WorldWideScience

Sample records for sub-saharan african states

  1. Overcoming the Odds: Challenges and Successes of Sub-Saharan African Women Seeking Higher Education in the United States

    Science.gov (United States)

    Gatua, Mary Wairimu

    2009-01-01

    This article describes the challenges Sub-Saharan African women, including the author, have experienced in their pursuit of graduate studies in the United States and successful strategies that have been adopted. The author begins with a brief overview of the education of girls and women in Sub-Saharan African countries. She then explores the…

  2. Schooling Experiences and Perceptions of Resettled Sub-Saharan African Refugee Middle School Students in a Southwest U.S. State

    Science.gov (United States)

    Sallu, Adama

    2012-01-01

    This study examined the schooling experiences and perceptions of resettled sub-Saharan African middle school refugee students in a metropolitan area of the United States Southwest. The research questions underpinning this study included: What are the schooling experiences and perceptions of resettled sub-Saharan African middle school refugee…

  3. Biogas technology research in selected sub-Saharan African countries

    African Journals Online (AJOL)

    This reviews aims to provide an insight and update of the state of biogas technology research in some selected sub-Saharan African countries in peer reviewed literature. This paper also aims to highlight the sub-Saharan countries' strengths and weaknesses in biogas research and development capacity. An attempt is ...

  4. 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)

    OpenAIRE

    Reinhart Kößler

    2015-01-01

    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.

  5. 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)

    OpenAIRE

    Reinhart Kößler; Arnold-Bergstraesser-Institut

    2015-01-01

    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. Besprechung der Monographie: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...

  6. 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.

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

    Science.gov (United States)

    Hagopian, Amy; Thompson, Matthew J; Fordyce, Meredith; Johnson, Karin E; Hart, L Gary

    2004-12-14

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

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

    Directory of Open Access Journals (Sweden)

    Johnson Karin E

    2004-12-01

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

  9. State of inequality in malaria intervention coverage in sub-Saharan African countries.

    Science.gov (United States)

    Galactionova, Katya; Smith, Thomas A; de Savigny, Don; Penny, Melissa A

    2017-10-18

    Scale-up of malaria interventions over the last decade have yielded a significant reduction in malaria transmission and disease burden in sub-Saharan Africa. We estimated economic gradients in the distribution of these efforts and of their impacts within and across endemic countries. Using Demographic and Health Surveys we computed equity metrics to characterize the distribution of malaria interventions in 30 endemic countries proxying economic position with an asset-wealth index. Gradients were summarized in a concentration index, tabulated against level of coverage, and compared among interventions, across countries, and against respective trends over the period 2005-2015. There remain broad differences in coverage of malaria interventions and their distribution by wealth within and across countries. In most, economic gradients are lacking or favor the poorest for vector control; malaria services delivered through the formal healthcare sector are much less equitable. Scale-up of interventions in many countries improved access across the wealth continuum; in some, these efforts consistently prioritized the poorest. Expansions in control programs generally narrowed coverage gaps between economic strata; gradients persist in countries where growth was slower in the poorest quintile or where baseline inequality was large. Despite progress, malaria is consistently concentrated in the poorest, with the degree of inequality in burden far surpassing that expected given gradients in the distribution of interventions. Economic gradients in the distribution of interventions persist over time, limiting progress toward equity in malaria control. We found that, in countries with large baseline inequality in the distribution of interventions, even a small bias in expansion favoring the least poor yielded large gradients in intervention coverage while pro-poor growth failed to close the gap between the poorest and least poor. We demonstrated that dimensions of disadvantage

  10. Revenue generation strategies in sub-Saharan African universities

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    Gebreyes, F.M.

    2015-01-01

    Financial sustainability is one of the key challenges for public universities in both developed and developing countries. Using a resource dependence approach, this study explores the issue of revenue generation in Sub-Saharan African universities. It analyses the diversification strategies that

  11. Suboptimal Utilisation of Resources in Sub-Saharan African Higher ...

    African Journals Online (AJOL)

    Suboptimal Utilisation of Resources in Sub-Saharan African Higher Education Institutions: the Case of Teaching Space at Makerere University. ... This means that the institutions need to evaluate their utilization of these resources—to pinpoint their need for the resources and potential for quality assurance. This paper reports ...

  12. Challenges of doing research in sub-Saharan African universities ...

    African Journals Online (AJOL)

    Challenges of doing research in sub-Saharan African universities: digital scholarship opportunities. ... to meet the changing needs of society intensifies as a result of trends in the transition towards a knowledge-based economy; massification of higher education; and the integration and assimilation of Information Technology ...

  13. Hand replantation: First experience in a sub-Saharan African country (Togo

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    Komla Sena Amouzou

    2016-01-01

    Full Text Available Fifty years after Chen has performed the first forearm replantation, we report our first case of hand replantation in a sub-Saharan African country. The etiology of the amputation was machete due to interpersonal violence. The amputation was trans-carpal, guillotine-type, subtotal non-viable maintained with a small skin bridge. The replantation procedure was successful. At one year follow-up, the functional result according to Chen's criteria was excellent. Through this first experience, we can state that hand replantation can be performed successfully both in survival and function in a non-specialized hospital of a sub-Saharan African country.

  14. Mastalgia: Prevalence at a Sub-Saharan African Tertiary Hospital

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    T. Makumbi

    2014-01-01

    Full Text Available Introduction. Mastalgia is a common breast condition among women referred to breast clinics worldwide. Whereas the prevalence is known in the Western world and Asia, the prevalence of the disease is unknown in many African countries. The aim of this study therefore was to determine the prevalence and describe factors associated with mastalgia among women attending a tertiary hospital in sub-Saharan Africa. Methods. A cross-sectional study was done in Kampala, Uganda. Mastalgia was defined as self-reported breast pain (unilateral or bilateral for a period not less than two months. A pretested questionnaire was used to collect the data and statistical analysis was performed using SPSS version 11. Ethical approval was obtained. Results. Out of the 1048 women who presented to the breast clinic during the study period, 168 (16% were diagnosed with mastalgia in the absence of breast cancer. Noncyclical and cyclical mastalgia were 22/168 (13% and 5/168 (3%, respectively. The onset of noncyclical category as compared to the cyclical type of mastalgia was observed to manifest before 24 years of age (P=0.006. Conclusion. Mastalgia was a common condition among women in this sub-Saharan African setting as is elsewhere. The early onset mastalgia in this sub-Saharan African study requires further exploration for determination of its risk factors.

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

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    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…

  16. Maternity health care: The experiences of Sub-Saharan African women in Sub-Saharan Africa and Australia.

    Science.gov (United States)

    Mohale, Hlengiwe; Sweet, Linda; Graham, Kristen

    2017-08-01

    Increasing global migration is resulting in a culturally diverse population in the receiving countries. In Australia, it is estimated that at least four thousand Sub-Saharan African women give birth each year. To respond appropriately to the needs of these women, it is important to understand their experiences of maternity care. The study aimed to examine the maternity experiences of Sub-Saharan African women who had given birth in both Sub-Saharan Africa and in Australia. Using a qualitative approach, 14 semi-structured interviews with Sub-Saharan African women now living in Australia were conducted. Data was analysed using Braun and Clark's approach to thematic analysis. Four themes were identified; access to services including health education; birth environment and support; pain management; and perceptions of care. The participants experienced issues with access to maternity care whether they were located in Sub-Saharan Africa or Australia. The study draws on an existing conceptual framework on access to care to discuss the findings on how these women experienced maternity care. The study provides an understanding of Sub-Saharan African women's experiences of maternity care across countries. The findings indicate that these women have maternity health needs shaped by their sociocultural norms and beliefs related to pregnancy and childbirth. It is therefore arguable that enhancing maternity care can be achieved by improving women's health literacy through health education, having an affordable health care system, providing respectful and high quality midwifery care, using effective communication, and showing cultural sensitivity including family support for labouring women. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  17. A survey of Sub-Saharan African medical schools

    Science.gov (United States)

    2012-01-01

    Background Sub-Saharan Africa suffers a disproportionate share of the world's burden of disease while having some of the world's greatest health care workforce shortages. Doctors are an important component of any high functioning health care system. However, efforts to strengthen the doctor workforce in the region have been limited by a small number of medical schools with limited enrolments, international migration of graduates, poor geographic distribution of doctors, and insufficient data on medical schools. The goal of the Sub-Saharan African Medical Schools Study (SAMSS) is to increase the level of understanding and expand the baseline data on medical schools in the region. Methods The SAMSS survey is a descriptive survey study of Sub-Saharan African medical schools. The survey instrument included quantitative and qualitative questions focused on institutional characteristics, student profiles, curricula, post-graduate medical education, teaching staff, resources, barriers to capacity expansion, educational innovations, and external relationships with government and non-governmental organizations. Surveys were sent via e-mail to medical school deans or officials designated by the dean. Analysis is both descriptive and multivariable. Results Surveys were distributed to 146 medical schools in 40 of 48 Sub-Saharan African countries. One hundred and five responses were received (72% response rate). An additional 23 schools were identified after the close of the survey period. Fifty-eight respondents have been founded since 1990, including 22 private schools. Enrolments for medical schools range from 2 to 1800 and graduates range from 4 to 384. Seventy-three percent of respondents (n = 64) increased first year enrolments in the past five years. On average, 26% of respondents' graduates were reported to migrate out of the country within five years of graduation (n = 68). The most significant reported barriers to increasing the number of graduates, and improving

  18. A survey of Sub-Saharan African medical schools.

    Science.gov (United States)

    Chen, Candice; Buch, Eric; Wassermann, Travis; Frehywot, Seble; Mullan, Fitzhugh; Omaswa, Francis; Greysen, S Ryan; Kolars, Joseph C; Dovlo, Delanyo; El Gali Abu Bakr, Diaa Eldin; Haileamlak, Abraham; Koumare, Abdel Karim; Olapade-Olaopa, Emiola Oluwabunmi

    2012-02-24

    Sub-Saharan Africa suffers a disproportionate share of the world's burden of disease while having some of the world's greatest health care workforce shortages. Doctors are an important component of any high functioning health care system. However, efforts to strengthen the doctor workforce in the region have been limited by a small number of medical schools with limited enrolments, international migration of graduates, poor geographic distribution of doctors, and insufficient data on medical schools. The goal of the Sub-Saharan African Medical Schools Study (SAMSS) is to increase the level of understanding and expand the baseline data on medical schools in the region. The SAMSS survey is a descriptive survey study of Sub-Saharan African medical schools. The survey instrument included quantitative and qualitative questions focused on institutional characteristics, student profiles, curricula, post-graduate medical education, teaching staff, resources, barriers to capacity expansion, educational innovations, and external relationships with government and non-governmental organizations. Surveys were sent via e-mail to medical school deans or officials designated by the dean. Analysis is both descriptive and multivariable. Surveys were distributed to 146 medical schools in 40 of 48 Sub-Saharan African countries. One hundred and five responses were received (72% response rate). An additional 23 schools were identified after the close of the survey period. Fifty-eight respondents have been founded since 1990, including 22 private schools. Enrolments for medical schools range from 2 to 1800 and graduates range from 4 to 384. Seventy-three percent of respondents (n = 64) increased first year enrolments in the past five years. On average, 26% of respondents' graduates were reported to migrate out of the country within five years of graduation (n = 68). The most significant reported barriers to increasing the number of graduates, and improving quality, related to

  19. A survey of Sub-Saharan African medical schools

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    Chen Candice

    2012-02-01

    Full Text Available Abstract Background Sub-Saharan Africa suffers a disproportionate share of the world's burden of disease while having some of the world's greatest health care workforce shortages. Doctors are an important component of any high functioning health care system. However, efforts to strengthen the doctor workforce in the region have been limited by a small number of medical schools with limited enrolments, international migration of graduates, poor geographic distribution of doctors, and insufficient data on medical schools. The goal of the Sub-Saharan African Medical Schools Study (SAMSS is to increase the level of understanding and expand the baseline data on medical schools in the region. Methods The SAMSS survey is a descriptive survey study of Sub-Saharan African medical schools. The survey instrument included quantitative and qualitative questions focused on institutional characteristics, student profiles, curricula, post-graduate medical education, teaching staff, resources, barriers to capacity expansion, educational innovations, and external relationships with government and non-governmental organizations. Surveys were sent via e-mail to medical school deans or officials designated by the dean. Analysis is both descriptive and multivariable. Results Surveys were distributed to 146 medical schools in 40 of 48 Sub-Saharan African countries. One hundred and five responses were received (72% response rate. An additional 23 schools were identified after the close of the survey period. Fifty-eight respondents have been founded since 1990, including 22 private schools. Enrolments for medical schools range from 2 to 1800 and graduates range from 4 to 384. Seventy-three percent of respondents (n = 64 increased first year enrolments in the past five years. On average, 26% of respondents' graduates were reported to migrate out of the country within five years of graduation (n = 68. The most significant reported barriers to increasing the number of

  20. Coal in sub-Saharan-African countries undergoing desertification

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    Weaver, J.N.; Brownfield, M.E.; Bergin, M.J.

    1990-01-01

    Coal has been reported in 11 of the 16 sub-Saharan countries discussed in this appraisal: Mauritania, Senegal, Mali, Niger, Benin, Nigeria, Cameroon, Central African Republic, Sudan, Ethiopia, and Somalia. No coal occurrences have been reported in Gambia, Togo, Burkina, Chad, and Djibouti but coal may be present within these countries because neighboring countries do contain coal-bearing rocks. Most of these countries are undergoing desertification or will in the near future. Wood, directly or in the form of charcoal, constitutes two-thirds of the fuel used in Africa. Destruction of forest and shrub lands for fuel is occurring at an increasing rate because of desertification and increasing energy demands. The decline in biological productivity, coupled with concentration of population in areas where water is available and crops may be grown, leads to increasing shortages of wood for fuel. Part of the present and future energy needs of the sub-Saharan region could be met by use of indigenous coal and peat. Nine sedimentary basins, completely or partially within the sub-Saharan region, have the potential of either coal and/or peat deposits of economic value: 1- Senegal Basin, 2- Taoudeni Basin and Gao Trough, 3- Niger Basin, 4- Chad Basin, 5- Chari Basin, 6- Benue Trough (Depression), 7- Sudan Trough, 8- Plateau and Rift Belt, and 9- Somali Basin. Niger and Nigeria are the only countries in sub-Saharan Africa in which coal is presently being mined as a fuel source for powerplants and domestic use. Peat occurs in the deltas, lower river, and interdunal basin areas of Senegal, Mauritania, and Sudan. Peat can be used as an alternate fuel source and is currently being tested as a soil amendment in the agricultural sector. Coal and peat exploration and development studies are urgently required and should be initiated so the coal and peat utilization potential of each country can be determined. The overall objective of these studies is to establish, within the sub-Saharan

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

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    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. © 2015 John Wiley & Sons Ltd.

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

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    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.

  3. Cancer incidence profile in sub-Saharan African-born blacks in the United States: Similarities and differences with US-born non-Hispanic blacks.

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    Medhanie, Genet A; Fedewa, Stacey A; Adissu, Hibret; DeSantis, Carol E; Siegel, Rebecca L; Jemal, Ahmedin

    2017-08-15

    Sub-Saharan African-born blacks (ABs) are one of the fastest-growing populations in the United States. However, to the authors' knowledge, data regarding the cancer burden in this group are lacking, which would inform targeted cancer prevention and control. The authors calculated age-standardized proportional incidence ratios (PIRs) comparing the frequency of the top 15 cancers in ABs with that of US-born non-Hispanic blacks (USBs) by sex and region of birth using incidence data for 2000 through 2012 from the Surveillance, Epidemiology, and End Results (SEER 17) program. Compared with USBs, ABs had significantly higher PIRs of infection-related cancers (liver, stomach, and Kaposi sarcoma), blood cancers (leukemia and non-Hodgkin lymphoma), prostate cancer, and thyroid cancers (females only). For example, the PIR for Kaposi sarcoma in AB versus USB women was 12.06 (95% confidence interval [95% CI], 5.23-18.90). In contrast, ABs had lower PIRs for smoking-related and colorectal cancers (eg, for lung cancer among men, the PIR was 0.30 [95% CI, 0.27-0.34]). Furthermore, cancer occurrence in ABs versus USBs varied by region of birth. For example, the higher PIRs for liver cancer noted among male ABs (PIR, 3.57; 95% CI, 1.79-5.35) and for thyroid cancer in female ABs (PIR, 3.03; 95% CI, 2.03-4.02) were confined to Eastern African-born blacks, whereas the higher PIR for prostate cancer (PIR, 1.90; 95% CI, 1.78, 2.02) was confined to Western African-born blacks. The cancer incidence profile of ABs is different from that of USBs and varies by region of birth, suggesting differences in environmental, cultural, social, and genetic factors. The findings of the current study could stimulate etiologic research and help to inform targeted interventions. Cancer 2017;123:3116-24. © 2017 American Cancer Society. © 2017 American Cancer Society.

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

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    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.

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

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    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

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

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    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…

  7. [Health care access of Sub-Saharan African migrants living with chronic hepatitis B].

    Science.gov (United States)

    Vignier, Nicolas; Spira, Rosemary Dray; Lert, France; Pannetier, Julie; Ravalihasy, Andrainolo; Gosselin, Anne; Lydié, Nathalie; Bouchaud, Olivier; Desgrées du Loû, Annabel

    2017-07-10

    Objective: The objective of this study was to analyse health care access of Sub-Saharan African migrants living with chronic hepatitis B (CHB) in France. Methods: The ANRS-Parcours survey was a life-event survey conducted in 2012-2013 among Sub-Saharan African migrants recruited by health care facilities managing CHB in the Paris region. Data were collected by face-to-face interview using a biographical grid and a standardized questionnaire. Results: 96.4% of the 619 participants basic health insurance coverage with CMU universal health insurance coverage in 18.6% of cases and AME state medical assistance in 23.4% of cases. One-third of basic health insurance beneficiaries did not have any complementary health insurance and 75.7% had long-term disease status. The median time to acquisition of health insurance cover after arrival in France was one year. 22.0% of participants reported delaying health care for financial reasons since their arrival in France and 9.7% reported being refused health care usually due to refusal of CMU or AME. Health care access was effective within one year of the diagnosis. Delayed health care access was more common among people without health insurance coverage in the year of diagnosis. Patients lost to follow-up for more than 12 months were rare. Conclusion: Sub-Saharan African migrants living with chronic hepatitis B rapidly access health insurance coverage and health care. However, barriers to health care access persist for some people, essentially due to absent or incomplete health insurance cover and refusal of care for AME or CMU beneficiaries.

  8. Temperament Styles of Children in Three Sub-Saharan African Countries

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    Oakland, Thomas; Callueng, Carmelo

    2015-01-01

    This cross-national research examined temperament style preferences among children in three sub-Saharan African countries (i.e., Nigeria, South Africa, and Zimbabwe) and possible differences between them on four bipolar temperament styles: extroverted-introverted, practical-imaginative, thinking-feeling, and organized-flexible. Children in these…

  9. A Citation Analysis of Sub-Saharan African Library and Information ...

    African Journals Online (AJOL)

    In bibliometrics, the numbers of research articles and citations constitute the main measurement indicators of research output and impact respectively. This study evaluates the library and information science/studies (LIS) journals published in sub-Saharan African countries in order to assess their performance. Drawing its ...

  10. Staying put in moving sands. The stepwise migration process of sub-Saharan African migrants heading north

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    Schapendonk, J.

    2010-01-01

    This chapter focuses on the stepwise migration process of sub-Saharan African migrants heading North with a strong actor-centred approach. It aims to gain more insights into the migration processes by investigating migrant's flexibility and dependency. The chapter examines the way sub-Saharan

  11. Population affinities of African Colombians to Sub-Saharan Africans based on dental morphology.

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    Delgado-Burbano, M E

    2007-01-01

    The Atlantic slave trade moved more than 13 million Africans to American lands between the 15th and 19th centuries. Previous historical, linguistic, and social-cultural studies suggested a Western-Central Bantu African origin for the Colombian slaves; however, their precise provenance remains unclear. The present study investigates the variation of the epigenetic dental traits in the deciduous and permanent dentition and phenotypic affinities of a contemporary Afro-Colombian community (n=178) in an attempt to identify their possible African ancestors. The results of a multivariate analysis of principal components show that Afro-descendents from Guapi have strong phenotypic relationships with several Bantu-speakers groups of Western and Western-Central Africa (Sub-Saharan region), specifically from Gabon, Congo, Pygmies, Nigeria, Cameroon, Togo and Benin. In concordance with recent mtDNA studies, this research suggests a distant but important relationship between Afro-Colombians and Eastern and South-Eastern African populations. This analysis also shows a marked dental divergence with North African samples. The dental information is not very different from the cultural, linguistic and historic data; however, it is more in agreement with studies based on molecular variation. In addition, this study reveals that African-Americans from North America, Central America-Caribbean and South America have high biological variation essentially identical to their several Sub-Saharan sources. Although a microevolutionary model, based on differential rates of gene flow with Native American and European-American groups and little selective pressures influence, better explains the phenotypic variation observed, more African-American dental samples must be analyzed from a regional perspective.

  12. Into Africa: Molecular phylogenetics and historical biogeography of sub-Saharan African woodferns (Dryopteris).

    Science.gov (United States)

    Sessa, Emily B; Juslén, Aino; Väre, Henry; Chambers, Sally M

    2017-03-01

    Our goal was to infer the phylogenetic relationships and historical biogeography of the genus Dryopteris with a focus on taxa in sub-Saharan Africa and neighboring islands. In general, little is known about the relationships between African fern species and their congeners in other geographic regions, and our aim was to determine whether the sub-Saharan African species of Dryopteris are monophyletic and evolved within Africa or arrived there via repeated dispersals into Africa from other regions. We obtained sequence data for five chloroplast markers from 214 species of Dryopteris and 18 outgroups. We performed phylogenetic and molecular dating analyses using a Bayesian relaxed clock method in BEAST with fossil and secondary calibration points and estimated ancestral ranges for the genus globally by comparing multiple models in BioGeoBEARS. We found that 22 of 27 accessions of sub-Saharan African Dryopteris belong to a large clade of 31 accessions that also includes taxa from Indian and Atlantic Ocean islands. Additional accessions of taxa from our regions of interest have Asian, Hawaiian, European, or North American species as their closest relatives. The majority of sub-Saharan African Dryopteris species are descended from a shared common ancestor that dispersed to Africa from Asia approximately 10 Ma. There have been subsequent dispersal events from the African mainland to islands in the Atlantic and Indian Oceans, including Madagascar. Several additional species are estimated to have descended from ancestors that reached Africa via separate events over the last roughly 20 million years. © 2017 Sessa et al. Published by the Botanical Society of America.This work is licensed under a Creative Commons Attribution License (CC-BY-NC).

  13. Energy intensity and manufacturing firm characteristics in Sub-Saharan African countries

    OpenAIRE

    Kaulich, Florian; Luken, Ralph; Mhlanga, Alois; Polzerova, Ingrid

    2016-01-01

    We draw on a unique dataset for energy use by manufacturing firms in 18 Sub-Saharan African countries to estimate the relationship between energy intensity of production and firms' characteristics. Our results show that lower levels of energy intensity are associated with export activity, foreign ownership, size and capital-labor ratio, while higher levels of energy intensity are associated with a higher share of fuels in total energy consumption. We do not find a statistically significant re...

  14. External Sustainability of Oil-Producing Sub-Saharan African Countries

    OpenAIRE

    Robert C York; Misa Takebe

    2011-01-01

    In the extensive empirical work carried out across the IMF on oil-producing sub-Saharan African (SSA) countries, the notion of "sustainability" is often directed toward fiscal policies, and, in particular, views on the "optimal" non-oil primary fiscal deficit. The bulk of this work does not, however, address external sustainability, which is a concern especially for those SSA oil producers operating under a fixed exchange rate regime. A couple of recent papers have extended the existing metho...

  15. Pilot study of quality of care training and knowledge in Sub-Saharan African medical schools.

    Science.gov (United States)

    Bowser, Diana; Abbas, Yasmin; Odunleye, Temitope; Broughton, Edward; Bossert, Thomas

    2017-07-24

    To identify the level of knowledge and competencies related to quality of care during medical education in sub-Saharan African medical schools. A cross-sectional study design was utilized to examine the capacity of medical schools in sub-Saharan African (SSA) countries to teach about the concepts of quality of care and the inclusion of these concepts in their curriculum. A purposeful convenience sampling technique was used to select participants from 25 medical schools in 5 sub-Saharan African countries. Respondents included medical school deans or senior academic personnel.  A survey was developed using the Institute of Medicine's definition of quality of care as the guiding framework.  Sample means and summary statistics were used to present the results of the survey responses. While 45% of the schools surveyed are teaching on at least one of the six domains of the Institute of Medicine's definition of quality of care, there are some schools who report not teaching about quality at all, or that they "do not know". Despite these low numbers, when asked about topics related to quality of care, many schools are teaching applied management related topics and almost all schools teach about equity and patient-centered care. The results have important impacts both for incorporating quality of care into medical education and for practitioners.  The tool developed for this study can be used in future qualitative and quantitative studies to further understanding of how to improve the teaching and learning about quality of care in medical schools. Keywords: quality of care, medical schools, sub-Saharan Africa, medical errors, healthcare improvement.

  16. Men's multiple sexual partnerships in 15 Sub-Saharan African countries: sociodemographic patterns and implications.

    Science.gov (United States)

    Bingenheimer, Jeffrey B

    2010-03-01

    Men's multiple sexual partnerships contribute to the spread of HIV in sub-Saharan Africa, but the social determinants of these relationships remain poorly understood. Prevailing wisdom suggests that men's institutionalized authority over women and their control of economic resources are key facilitators of multiple partnerships in this region. Men's exposure to or freedom from social control mechanisms embedded in family and village life may also play a role. This article provides insight into these issues by examining sociodemographic correlates of men's multiple sexual partnerships using data from recent Demographic and Health Surveys in 15 sub-Saharan African countries. The prevalence of self-reported multiple partnerships varies widely among countries. Sociodemographic patterns of such partnerships confirm the importance of men's control of economic resources and suggest that men's freedom from social control mechanisms may be more important than their authority over their wives.

