ‘hidden hunger’ resulting from unbalanced diets based on starchy staple crops are prevalent among the population of sub-Saharan Africa. This review discusses the effectiveness of agronomic biofortification - the application of mineral micronutrient fertilizers to soils

  9. Networks, communities and markets in sub-Saharan Africa: Implications for growth and investment

    OpenAIRE

    Fafchamps, M.

    2001-01-01

    Metadata only record This article explores the importance that relationships and networks have in market exchanges in Sub-Saharan Africa. The study concludes that in order to reduce transactions costs, Africans traders establish long term trading relationships, which are determinant for business and market outcomes. These relationships are based on trust, but often keeping family and relatives separate from business. Socialization is another important part of business for different network...

  10. POST-COLONIAL MODERNIZATION OF SPACIAL ECONOMICAL SYSTEM OF THE SUB-SAHARAN REGION

    Directory of Open Access Journals (Sweden)

    Youssouf Ali Mahamat

    2013-01-01

    Full Text Available The article covers the main problems of the post-colonial modernization of countries of sub-Saharan region. Market-oriented approaches to the development of economic systems are being implemented in the region in the form of structural adaptation plans. In general, the connection of the African economy to the market regulators is a complex process which requires a sharp, painful break-up of traditional social structures.

  11. Investigating the Impacts of Surface Temperature Anomalies due to Burned Area Albedo in Northern sub-Saharan Africa

    Science.gov (United States)

    Gabbert, T.; Matsui, T.; Capehart, W. J.; Ichoku, C. M.; Gatebe, C. K.

    2015-12-01

    The northern Sub-Saharan African region (NSSA) is an area of intense focus due to periodic severe droughts that have dire consequences on the growing population, which relies mostly on rain fed agriculture for its food supply. This region's weather and hydrologic cycle are very complex and are dependent on the West African Monsoon. Different regional processes affect the West African Monsoon cycle and variability. One of the areas of current investigation is the water cycle response to the variability of land surface characteristics. Land surface characteristics are often altered in NSSA due to agricultural practices, grazing, and the fires that occur during the dry season. To better understand the effects of biomass burning on the hydrologic cycle of the sub-Saharan environment, an interdisciplinary team sponsored by NASA is analyzing potential feedback mechanisms due to the fires. As part of this research, this study focuses on the effects of land surface changes, particularly albedo and skin temperature, that are influenced by biomass burning. Surface temperature anomalies can influence the initiation of convective rainfall and surface albedo is linked to the absorption of solar radiation. To capture the effects of fire perturbations on the land surface, NASA's Unified Weather and Research Forecasting (NU-WRF) model coupled with NASA's Land Information System (LIS) is being used to simulate burned area surface albedo inducing surface temperature anomalies and other potential effects to environmental processes. Preliminary sensitivity results suggest an altered surface radiation budget, regional warming of the surface temperature, slight increase in average rainfall, and a change in precipitation locations.

  12. Diversification and a multidisciplinary approach for raising agriculture production and attaining food security in smallholder farming systems of Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Catherine N. Munyua

    2015-10-01

    Full Text Available Agriculture is the primary economic activity for between 50 and 90 percent of the population in Sub-Saharan African countries. Ninety five percent of the food that is produced in Sub-Saharan Africa is grown through rain-fed agriculture. This implies that the region will suffer most from climate change due to its dependence on rain-fed agriculture. Vulnerability to climate change will be especially significant among the resource poor smallholder farmers in African countries whose livelihoods depend on rain-fed agriculture in marginal areas. African agriculture is characterized by variations in farming systems with about 90% of the farming occurring in integrated systems. In these mixed farming systems, the food security challenge may require an integrated approach to match the existing systems. A rainbow evolution which emphasizes the need for diversified systems may be the best practice in raising agricultural productivity. A multidisciplinary approach based on the theory of embededdness whereby farmers, researchers, extension institutions, and political institutions work together can further raise agriculture production and improve food security. Social networks in communities of farmers provide channels for identifying problems and farmers’ knowledge integrated with that of research and extension can provide sustainable solutions for food production in smallholder farming systems in Africa.

  13. Educational attainment and adult literacy: A descriptive account of 31 Sub-Saharan Africa countries

    Directory of Open Access Journals (Sweden)

    Emily Smith-Greenaway

    2015-11-01

    Full Text Available Background: More than 60 years ago the international community declared literacy a basic human right. Recognition of its intrinsic value and evidence of its social and economic benefits have motivated an expansive international effort to estimate the percentage of adults that can read, especially in low-income countries where educational opportunities are limited. Population data on adults' educational attainment is commonly used to approximate adult literacy rates. Though increasing evidence from school-based studies of pupils confirm literacy achievement is not universal - even at advanced grades - it remains unclear whether adults' educational attainment is reflective of their literacy. Objective: This study leverages population-based data that include direct assessments of adults' literacy skills to provide a descriptive account of the proportion of adults that can read at each level of educational attainment. The study focuses on the Sub-Saharan African context, a world region where school participation has expanded rapidly in the last three decades. Because many African adults have discontinued their education at the primary level, the study focuses on basic reading skills at each level of primary school. The study focuses specifically on women, whose literacy has garnered extensive international interest. Results: Demographic and Health Survey data from 31 African countries confirm that there are many instances in which women have several years of primary school but cannot read. In fact, in some countries, large proportions of African women who never went to school can read, even as some of their peers who have completed primary school cannot. The weak correlation between educational attainment and literacy is not specific to older cohorts of women, but is also observed among younger women. Conclusions: The findings demonstrate that educational attainment is generally a poor proxy for literacy, highlighting the need to measure, theorize

  14. Are female orphans at risk for early marriage, early sexual debut, and teen pregnancy? Evidence from sub-Saharan Africa.

    Science.gov (United States)

    Palermo, Tia; Peterman, Amber

    2009-06-01

    Female orphans are widely cited as being at risk for early marriage, early childbearing, and risky sexual behavior; however, to date no studies have examined these linkages using population-level data across multiple countries. This study draws from recent Demographic and Health Surveys from ten sub-Saharan African countries to examine the relationship between orphanhood status and measures of early marriage, early sexual debut, and teen pregnancy among adolescent girls aged 15 to 17. Results indicate that, overall, little association is found between orphanhood and early marriage or teen pregnancy, whereas evidence from seven countries supports associations between orphanhood and early sexual debut. Findings are sensitive to the use of multivariate models, type of orphan, and country setting. Orphanhood status alone may not be a sufficient targeting mechanism for addressing these outcomes in many countries; a broader, multidimensional targeting scheme including orphan type, schooling, and poverty measures would be more robust in identifying and aiding young women at risk.

  15. Temperature effects on future energy demand in Sub-Saharan Africa

    Science.gov (United States)

    Shivakumar, Abhishek

    2016-04-01

    Climate change is projected to adversely impact different parts of the world to varying extents. Preliminary studies show that Sub-Saharan Africa is particularly vulnerable to climate change impacts, including changes to precipitation levels and temperatures. This work will analyse the effect of changes in temperature on critical systems such as energy supply and demand. Factors that determine energy demand include income, population, temperature (represented by cooling and heating degree days), and household structures. With many countries in Sub-Saharan Africa projected to experience rapid growth in both income and population levels, this study aims to quantify the amplified effects of these factors - coupled with temperature changes - on energy demand. The temperature effects will be studied across a range of scenarios for each of the factors mentioned above, and identify which of the factors is likely to have the most significant impact on energy demand in Sub-Saharan Africa. Results of this study can help set priorities for decision-makers to enhance the climate resilience of critical infrastructure in Sub-Saharan Africa.

  16. Energy Justice in Sub-Saharan Africa

    Science.gov (United States)

    Buchholz, Kathleen B.

    Sub-Saharan Africa has the lowest rates of electrification and some of the worst education statistics worldwide. In the absence of strong infrastructure for a reliable grid system and quality universal primary schooling, the poor suffer significantly. Though substantial research has been done on both issues separately, the relationship between the two has yet to be explored. This thesis uses social justice theories to introduce the connections between energy poverty and an individual's education capabilities through a case study in Zambia. Case study research was carried out in the urban low-resource settlements of Lusaka, Zambia over a period of two months with Lifeline Energy, using methods of participant observation. Drawing on trends discovered in survey responses, interviews and feedback from a distribution of renewable technologies, this study demonstrates that a lack of modern forms of energy detracts from education. By synthesizing the data with Martha Nussbaum's capabilities approach and Sendhil Mullainathan and Eldar Shafir's scarcity theory, the research reveals that energy poverty hinders an individual's ability to study and gain a quality education and diminishes their available cognitive capacity to learn by tunneling attention to the resource deficit. Furthermore, it supports the claim that energy poverty is not gender neutral. The research concludes that the scarcity caused by energy poverty can be lessened by the investment in and use of small-scale renewable technologies which alleviates some of the daily stress and grind of poverty. This thesis lays the groundwork to recognize energy poverty as an injustice. Keywords: Energy Poverty, Education, Gender, Sub-Saharan Africa, Scarcity, Capabilities Approach..

  17. Healthcare Programmes for Truck Drivers in Sub-Saharan Africa: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Samanta Tresha Lalla-Edward

    Full Text Available Truck drivers have unique health needs, and by virtue of their continuous travel, experience difficulty in accessing healthcare. Currently, planning for effective care is hindered by lack of knowledge about their health needs and about the impact of on-going programmes on this population's health outcomes. We reviewed healthcare programmes implemented for sub-Saharan African truck drivers, assessed the evaluation methods, and examined impact on health outcomes.We searched scientific and institutional databases, and online search engines to include all publications describing a healthcare programme in sub-Saharan Africa where the main clients were truck drivers. We consulted experts and organisations working with mobile populations to identify unpublished reports. Forest plots of impact and outcome indicators with unadjusted risk ratios and 95% confidence intervals were created to map the impact of these programmes. We performed a subgroup analysis by type of indicator using a random-effects model to assess between-study heterogeneity. We conducted a sensitivity analysis to examine both the summary effect estimate chosen (risk difference vs. risk ratio and model to summarise results (fixed vs. random effects.Thirty-seven publications describing 22 healthcare programmes across 30 countries were included from 5,599 unique records. All programmes had an HIV-prevention focus with only three expanding their services to cover conditions other primary healthcare services. Twelve programmes were evaluated and most evaluations assessed changes in input, output, and outcome indicators. Absence of comparison groups, preventing attribution of the effect observed to the programme and lack of biologically confirmed outcomes were the main limitations. Four programmes estimated a quantitative change in HIV prevalence or reported STI incidence, with mixed results, and one provided anecdotal evidence of changes in AIDS-related mortality and social norms. Most

  18. Oral Societies and Colonial Experiences: Sub-Saharan Africa and the "de-facto" Power of the Written Word

    Science.gov (United States)

    Abdi, Ali A.

    2007-01-01

    Pre-colonial traditional societies in Sub-Saharan Africa were mostly oral societies whose languages were not written. In the African context, especially, it was clear that the mostly oral traditions of these societies' languages were neither being appreciated nor promoted as media of communication, or means of education by the invading Europeans.…

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

    NARCIS (Netherlands)

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

    2011-01-01

    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

  20. The national determinants of deforestation in sub-Saharan Africa.

    Science.gov (United States)

    Rudel, Thomas K

    2013-01-01

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-02-15

    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?.

  2. British Military Strategy and Sub-Saharan African Colonial Retreat(1945-1964)%英国军事战略与黑非洲殖民撤退(1945-1964年)

    Institute of Scientific and Technical Information of China (English)

    杭聪

    2014-01-01

    The post-war British Government fully affirmed the strategic position of Sub-Saharan Africa,and tired to make it a logistic base in support of the global war.In order to safeguard their own interests,when unable to suppress the national liberation movement,the British government would make use of its military agreements,change the organizational forms of the governments and military institutions,choose colonial parties and monopolise officer positions and employ mili-tary means to intervene.%战后的英国政府充分肯定了黑非洲殖民地的战略地位,力图将黑非洲建设成全球战争的后勤支援基地。当无力镇压民族解放运动之时,为了维护自己的利益,英国政府既利用军事协议,变更政府和军事机构组织形式,选择移交政权党派和垄断军官职位等手段,又选择性地利用军事干预手段。

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

    Science.gov (United States)

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

    2012-12-01

    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.

  4. Non-physician Clinicians – A Gain for Physicians’ Working in Sub-Saharan Africa

    Science.gov (United States)

    Dovlo, Delanyo; King-Harry, Ibiso Ivy; Ousman, Kevin

    2017-01-01

    The changing demands on the health sectors in low- and middle-income countries especially sub-Saharan African countries continue to challenge efforts to address critical shortages of the health workforce. Addressing these challenges have led to the evolution of "non-physician clinicians" (NPCs), that assume some physician roles and thus mitigate the continuing shortage of doctors in these countries. While it is agreed that changes are needed in physicians’ roles and their training as part of the new continuum of care that includes NPCs, we disagree that such training should be geared solely at ensuring physicians dominated health systems. Discussions on the workforce models to suit low-income countries must avoid an endorsement of a culture of physician focused health systems as the only model for sub-Saharan Africa (SSA). It is also essential that training for NPCs be harmonized with that of physicians to clarify the technical roles of both.

  5. Prioritizing West African medicinal plants for conservation and sustainable extraction studies based on market surveys and species distribution models.

    NARCIS (Netherlands)

    Andel, van T.R.; Croft, S.; Loon, van E.E.; Quiroz Villarreal, D.K.; Towns, A.M.; Raes, N.

    2015-01-01

    Sub-Saharan African human populations rely heavily on wild-harvested medicinal plants for their health. The trade in herbal medicine provides an income for many West African people, but little is known about the effects of commercial extraction on wild plant populations. Detailed distribution maps a

  6. Prioritizing West African medicinal plants for conservation and sustainable extraction studies based on market surveys and species distribution models

    NARCIS (Netherlands)

    van Andel, T.R.; Croft, S.; van Loon, E.E.; Quiroz, D.; Towns, A.M.; Raes, N.

    2015-01-01

    Sub-Saharan African human populations rely heavily on wild-harvested medicinal plants for their health. The trade in herbal medicine provides an income for many West African people, but little is known about the effects of commercial extraction on wild plant populations. Detailed distribution maps a

  7. The Role of Nurses and Community Health Workers in Confronting Neglected Tropical Diseases in Sub-Saharan Africa: A Systematic Review

    Science.gov (United States)

    Corley, Andrew G.; Thornton, Clifton P.; Glass, Nancy E.

    2016-01-01

    Introduction Neglected tropical diseases produce an enormous burden on many of the poorest and most disenfranchised populations in sub-Saharan Africa. Similar to other developing areas throughout the world, this region’s dearth of skilled health providers renders Western-style primary care efforts to address such diseases unrealistic. Consequently, many countries rely on their corps of nurses and community health workers to engage with underserved and hard-to-reach populations in order provide interventions against these maladies. This article attempts to cull together recent literature on the impact that nurses and community health workers have had on neglected tropical diseases. Methods A review of the literature was conducted to assess the role nurses and community health workers play in the primary, secondary, and tertiary prevention of neglected tropical diseases in sub-Saharan Africa. Articles published between January 2005 and December 2015 were reviewed in order to capture the full scope of nurses’ and community health workers’ responsibilities for neglected tropical disease control within their respective countries’ health systems. Results A total of 59 articles were identified that fit all inclusion criteria. Conclusions Successful disease control requires deep and meaningful engagement with local communities. Expanding the role of nurses and community health workers will be required if sub-Saharan African countries are to meet neglected tropical disease treatment goals and eliminate the possibility future disease transmission. Horizontal or multidisease control programs can create complimentary interactions between their different control activities as well as reduce costs through improved program efficiencies—benefits that vertical programs are not able to attain. PMID:27631980

  8. A Systematic Review of Research on Autism Spectrum Disorders in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Amina Abubakar

    2016-01-01

    Full Text Available The burden of autism spectrum disorders (ASDs in sub-Saharan Africa (SSA is not well known. We carried out a systematic review of the literature to identify published work from SSA. We have systematically searched four databases, namely, Medline, PsycINFO, CINAHL, and Child Development & Adolescent Studies, through EBSCO and identified studies from across SSA. Based on predefined inclusion criteria, 47 studies were included in this review. Most of the identified studies (74% were conducted in only 2 African countries, that is, South Africa and Nigeria. Additionally, most of these studies (83% were carried out in the last decade. These studies had four major themes: development of measurement tools of ASD in Africa, examining the prevalence of ASD, identifying risk factors and risk markers, and examining psychosocial issues. We identified only a single population level study aimed at documenting the prevalence of ASD and could not identify a single case-control study aimed at examining a comprehensive set of potential risk factors. All intervention studies were based on very small sample sizes. Put together, our findings suggest that current evidence base is too scanty to provide the required information to plan adequately for effective intervention strategies for children with ASD in Africa.

  9. A Systematic Review of Research on Autism Spectrum Disorders in Sub-Saharan Africa

    Science.gov (United States)

    Ssewanyana, Derrick

    2016-01-01

    The burden of autism spectrum disorders (ASDs) in sub-Saharan Africa (SSA) is not well known. We carried out a systematic review of the literature to identify published work from SSA. We have systematically searched four databases, namely, Medline, PsycINFO, CINAHL, and Child Development & Adolescent Studies, through EBSCO and identified studies from across SSA. Based on predefined inclusion criteria, 47 studies were included in this review. Most of the identified studies (74%) were conducted in only 2 African countries, that is, South Africa and Nigeria. Additionally, most of these studies (83%) were carried out in the last decade. These studies had four major themes: development of measurement tools of ASD in Africa, examining the prevalence of ASD, identifying risk factors and risk markers, and examining psychosocial issues. We identified only a single population level study aimed at documenting the prevalence of ASD and could not identify a single case-control study aimed at examining a comprehensive set of potential risk factors. All intervention studies were based on very small sample sizes. Put together, our findings suggest that current evidence base is too scanty to provide the required information to plan adequately for effective intervention strategies for children with ASD in Africa. PMID:27872512

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

    Directory of Open Access Journals (Sweden)

    Saul Tobias

    2012-11-01

    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.

  11. Urban air pollution in Sub-Saharan Africa: Time for action.

    Science.gov (United States)

    Amegah, A Kofi; Agyei-Mensah, Samuel

    2017-01-01

    Air quality in cities of Sub-Saharan African (SSA) countries has deteriorated with the situation driven by rapid population growth and its attendant increased vehicle ownership, increased use of solid fuels for cooking and heating, and poor waste management practices. Industrial expansion in these cities is also a major contributor to the worsening air pollution. Exposure to ambient air pollution is a major threat to human health in SSA with 176,000 deaths and 626,000 DALYs in the region attributable to ambient air pollution exposure. These estimates are however likely to be much higher than reported due to the limited data emanating from the region. Recently, the adoption of the World Health Assembly resolution on air pollution and health, and Sustainable Development Goals are a welcome boost for urban air pollution control efforts in SSA. In this article, we have outlined within the broad framework of these international policy instruments, measures for addressing urban air pollution and its associated health impacts in SSA sustainably.

  12. HLA genes in Macedonians and the sub-Saharan origin of the Greeks.

    Science.gov (United States)

    Arnaiz-Villena, A; Dimitroski, K; Pacho, A; Moscoso, J; Gómez-Casado, E; Silvera-Redondo, C; Varela, P; Blagoevska, M; Zdravkovska, V; Martínez-Laso, J

    2001-02-01

    HLA alleles have been determined in individuals from the Republic of Macedonia by DNA typing and sequencing. HLA-A, -B, -DR, -DQ allele frequencies and extended haplotypes have been for the first time determined and the results compared to those of other Mediterraneans, particularly with their neighbouring Greeks. Genetic distances, neighbor-joining dendrograms and correspondence analysis have been performed. The following conclusions have been reached: 1) Macedonians belong to the "older" Mediterranean substratum, like Iberians (including Basques), North Africans, Italians, French, Cretans, Jews, Lebanese, Turks (Anatolians), Armenians and Iranians, 2) Macedonians are not related with geographically close Greeks, who do not belong to the "older" Mediterranenan substratum, 3) Greeks are found to have a substantial relatedness to sub-Saharan (Ethiopian) people, which separate them from other Mediterranean groups. Both Greeks and Ethiopians share quasi-specific DRB1 alleles, such as *0305, *0307, *0411, *0413, *0416, *0417, *0420, *1110, *1112, *1304 and *1310. Genetic distances are closer between Greeks and Ethiopian/sub-Saharan groups than to any other Mediterranean group and finally Greeks cluster with Ethiopians/sub-Saharans in both neighbour joining dendrograms and correspondence analyses. The time period when these relationships might have occurred was ancient but uncertain and might be related to the displacement of Egyptian-Ethiopian people living in pharaonic Egypt.

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

    Science.gov (United States)

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

    2013-08-30

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

  14. People in sub-Saharan Africa rate their health and health care among the lowest in the world.

    Science.gov (United States)

    Deaton, Angus S; Tortora, Robert

    2015-03-01

    The health of people in sub-Saharan Africa is a major global concern. However, data are weak, and little is known about how people in the region perceive their health or their health care. We used data from the Gallup World Poll in 2012 to document sub-Saharan Africans' perceived health status, their satisfaction with health care, their contact with medical professionals, and the priority they attach to health care. In comparison to other regions of the world, sub-Saharan Africa has the lowest ratings for well-being and the lowest satisfaction with health care. It also has the second-lowest perception of personal health, after only the former Soviet Union and its Eastern European satellites. HIV prevalence is positively correlated with perceived improvements in health care in countries with high prevalence. This is consistent with an improvement in at least some health care services as a result of the largely aid-funded rollout of antiretroviral treatment. Even so, sub-Saharan Africans do not prioritize health care as a matter of policy, although donors are increasingly shifting their aid efforts in the region toward health.

  15. HIV/AIDS drugs for Sub-Saharan Africa: how do brand and generic supply compare?

    Directory of Open Access Journals (Sweden)

    Colleen V Chien

    Full Text Available BACKGROUND: Significant quantities of antiretroviral drugs (ARVs to treat HIV/AIDS have been procured for Sub-Saharan Africa for the first time in their 20-year history. This presents a novel opportunity to empirically study the roles of brand and generic suppliers in providing access to ARVs. METHODOLOGY/PRINCIPAL FINDINGS: An observational study of brand and generic supply based on a dataset of 2,162 orders of AIDS drugs for Sub-Saharan Africa reported to the Global Price Reporting Mechanism at the World Health Organization from January 2004-March 2006 was performed. Generic companies supplied 63% of the drugs studied, at prices that were on average about a third of the prices charged by brand companies. 96% of the procurement was of first line drugs, which were provided mostly by generic firms, while the remaining 4%, of second line drugs, was sourced primarily from brand companies. 85% of the generic drugs in the sample were manufactured in India, where the majority of the drugs procured were ineligible for patent protection. The remaining 15% was manufactured in South Africa, mostly under voluntary licenses provided by brand companies to a single generic company. In Sub-Saharan African countries, four first line drugs in the dataset were widely patented, however no general deterrent to generic purchasing based on a patent was detected. CONCLUSIONS/SIGNIFICANCE: Generic and brand companies have played distinct roles in increasing the availability of ARVs in Sub-Saharan Africa. Generic companies provided most of the drugs studied, at prices below those charged by brand companies, and until now, almost exclusively supplied several fixed-dose combination drugs. Brand companies have supplied almost all second line drugs, signed voluntary licenses with generic companies, and are not strictly enforcing patents in certain countries. Further investigation into how price reductions in second line drugs can be achieved and the cheapest drugs can

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

    Science.gov (United States)

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

    2013-01-01

    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.

  17. The challenge of AIDS-related malignancies in sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Annie J Sasco

    relatively small number of studies warrant further epidemiological investigations, taking into account other known risk factors for these tumors. CONCLUSION: Studies conducted in sub-Saharan Africa show that HIV infection is not only strongly associated with AIDS-classifying cancers but also provided some evidence of association for other neoplasia. African countries need now to implement well designed population-based studies in order to better describe the spectrum of AIDS-associated malignancies and the most effective strategies for their prevention, screening and treatment.

  18. Evaluating Spatial Interaction Models for Regional Mobility in Sub-Saharan Africa.

    Science.gov (United States)

    Wesolowski, Amy; O'Meara, Wendy Prudhomme; Eagle, Nathan; Tatem, Andrew J; Buckee, Caroline O

    2015-07-01

    Simple spatial interaction models of human mobility based on physical laws have been used extensively in the social, biological, and physical sciences, and in the study of the human dynamics underlying the spread of disease. Recent analyses of commuting patterns and travel behavior in high-income countries have led to the suggestion that these models are highly generalizable, and as a result, gravity and radiation models have become standard tools for describing population mobility dynamics for infectious disease epidemiology. Communities in Sub-Saharan Africa may not conform to these models, however; physical accessibility, availability of transport, and cost of travel between locations may be variable and severely constrained compared to high-income settings, informal labor movements rather than regular commuting patterns are often the norm, and the rise of mega-cities across the continent has important implications for travel between rural and urban areas. Here, we first review how infectious disease frameworks incorporate human mobility on different spatial scales and use anonymous mobile phone data from nearly 15 million individuals to analyze the spatiotemporal dynamics of the Kenyan population. We find that gravity and radiation models fail in systematic ways to capture human mobility measured by mobile phones; both severely overestimate the spatial spread of travel and perform poorly in rural areas, but each exhibits different characteristic patterns of failure with respect to routes and volumes of travel. Thus, infectious disease frameworks that rely on spatial interaction models are likely to misrepresent population dynamics important for the spread of disease in many African populations.

  19. Evaluating Spatial Interaction Models for Regional Mobility in Sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Amy Wesolowski

    2015-07-01

    Full Text Available Simple spatial interaction models of human mobility based on physical laws have been used extensively in the social, biological, and physical sciences, and in the study of the human dynamics underlying the spread of disease. Recent analyses of commuting patterns and travel behavior in high-income countries have led to the suggestion that these models are highly generalizable, and as a result, gravity and radiation models have become standard tools for describing population mobility dynamics for infectious disease epidemiology. Communities in Sub-Saharan Africa may not conform to these models, however; physical accessibility, availability of transport, and cost of travel between locations may be variable and severely constrained compared to high-income settings, informal labor movements rather than regular commuting patterns are often the norm, and the rise of mega-cities across the continent has important implications for travel between rural and urban areas. Here, we first review how infectious disease frameworks incorporate human mobility on different spatial scales and use anonymous mobile phone data from nearly 15 million individuals to analyze the spatiotemporal dynamics of the Kenyan population. We find that gravity and radiation models fail in systematic ways to capture human mobility measured by mobile phones; both severely overestimate the spatial spread of travel and perform poorly in rural areas, but each exhibits different characteristic patterns of failure with respect to routes and volumes of travel. Thus, infectious disease frameworks that rely on spatial interaction models are likely to misrepresent population dynamics important for the spread of disease in many African populations.

  20. North African influences and potential bias in case-control association studies in the Spanish population.

    Directory of Open Access Journals (Sweden)

    María Pino-Yanes

    Full Text Available BACKGROUND: Despite the limited genetic heterogeneity of Spanish populations, substantial evidences support that historical African influences have not affected them uniformly. Accounting for such population differences might be essential to reduce spurious results in association studies of genetic factors with disease. Using ancestry informative markers (AIMs, we aimed to measure the African influences in Spanish populations and to explore whether these might introduce statistical bias in population-based association studies. METHODOLOGY/PRINCIPAL FINDINGS: We genotyped 93 AIMs in Spanish (from the Canary Islands and the Iberian Peninsula and Northwest Africans, and conducted population and individual-based clustering analyses along with reference data from the HapMap, HGDP-CEPH, and other sources. We found significant differences for the Northwest African influence among Spanish populations from as low as ≈ 5% in Spanish from the Iberian Peninsula to as much as ≈ 17% in Canary Islanders, whereas the sub-Saharan African influence was negligible. Strikingly, the Northwest African ancestry showed a wide inter-individual variation in Canary Islanders ranging from 0% to 96%, reflecting the violent way the Islands were conquered and colonized by the Spanish in the XV century. As a consequence, a comparison of allele frequencies between Spanish samples from the Iberian Peninsula and the Canary Islands evidenced an excess of markers with significant differences. However, the inflation of p-values for the differences was adequately controlled by correcting for genetic ancestry estimates derived from a reduced number of AIMs. CONCLUSIONS/SIGNIFICANCE: Although the African influences estimated might be biased due to marker ascertainment, these results confirm that Northwest African genetic footprints are recognizable nowadays in the Spanish populations, particularly in Canary Islanders, and that the uneven African influences existing in these

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

    Directory of Open Access Journals (Sweden)

    Svetlane Dimi

    2014-11-01

    Full Text Available Introduction: In 2011, a French national survey of people living with HIV (PLHIV has shown that 40% of persons diagnosed since 2003 are originated from sub-Saharan Africa, two thirds of them being women. For them, in the short term, access to social rights is a priority. Today, over 90% of PLHIV are treated effectively and with the aging of this population, questions about their future perspectives arise. Our service provides a multidisciplinary (medical, psychological, social approach to PLHIV. The aim of our study is to describe the future perspectives of sub-Saharan women living with HIV residing in France for more than 7 years, because it is the time required for the implementation of fundamental rights and social insertion. Do they plan to return to their country of origin after their retirement? Does the HIV infection force them to stay in France? Materials and Methods: Prospective pilot mono-centric study. Between January and April 2014, every HIV-infected woman born in a sub-Saharan country, resident in France for at least 7 years, attending for their routine outpatient visit was consecutively included. Data were collected through a structured, semi-directed interview made by their usual hospital physician or social worker. Results: Consecutively, 76 women agreed to participate to the interview, none refused. Mean age: 42 years [26–70], time since HIV diagnosis: 12 years [1–25]. HIV diagnosis was made before arriving in France for 3% of them; in 33% diagnosis was made in the year of arrival; diagnosis made several years after arrival in 63%. Even if 69% of these women had been irregularly residing in France for a period, all of them had obtained a regular situation for residence and 50% acquired the French nationality. Mean duration of residence was 15 years [7–33]. Two thirds of them are employed. In the future, although 50% plan to have a shared residence between France and Africa, only 20% of them plan to settle back definitely

  2. Exploring the determinants of sanitation success in Sub-Saharan Africa.

    Science.gov (United States)

    Munamati, Muchaneta; Nhapi, Innocent; Misi, Shepherd

    2016-10-15

    Sub-Saharan Africa (SSA) missed the Millennium Development Goal (MDG) sanitation target by a wide margin. However, there are a few African countries which made remarkable progress towards achieving the sanitation target. While the general factors that influence sanitation success are widely known, some of the few studies that have investigated the SSA sanitation situation have arrived at different conclusions regarding the determinants of sanitation success. The objectives of this paper were to establish the key determinants of sanitation success in SSA countries and to classify the SSA countries based on factors associated with sanitation success. This was achieved by analysing data drawn from 46 SSA countries. An objective methodological approach, using regression and cluster analyses to reveal the underlying sanitation success factors, has been adopted. A total of 11 economic and socio-political independent variables were tested against the dependent variable; proportion of the 2015 population that has gained access to sanitation since 2000. Regression results showed consistent and robust association between sanitation success and education for the national, rural and socio-political samples (p values 0.018-0.038). These results suggest that the level of education contributed to sanitation success in SSA during the MDG period. For the urban sample, a negative association was demonstrated between sanitation success and access to improved water sources (p = 0.034). This implies that countries which made huge sanitation gains had low coverage of improved water sources. The results from cluster analysis showed that countries which achieved great sanitation success were characterized by the highest education levels, incomes, population densities, political stability and high proportions of urban population. The knowledge of the key determinants of sanitation success could help in the formulation and design of appropriate policies and interventions to improve

  3. Technology Transfer Strategies for Creating Growth Opportunities in Frontier Markets of Sub-Saharan Africa

    DEFF Research Database (Denmark)

    Nielsen, Ulrik B.

    In the past decade, Africa has developed from being an extremely impoverished continent with discouraging prospects to a more promising destination and home to some of the fastest growing Frontier Market economies. Approximately 75% of Africans rely on agriculture for their livelihoods, making...... it the most important economic sector. Despite possessing the world´s largest reservoir of unused arable land (about 60%), Africa has the lowest agricultural productivity, amounting to approximately 10% of global agricultural output. This suggests that scaling up agricultural production in SSA could...... to create growth opportunities in Frontier Markets of Sub-Saharan Africa....

  4. International migration and the propagation of HIV in sub-Saharan Africa.

    Science.gov (United States)

    Docquier, F; Vasilakis, Ch; Tamfutu Munsi, D

    2014-05-01

    In this paper, we identify and quantify the role of international migration in the propagation of HIV across sub-Saharan African countries. We use panel data on bilateral migration flows and HIV prevalence rates covering 44 countries after 1990. Controlling for unobserved heterogeneity, reverse causality, reflection issues, incorrect treatment of country fixed effects and spatial autocorrelation, we find evidence of a highly robust emigration-induced propagation mechanism. On the contrary, immigration has no significant effect. Numerical experiments reveal that the long-run effect of emigration accounts for more than 4 percent of the number of HIV cases in 15 countries (and more than 20 percent in 6 countries).

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    powerful ingredients, for example palm oil used as a medium to blend and make coherent the healing mixture. A better understanding of the cultural context of medicinal use of palms is needed in order to obtain a more accurate and complete insight into palm-based traditional medicines.......Palms (Arecaceae) are prominent elements in African traditional medicines. It is, however, a challenge to find detailed information on the ritual use of palms, which are an inextricable part of African medicinal and spiritual systems. This work reviews ritual uses of palms within African...... ethnomedicine. We studied over 200 publications on uses of African palms and found information about ritual uses in 26 of them. At least 12 palm species in sub-Saharan Africa are involved in various ritual practices: Borassus aethiopum, Cocos nucifera, Dypsis canaliculata, D. fibrosa, D. pinnatifrons, Elaeis...

  6. 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.

    Science.gov (United States)

    Odee, D W; Telford, A; Wilson, J; Gaye, A; Cavers, S

    2012-12-01

    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.

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

    Directory of Open Access Journals (Sweden)

    E. Jane Morris

    2011-06-01

    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.

  8. Burden of undiagnosed hypertension in sub-saharan Africa: a systematic review and meta-analysis.

    Science.gov (United States)

    Ataklte, Feven; Erqou, Sebhat; Kaptoge, Stephen; Taye, Betiglu; Echouffo-Tcheugui, Justin B; Kengne, Andre P

    2015-02-01

    The burden of hypertension in Sub-Saharan Africa has been increasing over the past few decades. However, a large proportion of the population with hypertension remains undiagnosed, untreated, or inadequately treated, contributing to the rising burden of cardiovascular disease in the region. We conducted a systematic review and meta-analysis to assess the recent burden of hypertension in Sub-Saharan Africa, based on studies published between 2000 and 2013. We pooled data from 33 surveys involving over 110 414 participants of mean age 40 years. Hypertension prevalence varied widely across the studies (range 15%-70%), partly because of differences in participant mean ages (31-76 years). The predicted prevalence of hypertension at mean participant ages of 30, 40, 50, and 60 years were 16%, 26%, 35%, and 44%, respectively, with a pooled prevalence of 30% (95% confidence interval, 27%-34%). Of those with hypertension, only between 7% and 56% (pooled prevalence: 27%; 95% confidence interval, 23%-31%) were aware of their hypertensive status before the surveys. Overall, 18% (95% confidence interval, 14%-22%) of individuals with hypertension were receiving treatment across the studies, and only 7% (95% confidence interval, 5%-8%) had controlled blood pressure. This review found a high prevalence of hypertension, as well as low percentage of hypertension awareness, treatment, and control in Sub-Saharan Africa, highlighting the need for implementation of timely and appropriate strategies for diagnosis, control, and prevention.

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

    Directory of Open Access Journals (Sweden)

    Gautier Jean-François

    2007-10-01

    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 μg/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 (β = -3.30; p = 0.002, fat mass (β = -2.68; p = 0.01, and insulin resistance (β = -2.38; p = 0.02 but not age (β = 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.