  17. United States aid policy and induced abortion in sub-Saharan Africa.

    Science.gov (United States)

    Bendavid, Eran; Avila, Patrick; Miller, Grant

    2011-12-01

    To determine whether the Mexico City Policy, a United States government policy that prohibits funding to nongovernmental organizations performing or promoting abortion, was associated with the induced abortion rate in sub-Saharan Africa. Women in 20 African countries who had induced abortions between 1994 and 2008 were identified in Demographic and Health Surveys. A country's exposure to the Mexico City Policy was considered high (or low) if its per capita assistance from the United States for family planning and reproductive health was above (or below) the median among study countries before the policy's reinstatement in 2001. Using logistic regression and a difference-in-difference design, the authors estimated the differential change in the odds of having an induced abortion among women in high exposure countries relative to low exposure countries when the policy was reinstated. The study included 261,116 women aged 15 to 44 years. A comparison of 1994-2000 with 2001-2008 revealed an adjusted odds ratio for induced abortion of 2.55 for high-exposure countries versus low-exposure countries under the policy (95% confidence interval, CI: 1.76-3.71). There was a relative decline in the use of modern contraceptives in the high-exposure countries over the same time period. The induced abortion rate in sub-Saharan Africa rose in high-exposure countries relative to low-exposure countries when the Mexico City Policy was reintroduced. Reduced financial support for family planning may have led women to substitute abortion for contraception. Regardless of one's views about abortion, the findings may have important implications for public policies governing abortion.

  18. HUMAN SIDE OF E-COMMERCE IN THE SUB-SAHARAN AFRICAN COUNTRIES

    OpenAIRE

    DURAK, Görkem

    2017-01-01

    E-commerce is a new way of shopping through using internet since 1990s. This latest from of shopping is based on progress in information technologies. In the 1990s, companies just as Amazon and eBay started to change the shopping behavior of people. In this research, e-commerce index of 44 Sub-Saharan African countries are calculated by using World Development Indicators which are issued by the World Bank Group. The E-commerce index is consisting of access to electricity, co...

  19. 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.

  20. Screening of imported infectious diseases among asymptomatic sub-Saharan African and Latin American immigrants: a public health challenge.

    Science.gov (United States)

    Monge-Maillo, Begoña; López-Vélez, Rogelio; Norman, Francesca F; Ferrere-González, Federico; Martínez-Pérez, Ángela; Pérez-Molina, José Antonio

    2015-04-01

    Migrants from developing countries are usually young and healthy but several studies report they may harbor asymptomatic infections for prolonged periods. Prevalence of infections were determined for asymptomatic immigrants from Latin America and sub-Saharan Africa who ettended to a European Tropical Medicine Referral Center from 2000 to 2009. A systematic screening protocol for selected infections was used. Data from 317 sub-Saharan Africans and 383 Latin Americans were analyzed. Patients were mostly young (mean age 29 years); there were significantly more males among sub-Saharan Africans (83% versus 31.6%) and pre-consultation period was longer for Latin Americans (5 versus 42 months). Diagnoses of human immunodeficiency virus (HIV), chronic hepatitis B and C virus infection, and latent tuberculosis were significantly more frequent in sub-Saharan Africans (2.3% versus 0.3%; 14% versus 1.6%; 1.3 versus 0%; 71% versus 32.1%). There were no significant differences in prevalence for syphilis and intestinal parasites. Malaria and schistosomiasis prevalence in sub-Saharan Africans was 4.6% and 5.9%, respectively, and prevalence of Chagas disease in Latin Americans was 48.5%. Identifying and treating asymptomatic imported infectious diseases may have an impact both for the individual concerned and for public health. Based on these results, a systematic screening protocol for asymptomatic immigrants is proposed. © The American Society of Tropical Medicine and Hygiene.

  1. Mobilities and Sediments : Spatial Dynamics in the Context of Contemporary Sub-Saharan African Migration to Europe

    NARCIS (Netherlands)

    Schapendonk, J.

    2012-01-01

    Contemporary African migration to the European Union (EU) is triggered by global interconnectedness, but at the same time it is opposed by the hard borders of the EU. As a consequence, sub- Saharan African migrants often undertake fragmented and dangerous journeys to the North. These journeys are

  2. 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

  3. Psychosocial distress and alcohol use as factors in adolescent sexual behavior among sub-Saharan African adolescents.

    Science.gov (United States)

    Page, Randy M; Hall, Cougar P

    2009-08-01

    This study examines the relationship between sexual behavior, alcohol use, and indicators of psychosocial distress (mental health) of adolescents in 6 sub-Saharan African countries using the Global School-based Student Health Survey (GSHS). The sample consisted of 22,949 adolescents from Botswana, Kenya, Namibia, Uganda, Zambia, and Zimbabwe who participated in 2003 or 2004 GSHS surveys. Statistical analysis was conducted to determine whether sexual behaviors increased with levels of psychosocial distress and alcohol use. Sexual behaviors (having sex or having sex with 2 or more people) were associated with both psychosocial distress and alcohol use. Odds ratios showed that both boys and girls reporting psychosocial distress and alcohol use were at higher risk for having sex. Results also indicated that the likelihood of sexual behaviors increased when there was an increase in the number of psychosocial indicators and frequency of alcohol consumption. The results of this study are consistent with those conducted in the United States suggesting that sexual behavior, psychosocial distress, and substance use are interconnected. These findings highlight the need for school health education and health services in sub-Saharan Africa, specifically the efforts to reduce psychosocial distress and prevent substance use in efforts to prevent the spread of human immunodeficiency virus and other sexually transmitted infections.

  4. Genetics of Sub-Saharan African Human Population: Implications for HIV/AIDS, Tuberculosis, and Malaria

    Directory of Open Access Journals (Sweden)

    Gerald Mboowa

    2014-01-01

    Full Text Available Sub-Saharan Africa has continued leading in prevalence and incidence of major infectious disease killers such as HIV/AIDS, tuberculosis, and malaria. Epidemiological triad of infectious diseases includes susceptible host, pathogen, and environment. It is imperative that all aspects of vertices of the infectious disease triad are analysed to better understand why this is so. Studies done to address this intriguing reality though have mainly addressed pathogen and environmental components of the triad. Africa is the most genetically diverse region of the world as well as being the origin of modern humans. Malaria is relatively an ancient infection in this region as compared to TB and HIV/AIDS; from the evolutionary perspective, we would draw lessons that this ancestrally unique population now under three important infectious diseases both ancient and exotic will be skewed into increased genetic diversity; moreover, other evolutionary forces are also still at play. Host genetic diversity resulting from many years of malaria infection has been well documented in this population; we are yet to account for genetic diversity from the trio of these infections. Effect of host genetics on treatment outcome has been documented. Host genetics of sub-Saharan African population and its implication to infectious diseases are an important aspect that this review seeks to address.

  5. 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...... and regulated by the state. In most cases in SSA cities urban development has no professional assistance in the form of architects or engineers, and what is characterised as ‘disorder’, as is the case with informal urbanisation, is considered as undesirable, inappropriate, dangerous, unhealthy and un...

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

    NARCIS (Netherlands)

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

    2009-01-01

    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

  7. 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

  8. 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

  9. The influence of human induced factors on African elephant (Loxodonta africana) populations in Sub-Saharan Africa

    OpenAIRE

    Hunninck, Louis Marcel

    2015-01-01

    Numerous studies have been done on the conservation of the African elephant (Loxodonta africana) yet too few studies have focused on comparing the ultimate factors that influence the African elephant populations. Here, we looked at several human induced factors that reflect parts of the Human Elephant conflict and tried to find which one of those had the most important effect on African elephant populations in Sub-Saharan countries. Agricultural activity and deforestation together with increa...

  10. National laboratory policies and plans in sub-Saharan African countries: gaps and opportunities.

    Science.gov (United States)

    Ondoa, Pascale; van der Broek, Ankie; Jansen, Christel; de Bruijn, Hilde; Schultsz, Constance

    2017-01-01

    The 2008 Maputo Declaration calls for the development of dedicated national laboratory policies and strategic plans supporting the enhancement of laboratory services in response to the long-lasting relegation of medical laboratory systems in sub-Saharan Africa. This study describes the extent to which laboratories are addressed in the national health policies and plans created directly following the 2008 momentum for laboratory strengthening. National health policies and plans from 39 sub-Saharan African countries, valid throughout and beyond 31 December 2010 were collected in March 2012 and analysed during 2013. Laboratories were addressed by all countries. Human resources were the most addressed topic (38/39) and finances and budget were the least addressed (strategic planning at the end of 2013 (17/39) were more likely to be francophone countries located in West-Central Africa (13/17) and have historically low HIV prevalence. The most common gaps anticipated to compromise the implementation of the policies and plans were the disconnect between policies and plans, under-developed finance sections and monitoring and evaluating frameworks, absence of points of reference to define gaps and shortages, and inappropriate governance structure. The availability of laboratory policy and plan implementation can be improved by strictly applying a more standardised methodology for policy development, using harmonised norms to set targets for improvement and intensifying the establishment of directorates of laboratory services directly under the authority of Ministries of Health. Horizontal programmes such as the Global Health Security Agenda could provide the necessary impulse to take the least advanced countries on board.

  11. National laboratory policies and plans in sub-Saharan African countries: gaps and opportunities

    Directory of Open Access Journals (Sweden)

    Pascale Ondoa

    2017-02-01

    Full Text Available Background: The 2008 Maputo Declaration calls for the development of dedicated national laboratory policies and strategic plans supporting the enhancement of laboratory services in response to the long-lasting relegation of medical laboratory systems in sub-Saharan Africa.Objectives: This study describes the extent to which laboratories are addressed in the national health policies and plans created directly following the 2008 momentum for laboratory strengthening.Method: National health policies and plans from 39 sub-Saharan African countries, valid throughout and beyond 31 December 2010 were collected in March 2012 and analysed during 2013.Results: Laboratories were addressed by all countries. Human resources were the most addressed topic (38/39 and finances and budget were the least addressed (< 5/39. Countries lagging behind in national laboratory strategic planning at the end of 2013 (17/39 were more likely to be francophone countries located in West-Central Africa (13/17 and have historically low HIV prevalence. The most common gaps anticipated to compromise the implementation of the policies and plans were the disconnect between policies and plans, under-developed finance sections and monitoring and evaluating frameworks, absence of points of reference to define gaps and shortages, and inappropriate governance structure.Conclusion: The availability of laboratory policy and plan implementation can be improved by strictly applying a more standardised methodology for policy development, using harmonised norms to set targets for improvement and intensifying the establishment of directorates of laboratory services directly under the authority of Ministries of Health. Horizontal programmes such as the Global Health Security Agenda could provide the necessary impulse to take the least advanced countries on board.

  12. National laboratory policies and plans in sub-Saharan African countries: gaps and opportunities

    Directory of Open Access Journals (Sweden)

    Pascale Ondoa

    2017-07-01

    Full Text Available Background: The 2008 Maputo Declaration calls for the development of dedicated national laboratory policies and strategic plans supporting the enhancement of laboratory services in response to the long-lasting relegation of medical laboratory systems in sub-Saharan Africa. Objectives: This study describes the extent to which laboratories are addressed in the national health policies and plans created directly following the 2008 momentum for laboratory strengthening. Method: National health policies and plans from 39 sub-Saharan African countries, valid throughout and beyond 31 December 2010 were collected in March 2012 and analysed during 2013. Results: Laboratories were addressed by all countries. Human resources were the most addressed topic (38/39 and finances and budget were the least addressed (< 5/39. Countries lagging behind in national laboratory strategic planning at the end of 2013 (17/39 were more likely to be francophone countries located in West-Central Africa (13/17 and have historically low HIV prevalence. The most common gaps anticipated to compromise the implementation of the policies and plans were the disconnect between policies and plans, under-developed finance sections and monitoring and evaluating frameworks, absence of points of reference to define gaps and shortages, and inappropriate governance structure. Conclusion: The availability of laboratory policy and plan implementation can be improved by strictly applying a more standardised methodology for policy development, using harmonised norms to set targets for improvement and intensifying the establishment of directorates of laboratory services directly under the authority of Ministries of Health. Horizontal programmes such as the Global Health Security Agenda could provide the necessary impulse to take the least advanced countries on board.

  13. 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

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

    Science.gov (United States)

    Galactionova, Katya; Tediosi, Fabrizio; de Savigny, Don; Smith, Thomas; Tanner, Marcel

    2015-01-01

    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 intervening to tackle

  15. Control beliefs and health locus of control in Ugandan, German and migrated sub-Saharan African HIV infected individuals.

    Science.gov (United States)

    Milz, Ruth U; Husstedt, Ingo-W; Reichelt, Doris; Evers, Stefan

    2016-04-01

    Little is known about the influence of control beliefs on antiretroviral drug adherence in patients who migrated from sub-Saharan Africa to Europe. The aim of this study was to explore the differences in health locus of control and control beliefs between HIV infected patients from sub-Saharan Africa with and without a lifetime experience of migration. A sample of 62 HIV infected consecutive patients referred to the HIV clinics at the University Hospital of Münster (Germany) and at the Rubaga Hospital Kampala (Uganda) were enrolled into this study. We compared three groups of patients: sub-Saharan African migrants, German patients, and local Ugandan patients. We used the German health and illness related control beliefs questionnaire (KKG), the Competence and control beliefs questionnaire (FKK), and the Powe Fatalism Inventory-HIV/AIDS-Version (PFI-HIV/AIDS-Version) and translated these scales into English and Luganda. In addition, the patients' sociodemographic, acculturation, clinical, and immunological data were registered. Significant results were shown in HIV related external locus of control between migrated sub-Saharan African and local Ugandan patients compared to German patients. General control beliefs showed no significant differences. In the PFI-HIV-Version, there was a significant difference between migrated sub-Saharan African and Ugandan patients compared to German patients. Our data suggest that the experience of migration does not influence the locus of control. Compared to German HIV patients, African patients in general showed a significantly higher external health locus of control which might have implications for drug adherence. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Land-related conflicts in Sub-Saharan Africa | Bob | African Journal ...

    African Journals Online (AJOL)

    Sub-Saharan Africa has a history of land dispossession and contestation which have resulted in various types of inequalities and a skewed distribution of land resources. Land in Sub-Saharan Africa has been subject to conflict, conquest, expropriation and exploitation thus resulting in the many discrepancies that exist today ...

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

    OpenAIRE

    Evans, Olaniyi

    2013-01-01

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

  18. Self-Reported HIV-Positive Status But Subsequent HIV-Negative Test Result Using Rapid Diagnostic Testing Algorithms Among Seven Sub-Saharan African Military Populations

    Science.gov (United States)

    2017-07-07

    in many sub-Saharan African countries, and extensive laboratory testing has con- firmed HIV RDTs have excellent sensitivity and specificity. However... interpretation of results. We conducted HIV serosur- veys in seven sub-Saharan African military populations and recorded the frequency of per- sonnel...positive results, such as greater adherence to quality assurance guidelines and prevalence-specific HIV testing algorithms as described in the World

  19. Sub-Saharan Africa Report

    National Research Council Canada - National Science Library

    1985-01-01

    This is Sub Saharan Africa Report. It contains the issues with different topics on Inter African Affairs, Angola, Cameroon, Cape Verde, Chad, Congo, Ethiopia, Gambia, Ghana, Guinea, Guinea Bissau, Kenya, madagascar, Mozambique...

  20. Contraceptive Use and Uptake of HIV-Testing among Sub-Saharan African Women.

    Directory of Open Access Journals (Sweden)

    Katherine E Center

    Full Text Available Despite improved availability of simple, relatively inexpensive, and highly effective antiretroviral treatment for HIV/AIDS, the disease remains a major public health challenge for women in sub-Saharan Africa (SSA. Given the numerous barriers in access to care for women in this region, every health issue that brings them into contact with the health system should be optimized as an opportunity to integrate HIV/AIDS prevention. Because most non-condom forms of modern contraception require a clinical appointment for use, contraception appointments could provide a confidential opportunity for access to HIV counseling, testing, and referral to care. This study sought to investigate the relationship between contraceptive methods and HIV testing among women in SSA. Data from the Demographic and Health Survey from four African countries-Congo, Mozambique, Nigeria, and Uganda-was used to examine whether modern (e.g., pills, condom or traditional (e.g., periodic abstinence, withdrawal forms of contraception were associated with uptake of HIV testing. Data for the current analyses were restricted to 35,748 women with complete information on the variables of interest. Chi-square tests and logistic regression models were used to assess the relationship between uptake of HIV testing and respondents' baseline characteristics and contraceptive methods. In the total sample and in Mozambique, women who used modern forms of contraception were more likely to be tested for HIV compared to those who did not use contraception. This positive association was not demonstrated in Congo, Nigeria, or Uganda. That many women who access modern contraception are not tested for HIV in high HIV burden areas highlights a missed opportunity to deliver an important intervention to promote maternal and child health. Given the increasing popularity of hormonal contraception methods in low-income countries, there is an urgent need to integrate HIV counseling, testing, and treatment

  1. Association between coverage of maternal and child health interventions, and under-5 mortality: a repeated cross-sectional analysis of 35 sub-Saharan African countries

    OpenAIRE

    Daniel J. Corsi; S. V. Subramanian

    2014-01-01

    Background: Infant and child mortality rates are among the most important indicators of child health, nutrition, implementation of key survival interventions, and the overall social and economic development of a population. In this paper, we investigate the role of coverage of maternal and child health (MNCH) interventions in contributing to declines in child mortality in sub-Saharan Africa.Design: Data are from 81 Demographic and Health Surveys from 35 sub-Saharan African countries. Using ec...

  2. Surgery for rheumatic mitral valve disease in sub-saharan African ...

    African Journals Online (AJOL)

    Rheumatic valve disease, a consequence of acute rheumatic fever, remains endemic in developing countries in the sub-Saharan region where it is the leading cause of heart failure and cardiovascular death, involving predominantly a young population. The involvement of the mitral valve is pathognomonic and mitral ...

  3. Shaping the Role of sub-Saharan African Nurses and Midwives ...

    African Journals Online (AJOL)

    To explore the role expectations of different stakeholders in the health care system on the roles and tasks that nurses and midwives perform, in order to clarify and strengthen these roles and shape the future of nursing education and practice in sub-Saharan Africa. Qualitative focus group discussions were held with different ...

  4. Descriptive systematic review of sub-Saharan African studies on the ...

    African Journals Online (AJOL)

    The purpose of this review was to identify and assess studies that have quantified the association between alcohol consumption and HIV infection in sub-Saharan Africa. PubMed, CAB Abstracts and article references were searched to identify studies published in English between 2000 and 2008 that reported relative ...

  5. National laboratory policies and plans in sub-Saharan African countries: gaps and opportunities

    NARCIS (Netherlands)

    Ondoa, Pascale; van der Broek, Ankie; Jansen, Christel; de Bruijn, Hilde; Schultsz, Constance

    2017-01-01

    The 2008 Maputo Declaration calls for the development of dedicated national laboratory policies and strategic plans supporting the enhancement of laboratory services in response to the long-lasting relegation of medical laboratory systems in sub-Saharan Africa. This study describes the extent to

  6. Water quality monitoring in sub-Saharan African lakes: a review of ...

    African Journals Online (AJOL)

    Water quality deterioration in sub-Saharan Africa has attained a scale that requires scientific intervention. It is therefore important to devise appropriate and reliable techniques to investigate the water quality of lakes and reservoirs for the development of water resource management strategies. Whilst conventional water ...

  7. Pharmacokinetics of Antibiotics in Sub-Saharan African Patient Populations: A Systematic Review

    NARCIS (Netherlands)

    Bos, Jeannet C.; van Hest, Reinier M.; Prins, Jan M.

    2017-01-01

    Background: In sub-Saharan Africa (SSA), severe febrile illness accounts for a large majority of medical admissions. SSA patients may also suffer from cachexia and organ dysfunction resulting from tuberculosis, hepatitis B, and hypertension. It is hard to tell how these conditions influence the

  8. 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.

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

    Science.gov (United States)

    Marsicano, Elise; Lydié, Nathalie; Bajos, Nathalie

    2013-01-01

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

  10. 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

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

    Science.gov (United States)

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

    2014-01-01

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

  12. The Impact of Internal Migration on under-Five Mortality in 27 Sub-Saharan African Countries.

    Directory of Open Access Journals (Sweden)

    Abukari I Issaka

    Full Text Available The literature on the impact of internal migration on under-five mortality in sub-Saharan Africa has been limited. This study examined the impact of internal migration on under-five mortality rate in 27 sub-Saharan African countries.The analysis used cross-sectional data from the most recent Demographic and Health Surveys of 27 sub-Saharan African countries. Information on the number of live births and the number of under-five deaths in the five years preceding the surveys in these countries was examined. Using variables from which migration data were generated, four migration statuses were computed, and the impact of each migration status on under-five mortality was analysed by using multivariate Cox proportional hazards regression models.Of the 96333 live births, 7036 deaths were reported. In the unadjusted model, we found that, compared to urban non-migrant mothers, hazard of under-five mortality was 20% [HR: 1.20; 95% confidence interval (CI: (1.06–1.35], 40% [HR: 1.40; 95% CI: (1.29–1.53], and 43% [HR: 1.43; 95% CI: (1.30–1.58] higher among urban-rural migrant, rural non-migrant, and rural-urban migrant mothers respectively. The likelihood of children dying did not change considerably when country and demographic variables were adjusted for. However, after controlling for health care service utilization factors, the results remained consistently significant for rurality. That is, mortality rates remained significantly higher among children of rural non-migrant [(HR: 1.20; 95% CI: (1.08–1.33, P-value (p < 0.001] and rural-urban migrant [HR: 1.29; 95% CI: (1.15–1.45, p < 0.001] mothers than those of urban non-migrant mothers.Although under-five child mortality rate declined by 52% between 1990 and 2015 (from 179 to 86 per1000 live births in sub-Saharan Africa, the continent still has the highest rate in the world. This finding highlights the need to consider providing education and health care services in rural areas, when

  13. Infertility in sub-Saharan women. New technologies in traditional African culture

    Directory of Open Access Journals (Sweden)

    Auxiliadora Nieves Vázquez

    2018-02-01

    Full Text Available Africa is a multicultural continent with a large variety of sociopolitical situations. All along the continent there is a common characteristic based on traditional culture: women’s reproductive role is the basis of social and economic structure. Women’s infertility implies an important stigma which has a great personal, familiar and social impact. I study the incidence, causes and consequences of sub-Saharan women’s infertility. I also analyze the different therapeutic approaches, feasibility of new reproductive techniques for the general population in their real lives and the bioethics discussion this involves.

  14. 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.

  15. Workable Social Health Insurance Systems in Sub-Saharan Africa ...

    African Journals Online (AJOL)

    One of the major barriers to access to healthcare in most sub-Saharan African countries is financial constraints. The need therefore arises for African states to put in place workable social health insurance schemes, as is the practice in most developed countries. This article assesses the peculiar characteristics of ...

  16. 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.

  17. Parental Depression and Associations with Parenting and Children's Physical and Mental Health in a Sub-Saharan African Setting.

    Science.gov (United States)

    Huang, Keng-Yen; Abura, Gloria; Theise, Rachelle; Nakigudde, Janet

    2017-08-01

    Depression is one of the most prevalent mental health challenges in low- and middle-income countries. However, the mechanisms of parental depression on children's development are understudied in these countries. This study examined the prevalence of parental depression, contextual predictors of parental depression, and the associations between parental depression, parenting and children's development in one of the Sub-Saharan African countries-Uganda. Three hundred and three Ugandan parents of young children were recruited and interviewed. Results indicated that about 28 % of parents were depressed. Contextual factors such as low educational attainment, food insecurity, low social support, and high number of children were associated with parental depression. Structural equation modeling also indicated that Ugandan parents' depression was associated with less optimal parenting, and higher problem behavior, lower social competence, and poorer physical health and school functioning in children. Results provide several cross cultural consistency evidence in associations among parental depression, parenting, and child development.

  18. "It's Better Not to Know": Perceived Barriers to HIV Voluntary Counseling and Testing among Sub-Saharan African Migrants in Belgium

    Science.gov (United States)

    Manirankunda, Lazare; Loos, Jasna; Alou, Therese Assebide; Colebunders, Robert; Nostlinger, Christiana

    2009-01-01

    This study explored perceptions, needs, and barriers of sub-Saharan African migrants in relation to HIV voluntary counseling and testing (VCT). Using an inductive qualitative methodological approach, data were obtained from focus group discussions. Results showed that participants were in principle in favor of VCT. However, they indicated that…

  19. Peripheral insulin resistance rather than beta cell dysfunction accounts for geographical differences in impaired fasting blood glucose among sub-Saharan African individuals : findings from the RODAM study

    NARCIS (Netherlands)

    Meeks, Karlijn A C; Stronks, Karien; Adeyemo, Adebowale; Addo, Juliet; Bahendeka, Silver; Beune, Erik; Owusu-Dabo, Ellis; Danquah, Ina; Galbete, Cecilia; Henneman, Peter; Klipstein-Grobusch, Kerstin; Mockenhaupt, Frank P; Osei, Kwame; Schulze, Matthias B; Spranger, Joachim; Smeeth, Liam; Agyemang, Charles

    2017-01-01

    AIMS/HYPOTHESIS: The aim of this study was to assess the extent to which insulin resistance and beta cell dysfunction account for differences in impaired fasting blood glucose (IFBG) levels in sub-Saharan African individuals living in different locations in Europe and Africa. We also aimed to

  20. Is greater tissue activity of creatine kinase the genetic factor increasing hypertension risk in black people of sub-Saharan African descent?

    NARCIS (Netherlands)

    Brewster, L. M.; Clark, J. F.; van Montfrans, G. A.

    2000-01-01

    We postulate that the genetic factor increasing the propensity of black people of sub-Saharan African descent to develop high blood pressure is the relatively high activity of creatine kinase, predominantly in vascular and cardiac muscle tissue. Such greater activity of creatine kinase has been

  1. Mental health of sub-saharan african migrants: The gendered role of migration paths and transnational ties

    Directory of Open Access Journals (Sweden)

    Julie Pannetier

    2017-12-01

    Full Text Available In Europe, migrants are at higher risk of common mental disorders or psychological distress than are natives. Little is known regarding the social determinants of migrant mental health, particularly the roles played by migration conditions and transnational practices, which may manifest themselves in different ways for men and for women. The goal of this paper was to understand the gendered roles of migration paths and transnational ties in mental health among sub-Saharan African migrants residing in the Paris, France, metropolitan area. This study used data from the Parcours study conducted in 2012–2013, which employed a life-event approach to collect data from a representative sample of migrants who visited healthcare facilities (n = 2468. We measured anxiety and depressive symptoms at the time of data collection with the Patient Health Questionnaire-4 (PHQ-4. Reasons for migration, the living conditions in the host country and transnational ties after migration were taken into account by sex and after adjustment. Our study demonstrates that among sub-Saharan African migrants, mental health is related to the migratory path and the migrant’s situation in the host country but differently for women and men. Among women, anxiety and depressive symptoms were strongly related to having left one’s home country because of threats to one’s life. Among men, residing illegally in the host country was related to impaired mental health. For both women and men, cross-border separation from a child less than 18 years old was not independently associated with anxiety and depressive symptoms. In addition, social and emotional support from relatives and friends—both from the society of origin and of destination—were associated with lower anxiety and depressive symptoms. Migrant mental health may be impaired in the current context of anti-migrant policies and an anti-immigrant social environment in Europe.

  2. Mental health of sub-saharan african migrants: The gendered role of migration paths and transnational ties.

    Science.gov (United States)

    Pannetier, Julie; Lert, France; Jauffret Roustide, Marie; du Loû, Annabel Desgrées

    2017-12-01

    In Europe, migrants are at higher risk of common mental disorders or psychological distress than are natives. Little is known regarding the social determinants of migrant mental health, particularly the roles played by migration conditions and transnational practices, which may manifest themselves in different ways for men and for women. The goal of this paper was to understand the gendered roles of migration paths and transnational ties in mental health among sub-Saharan African migrants residing in the Paris, France, metropolitan area. This study used data from the Parcours study conducted in 2012-2013, which employed a life-event approach to collect data from a representative sample of migrants who visited healthcare facilities (n = 2468). We measured anxiety and depressive symptoms at the time of data collection with the Patient Health Questionnaire-4 (PHQ-4). Reasons for migration, the living conditions in the host country and transnational ties after migration were taken into account by sex and after adjustment. Our study demonstrates that among sub-Saharan African migrants, mental health is related to the migratory path and the migrant's situation in the host country but differently for women and men. Among women, anxiety and depressive symptoms were strongly related to having left one's home country because of threats to one's life. Among men, residing illegally in the host country was related to impaired mental health. For both women and men, cross-border separation from a child less than 18 years old was not independently associated with anxiety and depressive symptoms. In addition, social and emotional support from relatives and friends-both from the society of origin and of destination-were associated with lower anxiety and depressive symptoms. Migrant mental health may be impaired in the current context of anti-migrant policies and an anti-immigrant social environment in Europe.

  3. 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.

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

    Science.gov (United States)

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

    2008-12-01

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

  5. Improving the United States’ Efforts in Countering Violent Extremist Organizations in Sub-Saharan Africa

    Science.gov (United States)

    2016-04-04

    resources used to promote security and strengthen security reforms in Sub-Saharan Africa, there is little evidence to suggest that sustainable successes...the President highlights is that the U.S. will shift away from fighting terrorism through costly, large scale wars and pursue a more sustainable ...2013, and an attack against a restaurant frequented by Westerners in Djibouti in 2014, they are not as deadly as the two groups listed in the previous

  6. Improving the United States Efforts in Countering Violent Extremist Organizations in Sub-Saharan Africa

    Science.gov (United States)

    2016-04-06

    resources used to promote security and strengthen security reforms in Sub-Saharan Africa, there is little evidence to suggest that sustainable successes...the President highlights is that the U.S. will shift away from fighting terrorism through costly, large scale wars and pursue a more sustainable ...2013, and an attack against a restaurant frequented by Westerners in Djibouti in 2014, they are not as deadly as the two groups listed in the previous

  7. 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

  8. Kinship Structures and Social Justice in Sub-Saharan Africa ...

    African Journals Online (AJOL)

    A major obstacle to the development of sustainable democratic systems of government in contemporary sub-Saharan African states is the difficulty in articulating an adequate conception of social justice to serve as a guiding principle in these polities. This difficulty is a consequence of the ethnically heterogeneous character ...

  9. Bibliography on Islam in contemporary Sub-Saharan Africa

    NARCIS (Netherlands)

    Schrijver, P.

    2006-01-01

    This book has been nominated for the Conover-Porter Award 2008 - This bibliography on Islam in contemporary Sub-Saharan Africa has been prepared as part of the African Studies Centre/Centre d'Etude d'Afrique Noire project entitled "Islam, the Disengagement of the State, and Globalization in

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

    Science.gov (United States)

    Ichoku, Charles

    2012-01-01

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

  11. The first two confirmed sub-Saharan African families with germline TP53 mutations causing Li-Fraumeni syndrome.

    Science.gov (United States)

    Macaulay, Shelley; Goodyear, Quintin Clive; Kruger, Mia; Chen, Wenlong; Essop, Fahmida; Krause, Amanda

    2018-02-01

    Li-Fraumeni syndrome is a rare inherited cancer syndrome characterised by the early onset of specific cancers. Li-Fraumeni syndrome (LFS) is associated with germline mutations in the tumour suppressor gene, TP53. This study reports the first cases of molecularly confirmed LFS germline mutations in sub-Saharan Africa. Three black African patients, all with LFS-associated cancers, were seen through the Clinical and Counselling Section of the Division of Human Genetics at the National Health Laboratory Service and University of the Witwatersrand in Johannesburg, South Africa, during 2011-2012. All three patients (two were related) were recruited into this research study. Sequence analysis of the coding region of the TP53 gene identified a Class IV (likely pathogenic) variant, c.326T > C (p.Phe109Ser), in the two related patients, and a known pathogenic mutation, c.1010G > A (p.Arg337His), also referred to as the Brazilian founder mutation, in the other patient. A confirmed diagnosis in these patients will assist in tailored medical management (it is recommended that individuals carrying a germline TP53 mutation avoid radiotherapy as this might cause secondary radiotherapy-induced malignancies) and in addition, genetic testing of at-risk family members can be offered. Very little is known and documented on LFS in African individuals. Despite the small number of patients in this study, the results support the need for diagnostic genetic testing for LFS in South Africa.

  12. Sub-Saharan Botanical Collections

    DEFF Research Database (Denmark)

    Demissew, Sebsebe; Beentje, Henk; Cheek, Martin

    2015-01-01

    Many historical specimens from sub-Saharan Africa are only found in European herbaria, but a higher number of newer specimens than widely assumed are kept in African herbaria, with a concentration in eastern and southern parts of the continent. Many of these herbaria were initiated in connection ...... in collaboration between African and European herbaria, and the increasing digitization of herbaria and the general development of relevant services on the Internet, which provides new possibilities for botanical studies in Africa....

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

    Science.gov (United States)

    Gurney, Karen A.; Mgone, Charles S.

    2015-01-01

    Background 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. Methodology/Principal Findings 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). Conclusions The volume and citation impact of papers from sub-Saharan Africa has increased since 2003, as has collaborative research between Europe and

  15. The Crisis of Funding Education in Sub-Saharan Africa: African Perspectives versus World Bank Prescriptions.

    Science.gov (United States)

    Senanu, K. E.

    1996-01-01

    Reforms of African educational systems with World Bank assistance are likely to fail unless they are based on a fundamentally African vision of society. This vision involves creating a habitat for human resource development, the use of intermediate technology, and space for the informal sector. (SK)

  16. 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

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

    Directory of Open Access Journals (Sweden)

    Annelien Poppe

    2014-05-01

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

  18. Antenatal syphilis screening using point-of-care testing in Sub-Saharan African countries: a cost-effectiveness analysis.

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    Andreas Kuznik

    2013-11-01

    Full Text Available Untreated syphilis in pregnancy is associated with adverse clinical outcomes for the infant. Most syphilis infections occur in sub-Saharan Africa (SSA, where coverage of antenatal screening for syphilis is inadequate. Recently introduced point-of-care syphilis tests have high accuracy and demonstrate potential to increase coverage of antenatal screening. However, country-specific cost-effectiveness data for these tests are limited. The objective of this analysis was to evaluate the cost-effectiveness and budget impact of antenatal syphilis screening for 43 countries in SSA and estimate the impact of universal screening on stillbirths, neonatal deaths, congenital syphilis, and disability-adjusted life years (DALYs averted.The decision analytic model reflected the perspective of the national health care system and was based on the sensitivity (86% and specificity (99% reported for the immunochromatographic strip (ICS test. Clinical outcomes of infants born to syphilis-infected mothers on the end points of stillbirth, neonatal death, and congenital syphilis were obtained from published sources. Treatment was assumed to consist of three injections of benzathine penicillin. Country-specific inputs included the antenatal prevalence of syphilis, annual number of live births, proportion of women with at least one antenatal care visit, per capita gross national income, and estimated hourly nurse wages. In all 43 sub-Saharan African countries analyzed, syphilis screening is highly cost-effective, with an average cost/DALY averted of US$11 (range: US$2-US$48. Screening remains highly cost-effective even if the average prevalence falls from the current rate of 3.1% (range: 0.6%-14.0% to 0.038% (range: 0.002%-0.113%. Universal antenatal screening of pregnant women in clinics may reduce the annual number of stillbirths by up to 64,000, neonatal deaths by up to 25,000, and annual incidence of congenital syphilis by up to 32,000, and avert up to 2.6 million

  19. Antenatal syphilis screening using point-of-care testing in Sub-Saharan African countries: a cost-effectiveness analysis.

    Science.gov (United States)

    Kuznik, Andreas; Lamorde, Mohammed; Nyabigambo, Agnes; Manabe, Yukari C

    2013-11-01

    Untreated syphilis in pregnancy is associated with adverse clinical outcomes for the infant. Most syphilis infections occur in sub-Saharan Africa (SSA), where coverage of antenatal screening for syphilis is inadequate. Recently introduced point-of-care syphilis tests have high accuracy and demonstrate potential to increase coverage of antenatal screening. However, country-specific cost-effectiveness data for these tests are limited. The objective of this analysis was to evaluate the cost-effectiveness and budget impact of antenatal syphilis screening for 43 countries in SSA and estimate the impact of universal screening on stillbirths, neonatal deaths, congenital syphilis, and disability-adjusted life years (DALYs) averted. The decision analytic model reflected the perspective of the national health care system and was based on the sensitivity (86%) and specificity (99%) reported for the immunochromatographic strip (ICS) test. Clinical outcomes of infants born to syphilis-infected mothers on the end points of stillbirth, neonatal death, and congenital syphilis were obtained from published sources. Treatment was assumed to consist of three injections of benzathine penicillin. Country-specific inputs included the antenatal prevalence of syphilis, annual number of live births, proportion of women with at least one antenatal care visit, per capita gross national income, and estimated hourly nurse wages. In all 43 sub-Saharan African countries analyzed, syphilis screening is highly cost-effective, with an average cost/DALY averted of US$11 (range: US$2-US$48). Screening remains highly cost-effective even if the average prevalence falls from the current rate of 3.1% (range: 0.6%-14.0%) to 0.038% (range: 0.002%-0.113%). Universal antenatal screening of pregnant women in clinics may reduce the annual number of stillbirths by up to 64,000, neonatal deaths by up to 25,000, and annual incidence of congenital syphilis by up to 32,000, and avert up to 2.6 million DALYs at an

  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. Transnational ties and the health of sub-Saharan African migrants: The moderating role of gender and family separation.

    Science.gov (United States)

    Afulani, Patience A; Torres, Jacqueline M; Sudhinaraset, May; Asunka, Joseph

    2016-11-01

    Recent scholarship has focused on the role that cross-border social and economic ties play in shaping health outcomes for migrant populations. Nevertheless, the extant empirical work on this topic has paid little attention to the health impacts of cross-border separation from close family members. In this paper we examine the association between cross-border ties-and cross-border separation-with the health of sub-Saharan African (SSA) migrant adults living in metropolitan France using data from the nationally representative "Trajectoire et Origines" survey (n = 1980 SSA migrants). In logistic regression analyses we find that remitting money and having a child abroad are each associated with poor health among women, but not men. The effect of remittances on health is also modified by the location of one's children: remittance sending is associated with poor health only for SSA-migrants separated from their children. These findings underscore the importance of examining both cross-border connection and cross-border separation in studies of immigrant health, and also underscore the heterogeneous relationships between cross-border ties and health for men and women. This is the first study to our knowledge that examines the relationship between cross-border ties and health for migrants in Europe, with a focus on SSA-migrants in France. These findings have important implications for the health of the growing immigrant and refugee populations in Europe and around the globe. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

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    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.

  3. Burden of human scabies in sub-Saharan African prisons: Evidence from the west region of Cameroon.

    Science.gov (United States)

    Kouotou, Emmanuel Armand; Nansseu, Jobert Richie N; Sangare, Abdoulaye; Moguieu Bogne, Léonnelle-Lynda; Sieleunou, Isidore; Adegbidi, Hugues; Tameyi Tatsa, Joël; Moyou Somo, Roger

    2018-02-01

    There is little data on the profile and magnitude of scabies in sub-Saharan African prisons. The present study aimed to assess the prevalence and determinants of scabies in prisons of the west region of Cameroon. We conducted a cross-sectional study from March to August 2014, and consecutively recruited volunteer detainees of three randomly selected prisons in the West Region of Cameroon. The diagnosis was based on clinical findings after assessment by two experienced and well-trained dermatologists. We enrolled 755 prisoners, 17 (2%) of whom were women. Their mean age was 32 ± 12 years. There were 242 cases (32%) of scabies, with significantly more cases in the most crowded prison (P 10 (aOR 1.89; P = 0.002), but not age, duration of incarceration, number of baths/week and washing/week, were independent drivers of scabies occurrence. Almost one-third of prisoners suffered from scabies in our prisons. A low educational level, the sharing of clothes/bedding and number of detainees/cell > 10 were independent determinants of the disease. Urgent measures must be undertaken to reduce the burden of scabies in our prisons. © 2017 The Australasian College of Dermatologists.

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

    Science.gov (United States)

    Choukem, S P; Fabreguettes, C; Akwo, E; Porcher, R; Nguewa, J L; Bouche, C; Kaze, F F; Kengne, A P; Vexiau, P; Mbanya, J C; Sobngwi, E; Gautier, J-F

    2014-02-01

    This study compared the clinical and biochemical characteristics and microvascular complications found in three groups of type 2 diabetes (T2D) patients: Africans living in Africa; African immigrants living in France; and Caucasians living in France. Diagnosed T2D Africans living in Cameroon (n=100) were compared with 98 African migrants diagnosed with T2D after having moved to France, and a group of 199 T2D Caucasian patients living in France. All underwent clinical and biochemical evaluations, and all were assessed for microvascular complications. The median duration of stay of the migrants in France was 15years before being diagnosed with diabetes. Despite similar durations of diagnosis, they were 8.9years younger at the time of diagnosis than Africans living in Cameroon (PAfrican immigrants in France had lower HbA1c values than Africans in Cameroon (PAfricans who emigrate to France may develop diabetes earlier than those staying in their home country. However, the latter may be a reflection of late diagnosis of diabetes. Also, the less adequate diabetes and hypertension control in the latter would explain their higher rates of nephropathy. Large-scale cohorts are now warranted to substantiate these observations. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  5. Association of the leptin-to-adiponectin ratio with metabolic syndrome in a sub-Saharan African population.

    Science.gov (United States)

    Ayina, Clarisse Noël A; Endomba, Francky Teddy A; Mandengue, Samuel Honoré; Noubiap, Jean Jacques N; Ngoa, Laurent Serge Etoundi; Boudou, Philippe; Gautier, Jean-François; Mbanya, Jean Claude; Sobngwi, Eugene

    2017-01-01

    Worldwide there is an increased prevalence of metabolic syndrome mainly due to life-style modifications, and Africans are not saved of this situation. Many markers have been studied to predict the risk of this syndrome but the most used are leptin and adiponectin. Data on these metabolic markers are scare in Africa and this study aimed to assess the association between the leptin-to-adiponectin ratio (LAR) with metabolic syndrome in a Cameroonian population. This was a cross-sectional study that included 476 adults among a general population of Cameroon. Data collected concerned the body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, fasting blood glucose, plasma lipids, adiponectin, leptin, insulin and homeostasis model for assessment of insulin resistance (HOMA-IR). To assess correlations we used Spearman's analyses and association of the studied variables with metabolic syndrome were done using binary logistic regression analysis. The leptin to adiponectin ratio was significantly and positively correlated with the body mass index (r = 0.669, p metabolic syndrome with respective unadjusted OR of 1.429, 0.468 and 1.502. After adjustment, for age and sex, the associations remained significative; LAR was also found to be significantly associated with metabolic syndrome (OR = 1.573, p value =0.000) as well as lower levels of adiponectin (OR = 0.359, p value =0.000) and higher levels of leptin (OR = 1.469, p value =0.001). This study revealed that LAR is significantly associated with metabolic syndrome in sub-Saharan African population, independently to age and sex.

  6. Measuring Government Effectiveness and Its Consequences for Social Welfare in Sub-Saharan African Countries

    Science.gov (United States)

    Sacks, Audrey; Levi, Margaret

    2010-01-01

    We introduce a method for measuring effective government and modeling its consequences for social welfare at the individual level. Our focus is on the experiences of citizens living in African countries where famine remains a serious threat. If a government is effective, it will be able to deliver goods that individuals need to improve their…

  7. 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.

  8. A Comparative Analysis of United States and Chinese Economic Engagement in Sub Saharan Africa

    Science.gov (United States)

    2016-03-01

    trains entrepreneurs and then aids their launch among a value-chain-network of BRAC assisted entities, which thus creates an entrepreneurial ecosystem at...action, The Africa Entrepreneur Facility was promptly created. It is a United States Agency for International Development (USAID...Saharan African entrepreneurs present successful business proposals to private investors through the Overseas Private Investment Corporation (OPIC

  9. A Smartphone-Based Approach for Triage of Human Papillomavirus-Positive Sub-Saharan African Women: A Prospective Study.

    Science.gov (United States)

    Urner, Esther; Delavy, Martine; Catarino, Rosa; Viviano, Manuela; Meyer-Hamme, Ulrike; Benski, Anne-Caroline; Jinoro, Jeromine; Heriniainasolo, Josea Lea; Undurraga, Manuela; De Vuyst, Hugo; Combescure, Christophe; Vassilakos, Pierre; Petignat, Patrick

    2017-05-29

    Sub-Saharan African countries are marked by a high incidence of cervical cancer. Madagascar ranks 11th among the countries with the highest cervical cancer incidence worldwide. The aim of the study was to evaluate the performances of digital smartphone-based visual inspection with acetic acid (D-VIA) and Lugol's iodine (D-VILI) for diagnosing cervical precancer and cancer. Human papillomavirus (HPV)-positive women recruited through a cervical screening campaign had D-VIA and D-VILI examinations with endocervical curettage (ECC) and cervical biopsy. Three images were captured for each woman (native, D-VIA, D-VILI) using a smartphone camera. The images were randomly coded and distributed on 2 online databases (Google Forms). The D-VIA form included native and D-VIA images, and the D-VILI form included native and D-VILI images. Pathological cases were defined as cervical intraepithelial neoplasia grade 2 or worse (CIN2+). Physicians rated the images as non-pathological or pathological. Using the ECC and cervical biopsy results as references, the sensitivity and specificity of D-VIA and D-VILI examinations for each and all physicians were calculated. Altogether, 15 clinicians assessed 240 images. Sensitivity was higher for the D-VIA interpretations (94.1%; 95% CI 81.6-98.3) than for the D-VILI interpretations (78.8%; 95% CI 54.1-92.1; P=.009). In contrast, the specificity was higher for the D-VILI interpretations (56.4%; 95% CI 38.3-72.9) than for the D-VIA interpretations (50.4%; 95% CI 35.9-64.8; P=.005). Smartphone-based image for triage of HPV-positive women is more accurate for detecting CIN2+ lesions with D-VIA than D-VILI, although with a small loss of specificity.

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

    Science.gov (United States)

    Ichoku, Charles M.

    2010-01-01

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

  11. 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.

  12. 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.

  13. 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

    2016-05-01

    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 cholera incidence, age distribution, clinical presentation, culture confirmation, and testing frequency. These results can help guide preventive activities, including vaccine use.

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

    Science.gov (United States)

    Qian, Frank; Ogundiran, Temidayo; Hou, Ningqi; Ndom, Paul; Gakwaya, Antony; Jombwe, Johashaphat; Morhason-Bello, Imran; Adebamowo, Clement; Ademola, Adeyinka; Ojengbede, Oladosu; Olopade, Olufunmilayo I; Huo, Dezheng

    2014-01-01

    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. 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). 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 breast cancer risk, suggesting that this modifiable risk factor should be addressed in breast cancer prevention programs in Africa.

  15. Association between coverage of maternal and child health interventions, and under-5 mortality: a repeated cross-sectional analysis of 35 sub-Saharan African countries.

    Science.gov (United States)

    Corsi, Daniel J; Subramanian, S V

    2014-01-01

    Infant and child mortality rates are among the most important indicators of child health, nutrition, implementation of key survival interventions, and the overall social and economic development of a population. In this paper, we investigate the role of coverage of maternal and child health (MNCH) interventions in contributing to declines in child mortality in sub-Saharan Africa. Data are from 81 Demographic and Health Surveys from 35 sub-Saharan African countries. Using ecological time-series and child-level regression models, we estimated the effect of MNCH interventions (summarized by the percent composite coverage index, or CCI) on child mortality with in the first 5 years of life net of temporal trends and covariates at the household, maternal, and child levels. At the ecologic level, a unit increase in standardized CCI was associated with a reduction in under-5 child mortality rate (U5MR) of 29.0 per 1,000 (95% CI: -43.2, -14.7) after adjustment for survey period effects and country-level per capita gross domestic product (pcGDP). At the child level, a unit increase in standardized CCI was associated with an odds ratio of 0.86 for child mortality (95% CI: 0.82-0.90) after adjustment for survey period effect, country-level pcGDP, and a set of household-, maternal-, and child-level covariates. MNCH interventions are important in reducing U5MR, while the effects of economic growth in sub-Saharan Africa remain weak and inconsistent. Improved coverage of proven life-saving interventions will likely contribute to further reductions in U5MR in sub-Saharan Africa.

  16. African stakeholders' views of research options to improve nutritional status in sub-Saharan Africa.

    Science.gov (United States)

    Holdsworth, Michelle; Kruger, Annamarie; Nago, Eunice; Lachat, Carl; Mamiro, Peter; Smit, Karlien; Garimoi-Orach, Chris; Kameli, Yves; Roberfroid, Dominique; Kolsteren, Patrick

    2015-09-01

    Setting research priorities for improving nutrition in Africa is currently ad hoc and there is a need to shift the status quo in the light of slow progress in reducing malnutrition. This study explored African stakeholders' views on research priorities in the context of environmental and socio-demographic changes that will impact on nutritional status in Africa in the coming years. Using Multi-Criteria Mapping, quantitative and qualitative data were gathered from 91 stakeholders representing 6 stakeholder groups (health professionals, food Industry, government, civil society, academics and research funders) in Benin, Mozambique, South Africa, Tanzania, Togo and Uganda. Stakeholders appraised six research options (ecological nutrition, nutritional epidemiology, community nutrition interventions, behavioural nutrition, clinical nutrition and molecular nutrition) for how well they could address malnutrition in Africa. Impact (28.3%), research efficacy (23.6%) and social acceptability (22.4%) were the criteria chosen the most to evaluate the performance of research options. Research on the effectiveness of community interventions was seen as a priority by stakeholders because they were perceived as likely to have an impact relatively quickly, were inexpensive and cost-effective, involved communities and provided direct evidence of what works. Behavioural nutrition research was also highly appraised. Many stakeholders, particularly academics and government were optimistic about the value of ecological nutrition research (the impact of environmental change on nutritional status). Research funders did not share this enthusiasm. Molecular nutrition was least preferred, considered expensive, slow to have an impact and requiring infrastructure. South Africa ranked clinical and molecular nutrition the highest of all countries. Research funders should redirect research funds in Africa towards the priorities identified by giving precedence to develop the evidence for effective

  17. 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 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.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.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.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.

  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. 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.

  20. Physical health policies and metabolic screening in mental health care systems of sub-Saharan African countries: a systematic review.

    Science.gov (United States)

    Mugisha, James; De Hert, Marc; Stubbs, Brendon; Basangwa, David; Vancampfort, Davy

    2017-01-01

    There is a need for interventions to address the escalating mental health burden in sub-Saharan Africa (SSA). Addressing physical health needs should have a central role in reducing the burden and facilitating recovery in people with severe mental illness (SMI). We systematically investigated (1) physical health policies in the current mental health plans, and (2) the routine metabolic screening rates for people with SMI in SSA. The Mental Health Atlas and MiNDbank of the World Health Organization were screened for physical health policies in mental health plans. Next, we systematically searched PubMed from inception until February 1st, 2017 for relevant studies on metabolic screening rates in people with SMI in SSA. The current systematic review shows that in 22 screened plans only 6 made reference to a physical health component or policy. Only the South-African mental health plan reported about routine screening and treatment of physical illness for people with SMI. In 2 South-African studies (n = 431) routine screening was unacceptably low with less than 1% adequately screened for all modifiable metabolic syndrome risk factors. Our review data clearly show that a physical health policy is yet to be embraced in mental health care systems of most SSA countries. There is a clear need for integrated mental and medical services in SSA. All psychiatric services, including poorly developed community-based primary health care settings should standardly assess the body mass index and waist circumference at initiation of psycho-pharmacotherapy, and afterwards at regular intervals. Optimal monitoring should include assessments of fasting glucose, lipids, cholesterol, and blood pressure. Mental health care providers in SSA countries need to be informed that their roles extend beyond taking care of the mental health of their patients and assume responsibility for the physical health of their patients as well. Policy makers should be made aware that investment in continued

  1. [Developing a coherent functional sanitary setting in sub-Saharan African cities: proof of the health district].