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

    Directory of Open Access Journals (Sweden)

    Brian Kevin Reilly

    2009-09-01

    Full Text Available This is an historic overview of conservation in Sub-Saharan Africa from pre-colonial times through the present. It demonstrates that Africans practiced conservation that was ignored by the colonial powers. The colonial market economy combined with the human and livestock population explosion of the 21st century are the major factors contributing to the demise of wildlife and critical habitat. Unique insight is provided into the economics of a representative safari company, something that has not been readily available to Community Based Natural Resources Management (CBNRM practitioners. Modern attempts at sharing benefits from conservation with rural communities will fail due to the low rural resource to population ratio regardless of the model, combined with the uneven distribution of profits from safari hunting that drives most CBNRM programs, unless these ratios are changed. Low household incomes from CBNRM are unlikely to change attitudes of rural dwellers towards Western approaches to conservation. Communities must sustainably manage their natural areas as "green factories" for the multitude of natural resources they contain as a means of maximizing employment and thus household incomes, as well as meeting the often overlooked socio-cultural ties to wildlife and other natural resources, which may be as important as direct material benefits in assuring conservation of wildlife and its habitat. For CBNRM to be successful in the long-term, full devolution of ownership over land and natural resources must take place. In addition, as a means of relieving pressure on the rural resource base, this will require an urbanization process that creates a middleclass, as opposed to the current slums that form the majority of Africa‘s cities, through industrialization that transforms the unique natural resources of the subcontinent (e.g., strategic minerals, petroleum, wildlife, hardwoods, fisheries, wild medicines, agricultural products, etc. in Africa.

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

    Science.gov (United States)

    McNamara, Robert S.

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

  12. What would it take to prevent stunted growth in children in sub-Saharan Africa?

    Science.gov (United States)

    Lartey, Anna

    2015-11-01

    There is increasing agreement among the nutrition community about the use of length/height-for-age as the indicator to monitor the long-term impact of chronic nutritional deficiencies. Stunting, an indicator of linear growth failure, has both long- and short-term consequences affecting growth and development and adult work potential. The number of stunted children in sub-Saharan Africa is expected to increase by 2025 if the current trends remain. Stunting among African children peaks during the complementary feeding period, which coincides with the period when children are no longer on exclusive breastfeeding and infections are frequent. Addressing stunting has become the focus of global efforts. The World Health Assembly in 2012 set a 40 % reduction in the number of stunted children by 2025. To effectively address the issues of stunting in sub-Saharan Africa is it appropriate to examine the issue of what it takes. The WHO Multicentre Growth Reference Study (MGRS) conducted in several regions of the world, including Africa has lessons on what it would take to prevent in African children. The children in the MGRS had good socioeconomic background characteristics reflected by years of maternal education and availability of basic amenities, such as potable water and sanitary conditions. The prescription of exclusive breastfeeding, high-quality diversified diets and attention to care were critical factors contributing to healthy growth for the African children. Preventing stunting in sub-Saharan Africa is possible. It requires governments to put in place policies that would create the conducive environment needed. The complex and multiple causes of stunting offer the opportunity to address stunting in a multisectoral and within a food systems approach. The global resolve to make food systems deliver on healthy diet requires all stakeholders to work together to achieve the global goal of reducing stunting. This review highlights the key elements contributing to adequate

  13. The Perplex of Deforestation in sub-Saharan Africa

    OpenAIRE

    Yalew, A.W. (Alemayehu W.)

    2015-01-01

    Deforestation has been a complex phenomenon to study in sub-Saharan Africa. The average annual deforestation rate in the region is by far higher than the world average. What causes and drives deforestation in the region are debated to date. The present paper is motivated by this debate. It attempts to test whether the maintained hypotheses on the causes of deforestation can give answer to the problem in sub-Saharan Africa. It used average cross-national data of forty eight countries in the re...

  14. Customs Administration Reform and Modernization in Francophone Sub-Saharan Africa, 1995–2010

    OpenAIRE

    Gilles Montagnat-Rentier; Gilles Parent

    2012-01-01

    This paper outlines reforms that have been achieved in the modernization of the customs administrations of francophone sub-Saharan (African) countries since the mid-1990s. It also highlights the remaining issues in this process. Progress has been made in the automation of operations and procedures, with constant and significant efforts to strengthen revenue collection and improve trade facilitation in a number of countries. However, the pace and scope of modernization remains insufficient, pa...

  15. Regionalism, end markets and ownership matter: Shifting dynamics in the apparel export industry in Sub Saharan Africa

    OpenAIRE

    Morris, Mike; Staritz, Cornelia; Plank, Leonhard

    2014-01-01

    This paper shows the importance of ownership, end markets and regionalism within the global value chain (GVC) conceptual framework. This is done through unpacking the development trajectories of the major Sub Saharan African (SSA) apparel export industries (Mauritius, Madagascar, Kenya, Lesotho, Swaziland) against the backdrop of global and regional trade regime changes and the manner in which different supplier firms react to these opportunities and/or constraints. These trajectories demonst...

  16. Population structure of Staphylococcus aureus from remote African Babongo Pygmies.

    Directory of Open Access Journals (Sweden)

    Frieder Schaumburg

    Full Text Available BACKGROUND: Pandemic community-acquired methicillin-resistant Staphylococcus aureus isolates (CA-MRSA predominantly encode the Panton-Valentine leukocidin (PVL, which can be associated with severe infections. Reports from non-indigenous Sub-Saharan African populations revealed a high prevalence of PVL-positive isolates. The objective of our study was to investigate the S. aureus carriage among a remote indigenous African population and to determine the molecular characteristics of the isolates, particularly those that were PVL-positive. METHODOLOGY/PRINCIPAL FINDINGS: Nasal S. aureus carriage and risk factors of colonization were systematically assessed in remote Gabonese Babongo Pygmies. Susceptibility to antibiotics, possession of toxin-encoding genes (i.e., PVL, enterotoxins, and exfoliative toxins, S. aureus protein A (spa types and multi-locus sequence types (MLST were determined for each isolate. The carriage rate was 33%. No MRSA was detected, 61.8% of the isolates were susceptible to penicillin. Genes encoding PVL (55.9%, enterotoxin B (20.6%, exfoliative toxin D (11.7% and the epidermal cell differentiation inhibitor B (11.7% were highly prevalent. Thirteen spa types were detected and were associated with 10 STs predominated by ST15, ST30, ST72, ST80, and ST88. CONCLUSIONS: The high prevalence of PVL-positive isolates among Babongo Pygmies demands our attention as PVL can be associated with necrotinzing infection and may increase the risk of severe infections in remote Pygmy populations. Many S. aureus isolates from Babongo Pygmies and pandemic CA-MRSA-clones have a common genetic background. Surveillance is needed to control the development of resistance to antibiotic drugs and to assess the impact of the high prevalence of PVL in indigenous populations.

  17. Investigation of Economic Impacts of Economic Partnership Agreements between Sub-Saharan Africa and European Union

    Directory of Open Access Journals (Sweden)

    Metin Pişkin

    2016-06-01

    Full Text Available This study tries to quantify the economic effects of Economic Partnership Agreements (EPAs which have been negotiating between sub-Saharan Africa (SSA and European Union (EU. The study addresses the following questions:  How are African countries likely to gain or lose from a bilateral trade liberalisation between Africa and the EU?, what are the welfare implications for the African countries from the EPAs?, how will the formation of EPAs affect trade expansion through trade creation and trade diversion effects?, what are the potential fiscal implications of the EPAs. Even though the full reciprocity principle appears to be trade expanding (singularly infavour of EU, this study indicates that it will pose serious implications for deepening of regional integration in Africa because of trade diversion effect between African countries.  Another key finding is welfare effect through the way of trade expantion between EU and SSA. 

  18. South-South Cooperation. The Primafamed network as an example in creating a network between universities in Sub-Saharan Africa

    DEFF Research Database (Denmark)

    Flinkenflögel, Maaike; Kallestrup, Per

    2013-01-01

    International studies have demonstrated that well-functioning primary health care organized around family and community health teams is adamant in establishing a cost-effective health system that provides equitable and accessible health services to the entire population. The World Health Report...... 2008 (PHC Now more than ever) urged health systems worldwide to make a shift to more comprehensive health care. Family and community medicine training is developing in Sub-Saharan Africa but in many countries there still is a long way to go. With a network linking the different training programs...... in African universities synergies can be established and training programs can get stronger with good quality assurance. With South-South cooperation the partners share experiences and resources and therefore improve the development of the training. Research into the effects on health and civil society...

  19. [Potential role of prenatal care in reducing maternal and perinatal mortality in sub-Saharan Africa].

    Science.gov (United States)

    Prual, A; De Bernis, L; El Joud, D Ould

    2002-02-01

    Prenatal care has been implemented in developing countries according to the same mode as applied in industrialized countries without considering its real effectiveness in reducing maternal and neonatal mortality. Several recent studies suggest that the goals should be revisited in order to implement a program of prenatal care based on real scientific evidence. Based on the current literature, we propose a potentially effective content for prenatal care adapted to the context of developing countries. Four antenatal consultations would be enough if appropriately timed at 12, 26, 32 and 36 weeks pregnancy. The purpose of these consultations would be: 1) to screen for three major risk factors, which, when recognized, lead to specific action: uterine, scare, malpresentation, premature rupture of the membranes; 2) to prevent and/or detect (and treat) specific complications of pregnancy: hypertension, infection (malaria, venereal disease, HIV, tetanus, urinary tract infection); anemia and trace element deficiencies, gestational diabetes mellitus; 3) to provide counseling, support and information for pregnant women and their families (including the partner) concerning: severe signs and symptoms of pregnancy and delivery, community organization of emergency transfer, delivery planning. These potentially effective actions can only have a real public health impact if implemented within an organized maternal health system with a functional network of delivery units, if truly quality care is given, and if the relationships between health care providers and the population are based on mutual respect. Sub-Saharan African women use prenatal care extensively when it is accessible; this opportunity must be used to implement evidence-based actions with appropriate and realistic goals.

  20. The post-2015 development agenda for diabetes in sub-Saharan Africa: challenges and future directions

    Directory of Open Access Journals (Sweden)

    Andre M. N. Renzaho

    2015-05-01

    Full Text Available Background: Diabetes is one of the non-communicable diseases (NCDs which is rising significantly across sub-Saharan African (SSA countries and posing a threat to the social, economic, and cultural fabric of the SSA population. The inclusion of NCDs into the post-2015 development agenda along with the global monitoring framework provides an opportunity to monitor progress of development programmes in developing countries. This paper examines challenges associated with dealing with diabetes within the development agenda in SSA and explores some policy options. Design: This conceptual review draws from a range of works published in Medline and the grey literature to advance the understanding of the post-2015 development agenda and how it relates to NCDs. The paper begins with the burden of diabetes in sub-Sahara Africa and then moves on to examine challenges associated with diabetes prevention, treatment, and management in Africa. It finishes by exploring policy implications. Results: With regards to development programmes on NCDs in the SSA sub-continent, several challenges exist: 1 poor documentation of risk factors, 2 demographic transitions (rapid urbanisation and ageing, 3 the complementary role of traditional healers, 4 tuberculosis and the treatment of the acquired immunodeficiency syndrome as risk factors for diabetes, 5 diabetes in complex emergencies, 6 diabetes as an international development priority and not a policy agenda for many SSA countries, and 7 poorly regulated food and beverage industry. Conclusion: For the post-2015 development agenda for NCDs to have an impact, sufficient investments will be needed to address legislative, technical, human, and fiscal resource constraints through advocacy, accountability, political leadership, and effective public–private partnership. Striking the right balance between competing demands and priorities, policies, and implementation strategies hold the key to an effective response to diabetes

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

    Science.gov (United States)

    Smith-Greenaway, Emily; Trinitapoli, Jenny

    2014-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Sunday A. Reju

    2012-04-01

    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.

  3. Export and Innovation in Sub-Saharan Africa

    NARCIS (Netherlands)

    Barasa, L.; Kinyanjui, B.; Knoben, Joris; Kimuyu, P.; Vermeulen, P.A.M.

    2016-01-01

    Our study seeks to examine the bi-directional relationship between innovation and exporting in four countries in Sub-Saharan Africa. We hypothesize that there is a positive relationship between innovation and subsequent exporting, and that this relationship is mediated by market creation. We also hy

  4. Curriculum Reform in Post-1990s Sub-Saharan Africa

    Science.gov (United States)

    Chisholm, Linda; Leyendecker, Ramon

    2008-01-01

    The article uses both primary and secondary sources to examine why learner-centredness, outcomes- and competency-based education and national qualifications frameworks were favourably received at local level in sub-Saharan Africa but have not resulted in widespread change in classroom practice. It argues that they found local favour because they…

  5. Peculiarities of the Digital Divide in Sub-Saharan Africa

    Science.gov (United States)

    Mutula, Stephen M.

    2005-01-01

    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…

  6. Monetary stability and financial development in Sub-Saharan countries

    NARCIS (Netherlands)

    Adema, Yvonne; Sterken, Elmer

    2001-01-01

    Abstract We analyze the interrelation between monetary stability and financial structure in 20 Sub-Saharan economies. Using a panel data set we estimate the impact of monetary stability and financial development on income per capita. Special interest is given to the conditions of the so-called CFA-c

  7. Monetary stability and financial development in Sub-Saharan countries

    NARCIS (Netherlands)

    Adema, Yvonne; Sterken, Elmer

    2001-01-01

    We analyze the interrelation between monetary stability and financial structure in 20 Sub-Saharan economies. Using a panel data set we estimate the impact of monetary stability and financial development on income per capita. Special interest is given to the conditions of the so-called CFA-countries,

  8. Human papillomavirus prevalence among men in sub-Saharan Africa

    DEFF Research Database (Denmark)

    Olesen, Tina Bech; Munk, Christian; Christensen, Jane

    2014-01-01

    BACKGROUND: We performed a systematic review and meta-analysis to summarise the available data on the prevalence of human papillomavirus (HPV) among men in sub-Saharan Africa. METHODS: PubMed and Embase were searched up to 10 March 2014. Random effects meta-analyses were used to calculate a poole...

  9. Rural employment in Sub-Saharan Africa : a bibliography

    NARCIS (Netherlands)

    Tellegen, N.

    1993-01-01

    This bibliography concerns the existing scientific literature on different aspects of rural employment. It contains 301 references, listed in alphabetical order by author. The references are either of a general nature or concern the situation in the countries of sub-Saharan Africa. Also included are

  10. Priorities for Boosting Employment in Sub-Saharan Africa

    DEFF Research Database (Denmark)

    Jones, Edward Samuel; Tarp, Finn

    2015-01-01

    Should policy-makers, including foreign donors, focus employment strategies in sub-Saharan Africa on strengthening access to formal wage employment or on raising productivity in the informal sector? We examine the evidence in Mozambique and show that crude distinctions between formality...

  11. The European Union and sub-Saharan Africa

    DEFF Research Database (Denmark)

    Kluth, Michael Friederich

    2013-01-01

    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...

  12. Economic Geography and Economic Development in Sub-Saharan Africa

    NARCIS (Netherlands)

    Bosker, Maarten; Garretsen, Harry

    2012-01-01

    Sub-Saharan Africas (SSA) physical geography is often blamed for its poor economic performance. A countrys geographical location does, however, not only determine its agricultural conditions or disease environment. It also pins down a countrys relative position vis--vis other countries, affecting it

  13. Community responses to malaria: interventions in sub-Saharan Africa

    NARCIS (Netherlands)

    C.L. Pell

    2014-01-01

    This thesis presents data from two multi-site programmes of research that have examined the social responses to malaria interventions in sub -Saharan Africa. The first dealt specifically with the attitudes and behaviours linked to a single intervention aimed at reducing malaria morbidity and mortali

  14. Nutritional Status and Poverty in Sub-Saharan Africa

    OpenAIRE

    Sahn, David E.; H. Alderman

    1998-01-01

    Sub-Saharan Africa (SSA) has had an aggregate malnutrition rate of nearly 30 percent for the last decade. While malnutrition prevalence has decreased significantly in most other developing countries in the last decade, it has been nearly static for SSA. This static trend in the percentage of malnourished children, however, does not fully reflect the rapidly rising numbers of malnourished c...

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

    Directory of Open Access Journals (Sweden)

    Henriksen Ole

    2011-07-01

    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

  16. Rh isoimmunization in Sub-Saharan Africa indicates need for universal access to anti-RhD immunoglobulin and effective management of D-negative pregnancies.

    Science.gov (United States)

    Osaro, Erhabor; Charles, Adias Teddy

    2010-12-01

    Transplacental or fetomaternal hemorrhage (FMH) may occur during pregnancy or at delivery and lead to immunization to the D antigen if the mother is Rh-negative and the baby is Rh-positive. This can result in hemolytic disease of the fetus and newborn (HDFN) in subsequent D-positive pregnancies. The aim of this study is to highlight the challenges associated with the effective management and prevention of Rh alloimmunization among Rh-negative women in Sub-Saharan Africa. In most Sub-Saharan African countries, there is poor and sometimes no alloimmunization prevention following potentially sensitizing events and during medical termination of pregnancy in Rh-negative women. Information about previous pregnancies and termination are often lacking in patients' medical notes due to poor data management. These issues have made the management of Rh-negative pregnancy a huge challenge. Despite the fact that the prevalence of Rh-negative phenotype is significantly lower among Africans than Caucasians, Rh alloimmunization remains a major factor responsible for perinatal morbidity in Sub-Saharan Africa and may result in the compromise of the woman's obstetric care due to the unaffordability of anti-D immunoglobulin. There is the urgent need for the implementation of universal access to anti-D immunoglobulin for the Rh-negative pregnant population in Africa. Anti-D immunoglobulin should be available in cases of potentially sensitizing events such as amniocentesis, cordocentesis, antepartum hemorrhage, vaginal bleeding during pregnancy, external cephalic version, abdominal trauma, intrauterine death and stillbirth, in utero therapeutic interventions, miscarriage, and therapeutic termination of pregnancy. There is also the need for the availability of FMH measurements following potentially sensitizing events. The low-cost acid elution method, a modification of the Kleihauer-Betke (KB) test, can become a readily available, affordable, and minimum alternative to flow cytometric

  17. Sub-Saharan Africa Report, No. 2826

    Science.gov (United States)

    2007-11-02

    Conference, SADCC, whose aim is to promote regional cooperation among independent Southern African states. It should here be noted that the SADCC states have...businessmen and industrialists in Zambia and Malawi much ground for promoting commercial ties, but it is also a step forward to improving regional...An attempt had been made to limit the demand for family dwellings in the urban areas of the peninsula and the Eiselen Line area by providing hostel

  18. Sub-Saharan Africa Report, No. 2869.

    Science.gov (United States)

    2007-11-02

    the USSR,-" illus- trate the importance which Africans attach to promotion of the development of their own cultures and the difficulties affecting the...Government’s first tenative steps through the Promotion of Local Government Bill to co-ordi- nate local government af- fairs was nearly aborted...supporters entered the hostels and allegedly attacked students. The Inkatha supporters seemed to concentrate their attention on student supporters of

  19. Sub-Saharan Africa Report No. 2809.

    Science.gov (United States)

    2007-11-02

    Pragmatic Aspects of FRELIMO’s Congress Viewed (Editorial; DIARIO DE NQTICIAS, k Mar 83) 30 Portuguese-South African Discussions on Cahora Bassa...climate of conscientiousness, confidence and frank cooperation, he added. With this in mind, the cooperation of the National Assembly was once again...recognition of their inalienable right to Klf-ie?ermination and independence are the elements that could permit a just ana lastS solution to this

  20. Russian Interests in Sub-Saharan Africa

    Science.gov (United States)

    2013-07-01

    in the same year, reached ZAR188 billion. Russia’s trade with its most important African partner is, in fact, the smallest of all of the BRIC ...Brazil, Russia, India, and China) coun- tries, the notional grouping of BRIC and South Africa, to be discussed in more detail.76 The growth in trade...AFRICA Russia is attracted by the notion of cooperation in Africa between countries making up the BRICS (Bra- zil, Russia, India, China, South Africa

  1. Rapid urban malaria appraisal (RUMA in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Akogbeto Martin

    2005-09-01

    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.

  2. Beyond ‘test and treat’ – malaria diagnosis for improved pediatric fever management in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Emily White Johansson

    2016-12-01

    Full Text Available Background: Malaria rapid diagnostic tests (RDTs have great potential to improve quality care and rational drug use in malaria-endemic settings although studies have shown common RDT non-compliance. Yet, evidence has largely been derived from limited hospital settings in few countries. This article reviews a PhD thesis that analyzed national surveys from multiple sub-Saharan African countries to generate large-scale evidence of malaria diagnosis practices and its determinants across different contexts. Design: A mixed-methods approach was used across four studies that included quantitative analysis of national household and facility surveys conducted in multiple sub-Saharan African countries at the outset of new guidelines (Demographic and Health Surveys and Service Provision Assessments. Qualitative methods were used to explore reasons for quantitative findings in select settings. Results: There was low (17% and inequitable test uptake across 13 countries in 2009–2011/12, with greater testing at hospitals than at peripheral clinics (odds ratio [OR]: 0.62, 95% confidence interval [CI]: 0.56–0.69 or community health workers (OR: 0.31, 95% CI: 0.23–0.43 (Study I. Significant variation was found in the effect of diagnosis on antimalarial use at the population level across countries (Uganda OR: 0.84, 95% CI: 0.66–1.06; Mozambique OR: 3.54, 95% CI: 2.33–5.39 (Study II. A Malawi national facility census indicated common compliance to malaria treatment guidelines (85% clients with RDT-confirmed malaria prescribed first-line treatment, although other fever assessments were not often conducted and there was poor antibiotic targeting (59% clients inappropriately prescribed antibiotics. RDT-negative patients had 16.8 (95% CI: 8.6–32.7 times higher odds of antibiotic overtreatment than RDT-positive patients conditioned by cough or difficult breathing complaints (Study III. In Mbarara (Uganda, health workers reportedly prescribed antimalarials to

  3. A Dragon and a Dove? A Comparative Overview of Chinese and European Trade Relations with Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Bert Jacobs

    2011-01-01

    Full Text Available As China’s footprint in African trade grows larger by the day, the need to contextualize this rise through comparative analysis becomes ever more necessary. This paper contrasts the sub-Saharan trade relations of both China and Europe with their respective designated stereotypes: those of a dragon and a dove. The article compares the trade dynamics on four levels: the policies and institutional mechanisms that shape the relationship; the composition of the trade flows; the geographic distribution of trade dominance; and the influence of norms and values on the trade pattern. It concludes that although there are empirical grounds behind these stereotypes, Chinese and European trade relations with sub-Saharan Africa are becoming more similar, partly due to a more hawkish European stance.

  4. The Sub-Saharan Africa carbon balance, an overview

    Directory of Open Access Journals (Sweden)

    A. Bombelli

    2009-02-01

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

  5. The African Genome Variation Project shapes medical genetics in Africa.

    Science.gov (United States)

    Gurdasani, Deepti; Carstensen, Tommy; Tekola-Ayele, Fasil; Pagani, Luca; Tachmazidou, Ioanna; Hatzikotoulas, Konstantinos; Karthikeyan, Savita; Iles, Louise; Pollard, Martin O; Choudhury, Ananyo; Ritchie, Graham R S; Xue, Yali; Asimit, Jennifer; Nsubuga, Rebecca N; Young, Elizabeth H; Pomilla, Cristina; Kivinen, Katja; Rockett, Kirk; Kamali, Anatoli; Doumatey, Ayo P; Asiki, Gershim; Seeley, Janet; Sisay-Joof, Fatoumatta; Jallow, Muminatou; Tollman, Stephen; Mekonnen, Ephrem; Ekong, Rosemary; Oljira, Tamiru; Bradman, Neil; Bojang, Kalifa; Ramsay, Michele; Adeyemo, Adebowale; Bekele, Endashaw; Motala, Ayesha; Norris, Shane A; Pirie, Fraser; Kaleebu, Pontiano; Kwiatkowski, Dominic; Tyler-Smith, Chris; Rotimi, Charles; Zeggini, Eleftheria; Sandhu, Manjinder S

    2015-01-15

    Given the importance of Africa to studies of human origins and disease susceptibility, detailed characterization of African genetic diversity is needed. The African Genome Variation Project provides a resource with which to design, implement and interpret genomic studies in sub-Saharan Africa and worldwide. The African Genome Variation Project represents dense genotypes from 1,481 individuals and whole-genome sequences from 320 individuals across sub-Saharan Africa. Using this resource, we find novel evidence of complex, regionally distinct hunter-gatherer and Eurasian admixture across sub-Saharan Africa. We identify new loci under selection, including loci related to malaria susceptibility and hypertension. We show that modern imputation panels (sets of reference genotypes from which unobserved or missing genotypes in study sets can be inferred) can identify association signals at highly differentiated loci across populations in sub-Saharan Africa. Using whole-genome sequencing, we demonstrate further improvements in imputation accuracy, strengthening the case for large-scale sequencing efforts of diverse African haplotypes. Finally, we present an efficient genotype array design capturing common genetic variation in Africa.

  6. Experiences of leadership in health care in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Curry Leslie

    2012-09-01

    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

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

    Science.gov (United States)

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

    2014-02-01

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

  8. Heat Pump Drying of Fruits and Vegetables: Principles and Potentials for Sub-Saharan Africa

    Science.gov (United States)

    Fayose, Folasayo; Huan, Zhongjie

    2016-01-01

    Heat pump technology has been used for heating, ventilation, and air-conditioning in domestic and industrial sectors in most developed countries of the world including South Africa. However, heat pump drying (HPD) of fruits and vegetables has been largely unexploited in South Africa and by extension to the sub-Saharan African region. Although studies on heat pump drying started in South Africa several years ago, not much progress has been recorded to date. Many potential users view heat pump drying technology as fragile, slow, and high capital intensive when compared with conventional dryer. This paper tried to divulge the principles and potentials of heat pump drying technology and the conditions for its optimum use. Also, various methods of quantifying performances during heat pump drying as well as the quality of the dried products are highlighted. Necessary factors for maximizing the capacity and efficiency of a heat pump dryer were identified. Finally, the erroneous view that heat pump drying is not feasible economically in sub-Saharan Africa was clarified. PMID:26904668

  9. Extending freight flow modelling to sub-Saharan Africa to inform infrastructure investments - trade data issues

    Directory of Open Access Journals (Sweden)

    Jan Havenga

    2012-11-01

    Full Text Available This paper highlights the first attempt by researchers at Stellenbosch University to model freight flows between and for 17 countries in sub-Saharan Africa (SSA. The model will be informed by and linked to the South African surface Freight Demand Model (FDM given these dimensions. By analysing and collating available datasets and developing a freight flow model, a better understanding of freight movements between countries can be obtained and then used for long-term planning efforts. A simple methodology is envisaged that will entail a high-level corridor classification that links a major district in the country with a similar district in another country. Existing trade data will be used to corroborate new base-year economic demand and supply volumetric data that will be generated from social accounting matrices for each country. The trade data will also provide initial flow dynamics between countries that will be refined according to the new volumes. The model can then generate commodity-level corridor flows between SSA countries, and between SSA countries and the rest of the world, as well as intra-country rural and metropolitan flows, using a gravity-based modelling approach. This article outlines efforts to harmonise trade data between the 17 countries identified, as well as between these countries and the rest of the world as a first step towards developing a freight demand model for sub-Saharan Africa.

  10. Diabetic ketoacidosis: an overlooked child killer in sub-Saharan Africa?

    Science.gov (United States)

    Murunga, A N; Owira, P M O

    2013-11-01

    The true incidence of diabetic ketoacidosis (DKA) in sub-Saharan Africa is unknown but unlike in the Western countries, DKA is also uniquely frequent among type 2 diabetes patients of African origin. Increased hyperglycaemia and hepatic ketogenesis lead to osmotic diuresis, dehydration and tissue hypoxia. Acute complications of DKA include cerebral oedema, which may be compounded by malnutrition, parasitic and microbial infections with rampant tuberculosis and HIV. Overlapping symptoms of these conditions and misdiagnosis of DKA contribute to increased morbidity and mortality. Inability of the patients to afford insulin treatment leads to poor glycemic control as some patients seek alternative treatment from traditional healers or use herbal remedies further complicating the disease process. Standard treatment guidelines for DKA currently used may not be ideal as they are adapted from those of the developed world. Children presenting with suspected DKA should be screened for comorbidities which may complicate fluid and electrolyte replacement therapy protocol. Patient rehabilitation should take into account concurrent treatment for infectious conditions to avoid possible life-threatening drug interactions. We recommend that health systems in sub-Saharan Africa leverage the Expanded Immunization Programme or TB/HIV/AIDS programmes, which are fairly well entrenched to support diabetes services.

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

    Directory of Open Access Journals (Sweden)

    K Gnassingbé

    2011-01-01

    Full Text Available 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.

  12. Heat Pump Drying of Fruits and Vegetables: Principles and Potentials for Sub-Saharan Africa.

    Science.gov (United States)

    Fayose, Folasayo; Huan, Zhongjie

    2016-01-01

    Heat pump technology has been used for heating, ventilation, and air-conditioning in domestic and industrial sectors in most developed countries of the world including South Africa. However, heat pump drying (HPD) of fruits and vegetables has been largely unexploited in South Africa and by extension to the sub-Saharan African region. Although studies on heat pump drying started in South Africa several years ago, not much progress has been recorded to date. Many potential users view heat pump drying technology as fragile, slow, and high capital intensive when compared with conventional dryer. This paper tried to divulge the principles and potentials of heat pump drying technology and the conditions for its optimum use. Also, various methods of quantifying performances during heat pump drying as well as the quality of the dried products are highlighted. Necessary factors for maximizing the capacity and efficiency of a heat pump dryer were identified. Finally, the erroneous view that heat pump drying is not feasible economically in sub-Saharan Africa was clarified.

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

    Science.gov (United States)

    Lund, Troy C; Hume, Heather; Allain, Jean P; McCullough, Jeffrey; Dzik, Walter

    2013-12-01

    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.

  14. Money, power and HIV: economic influences and HIV among men who have sex with men in sub-Saharan Africa.

    Science.gov (United States)

    Scheibe, Andrew; Kanyemba, Brian; Syvertsen, Jennifer; Adebajo, Sylvia; Baral, Stefan

    2014-09-01

    Despite consistent evidence, effective interventions and political declarations to reduce HIV infections among men who have sex with men (MSM), coverage of MSM programmes in sub-Saharan Africa (SSA) remains low. Punitive legal frameworks and hostile social circumstances and inadequate health systems further contribute to the high HIV burden among MSM in SSA. The authors use the Modified Social Ecological Model to discuss economic influences in relation to HIV and MSM in SSA. Nigerian, South African and Ugandan case studies are used to highlight economic factors and considerations related to HIV among MSM. The authors argue that criminalisation of consensual sexual practices among adults increases the frequency of human rights violations contributing to the incidence of HIV infections. Furthermore, marginalisation and disempowerment of MSM limits their livelihood opportunities, increases the prevalence of sex work and drug use and limits financial access to HIV services. Sexual and social networks are complex and ignoring the needs of MSM results in increased risks for HIV acquisition and transmission to all sexual partners with cumulative economic and health implications. The authors recommend a public health and human rights approach that employs effective interventions at multiple levels to reduce the HIV burden among MSM and the general population in SSA.

  15. Bantu language trees reflect the spread of farming across sub-Saharan Africa: a maximum-parsimony analysis.

    Science.gov (United States)

    Holden, Clare Janaki

    2002-04-22

    Linguistic divergence occurs after speech communities divide, in a process similar to speciation among isolated biological populations. The resulting languages are hierarchically related, like genes or species. Phylogenetic methods developed in evolutionary biology can thus be used to infer language trees, with the caveat that 'borrowing' of linguistic elements between languages also occurs, to some degree. Maximum-parsimony trees for 75 Bantu and Bantoid African languages were constructed using 92 items of basic vocabulary. The level of character fit on the trees was high (consistency index was 0.65), indicating that a tree model fits Bantu language evolution well, at least for the basic vocabulary. The Bantu language tree reflects the spread of farming across this part of sub-Saharan Africa between ca. 3000 BC and AD 500. Modern Bantu subgroups, defined by clades on parsimony trees, mirror the earliest farming traditions both geographically and temporally. This suggests that the major subgroups of modern Bantu stem from the Neolithic and Early Iron Age, with little subsequent movement by speech communities.

  16. Industrialization in Sub-Saharan Africa and import substitution policy

    Directory of Open Access Journals (Sweden)

    Ana Paula F. Mendes

    2014-03-01

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

  17. Defining children's rights and responsibilities in Sub-Saharan Africa

    DEFF Research Database (Denmark)

    Evans, Ruth; Skovdal, Morten

    2015-01-01

    This chapter explores the spatialities of children’s rights through a focus on how children’s paid and unpaid work in sub-Saharan Africa intersects with wider debates about child labor, child domestic work, and young caregiving. Several tensions surround the universalist and individualistic nature...... of the rights discourse in the context of sub-Saharan Africa, and policymakers, practitioners, children, and community members have emphasized children’s responsibilities to their families and communities, as well as their rights. The limitations of ILO definitions of child labor and child domestic work...... by policymakers and practitioners in East Africa, ranging from a child labor/child protection/abolitionist approach to a “young carer”/child-centered rights perspective. These differing perspectives influence the level and nature of support and resources that children involved in care work may be able to access...

  18. Projected climate change impacts and short term predictions on staple crops in Sub-Saharan Africa

    Science.gov (United States)

    Mereu, V.; Spano, D.; Gallo, A.; Carboni, G.

    2013-12-01

    Agriculture in Sub-Saharan Africa (SSA) drives the economy of many African countries and it is mainly rain-fed agriculture used for subsistence. Increasing temperatures, changed precipitation patterns and more frequent droughts may lead to a substantial decrease of crop yields. The projected impacts of future climate change on agriculture are expected to be significant and extensive in the SSA due to the shortening of the growing seasons and the increasing of water-stress risk. Differences in Agro-Ecological Zones and geographical characteristics of SSA influence the diverse impacts of climate change, which can greatly differ across the continent and within countries. The vulnerability of African Countries to climate change is aggravated by the low adaptive capacity of the continent, due to the increasing of its population, the widespread poverty, and other social factors. In this contest, the assessment of climate change impact on agricultural sector has a particular interest to stakeholder and policy makers, in order to identify specific agricultural sectors and Agro-Ecological Zones that could be more vulnerable to changes in climatic conditions and to develop the most appropriate policies to cope with these threats. For these reasons, the evaluation of climate change impacts for key crops in SSA was made exploring climate uncertainty and focusing on short period monitoring, which is particularly useful for food security and risk management analysis. The DSSAT-CSM (Decision Support System for Agrotechnology Transfer - Cropping System Model) software, version 4.5 was used for the analysis. Crop simulation models included in DSSAT-CSM are tools that allow to simulate physiological process of crop growth, development and production, by combining genetic crop characteristics and environmental (soil and weather) conditions. For each selected crop, the models were used, after a parameterization phase, to evaluate climate change impacts on crop phenology and production

  19. Fiscal Policy Implementation in Sub-Saharan Africa

    OpenAIRE

    Victor Duarte Lledo; Marcos Poplawski-Ribeiro

    2011-01-01

    This paper investigates economic, political, and institutional constraints to fiscal policy implementation in sub-saharan Africa. We find that planned fiscal adjustments or expansions are less likely to be implemented the larger they are, the more inaccurate the growth forecasts they are based on, the more fragile the regulatory system in the country, and the weaker the institutions framing the design, approval, and execution of the budget. The findings support ongoing efforts in the region t...

  20. Greenhouse gas emissions in Sub-Saharan Africa

    Energy Technology Data Exchange (ETDEWEB)

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

    1990-11-01

    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.

  1. Economic Geography and Economic Development in Sub-Saharan Africa

    OpenAIRE

    Bosker, E. Maarten; Garretsen, Harry

    2008-01-01

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

  2. Vaccination for typhoid fever in sub-Saharan Africa.

    Science.gov (United States)

    Slayton, Rachel B; Date, Kashmira A; Mintz, Eric D

    2013-04-01

    Emerging 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.

  3. Genetic consequences of war and social strife in sub-Saharan Africa : the case of Uganda's large mammals

    DEFF Research Database (Denmark)

    Muwanika, Vincent B.; Nyakaana, Silvester; Siegismund, Hans Redlef

    2005-01-01

    data that are relevant to understanding of the genetic effects of war and social strife on Africa's wildlife. Uganda was probably one of the worst affected countries. Before 1972, Uganda had large herds and a variety of mammals. However, following the breakdown of law and order, some large mammals were......The spectacular diversity of sub-Saharan Africa's large mammals was hit by constant social strife and civil war over three decades (1970s-1990s) leading to localized extinctions and drastic reductions in population sizes for many species. These localized extinctions and reduction in population...... sizes undermine the ability of species to evolve and adapt to changing environments as a result of genetic erosion. The genetic consequences of the widespread reduction of population sizes as a result of social strife in sub-Saharan Africa are not well documented. Here we review past molecular genetic...