    Science.gov (United States)

    Grodos, Daniel; Tonglet, René

    2002-11-01

    strategies of local actors. Greater achievements could be reached by urban health systems in sub-Saharan Africa if they were organized and structured according to a health district policy. Key elements of such an organizational and managerial strategy should be realistically understood and assessed so as to provide health managers with a suitable tool for the successful development of primary health care in urban settings. Given the identified contextual constraints, implementation of a district health system in an urban context appears to depend mainly on political will and decision. It calls only incidentally for technical solutions. The following are among the most important requirements that have to be taken into account: ensuring appropriate allocation of resources to a legitimate urban health authority responsible for effective co-ordination of the many actors involved in urban health, setting out key developmental guidelines for the big city hospitals and effective communication channels with these institutions, ensuring development regulation and good governance of the private health sector. The role of the state remains crucial in this perspective.

  2. Appraising the quality of sub-Saharan African cancer registration systems that contributed to GLOBOCAN 2008: a review of the literature and critical appraisal.

    Science.gov (United States)

    Crocker-Buque, Tim; Pollock, Allyson M

    2015-02-01

    To critically appraise the quality of sub-Saharan African cancer registration systems that submitted data to GLOBOCAN 2008 with respect to population coverage using publicly available information and to show the use of GLOBOCAN statistics in determining global health priorities. Sources of cancer registration data for twenty-six sub-Saharan African cancer registries were identified from GLOBOCAN 2008 factsheets. Additional information was extracted from International Agency for Research on Cancer publications. A literature search was conducted to identify studies that reported additional information on data collection methods and provided 27 studies. The websites of the 10 largest funders of development assistance for health were searched for GLOBOCAN citations. Twenty-six sub-Saharan African cancer registration systems submitting data to GLOBOCAN 2008 in relation to 21 countries. Information on 15 quality variables were extracted and compared with the international gold standard for cancer registration systems. Population coverage of the cancer registries ranged from from 2.3% of the population in Kenya to 100% in The Gambia, with a heavy urban bias in all countries. However, 20 countries (300 million people) had no cancer registration systems. Nineteen of the 26 registries failed to meet more than five of the 15 quality criteria and only one country met more than 10. Seven of the 10 largest funders of development assistance for health cite GLOBOCAN statistics in support of policy priorities. GLOBOCAN 2008 estimates are based on data drawn from poor quality cancer registration systems, with limited or no population registry coverage. It is essential the GLOBOCAN 2012 estimates should provide information on the quality of the data collection and explain the limitations of the estimates. Development organisations and the World Health Organization need to take a more cautious approach when using these data to determine priorities and allocating resources. © The

  3. 78 FR 22260 - Sub-Saharan Africa Advisory Committee of the Export-Import Bank of the United States (Ex-Im Bank...

    Science.gov (United States)

    2013-04-15

    ...-Saharan Africa Advisory Committee of the Export-Import Bank of the United States (Ex-Im Bank); Notice of Open Special Meeting SUMMARY: The Sub-Saharan Africa Advisory Committee was established by Public Law... Africa under the loan, guarantee, and insurance programs of the Bank. Further, the Committee shall make...

  4. GDP Structure and Economic Performance in Sub-Saharan Countries

    Directory of Open Access Journals (Sweden)

    Luboš Smutka

    2014-01-01

    Full Text Available Africa belongs to important regions of the world economy with specific problems distinguishing this part of the world from other regions. The region is suffering because of limited economy structure and high level of poverty. Low economic performance ranks most of African countries among the worldwide poorest ones (both from the point of view of total economy performance and also individuals living standards; the development is hindered by political instability and also by other accompanied problems as high level of corruption, deficit of democracy, low level of education, limited investments, criminality, local conflicts, civil wars etc. On the other hand, African natural, economy and social resources and unexploited opportunities in many areas offer a potential for a considerable economic development. Understanding the current economic position of African states thus may reveal causes of problematic development and outline ways to overcome existing shortcomings. The aim of the paper is to analyze main changes in area of GDP structure formation (agricultural, industrial and services sector share in GDP and value performance which have occurred in selected African (Sub-Saharan countries. Changes are analyzed both in relation to the total GDP and GDP per capita. The authors identify main trends of economic development in the Sub-Saharan region and to specify differences among Sub-Saharan countries with the intention to identify particular groups of African countries according to their economic structure and to identify differences in their GDP formation.

  5. Sub-Saharan African migrants living with HIV acquired after migration, France, ANRS PARCOURS study, 2012 to 2013.

    Science.gov (United States)

    Desgrées-du-Loû, Annabel; Pannetier, Julie; Ravalihasy, Andrainolo; Gosselin, Anne; Supervie, Virginie; Panjo, Henri; Bajos, Nathalie; Lert, France; Lydié, Nathalie; Dray-Spira, Rosemary

    2015-01-01

    We estimated the proportion of migrants from sub-Saharan Africa who acquired human immunodeficiency virus (HIV) while living in France. Life-event and clinical information was collected in 2012 and 2013 from a random sample of HIV-infected outpatients born in sub-Saharan Africa and living in the Paris region. We assumed HIV infection in France if at least one of the following was fulfilled: (i) HIV diagnosis at least 11 years after arrival in France, (ii) at least one negative HIV test in France, (iii) sexual debut after arrival in France. Otherwise, time of HIV infection was based on statistical modelling of first CD4(+) T-cell count; infection in France was assumed if more than 50% (median scenario) or more than 95% (conservative scenario) of modelled infection times occurred after migration. We estimated that 49% of 898 HIV-infected adults born in sub-Saharan Africa (95% confidence interval (CI): 45-53) in the median and 35% (95% CI: 31-39) in the conservative scenario acquired HIV while living in France. This proportion was higher in men than women (44% (95% CI: 37-51) vs 30% (95% CI: 25-35); conservative scenario) and increased with length of stay in France. These high proportions highlight the need for improved HIV policies targeting migrants.

  6. Sub-Saharan Africa

    African Journals Online (AJOL)

    Sub-Saharan Africa. Inbound tourism movement has emerged as an important factor in the preva- lence of the disease, after education. Defects of quality of data would not be far fetched, given the lack of logistics and financial resources of most governments for the exercise, possible political manipulations and ideological ...

  7. SUB-SAHARAN AFRICA

    African Journals Online (AJOL)

    (Meade and l'iot, 1993). Such findings which were carried out at different settings of develop' ing countries including Sub-Saharan Africa, appear conflicting and need to be reconciled through a sub-regional survey. Touching on the preventive mechanisms, especially the use of condoms, the educated are more likely to ...

  8. 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.

  9. 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.

    Science.gov (United States)

    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

    2016-10-21

    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 Ghanaians living in rural and urban Ghana and Ghanaian migrants living in different European countries. A multi-centre cross-sectional study was conducted among Ghanaian adults (n = 5659) aged 25-70 years residing in rural and urban Ghana and three European cities (Amsterdam, London and Berlin). Comparisons between groups were made using prevalence ratios (PRs) with adjustments for age and education. In rural Ghana, the prevalence of obesity was 1.3 % in men and 8.3 % in women. The prevalence was considerably higher in urban Ghana (men, 6.9 %; PR: 5.26, 95 % CI, 2.04-13.57; women, 33.9 %; PR: 4.11, 3.13-5.40) and even more so in Europe, especially in London (men, 21.4 %; PR: 15.04, 5.98-37.84; women, 54.2 %; PR: 6.63, 5.04-8.72). The prevalence of T2D was low at 3.6 % and 5.5 % in rural Ghanaian men and women, and increased in urban Ghanaians (men, 10.3 %; PR: 3.06; 1.73-5.40; women, 9.2 %; PR: 1.81, 1.25-2.64) and highest in Berlin (men, 15.3 %; PR: 4.47; 2.50-7.98; women, 10.2 %; PR: 2.21, 1.30-3.75). Impaired fasting glycaemia prevalence was comparatively higher only in Amsterdam, and in London, men compared with rural Ghana. Our study shows high risks of obesity and T2D among sub-Saharan African populations living in Europe. In Ghana, similarly high prevalence rates were seen in an urban environment, whereas in rural areas, the prevalence of obesity among women is already remarkable. Similar processes underlying the high burden of obesity and T2D following migration may also be at play in sub-Saharan Africa as a consequence of urbanisation.

  10. Population genetic structure of Schistosoma mansoni and Schistosoma haematobium from across six sub-Saharan African countries: implications for epidemiology, evolution and control.

    Science.gov (United States)

    Gower, Charlotte M; Gouvras, Anouk N; Lamberton, Poppy H L; Deol, Arminder; Shrivastava, Jaya; Mutombo, Polydor N; Mbuh, Judith V; Norton, Alice J; Webster, Bonnie L; Stothard, J Russell; Garba, Amadou; Lamine, Mariama S; Kariuki, Curtis; Lange, Charles N; Mkoji, Gerald M; Kabatereine, Narcis B; Gabrielli, Albis F; Rudge, James W; Fenwick, Alan; Sacko, Moussa; Dembelé, Robert; Lwambo, Nicholas J S; Tchuem Tchuenté, Louis-Albert; Rollinson, David; Webster, Joanne P

    2013-11-01

    We conducted the first meta-analysis of ten Schistosoma haematobium (one published and nine unpublished) and eight Schistosoma mansoni (two published and six unpublished) microsatellite datasets collected from individual schistosome-infected school-children across six sub-Saharan Africa countries. High levels of genetic diversity were documented in both S. haematobium and S. mansoni. In S. haematobium populations, allelic richness did not differ significantly between the ten schools, despite widely varying prevalences and intensities of infection, but higher levels of heterozygote deficiency were seen in East than in West Africa. In contrast, S. mansoni populations were more diverse in East than West African schools, but heterozygosity levels did not vary significantly with geography. Genetic structure in both S. haematobium and S. mansoni populations was documented, at both a regional and continental scale. Such structuring might be expected to slow the spread to new areas of anti-schistosomal drug resistance should it develop. There was, however, limited evidence of genetic structure at the individual host level, which might be predicted to promote the development or establishment of drug resistance, particularly if it were a recessive trait. Our results are discussed in terms of their potential implications for the epidemiology and evolution of schistosomes as well as their subsequent control across sub-Saharan Africa. Copyright © 2012 Elsevier B.V. All rights reserved.

  11. Framing of AIDS in Africa: press-state relations, HIV/AIDS news, and journalistic advocacy in four sub-Saharan Anglophone newspapers.

    Science.gov (United States)

    D'Angelo, Paul; Pollock, John C; Kiernicki, Kristen; Shaw, Donna

    2013-01-01

    This study offers the first systematic analysis of the impact of press-state relations, or media systems, on the HIV/AIDS news agenda in African news coverage. The premise is that media systems play a determining role in the degree to which journalists can independently advocate for social change when covering HIV/AIDS. Drawing on comparative research, four sub-Saharan countries were categorized into two media systems: Contained Democratic (South Africa, Nigeria) and Repressive Autocratic (Zimbabwe, Kenya). A sample of HIV/AIDS stories (n = 393) published from 2002-2007 in each country's leading Anglophone newspaper was content analyzed. Across all coverage, the topic of social costs was framed more for the responsibility borne by nongovernmental agents than governmental agents. In Contained Democratic media systems, however, story emphasis shifted toward government agents taking responsibility for addressing the social costs of HIV/AIDS. Prevention campaigns were framed more as progress than decline across all newspapers; however, campaigns were reported as being more efficacious in Contained Democratic systems than in Repressive Autocratic systems. No impact of media system on framing of medical developments was found. Results show the value of comparative analysis in understanding the agenda-setting process: with greater emphasis on positive efficacy and government initiative, the news agenda in Contained Democratic media systems can facilitate stronger positive societal-level responses than the news agenda in Repressive Autocratic media systems.

  12. Determinants of successful vitamin A supplementation coverage among children aged 6-59 months in thirteen sub-Saharan African countries.

    Science.gov (United States)

    Janmohamed, Amynah; Klemm, Rolf Dw; Doledec, David

    2017-08-01

    Vitamin A supplementation (VAS) for children aged 6-59 months occurs regularly in most sub-Saharan African countries. The present study aimed to explore child, household and delivery platform factors associated with VAS coverage and identify barriers to compliance in thirteen African countries. We pooled data (n ~60 000) from forty-four household coverage surveys and used bivariate and multivariable regression analyses to assess the effects of supplementation strategy, rural v. urban residence, child sex, child age, caregiver education and campaign awareness on child VAS status. Setting/Subjects Primary caregivers of children aged 6-59 months in thirteen countries. Door-to-door distribution resulted in higher VAS coverage than fixed-site plus outreach approaches (91 v. 63 %) and was a significant predictor of supplementation in the adjusted model (OR=19·0; 95 % CI 17·2, 21·1; P<0·001). Having been informed about the campaign was the main predictor of VAS in the door-to-door (OR=6·8; 95 % CI 5·8, 7·9; P<0·001) and fixed-site plus outreach (OR=72·5; 95 % CI 66·6, 78·8; P<0·001) groups. Door-to-door provision of VAS may achieve higher coverage than fixed-site models in the African context. However, the phase-out of door-to-door polio immunization campaigns in most sub-Saharan African countries threatens the main distribution vehicle for VAS. Our findings suggest well-informed communities are key to attaining higher coverage using fixed-site delivery alternatives.

  13. Pregnancy Associated Plasma Protein-A and Placental Growth Factor in a Sub-Saharan African Population: A Nested Cross-Sectional Study.

    Science.gov (United States)

    Browne, Joyce L; Klipstein-Grobusch, Kerstin; Koster, Maria P H; Ramamoorthy, Dhivya; Antwi, Edward; Belmouden, Idder; Franx, Arie; Grobbee, Diederick E; Schielen, Peter C J I

    2016-01-01

    Baseline distributions of pregnancy disorders' biomarkers PlGF and PAPP-A levels are primarily based on Western European populations of Caucasian ethnicity. Differences in PAPP-A and PlGF concentrations by ethnicity have been observed, with increased levels in Afro-Caribbean, East Asian, and South Asian women. Baseline concentrations of sub-Saharan African women have not been evaluated. To investigate PlGF and PAPP-A in a sub-Saharan African population and assess the performance of existing reference values of PAPP-A and PlGF. A nested cross-sectional study was conducted in two public hospitals in Accra, Ghana. Out of the original 1010 women enrolled in the cohort, 398 participants were eligible for inclusion with a normotensive singleton gestation and serum samples taken between 56-97 days of pregnancy. PAPP-A and PlGF concentrations were measured with an automated immunoassay. Multiple of the median (MoM) values corrected for gestation and maternal weight for PAPP-A and PlGF were calculated using reference values of a Dutch perinatal screening laboratory based on over 10.000 samples, and PlGF manufacturer reference values, respectively. The PAPP-A median MoM was 2.34 (interquartile range (IQR) 1.24-3.97). Median PlGF MoM was 1.25 (IQR 0.95-1.80). Median MoM values for PAPP-A and PlGF tended to be slightly different for various Ghanaian ethnic subgroups. PAPP-A and PlGF MoM values appear to be substantially higher in a sub-Saharan African population compared to the Caucasian or Afro-Caribbean MoM values previously reported. The difference suggests the need for a specific correction factor for this population to avoid underestimation of risk for fetal aneuploidies or placental disorders when using PAPP-A and PlGF MoM for screening purposes.

  14. Pregnancy Associated Plasma Protein-A and Placental Growth Factor in a Sub-Saharan African Population: A Nested Cross-Sectional Study.

    Directory of Open Access Journals (Sweden)

    Joyce L Browne

    Full Text Available Baseline distributions of pregnancy disorders' biomarkers PlGF and PAPP-A levels are primarily based on Western European populations of Caucasian ethnicity. Differences in PAPP-A and PlGF concentrations by ethnicity have been observed, with increased levels in Afro-Caribbean, East Asian, and South Asian women. Baseline concentrations of sub-Saharan African women have not been evaluated.To investigate PlGF and PAPP-A in a sub-Saharan African population and assess the performance of existing reference values of PAPP-A and PlGF.A nested cross-sectional study was conducted in two public hospitals in Accra, Ghana. Out of the original 1010 women enrolled in the cohort, 398 participants were eligible for inclusion with a normotensive singleton gestation and serum samples taken between 56-97 days of pregnancy. PAPP-A and PlGF concentrations were measured with an automated immunoassay. Multiple of the median (MoM values corrected for gestation and maternal weight for PAPP-A and PlGF were calculated using reference values of a Dutch perinatal screening laboratory based on over 10.000 samples, and PlGF manufacturer reference values, respectively.The PAPP-A median MoM was 2.34 (interquartile range (IQR 1.24-3.97. Median PlGF MoM was 1.25 (IQR 0.95-1.80. Median MoM values for PAPP-A and PlGF tended to be slightly different for various Ghanaian ethnic subgroups.PAPP-A and PlGF MoM values appear to be substantially higher in a sub-Saharan African population compared to the Caucasian or Afro-Caribbean MoM values previously reported. The difference suggests the need for a specific correction factor for this population to avoid underestimation of risk for fetal aneuploidies or placental disorders when using PAPP-A and PlGF MoM for screening purposes.

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

    Science.gov (United States)

    2014-01-01

    Background We aimed to evaluate the predictive utility of common fasting insulin sensitivity indices, and non-laboratory surrogates [BMI, waist circumference (WC) and waist-to-height ratio (WHtR)] in sub-Saharan Africans without diabetes. Methods We measured fasting glucose and insulin, and glucose uptake during 80/mU/m2/min euglycemic clamp in 87 Cameroonians (51 men) aged (SD) 34.6 (11.4) years. We derived insulin sensitivity indices including HOMA-IR, quantitative insulin sensitivity check index (QUICKI), fasting insulin resistance index (FIRI) and glucose-to-insulin ratio (GIR). Indices and clinical predictors were compared to clamp using correlation tests, robust linear regressions and agreement of classification by sex-specific thirds. Results The mean insulin sensitivity was M = 10.5 ± 3.2 mg/kg/min. Classification across thirds of insulin sensitivity by clamp matched with non-laboratory surrogates in 30-48% of participants, and with fasting indices in 27-51%, with kappa statistics ranging from −0.10 to 0.26. Fasting indices correlated significantly with clamp (/r/=0.23-0.30), with GIR performing less well than fasting insulin and HOMA-IR (both p insulin sensitivity indices are modest predictors of insulin sensitivity measured by euglycemic clamp, and do not perform better than clinical surrogates in this population. PMID:25106496

  16. Knowledge, attitude, and experience of cervical cancer and screening among Sub-saharan African female students in a UK University.

    Science.gov (United States)

    Ogbonna, Faith Sopuruchukwu

    2017-01-01

    Cervical cancer is one of the major diseases that affect women of child bearing age. Its main cause is the human papilloma virus; although, other associated factors have been evidenced to increase its risk. Pap-smear screening and vaccination which has been shown to be successful in reducing the incidence and prevalence of the disease in developed countries, has been neglected in developing countries due to lack of knowledge, misconceptions, and cultural beliefs. A cross-sectional study involving only female Sub-Saharan Africa (SSA) students in a UK university setting. One hundred and eighty-six (42%) African female students were recruited from the 442 SSA students attending one of the major Universities in the UK. Seventy-one (38.2%) of the students were aware of cervical screening, but only 20 (10.8%) reported having knowledge of cervical cancer. A small percentage of about 26.9% (50 Students) were already part of this screening program; although, 81 (43.5%) showed willingness to participate in future screening programs. More so, it was evident that student's perception was dependent on their experience of the disease (P = 000) just as their participation in screening program was dependent on their awareness level (P ≤ 0.01). Female African students from the SSA region have poor knowledge of the disease which influenced their attitude toward screening. More needs to be carried out to increase awareness and uptake of screening within the school environment as university setting provides a viable platform to promote healthy behavior. Résumé Contexte: Le cancer du col de l'utérus est l'une des principales maladies qui touchent les femmes en âge de procréer. Sa principale cause est le virus du papillome humain; Bien que, d'autres facteurs associés ont été mis en évidence pour augmenter son risque. Le dépistage du Pap et la vaccination, qui s'est avéré efficace pour réduire l'incidence et la prévalence de la maladie dans les pays développés, a

  17. Ancient Egyptian mummy genomes suggest an increase of Sub-Saharan African ancestry in post-Roman periods.

    Science.gov (United States)

    Schuenemann, Verena J; Peltzer, Alexander; Welte, Beatrix; van Pelt, W Paul; Molak, Martyna; Wang, Chuan-Chao; Furtwängler, Anja; Urban, Christian; Reiter, Ella; Nieselt, Kay; Teßmann, Barbara; Francken, Michael; Harvati, Katerina; Haak, Wolfgang; Schiffels, Stephan; Krause, Johannes

    2017-05-30

    Egypt, located on the isthmus of Africa, is an ideal region to study historical population dynamics due to its geographic location and documented interactions with ancient civilizations in Africa, Asia and Europe. Particularly, in the first millennium BCE Egypt endured foreign domination leading to growing numbers of foreigners living within its borders possibly contributing genetically to the local population. Here we present 90 mitochondrial genomes as well as genome-wide data sets from three individuals obtained from Egyptian mummies. The samples recovered from Middle Egypt span around 1,300 years of ancient Egyptian history from the New Kingdom to the Roman Period. Our analyses reveal that ancient Egyptians shared more ancestry with Near Easterners than present-day Egyptians, who received additional sub-Saharan admixture in more recent times. This analysis establishes ancient Egyptian mummies as a genetic source to study ancient human history and offers the perspective of deciphering Egypt's past at a genome-wide level.

  18. 'Side effects' are 'central effects' that challenge retention on antiretroviral therapy in HIV treatment programmes in six sub-Saharan African countries

    DEFF Research Database (Denmark)

    Renju, Jenny; Moshabela, Mosa; McLean, Estelle

    2017-01-01

    PLHIV who were lost to follow-up and 53 healthcare workers (HCWs) in Kenya, Uganda, Tanzania, Malawi, Zimbabwe and South Africa. PLHIV were purposely selected to include a range of HIV treatment histories. Deductive and inductive analysis was guided by aspects of practice theory; retention in HIV care......Objectives: To explore the bodily and relational experience of taking antiretroviral therapy (ART) and the subsequent effect on retention in HIV care in six sub-Saharan African countries. Methods: In-depth interviews were conducted with 130 people living with HIV (PLHIV) who had initiated ART, 38...... following ART initiation was the practice of interest. Results: PLHIV who were engaged in HIV care took ART every day, attended clinic appointments and ate as well as possible. For PLHIV, biomedical markers acted as reassurance for their positive treatment progression. However, many described ART side...

  19. Self-reported HIV-positive status but subsequent HIV-negative test result using rapid diagnostic testing algorithms among seven sub-Saharan African military populations.

    Directory of Open Access Journals (Sweden)

    Judith Harbertson

    Full Text Available HIV rapid diagnostic tests (RDTs combined in an algorithm are the current standard for HIV diagnosis in many sub-Saharan African countries, and extensive laboratory testing has confirmed HIV RDTs have excellent sensitivity and specificity. However, false-positive RDT algorithm results have been reported due to a variety of factors, such as suboptimal quality assurance procedures and inaccurate interpretation of results. We conducted HIV serosurveys in seven sub-Saharan African military populations and recorded the frequency of personnel self-reporting HIV positivity, but subsequently testing HIV-negative during the serosurvey. The frequency of individuals who reported they were HIV-positive but subsequently tested HIV-negative using RDT algorithms ranged from 3.3 to 91.1%, suggesting significant rates of prior false-positive HIV RDT algorithm results, which should be confirmed using biological testing across time in future studies. Simple measures could substantially reduce false-positive results, such as greater adherence to quality assurance guidelines and prevalence-specific HIV testing algorithms as described in the World Health Organization's HIV testing guidelines. Other measures to improve RDT algorithm specificity include classifying individuals with weakly positive test lines as HIV indeterminate and retesting. While expansion of HIV testing in resource-limited countries is critical to identifying HIV-infected individuals for appropriate care and treatment, careful attention to potential causes of false HIV-positive results are needed to prevent the significant medical, psychological, and fiscal costs resulting from individuals receiving a false-positive HIV diagnosis.

  20. Self-reported HIV-positive status but subsequent HIV-negative test result using rapid diagnostic testing algorithms among seven sub-Saharan African military populations.

    Science.gov (United States)

    Harbertson, Judith; Hale, Braden R; Tran, Bonnie R; Thomas, Anne G; Grillo, Michael P; Jacobs, Marni B; McAnany, Jennifer; Shaffer, Richard A

    2017-01-01

    HIV rapid diagnostic tests (RDTs) combined in an algorithm are the current standard for HIV diagnosis in many sub-Saharan African countries, and extensive laboratory testing has confirmed HIV RDTs have excellent sensitivity and specificity. However, false-positive RDT algorithm results have been reported due to a variety of factors, such as suboptimal quality assurance procedures and inaccurate interpretation of results. We conducted HIV serosurveys in seven sub-Saharan African military populations and recorded the frequency of personnel self-reporting HIV positivity, but subsequently testing HIV-negative during the serosurvey. The frequency of individuals who reported they were HIV-positive but subsequently tested HIV-negative using RDT algorithms ranged from 3.3 to 91.1%, suggesting significant rates of prior false-positive HIV RDT algorithm results, which should be confirmed using biological testing across time in future studies. Simple measures could substantially reduce false-positive results, such as greater adherence to quality assurance guidelines and prevalence-specific HIV testing algorithms as described in the World Health Organization's HIV testing guidelines. Other measures to improve RDT algorithm specificity include classifying individuals with weakly positive test lines as HIV indeterminate and retesting. While expansion of HIV testing in resource-limited countries is critical to identifying HIV-infected individuals for appropriate care and treatment, careful attention to potential causes of false HIV-positive results are needed to prevent the significant medical, psychological, and fiscal costs resulting from individuals receiving a false-positive HIV diagnosis.

  1. Education Decentralization in Sub-Saharan Africa--Espoused Theories and Theories in Use.

    Science.gov (United States)

    Naidoo, Jordan P.

    Education decentralization efforts are examined in six primarily rural, sub-Saharan African countries--Ghana, Mali, Nigeria, Tanzania, Uganda, and Zimbabwe. Stated reasons do not always reflect the real underlying rationales for decentralization. Education decentralization that is publicly advocated to improve service delivery and local…

  2. Postcolonial Sub-Saharan 1 State and Contemporary General Business Environment. Selected Issues

    Directory of Open Access Journals (Sweden)

    Tomasz W. Kolasinski

    2015-06-01

    Full Text Available Purpose: The paper presents the results of a qualitative analysis of selected aspects of general business environment. The author strives to answer the following question formulated in the context of postcolonial deliberations: has the general business environment been affected by European colonialism? Methodology: Semantic and semiotic analysis of primary sources (statistical data and research findings formulated by international organisations, such as the World Bank, OECD, UNIDO and secondary sources (scientific and research studies of Polish and foreign authors based on primary sources; literature review. Findings: In the postcolonial perspective, qualitative analysis shows neither a positive nor a negative impact of colonialism on the contemporary general business environment. If certain signs of its deterioration are observed, they are mostly due to the erosion of state capacity, whose origins can be traced back to the Berlin Conference. Originality: Papers on Postcolonial Management and Critical Management Studies (CMS bridge the gap in literaturę pertaining to management issues, especially in Poland. Due to their interdisciplinary nature, Postcolonial Management and CMS cover a broad range of research areas (i.e. theory of state and nation, sociology, economic history. They pertain to both economics an management, and are therefore difficult to classify.

  3. 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

  4. Urban–rural and geographic differences in overweight and obesity in four sub-Saharan African adult populations: a multi-country cross-sectional study

    Directory of Open Access Journals (Sweden)

    IkeOluwapo O. Ajayi

    2016-10-01

    Full Text Available Abstract Background Overweight and obesity are on the rise in developing countries including sub-Saharan Africa. We undertook a four-country survey to show the collective burden of these health conditions as they occur currently in sub-Saharan Africa and to determine the differences between urban and rural populations and other socio-economic factors. Methods Participants were nurses in two hospitals in Nigeria (200, school teachers in South Africa (489 and Tanzania (229, and village residents in one peri-urban (297 and one rural location in Uganda (200 who completed a standardised questionnaire. Their height and weight were measured and body mass index calculated. Factor analysis procedure (Principal component was used to generate a wealth index. Univariate and multivariate analyses with binary logistic regression models were conducted to examine the associations between potential correlates and the prevalence of overweight and obesity with 95 % confidence intervals. Results The prevalence of overweight and obese (combined was 46 %, 48 %, 68 %, 75 % and 85 % in rural Uganda, peri-urban Uganda, Nigeria, Tanzania and South Africa (SA, respectively. Rural Uganda, Peri- urban Uganda, Nigeria, Tanzania and SA had obesity prevalence of 10 %, 14 %, 31 %, 40 % and 54 %, respectively (p  =25 kg/m2 in Nigeria [Age > =45 - AOR = 9.11; 95 % CI: 1.72, 48.16] and SA [AOR = 6.22; 95 % CI: 2.75, 14.07], while marital status was predictor of BMI > =25 kg/m2 only in peri-urban Uganda. [Married - AOR = 4.49; 95 % CI: 1.74, 11.57]. Those in Nigeria [AOR = 2.56; 95 % CI: 1.45, 4.53], SA [AOR = 4.97; 95 % CI: 3.18, 7.78], and Tanzania [AOR = 2.68; 95 % CI: 1.60, 4.49] were more likely to have BMI > =25 kg/m2 compared with the rural and peri-urban sites. Conclusion The high prevalence of overweight and obesity in these sub-Saharan African countries and the differentials in prevalence and risk factors further

  5. From policy to practice: exploring the implementation of antiretroviral therapy access and retention policies between 2013 and 2016 in six sub-Saharan African countries

    Directory of Open Access Journals (Sweden)

    Julie Ambia

    2017-11-01

    Full Text Available Abstract Background Understanding the implementation of 2013 World Health Organization (WHO consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection at the facility level provides important lessons for the roll-out of future HIV policies. Methods A national policy review was conducted in six sub-Saharan African countries to map the inclusion of the 2013 WHO HIV treatment recommendations. Twenty indicators of policy adoption were selected to measure ART access (n = 12 and retention (n = 8. Two sequential cross-sectional surveys were conducted in facilities between 2013/2015 (round 1 and 2015/2016 (round 2 from ten health and demographic surveillance sites in Kenya, Malawi, South Africa, Tanzania, Uganda and Zimbabwe. Using standardised questionnaires, facility managers were interviewed. Descriptive analyses were used to assess the change in the proportion of facilities that implemented these policy indicators between rounds. Results Although, expansion of ART access was explicitly stated in all countries’ policies, most lacked policies that enhanced retention. Overall, 145 facilities were included in both rounds. The proportion of facilities that initiated ART at CD4 counts of 500 or less cells/μL increased between round 1 and 2 from 12 to 68%, and facilities initiating patients on 2013 WHO recommended ART regimen increased from 42 to 87%. There were no changes in the proportion of facilities reporting stock-outs of first-line ART in the past year (18 to 11% nor in the provision of three-month supply of ART (43 to 38%. None of the facilities provided community-based ART delivery. Conclusion The increase in ART initiation CD4 threshold in most countries, and substantial improvements made in the provision of WHO recommended first-line ART regimens demonstrates that rapid adoption of WHO recommendations is possible. However, improved logistics and resources and/or changes in policy are required

  6. Women's Education and Health Inequalities in Under-Five Mortality in Selected Sub-Saharan African Countries, 1990-2015.

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    Aristide Romaric Bado

    Full Text Available The aim of the study was to analyse trends in the relationship between mother's educational level and mortality of children under the year of five in Sub-Saharan Africa, from 1990 to 2015.Data used in this study came from different waves of Demographic and Health Surveys (DHS of Sub-Saharan countries. Logistic regression and Buis's decomposition method were used to explore the effect of mother's educational level on the mortality of children under five years.Although the results of our study in the selected countries show that under-five mortality rates of children born to mothers without formal education are higher than the mortality rates of children of educated mothers, it appears that differences in mortality were reduced over the past two decades. In selected countries for our study, we noticed a significant decline in mortality among children of non-educated mothers compared to the decrease in mortality rates among children of educated mothers during the period of 1990-2010. The results show that the decline in mortality of children under five years was much higher among the children born to mothers who have never received formal education-112 points drop in Malawi, over 80 in Zambia and Zimbabwe, 65 points in Burkina Faso, 56 in Congo, 43 in Namibia, 27 in Guinea, Cameroon, and 22 to 15 in Niger. However, we noted a variation in results among the countries selected for the study-in Burkina Faso (OR = 0.7, in Cameroon (OR = 0.8, in Guinea (OR = 0.8 and Niger (OR = 0.8. It is normally observed that children of mothers with 0-6 years of education are about 20% more likely to survive until their fifth year compared to children of mothers who have not been to school. Conversely, the results did not reveal significant differences between the under-five deaths of children born to non-educated mothers and children of low-level educated mothers in Congo, Malawi and Namibia.The decline in under-five mortality rates, during last two decades, can be

  7. Civilian Skills for African Military Officers to Resolve the Infrastructure, Economic Development, and Stability Crisis in Sub-Saharan Africa

    Science.gov (United States)

    2011-03-01

    money [from diamond revenues] on giving its people improved education and health and better roads and water. Visiting Botswana makes you realize what...in the 1970s, to the West’s ravenous search for minerals today, roads and rails were built from the mine or the well to the port. These innova...States. When African officers and NCOs retire, all they know is soldiering. Botswana is known in the region for its stability and relative economic

  8. The impact of sociodemographic and health-service factors on breast-feeding in sub-Saharan African countries with high diarrhoea mortality.

    Science.gov (United States)

    Ogbo, Felix A; Eastwood, John; Page, Andrew; Efe-Aluta, Oniovo; Anago-Amanze, Chukwudi; Kadiri, Eshioramhe A; Ifegwu, Ifegwu K; Woolfenden, Sue; Agho, Kingsley E

    2017-12-01

    The current study aimed to examine the impact of sociodemographic and health-service factors on breast-feeding in sub-Saharan African (SSA) countries with high diarrhoea mortality. The study used the most recent and pooled Demographic and Health Survey data sets collected in nine SSA countries with high diarrhoea mortality. Multivariate logistic regression models that adjusted for cluster and sampling weights were used to investigate the association between sociodemographic and health-service factors and breast-feeding in SSA countries. Sub-Saharan Africa with high diarrhoea mortality. Children (n 50 975) under 24 months old (Burkina Faso (2010, N 5710); Demographic Republic of Congo (2013, N 6797); Ethiopia (2013, N 4193); Kenya (2014, N 7024); Mali (2013, N 3802); Niger (2013, N 4930); Nigeria (2013, N 11 712); Tanzania (2015, N 3894); and Uganda (2010, N 2913)). Overall prevalence of exclusive breast-feeding (EBF) and early initiation of breast-feeding (EIBF) was 35 and 44 %, respectively. Uganda, Ethiopia and Tanzania had higher EBF prevalence compared with Nigeria and Niger. Prevalence of EIBF was highest in Mali and lowest in Kenya. Higher educational attainment and frequent health-service visits of mothers (i.e. antenatal care, postnatal care and delivery at a health facility) were associated with EBF and EIBF. Breast-feeding practices in SSA countries with high diarrhoea mortality varied across geographical regions. To improve breast-feeding behaviours among mothers in SSA countries with high diarrhoea mortality, breast-feeding initiatives and policies should be context-specific, measurable and culturally appropriate, and should focus on all women, particularly mothers from low socio-economic groups with limited health-service access.

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

    Science.gov (United States)

    Sobngwi, Eugene; Kengne, Andre-Pascal; Echouffo-Tcheugui, Justin B; Choukem, Simeon; Sobngwi-Tambekou, Joelle; Balti, Eric V; Pearce, Mark S; Siaha, Valentin; Mamdjokam, Aissa S; Effoe, Valery; Lontchi-Yimagou, Eric; Donfack, Oliver T; Atogho-Tiedeu, Barbara; Boudou, Philippe; Gautier, Jean-Francois; Mbanya, Jean-Claude

    2014-08-09

    We aimed to evaluate the predictive utility of common fasting insulin sensitivity indices, and non-laboratory surrogates [BMI, waist circumference (WC) and waist-to-height ratio (WHtR)] in sub-Saharan Africans without diabetes. We measured fasting glucose and insulin, and glucose uptake during 80/mU/m2/min euglycemic clamp in 87 Cameroonians (51 men) aged (SD) 34.6 (11.4) years. We derived insulin sensitivity indices including HOMA-IR, quantitative insulin sensitivity check index (QUICKI), fasting insulin resistance index (FIRI) and glucose-to-insulin ratio (GIR). Indices and clinical predictors were compared to clamp using correlation tests, robust linear regressions and agreement of classification by sex-specific thirds. The mean insulin sensitivity was M = 10.5 ± 3.2 mg/kg/min. Classification across thirds of insulin sensitivity by clamp matched with non-laboratory surrogates in 30-48% of participants, and with fasting indices in 27-51%, with kappa statistics ranging from -0.10 to 0.26. Fasting indices correlated significantly with clamp (/r/=0.23-0.30), with GIR performing less well than fasting insulin and HOMA-IR (both p fasting indices (/r/=0.38-0.43). Combinations of fasting indices and clinical predictors explained 25-27% of variation in clamp values. Fasting insulin sensitivity indices are modest predictors of insulin sensitivity measured by euglycemic clamp, and do not perform better than clinical surrogates in this population.

  10. Sub-Saharan Africa Report

    National Research Council Canada - National Science Library

    1986-01-01

    .... This report contains articles from Sub-Saharan Africa, Angola, Ethiopia, Ghana, Mozambique, Namibia, Sierra Leone, Togo, Zambia, and South Africa, the articles deal mainly with Politics, Sociology...

  11. Sub-Saharan Africa Report

    National Research Council Canada - National Science Library

    1987-01-01

    Partial Contents: Sub Saharan Africa, Military Exercise, Radio Commentary, Stock Exchange, Prime Minister, Economic, Domestic Service, Armed Forces, Health, Organizations, Death, International Service, Foreign Policy...

  12. Sub-Saharan Africa Report

    National Research Council Canada - National Science Library

    1985-01-01

    .... This report from Sub-Saharan Africa, Benin, Botswana, Burkina, Cameroon, Chad, Comoros, Ethiopia, Ghana, Guinea, Kenya, Liberia, Madagascar, Mauritius, Mozambique, Sierra Leone, Somalia, South Africa...

  13. Sub-Saharan Africa Report

    National Research Council Canada - National Science Library

    1985-01-01

    .... This report on Sub-Saharan Africa, Angola, Botswana, Burkina, Cameroon, Ghana, Ivory Coast, Liberia, Madagascar, Malawi, Mali, Mozambique, Namibia, Senegal, South Africa, and Swaziland, contains...

  14. 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

  15. Explanatory model of psychosis: impact on perception of self-stigma by patients in three sub-saharan African cities.

    Science.gov (United States)

    Makanjuola, Victor; Esan, Yomi; Oladeji, Bibilola; Kola, Lola; Appiah-Poku, John; Harris, Benjamin; Othieno, Caleb; Price, Leshawndra; Seedat, Soraya; Gureje, Oye

    2016-12-01

    Most cultures in sub-Saharan Africa subscribe to the belief that the root cause of psychosis is supernatural. Individuals in the community who hold a religiomagical explanatory model of causation have been shown to exhibit more stigmatizing attitudes towards people with psychosis. Self-stigma among individuals with psychosis is less frequently studied. We used a mixed-method approach, consisting of key informant's interviews to elicit information on explanatory models of causation of psychosis and questionnaire assessment of internalized stigma with an adapted version of the Scale for Internalized Stigma of Mental Illness. Twenty-four, 31, and 30 subjects with recent experience of utilizing the service of traditional or faith healers for severe mental disorders in Ibadan (Nigeria), Kumasi (Ghana), and Nairobi (Kenya), respectively, were interviewed. About 44 % (42.1 %) of the Nigerian respondents had a high (severe) level of self-stigma with the respective proportions among Ghanaian and Kenyan respondents being 20.7 and 37.5 %. Compared with 4 out of a total of 12 respondents (33.3 %) who reported low self-stigma reported supernatural attribution, 14 out of 20 respondents (70 %) with the highest level of self-stigma reported supernatural attribution across the three sites. When low scorers ascribed supernatural causation, it was often with a religious focus. There is a greater tendency for persons with high levels of self-stigma than those with low levels to ascribe supernatural attribution to their experience of a severe mental health condition.

  16. 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

  17. Physician emigration from sub-Saharan Africa to the United States: analysis of the 2011 AMA physician masterfile.

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    Akhenaten Benjamin Siankam Tankwanchi

    Full Text Available BACKGROUND: The large-scale emigration of physicians from sub-Saharan Africa (SSA to high-income nations is a serious development concern. Our objective was to determine current emigration trends of SSA physicians found in the physician workforce of the United States. METHODS AND FINDINGS: We analyzed physician data from the World Health Organization (WHO Global Health Workforce Statistics along with graduation and residency data from the 2011 American Medical Association Physician Masterfile (AMA-PM on physicians trained or born in SSA countries who currently practice in the US. We estimated emigration proportions, year of US entry, years of practice before emigration, and length of time in the US. According to the 2011 AMA-PM, 10,819 physicians were born or trained in 28 SSA countries. Sixty-eight percent (n = 7,370 were SSA-trained, 20% (n = 2,126 were US-trained, and 12% (n = 1,323 were trained outside both SSA and the US. We estimated active physicians (age ≤ 70 years to represent 96% (n = 10,377 of the total. Migration trends among SSA-trained physicians increased from 2002 to 2011 for all but one principal source country; the exception was South Africa whose physician migration to the US decreased by 8% (-156. The increase in last-decade migration was >50% in Nigeria (+1,113 and Ghana (+243, >100% in Ethiopia (+274, and >200% (+244 in Sudan. Liberia was the most affected by migration to the US with 77% (n = 175 of its estimated physicians in the 2011 AMA-PM. On average, SSA-trained physicians have been in the US for 18 years. They practiced for 6.5 years before US entry, and nearly half emigrated during the implementation years (1984-1999 of the structural adjustment programs. CONCLUSION: Physician emigration from SSA to the US is increasing for most SSA source countries. Unless far-reaching policies are implemented by the US and SSA countries, the current emigration trends will persist, and the US will remain a leading destination for

  18. The European Union and sub-Saharan Africa

    DEFF Research Database (Denmark)

    Kluth, Michael Friederich

    2013-01-01

    of the main EU powers. While Europe's initial African focus was on stabilising a continent marred by state failure, civil wars and genocides, changes in the global security context, especially the shift towards multipolarity manifest in China's growing engagement, has prompted a complementary focus...... on deterring other powers from making military inroads into the subcontinent. Hence Europe's sub-Saharan security focus is shifting from stabilisation towards deterrence. This helps explain recent military procurements which, in spite of the extremely challenging fiscal position of most EU member states...

  19. State-of-the-Art: Research Theoretical Framework of Information Systems Implementation Research in the Health Sector in Sub-Saharan Africa

    DEFF Research Database (Denmark)

    Tetteh, Godwin Kofi

    2014-01-01

    This study is about the state-of-the-art of reference theories and theoretical framework of information systems implementation research in the health industry in the Sub-Saharan countries from a process perspective. A process – variance framework, Poole et al, (2000), Markus & Robey, (1988......, CINAHL, Science Direct and Emerald, we identified 41 published research articles that met our inclusion criteria. The articles were mapped unto the process-variance framework. A significant finding in this critical review is that, the state-of-the-art of a large proportion of the studies was underpinned...

  20. Association of serum leptin and adiponectin with anthropomorphic indices of obesity, blood lipids and insulin resistance in a Sub-Saharan African population.

    Science.gov (United States)

    Ayina, Clarisse Noël A; Noubiap, Jean Jacques N; Etoundi Ngoa, Laurent Serge; Boudou, Philippe; Gautier, Jean François; Mengnjo, Michel Karngong; Mbanya, Jean Claude; Sobngwi, Eugene

    2016-05-17

    There is little data on the metabolic effects of adipokines in sub-Saharan African populations. This study aimed to explore the potential relationship of leptin and adiponectin, with obesity, plasma lipids and insulin resistance in a Cameroonian population. We enrolled 167 men and 309 women aged ≥18 years from the general population in Cameroon. Data were collected on waist circumference (WC), body mass index (BMI), waist-to-hip ratio (WHR), body fat (BF%), fasting blood glucose, plasma lipids, adiponectin, leptin, insulin and homeostasis model for assessment of insulin resistance (HOMA-IR). Pearson's correlation and multiple stepwise linear regression analyses were used to determine correlates of leptin and adiponectin serum levels. The prevalence of obesity was higher in women compared to men (p obesity which is more prevalent particularly in women (WC = 42.4%, WHR = 42.3%), is almost for 90% comparable to %BF (42.7%). Adiponectin negatively with BMI (r = -0.294, p obesity, blood lipids and insulin resistance for the first time in an African population. Gender was significant covariate interacting with insulin sensitivity/insulin resistance and obesity indexes associations in this population.

  1. A long way to go - Estimates of combined water, sanitation and hygiene coverage for 25 sub-Saharan African countries.

    Directory of Open Access Journals (Sweden)

    Rachel Roche

    Full Text Available Water, sanitation and hygiene (WASH are essential for a healthy and dignified life. International targets to reduce inadequate WASH coverage were set under the Millennium Development Goals (MDGs, 1990-2015 and now the Sustainable Development Goals (SDGs, 2016-2030. The MDGs called for halving the proportion of the population without access to adequate water and sanitation, whereas the SDGs call for universal access, require the progressive reduction of inequalities, and include hygiene in addition to water and sanitation. Estimating access to complete WASH coverage provides a baseline for monitoring during the SDG period. Sub-Saharan Africa (SSA has among the lowest rates of WASH coverage globally.The most recent available Demographic Household Survey (DHS or Multiple Indicator Cluster Survey (MICS data for 25 countries in SSA were analysed to estimate national and regional coverage for combined water and sanitation (a combined MDG indicator for 'improved' access and combined water with collection time within 30 minutes plus sanitation and hygiene (a combined SDG indicator for 'basic' access. Coverage rates were estimated separately for urban and rural populations and for wealth quintiles. Frequency ratios and percentage point differences for urban and rural coverage were calculated to give both relative and absolute measures of urban-rural inequality. Wealth inequalities were assessed by visual examination of coverage across wealth quintiles in urban and rural populations and by calculating concentration indices as standard measures of relative wealth related inequality that give an indication of how unevenly a health indicator is distributed across the wealth distribution.Combined MDG coverage in SSA was 20%, and combined basic SDG coverage was 4%; an estimated 921 million people lacked basic SDG coverage. Relative measures of inequality were higher for combined basic SDG coverage than combined MDG coverage, but absolute inequality was lower

  2. 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

  3. HIV treatment and care services for adolescents: a situational analysis of 218 facilities in 23 sub-Saharan African countries.

    Science.gov (United States)

    Mark, Daniella; Armstrong, Alice; Andrade, Catarina; Penazzato, Martina; Hatane, Luann; Taing, Lina; Runciman, Toby; Ferguson, Jane

    2017-05-16

    In 2013, an estimated 2.1 million adolescents (age 10-19 years) were living with HIV globally. The extent to which health facilities provide appropriate treatment and care was unknown. To support understanding of service availability in 2014, Paediatric-Adolescent Treatment Africa (PATA), a non-governmental organisation (NGO) supporting a network of health facilities across sub-Saharan Africa, undertook a facility-level situational analysis of adolescent HIV treatment and care services in 23 countries. Two hundred and eighteen facilities, responsible for an estimated 80,072 HIV-infected adolescents in care, were surveyed. Sixty per cent of the sample were from PATA's network, with the remaining gathered via local NGO partners and snowball sampling. Data were analysed using descriptive statistics and coding to describe central tendencies and identify themes. Respondents represented three subregions: West and Central Africa (n = 59; 27%), East Africa (n = 77, 35%) and southern Africa (n = 82, 38%). Half (50%) of the facilities were in urban areas, 17% peri-urban and 33% rural settings. Insufficient data disaggregation and outcomes monitoring were critical issues. A quarter of facilities did not have a working definition of adolescence. Facilities reported non-adherence as their key challenge in adolescent service provision, but had insufficient protocols for determining and managing poor adherence and loss to follow-up. Adherence counselling focused on implications of non-adherence rather than its drivers. Facilities recommended peer support as an effective adherence and retention intervention, yet not all offered these services. Almost two-thirds reported attending to adolescents with adults and/or children, and half had no transitioning protocols. Of those with transitioning protocols, 21% moved pregnant adolescents into adult services earlier than their peers. There was limited sexual and reproductive health integration, with 63% of facilities offering

  4. A long way to go - Estimates of combined water, sanitation and hygiene coverage for 25 sub-Saharan African countries.

    Science.gov (United States)

    Roche, Rachel; Bain, Robert; Cumming, Oliver

    2017-01-01

    Water, sanitation and hygiene (WASH) are essential for a healthy and dignified life. International targets to reduce inadequate WASH coverage were set under the Millennium Development Goals (MDGs, 1990-2015) and now the Sustainable Development Goals (SDGs, 2016-2030). The MDGs called for halving the proportion of the population without access to adequate water and sanitation, whereas the SDGs call for universal access, require the progressive reduction of inequalities, and include hygiene in addition to water and sanitation. Estimating access to complete WASH coverage provides a baseline for monitoring during the SDG period. Sub-Saharan Africa (SSA) has among the lowest rates of WASH coverage globally. The most recent available Demographic Household Survey (DHS) or Multiple Indicator Cluster Survey (MICS) data for 25 countries in SSA were analysed to estimate national and regional coverage for combined water and sanitation (a combined MDG indicator for 'improved' access) and combined water with collection time within 30 minutes plus sanitation and hygiene (a combined SDG indicator for 'basic' access). Coverage rates were estimated separately for urban and rural populations and for wealth quintiles. Frequency ratios and percentage point differences for urban and rural coverage were calculated to give both relative and absolute measures of urban-rural inequality. Wealth inequalities were assessed by visual examination of coverage across wealth quintiles in urban and rural populations and by calculating concentration indices as standard measures of relative wealth related inequality that give an indication of how unevenly a health indicator is distributed across the wealth distribution. Combined MDG coverage in SSA was 20%, and combined basic SDG coverage was 4%; an estimated 921 million people lacked basic SDG coverage. Relative measures of inequality were higher for combined basic SDG coverage than combined MDG coverage, but absolute inequality was lower. Rural

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

    Science.gov (United States)

    Mutale, Wilbroad; Chintu, Namwinga; Amoroso, Cheryl; Awoonor-Williams, Koku; Phillips, James; Baynes, Colin; Michel, Cathy; Taylor, Angela; Sherr, Kenneth

    2013-01-01

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

  6. HIV/AIDS National Strategic Plans of Sub-Saharan African countries: an analysis for gender equality and sex-disaggregated HIV targets.