  4. Efficacy of artesunate-amodiaquine for treating uncomplicated falciparum malaria in sub-Saharan Africa: a multi-centre analysis

    Directory of Open Access Journals (Sweden)

    Same-Ekobo Albert

    2009-08-01

    Full Text Available Abstract Background Artesunate and amodiaquine (AS&AQ is at present the world's second most widely used artemisinin-based combination therapy (ACT. It was necessary to evaluate the efficacy of ACT, recently adopted by the World Health Organization (WHO and deployed over 80 countries, in order to make an evidence-based drug policy. Methods An individual patient data (IPD analysis was conducted on efficacy outcomes in 26 clinical studies in sub-Saharan Africa using the WHO protocol with similar primary and secondary endpoints. Results A total of 11,700 patients (75% under 5 years old, from 33 different sites in 16 countries were followed for 28 days. Loss to follow-up was 4.9% (575/11,700. AS&AQ was given to 5,897 patients. Of these, 82% (4,826/5,897 were included in randomized comparative trials with polymerase chain reaction (PCR genotyping results and compared to 5,413 patients (half receiving an ACT. AS&AQ and other ACT comparators resulted in rapid clearance of fever and parasitaemia, superior to non-ACT. Using survival analysis on a modified intent-to-treat population, the Day 28 PCR-adjusted efficacy of AS&AQ was greater than 90% (the WHO cut-off in 11/16 countries. In randomized comparative trials (n = 22, the crude efficacy of AS&AQ was 75.9% (95% CI 74.6–77.1 and the PCR-adjusted efficacy was 93.9% (95% CI 93.2–94.5. The risk (weighted by site of failure PCR-adjusted of AS&AQ was significantly inferior to non-ACT, superior to dihydroartemisinin-piperaquine (DP, in one Ugandan site, and not different from AS+SP or AL (artemether-lumefantrine. The risk of gametocyte appearance and the carriage rate of AS&AQ was only greater in one Ugandan site compared to AL and DP, and lower compared to non-ACT (p = 0.001, for all comparisons. Anaemia recovery was not different than comparator groups, except in one site in Rwanda where the patients in the DP group had a slower recovery. Conclusion AS&AQ compares well to other treatments and meets the

  5. Background rates of adverse pregnancy outcomes for assessing the safety of maternal vaccine trials in sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Lauren A V Orenstein

    Full Text Available BACKGROUND: Maternal immunization has gained traction as a strategy to diminish maternal and young infant mortality attributable to infectious diseases. Background rates of adverse pregnancy outcomes are crucial to interpret results of clinical trials in Sub-Saharan Africa. METHODS: We developed a mathematical model that calculates a clinical trial's expected number of neonatal and maternal deaths at an interim safety assessment based on the person-time observed during different risk windows. This model was compared to crude multiplication of the maternal mortality ratio and neonatal mortality rate by the number of live births. Systematic reviews of severe acute maternal morbidity (SAMM, low birth weight (LBW, prematurity, and major congenital malformations (MCM in Sub-Saharan African countries were also performed. FINDINGS: Accounting for the person-time observed during different risk periods yields lower, more conservative estimates of expected maternal and neonatal deaths, particularly at an interim safety evaluation soon after a large number of deliveries. Median incidence of SAMM in 16 reports was 40.7 (IQR: 10.6-73.3 per 1,000 total births, and the most common causes were hemorrhage (34%, dystocia (22%, and severe hypertensive disorders of pregnancy (22%. Proportions of liveborn infants who were LBW (median 13.3%, IQR: 9.9-16.4 or premature (median 15.4%, IQR: 10.6-19.1 were similar across geographic region, study design, and institutional setting. The median incidence of MCM per 1,000 live births was 14.4 (IQR: 5.5-17.6, with the musculoskeletal system comprising 30%. INTERPRETATION: Some clinical trials assessing whether maternal immunization can improve pregnancy and young infant outcomes in the developing world have made ethics-based decisions not to use a pure placebo control. Consequently, reliable background rates of adverse pregnancy outcomes are necessary to distinguish between vaccine benefits and safety concerns. Local studies

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

    Directory of Open Access Journals (Sweden)

    Andre Pascal Kengne

    2008-02-01

    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

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

    Science.gov (United States)

    Masse, Dominique; Ndour Badiane, Yacine; Hien, Edmond; Akpo, Léonard-Élie; Assigbetsé, Komi; Bilgo, Ablassé; Diédhiou, Ibrahima; Hien, Victor; Lardy, Lydie

    2013-01-01

    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).

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

    Science.gov (United States)

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

    2014-01-01

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

  9. 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)

    Korenromp Eline

    2008-07-01

    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.

  10. The African diaspora: history, adaptation and health.

    Science.gov (United States)

    Rotimi, Charles N; Tekola-Ayele, Fasil; Baker, Jennifer L; Shriner, Daniel

    2016-12-01

    The trans-Atlantic slave trade brought millions of Africans to the New World. Advances in genomics are providing novel insights into the history and health of Africans and the diasporan populations. Recent examples reviewed here include the unraveling of substantial hunter-gatherer and 'Eurasian' admixtures across sub-Saharan Africa, expanding our understanding of ancestral African genetics; the global ubiquity of mixed ancestry; the revealing of African ancestry in Latin Americans that likely derived from the slave trade; and understanding of the ancestral backgrounds of APOL1 and LPL found to influence kidney disease and lipid levels, respectively, providing specific insights into disease etiology and health disparities.

  11. Currently important animal disease management issues in sub-Saharan Africa : policy and trade issues

    Directory of Open Access Journals (Sweden)

    G.R. Thomson

    2009-09-01

    Full Text Available The present international approach to management of transboundary animal diseases (TADs is based on the assumption that most can be eradicated ; consequently, that is the usual objective adopted by international organizations concerned with animal health. However, for sub-Saharan Africa and southern Africa more particularly, eradication of most TADs is impossible for the foreseeable future for a variety of technical, financial and logistical reasons. Compounding this, the present basis for access to international markets for products derived from animals requires that the area of origin (country or zone is free from trade-influencing TADs. The ongoing development of transfrontier conservation areas (TFCAs, extending across huge areas of southern Africa, therefore presents a development conundrum because it makes creation of geographic areas free from TADs more difficult and brings development based on wildlife conservation on the one hand and that based on livestock production on the other into sharp conflict. Sub-Saharan Africa is consequently confronted by a complex problem that contributes significantly to retarded rural development which, in turn, impedes poverty alleviation. In southern Africa specifically, foot-and-mouth disease (FMD presents the greatest problem in relation to access to international markets for animal products. However, it is argued that this problem could be overcome by a combination between (1 implementation of a commodity-based approach to trade in products derived from animals and (2 amendment of the international standards for FMD specifically (i.e. the FMD chapter in the Terrestrial Animal Health Code of the World Organisation for Animal Health [OIE] so that occurrence of SAT serotype viruses in free-living African buffalo need not necessarily mean exclusion of areas where buffalo occur from international markets for animal products. This would overcome a presently intractable constraint to market access for

  12. Currently important animal disease management issues in sub-Saharan Africa.

    Science.gov (United States)

    Thomson, G R

    2009-03-01

    The present international approach to management of transboundary animal diseases (TADs) is based on the assumption that most can be eradicated; consequently, that is the usual objective adopted by international organizations concerned with animal health. However, for sub-Saharan Africa and southern Africa more particularly, eradication of most TADs is impossible for the foreseeable future for a variety of technical, financial and logistical reasons. Compounding this, the present basis for access to international markets for products derived from animals requires that the area of origin (country or zone) is free from trade-influencing TADs. The ongoing development of transfrontier conservation areas (TFCAs), extending across huge areas of southern Africa, therefore presents a development conundrum because it makes creation of geographic areas free from TADs more difficult and brings development based on wildlife conservation on the one hand and that based on livestock production on the other into sharp conflict. Sub-Saharan Africa is consequently confronted by a complex problem that contributes significantly to retarded rural development which, in turn, impedes poverty alleviation. In southern Africa specifically, foot-and-mouth disease (FMD) presents the greatest problem in relation to access to international markets for animal products. However, it is argued that this problem could be overcome by a combination between (1) implementation of a commodity-based approach to trade in products derived from animals and (2) amendment of the international standards for FMD specifically (i.e. the FMD chapter in the Terrestrial Animal Health Code of the World Organisation for Animal Health [OIE]) so that occurrence of SAT serotype viruses in free-living African buffalo need not necessarily mean exclusion of areas where buffalo occur from international markets for animal products. This would overcome a presently intractable constraint to market access for southern African

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

    Science.gov (United States)

    Haile, Menghestab

    2005-11-29

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

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

    Directory of Open Access Journals (Sweden)

    Oluleye TS

    2012-04-01

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

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

    Science.gov (United States)

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

    2014-07-23

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

  16. At the southeast fringe of the Bantu expansion: genetic diversity and phylogenetic relationships to other sub-Saharan tribes.

    Science.gov (United States)

    Rowold, Diane; Garcia-Bertrand, Ralph; Calderon, Silvia; Rivera, Luis; Benedico, David Perez; Alfonso Sanchez, Miguel A; Chennakrishnaiah, Shilpa; Varela, Mangela; Herrera, Rene J

    2014-12-01

    Here, we present 12 loci paternal haplotypes (Y-STR profiles) against the backdrop of the Y-SNP marker system of Bantu males from the Maputo Province of Southeast Africa, a region believed to represent the southeastern fringe of the Bantu expansion. Our Maputo Bantu group was analyzed within the context of 27 geographically relevant reference populations in order to ascertain its genetic relationship to other Bantu and non Bantu (Pygmy, Khoisan and Nilotic) sub-equatorial tribes from West and East Africa. This study entails statistical pair wise comparisons and multidimensional scaling based on YSTR Rst distances, network analyses of Bantu (B2a-M150) and Pygmy (B2b-M112) lineages as well as an assessment of Y-SNP distribution patterns. Several notable findings include the following: 1) the Maputo Province Bantu exhibits a relatively close paternal affinity with both east and west Bantu tribes due to high proportion of Bantu Y chromosomal markers, 2) only traces of Khoisan (1.3%) and Pygmy (1.3%) markers persist in the Maputo Province Bantu gene pool, 3) the occurrence of R1a1a-M17/M198, a member of the Eurasian R1a-M420 branch in the population of the Maputo Province, may represent back migration events and/or recent admixture events, 4) the shared presence of E1b1b1-M35 in all Tanzanian tribes examined, including Bantu and non-Bantu groups, in conjunction with its nearly complete absence in the West African populations indicate that, in addition to a shared linguistic, cultural and genetic heritage, geography (e.g., east vs. west) may have impacted the paternal landscape of sub-Saharan Africa, 5) the admixture and assimilation processes of Bantu elements were both highly complex and region-specific.

  17. At the southeast fringe of the Bantu expansion: genetic diversity and phylogenetic relationships to other sub-Saharan tribes

    Directory of Open Access Journals (Sweden)

    Diane Rowold

    2014-12-01

    Full Text Available Here, we present 12 loci paternal haplotypes (Y-STR profiles against the backdrop of the Y-SNP marker system of Bantu males from the Maputo Province of Southeast Africa, a region believed to represent the southeastern fringe of the Bantu expansion. Our Maputo Bantu group was analyzed within the context of 27 geographically relevant reference populations in order to ascertain its genetic relationship to other Bantu and non Bantu (Pygmy, Khoisan and Nilotic sub-equatorial tribes from West and East Africa. This study entails statistical pair wise comparisons and multidimensional scaling based on YSTR Rst distances, network analyses of Bantu (B2a-M150 and Pygmy (B2b-M112 lineages as well as an assessment of Y-SNP distribution patterns. Several notable findings include the following: 1 the Maputo Province Bantu exhibits a relatively close paternal affinity with both east and west Bantu tribes due to high proportion of Bantu Y chromosomal markers, 2 only traces of Khoisan (1.3% and Pygmy (1.3% markers persist in the Maputo Province Bantu gene pool, 3 the occurrence of R1a1a-M17/M198, a member of the Eurasian R1a-M420 branch in the population of the Maputo Province, may represent back migration events and/or recent admixture events, 4 the shared presence of E1b1b1-M35 in all Tanzanian tribes examined, including Bantu and non-Bantu groups, in conjunction with its nearly complete absence in the West African populations indicate that, in addition to a shared linguistic, cultural and genetic heritage, geography (e.g., east vs. west may have impacted the paternal landscape of sub-Saharan Africa, 5 the admixture and assimilation processes of Bantu elements were both highly complex and region-specific.

  18. Indigenous Knowledge and Public Education in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Munyaradzi Mawere

    2015-01-01

    Full Text Available The discourse on indigenous knowledge has incited a debate of epic proportions across the world over the years. In Africa, especially in the sub-Saharan region, while the so-called indigenous communities have always found value in their own local forms of knowledge, the colonial administration and its associates viewed indigenous knowledge as unscientific, illogical, anti-development, and/or ungodly. The status and importance of indigenous knowledge has changed in the wake of the landmark 1997 Global Knowledge Conference in Toronto, which emphasised the urgent need to learn, preserve, and exchange indigenous knowledge. Yet, even with this burgeoning interest and surging call, little has been done, especially in sub-Saharan Africa, to guarantee the maximum exploitation of indigenous knowledge for the common good. In view of this realisation, this paper discusses how indigenous knowledge can and should both act as a tool for promoting the teaching/learning process in Africa’s public education and address the inexorably enigmatic amalgam of complex problems and cataclysms haunting the world.

  19. Genomic ancestry of North Africans supports back-to-Africa migrations.

    Science.gov (United States)

    Henn, Brenna M; Botigué, Laura R; Gravel, Simon; Wang, Wei; Brisbin, Abra; Byrnes, Jake K; Fadhlaoui-Zid, Karima; Zalloua, Pierre A; Moreno-Estrada, Andres; Bertranpetit, Jaume; Bustamante, Carlos D; Comas, David

    2012-01-01

    North African populations are distinct from sub-Saharan Africans based on cultural, linguistic, and phenotypic attributes; however, the time and the extent of genetic divergence between populations north and south of the Sahara remain poorly understood. Here, we interrogate the multilayered history of North Africa by characterizing the effect of hypothesized migrations from the Near East, Europe, and sub-Saharan Africa on current genetic diversity. We present dense, genome-wide SNP genotyping array data (730,000 sites) from seven North African populations, spanning from Egypt to Morocco, and one Spanish population. We identify a gradient of likely autochthonous Maghrebi ancestry that increases from east to west across northern Africa; this ancestry is likely derived from "back-to-Africa" gene flow more than 12,000 years ago (ya), prior to the Holocene. The indigenous North African ancestry is more frequent in populations with historical Berber ethnicity. In most North African populations we also see substantial shared ancestry with the Near East, and to a lesser extent sub-Saharan Africa and Europe. To estimate the time of migration from sub-Saharan populations into North Africa, we implement a maximum likelihood dating method based on the distribution of migrant tracts. In order to first identify migrant tracts, we assign local ancestry to haplotypes using a novel, principal component-based analysis of three ancestral populations. We estimate that a migration of western African origin into Morocco began about 40 generations ago (approximately 1,200 ya); a migration of individuals with Nilotic ancestry into Egypt occurred about 25 generations ago (approximately 750 ya). Our genomic data reveal an extraordinarily complex history of migrations, involving at least five ancestral populations, into North Africa.

  20. The food multimix concept: new innovative approach to meeting nutritional challenges in Sub-Saharan Africa.

    Science.gov (United States)

    Zotor, F B; Amuna, P

    2008-02-01

    Food insecurity, chronic hunger, starvation and malnutrition continue to affect millions of individuals throughout the developing world, especially Sub-Saharan Africa. Various initiatives by African governments and International Agencies such as the UN, the industrial nations, the International Monetary Fund, the World Bank and the World Trade Organisation to boost economic development, have failed to provide the much-needed solution to these challenges. The impact of these economic shifts and the failures of structural adjustment programmes on the nutritional well-being and health of the most vulnerable members of poor communities cannot be over-emphasised. The use of ad hoc measures as an adjunct to community-based rural integrated projects have provided little success and will be unsustainable unless they are linked to harnessing available local resources. The present paper therefore focuses on exploring alternative ways of harnessing the scant agricultural resources by employing a scientific approach to food-related problem-solving. The food multimix (FMM) concept offers a scientific contribution alongside other attempts currently in use by the World Food Programme, WHO and FAO to meet the food insecurity challenges that confront most of the developing world in the twenty-first century. It is an innovative approach that makes better use of traditional food sources as a tool for meeting community nutritional needs. The FMM concept employs a food-based approach using traditional methods of food preparation and locally-available, cheap and affordable staples (fruits, pulses, vegetables and legumes) in the formulation of nutrient-enriched multimixes. Developed recipes can provide > or =40% of the daily nutritional requirements of vulnerable groups, including patients with HIV/AIDS and children undergoing nutrition rehabilitation. The FMM approach can also be used as a medium- to long-term adjunct to community-based rural integration projects aimed at health

  1. Genome-wide association for plant height and flowering time across 15 tropical maize populations under managed drought stress and well-watered conditions in sub-Saharan Africa

    Science.gov (United States)

    Genotyping breeding materials is now relatively inexpensive but phenotyping costs have remained the same. One method to increase gene mapping power is to use genome-wide genetic markers to combine existing phenotype data for multiple populations into a unified analysis. We combined data from 15 bipa...

  2. Réforme et modernisation des douanes en Afrique subsaharienne francophone, 1995-2010. Customs Administration Reform and Modernization in Francophone Sub-Saharan Africa, 1995-2010

    OpenAIRE

    Gilles Montagnat-Rentier; Gilles Parent

    2012-01-01

    This paper outlines reforms that have been achieved in the modernization of the customs administrations of francophone sub-Saharan (African) countries since the mid-1990s. It also highlights the remaining issues in this process. Progress has been made in automation of operations and procedures, with constant and significant efforts to strengthen revenue collection and improve trade facilitation in a number of countries. However, the pace and scope of modernization remains insufficient, partic...

  3. Implications of Severe Economic Decline & Demographic Pressures on Youth Literacy in Sub-Saharan Africa

    Science.gov (United States)

    Okpala, Comfort O.

    2009-01-01

    Although literacy rates have improved somehow in recent years, there are still large numbers of people that are illiterates in developing countries. This paper examines the impact of severe economic decline and demographic pressures on youth literacy rate in Sub-Saharan Africa. In this study, a cross-sectional data of 39 Sub-Saharan African…

  4. The impact of asthma and COPD in sub-Saharan Africa

    NARCIS (Netherlands)

    van Gemert, Frederik; van der Molen, Thys; Jones, Rupert; Chavannes, Niels

    2011-01-01

    Background: Many countries in sub-Saharan Africa have the highest risk of developing chronic diseases and are the least able to cope with them. Aims: To assess the current knowledge of the prevalence and impact of asthma and chronic obstructive pulmonary disease (COPD) in sub-Saharan Africa. Methods

  5. Long-term effects of HIV treatment in sub-Saharan Africa: from access to quality

    NARCIS (Netherlands)

    Boender, T.S.

    2016-01-01

    As HIV treatment programs in sub-Saharan Africa mature, there are rising concerns about the long-term sustainability and quality of these programs. Increasing levels of HIV drug resistance have been measured in sub-Saharan Africa, and could jeopardize long-term treatment success. This thesis present

  6. Population structure of African buffalo inferred from mtDNA sequences and microsatellite loci: high variation but low differentiation

    DEFF Research Database (Denmark)

    Simonsen, Bo Thisted; Siegismund, H R; Arctander, P

    1998-01-01

    The African buffalo (Syncerus caffer) is widespread throughout sub-Saharan Africa and is found in most major vegetation types, wherever permanent sources of water are available, making it physically able to disperse through a wide range of habitats. Despite this, the buffalo has been assumed to b...

  7. Y-chromosomal variation in sub-Saharan Africa: insights into the history of Niger-Congo groups.

    Science.gov (United States)

    de Filippo, Cesare; Barbieri, Chiara; Whitten, Mark; Mpoloka, Sununguko Wata; Gunnarsdóttir, Ellen Drofn; Bostoen, Koen; Nyambe, Terry; Beyer, Klaus; Schreiber, Henning; de Knijff, Peter; Luiselli, Donata; Stoneking, Mark; Pakendorf, Brigitte

    2011-03-01

    Technological and cultural innovations as well as climate changes are thought to have influenced the diffusion of major language phyla in sub-Saharan Africa. The most widespread and the richest in diversity is the Niger-Congo phylum, thought to have originated in West Africa ∼ 10,000 years ago (ya). The expansion of Bantu languages (a family within the Niger-Congo phylum) ∼ 5,000 ya represents a major event in the past demography of the continent. Many previous studies on Y chromosomal variation in Africa associated the Bantu expansion with haplogroup E1b1a (and sometimes its sublineage E1b1a7). However, the distribution of these two lineages extends far beyond the area occupied nowadays by Bantu-speaking people, raising questions on the actual genetic structure behind this expansion. To address these issues, we directly genotyped 31 biallelic markers and 12 microsatellites on the Y chromosome in 1,195 individuals of African ancestry focusing on areas that were previously poorly characterized (Botswana, Burkina Faso, Democratic Republic of Congo, and Zambia). With the inclusion of published data, we analyzed 2,736 individuals from 26 groups representing all linguistic phyla and covering a large portion of sub-Saharan Africa. Within the Niger-Congo phylum, we ascertain for the first time differences in haplogroup composition between Bantu and non-Bantu groups via two markers (U174 and U175) on the background of haplogroup E1b1a (and E1b1a7), which were directly genotyped in our samples and for which genotypes were inferred from published data using linear discriminant analysis on short tandem repeat (STR) haplotypes. No reduction in STR diversity levels was found across the Bantu groups, suggesting the absence of serial founder effects. In addition, the homogeneity of haplogroup composition and pattern of haplotype sharing between Western and Eastern Bantu groups suggests that their expansion throughout sub-Saharan Africa reflects a rapid spread followed by

  8. Unconsummated marriage in sub-Saharan Africa: case reports.

    Science.gov (United States)

    Lema, Valentino M

    2014-09-01

    Unconsummated marriage is a condition where newly married couples are unable to achieve penile-vaginal intercourse for variable periods despite desire and several attempts to do so. Its exact cause(s) is/are unknown, but performance anxiety resulting from or leading to other conditions is reportedly the major etiological factor. It is thought to be more prevalent in traditional and conservative religious communities where premarital sexual exposure is strictly prohibited. Most publications on unconsummated marriage have originated from North America, European and Middle Eastern countries. There have not been any such reports from sub-Saharan Africa, which is home to diverse cultures and traditions regarding premarital sex and marriage. This paper presents a sample of four cases with unconsummated marriage managed by the author in his private clinic based in the city of Nairobi Kenya, over the past five years. Possible etiological factors and management approaches are discussed, with a review of relevant literature.

  9. SUCCESSFUL DISTANCE EDUCATION PROGRAMS IN SUB-SAHARAN AFRICA

    Directory of Open Access Journals (Sweden)

    Zane BERGE

    2007-04-01

    Full Text Available This paper explains the purposes, delivery methods, and program characteristics of successful distance education (DE in sub-Saharan Africa (SSA. This paper investigates the design and delivery systems of these programs and identifies ways the DE programs are working to improve. There are about 150 formidable distance education programs working in SSA. They aim to increase and improve a variety of existing programs, including primary and high school education, college-level and graduate programs, language training, teacher training, and continuing education for adults. The primary delivery system used by most institutions consists of printed manuals and texts that are distributed to all students. Despite the continued development of information and communication technology (ICT, including videos, online training modules, and web-based training (WBT systems, traditional DE delivery methods continue to prove as the most reliable, most sustainable, and most widely used.

  10. 10-daily soil erosion modelling over sub-Saharan Africa.

    Science.gov (United States)

    Symeonakis, Elias; Drake, Nick

    2010-02-01

    Soil erosion is considered to be one of the greatest environmental problems of sub-Saharan Africa. This paper investigates the advantages and disadvantages of modelling soil erosion at the continental scale and suggests an operational methodology for mapping and quantifying 10-daily water runoff and soil erosion over this scale using remote sensing data in a geographical information system framework. An attempt is made to compare the estimates of this study with general data on the severity of soil erosion over Africa and with measured rates of soil loss at different locations over the continent. The results show that the measured and estimated rates of erosion are in some areas very similar and in general within the same order of magnitude. The importance and the potential of using the soil erosion estimates with simple models and easily accessible free data for various continental-scale environmental applications are also demonstrated.

  11. Neoliberalism and University Education in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    James R. Ochwa-Echel

    2013-09-01

    Full Text Available This article reviews the history of university development in Sub-Saharan Africa (SSA and discusses the impact of neoliberal policies. This will be followed by an examination of the problems facing universities in the region. The following questions will be explored: (a Are the existing universities in SSA serving the development needs of the region? (b Are these universities up to the task of moving SSA out of the predicaments it faces such as famine, HIV/AIDS, poverty, diseases, debt, and human rights abuses? Finally, the article argues that for universities to play a role in the development of the region, a new paradigm that makes university education a public good should be established.

  12. The political economy of health policy in Sub-Saharan Africa.

    Science.gov (United States)

    Cook, Cynthia T; Kalu, Kelechi

    2008-03-01

    This paper discusses the health status of Sub-Saharan Africa focusing on infectious and parasitic diseases, HIV/AIDS, maternal and child health, famine, and political instability. Its contention is that Africa is stuck in the second stage of the demographic transition (high birth rate, low death rate) and the first stage of the epidemiological transition (deaths related to pestilence, famine, and war). Africa's lack of sustainable development is attributed to ineffective governmental policy and leadership. The prognosis is that the health and well-being of Africa's most vulnerable population, women and children, will improve when government shifts its attention from external funding and affairs to internal and concentrates on retaining Africa's 'talented tenth'; that the 'brain drain' and political instability has robbed Africa of its most talented young people, medical and science professionals, who are needed to provide primary care and development to a region with a high mortality rate, a low life expectancy, and a low per capita income.

  13. Identification of advantageous electricity generation options in sub-Saharan Africa integrating existing resources

    Science.gov (United States)

    Szabó, Sándor; Moner-Girona, Magda; Kougias, Ioannis; Bailis, Rob; Bódis, Katalin

    2016-10-01

    Pioneering approaches are needed to accelerate universal access to electricity while simultaneously transitioning to reliable, sustainable and affordable energy systems. In sub-Saharan Africa (SSA), the challenges lie in attracting the private sector to complement public investments. Here, we present an integrated ‘low-hanging-fruit’ approach aimed at boosting private investment and speeding up the deployment of renewable energy systems in SSA. We analyse the potential of existing energy infrastructure, where a significant upfront investment has already been made, to be exploited for electricity generation. We develop a comprehensive methodology to identify and select suitable locations in SSA and estimate their potential for exploitation. These locations have been further analysed in terms of power capacity potential, electricity output, investments needed and population to be benefited. This strategy to attract additional finance can easily be reproduced, engaging private investors while simultaneously helping to achieve the United Nations (UN) Sustainable Development Goals on energy.

  14. Invasive Infections with Nontyphoidal Salmonella in Sub-Saharan Africa.

    Science.gov (United States)

    Mahon, Barbara E; Fields, Patricia I

    2016-06-01

    Invasive nontyphoidal Salmonella (NTS) infections in Africa cause an enormous burden of illness. These infections are often devastating, with mortality estimated at 20%, even with appropriate antimicrobial therapy. Two major groups-young children and HIV-infected adults-suffer the great majority of these infections. In children, younger age itself, as well as malaria, malnutrition, and HIV infection, are prominent risk factors. In adults, HIV infection is by far the most important risk factor. The most common serotypes in invasive infections are Salmonella enterica serotypes Typhimurium and Enteritidis. In recent years, a specific strain of Salmonella Typhimurium, multilocus sequence type 313, has caused epidemics of invasive disease. Little is known about risk factors for exposure to NTS, making the design of rational interventions to decrease exposure difficult. Antimicrobial therapy is critically important for treatment of invasive NTS infections. Thus, the emergence and spread of resistance to agents commonly used for treatment of invasive NTS infection, now including third-generation cephalosporins, is an ominous development. Already, many invasive NTS infections are essentially untreatable in many health care facilities in sub-Saharan Africa. Several candidate vaccines are in early development and, if safe and effective, could be promising. Interventions to prevent exposure to NTS (e.g., improved sanitation), to prevent the occurrence of disease if exposure does occur (e.g., vaccination, malaria control), and to prevent severe disease and death in those who become ill (e.g., preserving antimicrobial effectiveness) are all important in reducing the toll of invasive NTS disease in sub-Saharan Africa.

  15. Comparison of calculated versus directly-measured low-density lipoprotein-cholesterol: An evaluation of ten formulas for an HIV-positive population in Sub-Saharan Africa

    Science.gov (United States)

    Osegbe, Ifeyinwa; Ugonabo, Martin; Chukwuka, Chinwe; Meka, Ijeoma; Nwosu, Nnamdi

    2017-01-01

    BACKGROUND: Low-density lipoprotein cholesterol (LDLC) is a modifiable risk factor for atherosclerotic cardiovascular disease, therefore needs to be assessed and monitored. Direct homogeneous assays and various formulas exist to determine LDLC. We aimed to compare the directly measured LDL (dLDLC) with ten formulas for estimating LDLC. MATERIALS AND METHODS: This was a 2-year retrospective study of fasting lipid profile results obtained from HIV-positive patients attending an outpatient clinic at the University of Nigeria Teaching Hospital, Enugu, Nigeria, using homogeneous direct assays. Estimated LDLC was determined using ten formulas. Pearson's correlation, Bland–Altman plots, and linear regression were performed. Statistical significance was P < 0.05. RESULTS: Three thousand four hundred and eighty-two lipid results with mean ± standard deviation (SD) dLDLC of 2.1 ± 1.1 mmol/L were included in this study. There was a strong, positive correlation between Friedewald's LDLC and dLDLC n = 3412, r = 0.84, P < 0.001, but linear regression demonstrated a proportional bias P = 0.005. Ahmadi's equation showed the worst correlation n = 3482, r = 0.35, P < 0.001, but when applied to samples with triglyceride (TG) <1.13 mmol/L (100 mg/dl), the correlation showed a strong, positive relationship n = 1395, r = 0.80, P < 0.001, and no proportional bias P = 0.86. Teerankanchana's equation was the only formula that showed no difference between its LDLC and dLDLC (n = 3482, P = 0.056). It also demonstrated strong, positive correlation (n = 3482, r = 0.84, P < 0.001) and had a mean difference ± SD of −0.68 ± 0.63. CONCLUSION: Teerankanchana's formula showed good correlation and minimal bias with dLDLC at all TG levels. Moreover, linear regression showed no difference in the two. It seems to be the most suitable formula for estimating LDLC in our HIV-positive population.

  16. A review of screening strategies for cervical cancer in human immunodeficiency virus-positive women in sub-Saharan Africa

    Science.gov (United States)

    Viviano, Manuela; DeBeaudrap, Pierre; Tebeu, Pierre-Marie; Fouogue, Jovanny T; Vassilakos, Pierre; Petignat, Patrick

    2017-01-01

    Cervical cancer (CC) is a leading cause of cancer-related death and a major public health issue in sub-Saharan Africa. This heavy burden parallels that of the human immunodeficiency virus (HIV) infection, which increases the risk of developing CC. Despite the progressive reduction of HIV prevalence in the past decade, the CC incidence and mortality rates in sub-Saharan Africa remain high. The heterogeneity of the distribution of the two diseases in the African continent, together with the different availability of human and material resources, stands in the way of finding an appropriate screening strategy. The lack of high-quality evidence on the prevention of CC for HIV-positive women, which is necessary for the implementation of efficient screening and treatment strategies, results in the absence of a clearly defined program, which is responsible for the low screening uptake and high mortality rates in sub-Saharan Africa. By taking advantage of the HIV-positive women’s frequent access to health facilities, one way to increase the CC screening coverage rates would be by providing integrated HIV and screening services within the same infrastructure. With the increasing availability of cost-effective methods, screening is becoming more and more available to women who have limited access to health care. Moreover, the introduction of point-of-care technologies for human papillomavirus testing and the subsequent implementation of screen-and-treat strategies, by reducing the number of clinical appointments and, in the long term, the loss to follow-up rates, open up new opportunities for all women, regardless of their HIV status. The purpose of this review is to provide an insight into the different screening practices for CC in order to help define one that is adapted to the resources and necessities of HIV-positive women living in middle-to-low income countries. PMID:28203108

  17. Human Heredity and Health (H3) in Africa Kidney Disease Research Network: A Focus on Methods in Sub-Saharan Africa.

    Science.gov (United States)

    Osafo, Charlotte; Raji, Yemi Raheem; Burke, David; Tayo, Bamidele O; Tiffin, Nicki; Moxey-Mims, Marva M; Rasooly, Rebekah S; Kimmel, Paul L; Ojo, Akinlolu; Adu, Dwomoa; Parekh, Rulan S

    2015-12-01

    CKD affects an estimated 14% of adults in sub-Saharan Africa, but very little research has been done on the cause, progression, and prevention of CKD there. As part of the Human Heredity and Health in Africa (H3Africa) Consortium, the H3Africa Kidney Disease Research Network was established to study prevalent forms of kidney disease in sub-Saharan Africa and increase the capacity for genetics and genomics research. The study is performing comprehensive phenotypic characterization and analyzing environmental and genetic factors from nine clinical centers in four African countries (Ghana, Nigeria, Ethiopia, and Kenya) over a 5-year period. Approximately 4000 participants with specified kidney disease diagnoses and 4000 control participants will be enrolled in the four African countries. In addition, approximately 50 families with hereditary glomerular disease will be enrolled. The study includes both pediatric and adult participants age research infrastructure can be successfully established in Africa. This study will provide clinical, biochemical, and genotypic data that will greatly increase the understanding of CKD in sub-Saharan Africa.

  18. Political and socio-economic instability: does it have a role in the HIV/AIDS epidemic in sub-Saharan Africa?

    Science.gov (United States)

    Premkumar, Ramaswamy; Tebandeke, Achilles

    2011-01-01

    Many sub-Saharan African countries are confronted by the HIV/AIDS epidemic. This article reviews academic literature in the social sciences and health to discover why HIV/AIDS has become an epidemic in sub-Saharan Africa and not in other parts of the world. This was studied by examining the social determinants of diminishment of tradition and social cohesion in terms of political, social and economic problems. Four countries in this region were selected for this case study, namely South Africa, Botswana, Uganda and Zimbabwe. The findings showed that instability in socio-economic and political aspects in these nations was responsible for creating a suitable environment for the spread of HIV/AIDS infection. This paper concludes by using the theories of collective action/responsibility and social cohesion to hypothesise that the breakdown of social ties due to various kinds of conflicts and unrest is one of the main contributors to the HIV/AIDS epidemic.

  19. Transitioning toward Sustainable Development Goals: The Role of Household Environment in Influencing Child Health in Sub-Saharan Africa and South Asia Using Recent Demographic Health Surveys.

    Science.gov (United States)

    Anand, Ankit; Roy, Nobhojit

    2016-01-01

    The Millennium Development Goals are now replaced by 17 sustainable development goals. The emphasis of old goals was on improving water, sanitation, and child mortality conditions in developing countries. The study explored the major question about the association between different household environment conditions with child survival and health in Sub-Saharan African and South Asian countries in the current scenario. This paper estimated the risk of death, morbidity, and undernutrition among children living in households with the improved sources of water, sanitation, and non-solid cooking fuel. Two sources of information are explored in this study. First, data from World Health Statistics (WHS)-2014 for all of the Sub-Saharan African and South Asian countries were used. Second, available standard Demographic and Health Survey (DHS) performed in the countries of Sub-Saharan Africa and South Asia after 2010 was included in the study. It resulted in the inclusion of 15 countries which were Bangladesh (2011), Congo Republic (2013-2014), Cote d'Ivoire (2011-2012), Ethiopia (2011), Gambia (2013), Mali (2012-2013), Mozambique (2011), Namibia (2013), Nepal (2011), Niger (2012), Nigeria (2013), Pakistan (2012-2013), Sierra Leone (2013), Uganda (2011), and Zambia (2013). The scatter plot diagram was plotted, and the curve was fitted using the WHS-2014. Cox regression and logistic regression were used to estimate adjusted risks (odds ratio) of child mortality and health outcomes using DHSs. The use of non-solid cooking fuel was very high in most of the Sub-Saharan African and South Asian countries. There was a positive correlation between improving access to safe drinking water and sanitation. The exponential curve fitted well with child mortality and household environmental indicators. The use of improved source of water and sanitation significantly related with the lower odds ratio of death, morbidity, and undernutrition among children aged 12-59 months. The risks were

  20. Eurasian and African mitochondrial DNA influences in the Saudi Arabian population

    Directory of Open Access Journals (Sweden)

    Bosley Thomas M

    2007-03-01

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

  1. HIV prevention in sub-Saharan Africa: a multilevel analysis of message frames and their social determinants.

    Science.gov (United States)

    Beaudoin, Christopher E

    2007-09-01

    In light of the great threat that HIV/AIDS poses in sub-Saharan Africa, the current study assesses HIV/AIDS posters from this region with specific reference to health message frames, including HIV sources, consequences, self-efficacy, preventive means, and barriers and benefits to employing such means of prevention. There is a two-step methodology. First, the content of HIV/AIDS posters from 15 sub-Saharan African countries was coded for the six health message frames. Second, relationships between the health message frames and four social determinants (HIV rate, HIV awareness, condom use and uncertainty avoidance (UAI)) were assessed with hierarchical linear modeling (HLM). Analysis indicates that self-efficacy is the most common frame, but that almost one-quarter of the posters has none of the six health message frames. HLM indicates some favorable findings, including that health message frames are used most often in countries with the most troubling levels of HIV awareness and condom use. Less favorably, health message frames are used least common in countries that have high levels of UAI and high HIV rates. Improvements for related media practices and policy are articulated.