    Science.gov (United States)

    Sherwood, Jennifer; Sharp, Alana; Cooper, Bergen; Roose-Snyder, Beirne; Blumenthal, Susan

    2017-12-01

    National Strategic Plans (NSPs) for HIV/AIDS are country planning documents that set priorities for programmes and services, including a set of targets to quantify progress toward national and international goals. The inclusion of sex-disaggregated targets and targets to combat gender inequality is important given the high disease burden among young women and adolescent girls in Sub-Saharan Africa, yet no comprehensive gender-focused analysis of NSP targets has been performed. This analysis quantitatively evaluates national HIV targets, included in NSPs from eighteen Sub-Saharan African countries, for sex-disaggregation. Additionally, NSP targets aimed at reducing gender-based inequality in health outcomes are compiled and inductively coded to report common themes. On average, in the eighteen countries included in this analysis, 31% of NSP targets include sex-disaggregation (range 0-92%). Three countries disaggregated a majority (>50%) of their targets by sex. Sex-disaggregation in data reporting was more common for targets related to the early phases of the HIV care continuum: 83% of countries included any sex-disaggregated targets for HIV prevention, 56% for testing and linkage to care, 22% for improving antiretroviral treatment coverage, and 11% for retention in treatment. The most common target to reduce gender inequality was to prevent gender-based violence (present in 50% of countries). Other commonly incorporated target areas related to improving women's access to family planning, human and legal rights, and decision-making power. The inclusion of sex-disaggregated targets in national planning is vital to ensure that programmes make progress for all population groups. Improving the availability and quality of indicators to measure gender inequality, as well as evaluating programme outcomes by sex, is critical to tracking this progress. This analysis reveals an urgent need to set specific and separate targets for men and women in order to achieve an equitable

  7. Prevalence of key breastfeeding indicators in 29 sub-Saharan African countries: a meta-analysis of demographic and health surveys (2010–2015)

    Science.gov (United States)

    Issaka, Abukari Ibrahim; Agho, Kingsley Emwinyore; Renzaho, Andre MN

    2017-01-01

    Objectives To carry out a meta-analysis to assess the prevalence of four key breastfeeding indicators in four subregions of 29 sub-Saharan African countries. Design, settings and participants The 29 countries were categorised into four subregions, and using cross-sectional data from the most recent Demographic and Health Surveys (2010–2015) of these countries prevalence of each of four key breastfeeding indicators was estimated for each of the subregions by carrying out a meta-analysis. Due to the presence of significant heterogeneity among the various surveys (I2>50%), a random-effect analytic model was used, and sensitivity analysis was performed to examine the effects of outliers. Main outcome variables Early initiation of breast feeding, exclusive breast feeding, predominant breast feeding and bottle feeding. Results The overall prevalence of early initiation of breast feeding varied between a lowest of 37.84% (95% CI 24.62 to 51.05) in Central Africa to a highest of 69.31% (95% CI 67.65 to 70.97) in Southern Africa; the overall prevalence of exclusive breast feeding ranged between a lowest of 23.70% (95% CI 5.37 to 42.03) in Central Africa to a highest of 56.57% (95% CI 53.50 to 59.95) in Southern Africa; the overall prevalence of predominant breast feeding ranged between a lowest of 17.63% (95% CI 12.70 to 22.55) in East Africa and a highest of 46.37% (95% CI 37.22 to 55.52) in West Africa; while the prevalence of bottle feeding varied between a lowest of 8.17% (95% CI 5.51 to 10.84) in West Africa and a highest of 30.05% (95% CI 28.42 to 31.69) in Southern Africa. Conclusions West Africa and Central Africa recorded lower overall prevalence of early initiation of breast feeding and exclusive breast feeding than the WHO’s recommended target of 50% by the year 2025. Intervention for improved breastfeeding practices in sub-Saharan Africa should target West and Central Africa, while intervention to minimise bottle feeding should target Southern Africa. PMID

  8. Urban-rural and geographic differences in overweight and obesity in four sub-Saharan African adult populations: a multi-country cross-sectional study.

    Science.gov (United States)

    Ajayi, IkeOluwapo O; Adebamowo, Clement; Adami, Hans-Olov; Dalal, Shona; Diamond, Megan B; Bajunirwe, Francis; Guwatudde, David; Njelekela, Marina; Nankya-Mutyoba, Joan; Chiwanga, Faraja S; Volmink, Jimmy; Kalyesubula, Robert; Laurence, Carien; Reid, Todd G; Dockery, Douglas; Hemenway, David; Spiegelman, Donna; Holmes, Michelle D

    2016-10-28

    .53], SA [AOR = 4.97; 95 % CI: 3.18, 7.78], and Tanzania [AOR = 2.68; 95 % CI: 1.60, 4.49] were more likely to have BMI > =25 kg/m(2) compared with the rural and peri-urban sites. The high prevalence of overweight and obesity in these sub-Saharan African countries and the differentials in prevalence and risk factors further highlights the need for urgent focused intervention to stem this trend, especially among women, professionals and urban dwellers.

  9. Mitigating Satellite-Based Fire Sampling Limitations in Deriving Biomass Burning Emission Rates: Application to WRF-Chem Model Over the Northern sub-Saharan African Region

    Science.gov (United States)

    Wang, Jun; Yue, Yun; Wang, Yi; Ichoku, Charles; Ellison, Luke; Zeng, Jing

    2018-01-01

    Largely used in several independent estimates of fire emissions, fire products based on MODIS sensors aboard the Terra and Aqua polar-orbiting satellites have a number of inherent limitations, including (a) inability to detect fires below clouds, (b) significant decrease of detection sensitivity at the edge of scan where pixel sizes are much larger than at nadir, and (c) gaps between adjacent swaths in tropical regions. To remedy these limitations, an empirical method is developed here and applied to correct fire emission estimates based on MODIS pixel level fire radiative power measurements and emission coefficients from the Fire Energetics and Emissions Research (FEER) biomass burning emission inventory. The analysis was performed for January 2010 over the northern sub-Saharan African region. Simulations from WRF-Chem model using original and adjusted emissions are compared with the aerosol optical depth (AOD) products from MODIS and AERONET as well as aerosol vertical profile from CALIOP data. The comparison confirmed an 30-50% improvement in the model simulation performance (in terms of correlation, bias, and spatial pattern of AOD with respect to observations) by the adjusted emissions that not only increases the original emission amount by a factor of two but also results in the spatially continuous estimates of instantaneous fire emissions at daily time scales. Such improvement cannot be achieved by simply scaling the original emission across the study domain. Even with this improvement, a factor of two underestimations still exists in the modeled AOD, which is within the current global fire emissions uncertainty envelope.

  10. “It’s My Secret”: Fear of Disclosure among Sub-Saharan African Migrant Women Living with HIV/AIDS in Belgium

    Science.gov (United States)

    Arrey, Agnes Ebotabe; Bilsen, Johan; Lacor, Patrick; Deschepper, Reginald

    2015-01-01

    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. PMID:25781906

  11. Gender Inequality in Education in sub-Saharan Africa

    OpenAIRE

    Victor Ombati; Ombati Mokua

    2012-01-01

    This paper examines the issue of gender inequality in education in sub-Saharan Africa. It argues that in sub-Saharan African countries, the provision of education for boys and girls is uneven, and biased through gender, location, class and region- resulting to high illiteracy rates for girls and women. The paper concludes that political instability and violence, poverty and economical challenges, negative cultural values, female genital mutilation, early marriage, and sexual harassment are so...

  12. First HIV prevalence estimates of a representative sample of adult sub-Saharan African migrants in a European city. Results of a community-based, cross-sectional study in Antwerp, Belgium.

    Directory of Open Access Journals (Sweden)

    Jasna Loos

    Full Text Available While sub-Saharan African migrants are the second largest group affected by HIV in Europe, sound HIV prevalence estimates based on representative samples of these heterogeneous communities are lacking. Such data are needed to inform prevention and public health policy.This community-based, cross-sectional study combined oral fluid HIV testing with an electronic behavioral survey. Adopting a two-stage time location sampling HIV prevalence estimates for a representative sample of adult sub-Saharan African migrants in Antwerp, Belgium were obtained. Sample proportions and estimated adjusted population proportions were calculated for all variables. Univariable and multivariable logistic regression analysis explored factors independently associated with HIV infection.Between December 2013 and October 2014, 744 sub-Saharan African migrants were included (37% women. A substantial proportion was socially, legally and economically vulnerable: 21% were probably of undocumented status, 63% had financial problems in the last year and 9% lacked stable housing. Sexual networks were mostly African and crossed national borders, i.e. sexual encounters during travels within Europa and Africa. Concurrency is common, 34% of those in a stable relationship had a partner on the side in the last year. HIV prevalence was 5.9%(95%CI:3.4%-10.1% among women and 4.2% (95%CI:1.6%-10.6% among men. Although high lifetime HIV testing was reported at community level (73%, 65.2% (CI95%:32.4%-88.0% of sub-Saharan African migrants were possibly undiagnosed. Being 45 years or older, unprotected sex when travelling within Europe in the last year, high intentions to use condoms, being unaware of their last sexual partners' HIV status, recent HIV testing and not having encountered partner violence in the last year were independently associated with HIV infection in multivariable logical regression. In univariable analysis, HIV infection was additionally associated to unemployment

  13. 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.

  14. CDM in sub-Saharan Africa and the prospects of the Nairobi Framework Initiative

    OpenAIRE

    Byigero, Alfred D.; Clancy, Joy S.; Skutsch, Margaret

    2010-01-01

    To what extent can capacity-building activities under the Nairobi Framework (NF) Initiative overcome barriers to the Clean Development Mechanism (CDM) in sub-Saharan Africa and, in particular, the East African region? The level of CDM penetration into sub-Saharan Africa is compared with CDM market trends globally. The relatively low CDM penetration in sub-Saharan Africa and the East African Community (SSA/EAC) countries is a result of endogenous barriers, particularly the inadequate general i...

  15. How to analyze palliative care outcome data for patients in Sub-Saharan Africa: an international, multicenter, factor analytic examination of the APCA African POS.

    Science.gov (United States)

    Harding, Richard; Selman, Lucy; Simms, Victoria M; Penfold, Suzanne; Agupio, Godfrey; Dinat, Natalya; Downing, Julia; Gwyther, Liz; Ikin, Barbara; Mashao, Thandi; Mmoledi, Keletso; Sebuyira, Lydia Mpanga; Moll, Tony; Mwangi-Powell, Faith; Namisango, Eve; Powell, Richard A; Walkey, Frank H; Higginson, Irene J; Siegert, Richard J

    2013-04-01

    The incidence of life-limiting progressive disease in sub-Saharan Africa presents a significant clinical and public health challenge. The ability to easily measure patient outcomes is essential to improving care. The present study aims to determine the specific factors (if any) that underpin the African Palliative Care Association African Palliative Outcome Scale to assist the analysis of data in routine clinical care and audit. Using self-reported data collected from patients with HIV infection in eastern and southern Africa, an exploratory factor analysis was undertaken with 1337 patients; subsequently, a confirmatory analysis was done on two samples from separate data sets (n = 445). Using exploratory factor analysis initially, both two- and three-factor solutions were examined and found to meet the criteria for simple structure and be readily interpretable. Then using confirmatory factor analysis on two separate samples, the three-factor solution demonstrated better fit, with Goodness-of-Fit Index values greater than 0.95 and Normative Fit Index values close to 0.90. The resulting three factors were 1) physical and psychological well-being, 2) interpersonal well-being, and 3) existential well-being. This analysis presents an important new opportunity in the analysis of outcome data for patients with progressive disease. It has advantages over both the total scoring of multidimensional scaling (which masks differences between domains) and of item scoring (which requires repeated analyses). The three factors map well onto the underlying concept and clinical goals of palliative care, and will enable audit of facility care. Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  16. Spirituality/Religiosity: A Cultural and Psychological Resource among Sub-Saharan African Migrant Women with HIV/AIDS in Belgium.

    Directory of Open Access Journals (Sweden)

    Agnes Ebotabe Arrey

    Full Text Available Spirituality/religion serves important roles in coping, survival and maintaining overall wellbeing within African cultures and communities, especially when diagnosed with a chronic disease like HIV/AIDS that can have a profound effect on physical and mental health. However, spirituality/religion can be problematic to some patients and cause caregiving difficulties. The objective of this paper was to examine the role of spirituality/religion as a source of strength, resilience and wellbeing among sub-Saharan African (SSA migrant women with HIV/AIDS. A qualitative study of SSA migrant women was conducted between April 2013 and December 2014. Participants were recruited through purposive sampling and snowball techniques from AIDS Reference Centres and AIDS workshops in Belgium, if they were 18 years and older, French or English speaking, and diagnosed HIV positive more than 3 months beforehand. We conducted semi-structured interviews with patients and did observations during consultations and support groups attendances. Thematic analysis was used to analyse the data. 44 women were interviewed, of whom 42 were Christians and 2 Muslims. None reported religious/spiritual alienation, though at some point in time many had felt the need to question their relationship with God by asking "why me?" A majority reported being more spiritual/religious since being diagnosed HIV positive. Participants believed that prayer, meditation, regular church services and religious activities were the main spiritual/religious resources for achieving connectedness with God. They strongly believed in the power of God in their HIV/AIDS treatment and wellbeing. Spiritual/religious resources including prayer, meditation, church services, religious activities and believing in the power of God helped them cope with HIV/AIDS. These findings highlight the importance of spirituality in physical and mental health and wellbeing among SSA women with HIV/AIDS that should be taken into

  17. Spirituality/Religiosity: A Cultural and Psychological Resource among Sub-Saharan African Migrant Women with HIV/AIDS in Belgium.

    Science.gov (United States)

    Arrey, Agnes Ebotabe; Bilsen, Johan; Lacor, Patrick; Deschepper, Reginald

    2016-01-01

    Spirituality/religion serves important roles in coping, survival and maintaining overall wellbeing within African cultures and communities, especially when diagnosed with a chronic disease like HIV/AIDS that can have a profound effect on physical and mental health. However, spirituality/religion can be problematic to some patients and cause caregiving difficulties. The objective of this paper was to examine the role of spirituality/religion as a source of strength, resilience and wellbeing among sub-Saharan African (SSA) migrant women with HIV/AIDS. A qualitative study of SSA migrant women was conducted between April 2013 and December 2014. Participants were recruited through purposive sampling and snowball techniques from AIDS Reference Centres and AIDS workshops in Belgium, if they were 18 years and older, French or English speaking, and diagnosed HIV positive more than 3 months beforehand. We conducted semi-structured interviews with patients and did observations during consultations and support groups attendances. Thematic analysis was used to analyse the data. 44 women were interviewed, of whom 42 were Christians and 2 Muslims. None reported religious/spiritual alienation, though at some point in time many had felt the need to question their relationship with God by asking "why me?" A majority reported being more spiritual/religious since being diagnosed HIV positive. Participants believed that prayer, meditation, regular church services and religious activities were the main spiritual/religious resources for achieving connectedness with God. They strongly believed in the power of God in their HIV/AIDS treatment and wellbeing. Spiritual/religious resources including prayer, meditation, church services, religious activities and believing in the power of God helped them cope with HIV/AIDS. These findings highlight the importance of spirituality in physical and mental health and wellbeing among SSA women with HIV/AIDS that should be taken into consideration in

  18. Peripheral insulin resistance rather than beta cell dysfunction accounts for geographical differences in impaired fasting blood glucose among sub-Saharan African individuals: findings from the RODAM study.

    Science.gov (United States)

    Meeks, Karlijn A C; Stronks, Karien; Adeyemo, Adebowale; Addo, Juliet; Bahendeka, Silver; Beune, Erik; Owusu-Dabo, Ellis; Danquah, Ina; Galbete, Cecilia; Henneman, Peter; Klipstein-Grobusch, Kerstin; Mockenhaupt, Frank P; Osei, Kwame; Schulze, Matthias B; Spranger, Joachim; Smeeth, Liam; Agyemang, Charles

    2017-05-01

    The aim of this study was to assess the extent to which insulin resistance and beta cell dysfunction account for differences in impaired fasting blood glucose (IFBG) levels in sub-Saharan African individuals living in different locations in Europe and Africa. We also aimed to identify determinants associated with insulin resistance and beta cell dysfunction among this population. Data from the cross-sectional multicentre Research on Obesity and Diabetes among African Migrants (RODAM) study were analysed. Participants included Ghanaian individuals without diabetes, aged 18-96 years old, who were residing in Amsterdam (n = 1337), Berlin (n = 502), London (n = 961), urban Ghana (n = 1309) and rural Ghana (n = 970). Glucose and insulin were measured in fasting venous blood samples. Anthropometrics were assessed during a physical examination. Questionnaires were used to assess demographics, physical activity, smoking status, alcohol consumption and energy intake. Insulin resistance and beta cell function were determined using homeostatic modelling (HOMA-IR and HOMA-B, respectively). Logistic regression analysis was used to study the contribution of HOMA-IR and inverse HOMA-B (beta cell dysfunction) to geographical differences in IFBG (fasting glucose 5.6-6.9 mmol/l). Multivariate linear regression analysis was used to identify determinants associated with HOMA-IR and inverse HOMA-B. IFBG was more common in individuals residing in urban Ghana (OR 1.41 [95% CI 1.08, 1.84]), Amsterdam (OR 3.44 [95% CI 2.69, 4.39]) and London (OR 1.58 [95% CI 1.20 2.08), but similar in individuals living in Berlin (OR 1.00 [95% CI 0.70, 1.45]), compared with those in rural Ghana (reference population). The attributable risk of IFBG per 1 SD increase in HOMA-IR was 69.3% and in inverse HOMA-B was 11.1%. After adjustment for HOMA-IR, the odds for IFBG reduced to 0.96 (95% CI 0.72, 1.27), 2.52 (95%CI 1.94, 3.26) and 1.02 (95% CI 0.78, 1.38) for individuals in Urban Ghana

  19. Livestock Ownership Among Rural Households and Child Morbidity and Mortality: An Analysis of Demographic Health Survey Data from 30 Sub-Saharan African Countries (2005-2015).

    Science.gov (United States)

    Kaur, Maneet; Graham, Jay P; Eisenberg, Joseph N S

    2017-03-01

    AbstractChildren living in homes with livestock may have both an increased risk of enteric infections and improved access to food, and therefore improved nutritional status. Few studies, however, have characterized these relationships in tandem. This study investigated the association between child health and household ownership of livestock. A cross-sectional study was performed using data from Demographic and Health Surveys conducted in 30 sub-Saharan African countries with 215,971 rural children under 5 years of age from 2005 to 2015. Logistic regression was performed for each country to estimate the relationship between a log2 increase in the number of livestock owned by the household and three child-health outcomes: 2-week prevalence of diarrhea, stunting, and all-cause mortality. Results for each country were combined using meta-analyses. Most countries (22 of 30) displayed an odds ratio (OR) less than 1 for child stunting associated with livestock (pooled OR = 0.97; 95% confidence interval [CI] = 0.95, 0.99). The results for diarrhea were more even with 14 countries displaying ORs greater than 1 and 10 displaying ORs less than 1. Most countries (22 of 30) displayed an OR greater than 1 for child mortality (pooled OR = 1.04; 95% CI = 1.02, 1.06). All meta-analyses displayed significant heterogeneity by country. Our analysis is consistent with the theory that livestock may have a dual role as protective against stunting, an indicator of chronic malnutrition, and a risk factor for all-cause mortality in children, which may be linked to acute infections. The heterogeneity by country, however, indicates more data are needed on specific household livestock management practices.

  20. Effect of low-dose spironolactone on resistant hypertension in type 2 diabetes mellitus: a randomized controlled trial in a sub-Saharan African population.

    Science.gov (United States)

    Djoumessi, Romance Nguetse; Noubiap, Jean Jacques N; Kaze, Francois Folefack; Essouma, Mickael; Menanga, Alain Patrick; Kengne, Andre Pascal; Mbanya, Jean Claude; Sobngwi, Eugene

    2016-03-23

    Low-dose spironolactone has been proven to be effective for resistant hypertension in the general population, but this has yet to be confirmed in type 2 diabetic (T2DM) patients. We assessed the efficacy of a low-dose spironolactone on resistant hypertension in a sub-Saharan African population of T2DM patients from Cameroon. This was a four-week single blinded randomized controlled trial in 17 subjects presenting with resistant hypertension in specialized diabetes care units in Cameroon. They were randomly assigned to treatment with a daily 25 mg of spironolactone (n = 9) or to an alternative antihypertensive regimen (n = 8), on top of any ongoing regimen and prevailing lifestyle prescriptions. They were seen at the start of the treatment, then 2 and 4 weeks later. The primary outcome was change in office and self-measured blood pressure (BP) during follow-up, and secondary outcomes were changes in serum potassium, sodium, and creatinine levels. Compared with alternative treatment, low-dose spironolactone was associated with significant decrease in office systolic BP (-33 vs. -14 mmHg; p = 0.024), and in diastolic BP (-14 vs. -5 mmHg; p = 0.006). After 1 month of spironolactone, all the patients were controlled based on BP below 130/80 mmHg, with significant office BP reduction from 158 ± 17/86 ± 11 to 125 ± 11/72 ± 8, vs. 158 ± 8/94 ± 8 to 144 ± 17/89 ± 12 mmHg in the alternative treatment group. There was no significant variation in sodium and creatinine levels in both groups, but a mild increase of potassium levels in the spironolactone group. Add-on low-dose spironolactone was effective in reducing BP to optimal levels in T2DM Cameroonian patients despite mild increase in serum potassium. Trial registration ClinicalTrials.gov Identifier NCT02426099. Date of registration April 2015.

  1. Prevalence and determinants of extrapulmonary involvement in patients with pulmonary tuberculosis in a Sub-Saharan African country: a cross-sectional study.

    Science.gov (United States)

    Yone, Eric Walter Pefura; Kengne, André Pascal; Moifo, Boniface; Kuaban, Christopher

    2013-02-01

    Determinants of extrapulmonary involvement during pulmonary tuberculosis (PTB) have not been extensively investigated. We assessed the prevalence and determinants of extrapulmonary involvement during PTB in a Sub-Saharan African country with a high prevalence of both TB and human immunodeficiency virus (HIV) infection. The medical records of patients aged ≥ 15 y, admitted for a first episode of TB to the Pneumology Service of Yaoundé Jamot Hospital, Cameroon, between 2009 and 2010 were considered. Determinants of extrapulmonary involvement were investigated through logistic regression. A total of 984 patients (58.9% male), with a median age (25(th)-75(th) percentiles) of 32 (25-41) y were admitted for a first episode of TB, including 629 (63.9%) with isolated PTB, 127 (12.9%) with isolated extrapulmonary TB (EPTB), and 228 (23.2%) with both PTB and EPTB (PTB/EPTB). Therefore, the prevalence of EPTB among those with PTB was 26.6% (228/857). The main determinants of EPTB among patients with PTB were male sex (adjusted odds ratio (OR) 2.71, 95% confidence interval (95% CI) 1.71-4.03), HIV infection (OR 2.20, 95% CI 1.36-3.55), absence of fibrotic lung lesions (OR 1.96, 95% CI 1.23-3.14), smear-negative PTB (OR 7.20, 95% CI 4.13-12.56), anaemia (OR 1.60, 95% CI 1.03-2.50), and leukopenia (OR 2.59, 95% CI 1.12-5.98). About a quarter of patients with PTB in this setting also have extrapulmonary involvement. EPTB is less contagious, less frequent than PTB, and less well addressed by programs in developing countries, while its identification is important for optimizing care. The presence of determinants of EPTB among patients with PTB should motivate active investigation of extrapulmonary involvement in order to improve management.

  2. Energy-water-food nexus under financial constraint environment: good, the bad, and the ugly sustainability reforms in sub-Saharan African countries.

    Science.gov (United States)

    Zaman, Khalid; Shamsuddin, Sadaf; Ahmad, Mehboob

    2017-05-01

    Environmental sustainability agenda are generally compromised by energy, water, and food production resources, while in the recent waves of global financial crisis, it mediates to increase the intensity of air pollutants, which largely affected the less developing countries due to their ease of environmental regulation policies and lack of optimal utilization of economic resources. Sub-Saharan African (SSA) countries are no exception that majorly hit by the recent global financial crisis, which affected the country's natural environment through the channel of unsustainable energy-water-food production. The study employed panel random effect model that addresses the country-specific time-invariant shocks to examine the non-linear relationship between water-energy-food resources and air pollutants in a panel of 19 selected SSA countries, for a period of 2000-2014. The results confirmed the carbon-fossil-methane environmental Kuznets curve (EKC) that turned into inverted U-shaped relationships in a panel of selected SSA countries. Food resources largely affected greenhouse gas (GHG), methane (CH4), and nitrous oxide (N2O) emissions while water resource decreases carbon dioxide (CO2), fossil fuel, and CH4 emissions in a region. Energy efficiency improves air quality indicators while industry value added increases CO2 emissions, fossil fuel energy, and GHG emissions. Global financial crisis increases the risk of climate change across countries. The study concludes that although SSA countries strive hard to take some "good" initiatives to reduce environmental degradation in a form of improved water and energy sources, however, due to lack of optimal utilization of food resources and global financial constraints, it leads to "the bad" and "the ugly" sustainability reforms in a region.

  3. Association between caregivers' knowledge and care seeking behaviour for children with symptoms of pneumonia in six sub-Saharan African Countries.

    Science.gov (United States)

    Noordam, Aaltje Camielle; Sharkey, Alyssa B; Hinssen, Paddy; Dinant, GeertJan; Cals, Jochen W L

    2017-02-02

    Pneumonia is the main cause of child mortality world-wide and most of these deaths occur in sub-Saharan Africa (SSA). Treatment with effective antibiotics is crucial to prevent these deaths; nevertheless only 2 out of 5 children with symptoms of pneumonia are taken to an appropriate care provider in SSA. While various factors associated with care seeking have been identified, the relationship between caregivers' knowledge of pneumonia symptoms and actual care seeking for their child with symptoms of pneumonia is not well researched. Based on data from Multiple Indicator Cluster Surveys, we assessed the association between caregivers' knowledge of symptoms related to pneumonia - namely fast or difficulty breathing - and care seeking behaviour for these symptoms. We analysed data of 4,163 children with symptoms of pneumonia and their caregivers. A Chi-square tests and multivariable logistic regression was performed to assess the association between care seeking and knowledge of at least one symptom (i.e., fast or difficulty breathing). Across all 6 countries only around 30% of caregivers were aware of at least one of the two symptoms of pneumonia (i.e., fast or difficulty breathing). Our study shows that in the Democratic Republic of the Congo and Nigeria there was a positive association between knowledge and care seeking (P ≤ 0.01), even after adjusting for key variables (including wealth, residence, education). We found no association between caregivers' knowledge of pneumonia symptoms and actual care seeking for their child with symptoms of pneumonia in Central African Republic, Chad, Malawi, and Sierra Leone. These findings reveal an urgent need to increase community awareness of pneumonia symptoms, while simultaneously designing context specific strategies to address the fundamental challenges associated with timely care seeking.

  4. Cross-Sectional Analysis of Selected Genital Tract Immunological Markers and Molecular Vaginal Microbiota in Sub-Saharan African Women, with Relevance to HIV Risk and Prevention.

    Science.gov (United States)

    Kyongo, Jordan K; Crucitti, Tania; Menten, Joris; Hardy, Liselotte; Cools, Piet; Michiels, Johan; Delany-Moretlwe, Sinead; Mwaura, Mary; Ndayisaba, Gilles; Joseph, Sarah; Fichorova, Raina; van de Wijgert, Janneke; Vanham, Guido; Ariën, Kevin K; Jespers, Vicky

    2015-05-01

    Data on immune mediators in the genital tract and the factors that modulate them in sub-Saharan women are limited. Cervicovaginal lavage (CVL) samples from 430 sexually active women from Kenya, South Africa, and Rwanda were analyzed for 12 soluble immune mediators using Bio-Plex and Meso Scale Discovery multiplex platforms, as well as single enzyme-linked immunosorbent assays. Ten bacterial species were quantified in vaginal swab samples. Bacterial vaginosis (BV) was defined by Nugent scoring. CVL samples from HIV-infected women showed a clear-cut proinflammatory profile. Pregnant women, adolescents, and women engaging in traditional vaginal practices differed in specific soluble markers compared to reference groups of adult HIV-negative women. Cervical mucus, cervical ectopy, abnormal vaginal discharge, and having multiple sex partners were each associated with an increase in inflammatory mediators. The levels of interleukin-1α (IL-1α), IL-1β, IL-6, IL-12(p70), and IL-8 were elevated, whereas the IL-1RA/IL-1(α+β) ratio decreased in women with BV. The level of gamma interferon-induced protein 10 was lower in BV-positive than in BV-negative women, suggesting its suppression as a potential immune evasion mechanism by BV-associated bacteria. Lactobacillus crispatus and Lactobacillus vaginalis were associated with decreased proinflammatory cytokines and each BV-associated species with increased proinflammatory cytokines. Remarkably, the in vitro anti-HIV activity of CVL samples from BV-positive women was stronger than that of BV-negative women. In conclusion, we found significant associations of factors, including vaginal microbiota, which can influence immune mediators in the vaginal environment in sexually active women. These factors need to be considered when establishing normative levels or pathogenic cutoffs of biomarkers of inflammation and associated risks in African women. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

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

    Science.gov (United States)

    Moens, Katrien; Siegert, Richard J; Taylor, Steve; Namisango, Eve; Harding, Richard

    2015-01-01

    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, pART (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 test cluster

  6. Sensitivity of Mesoscale Modeling of Smoke Direct Radiative Effect to the Emission Inventory: a Case Study in Northern Sub-Saharan African Region

    Science.gov (United States)

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

    2014-01-01

    An ensemble approach is used to examine the sensitivity of smoke loading and smoke direct radiative effect in the atmosphere to uncertainties in smoke emission estimates. Seven different fire emission inventories are applied independently to WRF-Chem model (v3.5) with the same model configuration (excluding dust and other emission sources) over the northern sub-Saharan African (NSSA) biomass-burning region. Results for November and February 2010 are analyzed, respectively representing the start and end of the biomass burning season in the study region. For February 2010, estimates of total smoke emission vary by a factor of 12, but only differences by factors of 7 or less are found in the simulated regional (15degW-42degE, 13degS-17degN) and monthly averages of column PM(sub 2.5) loading, surface PM(sub 2.5) concentration, aerosol optical depth (AOD), smoke radiative forcing at the top-of-atmosphere and at the surface, and air temperature at 2 m and at 700 hPa. The smaller differences in these simulated variables may reflect the atmospheric diffusion and deposition effects to dampen the large difference in smoke emissions that are highly concentrated in areas much smaller than the regional domain of the study. Indeed, at the local scale, large differences (up to a factor of 33) persist in simulated smoke-related variables and radiative effects including semi-direct effect. Similar results are also found for November 2010, despite differences in meteorology and fire activity. Hence, biomass burning emission uncertainties have a large influence on the reliability of model simulations of atmospheric aerosol loading, transport, and radiative impacts, and this influence is largest at local and hourly-to-daily scales. Accurate quantification of smoke effects on regional climate and air quality requires further reduction of emission uncertainties, particularly for regions of high fire concentrations such as NSSA.

  7. Clinical and neuroimaging profile of HIV-1 encephalopathy in infancy and childhood in a sub-Saharan African country.

    Science.gov (United States)

    G Mariam, Ayle; Assefa, Getachew

    2012-10-01

    Neurological dysfunction in AIDS is common, occurring in as many as eighty percent of children. Thus, it is important to recognize the central nervous system imaging appearance of HIV, in particular those of HIV encephalopathy, as this is an AIDS defining illness and with distinct neuro-imaging features essential for early diagnosis and timely therapeutic intervention To identify the clinical features in HIV-1 infection of the central nervous system and their associated neuroradiological correlates. Retrospective review of the records of all children with HIV-1 encephalopathy identified among children with neurological and developmental problems and who were on follow up at a child development and neurology clinic in an African city. A total of 22 children (10 male and 12 female) with HIV-1 encephalopathy were identified among 2382 children with various forms of neurological and developmental problems and who were on follow up at a child development and neurology clinic for a little bit over eight years period. All the children acquired the infection vertically. The age range of these children was between 10 months to 14 years. The median age was 5.6 years. The mean duration of symptom was 3.2 years. Global delay or regression in development along with signs of pyramidal tract involvement and seizures were the commonest clinical signs observed in these children. Neuro-behavioral problems were commonly observed among preschool and school aged children. In older children and preadolescents focal seizures with or with out neurologic deficit and neuroradiological findings were common. Nonhemorrhagic stroke was rare and occurred in one child and another child had cortical blindness. Three children had no neurological deficit. Rapid progression of the disease carried grave prognosis. Opportunistic infections and tumors of the central nervous system were also uncommon among these children. Brain volume loss with dilatation of the lateral ventricle, bilateral symmetrical

  8. 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; Smit Sibinga, Cees Th.; Lowrance, David W.; Marfin, Anthony A.; Postma, Maarten J.; Mataranyika, Mary; Basavaraju, Sridhar V.

    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

  9. Implementation of a socio-ecological system navigation approach to human development in Sub-Saharan African communities

    Directory of Open Access Journals (Sweden)

    Gianni Gilioli

    2014-04-01

    Full Text Available This paper presents a framework for the development of socio-eco- logical systems towards enhanced sustainability. Emphasis is given to the dynamic properties of complex, adaptive social-ecological systems, their structure and to the fundamental role of agriculture. The tangible components that meet the needs of specific projects executed in Kenya and Ethiopia encompass project objectives, innovation, facilitation, continuous recording and analyses of monitoring data, that allow adaptive management and system navigation. Two case studies deal with system navigation through the mitigation of key constraints; they aim to improve human health thanks to anopheline malaria vectors control in Nyabondo (Kenya, and to improve cattle health through tsetse control and antitrypanosomal drug administration to cattle in Luke (Ethiopia. The second case deals with a socio-ecological navigation system to enhance sustainability, establishing a periurban diversified enterprise in Addis Ababa (Ethiopia and developing a rural sustainable social-ecological system in Luke (Ethiopia. The project procedures are briefly described here and their outcomes are analysed in relation to the stated objectives. The methodology for human and cattle disease vector control were easier to implement than the navigation of social-ecological systems towards sustainability enhancement. The achievements considerably differed between key constraints removal and sustainability enhancement projects. Some recommendations are made to rationalise human and cattle health improvement efforts and to smoothen the road towards enhanced sustainability: i technology system implementation should be carried out through an innovation system; ii transparent monitoring information should be continuously acquired and evaluated for assessing the state of the system in relation to stated objectives for (a improving the insight into the systems behaviour and (b rationalizing decision support; iii the

  10. Is urbanization in Sub-Saharan Africa different ?

    OpenAIRE

    Henderson, J. Vernon; Roberts, Mark; Storeygard, Adam

    2013-01-01

    In the past dozen years, a literature has developed arguing that urbanization has unfolded differently in post-independence Sub-Saharan Africa than in the rest of the developing world, with implications for African economic growth overall. While African countries are more urbanized than other countries at comparable levels of income, it is well-recognized that total and sector gross domest...

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

    Science.gov (United States)

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

    2014-01-01

    This paper presents a framework for the development of socio-ecological systems towards enhanced sustainability. Emphasis is given to the dynamic properties of complex, adaptive social-ecological systems, their structure and to the fundamental role of agriculture. The tangible components that meet the needs of specific projects executed in Kenya and Ethiopia encompass project objectives, innovation, facilitation, continuous recording and analyses of monitoring data, that allow adaptive management and system navigation. Two case studies deal with system navigation through the mitigation of key constraints; they aim to improve human health thanks to anopheline malaria vectors control in Nyabondo (Kenya), and to improve cattle health through tsetse control and antitrypanosomal drug administration to cattle in Luke (Ethiopia). The second case deals with a socio-ecological navigation system to enhance sustainability, establishing a periurban diversified enterprise in Addis Ababa (Ethiopia) and developing a rural sustainable social-ecological system in Luke (Ethiopia). The project procedures are briefly described here and their outcomes are analysed in relation to the stated objectives. The methodology for human and cattle disease vector control were easier to implement than the navigation of social-ecological systems towards sustainability enhancement. The achievements considerably differed between key constraints removal and sustainability enhancement projects. Some recommendations are made to rationalise human and cattle health improvement efforts and to smoothen the road towards enhanced sustainability: i) technology system implementation should be carried out through an innovation system; ii) transparent monitoring information should be continuously acquired and evaluated for assessing the state of the system in relation to stated objectives for (a) improving the insight into the systems behaviour and (b) rationalizing decision support; iii) the different views of

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

    Science.gov (United States)

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

    2014-03-26

    This paper presents a framework for the development of socio-ecological systems towards enhanced sustainability. Emphasis is given to the dynamic properties of complex, adaptive social-ecological systems, their structure and to the fundamental role of agriculture. The tangible components that meet the needs of specific projects executed in Kenya and Ethiopia encompass project objectives, innovation, facilitation, continuous recording and analyses of monitoring data, that allow adaptive management and system navigation. Two case studies deal with system navigation through the mitigation of key constraints; they aim to improve human health thanks to anopheline malaria vectors control in Nyabondo (Kenya), and to improve cattle health through tsetse control and antitrypanosomal drug administration to cattle in Luke (Ethiopia). The second case deals with a socio-ecological navigation system to enhance sustainability, establishing a periurban diversified enterprise in Addis Ababa (Ethiopia) and developing a rural sustainable social-ecological system in Luke (Ethiopia). The project procedures are briefly described here and their outcomes are analysed in relation to the stated objectives. The methodology for human and cattle disease vector control were easier to implement than the navigation of social-ecological systems towards sustainability enhancement. The achievements considerably differed between key constraints removal and sustainability enhancement projects. Some recommendations are made to rationalise human and cattle health improvement efforts and to smoothen the road towards enhanced sustainability: i) technology system implementation should be carried out through an innovation system; ii) transparent monitoring information should be continuously acquired and evaluated for assessing the state of the system in relation to stated objectives for (a) improving the insight into the systems behaviour and (b) rationalizing decision support; iii) the different views of

  13. United States Military Assistance Programs C-130B's to Sub-Saharan Africa: A Case Study in Policy, Decision Making & Strategy

    National Research Council Canada - National Science Library

    Schroer, D. J

    1997-01-01

    This case study will examine decision making in U.S. Military Assistance Programs in the form of C-l3OB transfers to the Sub-Saharan countries of Zimbabwe, Botswana and South Africa from 1994 to present...

  14. How can African agriculture adapt to climate change: Climate Change Impacts on Food Security in Sub-Saharan Africa: Insights from Comprehensive Climate Change Modeling

    OpenAIRE

    Ringler, Claudia; Zhu, Tingju; Cai, Ximing; Koo, Jawoo; Wang, Dingbao

    2011-01-01

    According to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change, warming in Sub-Saharan Africa (SSA) is expected to be greater than the global average, and rainfall will decline in certain areas. Global circulation models (GCMs), which provide an understanding of climate and project climate change, tend to agree that temperatures are increasing across the region, but models vary widely regarding predicted changes in precipitation—with the exception of some agreeme...

  15. Scarification in sub-Saharan Africa: social skin, remedy and medical import.

    Science.gov (United States)

    Garve, Roland; Garve, Miriam; Türp, Jens C; Fobil, Julius N; Meyer, Christian G

    2017-06-01

    Various forms of body modification may be observed in sub-Saharan Africa. Hypotheses and theories of scarification and tribal marking in sub-Saharan Africa are described, plus the procedure of scarification, examples from several African countries, assumed effects in prevention and treatment of diseases, and the medical risks resulting from unsterile manipulation. © 2017 John Wiley & Sons Ltd.

  16. Therapeutic misconception and clinical trials in sub-saharan Africa ...

    African Journals Online (AJOL)

    Objectives: To identify possible existence of therapeutic misconception and its effects on clinical trials in sub-Saharan Africa. Data source: Original research findings and reviews published in the English literature and author's professional experience with clinical trials in some East, Central and West African countries.

  17. Workshop report: building biostatistics capacity in Sub-saharan ...

    African Journals Online (AJOL)

    To address the need for capacity development in biostatistics in the Sub-Saharan African region and to move recommendations from previous workshops into action, we brought together biostatisticians from the region to provide an opportunity to brainstorm biostatistics capacity development in Africa, how to enhance what ...

  18. Managing Endometriosis in sub-Saharan Africa: Emerging Concepts ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    endometriosis and improve service delivery that will ultimately result in an improved quality of life for women with endometriosis. The first ever Sub Saharan African scientific conference on endometriosis in. Kampala Uganda in 2006 highlighted the need to develop integrative and multidisciplinary endometriosis programs in ...

  19. Science Granting Councils Initiative in Sub-Saharan Africa ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This initiative seeks to strengthen the capacities of science granting councils in East Africa and other selected sub-Saharan African countries. The goal is to contribute to economic and social development in the region through research and evidence-based policies. About the science granting councils initiative The Science ...

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

    Science.gov (United States)

    Hinchliffe, Keith

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

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

    OpenAIRE

    Muideen O. Bakare; Kerim M. Munir; Mashudat A. Bello-Mojeed

    2014-01-01

    Sub-Saharan African (SSA) population consists of about 45% children, while in Europe and North America children population is 10- 15%. Lately, attention has been directed at mitigating childhood infectious and communicable diseases to reduce under-five mortality. As the under-five mortality index in Sub-Saharan Africa has relatively improved over the last two decades, more Sub-Saharan African children are surviving beyond the age of five and, apparently, a sizeable percentage of this populati...

  2. 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....

  3. 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.

  4. Impact of human schistosomiasis in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Abiola Fatimah Adenowo

    Full Text Available 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.

  5. 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. Copyright © 2015 Elsevier Editora Ltda. All rights

  6. Impact of human schistosomiasis in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Abiola Fatimah Adenowo

    2015-03-01

    Full Text Available 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.

  7. [Diabetes mellitus in sub-saharan Africa].

    Science.gov (United States)

    Sidibe el-H

    1998-01-01

    Diabetes mellitus is becoming more common in African cities, where it may affect up to 7% of the hospital population. It particularly affects poor male patients and 73 to 80% of those affected have non insulin-dependent diabetes. The frequency of non-obese, poorly cetogenic patients is high in Sub-Saharan Africa. This may be due to malnutrition, with a deficit either in protein or in calories. Such malnutrition is a major public health problem affecting children in Sudanese and Sahelian areas and may interact with environmental and genetic factors. In equatorial environments, the toxic effects of alcohol abuse on the pancreas are simply another environmental factor, reducing the endocrine function of the pancreas. These observations are important because: 1) diabetes mellitus has a severe social impact in this area and 2) nutrition has a general effect on the pathogenesis of diabetes mellitus.

  8. Consequences of Chinese aid in Sub-Saharan Africa

    OpenAIRE

    Sauls, Phillip R.; Heaton, Neal D.

    2016-01-01

    Approved for public release; distribution is unlimited China's position of non-interference in foreign governments' affairs, while currently good for Chinese business, may threaten to increase international terrorism, deepen regime corruption, and erode U.S. political relevance in sub-Saharan Africa. China has empowered private enterprises, which can monopolize African market sectors, marginalize African businesses, and exacerbate local social conditions. Using non-violent uprising and vio...

  9. Transitioning to groundwater irrigated intensified agriculture in Sub-Saharan Africa: An indicator based assessment

    NARCIS (Netherlands)

    Amjath, Amjath Babu; Krupnik, T.J.; Kaechele, Harald; Aravindakshan, S.; Sietz, D.

    2016-01-01

    Growing populations, changing market conditions, and the food security risks posed by rainfed cropping and climate change collectively indicate that Sub-Saharan African nations could benefit from transforming agricultural production to more intensive yet resilient and sustainable systems. Although

  10. HIV Incidence Prior to, during, and after Violent Conflict in 36 Sub-Saharan African Nations, 1990-2012: An Ecological Study.

    Directory of Open Access Journals (Sweden)

    Brady W Bennett

    Full Text Available The aim of this study was to determine the association between violent conflict and HIV incidence within and across 36 sub-Saharan Africa countries between 1990 and 2012.We used generalized linear mixed effect modeling to estimate the effect of conflict periods on country-level HIV incidence. We specified random intercepts and slopes to account for across and within country variation over time. We also conducted a sub-analysis of countries who experienced conflict to assess the effect of conflict intensity on country-level HIV incidence. All models controlled for level of economic development, number of refugees present in the country, and year.We found that, compared to times of peace, the HIV incidence rate increased by 2.1 per 1000 infections per year (95%CI: 0.39, 3.87 in the 5 years prior to conflict. Additionally, we found a decrease of 0.7 new infections per 1000 people per year (95%CI: -1.44, -0.01 in conflicts with 25 to 1000 battle-related deaths and a decrease of 1.5 new infections per 1000 people per year (95%CI:-2.50, -0.52 for conflict with more than 1000 battle-related deaths, compared to conflicts with less than 25 battle-related deaths.Our results demonstrate that HIV infection rates increase in the years immediately prior to times of conflict; however, we did not identify a significant increase during and immediately following periods of violent conflict. Further investigation, including more rigorous data collection, is needed, as is increased aid to nations at risk of violent conflict to help in the fight against HIV/AIDS in sub-Saharan Africa.

  11. 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

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

    NARCIS (Netherlands)

    Pantazis, Nikos; Morrison, Charles; Amornkul, Pauli N.; Lewden, Charlotte; Salata, Robert A.; Minga, Albert; Chipato, Tsungai; Jaffe, Harold; Lakhi, Shabir; Karita, Etienne; Porter, Kholoud; Meyer, Laurence; Touloumi, Giota; del Amo, Julia; Bucher, Heiner C.; Chêne, Geneviève; Hamouda, Osamah; Pillay, Deenan; Prins, Maria; Rosinska, Magda; Sabin, Caroline; Lodi, Sara; Coughlin, Kate; Walker, Sarah; Babiker, Abdel; de Luca, Andrea; Fisher, Martin; Muga, Roberto; Zangerle, Robert; Kelleher, A. D.; Cooper, D. A.; Grey, Pat; Finlayson, Robert; Bloch, Mark; Kelleher, Tony; Ramacciotti, Tim; Gelgor, Linda; Cooper, David; Smith, Don; Gill, John; Jørgensen, Louise Bruun; Lutsar, Irja; Dabis, Francois; Thiebaut, Rodolphe; Masquelier, Bernard; Costagliola, Dominique; Guiguet, Marguerite; Vanhems, Philippe; Chaix, Marie-Laure; Ghosn, Jade; Boufassa, Faroudy; Kücherer, Claudia; Bartmeyer, Barbara; Katsarou, Olga; Paparizos, V.; Gargalianos-Kakolyris, P.; Lazanas, M.; Rezza, Giovanni; Dorrucci, Maria; D'Arminio Monforte, Antonella; Geskus, Ronald; van der Helm, Jannie; Schuitemaker, Hanneke; Sannes, Mette; Brubakk, Oddbjorn; Kran, Anne-Marte Bakken; Rosinska, Magdalena; Tor, Jordi; Garcia de Olalla, Patricia; Cayla, Joan; Moreno, Santiago; Monge, Susana; del Romero, Jorge; Pérez-Hoyos, Santiago; Rickenbach, Martin; Francioli, Patrick; Malyuta, Ruslan; Brettle, Ray; Murphy, Gary; Johnson, Anne; Phillips, Andrew; Delpech, Valerie; Salata, Robert; Mugerwa, Roy; Amornkul, Pauli; Giaquinto, Carlo; Gibb, Di; Grarup, Jesper; Kirk, Ole; Ledergerber, Bruno; Panteleev, Alex; Thorne, Claire; Welch, Stephen; Aboulker, Jean-Pierre; Albert, Jan; Asandi, Silvia; de Wit, Stéphane; de Wolf, Frank; Gatell, José; Karpov, Igor; Lundgren, Jens; Møller, Claus; Rakhmanova, Aza; Rockstroh, Jürgen; Volny Anne, Alain; Dedes, Nikos; Fenton, Kevin; Pizzuti, David; Vitoria, Marco; Faggion, Silvia; Frost, Richard; Fradette, Lorraine; Schwimmer, Christine; Scott, Martin; Abo, Yao; Dohoun, Lambert; Drowa, Emma Anini Yah; Bades, Isidore Bohouo; Kouamé, Tatiana; N'Dri, Marie Julie; Ouattara, Minata; Sidibé, Abdelh; Afi, Roseline; Emieme, Arlette; Inwoley, André; Toni, Thomas d'Aquin; Coulibaly, Ali; Bomisso, Germain; Konaté, Mamadou; Anglaret, Xavier; Bazin, Brigitte; Danel, Christine; Deveau, Christiane; Goujard, Cécile; Quinty, Laurence; Salamon, Roger; Thiébaut, Rodolphe; Rouzioux, Christine; Sinet, Martine; Allen, Susan; Anzala, Omu; Bekker, Linda-Gail; Inambao, Mubiana; Kamali, Anatoli; Kilembe, William; Latka, Mary H.; Sanders, Eduard; Mutua, Gaudensia; Mwangome, Mary; Ruzagira, Eugene; Twesigye, Rogers; Cormier, Emmanuel; Fast, Pat; Gilmour, Jill; Krebs, Marietta; Price, Matt; Stevens, Gwynneth; Thomson, Helen; Yates, Sarah; Kaleebu, Pontiano; Hunter, Eric; Byamugisha, Josaphat; Magwali, Thulani

    2012-01-01

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

  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

    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 Ghanaians living

  14. 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

  15. 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…

  16. Leptospirosis in Sub-Saharan Africa: a systematic review.

    Science.gov (United States)

    de Vries, Sophia G; Visser, Benjamin J; Nagel, Ingeborg M; Goris, Marga G A; Hartskeerl, Rudy A; Grobusch, Martin P

    2014-11-01

    Leptospirosis is an emerging zoonotic infection worldwide, possibly due to climate change and demographic shifts. It is regarded as endemic in Sub-Saharan Africa; however, for most countries scarce epidemiological data, if any, exist. The primary objectives were to describe the prevalence of leptospirosis in countries in Sub-Saharan Africa, and to develop options for prevention and control in the future. A systematic review was conducted to determine the prevalence of leptospirosis in Sub-Saharan Africa; the PRISMA guidelines were followed. Medline/PubMed, Embase, The Cochrane Library, Web of Science, BIOSIS Previews, the African Index Medicus, AJOL, and Google Scholar were searched. Information about the prevalence and incidence of leptospirosis in humans is available, but remains scarce for many countries. Data are unavailable or outdated for many countries, particularly those in Central Africa. Most data are available from animals, probably due to the economic losses caused by leptospirosis in livestock. In humans, leptospirosis is an important cause of febrile illness in Sub-Saharan Africa. It concerns numerous serogroups, harboured by many different animal carriers. A wide variety of data was identified. Prevalence rates vary throughout the continent and more research, especially in humans, is needed to reliably gauge the extent of the problem. Preventive measures need to be reconsidered to control outbreaks in the future.

  17. 17. Alade Adetayo Oludare kinship Structures in sub Saharan Africa ...

    African Journals Online (AJOL)

    REGINALDS

    states, the conception of kinship needs to be broadened to transcend simple familial or ancestral relations. Key Words. Sub-Saharan Africa, kinship relations, ancestors, social justice, .... fundamentally rooted in kinship” (Finch 2008, 721). ... the ancestors laid the foundation for the order in the community is so important that it.

  18. A systematic review of physical activity policy recommendations and interventions for people with mental health problems in Sub-Saharan African countries.

    Science.gov (United States)

    Vancampfort, Davy; Stubbs, Brendon; De Hert, Marc; du Plessis, Christy; Gbiri, Caleb Ademola Omuwa; Kibet, Jepkemoi; Wanyonyi, Nancy; Mugisha, James

    2017-01-01

    There is a need for interventions to address the escalating mental health burden in Sub-Saharan Africa (SSA). Implementation of physical activity (PA) within the rehabilitation of people with mental health problems (PMHP) could reduce the burden and facilitate recovery. The objective of the current review was to explore (1) the role of PA within mental health policies of SSA countries, and (2) the current research evidence for PA to improve mental health in SSA. We screened the Mental Health Atlas and MiNDbank for mental health policies in SSA countries and searched PubMed for relevant studies on PA in PMHP in SSA. Sixty-nine percent (=33/48) of SSA countries have a dedicated mental health policy. Two of 22 screened mental health policies included broad physical activity recommendations. There is clear evidence for the role of PA in the prevention and rehabilitation of depression in SSA. Despite the existing evidence, PA is largely a neglected rehabilitation modality in the mental health care systems of SSA. Continued education of existing staff, training of specialized professionals and integration of PA for mental health in public health awareness programs are needed to initiate and improve PA programs within the mental health care systems of SSA.

  19. Cooking fuel and risk of under-five mortality in 23 Sub-Saharan African countries: a population-based study.

    Science.gov (United States)

    Owili, Patrick Opiyo; Muga, Miriam Adoyo; Pan, Wen-Chi; Kuo, Hsien-Wen

    2017-06-01

    Relationship between cooking fuel and under-five mortality has not been adequately established in Sub-Saharan Africa (SSA). We therefore investigated the association between cooking fuel and risk of under-five mortality in SSA, and further investigated its interaction with smoking. Using the most recent Demographic Health Survey data of 23 SSA countries (n = 783,691), Cox proportional hazard was employed to determine the association between cooking fuel and risk of under-five deaths. The adjusted hazard ratios were 1.21 (95 % CI, 1.10-1.34) and 1.20 (95 % CI, 1.08-1.32) for charcoal and biomass cooking fuel, respectively, compared to clean fuels. There was no positive interaction between biomass cooking fuel and smoking. Use of charcoal and biomass were associated with the risk of under-five mortality in SSA. Disseminating public health information on health risks of cooking fuel and development of relevant public health policies are likely to have a positive impact on a child's survival.