  2. HIV/AIDS and the construction of Sub-Saharan Africa: heuristic lessons from the social sciences for policy.

    Science.gov (United States)

    Yeboah, Ian E A

    2007-03-01

    There is no doubt that Sub-Saharan African countries face major problems due to the HIV/AIDS pandemic that has ravaged the region. Yet the Eurocentric construction of the region as the source of the virus not only creates negative stereotypes in social science disciplines like geography, but also glosses over the potential of social science disciplines to provide knowledge and influence policy about HIV/AIDS. This oppositional construction of the region has unfortunately contributed to a glossing over of many aspects of Sub-Saharan Africa's people, their environment, culture, history, politics, economics, gender relations, and the region's global status that would provide important input for policy aimed at curbing the devastating spread of HIV in the region. This paper argues that once we recognize that HIV is a global virus with trans-cultural implications, social science disciplines, such as geography, can reveal certain attributes about the region and its HIV/AIDS pandemic that can be used in policy formulation to combat the spread of the virus.

  3. mHealth in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Thomas J. Betjeman

    2013-01-01

    Full Text Available Mobile phone penetration rates have reached 63% in sub-Saharan Africa (SSA and are projected to pass 70% by 2013. In SSA, millions of people who never used traditional landlines now use mobile phones on a regular basis. Mobile health, or mHealth, is the utilization of short messaging service (SMS, wireless data transmission, voice calling, and smartphone applications to transmit health-related information or direct care. This systematic review analyzes and summarizes key articles from the current body of peer-reviewed literature on PubMed on the topic of mHealth in SSA. Studies included in the review demonstrate that mHealth can improve and reduce the cost of patient monitoring, medication adherence, and healthcare worker communication, especially in rural areas. mHealth has also shown initial promise in emergency and disaster response, helping standardize, store, analyze, and share patient information. Challenges for mHealth implementation in SSA include operating costs, knowledge, infrastructure, and policy among many others. Further studies of the effectiveness of mHealth interventions are being hindered by similar factors as well as a lack of standardization in study design. Overall, the current evidence is not strong enough to warrant large-scale implementation of existing mHealth interventions in SSA, but rapid progress of both infrastructure and mHealth-related research in the region could justify scale-up of the most promising programs in the near future.

  4. Prospects for malaria eradication in sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Ricardo Aguas

    Full Text Available BACKGROUND: A characteristic of Plasmodium falciparum infections is the gradual acquisition of clinical immunity resulting from repeated exposures to the parasite. While the molecular basis of protection against clinical malaria remains unresolved, its effects on epidemiological patterns are well recognized. Accumulating epidemiological data constitute a valuable resource that must be intensively explored and interpreted as to effectively inform control planning. METHODOLOGY/PRINCIPAL FINDING: Here we apply a mathematical model to clinical data from eight endemic regions in sub-Saharan Africa. The model provides a quantitative framework within which differences in age distribution of clinical disease are assessed in terms of the parameters underlying transmission. The shorter infectious periods estimated for clinical infections induce a regime of bistability of endemic and malaria-free states in regions of mesoendemic transmission. The two epidemiological states are separated by a threshold that provides a convenient measure for intervention design. Scenarios of eradication and resurgence are simulated. CONCLUSIONS/SIGNIFICANCE: In regions that support mesoendemic transmission, intervention success depends critically on reducing prevalence below a threshold which separates endemic and malaria-free regimes.

  5. "Times Are Changing": The Impact of HIV Diagnosis on Sub-Saharan Migrants’ Lives in France

    Science.gov (United States)

    Lelièvre, Eva; Ravalihasy, Andrainolo; Lydié, Nathalie; Lert, France; Desgrées du Loû, Annabel

    2017-01-01

    Background Migrants account for 35% of HIV diagnoses in the European Union (ECDC/WHO 2014). Little is known about the impact of such a lifelong infection diagnosis on lives that are already disrupted by migration. In this paper, we assess the impact of HIV diagnosis on activity, union, well-being among African migrants living in France, the second group most affected by HIV after MSM. We compare it with the impact of the diagnosis of Hepatitis B, another lifelong infection affecting African migrants. Methods We use the ANRS PARCOURS survey, a retrospective life-event survey led in 2012–2013 in 74 health structures in Paris greater area which collected 926 life histories of Sub-Saharan migrants living with HIV and 779 with Hepatitis B. We modelled the probability year by year since 18 years of age until data collection to lose one’s activity, to experience a conjugal break up and degradation of well-being and we estimated the impact of migration and of HIV and Hepatitis B diagnoses on these probabilities, after adjustment on other factors, thanks to discrete-time logistic regressions. Results Migration entailed loss of activity and conjugal break up, though HIV diagnosis after migration did not statistically impact on these outcomes. Yet HIV diagnosis had a massive negative impact on well-being (aOR = 11.31 [4.64–27.56] for men and 5.75 [2.79–11.86] for women). This negative impact on well-being tended to diminish for persons diagnosed after 2004. The negative impact of HIV diagnosis on African migrants’ well-being seems to be attenuated in the last decade, which hints at a normalization of the subjective experience of HIV diagnosis. PMID:28129342

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

    Science.gov (United States)

    Ayele, A.

    2012-04-01

    The East African Rift System (EARS) is a classic example of active continental rifting, and a natural laboratory setting to study initiation and early stage evolution of continental rifts. The EARS is at different stages of development that varies from relatively matured rift (16 mm/yr) in the Afar to a weakly extended Okavango Delta in the south with predicted opening velocity < 3 mm/yr. Recent studies in the region helped researchers to highlight the length and timescales of magmatism and faulting, the partitioning of strain between faulting and magmatism, and their implications for the development of along-axis segmentation. Although the human resource and instrument coverage is sparse in the continent, our understanding of rift processes and deep structure has improved in the last decade after the advent of space geodesy and broadband seismology. The recent major earthquakes, volcanic eruptions and mega dike intrusions that occurred along the EARS attracted several earth scientist teams across the globe. However, most African countries traversed by the rift do not have the full capacity to monitor and mitigate earthquake and volcanic hazards. Few monitoring facilities exist in some countries, and the data acquisition is rarely available in real-time for mitigation purpose. Many sub-Saharan Africa governments are currently focused on achieving the millennium development goals with massive infrastructure development scheme and urbanization while impending natural hazards of such nature are severely overlooked. Collaborations with overseas researchers and other joint efforts by the international community are opportunities to be used by African institutions to best utilize limited resources and to mitigate earthquake and volcano hazards.

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

    Science.gov (United States)

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

    2013-11-01

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

  8. External financial aid to blood transfusion services in sub-Saharan Africa

    DEFF Research Database (Denmark)

    Ala, Fereydoun; Allain, Jean-Pierre; Bates, Imelda;

    2012-01-01

    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....

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

    Directory of Open Access Journals (Sweden)

    Fereydoun Ala

    Full Text Available 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.

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

    DEFF Research Database (Denmark)

    Neerinckx, Simon B; Peterson, Andrew T; Gulinck, Hubert

    2008-01-01

    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...

  11. The EU as an emerging coordinator in development cooperation: perspectives from sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Delputte, Sarah

    2013-06-01

    Full Text Available This report presents the proceedings of the field research conducted in the framework of a doctoralresearch on the European Union (EU as an emerging coordinator in development cooperation.This research aims to seek in-depth and interpreted understanding of the paradox betweenthe EU’s ambitions on the one hand and practice on the ground on the other by investigating theEU’s role in four sub-Saharan African countries (Tanzania, Zambia, Burkina Faso and Senegal.As such, it aims to add empirical evidence to the debate on the role of the EU as a developmentactor. More specifically, it investigates how the ambitions of the EU are translated at country leveland in which situations the EU is more/less likely to act as a coordinator, making use of a pragmatistresearch approach. This approach is especially suited to problem-driven research that aims tounderstand a complex phenomenon. The article introduces the research question and the rationale,gives an overview of the research approach and the methodological considerations and endswith a summary of the research process and the preliminary findings of the field research.

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

    Directory of Open Access Journals (Sweden)

    Felix Kayode OLAKULEHIN

    2010-10-01

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

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

    Science.gov (United States)

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

    2011-01-13

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

  14. Inverting the pyramid: increasing awareness of mycobacterial sepsis in sub-Saharan Africa.

    Science.gov (United States)

    Cummings, M J; O'Donnell, M R

    2015-10-01

    Disseminated Mycobacterium tuberculosis is a leading cause of bloodstream infection and severe sepsis in sub-Saharan African settings with a high burden of tuberculosis (TB) and human immunodeficiency virus (HIV) infection. Despite the high prevalence of M. tuberculosis bacteremia in these settings it is under-recognized. This is in part because timely diagnosis of M. tuberculosis bacteremia is difficult using traditional TB diagnostics. Novel triage algorithms and rapid diagnostic tests are needed to expedite the identification and treatment of patients with severe sepsis due to M. tuberculosis bacteremia. In this article, we emphasize the importance of M. tuberculosis bacteremia as an under-recognized etiology of severe sepsis, and discuss the potential role of two emerging rapid diagnostic tests in the triage and prognostication of critically ill patients with advanced HIV infection and suspected disseminated M. tuberculosis. We conclude with the recommendation that clinicians in high TB-HIV burden settings strongly consider empiric anti-tuberculosis treatment in patients with advanced HIV infection and severe sepsis in the appropriate clinical context. Future studies are needed to assess diagnostic and prognostic algorithms for severe sepsis caused by disseminated M. tuberculosis in these settings, and the safety, efficacy, and duration of empiric anti-tuberculosis treatment.

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

    Science.gov (United States)

    Kravdal, Øystein; Kodzi, Ivy; Sigle-Rushton, Wendy

    2013-09-01

    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.

  16. Couple-centred testing and counselling for HIV serodiscordant heterosexual couples in sub-Saharan Africa.

    Science.gov (United States)

    Desgrées-du-Loû, Annabel; Orne-Gliemann, Joanna

    2008-11-01

    In Africa, a large proportion of HIV infections occur within stable relationships, either because of prior infection of one of the partners or because of infidelity. In five African countries at least two-thirds of couples with at least one HIV-positive partner were HIV serodiscordant; in half of them, the woman was the HIV-positive partner. Hence, there is an urgent need to define strategies to prevent HIV transmission within couple relationships. HIV counselling and testing have largely been organised on an individual and sex-specific basis, for pregnant women in programmes for prevention of mother-to-child transmission of HIV and in STI consultations and recently male circumcision for men. A couple-centred approach to HIV counselling and testing would facilitate communication about HIV status and adoption of preventive behaviours within couples. This paper reviews what is known about HIV serodiscordance in heterosexual couples in sub-Saharan Africa and what has been published about couple-centred initiatives for HIV counselling and testing since the early 1990s. Despite positive outcomes, couple-oriented programmes have not been implemented on a large scale. In order to stimulate and strengthen HIV prevention efforts, increased attention is required to promote prevention and testing and counselling for couples in stable relationships.

  17. Geographic distribution and genetic characterization of Lassa virus in sub-Saharan Mali.

    Directory of Open Access Journals (Sweden)

    David Safronetz

    Full Text Available Lassa fever is an acute viral illness characterized by multi-organ failure and hemorrhagic manifestations. Lassa fever is most frequently diagnosed in Nigeria, Sierra Leone, Liberia, and Guinea, although sporadic cases have been recorded in other West African countries, including Mali. The etiological agent of Lassa fever is Lassa virus (LASV, an Arenavirus which is maintained in nature and frequently transmitted to humans by Mastomys natalensis. The purpose of this study was to better define the geographic distribution of LASV-infected rodents in sub-Saharan Mali.Small mammals were live-trapped at various locations across Mali for the purpose of identifying potential zoonotic pathogens. Serological and molecular assays were employed and determined LASV infected rodents were exclusively found in the southern Mali near the border of Côte d'Ivoire. Overall, 19.4% of Mastomys natalensis sampled in this region had evidence of LASV infection, with prevalence rates for individual villages ranging from 0 to 52%. Full-length genomic sequences were determined using high throughput sequencing methodologies for LASV isolates generated from tissue samples of rodents collected in four villages and confirmed the phylogenetic clustering of Malian LASV with strain AV.The risk of human infections with LASV is greatest in villages in southern Mali. Lassa fever should be considered in the differential diagnosis for febrile individuals and appropriate diagnostic techniques need to be established to determine the incidence of infection and disease in these regions.

  18. Acquired immunodeficiency syndrome-associated cancers in Sub-Saharan Africa.

    Science.gov (United States)

    Thomas, J O

    2001-04-01

    Sub-Saharan Africa is considered home to more than 60% of all human immunodeficiency virus (HIV) infected cases, with an estimated adult prevalence of 8.0%. It is stated that this region has contributed more than 90% of childhood deaths related to HIV infection and about 93% of childhood acquired immunodeficiency syndrome (AIDS)-related deaths. Although no country in Africa is spared of the infection, the bulk is seen in East and South Africa, with the highest recorded rates of 20% to 50% in Zimbabwe. On the other hand, West Africa is less affected, while countries in Central Africa have relatively stable infection rates. Although infections, especially tuberculosis, have emerged as the most important HIV/AIDS-associated killers in recent times, AIDS-associated malignancies are increasingly identified in the late stages. As a result of incomplete data from African countries, it is unclear whether the epidemiology and risks of these cancers are the same as observed in the developed countries. Since the advent of AIDS, epidemic Kaposi's sarcoma (KS) has become more common in both sexes in Africa, with a dramatic lowering of the male to female ratio from 19:1 to 1.7:1, especially in East Africa. Although there has been a rising trend of AIDS-associated non-Hodgkin's lymphoma (NHL) worldwide, there is an apparently lower risk in Africa compared with that in the developing world. At present, there is no strong evidence linking increased incidence of invasive cervical cancer to the HIV epidemic; however, some studies have demonstrated an association between HIV and the increased prevalence of human papilloma virus (HPV) and cervical intraepithelial neoplasia (CIN). On the other hand, HIV infection is now established as a risk factor for the development of squamous cell neoplasia of the conjunctiva based on studies from Rwanda, Malawi, and Uganda. Despite the problems and limitations of information from sub-Saharan Africa, interesting trends of HIV/AIDS-related cancers

  19. Seismic hazard assessment of Sub-Saharan Africa using geodetic strain rate models

    Science.gov (United States)

    Poggi, Valerio; Pagani, Marco; Weatherill, Graeme; Garcia, Julio; Durrheim, Raymond J.; Mavonga Tuluka, Georges

    2016-04-01

    The East African Rift System (EARS) is the major active tectonic feature of the Sub-Saharan Africa (SSA) region. Although the seismicity level of such a divergent plate boundary can be described as moderate, several earthquakes have been reported in historical times causing a non-negligible level of damage, albeit mostly due to the high vulnerability of the local buildings and structures. Formulation and enforcement of national seismic codes is therefore an essential future risk mitigation strategy. Nonetheless, a reliable risk assessment cannot be done without the calibration of an updated seismic hazard model for the region. Unfortunately, the major issue in assessing seismic hazard in Sub-Saharan Africa is the lack of basic information needed to construct source and ground motion models. The historical earthquake record is largely incomplete, while instrumental catalogue is complete down to sufficient magnitude only for a relatively short time span. In addition, mapping of seimogenically active faults is still an on-going program. Recent studies have identified major seismogenic lineaments, but there is substantial lack of kinematic information for intermediate-to-small scale tectonic features, information that is essential for the proper calibration of earthquake recurrence models. To compensate this lack of information, we experiment the use of a strain rate model recently developed by Stamps et al. (2015) in the framework of a earthquake hazard and risk project along the EARS supported by USAID and jointly carried out by GEM and AfricaArray. We use the inferred geodetic strain rates to derive estimates of total scalar moment release, subsequently used to constrain earthquake recurrence relationships for both area (as distributed seismicity) and fault source models. The rates obtained indirectly from strain rates and more classically derived from the available seismic catalogues are then compared and combined into a unique mixed earthquake recurrence model

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

    Directory of Open Access Journals (Sweden)

    Downing Raymond V

    2011-07-01

    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

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

    DEFF Research Database (Denmark)

    Lund, Henrik Hautop

    2012-01-01

    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......) in remote areas. The concept leads to the implementation of modular interactive tiles for rehabilitation, and suggestions for future use in sub-Saharan Africa....

  2. A Hand-in-Hand Approach for Security and Development in Sub-Saharan Africa

    Science.gov (United States)

    2010-06-15

    to develop closer economic ties in the private sector. In fact, several major U.S. companies, such as DHL, FedEx, UPS and Coca Cola operate freely...United States Agency for International Development and U.S. AFRICOM each are key players in promoting stability and security in sub-Saharan Africa (SSA... promoting stability and security in sub- Saharan Africa (SSA). The thesis begins with a review of the history and environment, and then examines

  3. Diversity of aflatoxin-producing fungi and their impact on food safety in sub-Saharan Africa.

    Science.gov (United States)

    Probst, C; Bandyopadhyay, R; Cotty, P J

    2014-03-17

    Crops frequently contaminated by aflatoxins are important sources of revenue and daily nourishment in many portions of sub-Saharan Africa. In recent years, reports have associated aflatoxins with diminished human health and export opportunities in many African Nations. Aflatoxins are highly carcinogenic metabolites mainly produced by members of Aspergillus sect. Flavi. The current study examined aflatoxin-producing fungi associated with maize grain intended for human consumption in 18 sub-Saharan African countries. 4469 Aspergillus sect. Flavi isolates were obtained from 339 samples. The majority (75%) of isolates belonged to the L strain morphotype of A. flavus. Minor percentages were A. tamarii (6%), A. parasiticus (1%), and isolates with S strain morphology (3%). No A. bombycis or A. nomius isolates were detected. Phylogenetic analyses of partial sequences of the nitrate reductase gene (niaD, 1.3kb) and the aflatoxin pathway transcription factor gene (aflR, 1.7kb) were used to verify isolate assignments into species and lineages. Phylogenetics resolved S strain isolates producing only B aflatoxins into two lineages fully supported by sizes of deletions in the gene region spanning the aflatoxin biosynthesis genes cypA (aflU) and norB (aflF). One lineage was the A. flavus S strain with either 0.9 or 1.5kb deletions. The second lineage, recently described from Kenya, has a 2.2kb deletion. Taxa with S strain morphology differed in distribution with strain SBG limited to West Africa and both A. minisclerotigenes and the new lineage from Kenya in Central and East Africa. African A. flavus L strain isolates formed a single clade with L strain isolates from other continents. The sampled maize frequently tested positive for aflatoxins (65%), fumonisins (81%), and deoxynivalenol (40%) indicating the presence of fungi capable of producing the respective toxins. Percentage of samples exceeding US limits for total aflatoxins (regulatory limit), fumonisins (advisory limit

  4. The genetic impact of the lake chad basin population in North Africa as documented by mitochondrial diversity and internal variation of the L3e5 haplogroup.

    Science.gov (United States)

    Podgorná, Eliška; Soares, Pedro; Pereira, Luísa; Cerný, Viktor

    2013-11-01

    The presence of sub-Saharan L-type mtDNA sequences in North Africa has traditionally been explained by the recent slave trade. However, gene flow between sub-Saharan and northern African populations would also have been made possible earlier through the greening of the Sahara resulting from Early Holocene climatic improvement. In this article, we examine human dispersals across the Sahara through the analysis of the sub-Saharan mtDNA haplogroup L3e5, which is not only commonly found in the Lake Chad Basin (∼17%), but which also attains nonnegligible frequencies (∼10%) in some Northwestern African populations. Age estimates point to its origin ∼10 ka, probably directly in the Lake Chad Basin, where the clade occurs across linguistic boundaries. The virtual absence of this specific haplogroup in Daza from Northern Chad and all West African populations suggests that its migration took place elsewhere, perhaps through Northern Niger. Interestingly, independent confirmation of Early Holocene contacts between North Africa and the Lake Chad Basin have been provided by craniofacial data from Central Niger, supporting our suggestion that the Early Holocene offered a suitable climatic window for genetic exchanges between North and sub-Saharan Africa. In view of its younger founder age in North Africa, the discontinuous distribution of L3e5 was probably caused by the Middle Holocene re-expansion of the Sahara desert, disrupting the clade's original continuous spread.

  5. A KIR B centromeric region present in Africans but not Europeans protects pregnant women from pre-eclampsia.

    Science.gov (United States)

    Nakimuli, Annettee; Chazara, Olympe; Hiby, Susan E; Farrell, Lydia; Tukwasibwe, Stephen; Jayaraman, Jyothi; Traherne, James A; Trowsdale, John; Colucci, Francesco; Lougee, Emma; Vaughan, Robert W; Elliott, Alison M; Byamugisha, Josaphat; Kaleebu, Pontiano; Mirembe, Florence; Nemat-Gorgani, Neda; Parham, Peter; Norman, Paul J; Moffett, Ashley

    2015-01-20

    In sub-Saharan Africans, maternal mortality is unacceptably high, with >400 deaths per 100,000 births compared with pre-eclampsia, a syndrome arising from defective placentation. Controlling placentation are maternal natural killer (NK) cells that use killer-cell immunoglobulin-like receptor (KIR) to recognize the fetal HLA-C molecules on invading trophoblast. We analyzed genetic polymorphisms of maternal KIR and fetal HLA-C in 484 normal and 254 pre-eclamptic pregnancies at Mulago Hospital, Kampala, Uganda. The combination of maternal KIR AA genotypes and fetal HLA-C alleles encoding the C2 epitope associates with pre-eclampsia [P = 0.0318, odds ratio (OR) = 1.49]. The KIR genes associated with protection are located in centromeric KIR B regions that are unique to sub-Saharan African populations and contain the KIR2DS5 and KIR2DL1 genes (P = 0.0095, OR = 0.59). By contrast, telomeric KIR B genes protect Europeans against pre-eclampsia. Thus, different KIR B regions protect sub-Saharan Africans and Europeans from pre-eclampsia, whereas in both populations, the KIR AA genotype is a risk factor for the syndrome. These results emphasize the importance of undertaking genetic studies of pregnancy disorders in African populations with the potential to provide biological insights not available from studies restricted to European populations.

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

    Science.gov (United States)

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

    2014-10-01

    During the past decade, a number of large drug trials suggested that the initiation of levodopa therapy should be delayed to reduce the risk of motor complications in patients with Parkinson's disease. However, the relative contribution of the cumulative exposure to levodopa and of disease progression to the pathophysiology of motor fluctuations and dyskinesias is still poorly understood. In this 4-year multicentre study, we investigated a large cohort of patients with Parkinson's disease in a sub-Saharan African country (Ghana), where access to medication is limited and the initiation of levodopa therapy often occurs many years after onset. The primary objective was to investigate whether the occurrence of motor complications is primarily related to the duration of levodopa therapy or to disease-related factors. Study design included a cross-sectional case-control analysis of data collected between December 2008 and November 2012, and a prospective study of patients followed-up for at least 6 months after the initiation of levodopa therapy. Ninety-one patients fulfilled criteria for clinical diagnosis of idiopathic Parkinson's disease (58 males, mean age at onset 60.6 ± 11.3 years). Demographic data were compared to those of 2282 consecutive Italian patients recruited during the same period, whereas nested matched subgroups were used to compare clinical variables. Demographic features, frequency and severity of motor and non-motor symptoms were comparable between the two populations, with the only exception of more frequent tremor-dominant presentation in Ghana. At baseline, the proportion of Ghanaian patients with motor fluctuations and dyskinesias was 56% and 14%, respectively. Although levodopa therapy was introduced later in Ghana (mean disease duration 4.2 ± 2.8 versus 2.4 ± 2.1 years, P disease duration at the occurrence of motor fluctuations and dyskinesias was similar in the two populations. In multivariate analysis, disease duration and levodopa daily

  7. Hypertension in Sub-Saharan Africa: A Contextual View of Patterns of Disease, Best Management, and Systems Issues.

    Science.gov (United States)

    Nulu, Shanti; Aronow, Wilbert S; Frishman, William H

    2016-01-01

    Sub-Saharan Africa (SSA) bears the highest burden of both communicable and noncommunicable disease and has the weakest health systems. Much attention is directed toward a rising burden of chronic disease in the setting of epidemiologic transition and urbanization. Indeed, the highest prevalence of hypertension globally is in the World Health Organization's African region at 46% of adults aged 25 and above. And while hypertension in SSA is common, its prevalence varies significantly between urban and rural settings. Although there is evidence for epidemiologic transition in urban areas, there is also evidence of static levels of hypertension within rural areas, which comprise more than 70% of the population of SSA. Furthermore, overall cardiovascular (CV) risk in rural areas remains low. The mean age of hypertensives in SSA is approximately 30s to 40s, burdening those at peak productivity. Complications of hypertension are frequent, given the poor levels of awareness and treatment (hypertension on the continent. Such complications include primarily stroke and hypertensive heart disease, as ischemic heart disease is uncommon. Mortality associated with these complications is high, with in-hospital mortality from 2 different sites reported as around 20%. The overall burden of hypertension is likely to be more related to poor access and availability of health systems and is representative of a looming crisis in health care delivery. The best approaches to population-wide treatment are those that utilize CV risk prediction for those with stage 1 hypertension, whereas treatment is generally indicated for all those with stage 2 or greater hypertension, especially in light of the high burden of stroke in SSA. Current guidelines recommend first-line drug therapy with a diuretic or calcium channel blocker. Despite these recommendations, the major obstacles to hypertension treatment are systemic and include the availability and cost of medications, the adequacy of health

  8. Environmental heterogeneity predicts species richness of freshwater mollusks in sub-Saharan Africa

    Science.gov (United States)

    Hauffe, T.; Schultheiß, R.; Van Bocxlaer, B.; Prömmel, K.; Albrecht, C.

    2016-09-01

    Species diversity and how it is structured on a continental scale is influenced by stochastic, ecological, and evolutionary driving forces, but hypotheses on determining factors have been mainly examined for terrestrial and marine organisms. The extant diversity of African freshwater mollusks is in general well assessed to facilitate conservation strategies and because of the medical importance of several taxa as intermediate hosts for tropical parasites. This historical accumulation of knowledge has, however, not resulted in substantial macroecological studies on the spatial distribution of freshwater mollusks. Here, we use continental distribution data and a recently developed method of random and cohesive allocation of species distribution ranges to test the relative importance of various factors in shaping species richness of Bivalvia and Gastropoda. We show that the mid-domain effect, that is, a hump-shaped richness gradient in a geographically bounded system despite the absence of environmental gradients, plays a minor role in determining species richness of freshwater mollusks in sub-Saharan Africa. The western branch of the East African Rift System was included as dispersal barrier in richness models, but these simulation results did not fit observed diversity patterns significantly better than models where this effect was not included, which suggests that the rift has played a more complex role in generating diversity patterns. Present-day precipitation and temperature explain richness patterns better than Eemian climatic condition. Therefore, the availability of water and energy for primary productivity during the past does not influence current species richness patterns much, and observed diversity patterns appear to be in equilibrium with contemporary climate. The availability of surface waters was the best predictor of bivalve and gastropod richness. Our data indicate that habitat diversity causes the observed species-area relationship, and hence, that

  9. Oculocutaneous Albinism and Squamous Cell Carcinoma of the Skin of the Head and Neck in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    P. T. Lekalakala

    2015-01-01

    Full Text Available Oculocutaneous albinism which is characterised by impaired melanin biosynthesis is the most common inherited pigmentary disorder of the skin and it is common among Blacks in sub-Saharan Africa. All albinos are at great risk of developing squamous cell carcinoma of sun-exposed skin, and Black albinos in sub-Saharan Africa are at about a 1000-fold higher risk of developing squamous cell carcinoma of the skin than the general population. In Black albinos, skin carcinoma tends to run an aggressive course and is likely to recur after treatment, very probably because the aetiology and predisposing factors have not changed. Prevention or reduction of occurrence of squamous cell carcinoma of the skin in Black albinos might be achieved through educating the population to increase awareness of the harmful effects of exposure to sunlight and at the same time making available effective screening programs for early detection of premalignant and malignant skin lesions in schools and communities and for early treatment.

  10. The Healthy Migrant Families Initiative: development of a culturally competent obesity prevention intervention for African migrants

    OpenAIRE

    2015-01-01

    Background Although obesity among immigrants remains an important area of study given the increasing migrant population in Australia and other developed countries, research on factors amenable to intervention is sparse. The aim of the study was to develop a culturally-competent obesity prevention program for sub-Saharan African (SSA) families with children aged 12–17 years using a community-partnered participatory approach. Methods A community-partnered participatory approach that allowed the...

  11. Colonial Legacy and African Higher Education---Exploring the History of Higher Education Development in Sub-Saharan Francophone Africa%殖民主义遗产与非洲高等教育——撒哈拉以南非洲法语国家高等教育发展的历史考察

    Institute of Scientific and Technical Information of China (English)

    於荣; 黄丹华

    2011-01-01

    殖民主义时期,法国在撒哈拉以南非洲实施的教育同化政策对这些法语国家的高等教育发展产生了长期不利的影响。这些不利的影响主要表现为:高等教育成本高昂,入学机会严重不足,科学与技术在高等教育中受到忽视,非洲本土语言在高等教育中被边缘化。%During the age of Colonialism, French adopts Assimilation policy to the higher education in Sub-Saharan Africa countries which has a lot of long-term disadvantages influences on these Francophone states. The unfavorable effects include high unit cost of higher education and shortage of admission opportunity, neglect of science and technology, and marginalization of indigenous language.

  12. Control of Taenia solium taeniasis/cysticercosis: The best way forward for sub-Saharan Africa?

    Science.gov (United States)

    Gabriël, S; Dorny, P; Mwape, K E; Trevisan, C; Braae, U C; Magnussen, P; Thys, S; Bulaya, C; Phiri, I K; Sikasunge, C S; Makungu, C; Afonso, S; Nicolau, Q; Johansen, M V

    2017-01-01

    Taenia solium taeniasis/cysticercosis is a neglected parasitic zoonosis with significant economic and public health impacts. Control measures can be broadly grouped into community health education, improvements in hygiene and sanitary conditions, proper meat handling at household and community level, improved standards of meat inspection, pig management, treatment of individual patients and possibly human populations, and treatment and/or vaccination of porcine populations. This manuscript looks critically into currently existing control options and provides suggestions on which (combination of) tools would be most effective in the control of T. solium taeniasis/cysticercosis in sub-Saharan Africa. Field data and disease transmission simulations suggest that implementation of a single intervention control strategy will not lead to a satisfactory reduction of disease morbidity or transmission. A feasible strategy to combat T. solium taeniasis/cysticercosis would include a combination of approaches focussing on both human (health education and treatment) and animal host (management, treatment and vaccination), which can vary for different communities and different geographical locations. Selection of the specific strategy depends on cost-effectiveness analyses based on solid field data, currently unavailable, though urgently needed; as well as on health priorities and resources of the country. A One Health approach involving medical, veterinary, environmental and social sectors is essential for T. solium to be controlled and eventually eliminated. Finally the success of any intervention is largely dependent on the level of societal and political acceptance, commitment and engagement.

  13. Assessing coverage, equity and quality gaps in maternal and neonatal care in sub-saharan Africa: an integrated approach.

    Directory of Open Access Journals (Sweden)

    Calistus Wilunda

    Full Text Available Gaps in coverage, equity and quality of health services hinder the achievement of the Millennium Development Goals 4 and 5 in most countries of sub-Saharan Africa as well as in other high-burden countries, yet few studies attempt to assess all these dimensions as part of the situation analysis. We present the base-line data of a project aimed at simultaneously addressing coverage, equity and quality issues in maternal and neonatal health care in five districts belonging to three African countries.Data were collected in cross-sectional studies with three types of tools. Coverage was assessed in three hospitals and 19 health centres (HCs utilising emergency obstetric and newborn care needs assessment tools developed by the Averting Maternal Death and Disability program. Emergency obstetrics care (EmOC indicators were calculated. Equity was assessed in three hospitals and 13 HCs by means of proxy wealth indices and women delivering in health facilities were compared with those in the general population to identify inequities. Quality was assessed in three hospitals using the World Health Organization's maternal and neonatal quality of hospital care assessment tool which evaluates the whole range of aspects of obstetric and neonatal care and produces an average score for each main area of care.All the three hospitals qualified as comprehensive EmOC facilities but none of the HCs qualified for basic EmOC. None of the districts met the minimum requisites for EmOC indicators. In two out of three hospitals, there were major quality gaps which were generally greater in neonatal care, management of emergency and complicated cases and monitoring. Higher access to care was coupled by low quality and good quality by very low access. Stark inequities in utilisation of institutional delivery care were present in all districts and across all health facilities, especially at hospital level.Our findings confirm the existence of serious issues regarding coverage

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

    Directory of Open Access Journals (Sweden)

    Sexton Alexis R

    2011-06-01

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

  15. To What Extent is Drinking Water Tested in Sub-Saharan Africa? A Comparative Analysis of Regulated Water Quality Monitoring

    Directory of Open Access Journals (Sweden)

    Rachel Peletz

    2016-03-01

    Full Text Available Water quality information is important for guiding water safety management and preventing water-related diseases. To assess the current status of regulated water quality monitoring in sub-Saharan Africa, we evaluated testing programs for fecal contamination in 72 institutions (water suppliers and public health agencies across 10 countries. Data were collected through written surveys, in-person interviews, and analysis of microbial water quality testing levels. Though most institutions did not achieve the testing levels specified by applicable standards or World Health Organization (WHO Guidelines, 85% of institutions had conducted some microbial water testing in the previous year. Institutions were more likely to meet testing targets if they were suppliers (as compared to surveillance agencies, served larger populations, operated in urban settings, and had higher water quality budgets (all p < 0.05. Our results indicate that smaller water providers and rural public health offices will require greater attention and additional resources to achieve regulatory compliance for water quality monitoring in sub-Saharan Africa. The cost-effectiveness of water quality monitoring should be improved by the application of risk-based water management approaches. Efforts to strengthen monitoring capacity should pay greater attention to program sustainability and institutional commitment to water safety.

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

    Directory of Open Access Journals (Sweden)

    Donald P. King

    2012-06-01

    Full Text Available 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

  17. Traditional herbal medicine use among hypertensive patients in sub-Saharan Africa: a systematic review.

    Science.gov (United States)

    Liwa, Anthony C; Smart, Luke R; Frumkin, Amara; Epstein, Helen-Ann B; Fitzgerald, Daniel W; Peck, Robert N

    2014-06-01

    Hypertension is increasingly common in sub-Saharan Africa, and rates of hypertension control are low. Use of traditional herbal medicines (THM) is common among adults in sub-Saharan Africa and may affect hypertension therapy. We searched Ovid MEDLINE, Ovid EMBASE, and Web of Knowledge in June 2013 to find studies about THM use among hypertensive patients living in sub-Saharan Africa. Two independent reviewers evaluated titles and abstracts. Qualifying references were reviewed in full text. Data were extracted using a standardized questionnaire. Four hundred and eighty-one references were retrieved, and four articles from two countries met criteria for inclusion. The prevalence of THM use was 25-65% (average 38.6%). THM was the most common type of complementary and alternative medicines used by patients (86.7-96.6%). Among THM users, 47.5% concomitantly used both allopathic medicine and THM. Increased age (pmedicine. Healthcare workers in sub-Saharan Africa must discuss THM use with their hypertensive patients. More research is urgently needed to define the impact of THM use on hypertension control and outcomes in sub-Saharan Africa.

  18. The State of Soil Degradation in Sub-Saharan Africa: Baselines, Trajectories, and Solutions

    Directory of Open Access Journals (Sweden)

    Katherine Tully

    2015-05-01

    Full Text Available The primary cause of soil degradation in sub-Saharan Africa (SSA is expansion and intensification of agriculture in efforts to feed its growing population. Effective solutions will support resilient systems, and must cut across agricultural, environmental, and socioeconomic objectives. While many studies compare and contrast the effects of different management practices on soil properties, soil degradation can only be evaluated within a specific temporal and spatial context using multiple indicators. The extent and rate of soil degradation in SSA is still under debate as there are no reliable data, just gross estimates. Nevertheless, certain soils are losing their ability to provide food and essential ecosystem services, and we know that soil fertility depletion is the primary cause. We synthesize data from studies that examined degradation in SSA at broad spatial and temporal scales and quantified multiple soil degradation indicators, and we found clear indications of degradation across multiple indicators. However, different indicators have different trajectories—pH and cation exchange capacity tend to decline linearly, and soil organic carbon and yields non-linearly. Future research should focus on how soil degradation in SSA leads to changes in ecosystem services, and how to manage these soils now and in the future.

  19. Impact of poverty on hypertension and cardiovascular disease in sub-Saharan Africa.

    Science.gov (United States)

    Seedat, Y K

    2007-01-01

    Sub-Saharan Africa (SSA) has huge amounts of natural resources and a source of strategic minerals. It is not overpopulated compared to the Asian continent, yet the economic conditions have deteriorated alarmingly in recent years. It is the poorest continent and has the lowest per capita income in the world. An analysis of the causes of poverty and its impact on health, particularly cardiovascular diseases (CVD) and hypertension, was carried out and is reported on here. A 'second-wave epidemic' is currently sweeping through SSA, other developing countries and Eastern Europe, making a comprehensive CVD programme necessary. Social, economic and cultural factors impair the control of hypertension, diabetes, obesity, tobacco use and other risk factors for CVD in SSA. Primary prevention through a population-based, lifestyle-linked programme, as well as cost-effective methods for detection and management are synergistically linked. The existing healthcare infrastructure needs to be orientated to meet the challenge of CVD, while empowering the community through health education.

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

    Science.gov (United States)

    Cardoso, Luis Alfaro

    2012-12-01

    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.

  1. Sustainability of Water Safety Plans Developed in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Luca Rondi

    2015-08-01

    Full Text Available In developing countries, the drinking water supply is still an open issue. In sub-Saharan Africa, only 68% of the population has access to improved sources of drinking water. Moreover, some regions are affected by geogenic contaminants (e.g., fluoride and arsenic and the lack of access to sanitation facilities and hygiene practices causes high microbiological contamination of drinking water in the supply chain. The Water Safety Plan (WSP approach introduced by the World Health Organisation (WHO in 2004 is now under development in several developing countries in order to face up to these issues. The WSP approach was elaborated within two cooperation projects implemented in rural areas of Burkina Faso and Senegal by two Italian NGOs (Non-Governmental Organisations. In order to evaluate its sustainability, a questionnaire based on five different sustainability elements and a cost and time consumption evaluation were carried out and applied in both the case studies. Results demonstrated that the questionnaire can provide a useful and interesting overview regarding the sustainability of the WSP; however, further surveys in the field are recommended for gathering more information. Time and costs related to the WSP elaboration, implementation, and management were demonstrated not to be negligible and above all strongly dependent on water quality and the water supply system complexity.

  2. Modelling social vulnerability in sub-Saharan West Africa using a geographical information system

    Directory of Open Access Journals (Sweden)

    Olanrewaju Lawal

    2015-02-01

    Full Text Available In recent times, disasters and risk management have gained significant attention, especially with increasing awareness of the risks and increasing impact of natural and other hazards especially in the developing world. Vulnerability, the potential for loss of life or property from disaster, has biophysical or social dimensions. Social vulnerability relates to societal attributes which has negative impacts on disaster outcomes. This study sought to develop a spatially explicit index of social vulnerability, thus addressing the dearth of research in this area in sub-Saharan Africa. Nineteen variables were identified covering various aspects. Descriptive analysis of these variables revealed high heterogeneity across the South West region of Nigeria for both the state and the local government areas (LGAs. Feature identification using correlation analysis identified six important variables. Factor analysis identified two dimensions, namely accessibility and socioeconomic conditions, from this subset. A social vulnerability index (SoVI showed that Ondo and Ekiti have more vulnerable LGAs than other states in the region. About 50% of the LGAs in Osun and Ogun have a relatively low social vulnerability. Distribution of the SoVI shows that there are great differences within states as well as across regions. Scores of population density, disability and poverty have a high margin of error in relation to mean state scores. The study showed that with a geographical information system there are opportunities to model social vulnerability and monitor its evolution and dynamics across the continent.

  3. The role of seizure disorders in burn injury and outcome in Sub-Saharan Africa.

    Science.gov (United States)

    Boschini, Laura P; Tyson, Anna F; Samuel, Jonathan C; Kendig, Claire E; Mjuweni, Stephano; Varela, Carlos; Cairns, Bruce A; Charles, Anthony G

    2014-01-01

    Patients with epilepsy have higher incidence and severity of burn injury. Few studies describe the association between epilepsy and burns in low-income settings, where epilepsy burden is highest. The authors compared patients with and without seizure disorder in a burn unit in Lilongwe, Malawi. The authors conducted a retrospective study of patients admitted to the Kamuzu Central Hospital burn ward from July 2011 to December 2012. Descriptive analysis of patient characteristics and unadjusted and adjusted analyses of risk factors for mortality were conducted for patients with and without seizure disorder. Prevalence of seizure disorder was 10.7% in the study population. Adults with burns were more likely to have seizure disorder than children. Flame injury was most common in patients with seizure disorder, whereas scalds predominated among patients without seizure disorder. Whereas mortality did not differ between the groups, mean length of stay was longer for patients with seizure disorder, 42.1 days vs 21.6 days. Seizure disorder continues to be a significant risk factor for burn injury in adults in Malawi. Efforts to mitigate epilepsy will likely lead to significant decreases in burns among adults in Sub-Saharan Africa and must be included in an overall burn prevention strategy in our environment.

  4. Epidemiology of Dementia among the Elderly in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Olaniyi O. Olayinka

    2014-01-01

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

  5. Conflict and human African trypanosomiasis.

    Science.gov (United States)

    Berrang-Ford, Lea; Lundine, Jamie; Breau, Sebastien

    2011-02-01

    Human African Trypanosomiasis (HAT) has reemerged in sub-Saharan Africa as a disease of major public health importance. The success of HAT elimination in sub-Saharan Africa is subject to the feasibility of controlling, eliminating, or mitigating the determinants of incidence in affected countries. Conflict has been widely recognized and cited as a contributing factor to the resurgence of HAT in many countries, as well as to continuing HAT incidence in politically unstable and resource-poor regions. Despite extensive anecdotal and qualitative recognition of the role of conflict, there has been no quantitative research of this topic at the population level in affected African countries. We characterize the qualitative and quantitative associations between HAT incidence and conflict-related processes in HAT-affected African countries over the past 30 years. HAT and conflict-related data were collected for 35 affected countries in sub-Saharan Africa for the years 1976-2004. Descriptive and univariate inferential statistics, as well as negative binomial regression modeling, are used to assess the associations between HAT and conflict. A space-time scan statistic is used to identify significant incidence clusters. Clusters of HAT incidence over the past 30 years have predominantly coincided with periods of conflict or socio-political instability. HAT cases occurred significantly more often in countries and during years with conflict, high political terror, and internationalized civil war. The results indicate a lag period between the start of conflict events and a peak in incidence of approximately 10 years. We recommend explicit consideration and quantification of socio-political measures such as conflict and terror indices in GIS (Geographic Information Systems)-based risk assessments for HAT policy and intervention.

  6. Biomass Burning, Land-Cover Change, and the Hydrological Cycle in Northern Sub-Saharan Africa

    Science.gov (United States)

    Ichoku, Charles; Ellison, Luke T.; Willmot, K. Elena; Matsui, Toshihisa; Dezfuli, Amin K.; Gatebe, Charles K.; Wang, Jun; Wilcox, Eric M.; Lee, Jejung; Adegoke, Jimmy; Okonkwo, Churchill; Bolten, John; Policelli, Frederick S.; Habib, Shahid

    2016-01-01

    The Northern Sub-Saharan African (NSSA) region, which accounts for 20%-25%of the global carbon emissions from biomass burning, also suffers from frequent drought episodes and other disruptions to the hydrological cycle whose adverse societal impacts have been widely reported during the last several decades. This paper presents a conceptual framework of the NSSA regional climate system components that may be linked to biomass burning, as well as detailed analyses of a variety of satellite data for 2001-2014 in conjunction with relevant model-assimilated variables. Satellite fire detections in NSSA show that the vast majority (greater than 75%) occurs in the savanna and woody savanna land-cover types. Starting in the 2006-2007 burning season through the end of the analyzed data in 2014, peak burning activity showed a net decrease of 2-7% /yr in different parts of NSSA, especially in the savanna regions. However, fire distribution shows appreciable coincidence with land-cover change. Although there is variable mutual exchange of different land cover types, during 2003-2013, cropland increased at an estimated rate of 0.28% /yr of the total NSSA land area, with most of it (0.18% /yr) coming from savanna.During the last decade, conversion to croplands increased in some areas classified as forests and wetlands, posing a threat to these vital and vulnerable ecosystems. Seasonal peak burning is anti-correlated with annual water-cycle indicators such as precipitation, soil moisture, vegetation greenness, and evapotranspiration, except in humid West Africa (5 deg-10 deg latitude),where this anti-correlation occurs exclusively in the dry season and burning virtually stops when monthly mean precipitation reaches 4 mm/d. These results provide observational evidence of changes in land-cover and hydrological variables that are consistent with feedbacks from biomass burning in NSSA, and encourage more synergistic modeling and observational studies that can elaborate this feedback

  7. Communication rehabilitation in sub-Saharan Africa: A workforce profile of speech and language therapists

    Directory of Open Access Journals (Sweden)

    Karen Wylie

    2016-02-01

    Full Text Available Background: There is an urgent global need to strengthen rehabilitation services for people with disabilities. In sub-Saharan Africa, rehabilitation services for people with communication disabilities continue to be underdeveloped. A first step in strengthening services for people with a communication disabilities is to understand the composition and conditions of the current workforce.Objectives: This research describes a sample of the speech and language therapists (SLTs working in SSA (excluding South Africa. This study explores the characteristics of this workforce, including their demographics, education, experience and geographical stability.Method: A mixed-methods survey was used to collect data from SLTs within Anglophone countries of SSA. Completed surveys were received from 33 respondents working in 44 jobs across nine countries. Analysis included descriptive and non-parametric inferential statistics. This study reports on a subset of descriptive and quantitative data from the wider survey.Results: A background profile of SLTs across the region is presented. Results indicated that the workforce of SLTs comprised a mix of local and international SLTs, with university-level education. Local SLTs were educated both within and outside of Africa, with more recent graduates trained in Africa. These data reflected the local emergence of speech and language therapy training in SSA.Conclusion: This sample comprised a mix of African and international SLTs, with indications of growing localisation of the workforce. Workforce localisation offers potential advantages of linguistic diversity and stability. Challenges including workforce support and developing culturally and contextually relevant SLT practices are discussed.

  8. Biomass burning, land-cover change, and the hydrological cycle in Northern sub-Saharan Africa

    Science.gov (United States)

    Ichoku, Charles; Ellison, Luke T.; Willmot, K. Elena; Matsui, Toshihisa; Dezfuli, Amin K.; Gatebe, Charles K.; Wang, Jun; Wilcox, Eric M.; Lee, Jejung; Adegoke, Jimmy; Okonkwo, Churchill; Bolten, John; Policelli, Frederick S.; Habib, Shahid

    2016-09-01

    The Northern Sub-Saharan African (NSSA) region, which accounts for 20%-25% of the global carbon emissions from biomass burning, also suffers from frequent drought episodes and other disruptions to the hydrological cycle whose adverse societal impacts have been widely reported during the last several decades. This paper presents a conceptual framework of the NSSA regional climate system components that may be linked to biomass burning, as well as detailed analyses of a variety of satellite data for 2001-2014 in conjunction with relevant model-assimilated variables. Satellite fire detections in NSSA show that the vast majority (>75%) occurs in the savanna and woody savanna land-cover types. Starting in the 2006-2007 burning season through the end of the analyzed data in 2014, peak burning activity showed a net decrease of 2-7%/yr in different parts of NSSA, especially in the savanna regions. However, fire distribution shows appreciable coincidence with land-cover change. Although there is variable mutual exchange of different land cover types, during 2003-2013, cropland increased at an estimated rate of 0.28%/yr of the total NSSA land area, with most of it (0.18%/yr) coming from savanna. During the last decade, conversion to croplands increased in some areas classified as forests and wetlands, posing a threat to these vital and vulnerable ecosystems. Seasonal peak burning is anti-correlated with annual water-cycle indicators such as precipitation, soil moisture, vegetation greenness, and evapotranspiration, except in humid West Africa (5°-10° latitude), where this anti-correlation occurs exclusively in the dry season and burning virtually stops when monthly mean precipitation reaches 4 mm d-1. These results provide observational evidence of changes in land-cover and hydrological variables that are consistent with feedbacks from biomass burning in NSSA, and encourage more synergistic modeling and observational studies that can elaborate this feedback mechanism.

  9. Foreign Agricultural Land Acquisition and the Visibility of Water Resource Impacts in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Philip Woodhouse

    2012-06-01

    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.

  10. Making Mechanization Accessible to Smallholder Farmers in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Brian Sims

    2016-04-01

    Full Text Available This paper summarizes the deliberations at a meeting convened by the Bill & Melinda Gates Foundation held in Beijing in October 2015. Farm power and mechanization are agricultural production inputs that will be essential to raise the labor and land productivity required if Sustainable Development Goals 1 and 2 (ending poverty and hunger are to be achieved. The smallholder farm sector demand for mechanization needs to be raised to stimulate the product value chain and activate input supply (that is to raise farm productivity, stimulate value addition, and encourage private sector custom hire service provision. The sustainability of mechanization from a natural resource conservation point of view is discussed with reference to conservation agriculture principles. Mechanization appropriate for the smallholder sector covers the range of possible power sources human, draft animal and motorized. The key is to engage all the stakeholders in the supply chain and offer a range of suitable options from which the user can select. Sustainability of mechanization includes financial and social, as well as environmental factors. Local manufacturers should be supported where feasible as they can provide implements and machines adapted to local conditions—and better technical service and replacement part supply. The public sector role in providing access to mechanization should be restricted to promulgating enabling policies, building technical and business management skills and stimulating demand. The lessons to be learnt from Chinese experience in making mechanization available to smallholder farmers include subsidies, strong extension services, infrastructure development and a solid manufacturing sector that prioritizes the smallholder sector. The implications for sub-Saharan Africa appear to be that group ownership and custom hire service provision are the models to follow. Finally, the relevance of an African Center for Sustainable Agricultural

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

    Science.gov (United States)

    Foster-Wittig, T.

    2012-12-01

    The highest damages from climate change are predicted to be in the agricultural sector in sub-Saharan Africa. Agriculture is predicted to be especially vulnerable in this region because of its current state of high temperature and low precipitation and because it is usually rain-fed or relies on relatively basic technologies which therefore limit its ability to sustain in increased poor climatic conditions [1]. The goal of this research is to quantify the vulnerability of this ecosystem by projecting future changes in agriculture due to IPCC predicted climate change impacts on precipitation and temperature. This research will provide a better understanding of the relationship between precipitation and rain-fed agriculture in savannas. In order to quantify the effects of climate change on agriculture, the impacts of climate change are modeled through the use of a land surface vegetation dynamics model previously developed combined with a crop model [2,4]. In this project, it will be used to model yield for point cropland locations within sub-Saharan Africa between Kenya and Botswana with a range of annual rainfall. With this model, future projections are developed for what can be anticipated for the crop yield based on two precipitation climate change scenarios; (1) decreased depth and (2) decreased frequency as well as temperature change scenarios; (3) only temperature increased, (4) temperature increase dand decreased precipitation depth, and (5) temperature increased and decreased precipitation frequency. Therefore, this will allow conclusions to be drawn about how mean precipitation and a changing climate effect food security in sub-Saharan Africa. As an additional analysis, irrigation is added to the model as it is thought to be the solution to protect food security by maximizing on the potential of food production. In water-limited areas such as Sub-Saharan Africa, it is important to consider water efficient irrigation techniques such as demand-based micro

  12. Is HIV/AIDS epidemic outcome of poverty in sub-saharan Africa?

    Science.gov (United States)

    Mbirimtengerenji, Noel Dzimnenani

    2007-10-01

    Undisputable fact is that 14000 people in Sub-Saharan Africa are being infected daily with HIV and 11000 are dying every day due to HIV/AIDS related illnesses. In this region more than 60% of the people live below UN poverty line of US$ 1 per day. Some studies have shown that poverty and HIV infection are in correlation, but none has shown whether HIV/AIDS in Sub-Saharan Africa is an outcome of poverty. This article, therefore, shows that HIV is an important outcome of poverty, with sexual trade, migration, polygamy, and teenage marriages as its predictors in the Sub Saharan region. I used the examples of 20 countries with the highest poverty level in the region to demonstrate the gravity of the HIV scourge, using the data from different international databases.

  13. The road half traveled: agricultural market reform in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Kherallah Mylène

    2002-11-01

    Full Text Available This article reviews the extensive evidence on agricultural market reforms in Sub-Saharan Africa and summarises the impact reforms have had on market performance, agricultural production, use of modern inputs, and poverty. It offers eight recommendations for completing the reform process and developing a new agenda for agricultural markets in Sub-Saharan Africa. The reform experience in Sub-Saharan Africa has varied widely across countries and crop subsectors. The available evidence shows clear progress in some areas and mixed results in others. Most reforms were only partially implemented and policy reversal was common. Once implemented, however, reforms have increased competition and reduced marketing margins, benefiting both producers and consumers. Reforms have also boosted export crop production. On the other hand, food crop production has stagnated and yields have not improved. Further expansion of private trade is constrained by lack of access to credit, uncertainty about the government’s commitment to reform, and high transaction costs.

  14. A systematic review of missed opportunities for improving tuberculosis and HIV/AIDS control in Sub-saharan Africa: what is still missed by health experts?

    Science.gov (United States)

    Keugoung, Basile; Fouelifack, Florent Ymele; Fotsing, Richard; Macq, Jean; Meli, Jean; Criel, Bart

    2014-01-01

    In sub-Saharan Africa, HIV/AIDS and tuberculosis are major public health problems. In 2010, 64% of the 34 million of people infected with HIV were reported to be living in sub-Saharan Africa. Only 41% of eligible HIV-positive people had access to antiretroviral therapy (ART). Regarding tuberculosis, in 2010, the region had 12% of the world's population but reported 26% of the 8.8 million incident cases and 254000 tuberculosis-related deaths. This paper aims to review missed opportunities for improving HIV/AIDS and tuberculosis prevention and care. We conducted a systematic review in PubMed using the terms 'missed'(Title) AND 'opportunities'(Title). We included systematic review and original research articles done in sub-Saharan Africa on missed opportunities in HIV/AIDS and/or tuberculosis care. Missed opportunities for improving HIV/AIDS and/or tuberculosis care can be classified into five categories: i) patient and community; ii) health professional; iii) health facility; iv) local health system; and v) vertical programme (HIV/AIDS and/or tuberculosis control programmes). None of the reviewed studies identified any missed opportunities related to health system strengthening. Opportunities that are missed hamper tuberculosis and/or HIV/AIDS care in sub-Saharan Africa where health systems remain weak. What is still missing in the analysis of health experts is the acknowledgement that opportunities that are missed to strengthen health systems also undermine tuberculosis and HIV/AIDS prevention and care. Studying why these opportunities are missed will help to understand the rationales behind the missed opportunities, and customize adequate strategies to seize them and for effective diseases control.

  15. Children Living with HIV-Infected Adults: Estimates for 23 Countries in sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Susan E Short

    Full Text Available In sub-Saharan Africa many children live in extreme poverty and experience a burden of illness and disease that is disproportionately high. The emergence of HIV and AIDS has only exacerbated long-standing challenges to improving children's health in the region, with recent cohorts experiencing pediatric AIDS and high levels of orphan status, situations which are monitored globally and receive much policy and research attention. Children's health, however, can be affected also by living with HIV-infected adults, through associated exposure to infectious diseases and the diversion of household resources away from them. While long recognized, far less research has focused on characterizing this distinct and vulnerable population of HIV-affected children.Using Demographic and Health Survey data from 23 countries collected between 2003 and 2011, we estimate the percentage of children living in a household with at least one HIV-infected adult. We assess overlaps with orphan status and investigate the relationship between children and the adults who are infected in their households.The population of children living in a household with at least one HIV-infected adult is substantial where HIV prevalence is high; in Southern Africa, the percentage exceeded 10% in all countries and reached as high as 36%. This population is largely distinct from the orphan population. Among children living in households with tested, HIV-infected adults, most live with parents, often mothers, who are infected; nonetheless, in most countries over 20% live in households with at least one infected adult who is not a parent.Until new infections contract significantly, improvements in HIV/AIDS treatment suggest that the population of children living with HIV-infected adults will remain substantial. It is vital to on-going efforts to reduce childhood morbidity and mortality to consider whether current care and outreach sufficiently address the distinct vulnerabilities of these

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

    Directory of Open Access Journals (Sweden)

    Lawoko Stephen

    2009-07-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Harding Richard

    2005-08-01

    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.

  18. 75 FR 81077 - To Take Certain Actions Under the African Growth and Opportunity Act, and for Other Purposes

    Science.gov (United States)

    2010-12-27

    ... Democratic Republic of Congo (DRC) as an eligible sub-Saharan African country pursuant to section 104 of the... the authority provided to the President under section 506A(a)(1) of the 1974 Act to designate the DRC... October 31, 2003, the USTR designated the DRC as a beneficiary sub-Saharan African country (68 FR...

  19. Sub-Saharan Africa: An Assessment of Strategic U.S. Policy

    Science.gov (United States)

    1998-01-01

    these are urrtants rather than substantial threats And although the endermc poverty and mtemal warfare common to much of Sub-Saharan Africa gives rise...U S exports more to Sub-Saharan A&a than to the! former Soviet Umon, thrs is more a comment on the poor state of trade relations with the;Newly...region 1s a harsh one. and has exacerbated the human mrstakes. the most serious problems faced by the region stem from poor choices made by the native

  20. Correlation between genetic HLA class I and II polymorphisms and anthropological aspects in the Chaouya population from Morocco (Arabic speaking).

    Science.gov (United States)

    Canossi, A; Piancatelli, D; Aureli, A; Oumhani, K; Ozzella, G; Del Beato, T; Liberatore, G; El Aouad, R; Adorno, D

    2010-09-01

    The aim of this study was to provide genetic and anthropological information on the Chaouya (CH), an Arabic-speaking population living in West Morocco, Atlantic coast (Settat). In 98 unrelated healthy CH volunteers, we first investigated the human leukocyte antigen (HLA) class I and II allele polymorphisms using a sequence-based typing method and examined haplotypes and relatedness of this group to other African and Mediterranean populations. The study showed the close relatedness with Tunisian population and other North Africans, together with a strong influence of various immigrations, mainly Spaniards, French, and Portuguese, as expected. Nevertheless, analysis of class II allele frequencies (afs) showed that Oromo and Amhara Ethiopian groups cluster together with the Berbers and other North Africans, confirming the relationship between these populations (Afro-Asiatic linguistic group, Hamites). South and sub-Saharan Africans cluster separately at a great distance from CH, except the sub-Saharan Bantu population from Congo Kinshasa, which shows a relatively close genetic relationship ascribable to the effect of a diversifying selection. On the other hand, considering HLA class I afs analyses, it was noteworthy that CH grouped together with sub-Saharans, showing a close genetic distance mainly with Ugandas and Kenians Luo.

  1. Mortality of HIV-infected patients starting antiretroviral therapy in sub-Saharan Africa: comparison with HIV-unrelated mortality.

    Directory of Open Access Journals (Sweden)

    Martin W G Brinkhof

    2009-04-01

    Full Text Available BACKGROUND: Mortality in HIV-infected patients who have access to highly active antiretroviral therapy (ART has declined in sub-Saharan Africa, but it is unclear how mortality compares to the non-HIV-infected population. We compared mortality rates observed in HIV-1-infected patients starting ART with non-HIV-related background mortality in four countries in sub-Saharan Africa. METHODS AND FINDINGS: Patients enrolled in antiretroviral treatment programmes in Côte d'Ivoire, Malawi, South Africa, and Zimbabwe were included. We calculated excess mortality rates and standardised mortality ratios (SMRs with 95% confidence intervals (CIs. Expected numbers of deaths were obtained using estimates of age-, sex-, and country-specific, HIV-unrelated, mortality rates from the Global Burden of Disease project. Among 13,249 eligible patients 1,177 deaths were recorded during 14,695 person-years of follow-up. The median age was 34 y, 8,831 (67% patients were female, and 10,811 of 12,720 patients (85% with information on clinical stage had advanced disease when starting ART. The excess mortality rate was 17.5 (95% CI 14.5-21.1 per 100 person-years SMR in patients who started ART with a CD4 cell count of less than 25 cells/microl and World Health Organization (WHO stage III/IV, compared to 1.00 (0.55-1.81 per 100 person-years in patients who started with 200 cells/microl or above with WHO stage I/II. The corresponding SMRs were 47.1 (39.1-56.6 and 3.44 (1.91-6.17. Among patients who started ART with 200 cells/microl or above in WHO stage I/II and survived the first year of ART, the excess mortality rate was 0.27 (0.08-0.94 per 100 person-years and the SMR was 1.14 (0.47-2.77. CONCLUSIONS: Mortality of HIV-infected patients treated with combination ART in sub-Saharan Africa continues to be higher than in the general population, but for some patients excess mortality is moderate and reaches that of the general population in the second year of ART. Much of the

  2. Population genetics of African ungulates

    DEFF Research Database (Denmark)

    Lorenzen, Eline

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

  3. Community-Associated Staphylococcus aureus from Sub-Saharan Africa and Germany: A Cross-Sectional Geographic Correlation Study.

    Science.gov (United States)

    Ruffing, Ulla; Alabi, Abraham; Kazimoto, Theckla; Vubil, Delfino C; Akulenko, Ruslan; Abdulla, Salim; Alonso, Pedro; Bischoff, Markus; Germann, Anja; Grobusch, Martin P; Helms, Volkhard; Hoffmann, Jonas; Kern, Winfried V; Kremsner, Peter G; Mandomando, Inacio; Mellmann, Alexander; Peters, Georg; Schaumburg, Frieder; Schubert, Sabine; Strauß, Lena; Tanner, Marcel; Briesen, Hagen von; Wende, Laura; Müller, Lutz von; Herrmann, Mathias

    2017-12-01

    Clonal clusters and gene repertoires of Staphylococcus aureus are essential to understand disease and are well characterized in industrialized countries but poorly analysed in developing regions. The objective of this study was to compare the molecular-epidemiologic profiles of S. aureus isolates from Sub-Saharan Africa and Germany. S. aureus isolates from 600 staphylococcal carriers and 600 patients with community-associated staphylococcal disease were characterized by DNA hybridization, clonal complex (CC) attribution, and principal component (PCA)-based gene repertoire analysis. 73% of all CCs identified representing 77% of the isolates contained in these CCs were predominant in either African or German region. Significant differences between African versus German isolates were found for alleles encoding the accessory gene regulator type, enterotoxins, the Panton-Valentine leukocidin, immune evasion gene cluster, and adhesins. PCA in conjunction with silhouette analysis distinguished nine separable PCA clusters, with five clusters primarily comprising of African and two clusters of German isolates. Significant differences between S. aureus lineages in Africa and Germany may be a clue to explain the apparent difference in disease between tropical/(so-called) developing and temperate/industrialized regions. In low-resource countries further clinical-epidemiologic research is warranted not only for neglected tropical diseases but also for major bacterial infections.

  4. 78 FR 24744 - Postponement Notice of Open Special Meeting of the Sub-Saharan Africa Advisory Committee of the...

    Science.gov (United States)

    2013-04-26

    ... Postponement Notice of Open Special Meeting of the Sub-Saharan Africa Advisory Committee of the Export-Import Bank of the United States (Ex-Im Bank) SUMMARY: The Sub-Saharan Africa Advisory Committee was established by Public Law 105-121, November 26, 1997, to advise the Board of Directors on the development...

  5. 78 FR 56702 - Notice of Open Special Meeting of the Sub-Saharan Africa Advisory Committee (SAAC) of the Export...

    Science.gov (United States)

    2013-09-13

    ... of Open Special Meeting of the Sub-Saharan Africa Advisory Committee (SAAC) of the Export-Import Bank of the United States (Export-Import Bank). SUMMARY: The Sub-Saharan Africa Advisory Committee was established by Public Law 105-121, November 26, 1997, to advise the Board of Directors on the development...

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

    Science.gov (United States)

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

    2011-12-01

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

  7. PROBLEMS AND PROSPECTS OF THE DEVELOPMENT OF DIGITAL ECONOMY IN SUB-SAHARAN AFRICA

    Directory of Open Access Journals (Sweden)

    Traore B.

    2016-03-01

    Full Text Available This article deals with the problems and prospects of development of the digital economy of Sub-Saharan Africa. The work will examine the relationship between the development of new information and communication technologies (ICT and the formation of civil society in the region. The stages of implementation of Internet technologies will be explored. The development in different countries according to national circumstances, understand the basic functions of the new ICT in the development of civil society and freedom of expression and development trends in the region will be studied. Africa itself is not the leader in terms of providing access to a communication area, only 13% (according to research by the World Bank, the inhabitants of the continent using the Internet. But it’s observed in Africa a high growth of the World Wide Web users in a relatively short period. Subsaharan Africa is one of the developing parts of Africa, taking into account the higher interest of the residents, technology is developing faster and the communications is the higher quality, The reason why young people have access to educational, take part in the dialogue with people from different countries, learn about the labor market, are part of a large community of interest, and in consequence are more critical of what is happening around. The article gives a definition of "digital economy" ; the graphs and charts that reflect the level of ICT development and participation of civil society in their distribution ; the participation of civil society in their dissemination ; review: dynamics of development of the digital economy, dynamics of the African telecommunications market, mobile market and all in the region's economy, the incredible pace of development of Internet technologies, socio-economic problems and challenges, the emergence of new jobs, new technology is providing the usual banking services, the emergence of e-government and its impact on the quality of

  8. Research on Cognitive Development in Sub-Saharan Africa.

    Science.gov (United States)

    Serpell, Robert

    1984-01-01

    Describes three themes that have informed research on cognitive development in sub-Sahara Africa over the past 10 years: (1) extending the range of generalizability of Western theories; (2) interpreting the uniqueness of the African situation; and (3) deriving implications for social policy. (Author/AS)

  9. Salt Reduction Interventions in Sub-Saharan Africa: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Stella Kagwiria Muthuri

    Full Text Available Salt intake is associated with hypertension, the leading risk factor for cardiovascular disease. To promote population-level salt reduction, the World Health Organization recommends intervention around three core pillars: Reformulation of processed foods, consumer awareness, and environmental changes to increase availability and affordability of healthy food. This review investigates salt reduction interventions implemented and evaluated in sub-Saharan Africa (SSA.MEDLINE and google scholar electronic databases were searched for articles meeting inclusion criteria. Studies that reported evaluation results of a salt intervention in SSA were identified. Titles and abstracts were screened, and articles selected for full-text review. Quality of included articles was assessed, and a narrative synthesis of the findings undertaken. PROSPERO registration number CRD42015019055.Seven studies representing four countries-South Africa, Nigeria, Ghana, and Tanzania-were included. Two examined product reformulation, one in hypertensive patients and the other in normotensive volunteers. Four examined consumer awareness interventions, including individualised counselling and advisory health sessions delivered to whole villages. One study used an environmental approach by offering discounts on healthy food purchases. All the interventions resulted in at least one significantly improved outcome measure including reduction in systolic blood pressure (BP, 24 hour urinary sodium excretion, or mean arterial BP.More high quality studies on salt reduction interventions in the region are needed, particularly focused on consumer awareness and education in urban populations given the context of rapid urbanisation; and essentially, targeting product reformulation and environmental change, for greater promise for propagation across a vast, diverse continent.

  10. Control and non-progression of HIV-1 infection in sub-Saharan Africa: A case and review

    Directory of Open Access Journals (Sweden)

    P Patel

    2012-09-01

    Full Text Available Elite and viraemic controllers represent unique subsets of HIV-infected patients who may also be long-term non-progressors (LTNPs. LNTPs constitute an estimated 1 - 15% of the total HIV-positive population in the USA and Europe, but less is known about their epidemiology in sub-Saharan Africa. Though the exact mechanisms for long-term non-progression appear to be numerous and are still under investigation, research on elite controllers may hold the key to new therapeutics and vaccine development. The clinical management of such patients can be challenging, as there are no standard guidelines for treatment, particularly in resource-limited settings. We describe the case of an HIV-infected Botswanan man who is likely an elite or viraemic controller.

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

    Science.gov (United States)

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

    2014-05-01

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

  12. Language of Instruction: Unlocking Effectiveness of Education and Sustainable Development in Sub-Saharan Africa

    Science.gov (United States)

    Truong, Natasha

    2012-01-01

    The choice of the language of instruction in Sub-Saharan Africa (SSA) is a fundamental educational issue with ramifications for educational access and effectiveness and ultimately national development. Indigenous SSA languages have suffered devaluation in colonial and post-colonial SSA education, and this devaluation alienates the majority of SSA…

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

    CERN Document Server

    Blaha, S

    2003-01-01

    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.

  14. Rainwater harvesting and management in rainfed agricultural systems in Sub-Saharan Africa - A review

    NARCIS (Netherlands)

    Biazin, B.; Sterk, G.; Temesgen, M.; Abdulkedir, A.; Stroosnijder, L.

    2012-01-01

    Agricultural water scarcity in the predominantly rainfed agricultural system of sub-Saharan Africa (SSA) is more related to the variability of rainfall and excessive non-productive losses, than the total annual precipitation in the growing season. Less than 15% of the terrestrial precipitation takes

  15. Research on sub-Saharan Africa's unrecorded international trade : some methodological and conceptual problems

    NARCIS (Netherlands)

    Ellis, S.D.K.; MacGaffey, Janet

    1996-01-01

    This paper describes some of the methodological and conceptual problems in researching aspects of sub-Saharan Africa's international 'underground' trade, meaning commercial transactions which are conducted across international frontiers but which are unrecorded in official data. The authors focus in

  16. An Examination of the Influence of Globalisation on Science Education in Anglophone Sub-Saharan Africa

    Science.gov (United States)

    Koosimile, Anthony T.; Suping, Shanah M.

    2015-01-01

    This paper takes the view that the emergence of some trends and practices in science education mirrors the influence of the process of globalisation in Anglophone Sub-Saharan Africa. Through a literature review, an attempt is made to link science education and globalisation by answering the question: "What influence does globalisation have on…

  17. Access to Education in Sub-Saharan Africa: Patterns, Problems and Possibilities

    Science.gov (United States)

    Lewin, Keith M.

    2009-01-01

    The numbers of children with access to basic education in sub-Saharan Africa have increased substantially over the last two decades but many still remain out of school. Some fail to enrol at all, especially in fragile states, and many more start school but do not complete the basic cycle. Education for All (EFA) and the Millennium Development…

  18. Open Flexible Lifelong Learning as a Catalyst for Sustainable Development in Sub-Saharan Africa

    Science.gov (United States)

    Olakulehin, Felix Kayode

    2010-01-01

    Educational provision in developing sub-Saharan Africa states has been severely hindered by the hydra-headed problems of access, cost and quality. Amidst these challenges is the pledge of regional and national education policymakers and development planners to ensure that there is maximum access equitable and qualitative education for all (EFA) in…

  19. Novel biomarkers in the pathogenesis of placental malaria in sub-Saharan Africa

    NARCIS (Netherlands)

    Owens, S.

    2012-01-01

    Every year up to 125 million pregnant women are exposed to malaria, half of them in sub-Saharan Africa where a quarter of mothers have evidence of malaria infection in the placenta at delivery. This thesis presents original data on various bio-markers of placental malaria which may provide fresh ins

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

    Directory of Open Access Journals (Sweden)

    Caradee Y. Wright

    2012-10-01

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

  1. The language situation in Sub-Saharan Africa : Historical roots, measurement, and development impacts

    NARCIS (Netherlands)

    Buzasi, K.

    2015-01-01

    The broader aim of this thesis is to contribute to the literature seeking the role of languages in determining the socio-economic development in Sub-Saharan Africa. The four chapters are related to three issues: linguistic diversity measurement, the role of languages other than communication, and th

  2. De-agrarianization and rural employment generation in sub-Saharan Africa : process and prospects

    NARCIS (Netherlands)

    Bryceson, D.F.

    1993-01-01

    Sub-Saharan Africa is steadily becoming less rural in character. For decades development thinking has prescribed industrialization as the virtuous path leading away from economic dependence on agriculture. The present paper rejects the view that rural or even national industrialization has taken pla

  3. Private Enterprise-Led Economic Development in Sub-Saharan Africa

    DEFF Research Database (Denmark)

    Kuada, John Ernest

    Private Enterprise-Led Development in Sub-Saharan Africa provides a novel theoretical and conceptual model to guide research into Africa's economic development. It endorses the view that private enterprise-led growth will help reduce poverty since it strengthens individuals' capacity to care...... for themselves and their families....

  4. North-South Rivalry and Offshore Balancing in Sub-Saharan Africa

    DEFF Research Database (Denmark)

    Kluth, Michael Friederich; Pilegaard, Jess

    Sub-Saharan Africa constitutes a distinct security region and hosts a high proportion of fragile and failed states presiding over territories with abundant resources – but no indigenous great powers! Following offensive neorealist logic, the absence of local great powers explains the continued be...

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

    NARCIS (Netherlands)

    Gysels, M.H.; Pell, C.; Straus, L.; Pool, R.

    2011-01-01

    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 car

  6. Mobile phones and safety in developing countries : Evidence from Sub-Saharan Africa

    NARCIS (Netherlands)

    James, M.J.

    2015-01-01

    This paper is concerned with the relationship between safety and mobile phones with particular reference to Sub-Saharan Africa; and looks at a range of geographical contexts: non-violent, conflict and post-conflict situations. The main part of the paper reports on recent findings of extensive field-

  7. A systematic review of research on autism spectrum disorders in sub-Saharan Africa

    NARCIS (Netherlands)

    Abubakar, Amina; Ssewanyana, Derrick; Newton, Charles R.

    2016-01-01

    The burden of autism spectrum disorders (ASDs) in sub-Saharan Africa (SSA) is not well known. We carried out a systematic review of the literature to identify published work from SSA. We have systematically searched four databases, namely, Medline, PsycINFO, CINAHL, and Child Development & Adolescen

  8. Electronic performance support for curriculum materials developers: A design research project in Sub-Saharan Africa

    NARCIS (Netherlands)

    McKenney, Susan; Reeves, Thomas

    2014-01-01

    McKenney, S., & Reeves, T. (2013). Electronic performance support for curriculum materials developers: A design research project in Sub-Saharan Africa. In T. Plomp, & N. Nieveen (Eds.), Educational design research – Part B: Illustrative cases (pp. 533-555). Enschede, the Netherlands: SLO.

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

    Science.gov (United States)

    Tooley, James

    2013-01-01

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

  10. Understanding Hydrological Processes in an Ungauged Catchment in sub-Saharan Africa

    NARCIS (Netherlands)

    Mul, M.L.

    2009-01-01

    Ungauged catchments can be found in many parts of the world, but particularly in sub-Saharan Africa. Information collected in a gauged catchment and its regionalisation to ungauged areas is crucial for water resources assessment. Especially farmers in semi-arid areas are in need of such information.

  11. Taking the woman's perspective: Gender risks of regulatory reforms in Sub-Saharan Africa

    NARCIS (Netherlands)

    Milagrosa, A.; Frickenstein, J.

    2008-01-01

    Despite acknowledgment of the significant role of women in economic growth, gender-biased development policies still persist worldwide. In this context, the paper reviews recent policy reforms in Sub-Saharan Africa that perpetuate gender inequality and female poverty for the already impoverished con

  12. Health service delivery models for the provision of antiretroviral therapy in sub-Saharan Africa

    DEFF Research Database (Denmark)

    Lazarus, Jeffrey V; Safreed-Harmon, Kelly; Nicholson, Joey

    2014-01-01

    OBJECTIVES: In response to the lack of evidence-based guidance for how to continue scaling up antiretroviral therapy (ART) in ways that make optimal use of limited resources, to assess comparative studies of ART service delivery models implemented in sub-Saharan Africa. METHODS: A systematic lite...

  13. Effect of health development assistance on health status in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Negeri KG

    2016-04-01

    Full Text Available Keneni Gutema Negeri,1 Damen Halemariam,21School of Public and Environmental Health, Health Service Management Unit, College of Medicine and Health Sciences, Hawassa University, Hawassa, 2College of Medicine and Health Sciences, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia Introduction: Data on the effect of health aid on the health status in developing countries are inconclusive. Moreover, studies on this issue in sub-Saharan Africa are scarce. Therefore, this study aims to analyze the effect of health development aid in sub-Saharan Africa. Methods: Using panel data analytic method, as well as infant mortality rate as a proxy for health status, this study examines the effect of health aid on infant mortality rate in sub-Saharan Africa. The panel was constructed from data on 43 countries for the period 1990–2010. Fixed effect, random effect, and first difference generalized method of moments estimator were used for estimation. Results: Health development aid has a statistically significant positive effect. A 1% increase of health development assistance per capita saves the lives of two infants per 1,000 live births (P=0.000 in the region. Conclusion: Contrary to health aid pessimists’ view, this study observes the fact that health development assistance has strong favorable effect in improving health status in sub-Saharan Africa. Keywords: health aid, infant mortality, developing countries, panel data

  14. [The economic effects of the AIDS epidemic in Sub-Saharan Africa: a general equilibrium analysis].

    Science.gov (United States)

    Kambou, G; Devarajan, S; Over, M

    1993-01-01

    The authors attempt to estimate the economic impact of the spread of AIDS and the subsequent rise in adult mortality on the countries of Sub-Saharan Africa. In particular, they consider the extent to which spending on AIDS-related problems will absorb a large and growing portion of national savings and thus impede capital formation. (SUMMARY IN ENG)

  15. The World Bank and Financing Higher Education in Sub-Saharan Africa.

    Science.gov (United States)

    Banya, Kingsley; Elu, Juliet

    2001-01-01

    Critically examines World Bank and other donor agencies' policy changes toward financing of higher education in Sub-Saharan Africa. Concludes that policy vicissitudes have adversely affected these institutions. Recommends that the unique context of each state play a role in higher education financial policy formation and implementation. (EV)

  16. Moving methodologies. Learning about integrated soil fertility management in sub-Saharan Africa

    NARCIS (Netherlands)

    Defoer, T.

    2000-01-01

    Soil fertility management in sub-Saharan Africa is complex, diverse and dynamic. Farmers' investments are determined by a wide variety of factors, including bio-physical characteristics of the environment, access to resources and the institutional, and socio-economic context of farming and livelihoo

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

    Science.gov (United States)

    Mutula, Stephen Mudogo

    2012-01-01

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

  18. The Geographic and Sectoral Patterns of Large-scale Farmland Investments in Sub-Saharan Africa

    NARCIS (Netherlands)

    Schoneveld, G.C.

    2014-01-01

    Following the food and energy price crises of the mid 2000s, sub-Saharan Africa has become one of the largest recipients for large-scale farmland investments. While much has been written on the phenomenon, scant reliable empirical evidence is available as to the precise geographic and sectoral patte

  19. Nonformal Education and Informal Economies in Sub-Saharan Africa: Finding the Right Match

    Science.gov (United States)

    Minnis, John R.

    2006-01-01

    Education policy in sub-Saharan Africa is predicated on human capital assumptions and therefore promotes the expansion of formal education as a way to promote economic growth. As a result, formal education is valued primarily as a private consumer good, a form of cultural capital that allows some to get ahead and stay ahead, rather than as a…

  20. Polarization and Policy Reform : Anti-Corruption Policymaking in Sub-Saharan Africa

    NARCIS (Netherlands)

    Torenvlied, René; Klein Haarhuis, Carolien M.

    2008-01-01

    The ability of political systems to adopt policy reforms contributes to their internal stability. This article analyses 29 anti-corruption reforms in seven sub-Saharan countries. It seeks to explain the level of adopted reform in these countries from conflicts of interests between policy actors. Two

  1. Tuberculosis and poverty: the contribution of patient costs in sub-Saharan Africa – a systematic review

    Directory of Open Access Journals (Sweden)

    Barter Devra M

    2012-11-01

    Full Text Available Abstract Background Tuberculosis (TB is known to disproportionately affect the most economically disadvantaged strata of society. Many studies have assessed the association between poverty and TB, but only a few have assessed the direct financial burden TB treatment and care can place on households. Patient costs can be particularly burdensome for TB-affected households in sub-Saharan Africa where poverty levels are high; these costs include the direct costs of medical and non-medical expenditures and the indirect costs of time utilizing healthcare or lost wages. In order to comprehensively assess the existing evidence on the costs that TB patients incur, we undertook a systematic review of the literature. Methods PubMed, EMBASE, Science Citation Index, Social Science Citation Index, EconLit, Dissertation Abstracts, CINAHL, and Sociological Abstracts databases were searched, and 5,114 articles were identified. Articles were included in the final review if they contained a quantitative measure of direct or indirect patient costs for treatment or care for pulmonary TB in sub-Saharan Africa and were published from January 1, 1994 to Dec 31, 2010. Cost data were extracted from each study and converted to 2010 international dollars (I$. Results Thirty articles met all of the inclusion criteria. Twenty-one studies reported both direct and indirect costs; eight studies reported only direct costs; and one study reported only indirect costs. Depending on type of costs, costs varied from less than I$1 to almost I$600 or from a small fraction of mean monthly income for average annual income earners to over 10 times average annual income for income earners in the income-poorest 20% of the population. Out of the eleven types of TB patient costs identified in this review, the costs for hospitalization, medication, transportation, and care in the private sector were largest. Conclusion TB patients and households in sub-Saharan Africa often incurred high costs

  2. The X chromosome Alu insertions as a tool for human population genetics: data from European and African human groups.

    Science.gov (United States)

    Athanasiadis, Georgios; Esteban, Esther; Via, Marc; Dugoujon, Jean-Michel; Moschonas, Nicholas; Chaabani, Hassen; Moral, Pedro

    2007-05-01

    Alu elements are the most abundant mobile elements in the human genome (approximately 1,100,000 copies). Polymorphic Alu elements have been proved to be useful in studies of human origins and relationships owing to two important advantages: identity by descent and absence of the Alu element known to be the ancestral state. Alu variation in the X chromosome has been described previously in human populations but, as far as we know, these elements have not been used in population relationship studies. Here, we describe the allele frequencies of 13 'young' Alu elements of the X chromosome (Ya5DP62, Ya5DP57, Yb8DP49, Ya5a2DP1, Yb8DP2, Ya5DP3, Ya5NBC37, Yd3JX437, Ya5DP77, Ya5NBC491, Yb8NBC578, Ya5DP4 and Ya5DP13) in six human populations from sub-Saharan Africa (the Ivory Coast), North Africa (Moroccan High Atlas, Siwa oasis in Egypt, Tunisia), Greece (Crete Island) and Spain (Basque Country). Eight out of 13 Alu elements have shown remarkably high gene diversity values in all groups (average heterozygosities: 0.342 in the Ivory Coast, 0.250 in North Africa, 0.209 in Europe). Genetic relationships agree with a geographical pattern of differentiation among populations, with some peculiar features observed in North Africans. Crete Island and the Basque Country show the lowest genetic distance (0.0163) meanwhile Tunisia, in spite of its geographical location, lies far from the other two North African samples. The results of our work demonstrate that X chromosome Alu elements comprise a reliable set of genetic markers useful to describe human population relationships for fine-scale geographical studies.

  3. Structure of African elephant populations

    DEFF Research Database (Denmark)

    Siegismund, H R; Arctander, P

    1996-01-01

    The structure of elephant populations from east and south Africa has been analyzed by Georgiadis et al. (1994) on the basis of restriction site variation of mitochondrial DNA. They used F statistics based on identity by descent in tests for subdivision and reached the conclusion that there was a ......The structure of elephant populations from east and south Africa has been analyzed by Georgiadis et al. (1994) on the basis of restriction site variation of mitochondrial DNA. They used F statistics based on identity by descent in tests for subdivision and reached the conclusion...... that there was a significant differentiation at the continental level, but that "populations were not significantly subdivided at the regional levels." The data were reanalyzed by Monte-Carlo permutation tests where population subdivision was tested by using F statistics based on partitioning the total haplotype diversity...... among populations. This resulted in identical conclusions at the continental level, but revealed in addition a significant subdivision at the regional level indicating haplotype frequency differences among the populations....

  4. The Incidence Patterns Model to Estimate the Distribution of New HIV Infections in Sub-Saharan Africa: Development and Validation of a Mathematical Model

    Science.gov (United States)

    Cori, Anne; Pufall, Erica L.; Price, Alison; Elmes, Jocelyn; Zaba, Basia; Crampin, Amelia C.; Lutalo, Tom; Gregson, Simon; Hallett, Timothy B.

    2016-01-01

    inferred the potential contribution of each group to transmission using a simple model that builds on the results from the IPM and makes further assumptions about sexual mixing patterns and transmission rates. In all countries except Swaziland, individuals in unions were the single group contributing to the largest proportion of new infections acquired (39%–77%), followed by never married women and men. Female sex workers accounted for a large proportion of new infections (5%–16%) compared to their population size. Individuals in unions were also the single largest contributor to the proportion of infections transmitted (35%–62%), followed by key populations and previously married men and women. Swaziland exhibited different incidence patterns, with never married men and women accounting for over 65% of new infections acquired and also contributing to a large proportion of infections transmitted (up to 56%). Between- and within-country variations indicated different incidence patterns in specific settings. Conclusions It is possible to reliably predict the distribution of new HIV infections acquired using data routinely available in many countries in the sub-Saharan African region with a single relatively simple mathematical model. This tool would complement more specific analyses to guide resource allocation, data collection, and programme planning. PMID:27622516

  5. Science-based health innovation in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Daar Abdallah S

    2010-12-01

    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

  6. Verification of chemistry reference ranges using a simple method in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Irith De Baetselier

    2016-02-01

    Full Text Available Background: Chemistry safety assessments are interpreted by using chemistry reference ranges (CRRs. Verification of CRRs is time consuming and often requires a statistical background.Objectives: We report on an easy and cost-saving method to verify CRRs.Methods: Using a former method introduced by Sigma Diagnostics, three study sites in sub- Saharan Africa, Bondo, Kenya, and Pretoria and Bloemfontein, South Africa, verified the CRRs for hepatic and renal biochemistry assays performed during a clinical trial of HIV antiretroviral pre-exposure prophylaxis. The aspartate aminotransferase/alanine aminotransferase, creatinine and phosphorus results from 10 clinically-healthy participants at the screening visit were used. In the event the CRRs did not pass the verification, new CRRs had to be calculated based on 40 clinically-healthy participants.Results: Within a few weeks, the study sites accomplished verification of the CRRs without additional costs. The aspartate aminotransferase reference ranges for the Bondo, Kenya site and the alanine aminotransferase reference ranges for the Pretoria, South Africa site required adjustment. The phosphorus CRR passed verification and the creatinine CRR required adjustment at every site. The newly-established CRR intervals were narrower than the CRRs used previously at these study sites due to decreases in the upper limits of the reference ranges. As a result, more toxicities were detected.Conclusion: To ensure the safety of clinical trial participants, verification of CRRs should be standard practice in clinical trials conducted in settings where the CRR has not been validated for the local population. This verification method is simple, inexpensive, and can be performed by any medical laboratory.

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

    Science.gov (United States)

    Magadi, Monica A

    2013-06-01

    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.

  8. A prospective ascertainment of cancer incidence in sub-Saharan Africa: The case of Kaposi sarcoma.

    Science.gov (United States)

    Semeere, Aggrey; Wenger, Megan; Busakhala, Naftali; Buziba, Nathan; Bwana, Mwebesa; Muyindike, Winnie; Amerson, Erin; Maurer, Toby; McCalmont, Timothy; LeBoit, Philip; Musick, Beverly; Yiannoutsos, Constantin; Lukande, Robert; Castelnuovo, Barbara; Laker-Oketta, Miriam; Kambugu, Andrew; Glidden, David; Wools-Kaloustian, Kara; Martin, Jeffrey

    2016-05-01

    In resource-limited areas, such as sub-Saharan Africa, problems in accurate cancer case ascertainment and enumeration of the at-risk population make it difficult to estimate cancer incidence. We took advantage of a large well-enumerated healthcare system to estimate the incidence of Kaposi sarcoma (KS), a cancer which has become prominent in the HIV era and whose incidence may be changing with the rollout of antiretroviral therapy (ART). To achieve this, we evaluated HIV-infected adults receiving care between 2007 and 2012 at any of three medical centers in Kenya and Uganda that participate in the East Africa International Epidemiologic Databases to Evaluate AIDS (IeDEA) Consortium. Through IeDEA, clinicians received training in KS recognition and biopsy equipment. We found that the overall prevalence of KS among 102,945 HIV-infected adults upon clinic enrollment was 1.4%; it declined over time at the largest site. Among 140,552 patients followed for 319,632 person-years, the age-standardized incidence rate was 334/100,000 person-years (95% CI: 314-354/100,000 person-years). Incidence decreased over time and was lower in women, persons on ART, and those with higher CD4 counts. The incidence rate among patients on ART with a CD4 count >350 cells/mm(3) was 32/100,000 person-years (95% CI: 14-70/100,000 person-years). Despite reductions over time coincident with the expansion of ART, KS incidence among HIV-infected adults in East Africa equals or exceeds the most common cancers in resource-replete settings. In resource-limited settings, strategic efforts to improve cancer diagnosis in combination with already well-enumerated at-risk denominators can make healthcare systems attractive platforms for estimating cancer incidence.

  9. Urban Intensification and Expansion in Sub-Saharan Africa: Impacts on Urban Agriculture and Food Security

    Science.gov (United States)

    Uzokwe, V. N. E. N.; Muchelo, R. O.; Odeh, I. A.

    2015-12-01

    In Sub-Saharan Africa (SSA), urban intensification and expansion are increasing at alarming rates due to rapid population growth and rural-to-urban migration. This has led to the premise that the proportion of SSA urban residents most vulnerable to food insecurity is the highest in the world. Using a focused survey and multi-temporal (decadal) land use/cover classification of Landsat images, we explored the effect of urban intensification and expansion on urban agriculture and food security, focusing on a megacity and a regional center in Uganda: Kampala and Mbarara, respectively. We found that food insecurity arose due to a number of reasons, among which are: i) expansion and intensification of of urban settlements into previously productive agricultural lands in urban and peri-urban areas; ii) loss of predominantly young (rural agricultural) adult labor force to urban centers, leading to decline in rural food production; iii) lack of proper urban planning incorporating green and agricultural development leading to low productive market garden systems. We discussed these outcomes in light of existing studies which estimated that urban agriculture alone supports over 800 million people globally and accounts for 15-20% of world food supply. In spite of this relatively low contribution by urban/peri-urban agriculture, it probably accounts for higher proportion of food supply to urban poor in SSA and thus are most vulnerable to the loss of urban and peri-urban agricultural land. Further recommendations require policy makers and urban planners to team up to design a suitable framework for sustainable urban planning and development.

  10. Developing Agricultural Markets in Sub-Saharan Africa

    DEFF Research Database (Denmark)

    Jones, Edward Samuel; Gibbon, Peter

    2011-01-01

    This article investigates the process of development in a traditional African export market, focusing on a contract farming scheme for organic cocoa in rural Uganda. Based on a repeated household survey, we measure the impact of the scheme on the income of participants and the economic mechanisms...... behind these effects. We find substantial benefits from the scheme, driven primarily by the establishment of credible incentives for farmers to adopt technologies which improve cocoa quality. There is also evidence of broader trends of market deepening and increased productivity, probably due to positive...

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

    Directory of Open Access Journals (Sweden)

    Perel Pablo

    2010-02-01

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

  12. The effect of migration on family structures in sub-Saharan Africa.

    Science.gov (United States)

    Okoth-ogendo, H W

    1989-06-01

    This paper assesses the effect of migration or family structures in sub-Saharan Africa, especially the effect of emigration on the reproduction, production, and social stability of the family in areas of origin in the predominantly agrarian communities of East and Southern Africa. Migration in precolonial Africa usually occurred for 1 of the following reasons: 1) the search by communities for new habitats and opportunities; 2) as a community response to droughts, floods, environmental degradation, and similar disasters; and 3) as a result of internecine wars, civil strife, and general hostilities. Thus, because of the collective nature of early migrations, the family unit maintained a much greater degree of social cohesion. The effects of the rise of the modern state in Africa on migration include 1) spatial limits of collective migration were frozen, 2) the colonial boundaries did not always correspond to cultural divisions, 3) both migration within colonial boundaries and individual migration became dominant, and 4) cyclical migration began. The end of colonialism resulted in 1) difficulties in creating strong and internally coherent nation states because of the uncertainty of national borders and 2) more cyclical migrants. The effects of migration on reproduction in the family during the colonial period include 17 extremely low fertility rates, 2) widespread domestic instability, and 3) exacerbation of moral decadence. Contemporary patterns of emigration have been far less disruptive, due in part to increased personal mobility and migration of the complete reproductive unit. The effects of migration on production include 1) depletion of labor for production; 2) women had to assume production functions, together with all their other responsibilities; and 3) very little cash or goods were available for remittance to areas of origin. Production and productivity among rural African families will continue to suffer as long as plantations, mines, and urban centers

  13. Attributing Climate Conditions for Stable Malaria Transmission to Human Activity in sub-Saharan Africa

    Science.gov (United States)

    Sheldrake, L.; Mitchell, D.; Allen, M. R.

    2015-12-01

    Temperature and precipitation limit areas of stable malaria transmission, but the effects of climate change on the disease remain controversial. Previously, studies have not separated the influence of anthropogenic climate change and natural variability, despite being an essential step in the attribution of climate change impacts. Ensembles of 2900 simulations of regional climate in sub-Saharan Africa for the year 2013, one representing realistic conditions and the other how climate might have been in the absence of human influence, were used to force a P.falciparium climate suitability model developed by the Mapping Malaria Risk in Africa project. Strongest signals were detected in areas of unstable transmission, indicating their heightened sensitivity to climatic factors. Evidently, impacts of human-induced climate change were unevenly distributed: the probability of conditions being suitable for stable malaria transmission were substantially reduced (increased) in the Sahel (Greater Horn of Africa (GHOA), particularly in the Ethiopian and Kenyan highlands). The length of the transmission season was correspondingly shortened in the Sahel and extended in the GHOA, by 1 to 2 months, including in Kericho (Kenya), where the role of climate change in driving recent malaria occurrence is hotly contested. Human-induced warming was primarily responsible for positive anomalies in the GHOA, while reduced rainfall caused negative anomalies in the Sahel. The latter was associated with anthropogenic impacts on the West African Monsoon, but uncertainty in the RCM's ability to reproduce precipitation trends in the region weakens confidence in the result. That said, outputs correspond well with broad-scale changes in observed endemicity, implying a potentially important contribution of anthropogenic climate change to the malaria burden during the past century. Results support the health-framing of climate risk and help indicate hotspots of climate vulnerability, providing

  14. Y-chromosome and mtDNA genetics reveal significant contrasts in affinities of modern Middle Eastern populations with European and African populations.

    Directory of Open Access Journals (Sweden)

    Danielle A Badro

    Full Text Available The Middle East was a funnel of human expansion out of Africa, a staging area for the Neolithic Agricultural Revolution, and the home to some of the earliest world empires. Post LGM expansions into the region and subsequent population movements created a striking genetic mosaic with distinct sex-based genetic differentiation. While prior studies have examined the mtDNA and Y-chromosome contrast in focal populations in the Middle East, none have undertaken a broad-spectrum survey including North and sub-Saharan Africa, Europe, and Middle Eastern populations. In this study 5,174 mtDNA and 4,658 Y-chromosome samples were investigated using PCA, MDS, mean-linkage clustering, AMOVA, and Fisher exact tests of F(ST's, R(ST's, and haplogroup frequencies. Geographic differentiation in affinities of Middle Eastern populations with Africa and Europe showed distinct contrasts between mtDNA and Y-chromosome data. Specifically, Lebanon's mtDNA shows a very strong association to Europe, while Yemen shows very strong affinity with Egypt and North and East Africa. Previous Y-chromosome results showed a Levantine coastal-inland contrast marked by J1 and J2, and a very strong North African component was evident throughout the Middle East. Neither of these patterns were observed in the mtDNA. While J2 has penetrated into Europe, the pattern of Y-chromosome diversity in Lebanon does not show the widespread affinities with Europe indicated by the mtDNA data. Lastly, while each population shows evidence of connections with expansions that now define the Middle East, Africa, and Europe, many of the populations in the Middle East show distinctive mtDNA and Y-haplogroup characteristics that indicate long standing settlement with relatively little impact from and movement into other populations.

  15. Youth’s occupation and entrepreneurial intention influenced by parents’ occupations: A global study focused on Sub-Saharan Africa

    DEFF Research Database (Denmark)

    Cheraghi, Maryam; Schøtt, Thomas; Kew, Jaqueline

    whether to become an entrepreneur? Method – A survey of the youth has been conducted in Sub-Saharan Africa, as part of the Global Entrepreneurship Monitor Survey during 2012/13. The survey was conducted in ten countries, which fairly represent the region. Interviews were conducted with a random sample......Purpose – The purpose of the paper is to understand whether the vocational choices among youth in Sub-Saharan Africa i.e. to be an entrepreneur or pursue other occupations are affected by their parents’ occupation. Specifically, are parents’ occupations affecting young persons’ vocational intention...... to Sub-Saharan Africa....

  16. Families and educational systems in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Miquel Reynés Ramón

    2012-10-01

    Full Text Available Studies and analysis of African educational systems’ performance do not pay much attention to the role of families; to the value they give to school and to how this may affect their decisions. By contrast, there are numerous researches focused on the most subjective elements of the relation between families and school: the attitudes, meanings and representations families, separately or as members of a social class or ethnic group, have of school. In this paper we will give five examples, drawn on sociological and anthropological studies, of different schooling practices and family representations of school. These are examples situated in different contexts and geographical areas that will allow us to appreciate the level of heterogeneity of family-school relationships in Africa and that may contribute to make us think otherwise the evolution of these educational systems.

  17. Artesunate Plus Amodiaquine (AS+AQ) Versus Artemether -Lumefantrine (AL) for the Treatment of Uncomplicated Plasmodium Falciparum Malaria in Sub-Saharan Africa-A Meta-Analysis.

    Science.gov (United States)

    Bello, Shaibu O; Chika, Aminu; Abdulgafar, Jimoh O

    2010-01-01

    The purpose of this study is to summarize the available data on the efficacy of Artesunate plus Amodiaquine (AS+AQ) versus Artemether -Lumefantrine (AL) for the treatment of uncomplicated Plasmodium falciparum malaria in sub-Saharan Africa using uncorrected parasitaemia as a clinically relevant endpoint. Studies and conference abstracts identified through Pubmed, Medline, Embase, Ansinet, AJOL, Bioline, Cochrane Infectious Diseases Group trials register, The Cochrane Controlled Trials Register, Science Citation Index, Lilacs, African Index Medicus, Clusty, Google, Yahoo and Microsoft search engines. Randomized controlled clinical trials comparing Artesunate-Amodiaquine versus Artemether-Lumefantrine, in Sub-Saharan Africa from January 2004 to June 2009, and which had at least 30 patients per study arm. The authors independently applied the inclusion criteria, assessed methodological quality and extracted data into a predesigned form. The outcome of interest was uncorrected day 28 parasitological failure. Data were then checked for agreement and double entered into RevMan version 5 for further analyses. Fifteen trials (4265 participants) met the inclusion criteria. Day 28 parasitological failure was lower for AL (286 of 2201 participants or 13.0 % failures) when compared with AS+AQ (446 of 2424 participants or 18.4% failures). The relative risk of parasitological failure with AS+AQ was higher when compared with AL (RR 1.65, 95% CI, 1.18-2.32). There were significant heterogeneity and inconsistencies in the studies. AL appears more effective at avoiding parasitological failure at days 28 than AS+AQ.

  18. Evidence of an overweight/obesity transition among school-aged children and youth in Sub-Saharan Africa: a systematic review.

    Directory of Open Access Journals (Sweden)

    Stella K Muthuri

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

  19. Quantitative urban classification for malaria epidemiology in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Slutsker Laurence

    2008-02-01

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

  20. The Vulnerability of Rice Value Chains in Sub-Saharan Africa: A Review

    Directory of Open Access Journals (Sweden)

    Fanen Terdoo

    2016-09-01

    Full Text Available Rice is one of the most important food crops in sub-Saharan Africa. Climate change, variability, and economic globalization threatens to disrupt rice value chains across the subcontinent, undermining their important role in economic development, food security, and poverty reduction. This paper maps existing research on the vulnerability of rice value chains, synthesizes the evidence and the risks posed by climate change and economic globalization, and discusses agriculture and rural development policies and their relevance for the vulnerability of rice value chains in sub-Saharan Africa. Important avenues for future research are identified. These include the impacts of multiple, simultaneous pressures on rice value chains, the effects of climate change and variability on parts of the value chain other than production, and the forms and extent to which different development policies hinder or enhance the resilience of rice value chains in the face of climatic and other pressures.

  1. Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians

    Directory of Open Access Journals (Sweden)

    Nir Eyal

    2016-03-01

    Full Text Available Responding to critical shortages of physicians, most sub-Saharan countries have scaled up training of nonphysician clinicians (NPCs, resulting in a gradual but decisive shift to NPCs as the cornerstone of healthcare delivery. This development should unfold in parallel with strategic rethinking about the role of physicians and with innovations in physician education and in-service training. In important ways, a growing number of NPCs only renders physicians more necessary – for example, as specialized healthcare providers and as leaders, managers, mentors, and public health administrators. Physicians in sub-Saharan Africa ought to be trained in all of these capacities. This evolution in the role of physicians may also help address known challenges to the successful integration of NPCs in the health system.

  2. Remittances and the Dutch Disease in Sub-Saharan Africa: A Dynamic Panel Approach

    Directory of Open Access Journals (Sweden)

    Emmanuel Owusu-Sekyere

    2014-09-01

    Full Text Available This paper investigates the effect of remittance inflows on real exchange rates in sub-Saharan Africa (SSA using annual data from 1980 to 2008 for 34 countries, the method of moments estimator developed by Arellano and Bover (1995 and the feasible generalized least squares estimator developed by Parks (1967 and Kmenta (1986. We find that when cross-sectional dependence and individual effects are controlled for, remittances to sub-Saharan Africa as a whole increase the underlying real exchange rates of recipient countries. However, this real exchange rate appreciation is mitigated by monetary policy interventions and the direction of fiscal expenditures towards tradable goods. Thus, the real exchange rate appreciation does not lead to the loss of export competitiveness or a worsening of the trade deficit in the countries in the panel.

  3. Estimating the impact of birth control on fertility rate in sub-Saharan Africa.

    Science.gov (United States)

    Ijaiya, Gafar T; Raheem, Usman A; Olatinwo, Abdulwaheed O; Ijaiya, Munir-Deen A; Ijaiya, Mukaila A

    2009-12-01

    Using a cross-country data drawn from 40 countries and a multiple regression analysis, this paper examines the impact of birth control devices on the rate of fertility in sub-Saharan Africa. Our a-priori expectations are that the more women used birth control devices, the less will be the fertility rate in sub-Saharan Africa. The result obtained from the study indicates that except for withdrawal method that fall contrary to our expectation other variables (methods) like the use of pills, injection, intra uterine device (IUD), condom/diaphragm and cervical cap, female sterilization and periodic abstinence/rhythm fulfilled our a-priori expectations. These results notwithstanding, the paper suggests measures, such as the need for massive enlightenment campaign on the benefit of these birth control devices, the frequent checking of the potency of the devices and good governance in the delivery of the devices

  4. Financial Reforms and Determinants of FDI: Evidence from Landlocked Countries in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Husam Rjoub

    2017-01-01

    Full Text Available The recognition of Foreign Direct Investment (FDI as a source of funding to foster economic development in both developed and developing countries has been in ascendancy. The prime purpose of this study is to empirically investigate the determinants of FDI for the “landlocked countries” in Sub-Saharan Africa over the period 1995–2013. By employing panel data analysis, the result of the study revealed that domestic investment, trade (openness, human capital, political constraint, natural resource endowment and the market size (with the GDP growth as proxy as having positive impact on determining FDI flow into the sample countries with only the countries’ tax policies seen otherwise. Our study not only contributes to existing literature on FDI determinants by investigating landlocked countries of Sub-Saharan Africa (SSA for the first time but also includes natural resources that the landlocked countries are endowed with, tax policies and political constraints in such countries for the stipulated period.

  5. Entrepreneurship as a source of economic, political, and social improvement in Sub-Saharan Africa

    OpenAIRE

    Rabarijaona, Eric G.

    2015-01-01

    Approved for public release; distribution is unlimited A three-country case study was used to analyze the economic, political, and social impacts of entrepreneurship, and the development of entrepreneurship in Sub-Saharan Africa was studied through the lens of five entrepreneurial factors (freedom, labor, infrastructure, governance, and business environment). An increase of foreign direct investments, growing economic freedom for citizens, and a higher gross domestic product per capita wer...

  6. [Child sexual abuse and sexually transmitted infections in sub-saharan Africa].

    Science.gov (United States)

    Pitche, P

    2005-11-01

    Recently there has been increasing public concern regarding escalating child sexual abuse (CSA) in the sub-Saharan Africa. Medical consequences of child sexual abuse (CSA) include sexually transmitted infection (STI) and human immune virus (HIV) infection. The purpose of the study was to review literature on CSA and associated STI/HIV in the sub-Saharan Africa. The study covered the 23-year period from 1980 to 2003. The mean age of the child victims was 8 years. The incidence of penetrative sex in the studies ranged from 70 to 97%. Physical signs of CSA included genital or anal injuries, perineal trauma, and vesico-vaginal or recto-vaginal fistula. The incidence of STD varied according to whether the study was retrospective or prospective. Ten percent to 67% of children with STD had been sexually abused while 15 to 30% of sexual abuse incidents were associated with STD. The prevalence of HIV ranged from 3% in Togo to 37.5% in Cameroon. Most alleged child abusers were adult males known by the child, i.e., family members (30-60%), instructors or teachers, household personnel or neighbours. Some acts were motivated by traditional practices such as early, forced marriage and beliefs such as presumed benefits of sex with virgin children (cure for STI/HIV/STD, magic powers or wealth). This study shows that CSA is widespread throughout sub-Saharan Africa. Most problem involving CSA in sub-Saharan Afica have not been documented. Knowledge about the extent and special aspects of CSA in Africa can be useful for implementation of suitable management measures.

  7. Health and wealth in Uzbekistan and sub-Saharan Africa in comparative perspective.

    Science.gov (United States)

    Hohmann, Sophie; Garenne, Michel

    2010-12-01

    The study investigates the magnitude of differences in child and adult mortality by wealth in Uzbekistan, a former soviet country of Central Asia, and compares it with similar indicators from sub-Saharan Africa. Data were derived from Demographic and Health Surveys. An "Absolute Wealth Index" was built from data on goods owned by households and quality of housing, and scaled from 0 to 12. Wealth was distributed evenly in Uzbekistan, with a symmetric distribution around a mean of 5.5 modern goods. In sub-Saharan Africa, on the contrary, the wealth distribution had a lower mean (2.5) and was highly skewed towards the left, revealing a high proportion of very poor people. Adult and child mortality levels were lower in Uzbekistan. Despite these major differences, the relationships between mortality indicators and the wealth index were similar in the two cases. The magnitude of mortality differentials by wealth was of the same order in both cases, with gradients ranging from 2.5 to 1 for child mortality and 1.5 to 1 for adult mortality (poorest versus richest). However, mortality levels remained lower in Uzbekistan than in sub-Saharan Africa at the same level of wealth for both children and adults. A similar relationship was found between nutritional status and wealth index in both cases. On the contrary, there were no differences by wealth in use of health services and level of education in Uzbekistan, whereas wealth gradients were steep for the same variables in sub-Saharan Africa. The study suggests that mortality differentials were primarily due to nutritional status, and not to access and use of health services or to education. The discussion focuses on health and social policies during the colonial and post-colonial period that have produced these patterns.

  8. Is globalisation good for Sub-Saharan Africa? Threats and Opportunities

    OpenAIRE

    Njau Ntuli, Anthony

    2004-01-01

    This paper reviews the effects globalisation has on the economic prosperity of sub-Saharan Africa, on a global information economy context, and in particular, the threats that globalisation has brought about as well as, the opportunities that are likely to emerge because of it. The fundamental shift in the nature of the global economy backed up by viable strategies, acting within the realities of globalisation and information economy open-up new windows for latecomers, and enables them conver...

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

    OpenAIRE

    OLAKULEHIN, Felix Kayode

    2010-01-01

    Educational provision in developing sub-Saharan Africa states has been severely hindered by the hydra-headed problems of access, cost and quality. Amidst these challenges is the pledge of regional and national education policymakers and development planners to ensure that there is maximum access equitable and qualitative education for all (EFA) in Africa. There is also a burning need for improved literacy levels and functional education, in order to overcome the development deficits that are ...

  10. Moving methodologies. Learning about integrated soil fertility management in sub-Saharan Africa

    OpenAIRE

    Defoer, T.

    2000-01-01

    Soil fertility management in sub-Saharan Africa is complex, diverse and dynamic. Farmers' investments are determined by a wide variety of factors, including bio-physical characteristics of the environment, access to resources and the institutional, and socio-economic context of farming and livelihood making. Within this context, defining soil fertility problems in general terms is not meaningful and proposing a limited number of standard interventions, aimed at the 'average' farmer is of limi...

  11. Cushioning women against gender inequality through promoting indigenous chicken production in sub Saharan Africa

    OpenAIRE

    Never Assan

    2015-01-01

    Poultry sub sector is a privileged entry point for promoting gender equality. Gender inequalities in poultry and livestock activities are now more and more acknowledged by governments, scientists, and farmers in sub Saharan Africa. This is on the background that gender inequality has translated into loss of opportunities or potential gains on agricultural production and food security. This has been exacerbated by the fact that the progress in empowering women in agriculture and reducing gende...

  12. Epilepsy and tropical parasitic infections in Sub-Saharan Africa: A review.

    Science.gov (United States)

    Mazigo, Humphrey D; Morona, Domenica; Kweka, Eliningaya J; Waihenya, Rebecca; Mnyone, Ladslaus L; Heukelbach, Jorg

    2013-04-01

    Several reports have suggested that the high prevalence of epilepsy in sub-Saharan Africa is associated with the high prevalence of parasitic infections affecting the central nervous system. Though epidemiological evidence suggests an association between parasitic infections and epilepsy, the biological causal relationship has not been fully demonstrated for many of these infections. The objective of this paper is to review the available epidemiological evidence on the links between parasitic infections and epilepsy, the pathogenesis and the current gap of knowledge indicating the areas requiring further research. Data for this review were identified and collected using manual and electronic search strategies of published and unpublished sources. In Sub-Saharan Africa, the epidemiology of epilepsy remains unclear and given the differing study designs, the results of available epidemiological studies are difficult to interpret and compare. Evidence from surveys reported a median prevalence of 1.5%. Co-infection of parasitic infections and epilepsy in sub-Saharan Africa are common, particularly in areas characterized by poor hygiene standards. There is an epidemiological link on the association between epilepsy and various parasitic infections. However, the biological causal relationship requires further investigation in adequately designed studies. In conclusion, although several epidemiological and case control studies indicate a relationship between parasitic agents and epilepsy in sub-Saharan Africa, there is a considerable gap of knowledge on the cause and magnitude of the association. Thus, there is an urgent need for systematic epidemiological studies to understand the burden of epilepsy in areas endemic due to preventable parasitic infections, to prove a causal relationship, and to understand the impact of controlling these parasitic diseases on reduction of the burden of epilepsy.

  13. Recent developments in marketing and pricing systems for agricultural export commodities in sub-Saharan Africa

    OpenAIRE

    Varangis, Panos; Takamasa AKIYAMA; Thigpen, Elton

    1990-01-01

    This paper documents the difficulties various countries in sub - Saharan Africa have had with marketing and pricing systems, and shows how these systems have been caused or exacerbated by government controls. It documents the steps several countries have taken toward relaxing those controls and allowing more participation by private enterprise. Some general conclusions are drawn about the kinds of changes in parastatal marketing organizations that most effectively improve their ability to mar...

  14. Does quality affect maize prices in sub-Saharan Africa? Evidence from Benin

    OpenAIRE

    Kadjo, Didier; Ricker-Gilbert, Jacob; Alexander, Corinne

    2015-01-01

    This paper uses household survey data from Benin to evaluate how grain quality affects maize prices in rural markets of sub-Saharan Africa. Stated preference methods reveal that a 10% increase in insect damage results in a 9% maize price discount. However, revealed preference results from farmers involved in past market transactions indicate that this discount is only 3 %. Evidence also suggests that this discount is larger in periods of maize abundance than in the lean periods when maize is ...

  15. Trade Liberalization, Exchange Rate Changes, and Tax Revenue in Sub-Saharan Africa

    OpenAIRE

    Terence D.Agbeyegbe; Janet G. Stotsky; Asegedech WoldeMariam

    2004-01-01

    Empirical evidence on the relationship between trade liberalization, exchange rates, and tax revenue is mixed. This paper examines these linkages anew. Using a panel of 22 countries in Sub-Saharan Africa, over 1980–1996, we perform Generalized Method of Moment regressions to test this relationship. We find evidence that the relationship between trade liberalization and tax revenue is sensitive to the measure used to proxy trade liberalization, but that, in general, trade liberalization is not...

  16. PROBLEMS AND PROSPECTS OF THE DEVELOPMENT OF DIGITAL ECONOMY IN SUB-SAHARAN AFRICA

    OpenAIRE

    Traore B

    2016-01-01

    This article deals with the problems and prospects of development of the digital economy of Sub-Saharan Africa. The work will examine the relationship between the development of new information and communication technologies (ICT) and the formation of civil society in the region. The stages of implementation of Internet technologies will be explored. The development in different countries according to national circumstances, understand the basic functions of the new ICT in the development of ...

  17. Communication rehabilitation in sub-Saharan Africa: A workforce profile of speech and language therapists

    OpenAIRE

    Karen Wylie; Lindy McAllister; Bronwyn Davidson; Julie Marshall

    2016-01-01

    Background: There is an urgent global need to strengthen rehabilitation services for people with disabilities. In sub-Saharan Africa, rehabilitation services for people with communication disabilities continue to be underdeveloped. A first step in strengthening services for people with a communication disabilities is to understand the composition and conditions of the current workforce.Objectives: This research describes a sample of the speech and language therapists (SLTs) working in SSA (ex...

  18. Seasonality and Access to Education: the case of primary education in sub-Saharan Africa

    OpenAIRE

    2010-01-01

    This paper draws together research on seasonality, child labour and education in the context of primary education in sub-Saharan Africa. It describes how income poverty and demand for labour can fluctuate within and between years, affecting participation and progression through school systems. It highlights how analysis of the private and public costs of education frequently ignore the significance of seasonal patterns related to the agricultural cycle and migration. It argues that education ...

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

    Directory of Open Access Journals (Sweden)

    Hernández Valentín

    2009-12-01

    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.

  20. Women and social security in Latin America, the Caribbean and sub- saharan Africa.

    OpenAIRE

    Folbre N

    1993-01-01

    One of a series of reports examining issues related to equality for women in employment. Provides an overview of the treatment of women in social security programmes in Latin America, the Caribbean, and Sub- Saharan Africa. Calls attention to four separate aspects of gender bias. Also traces the evolution of social security programmes and highlights specific aspects of gender bias in current provisions. Makes recommendations for specific policy changes. Bibliography and statistical tables.

  1. Revisiting Modernization Theory in Sub-Saharan Africa: The Relationship Between Industrialization and Democratization

    Science.gov (United States)

    2012-06-01

    missionaries, civil and international warfare, corruption, clientelism, patrimony, ethnicity, culture or tribalism on the shape and form of Sub-Saharan...transform beyond the traditional society. John Dube, in early Twentieth Century South Africa, during the rise of Zulu nationalism, noted such...the World Economy. (London and New York: W.W. Norton & Company, 2011). 12 Nicholas Cope. "The Zulu Petit Bourgeoisie and Zulu Nationalism in the

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

    Directory of Open Access Journals (Sweden)

    Venkatesan Meera

    2011-05-01

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

  3. Women's rights and women's health during HIV/AIDS epidemics: the experience of women in sub-Saharan Africa.

    Science.gov (United States)

    Dugassa, Begna F

    2009-08-01

    Twenty-five years have passed since HIV/AIDS was recognized as a major public health problem. Although billions of dollars are spent in research and development, we still have no medical cure or vaccination. In the early days of the epidemic, public health slogans suggested that HIV/AIDS does not discriminate. Now it is becoming clear that HIV/AIDS spreads most rapidly among poor, marginalized, women, colonized, and disempowered groups of people more than others. The HIV/AIDS epidemic is exacerbated by the social, economic, political, and cultural conditions of societies such as gender, racial, class, and other forms of inequalities. Sub-Saharan African countries are severely hit by HIV/AIDS. For these countries the pandemic of HIV/AIDS demands the need to travel extra miles. My objective in this article is to promote the need to go beyond the biomedical model of "technical fixes" and the traditional public health education tools, and come up with innovative ideas and strategic thinking to contain the epidemic. In this article, I argue that containing the HIV/AIDS epidemic and improving family and community health requires giving appropriate attention to the social illnesses that are responsible for exacerbating biological disorders.

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

    Science.gov (United States)

    Rispel, Laetitia C; de Sousa, César A D Palha; Molomo, Boitumelo G

    2009-08-01

    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.

  5. Quality of clinical trials for selected priority mental and neurological disorders in sub-Saharan Africa: a systematic review

    Directory of Open Access Journals (Sweden)

    Mulugeta A

    2016-12-01

    Full Text Available Anwar Mulugeta,1 Girmay Medhin,2 Getnet Yimer,1 Rahimush Jemal,3 Abebaw Fekadu,4,5 1Department of Pharmacology, School of Medicine, College of Health Sciences, Addis Ababa University, 2Aklilu Lemma Institute of Pathobiology, Addis Ababa University, 3Department of Pharmacy, Tikur Anbesa Hospital, 4Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 5Department of Psychological Medicine, Centre for Affective Disorders, Institute of Psychiatry, King’s College London, London, UK Background: There is a developing consensus on the effectiveness of various interventions for mental disorders in low- and middle-income countries, and it has been proposed that the main task is to scale up these interventions. In this context, we aimed to review the quality and extent of intervention trials for selected priority mental and neurological disorders in sub-Saharan Africa.Methods: Medline and African Journals Online databases were used for searching relevant articles. Both randomized and nonrandomized clinical trials for the treatment of schizophrenia, depression, maternal depression, bipolar disorder, and epilepsy/seizure disorders that involve pharmacotherapy, psychotherapy, and physical therapy were included. An extensive list of search terms that identified locations, disorders, interventions, and study types were employed. The qualities of the trials were appraised using the single-component quality assessment of the consolidated standards of reporting trials (CONSORT statement and the Jadad scale.Results: From 1,136 studies identified, only 34 trials that fulfilled inclusion criteria were used for quality analysis. Most studies were clinical trials of treatments for epilepsy and were conducted after 2006. In terms of region, the majority of studies were conducted in South Africa (22 of the 34 studies. Approximately half of the trials (53% were conducted in single center and the majority

  6. AgMIP: New Results from Sub-Saharan Africa and South Asia Regional Integrated Assessments

    Science.gov (United States)

    Rosenzweig, C.

    2014-12-01

    AgMIP conducted the first set of comprehensive regional integrated assessments of climate change impacts on smallholder farmers in Sub-Saharan Africa and South Asia led by researchers from the regions themselves. The project developed new methods integrating climate, crop, livestock and economic models to conduct climate change impact assessments that characterize impacts on smallholder groups. AgMIP projections of climate change impacts on agriculture are more realistic than previous assessments because they take agricultural development into account. Using the best available data and models, the assessments directly evaluated yield, income, and poverty outcomes including the effects of adaptation packages and development pathways. Results show that even with agricultural development, climate change generally will exert negative pressure on yields of smallholder farmers in Sub-Saharan Africa and South Asia. Without adaptation, climate change leads to increased poverty in some locations in Sub-Saharan Africa and South Asia compared to a future in which climate change does not occur. Adaptation can significantly improve smallholder farmer responses to climate change. AgMIP expert teams identified improved varieties, sowing practices, fertilizer application, and irrigation applications as prioritized adaptation strategies. These targeted adaptation packages were able to overcome a portion of detrimental impacts but could not compensate completely in many locations. Even in cases where average impact is near zero, vulnerability (i.e., those at risk of loss) can be substantial even when mean impacts are positive.

  7. The potential for political leadership in HIV/AIDS communication campaigns in Sub-Saharan Africa

    Science.gov (United States)

    Karan, Abraar; Hartford, Emily; Coates, Thomas J.

    2017-01-01

    ABSTRACT Background: The HIV/AIDS epidemic has become a point of important political concern for governments especially in Sub-Saharan Africa. Clinical and public health interventions to curb the epidemic can be greatly enhanced with the strategic support of political leaders. Objective: We analyzed the role of national political leadership in large-scale HIV/AIDS communications campaigns in 14 countries in Sub-Saharan Africa. Methods: We primarily reviewed grey and white literature published from 2005–2014. We further triangulated data from in-person and phone interviews with key public health figures. Results: A number of themes emerged supporting political leaders’ efforts toward HIV/AIDS program improvement, including direct involvement of public officials in campaign spearheading, the acknowledgment of personal relationship to the HIV epidemic, and public testing and disclosure of HIV status. Areas for future improvement were also identified, including the need for more directed messaging, increased transparency both nationally and internationally and the reduction of stigmatizing messaging from leaders. Conclusions: The political system has a large role to play within the healthcare system, particularly for HIV/AIDS. This partnership between politics and the health must continue to strengthen and be leveraged to effect major change in behaviors and attitudes across Sub-Saharan Africa. PMID:28156196

  8. Three-Dimension and Its Substantive Characteristics of African States’ Development---Taking Sub-Saharan Africa as the Research Core%非洲国家发展特征的三个维度及其本质--以撒哈拉以南非洲国家为考察中心

    Institute of Scientific and Technical Information of China (English)

    王涛; 张嘉宸

    2016-01-01

    In the development process of Sub‐Saharan African states ,the interaction between social traditions characteristics and the outside world impact leads the nation‐state building failed which followed the western models to construct .African states are in “pre‐nation‐state”stage .These states have juridical sovereignty but lack of empirical sovereignty .The pre‐nation‐state is the result of the mixing between pre‐colonial African institutions and the non‐state organizations in the process of the nation‐state building . T his type of states are characterized by pre‐modernity ,so‐called“neopatrimonialism” .State authority can not be constructed and public recognition moved dow n to families ,clans ,tribes ,ethnic groups ,local com‐munities ,etc .These states also keep the modern nation‐state’s shell .In Africa ,“regional international community”also emerges by the African regional integration .However ,both are illusion based on the ju‐ridical sovereignty .While the competitive pressure in African interstate relations dispels ,African states themselves also are crumbled by non‐state organizations .%在撒哈拉以南非洲国家发展进程中,非洲社会传统特质与外部世界影响的交互作用,导致了按照西式民族国家模式构建的非洲国家在发展进程中受挫。它们大多处于“前民族国家”发展阶段。这些“前民族国家”虽然具备法理主权,但却缺乏经验主权。它们是在构建“民族国家”过程中,将早期非洲的国家机构与非国家组织等融为一体所形成的产物。这些国家具有一种以“新家长制”为特点的前现代性特征,使国家权威及认同下移至家族、氏族、部落、宗教群体、地域性社群等。同时,这些国家还维持着现代民族国家的外壳,以及由非洲地区一体化所促成的“地区国际社会”。不过,现代国家与后现代国际体系都只是法理主权架

  9. The HIV-poverty thesis re-examined: poverty, wealth or inequality as a social determinant of HIV infection in sub-Saharan Africa?

    Science.gov (United States)

    Fox, Ashley M

    2012-07-01

    Although health is generally believed to improve with higher wealth, research on HIV in sub-Saharan Africa has shown otherwise. Whereas researchers and advocates have frequently advanced poverty as a social determinant that can help to explain sub-Saharan Africa's disproportionate burden of HIV infection, recent evidence from population surveys suggests that HIV infection is higher among wealthier individuals. Furthermore, wealthier countries in Africa have experienced the fastest growing epidemics. Some researchers have theorized that inequality in wealth may be more important than absolute wealth in explaining why some countries have higher rates of infection and rapidly increasing epidemics. Studies taking a longitudinal approach have further suggested a dynamic process whereby wealth initially increases risk for HIV acquisition and later becomes protective. Prior studies, conducted exclusively at either the individual or the country level, have neither attempted to disentangle the effects of absolute and relative wealth on HIV infection nor to look simultaneously at different levels of analysis within countries at different stages in their epidemics. The current study used micro-, meso- and macro-level data from Demographic and Health Surveys (DHS) across 170 regions within sixteen countries in sub-Saharan Africa to test the hypothesis that socioeconomic inequality, adjusted for absolute wealth, is associated with greater risk of HIV infection. These analyses reveal that inequality trumps wealth: living in a region with greater inequality in wealth was significantly associated with increased individual risk of HIV infection, net of absolute wealth. The findings also reveal a paradox that supports a dynamic interpretation of epidemic trends: in wealthier regions/countries, individuals with less wealth were more likely to be infected with HIV, whereas in poorer regions/countries, individuals with more wealth were more likely to be infected with HIV. These

  10. Health inequities, environmental insecurity and the attainment of the millennium development goals in sub-Saharan Africa: the case study of Zambia.

    Science.gov (United States)

    Anyangwe, Stella C E; Mtonga, Chipayeni; Chirwa, Ben

    2006-09-01

    The United Nations Millennium Development Goals (MDGs) are a series of 8 goals and 18 targets aimed at ending extreme poverty by 2015, and there are 48 quantifiable indicators for monitoring the process. Most of the MDGs are health or health-related goals. Though the MDGs might sound ambitious, it is imperative that the world, and sub-Saharan Africa in particular, wake up to the persistent and unacceptably high rates of extreme poverty that populations live in, and find lasting solutions to age-old problems. Extreme poverty is a cause and consequence of low income, food insecurity and hunger, education and gender inequities, high disease burden, environmental degradation, insecure shelter, and lack of access to safe drinking water and basic sanitation. It is also directly linked to unsound governance and inequitable distribution of public wealth. While many regions in the world will strive to attain the MDGs by 2015, most of the countries in sub-Saharan Africa, with major human development challenges associated with socio-economic disparities, will not. Zambia's MDG progress reports of 2003 and 2005 show that despite laudable political commitment and some advances made towards achieving universal primary education, gender equality, improvement of child health and management of the HIV/AIDS epidemic, it is not likely that Zambia will achieve even half of the goals. Zambia's systems have been weakened by high disease burden and excess mortality, natural and man-made environmental threats and some negative effects of globalization such as huge external debt, low world prices for commodities and the human resource "brain drain", among others. Urgent action must follow political will, and some tried and tested strategies or "quick wins" that have been proven to produce high positive impact in the short term, need to be rapidly embarked upon by Zambia and other countries in sub-Saharan Africa if they are to achieve the Millennium Development Goals.

  11. Mapping human resources for eye health in 21 countries of sub-Saharan Africa: current progress towards VISION 2020

    Science.gov (United States)

    2014-01-01

    Background Development of human resources for eye health (HReH) is a major focus of the Global Action Plan 2014 to 2019 to reduce the prevalence of avoidable visual impairment by 25% by the year 2019. The eye health workforce is thought to be much smaller in sub-Saharan Africa than in other regions of the world but data to support this for policy-making is scarce. We collected HReH and cataract surgeries data from 21 countries in sub-Sahara to estimate progress towards key suggested population-based VISION 2020 HReH indicators and cataract surgery rates (CSR) in 2011. Methods Routinely collected data on practitioner and surgery numbers in 2011 was requested from national eye care coordinators via electronic questionnaires. Telephone and e-mail discussions were used to determine data collection strategies that fit the national context and to verify reported data quality. Information was collected on six practitioner cadres: ophthalmologists, cataract surgeons, ophthalmic clinical officers, ophthalmic nurses, optometrists and ‘mid-level refractionists’ and combined with publicly available population data to calculate practitioner to population ratios and CSRs. Associations with development characteristics were conducted using Wilcoxon rank sum tests and Spearman rank correlations. Results HReH data was not easily available. A minority of countries had achieved the suggested VISION 2020 targets in 2011; five countries for ophthalmologists/cataract surgeons, four for ophthalmic nurses/clinical officers and two for CSR. All countries were below target for optometrists, even when other cadres who perform refractions as a primary duty were considered. The regional (sample) ratio for surgeons (ophthalmologists and cataract surgeons) was 2.9 per million population, 5.5 for ophthalmic clinical officers and nurses, 3.7 for optometrists and other refractionists, and 515 for CSR. A positive correlation between GDP and CSR as well as many practitioner ratios was observed

  12. Genetics of hearing loss in Africans: use of next generation sequencing is the best way forward.

    Science.gov (United States)

    Lebeko, Kamogelo; Bosch, Jason; Noubiap, Jean Jacques Nzeale; Dandara, Collet; Wonkam, Ambroise

    2015-01-01

    Hearing loss is the most common communication disorder affecting about 1-7/1000 births worldwide. The most affected areas are developing countries due to extensively poor health care systems. Environmental causes contribute to 50-70% of cases, specifically meningitis in sub-Saharan Africa. The other 30-50% is attributed to genetic factors. Nonsyndromic hearing loss is the most common form of hearing loss accounting for up to 70% of cases. The most common mode of inheritance is autosomal recessive. The most prevalent mutations associated with autosomal recessive nonsyndromic hearing loss (ARNSHL) are found within connexin genes such as GJB2, mostly in people of European and Asian origin. For example, the c.35delG mutation ofGJB2 is found in 70% of ARNSHL patients of European descent is rare in populations of other ethnicities. Other GJB2 mutations have been reported in various populations. The second most common mutations are found in the connexin gene, GJB6, also with a high prevalence in patients of European descent. To date more than 60 genes have been associated with ARNSHL. We previously showed that mutations in GJB2, GJB6 and GJA1 are not significant causes of ARNSHL inpatients from African descents, i.e. Cameroonians and South Africans In order to resolve ARNSHL amongst sub-Saharan African patients, additional genes would need to be explored. Currently at least 60 genes are thought to play a role in ARNSHL thus the current approach using Sanger sequencing would not be appropriate as it would be expensive and time consuming. Next Generation sequencing (NGS) provides the best alternative approach. In this review, we reported on the success of using NGSas observed in various populations and advocate for the use of NGS to resolve cases of ARNSHL in sub-Saharan African populations.

  13. North African populations carry the signature of admixture with Neandertals

    DEFF Research Database (Denmark)

    Sánchez-Quinto, Federico; Botigué, Laura R; Civit, Sergi

    2012-01-01

    One of the main findings derived from the analysis of the Neandertal genome was the evidence for admixture between Neandertals and non-African modern humans. An alternative scenario is that the ancestral population of non-Africans was closer to Neandertals than to Africans because of ancient popu...

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

    Directory of Open Access Journals (Sweden)

    Isabel Gentil García

    2012-09-01

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

  15. The role of technical assistance in expanding access to Xpert(®) MTB/RIF: experience in sub-Saharan Africa.

    Science.gov (United States)

    Umubyeyi, A N; Bonsu, F; Chimzizi, R; Jemal, S; Melese, M; Ruttoh, E; Mundy, C

    2016-03-21

    To improve tuberculosis (TB) diagnosis, many national TB programmes have committed to deploying Xpert(®) MTB/RIF. Implementation of this relatively new technology has suffered from a lack of comprehensive technical assistance, however, including the formulation of policies and plans to address operational issues. While providing technical assistance, we observed numerous operational challenges in the implementation and scale-up of Xpert in five sub-Saharan African countries: low coverage, poor laboratory infrastructure, limited access, poor linkages to treatment, inadequate data on outcomes, problems with specimen transport, diagnostic algorithms that are not aligned with updated World Health Organization recommendations on target patient groups and financing challenges. We recommend better country preparedness and training, laboratory information and quality systems, supply management and referral mechanisms.

  16. Urban groundwater quality in sub-Saharan Africa: current status and implications for water security and public health

    Science.gov (United States)

    Lapworth, D. J.; Nkhuwa, D. C. W.; Okotto-Okotto, J.; Pedley, S.; Stuart, M. E.; Tijani, M. N.; Wright, J.

    2017-01-01

    Groundwater resources are important sources of drinking water in Africa, and they are hugely important in sustaining urban livelihoods and supporting a diverse range of commercial and agricultural activities. Groundwater has an important role in improving health in sub-Saharan Africa (SSA). An estimated 250 million people (40% of the total) live in urban centres across SSA. SSA has experienced a rapid expansion in urban populations since the 1950s, with increased population densities as well as expanding geographical coverage. Estimates suggest that the urban population in SSA will double between 2000 and 2030. The quality status of shallow urban groundwater resources is often very poor due to inadequate waste management and source protection, and poses a significant health risk to users, while deeper borehole sources often provide an important source of good quality drinking water. Given the growth in future demand from this finite resource, as well as potential changes in future climate in this region, a detailed understanding of both water quantity and quality is required to use this resource sustainably. This paper provides a comprehensive assessment of the water quality status, both microbial and chemical, of urban groundwater in SSA across a range of hydrogeological terrains and different groundwater point types. Lower storage basement terrains, which underlie a significant proportion of urban centres in SSA, are particularly vulnerable to contamination. The relationship between mean nitrate concentration and intrinsic aquifer pollution risk is assessed for urban centres across SSA. Current knowledge gaps are identified and future research needs highlighted.

  17. The exodus of health professionals from sub-Saharan Africa: balancing human rights and societal needs in the twenty-first century.

    Science.gov (United States)

    Ogilvie, Linda; Mill, Judy E; Astle, Barbara; Fanning, Anne; Opare, Mary

    2007-06-01

    Increased international migration of health professionals is weakening healthcare systems in low-income countries, particularly those in sub-Saharan Africa. The migration of nurses, physicians and other health professionals from countries in sub-Saharan Africa poses a major threat to the achievement of health equity in this region. As nurses form the backbone of healthcare systems in many of the affected countries, it is the accelerating migration of nurses that will be most critical over the next few years. In this paper we present a comprehensive analysis of the literature and argue that, from a human rights perspective, there are competing rights in the international migration of health professionals: the right to leave one's country to seek a better life; the right to health of populations in the source and destination countries; labour rights; the right to education; and the right to non-discrimination and equality. Creative policy approaches are required to balance these rights and to ensure that the individual rights of health professionals do not compromise the societal right to health.

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

    Directory of Open Access Journals (Sweden)

    Snounou Georges

    2011-04-01

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

  19. Effect of media use on mothers' vaccination of their children in sub-Saharan Africa.

    Science.gov (United States)

    Jung, Minsoo; Lin, Leesa; Viswanath, Kasisomayajula

    2015-05-21

    While several studies have examined the crucial role that parents' vaccination behaviors play in reducing disease spread and severity among children, few have evaluated the connection between parents' media use and their decision on whether or not to vaccinate their child, specifically in relation to the BCG (Bacillus Calmetter Guerin), DPT (Diptheria, Pertussis, Tetanus) polio, and measles vaccines. Media channels are a critical source of health information for parents, which is especially true in Sub-Saharan Africa, as there is often a dearth of local healthcare providers. The aim of this paper is to investigate the role that media use plays in a mothers' choice to vaccinate their infant children in sub-Saharan Africa, specifically focusing on whether media use is associated with socioeconomic status (SES) and a mothers' vaccination of their children. Cross-sectional data from the Demographic Health Surveys of 13 sub-Saharan countries (2004-2010) were pooled. A multivariate Poisson regression of 151,209 women was used to calculate adjusted relative ratios and 95% confidence intervals for the associations among SES, media use, and immunization. Education and wealth were found to be strongly and positively associated with vaccine-uptake behaviors. The effects of media use (radio and television) were found to be associated with the relationships between SES and vaccine uptake. However, it did not reduce the impact of SES on vaccination. These findings indicate that mass media may be an important tool for future efforts to reduce the health discrepancies between children from high- and low-socioeconomic backgrounds. Going forward, immunization strategies should include communication plans that will address and mitigate potential immunization disparities among parents of different SES backgrounds.

  20. Neuromeningeal cryptococcosis in sub-Saharan Africa: Killer disease with sparse data

    Directory of Open Access Journals (Sweden)

    Komi Assogba

    2015-01-01

    Full Text Available Introduction: The extent of neuromeningeal cryptococcosis (NMC has increased since the advent of HIV/AIDS. It has non-specific clinical signs but marked by high mortality. Objective: To analyze the characteristics of the NMC in sub-Saharan Africa. Materials and Methods: We have conducted a literature reviewed on the NMC in sub-Saharan Africa from the publications available on the basis of national and international data with keywords such as "Cryptococcus, Epidemiology, Symptoms, Outcomes and Mortality" and their equivalent in French in July 2011. All publications from 1990 to 2010 with 202 references were analyzed. The following results are the means of different studied variables. Results: We selected in final 43 publications dealing with the NMC which 24 involved 17 countries in Africa. The average age was 36 years old. The average prevalence was 3.41% and the average incidence was 10.48% (range 6.90% to 12%. The most common signs were fever (75%, headaches (62.50% and impaired consciousness. Meningeal signs were present in 49% of cases. The mean CD4 count was 44.8cells/mm 3 . The India ink and latex agglutination tests were the most sensitive. The average time before the consultation and the hospital stay was almost identical to 27.71 days. The average death rate was 45.90%. Fluconazole has been the most commonly used molecule. Conclusion: The epidemiological indicators of NMC varied more depending on the region of sub-Saharan Africa. Early and effective taking care of patients to reduce diagnostic delay and heavy mortality remains the challenges.

  1. Orphans and Vulnerable Children Affected by Human Immunodeficiency Virus in Sub-Saharan Africa.

    Science.gov (United States)

    Bryant, Malcolm; Beard, Jennifer

    2016-02-01

    In Sub-Saharan Africa, 15.1 million children have been orphaned because of human immunodeficiency virus (HIV). They face significant vulnerabilities, including stigma and discrimination, trauma and stress, illness, food insecurity, poverty, and difficulty accessing education. Millions of additional children who have living parents are vulnerable because their parents or other relatives are infected. This article reviews the current situation of orphans and vulnerable children, explores the underlying determinants of vulnerability and resilience, describes the response by the global community, and highlights the challenges as the HIV pandemic progresses through its fourth decade.

  2. Why is control of hypertension in sub-Saharan Africa poor?

    Science.gov (United States)

    Seedat, Y K

    2015-01-01

    In sub-Saharan Africa (SSA) in 2010, hypertension (defined as systolic blood pressure ≥ 115 mmHg) was the leading cause of death, increasing 67% since 1990. It was also the sixth leading cause of disability, contributing more than 11 million adjusted life years. In SSA, stroke was the main outcome of uncontrolled hypertension. Poverty is the major underlying factor for hypertension and cardiovascular disease. This article analyses the causes of poor compliance in the treatment of hypertension in SSA and provides suggestions on the treatment of hypertension in a poverty-stricken continent.

  3. Risk factors for vaginal fistula symptoms in Sub-Saharan Africa

    DEFF Research Database (Denmark)

    Maheu-Giroux, Mathieu; Filippi, Véronique; Maulet, Nathalie

    2016-01-01

    symptoms were observed for women of short stature (sexual violence (OR = 2.13; 95 % CrI: 1.60-2.86), those that reported sexual debut before the age of 14 (OR = 1.41; 95 % CrI: 1.16-1.71), and those....../birth, and preventing sexual violence could contribute to the elimination of obstetric fistula. Concomitant improvements in access to quality sexual and reproductive healthcare are, however, required to end fistula in sub-Saharan Africa....

  4. Contribution and performance of female Community-Directed Distributors in the treatment of onchocerciasis with Ivermectin in Sub-Saharan Africa: a systematic review.

    Science.gov (United States)

    Vouking, Marius Zambou; Tamo, Violette Claire; Tadenfok, Carine Nouboudem

    2015-01-01

    The African Program for Onchocerciasis Control (APOC) was launched in 1995 with the main goal being to boost the fight against onchocerciasis in Africa. In 2011, over 80 million people benefited from this intervention thanks to the contribution of 268.718 Community-Directed Distributors (CDD). These significant results obscure the role of women CDD in this fight. Indeed, the insufficient involvement of female CDD has been identified as a concern by the APOC partners early in the program. The present study aims to assess the contribution and performance of women involved in a strategy to control onchocerciasis by community-directed treatment with ivermectin in sub Saharan Africa. We searched the following electronic databases from January 1995 to July 2013: Medline, Embase (Excerpta Medica Database), CINAHL (Cumulative Index to Nursing and Allied Health Literature), LILAS (Latin American and Caribbean Literature on Health Sciences), International Bibliography of Social Sciences, Social Services Abstracts, and Sociological Abstracts. Two research team members independently conducted data extraction from the final sample of articles by using a pre-established data extraction sheet. The primary outcome was the contribution of female CDD in the control of onchocerciasis by community-directed treatment with Ivermectin. Of 25 hits, 7 papers met the inclusion criteria. For the management of onchocerciasis, female CDDs are elected by the health committee from the communities they will serve. The significant proportion of those treated (about 61%) were women, although only 24% of CDDs were women. Many community members reported that women were more committed, persuasive and more patient than men in the distribution of ivermectin. Some studies have identified underutilization of female CDD as one reason for the limited effectiveness or, in some cases, pure failure related to the distribution of Ivermectin interventions in the fight against onchocerciasis in sub-Saharan Africa

  5. Setting targets for human resources for eye health in sub-Saharan Africa: what evidence should be used?

    Science.gov (United States)

    Courtright, Paul; Mathenge, Wanjiku; Kello, Amir Bedri; Cook, Colin; Kalua, Khumbo; Lewallen, Susan

    2016-03-16

    With a global target set at reducing vision loss by 25% by the year 2019, sub-Saharan Africa with an estimated 4.8 million blind persons will require human resources for eye health (HReH) that need to be available, appropriately skilled, supported, and productive. Targets for HReH are useful for planning, monitoring, and resource mobilization, but they need to be updated and informed by evidence of effectiveness and efficiency. Supporting evidence should take into consideration (1) ever-changing disease-specific issues including the epidemiology, the complexity of diagnosis and treatment, and the technology needed for diagnosis and treatment of each condition; (2) the changing demands for vision-related services of an increasingly urbanized population; and (3) interconnected health system issues that affect productivity and quality. The existing targets for HReH and some of the existing strategies such as task shifting of cataract surgery and trichiasis surgery, as well as the scope of eye care interventions for primary eye care workers, will need to be re-evaluated and re-defined against such evidence or supported by new evidence.

  6. Occupational exposure to roadway emissions and inside informal settlements in sub-Saharan Africa: A pilot study in Nairobi, Kenya

    Science.gov (United States)

    Ngo, Nicole S.; Gatari, Michael; Yan, Beizhan; Chillrud, Steven N.; Bouhamam, Kheira; Kinneym, Patrick L.

    2015-01-01

    Few studies examine urban air pollution in sub-Saharan Africa (SSA), yet urbanization rates there are among the highest in the world. In this study, we measured 8-hr average occupational exposure levels of fine particulate matter (PM2.5), black carbon (BC), ultra violet active-particulate matter (UV-PM), and trace elements for individuals who worked along roadways in Nairobi, specifically bus drivers, garage workers, street vendors, and women who worked inside informal settlements. We found BC and re-suspended dust were important contributors to PM2.5 levels for all study populations, particularly among bus drivers, while PM2.5 exposure levels for garage workers, street vendors, and informal settlement residents were not statistically different from each other. We also found a strong signal for biomass emissions and trash burning, which is common in Nairobi’s low-income areas and open-air garages. These results suggest that the large portion of urban residents in SSA who walk along roadways would benefit from air quality regulations targeting roadway emissions from diesel vehicles, dust, and trash burning. This is the first study to measure occupational exposure to urban air pollution in SSA and results imply that roadway emissions are a serious public health concern. PMID:26034383

  7. Predictors of internalised HIV-related stigma: a systematic review of studies in sub-Saharan Africa.

    Science.gov (United States)

    Pantelic, Marija; Shenderovich, Yulia; Cluver, Lucie; Boyes, Mark

    2015-01-01

    This systematic review aims to synthesise evidence on predictors of internalised HIV stigma amongst people living with HIV in sub-Saharan Africa. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used. Studies were identified through electronic databases, grey literature, reference harvesting and contacts with key researchers. Quality of findings was assessed through an adapted version of the Cambridge Quality Checklists. A total of 590 potentially relevant titles were identified. Seventeen peer-reviewed articles and one draft book chapter were included. Studies investigated socio-demographic, HIV-related, intra-personal and interpersonal correlates of internalised stigma. Eleven articles used cross-sectional data, six articles used prospective cohort data and one used both prospective cohort and cross-sectional data to assess correlates of internalised stigma. Poor HIV-related health weakly predicted increases in internalised HIV stigma in three longitudinal studies. Lower depression scores and improvements in overall mental health predicted reductions in internalised HIV stigma in two longitudinal studies, with moderate and weak effects, respectively. No other consistent predictors were found. Studies utilising analysis of change and accounting for confounding factors are necessary to guide policy and programming but are scarce. High-risk populations, other stigma markers that might layer upon internalised stigma, and structural drivers of internalised stigma need to be examined.

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

    Directory of Open Access Journals (Sweden)

    E.E Akpan

    2013-06-01

    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.

  9. Optimizing cropland cover for stable food production in Sub-Saharan Africa using simulated yield and Modern Portfolio Theory

    Science.gov (United States)

    Bodin, P.; Olin, S.; Pugh, T. A. M.; Arneth, A.

    2014-12-01

    Food security can be defined as stable access to food of good nutritional quality. In Sub Saharan Africa access to food is strongly linked to local food production and the capacity to generate enough calories to sustain the local population. Therefore it is important in these regions to generate not only sufficiently high yields but also to reduce interannual variability in food production. Traditionally, climate impact simulation studies have focused on factors that underlie maximum productivity ignoring the variability in yield. By using Modern Portfolio Theory, a method stemming from economics, we here calculate optimum current and future crop selection that maintain current yield while minimizing variance, vs. maintaining variance while maximizing yield. Based on simulated yield using the LPJ-GUESS dynamic vegetation model, the results show that current cropland distribution for many crops is close to these optimum distributions. Even so, the optimizations displayed substantial potential to either increase food production and/or to decrease its variance regionally. Our approach can also be seen as a method to create future scenarios for the sown areas of crops in regions where local food production is important for food security.

  10. Informing Reactive Vaccination Strategies for Meningococcal Meningitis in sub-Saharan Africa using Dust and Climate Predictors

    Science.gov (United States)

    Pérez García-Pando, C.; Thomson, M. C.; Stanton, M. C.; Diggle, P. J.; Miller, R. L.; Perlwitz, J. P.; Ceccato, P.

    2014-12-01

    Epidemics of meningococcal meningitis occur in sub-Saharan Africa during the dry season, a period when the region is affected by the Harmattan, a dry and dusty northeasterly trade wind blowing from the Sahara into the Gulf of Guinea. Although the mechanisms remain unclear, the location and seasonality of meningitis epidemics suggest that environmental factors, such as low absolute or relative humidity, high temperatures, and dusty atmospheric conditions play an important role. Using a 20-year time series of meningitis incidence in Niger we examined the potential of statistical models to predict seasonal incidence based on data that would be operationally available, such as climate and dust, population and previous incidence. We used surface dust concentration estimates from a model given the paucity of direct in situ measurements especially at district level. The soil dust aerosol component of the model was thoroughly evaluated with existing satellite and in situ data over the region of interest showing daily aerosol optical depth correlations around 0.6 (p < 0.05). Our results show that wind and dust information along with incidence in the early dry season predict a significant part of the year-to-year variability of the seasonal incidence at both national and district levels. Such a model could provide an early-season alert when wind, dust, and other conditions are conducive to an epidemic. We additionally discuss how this research has focused at "getting science into practice" by engaging with practitioner communities to inform operational decision-making for reactive vaccination.

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

    Directory of Open Access Journals (Sweden)

    Yami Mastewal

    2009-01-01

    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.

  12. Knowledge and Awareness of HPV Vaccine and Acceptability to Vaccinate in Sub-Saharan Africa: A Systematic Review

    Science.gov (United States)

    Perlman, Stacey; Wamai, Richard G.; Bain, Paul A.; Welty, Thomas; Welty, Edith; Ogembo, Javier Gordon

    2014-01-01

    Objectives We assessed the knowledge and awareness of cervical cancer, HPV and HPV vaccine, and willingness and acceptability to vaccinate in sub-Saharan African (SSA) countries. We further identified countries that fulfill the two GAVI Alliance eligibility criteria to support nationwide HPV vaccination. Methods We conducted a systematic review of peer-reviewed studies on the knowledge and awareness of cervical cancer, HPV and HPV vaccine, and willingness and acceptability to vaccinate. Trends in Diphtheria-tetanus-pertussis (DTP3) vaccine coverage in SSA countries from 1990–2011 were extracted from the World Health Organization database. Findings The review revealed high levels of willingness and acceptability of HPV vaccine but low levels of knowledge and awareness of cervical cancer, HPV or HPV vaccine. We identified only six countries to have met the two GAVI Alliance requirements for supporting introduction of HPV vaccine: 1) the ability to deliver multi-dose vaccines for no less than 50% of the target vaccination cohort in an average size district, and 2) achieving over 70% coverage of DTP3 vaccine nationally. From 2008 through 2011 all SSA countries, with the exception of Mauritania and Nigeria, have reached or maintained DTP3 coverage at 70% or above. Conclusion There is an urgent need for more education to inform the public about HPV, HPV vaccine, and cervical cancer, particularly to key demographics, (adolescents, parents and healthcare professionals), to leverage high levels of willingness and acceptability of HPV vaccine towards successful implementation of HPV vaccination programs. There is unpreparedness in most SSA countries to roll out national HPV vaccination as per the GAVI Alliance eligibility criteria for supporting introduction of the vaccine. In countries that have met 70% DTP3 coverage, pilot programs need to be rolled out to identify the best practice and strategies for delivering HPV vaccines to adolescents and also to qualify for GAVI

  13. Knowledge and awareness of HPV vaccine and acceptability to vaccinate in sub-Saharan Africa: a systematic review.

    Directory of Open Access Journals (Sweden)

    Stacey Perlman

    Full Text Available OBJECTIVES: We assessed the knowledge and awareness of cervical cancer, HPV and HPV vaccine, and willingness and acceptability to vaccinate in sub-Saharan African (SSA countries. We further identified countries that fulfill the two GAVI Alliance eligibility criteria to support nationwide HPV vaccination. METHODS: We conducted a systematic review of peer-reviewed studies on the knowledge and awareness of cervical cancer, HPV and HPV vaccine, and willingness and acceptability to vaccinate. Trends in Diphtheria-tetanus-pertussis (DTP3 vaccine coverage in SSA countries from 1990-2011 were extracted from the World Health Organization database. FINDINGS: The review revealed high levels of willingness and acceptability of HPV vaccine but low levels of knowledge and awareness of cervical cancer, HPV or HPV vaccine. We identified only six countries to have met the two GAVI Alliance requirements for supporting introduction of HPV vaccine: 1 the ability to deliver multi-dose vaccines for no less than 50% of the target vaccination cohort in an average size district, and 2 achieving over 70% coverage of DTP3 vaccine nationally. From 2008 through 2011 all SSA countries, with the exception of Mauritania and Nigeria, have reached or maintained DTP3 coverage at 70% or above. CONCLUSION: There is an urgent need for more education to inform the public about HPV, HPV vaccine, and cervical cancer, particularly to key demographics, (adolescents, parents and healthcare professionals, to leverage high levels of willingness and acceptability of HPV vaccine towards successful implementation of HPV vaccination programs. There is unpreparedness in most SSA countries to roll out national HPV vaccination as per the GAVI Alliance eligibility criteria for supporting introduction of the vaccine. In countries that have met 70% DTP3 coverage, pilot programs need to be rolled out to identify the best practice and strategies for delivering HPV vaccines to adolescents and also to

  14. Long-term financing needs for HIV control in sub-Saharan Africa in 2015–2050: a modelling study

    Science.gov (United States)

    Atun, Rifat; Chang, Angela Y; Ogbuoji, Osondu; Silva, Sachin; Resch, Stephen; Hontelez, Jan; Bärnighausen, Till

    2016-01-01

    Objectives To estimate the present value of current and future funding needed for HIV treatment and prevention in 9 sub-Saharan African (SSA) countries that account for 70% of HIV burden in Africa under different scenarios of intervention scale-up. To analyse the gaps between current expenditures and funding obligation, and discuss the policy implications of future financing needs. Design We used the Goals module from Spectrum, and applied the most up-to-date cost and coverage data to provide a range of estimates for future financing obligations. The four different scale-up scenarios vary by treatment initiation threshold and service coverage level. We compared the model projections to current domestic and international financial sources available in selected SSA countries. Results In the 9 SSA countries, the estimated resources required for HIV prevention and treatment in 2015–2050 range from US$98 billion to maintain current coverage levels for treatment and prevention with eligibility for treatment initiation at CD4 count of debt levels and the present value of the stock of future HIV funding obligations) would rise substantially. Conclusions Investing upfront in scale-up of HIV services to achieve high coverage levels will reduce HIV incidence, prevention and future treatment expenditures by realising long-term preventive effects of ART to reduce HIV transmission. Future obligations are too substantial for most SSA countries to be met from domestic sources alone. New sources of funding, in addition to domestic sources, include innovative financing. Debt sustainability for sustained HIV response is an urgent imperative for affected countries and donors. PMID:26948960

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

    Science.gov (United States)

    Dembélé, Martial; Lefoka, Pulane

    2007-11-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Rees Helen V

    2009-11-01

    Full Text Available 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 their correct use. More than 20 studies in Africa have reported higher occurrence of HIV among people with problem drinking; a finding strongly consistent across studies and similar among women and men. Conflation of HIV and alcohol disease in these setting is not surprising given patterns of heavy-episodic drinking and that drinking contexts are often coterminous with opportunities for sexual encounters. HIV and alcohol also share common ground with sexual violence. Both perpetrators and victims of sexual violence have a high likelihood of having drunk alcohol prior to the incident, as with most forms of violence and injury in sub-Saharan Africa. Reducing alcohol harms necessitates multi-level interventions and should be considered a key component of structural interventions to alleviate the burden of HIV and sexual violence. Brief interventions for people with problem drinking (an important component of primary health care, must incorporate specific discussion of links between alcohol and unsafe sex, and consequences thereof. Interventions to reduce alcohol harm among HIV-infected persons are also an important element in positive-prevention initiatives. Most importantly, implementation of known effective interventions could alleviate a large portion of the alcohol-attributable burden of disease, including its effects on unsafe sex, unintended pregnancy and HIV transmission.

  17. Cushioning women against gender inequality through promoting indigenous chicken production in sub Saharan Africa

    Directory of Open Access Journals (Sweden)

    Never Assan

    2015-06-01

    Full Text Available Poultry sub sector is a privileged entry point for promoting gender equality. Gender inequalities in poultry and livestock activities are now more and more acknowledged by governments, scientists, and farmers in sub Saharan Africa. This is on the background that gender inequality has translated into loss of opportunities or potential gains on agricultural production and food security. This has been exacerbated by the fact that the progress in empowering women in agriculture and reducing gender inequality has been slow despite this realization. The paper presents an overview of the development of the indigenous chickens sector in sub Saharan Africa and its implication on addressing gender equality. The assumption is that despite the multitude of socio-economic constraints faced by women in agriculture they are capable of raising indigenous chickens for the welfare of their households, hence promoting indigenous chickens  can give women a chance to control more income, reducing gender inequality. Achieving gender equality and women’s empowerment is critical to the success of these development goals.

  18. The Bioethanol Industry in Sub-Saharan Africa: History, Challenges, and Prospects

    Directory of Open Access Journals (Sweden)

    Evanie Devi Deenanath

    2012-01-01

    Full Text Available 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.

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

    Science.gov (United States)

    Deenanath, Evanie Devi; Iyuke, Sunny; Rumbold, Karl

    2012-01-01

    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.

  20. Private Sector Provision of Oral Rehydration Therapy for Child Diarrhea in Sub-Saharan Africa

    Science.gov (United States)

    Sood, Neeraj; Wagner, Zachary

    2014-01-01

    Although diarrheal mortality is cheaply preventable with oral rehydration therapy (ORT), over 700,000 children die of diarrhea annually and many health providers fail to treat diarrheal cases with ORT. Provision of ORT may differ between for-profit and public providers. This study used Demographic and Health Survey data from 19,059 children across 29 countries in sub-Saharan Africa from 2003 to 2011 to measure differences in child diarrhea treatment between private for-profit and public health providers. Differences in treatment provision were estimated using probit regression models controlling for key confounders. For-profit providers were 15% points less likely to provide ORT (95% confidence interval [CI] 13–17) than public providers and 12% points more likely to provide other treatments (95% CI 10–15). These disparities in ORT provision were more pronounced for poorer children in rural areas. As private healthcare in sub-Saharan Africa continues to expand, interventions to increase private sector provision of ORT should be explored. PMID:24732456

  1. The core competencies for mental, neurological, and substance use disorder care in sub-Saharan Africa.

    Science.gov (United States)

    Collins, Pamela Y; Musisi, Seggane; Frehywot, Seble; Patel, Vikram

    2015-01-01

    The 2010 Global Burden of Disease Study points to a changing landscape in which non-communicable diseases, such as mental, neurological, and substance use (MNS) disorders, account for an increasing proportion of premature mortality and disability globally. Despite evidence of the need for care, a remarkable deficit of providers for MNS disorder service delivery persists in sub-Saharan Africa. This critical workforce can be developed from a range of non-specialist and specialist health workers who have access to evidence-based interventions, whose roles, and the associated tasks, are articulated and clearly delineated, and who are equipped to master and maintain the competencies associated with providing MNS disorder care. In 2012, the Neuroscience Forum of the Institute of Medicine convened a meeting of key stakeholders in Kampala, Uganda, to discuss a set of candidate core competencies for the delivery of mental health and neurological care, focusing specifically on depression, psychosis, epilepsy, and alcohol use disorders. This article discusses the candidate core competencies for non-specialist health workers and the complexities of implementing core competencies in low- and middle-income country settings. Sub-Saharan Africa, however, has the potential to implement novel training initiatives through university networks and through structured processes that engage ministries of health. Finally, we outline challenges associated with implementing competencies in order to sustain a workforce capable of delivering quality services for people with MNS disorders.

  2. Promotion of renewable energy to mitigate impact of heavy use of carbon energy on society and climate change in Central Sub-Saharan Africa remote areas.

    Science.gov (United States)

    Kenfack, Joseph; Bignom, Blaise

    2015-04-01

    Sub-Saharan Africa owns important renewable energy potential and is still heavily using carbon energy. This is having a negative impact on the climate and on the environment. Given the local cost of carbon energy, the purchase power of people, the availability and the reserve of carbon energy in the area, this resource is being heavily used. This practice is harmful to the climate and is also resulting on poor effort to promote renewable energy in remote areas. The important renewable energy potential is still suffering from poor development. The purpose of this paper is among other things aiming at showing the rate of carbon energy use and its potential impact on climate and environment. We will also ensure that the renewable energy resources of Central Sub-Saharan Africa are known and are subject to be used optimally to help mitigate climate change. After showing some negative impacts of carbon energy used in the area, the work also suggests actions to promote and sustain the development of renewable energy. Based on the knowledge of the Central African energy sector, this paper will identify actions for reduce access to carbon energy and improved access to sustainable, friendly, affordable energy services to users as well as a significant improvement of energy infrastructure and the promotion of energy efficiency. We will show all type of carbon energy used, the potential for solar, biomass and hydro while showing where available the level of development. After a swot analysis of the situation, identified obstacles for the promotion of clean energy will be targeted. Finally, suggestions will be made to help the region develop a vision aiming at developing good clean energy policy to increase the status of renewable energy and better contribute to fight against climate change. Cameroon case study will be examined as illustration. Analysis will be made from data collected in the field. |End Text|

  3. Impact of antiretroviral therapy on incidence of pregnancy among HIV-infected women in Sub-Saharan Africa: a cohort study.

    Directory of Open Access Journals (Sweden)

    Landon Myer

    2010-02-01

    Full Text Available BACKGROUND: With the rapid expansion of antiretroviral therapy (ART services in sub-Saharan Africa there is growing recognition of the importance of fertility and childbearing among HIV-infected women. However there are few data on whether ART initiation influences pregnancy rates. METHODS AND FINDINGS: We analyzed data from the Mother-to-Child Transmission-Plus (MTCT-Plus Initiative, a multicountry HIV care and treatment program for women, children, and families. From 11 programs in seven African countries, women were enrolled into care regardless of HIV disease stage and followed at regular intervals; ART was initiated according to national guidelines on the basis of immunological and/or clinical criteria. Standardized forms were used to collect sociodemographic and clinical data, including incident pregnancies. Overall 589 incident pregnancies were observed among the 4,531 women included in this analysis (pregnancy incidence, 7.8/100 person-years [PY]. The rate of new pregnancies was significantly higher among women receiving ART (9.0/100 PY compared to women not on ART (6.5/100 PY (adjusted hazard ratio, 1.74; 95% confidence interval, 1.19-2.54. Other factors independently associated with increased risk of incident pregnancy included younger age, lower educational attainment, being married or cohabiting, having a male partner enrolled into the program, failure to use nonbarrier contraception, and higher CD4 cell counts. CONCLUSIONS: ART use is associated with significantly higher pregnancy rates among HIV-infected women in sub-Saharan Africa. While the possible behavioral or biomedical mechanisms that may underlie this association require further investigation, these data highlight the importance of pregnancy planning and management as a critical but neglected component of HIV care and treatment services. Please see later in the article for the Editors' Summary.

  4. Impact of Antiretroviral Therapy on Incidence of Pregnancy among HIV-Infected Women in Sub-Saharan Africa: A Cohort Study

    Science.gov (United States)

    Myer, Landon; Carter, Rosalind J.; Katyal, Monica; Toro, Patricia; El-Sadr, Wafaa M.; Abrams, Elaine J.

    2010-01-01

    Background With the rapid expansion of antiretroviral therapy (ART) services in sub-Saharan Africa there is growing recognition of the importance of fertility and childbearing among HIV-infected women. However there are few data on whether ART initiation influences pregnancy rates. Methods and Findings We analyzed data from the Mother-to-Child Transmission-Plus (MTCT-Plus) Initiative, a multicountry HIV care and treatment program for women, children, and families. From 11 programs in seven African countries, women were enrolled into care regardless of HIV disease stage and followed at regular intervals; ART was initiated according to national guidelines on the basis of immunological and/or clinical criteria. Standardized forms were used to collect sociodemographic and clinical data, including incident pregnancies. Overall 589 incident pregnancies were observed among the 4,531 women included in this analysis (pregnancy incidence, 7.8/100 person-years [PY]). The rate of new pregnancies was significantly higher among women receiving ART (9.0/100 PY) compared to women not on ART (6.5/100 PY) (adjusted hazard ratio, 1.74; 95% confidence interval, 1.19–2.54). Other factors independently associated with increased risk of incident pregnancy included younger age, lower educational attainment, being married or cohabiting, having a male partner enrolled into the program, failure to use nonbarrier contraception, and higher CD4 cell counts. Conclusions ART use is associated with significantly higher pregnancy rates among HIV-infected women in sub-Saharan Africa. While the possible behavioral or biomedical mechanisms that may underlie this association require further investigation, these data highlight the importance of pregnancy planning and management as a critical but neglected component of HIV care and treatment services. Please see later in the article for the Editors' Summary PMID:20161723

  5. Eruption parameters elicitation for volcanoes in Ethiopia and Kenya Informing a World Bank GFDRR project on volcanic threat in sub-Saharan Africa

    Science.gov (United States)

    Jenkins, Susanna; Lark, Murray; Loughlin, Sue; Fontijn, Karen; Mather, Tamsin; Pyle, David; Lewi, Elias; Yirgu, Gezahegn; Vye-Brown, Charlotte; Sparks, Steve

    2016-04-01

    Despite large numbers of very visible active volcanoes in sub-Saharan Africa, data about eruptions are limited compared to elsewhere in the world. We present the method and findings from elicitations carried out to characterise likely future eruptions in the region as part of a World Bank GFDRR risk profiling project for sub-Saharan Africa. The purpose of the elicitations was to better understand the characteristics and frequencies of explosive eruptions at volcanoes in Ethiopia and Kenya. The elicitations will provide source parameters for tephra fall modelling at select volcanoes in Ethiopia (Aluto, Corbetti, Fentale) and Kenya (Menegai, Longonot, Suswa). There were two stages of elicitation: 1) a 'sanity check' of initial assumptions around likely eruption style, magnitude and frequency for the six selected volcanoes; 2) a formal SHELF (SHeffield ELicitation Framework) elicitation that centred round establishing frequency-magnitude relationships for the volcanoes. The elicitation suggested that explosive eruptions at Aluto and Corbetti were less likely than at the other volcanoes, although the uncertainty was significant. Menengai and Rungwe volcano in Tanzania (elicited as an analogue for Fentale, Longonot and Suswa volcanoes) were characterised by approximately similar probabilities of eruption. However, Rungwe was considered more likely to produce larger explosive (VEI ≥ 4) eruptions than Menengai. Elicitation discussions highlighted the knowledge and data gaps for African volcanoes and raised important questions around whether gaps in the eruption record were real and related to changing regimes at the volcanoes over time or if they were a function of under-recording or lack of preservation. Further investigation is therefore needed to validate the findings of the elicitation. It is hoped that continued collaboration with local partners and studies within the ongoing NERC-funded RiftVolc project will address these issues and help to improve our knowledge

  6. The PrePex device is unlikely to achieve cost-savings compared to the forceps-guided method in male circumcision programs in sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Walter Obiero

    Full Text Available BACKGROUND: Male circumcision (MC reduces the risk of heterosexual HIV acquisition in men by approximately 60%. MC programs for HIV prevention are currently being scaled-up in fourteen countries in sub-Saharan Africa. The current standard surgical technique for MC in many sub-Saharan African countries is the forceps-guided male circumcision (FGMC method. The PrePex male circumcision (PMC method could replace FGMC and potentially reduce MC programming costs. We compared the potential costs of introducing the PrePex device into MC programming to the cost of the forceps-guided method. METHODS: Data were obtained from the Nyanza Reproductive Health Society (NRHS, an MC service delivery organization in Kenya, and from the Kenya Ministry of Health. Analyses are based on 48,265 MC procedures performed in four Districts in western Kenya from 2009 through 2011. Data were entered into the WHO/UNAIDS Decision Makers Program Planning Tool. The tool assesses direct and indirect costs of MC programming. Various sensitivity analyses were performed. Costs were discounted at an annual rate of 6% and are presented in United States Dollars. RESULTS: Not including the costs of the PrePex device or referral costs for men with phimosis/tight foreskin, the costs of one MC surgery were $44.54-$49.02 and $54.52-$55.29 for PMC and FGMC, respectively. CONCLUSION: The PrePex device is unlikely to result in significant cost-savings in comparison to the forceps-guided method. MC programmers should target other aspects of the male circumcision minimum package for improved cost efficiency.

  7. Performance of HIV Prevention of Mother-To-Child Transmission Programs in Sub-Saharan Africa: Longitudinal Assessment of 64 Nevirapine-Based Programs Implemented in 25 Countries, 2000-2011.

    Directory of Open Access Journals (Sweden)

    Joël Ladner

    Full Text Available To evaluate the performance and to identify predictive factors of performance in prevention of mother-to-child HIV transmission programs (PMTCT in sub-Saharan African countries.From 2000 to 2011, PMTCT programs included in the Viramune Donation Programme (VDP were prospectively followed. Each institution included in the VDP provided data on program implementation, type of management institution, number of PMTCT sites, key programs outputs (HIV counseling and testing, NVP regimens received by mothers and newborns. Nevirapine Coverage Ratio (NCR, defined as the number of women who should have received nevirapine (observed HIV prevalence x number of women in antenatal care, was used to measure performance. Included programs were followed every six months through progress reports.A total of 64 programs in 25 sub-Saharan African countries were included. The mean program follow-up was 48.0 months (SD = 24.5; 20,084,490 women attended in antenatal clinics were included. The overall mean NCR was 0.52 (SD = 0.25, with an increase from 0.37 to 0.57 between the first and last progress reports (p<.0001; NCR increased by 3.26% per year-program. Between the first and the last report, the number of women counseled and tested increased from 64.3% to 86.0% (p<.0001, the number of women post-counseled from 87.5% to 91.3% (p = 0.08. After mixed linear regression analysis, type of responsible institution, number of women attended in ANC, and program initiation in 2005-2006 were significant predictive factors associated with the NCR. The effect of the time period increased from earlier to later periods.A longitudinal assessment of large PMTCT programs shows that scaling-up of programs was increased in sub-Saharan African countries. The PMTCT coverage increased throughout the study period, especially after 2006. Performance may be better for programs with a small or medium number of women attended in ANC. Identification of factors that predict PMTCT program

  8. The Africa Center for Biostatistical Excellence: a proposal for enhancing biostatistics capacity for sub-Saharan Africa.

    Science.gov (United States)

    Machekano, Rhoderick; Young, Taryn; Rusakaniko, Simbarashe; Musonda, Patrick; Sartorius, Ben; Todd, Jim; Fegan, Greg; Thabane, Lehana; Chikte, Usuf

    2015-11-30

    Sub-Saharan Africa has a shortage of well-trained biomedical research methodologists, in particular, biostatisticians. In July 2014, a group of biostatisticians and researchers from the region attended a brainstorming workshop to identify ways in which to reduce the deficit in this critical skill. The workshop recognized that recommendations from previous workshops on building biostatistics capacity in sub-Saharan Africa had not been implemented. The discussions culminated with a proposal to setup an Africa Center for Biostatistical Excellence, a collaborative effort across academic and researcher institutions within the region, as a vehicle for promoting biostatistics capacity building through specialized academic masters programs as well as regular workshops targeting researchers.

  9. Sub-Saharan African Students’ Experiences, Perceptions, and Expectations with American Health Services: An Intercultural Challenge

    Directory of Open Access Journals (Sweden)

    Claudia L. McCalman

    2009-12-01

    Full Text Available Understanding patients‟ cultural expectations could contribute to better health outcomes and decrease cultural health disparities. This qualitative pilot study objective was to explore experiences, perceptions, and expectations of males and females Angolan students as patients in America. Eighteen face-to-face interviews were conducted at a Midwestern university. Burgoon‟s expectancy violation theory (1991 was the theoretical background. Results revealed as positive expectation violations an advanced technology, quality of services, medicine availability, and emphasis on preventive care. Negative expectation violations included high service costs, complicated insurance system, short medical encounters, and difficulty in building relational history with providers. The study also revealed that culturally related communication barriers as well as negative violations of expectations hinder the quality of intercultural clinical encounters and can affect health outcomes. Participants emphasized the importance of these interpersonal relations and their connection with perceptions of caregivers‟ professional competence. International patients/students revealed that they believe friendliness on the part of the caregiver is a signal that they are dealing with a “good” doctor or nurse. Intercultural competence is an important asset of caregivers who work in multicultural clinics and in college health. Practical implications emerged in international advising and clinician‟s education.

  10. 78 FR 26031 - Notice of Open Special Meeting of the Sub-Saharan Africa Advisory Committee of the Export-Import...

    Science.gov (United States)

    2013-05-03

    ... Open Special Meeting of the Sub-Saharan Africa Advisory Committee of the Export-Import Bank of the United States (Ex-Im Bank) SUMMARY: The Sub-Saharan Africa Advisory Committee was established by Public Law 105-121, November 26, 1997, to advise the Board of Directors on the development and...

  11. Traumatic grief in young people in Sub-Saharan Africa: a scoping review

    Directory of Open Access Journals (Sweden)

    Taggart H

    2015-07-01

    Full Text Available Holly Taggart,1 Sheila Greatrex-White,2 1Mental Health Commission, CentreForum, Westminster, UK; 2School of Health Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, UK Aim: To identify relevant and pertinent themes and interventions within the literature relating to childhood traumatic grief, in order to provide a sound background of evidence for further research and service development. Background: Childhood traumatic grief is caused when a significant person in a child's life dies under circumstances that they perceive to be traumatic. This can leave a child unable to return to the same level of physical and emotional functioning that he or she had prior to the death occurring. In Sub-Saharan Africa, there is an increased risk for childhood traumatic grief due to a high prevalence of orphanhood, environmental stressors, stigma, and abuse. This can have detrimental effects upon mental health. Methods: The review followed the York methodology: identifying the purpose and agreeing on the strategy beforehand; identifying relevant sources/studies; selecting the studies; charting the data; and collating, summarizing, and reporting results. Results and discussion: Interventions identified to prevent and/or manage traumatic grief included narrative exposure therapy, psychotherapy, mentoring, peer-group support, psychosocial support, a grief and loss therapy session, and memory boxes. Mental health remains neglected within service and policy development as well as in global health spending. The average amount expended on mental health services per person per year in low-income countries is less than $0.25. Only 36% of people in low income countries are covered by a mental health policy, compared with 92% in high income countries. Limitations: The sixth stage of the York methodology was omitted. Only papers written in English were included in the review. Conclusion: Childhood traumatic grief in young people is an important issue

  12. The potential impact of male circumcision on HIV in Sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Brian G Williams

    2006-07-01

    Full Text Available BACKGROUND: A randomized controlled trial (RCT has shown that male circumcision (MC reduces sexual transmission of HIV from women to men by 60% (32%-76%; 95% CI offering an intervention of proven efficacy for reducing the sexual spread of HIV. We explore the implications of this finding for the promotion of MC as a public health intervention to control HIV in sub-Saharan Africa. METHODS AND FINDINGS: Using dynamical simulation models we consider the impact of MC on the relative prevalence of HIV in men and women and in circumcised and uncircumcised men. Using country level data on HIV prevalence and MC, we estimate the impact of increasing MC coverage on HIV incidence, HIV prevalence, and HIV-related deaths over the next ten, twenty, and thirty years in sub-Saharan Africa. Assuming that full coverage of MC is achieved over the next ten years, we consider three scenarios in which the reduction in transmission is given by the best estimate and the upper and lower 95% confidence limits of the reduction in transmission observed in the RCT. MC could avert 2.0 (1.1-3.8 million new HIV infections and 0.3 (0.1-0.5 million deaths over the next ten years in sub-Saharan Africa. In the ten years after that, it could avert a further 3.7 (1.9-7.5 million new HIV infections and 2.7 (1.5-5.3 million deaths, with about one quarter of all the incident cases prevented and the deaths averted occurring in South Africa. We show that a MC will increase the proportion of infected people who are women from about 52% to 58%; b where there is homogenous mixing but not all men are circumcised, the prevalence of infection in circumcised men is likely to be about 80% of that in uncircumcised men; c MC is equivalent to an intervention, such as a vaccine or increased condom use, that reduces transmission in both directions by 37%. CONCLUSIONS: This analysis is based on the result of just one RCT, but if the results of that trial are confirmed we suggest that MC could

  13. Poverty, Socio-Political Factors and Degradation of the Environment in Sub-Saharan Africa: The Need For a Holistic Approach to the Protection of the Environment and Realisation of the Right to Environment

    Directory of Open Access Journals (Sweden)

    Emeka Polycarp Amechi

    2009-09-01

    Full Text Available The right to environment is a recognised human right in Africa. However, despite the legal and institutional frameworks designed to respect, promote, protect and fulfil the right, its enjoyment is still a mirage to majority of African citizens as a result of environmental degradation. This article aims to proffer a holistic or integrated approach to tackling the problem of environmental degradation in sub-Saharan Africa in order to enhance the protection of the environment and the realisation of this right in the region. It recognises that the problem of environmental degradation in the region is not due to lack of regulatory frameworks, but rather due to other factors that are mainly socio-economic and political in nature. It argues that to enhance the protection of the environment and realisation of this right in sub-Saharan Africa, African governments must adopt a holistic approach towards the protection of the environment, and proposes the promotion of good governance and socio-economic reform in the region as an integral core of such approach.

  14. Sub-Saharan Africa’s rail freight transport system: Potential impact of densification on cost

    Directory of Open Access Journals (Sweden)

    Anneke de Bod

    2010-11-01

    Full Text Available The main response to sub-Saharan Africa’s (SSA challenges has been foreign aid. Yet, despite the large amounts received, the challenges remain. There is an opportunity to consider a different model with less focus on aid and more on investment. In the transport sector specifically, investment decisions should be informed by a longterm optimal balance between different transport modes. The research presented in this paper highlights the significant cost reduction opportunities possible through the densification of rail freight, especially over longer distances, with concomitant implications for increased profitability for rail operators. The densification opportunity should also place a core focus on transport corridors being developed throughout the region. SSA countries themselves can play a critical role in unlocking this potential through, inter alia, simplifying regional economic communities and taking the lead in structuring agreements with the international community.

  15. Brucellosis in Sub-Saharan Africa: Current challenges for management, diagnosis and control.

    Science.gov (United States)

    Ducrotoy, M; Bertu, W J; Matope, G; Cadmus, S; Conde-Álvarez, R; Gusi, A M; Welburn, S; Ocholi, R; Blasco, J M; Moriyón, I

    2017-01-01

    Brucellosis is a highly contagious zoonosis caused by bacteria of the genus Brucella and affecting domestic and wild mammals. In this paper, the bacteriological and serological evidence of brucellosis in Sub-Saharan Africa (SSA) and its epidemiological characteristics are discussed. The tools available for the diagnosis and treatment of human brucellosis and for the diagnosis and control of animal brucellosis and their applicability in the context of SSA are presented and gaps identified. These gaps concern mostly the need for simpler and more affordable antimicrobial treatments against human brucellosis, the development of a B. melitensis vaccine that could circumvent the drawbacks of the currently available Rev 1 vaccine, and the investigation of serological diagnostic tests for camel brucellosis and wildlife. Strategies for the implementation of animal vaccination are also discussed.

  16. Video-laryngoscopy introduction in a Sub-Saharan national teaching hospital: luxury or necessity?

    Science.gov (United States)

    Alain, Traoré Ibrahim; Drissa, Barro Sié; Flavien, Kaboré; Serge, Ilboudo; Idriss, Traoré

    2015-01-01

    Tracheal intubation using Macintosh blade is the technique of choice for the liberation of airways. It can turn out to be difficult, causing severe complications which can entail the prognosis for survival or the adjournment of the surgical operation. The video-laryngoscope allows a better display of the larynx and a good exposure of the glottis and then making tracheal intubation simpler compared with a conventional laryngoscope. It is little spread in sub-Saharan Africa and more particularly in Burkina Faso because of its high cost. We report our first experiences of use of the video-laryngoscope through two cases of difficult tracheal intubation which had required the adjournment of the interventions. It results that the video-laryngoscope makes tracheal intubation easier even in it's the first use because of the good glottal display which it gives and because its allows apprenticeship easy. Therefore, it is not a luxury to have it in our therapeutic arsenal.

  17. Efficacy of sublingual lorazepam versus intrarectal diazepam for prolonged convulsions in Sub-Saharan Africa.

    Science.gov (United States)

    Malu, Célestin Kaputu Kalala; Kahamba, Daniel Mukeba; Walker, Timothy David; Mukampunga, Caritas; Musalu, Eric Mafuta; Kokolomani, Jacques; Mayamba, Richard Mukendi Kavulu; Wilmshurst, Jo M; Dubru, Jean-Marie; Misson, Jean-Paul

    2014-07-01

    In Sub-Saharan Africa, intrarectal diazepam is the first-line anticonvulsant mostly used in children. We aimed to assess this standard care against sublingual lorazepam, a medication potentially as effective and safe, but easier to administer. A randomized controlled trial was conducted in the pediatric emergency departments of 9 hospitals. A total of 436 children aged 5 months to 10 years with convulsions persisting for more than 5 minutes were assigned to receive intrarectal diazepam (0.5 mg/kg, n = 202) or sublingual lorazepam (0.1 mg/kg, n = 234). Sublingual lorazepam stopped seizures within 10 minutes of administration in 56% of children compared with intrarectal diazepam in 79% (P efficacious in stopping pediatric seizures than intrarectal diazepam, and intrarectal diazepam should thus be preferred as a first-line medication in this setting.

  18. Chronic Disease Management in Sub-Saharan Africa: Whose Business Is It?

    Directory of Open Access Journals (Sweden)

    Slim Slama

    2009-08-01

    Full Text Available Public health specialists and clinicians alike agree that Humanity faces a global pandemic of chronic diseases in the 21st century. In this article we discuss the implications of this pandemic on another global issue, the health workforce. Because both issues are particularly acute in Sub-Saharan Africa (SSA, we will focus on this region and use Cameroon as a case in point. We first gauge the epidemic of chronic conditions in SSA. We then discuss the implications of chronic conditions for the reshaping of health systems and the health workforce. We conclude by making a strong case for the building up and strengthening the health workforce, insisting on the crucial role of nurses, their training, and involvement in chronic disease management.

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

    DEFF Research Database (Denmark)

    Nygaard, Ivan; Bindner, Henrik W.; Katic, Ivan

    2009-01-01

    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......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...

  20. Chronic disease management in Sub-Saharan Africa: whose business is it?

    Science.gov (United States)

    Bischoff, Alexander; Ekoe, Tetanye; Perone, Nicolas; Slama, Slim; Loutan, Louis

    2009-08-01

    Public health specialists and clinicians alike agree that Humanity faces a global pandemic of chronic diseases in the 21(st) century. In this article we discuss the implications of this pandemic on another global issue, the health workforce. Because both issues are particularly acute in Sub-Saharan Africa (SSA), we will focus on this region and use Cameroon as a case in point. We first gauge the epidemic of chronic conditions in SSA. We then discuss the implications of chronic conditions for the reshaping of health systems and the health workforce. We conclude by making a strong case for the building up and strengthening the health workforce, insisting on the crucial role of nurses, their training, and involvement in chronic disease management.