  20. Surgery for rheumatic mitral valve disease in sub-saharan African countries: why valve repair is still the best surgical option.

    Science.gov (United States)

    Mvondo, Charles Mve; Pugliese, Marta; Giamberti, Alessandro; Chelo, David; Kuate, Liliane Mfeukeu; Boombhi, Jerome; Dailor, Ellen Marie

    2016-01-01

    Rheumatic valve disease, a consequence of acute rheumatic fever, remains endemic in developing countries in the sub-Saharan region where it is the leading cause of heart failure and cardiovascular death, involving predominantly a young population. The involvement of the mitral valve is pathognomonic and mitral surgery has become the lone therapeutic option for the majority of these patients. However, controversies exist on the choice between valve repair or prosthetic valve replacement. Although the advantages of mitral valve repair over prosthetic valve replacement in degenerative mitral disease are well established, this has not been the case for rheumatic lesions, where the use of prosthetic valves, specifically mechanical devices, even in poorly compliant populations remains very common. These patients deserve more accurate evaluation in the choice of the surgical strategy which strongly impacts the post-operative outcomes. This report discusses the factors supporting mitral repair surgery in rheumatic disease, according to the patients' characteristics and the effectiveness of the current repair techniques compared to prosthetic valve replacement in developing countries.

  1. Improving data quality across 3 sub-Saharan African countries using the Consolidated Framework for Implementation Research (CFIR): results from the African Health Initiative.

    Science.gov (United States)

    Gimbel, Sarah; Mwanza, Moses; Nisingizwe, Marie Paul; Michel, Cathy; Hirschhorn, Lisa

    2017-12-21

    High-quality data are critical to inform, monitor and manage health programs. Over the seven-year African Health Initiative of the Doris Duke Charitable Foundation, three of the five Population Health Implementation and Training (PHIT) partnership projects in Mozambique, Rwanda, and Zambia introduced strategies to improve the quality and evaluation of routinely-collected data at the primary health care level, and stimulate its use in evidence-based decision-making. Using the Consolidated Framework for Implementation Research (CFIR) as a guide, this paper: 1) describes and categorizes data quality assessment and improvement activities of the projects, and 2) identifies core intervention components and implementation strategy adaptations introduced to improve data quality in each setting. The CFIR was adapted through a qualitative theme reduction process involving discussions with key informants from each project, who identified two domains and ten constructs most relevant to the study aim of describing and comparing each country's data quality assessment approach and implementation process. Data were collected on each project's data quality improvement strategies, activities implemented, and results via a semi-structured questionnaire with closed and open-ended items administered to health management information systems leads in each country, with complementary data abstraction from project reports. Across the three projects, intervention components that aligned with user priorities and government systems were perceived to be relatively advantageous, and more readily adapted and adopted. Activities that both assessed and improved data quality (including data quality assessments, mentorship and supportive supervision, establishment and/or strengthening of electronic medical record systems), received higher ranking scores from respondents. Our findings suggest that, at a minimum, successful data quality improvement efforts should include routine audits linked to

  2. 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.

  3. [Sub-Saharan traveler with papulovesicular exanthema and flu-like symptoms].

    Science.gov (United States)

    Strub, C; Weisser, M; Bassetti, S

    2004-12-01

    African tick bite fever (ATBF) is an infectious disease commonly observed in travelers to sub-Saharan Africa. Because the presentation of the disease is often not specific, ATBF is frequently not diagnosed or confused with Mediterranean spotted fever. We present the case of a 63-year-old woman with typical history and symptoms. The diagnosis of ATBF was serologically confirmed by immunofluoroscence. ATBF is an important differential diagnosis of fever in patients returning from sub-Saharan Africa.

  4. Is the Role of Physicians Really Evolving Due to Non-physician Clinicians Predominance in Staff Makeup in Sub-Saharan African Health Systems? Comment on "Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians".

    Science.gov (United States)

    Sidat, Mohsin M

    2016-07-02

    Health workforce shortages in Sub-Saharan Africa are widely recognized, particularly of physicians, leading the training and deployment of Non-physician clinicians (NPCs). The paper by Eyal et al provides interesting and legitimate viewpoints on evolving role of physicians in context of decisive increase of NPCss in Sub-Saharan Africa. Certainly, in short or mid-term, NPCs will continue to be a proxy solution and a valuable alternative to overcome physicians' shortages in sub-Saharan Africa. Indeed, NPCs have an important role at primary healthcare (PHC) level. Physicians at PHC level can certainly have all different roles that were suggested by Eyal et al, including those not directly related to healthcare provision. However, at secondary and higher levels of healthcare, physicians would assume other roles that are mainly related to patient clinical care. Thus, attempting to generalize the role of physicians without taking into account the context where they will work would be not entirely appropriate. It is true that often physicians start the professional carriers at PHC level and progress to other levels of healthcare particularly after clinical post-graduation training. Nevertheless, the training programs offered by medical institutions in sub-Saharan Africa need to be periodically reviewed and take into account professional and occupational roles physicians would take in context of evolving health systems in sub-Saharan Africa. © 2016 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  5. Teaching radical prostatectomy in sub-Saharan Africa.

    Science.gov (United States)

    Ruenes, Albert; Gueye, Serigne M

    2008-02-01

    In the United States alone, approximately 220,000 new cases of prostate cancer will be detected in 2007, and 27000 men will die of that disease. African American men will suffer disproportionately, having a prostate cancer incidence that is nearly 60% higher than their Caucasian counterparts. In fact, it is widely accepted that African American men have the highest incidence of prostate cancer in the world. This observation has led investigators to study the prostate cancer risk among African men in an effort to identify factors responsible for the high incidence of prostate cancer that plagues the African American population. Findings suggest that the public health burden of prostate cancer to native African men is substantial. Effective management of prostate cancer depends on early detection of the disease and its definitive treatment. Cost-effective management can be elusive. Radical prostatectomy can cure clinically localized disease and may offer long-term cancer control in patients with stage T3 disease. Of the various forms of radical prostatectomy, radical perineal prostatectomy is ideally suited to accomplish these goals in sub-Saharan Africa. A program to teach radical perineal prostatectomy has begun in Dakar, Senegal. It is a system based on graded surgical responsibility. High-quality audiovisual guides familiarize surgeons with the procedure's unique anatomic concerns. They then observe live procedures, assist in live procedures and eventually begin performing the live procedures under direct supervision. Repeated performance of the operation with simultaneous critique is the hallmark of this program, the goal of which is to establish a center of excellence where surgeons throughout the continent can come to learn this technique.

  6. Population growth and food supply in sub-Saharan Africa.

    Science.gov (United States)

    Meerman, J; Cochrane, S H

    1982-09-01

    It is argued in this article that sub-Saharan Africa, given its present institutions and endowments of capital and technology, is already dangerously close to overpopulation. The rapid growth of its population projected for the next decades will greatly increase human misery and depress economic development. Specifically, rapid population growth will have disastrous effects on the region's ability to increase exports and provide people with food. There must be a search for new ways in which these effects could be mitigated. In sub-Saharan Africa fertility either continues to be very high or is increasing, in part due to some decline in traditional practices that reduce fertility, such as prolonged breastfeeding. This situation and the expectation of declining mortality imply that African population growth may increase further. Currently, population in sub-Saharan Africa is about half that of India and a third of China. There are 2 main reasons why reduced fertility in the next few decades is unlikely in sub-Saharan Africa as a whole: Africa has low literacy, high infant and child mortality, and low urbanization; and average African fertility rates may even increase for the next 20 years or so. The question that arises is what are the implications of continuing and rapid population growth for the African food supply. The region's cereal production is largely restricted to 4 grains, i.e., millet, sorghum, maize, and rice. The volume of grain production is less, by weight, than 60% of the production of roots and tubers. There are 2 main differences between the output of these crops in sub-Saharan Africa and the rest of the world: yields/hectare are lower in Africa than in elsewhere; and yields have generally been decreasing or largely constant in Africa. The low productivity has several causes. Today, population pressure has brought diminishing returns to traditional agriculture in much of the Sahel and the savanna, in parts of East Africa, Southern Africa, and parts

  7. Angola - an Oil Dependant Country in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Baumgartner Boris

    2016-12-01

    Full Text Available The Sub-Saharan Africa belongs to the most underdeveloped regions in the world economy. This region consists of forty nine countries but it’s world GDP share is only a small percentage. There are some very resource rich countries in this region. One of them is Angola. This former Portuguese colony has one of the largest inventories of oil among all African countries. Angola recorded one of the highest growth of GDP between 2004-2008 from all countries in the world economy and nowadays is the third biggest economy in Sub-Saharan Africa after Nigeria and South Africa. The essential problem of Angola is the one-way oriented economy on oil and general on natural resources. Angola will be forced to change their one-way oriented economy to be more diversified and competitive in the future.

  8. 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.

  9. Trends in access to water supply and sanitation in 31 major sub-Saharan African cities: an analysis of DHS data from 2000 to 2012.

    Science.gov (United States)

    Hopewell, Mike R; Graham, Jay P

    2014-02-28

    By 2050, sub-Saharan Africa's (SSA) urban population is expected to grow from 414 million to over 1.2 billion. This growth will likely increase challenges to municipalities attempting to provide access to water supply and sanitation (WS&S). This study aims to characterize trends in access to WS&S in SSA cities and identify factors affecting those trends. DHS data collected between 2000 and 2012 were used for this analysis of thirty-one cities in SSA. Four categories of household access to WS&S were studied using data from demographic and health surveys--these included: 1) household access to an improved water supply, 2) household's time spent collecting water, 3) household access to improved sanitation, and 4) households reporting to engage in open defecation. An exploratory analysis of these measures was then conducted to assess the relationship of access to several independent variables. Among the 31 cities, there was wide variability in coverage levels and trends in coverage with respect to the four categories of access. The majority of cities were found to be increasing access in the categories of improved water supply and improved sanitation (65% and 83% of cities, respectively), while fewer were making progress in reducing the amount of time spent collecting water and reducing open defecation (50% and 38% of cities, respectively). Additionally, the prevalence of open defecation in study cities was found to be, on average, increasing. Based on DHS data, cities appeared to be making the most progress in gaining access to WS&S along metrics which reflect specified targets of the Millennium Development Goals. Nearly half of the cities, however, did not make progress in reducing open defecation or the time spent collecting water. This may reflect that the MDGs have led to a focus on "improved" services while other measures, potentially more relevant to the extreme poor, are being neglected. This study highlights the need to better characterize access, beyond

  10. Effects of South Africa’s Economic Growth on Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Kwon Sik Kim

    2007-06-01

    Full Text Available Major countries, such as the United States, Japan, and China have already recognized the potential of Africa’s markets. Korea has also taken notice of Africa's diverse export markets recently. However, Africa is comprised of 53 different countries and, as a result, entry into the region poses a formidable strategic challenge. Korean authorities and export groups have suggested a "3 plus 2 Country Strategy" in order to make inroads into the African region. This paper contributes to discussions of this strategy by comparing the effects of economic growth in South Africa and Nigeria on Sub-Saharan Africa. In addition, because economic power in Africa is concentrated in a small number of countries, whose market characteristics are different from those of integrated unions, the determinants of economic growth in Africa as a whole and unions may be different. This paper investigates whether or not this is, in fact, the case. The empirical results can be summarized as follows: First, the effects of South Africa's economic growth on Sub-Saharan Africa and the SADC (a representative union of South Africa are much larger than the effects of Nigeria's growth on Sub-Saharan Africa and the ECOWAS (a representative union of Nigeria. These empirical results imply that the preferred country to pursue economic cooperation with is South Africa. Second, we confirm that determinants of economic growth are different for Africa and the unions. The main determinant of growth in African countries may be the population ratio, but in the SADC, growth appears to be determined by ratio trade volumes of GDP. Finally, we also find that the ratio investments of GDP have a positive influence on the economic growth of both Africa and SADC.

  11. Diet, malnutrition in sub-Saharan Africa.

    Science.gov (United States)

    Serdula, M

    1988-12-01

    This study analyzes the association of protein energy malnutrition and mortality in preschool (non-emergency) children in Sub-Saharan Africa. 2 functional consequences of malnutrition are discussed: retarded physical growth (anthropometry) and mortality. The anthropometric measures used to assess malnutrition are weight-for-age, weight for height, and mid-upper arm circumference. The major factors associated with malnutrition and mortality include dietary intake, severity and frequency of infections, social, demographic, economic and cultural factors (area of residence, seasonality, socioeconomic status, mother's age and educational level, family support and cohesiveness, birth order of index child and birth interval between children and number of children under 5 in the family, maternal nutritional status and health and adequacy of breast milk volume and composition for young infants. Understanding these factors will identify children-at-risk for malnutrition and target them for intervention programs. The article focuses on the association of malnutrition with mortality in relation to: 1) breastfeeding and weaning practice; 2) vitamin A and 3) infection. Reviews of African and Asian studies on the subject demonstrated that higher mortality rates were associated with malnutrition, however, the causal associations remain unclear. Since malnourished children are at higher risk for illness, short-term interventions should include growth monitoring, nutrition education, prevention and treatment of infections, food supplementation, hospital rehabilitation, home gardens and improved agricultural practices; while long-term interventions should include improvement in the economic and environmental conditions. (author's modified).

  12. Program-level and contextual-level determinants of low-median CD4+ cell count in cohorts of persons initiating ART in eight sub-Saharan African countries.

    Science.gov (United States)

    Nash, Denis; Wu, Yingfeng; Elul, Batya; Hoos, David; El Sadr, Wafaa

    2011-07-31

    In sub-Saharan Africa, many patients initiate antiretroviral therapy (ART) at CD4 cell counts much lower than those recommended in national guidelines. We examined program-level and contextual-level factors associated with low median CD4 cell count at ART initiation in populations initiating ART. Multilevel analysis of aggregate and program-level service delivery data. We examined data on 1690 cohorts of patients initiating ART during 2004-2008 in eight sub-Saharan African countries. Cohorts with median CD4 less than 111 cells/μl (the lowest quartile) were classified as having low median CD4 cell count at ART initiation. Cohort information was combined with time-updated program-level data and subnational contextual-level data, and analyzed using multilevel models. The 1690 cohorts had median CD4 cell count of 136 cells/μl and included 121,504 patients initiating ART at 267 clinics. Program-level factors associated with low cohort median CD4 cell count included urban setting [adjusted odds ratio (AOR) 2.1; 95% confidence interval (CI) 1.3-3.3], lower provider-to-patient ratio (AOR 2.2; 95% CI 1.3-4.0), no PMTCT program (AOR 3.6; 95% CI 1.0-12.8), outreach services for ART patients only vs. both pre-ART and ART patients (AOR 2.4; 95% CI 1.5-3.9), fewer vs. more adherence support services (AOR 1.6; 95% CI 1.0-2.5), and smaller cohort size (AOR 2.5; 95% CI 1.4-4.5). Contextual-level factors associated with low cohort median CD4 cell count included initiating ART in areas where a lower proportion of the population heard of AIDS, tested for HIV recently, and a higher proportion believed 'limiting themselves to one HIV-uninfected sexual partner reduces HIV risk'. Determinants of CD4 cell count at ART initiation in populations initiating ART operate at multiple levels. Structural interventions targeting points upstream from ART initiation along the continuum from infection to diagnosis to care engagement are needed.

  13. 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)

    Schoonees, Anel; Rohwer, Anke; Young, Taryn

    2017-01-01

    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. 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. 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 EBHC, including lack of

  14. Patterns of HIV-1 Drug Resistance After First-Line Antiretroviral Therapy (ART) Failure in 6 Sub-Saharan African Countries: Implications for Second-Line ART Strategies

    NARCIS (Netherlands)

    Hamers, Raph L.; Sigaloff, Kim C. E.; Wensing, Annemarie M.; Wallis, Carole L.; Kityo, Cissy; Siwale, Margaret; Mandaliya, Kishor; Ive, Prudence; Botes, Mariette E.; Wellington, Maureen; Osibogun, Akin; Stevens, Wendy S.; Rinke de Wit, Tobias F.; Schuurman, Rob; Siwale, M.; Njovu, C.; Labib, M.; Menke, J.; Botes, M. E.; Conradie, F.; Ive, P.; Sanne, I.; Wallis, C. L.; Letsoalo, E.; Stevens, W. S.; Hardman, M.; Wellington, M.; Luthy, R.; Mandaliya, K.; Abdallah, S.; Jao, I.; Dolan, M.; Namayanja, G.; Nakatudde, L.; Nankya, I.; Kiconco, M.; Abwola, M.; Mugyenyi, P.; Osibogun, A.; Akanmu, S.; Schuurman, R.; Wensing, A. M.; Straatsma, E.; Wit, F. W.; Dekker, J.; van Vugt, M.; Lange, J. M.

    2012-01-01

    Background. Human immunodeficiency virus type 1 (HIV-1) drug resistance may limit the benefits of antiretroviral therapy (ART). This cohort study examined patterns of drug-resistance mutations (DRMs) in individuals with virological failure on first-line ART at 13 clinical sites in 6 African

  15. Sub-Saharan Africa Report.

    Science.gov (United States)

    1987-01-14

    society" in Africa has been effectively des- troyed —the activity of labor unions and other independent groups, for example. The West African Ghana...of South African industry," Dr Chris Garn - ers, president and chief executive officer of the CSIR, said in a statement released at a Press confer

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

    Science.gov (United States)

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

    2014-07-25

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

  17. The Implementation of the Responsibility to Protect (R2P) Norms by the African Standby Force in Sub-Saharan Africa

    Science.gov (United States)

    2017-06-09

    component of the African Peace and Security Architecture (APSA), which is the organ responsible for the AU mechanisms for promoting peace, security...S) Major Augustin Hodali 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES...support of many individuals and organizations . First, I am whole-heartedly thankful to the Rwandan Government and particularly the Rwanda Defense Forces

  18. Linking the sub-Saharan and West Eurasian gene pools: maternal and paternal heritage of the Tuareg nomads from the African Sahel.

    Science.gov (United States)

    Pereira, Luísa; Cerný, Viktor; Cerezo, María; Silva, Nuno M; Hájek, Martin; Vasíková, Alzbeta; Kujanová, Martina; Brdicka, Radim; Salas, Antonio

    2010-08-01

    The Tuareg presently live in the Sahara and the Sahel. Their ancestors are commonly believed to be the Garamantes of the Libyan Fezzan, ever since it was suggested by authors of antiquity. Biological evidence, based on classical genetic markers, however, indicates kinship with the Beja of Eastern Sudan. Our study of mitochondrial DNA (mtDNA) sequences and Y chromosome SNPs of three different southern Tuareg groups from Mali, Burkina Faso and the Republic of Niger reveals a West Eurasian-North African composition of their gene pool. The data show that certain genetic lineages could not have been introduced into this population earlier than approximately 9000 years ago whereas local expansions establish a minimal date at around 3000 years ago. Some of the mtDNA haplogroups observed in the Tuareg population were involved in the post-Last Glacial Maximum human expansion from Iberian refugia towards both Europe and North Africa. Interestingly, no Near Eastern mtDNA lineages connected with the Neolithic expansion have been observed in our population sample. On the other hand, the Y chromosome SNPs data show that the paternal lineages can very probably be traced to the Near Eastern Neolithic demic expansion towards North Africa, a period that is otherwise concordant with the above-mentioned mtDNA expansion. The time frame for the migration of the Tuareg towards the African Sahel belt overlaps that of early Holocene climatic changes across the Sahara (from the optimal greening approximately 10 000 YBP to the extant aridity beginning at approximately 6000 YBP) and the migrations of other African nomadic peoples in the area.

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

    Science.gov (United States)

    2012-01-01

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

  20. 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

  1. Association Studies and Direct DNA Sequencing Implicate Genetic Susceptibility Loci in the Etiology of Nonsyndromic Orofacial Clefts in Sub-Saharan African Populations

    Science.gov (United States)

    Gowans, L.J.J.; Adeyemo, W.L.; Eshete, M.; Mossey, P.A.; Busch, T.; Aregbesola, B.; Donkor, P.; Arthur, F.K.N.; Bello, S.A.; Martinez, A.; Li, M.; Augustine-Akpan, E.A.; Deressa, W.; Twumasi, P.; Olutayo, J.; Deribew, M.; Agbenorku, P.; Oti, A.A.; Braimah, R.; Plange-Rhule, G.; Gesses, M.; Obiri-Yeboah, S.; Oseni, G.O.; Olaitan, P.B.; Abdur-Rahman, L.; Abate, F.; Hailu, T.; Gravem, P.; Ogunlewe, M.O.; Buxó, C.J.; Marazita, M.L.; Adeyemo, A.A.; Murray, J.C.; Butali, A.

    2016-01-01

    Orofacial clefts (OFCs) are congenital dysmorphologies of the human face and oral cavity, with a global incidence of 1 per 700 live births. These anomalies exhibit a multifactorial pattern of inheritance, with genetic and environmental factors both playing crucial roles. Many loci have been implicated in the etiology of nonsyndromic cleft lip with or without cleft palate (NSCL/P) in populations of Asian and European ancestries, through genome-wide association studies and candidate gene studies. However, few populations of African descent have been studied to date. Here, the authors show evidence of an association of some loci with NSCL/P and nonsyndromic cleft palate only (NSCPO) in cohorts from Africa (Ghana, Ethiopia, and Nigeria). The authors genotyped 48 single-nucleotide polymorphisms that were selected from previous genome-wide association studies and candidate gene studies. These markers were successfully genotyped on 701 NSCL/P and 163 NSCPO cases, 1,070 unaffected relatives, and 1,078 unrelated controls. The authors also directly sequenced 7 genes in 184 nonsyndromic OFC (NSOFC) cases and 96 controls from Ghana. Population-specific associations were observed in the case-control analyses of the subpopulations, with West African subpopulations (Ghana and Nigeria) showing a similar pattern of associations. In meta-analyses of the case-control cohort, PAX7 (rs742071, P = 5.10 × 10−3), 8q24 (rs987525, P = 1.22 × 10−3), and VAX1 (rs7078160, P = 0.04) were nominally associated with NSCL/P, and MSX1 (rs115200552, P = 0.01), TULP4 (rs651333, P = 0.04), CRISPLD2 (rs4783099, P = 0.02), and NOG1 (rs17760296, P = 0.04) were nominally associated with NSCPO. Moreover, 7 loci exhibited evidence of threshold overtransmission in NSOFC cases through the transmission disequilibrium test and through analyses of the family-based association for disease traits. Through DNA sequencing, the authors also identified 2 novel, rare, potentially pathogenic variants (p.Asn323Asp

  2. 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

  3. Sub-Saharan Botanical Collections

    DEFF Research Database (Denmark)

    Demissew, Sebsebe; Beentje, Henk; Cheek, Martin

    2015-01-01

    with independence of former European colonies in Africa, fewer were built on well-established herbaria from the colonial period. There are many gaps in collecting coverage, not least with regard to areas of high plant diversity; this is often caused by poor access or political instability. High species diversity...... exists in both humid and arid parts of Africa. Lack of collections from and knowledge about areas of high species diversity makes it difficult to prioritise conservation efforts. Gaps in taxonomic knowledge exist in certain large families, such as Rubiaceae, or in large genera, such as Cyphostemma...... (Vitaceae), Euphorbia (Euphorbiaceae), Ipomoea (Convolvulaceae), Polystachya (Orchidaceae), and Barleria (Acanthaceae). Newly collected specimens are now mainly kept in African herbaria, but lack of training and resources in tropical African herbaria are important challenges to prevent African botanists...

  4. 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

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

    Science.gov (United States)

    Hamers, Raph L; Sigaloff, Kim C E; Wensing, Annemarie M; Wallis, Carole L; Kityo, Cissy; Siwale, Margaret; Mandaliya, Kishor; Ive, Prudence; Botes, Mariette E; Wellington, Maureen; Osibogun, Akin; Stevens, Wendy S; Rinke de Wit, Tobias F; Schuurman, Rob

    2012-06-01

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

  6. medication in sub-Saharan Africa

    African Journals Online (AJOL)

    2007-09-04

    Sep 4, 2007 ... In this review article, the issues related to provision of psychotropic drugs in services in sub-Saharan Africa are explored. Problems encountered in procurement of drugs, their safe prescription and practical supply systems are discussed, with possible solutions suggested. The evidence-base for the ...

  7. Sub-Saharan Africa Report.

    Science.gov (United States)

    1987-04-16

    people and reading newspapers, one grc\\»4o understand the heavy presence of security. South African aggression para- noia is at boiling point. Yet... David Sibeko’s death was finally attributed to internal PAC wrangles. First, there is no way the exile movements can start eliminating each other

  8. Sub-Saharan Africa Report

    Science.gov (United States)

    1987-02-20

    service and transit center thus is likely to increase still further. Djibouti is also profiting from the decline of the South Yemen port of Aden...due to be completed by 1988. Because of the geology of the region (the East African Rift valley), favorable conditions exist for tapping into this

  9. Sub-Saharan Africa Report

    Science.gov (United States)

    1987-04-10

    restructuring of the sanitation system, which consists in depolluting the water course which crosses the valley. Livestock and farm mechanization are also...lie said although the Of the money donated province was undergoing to the South African Soil - difficulties r e g a r 6 1 n g, darity Fund, $600 came

  10. The Complexity of Environmental Protection in Sub-Saharan Africa ...

    African Journals Online (AJOL)

    economic development in sub-Saharan Africa. However, there is an implicit determination of the people to protect the human health of the sub-Saharan population and the environment from the adverse effects of pollution and degraded ...

  11. 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

  12. 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

  13. 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

    2017-03-27

    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. Cross-sectional observational health facility assessment. Ethiopia, Kenya, Madagascar, Mozambique, Rwanda and Tanzania. Health workers in 643 facilities. 1016 health workers were interviewed, and 2377 babies were observed in the facilities surveyed. 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. 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. 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 the necessary equipment, supplies, knowledge and skills that are critical to

  14. Sub-Saharan Africa Report.

    Science.gov (United States)

    1987-04-21

    Portuguese, the common language, punctuated by cheers from the crowd. The spectacle reminded me of the big celebrations of the Chinese Cultural Revolution...feet. Leap- frogging over the protruding trees. That was the real piloting of the heroic times of aviation. Young South African Boers, scrappy fellows...NEWSLETTER in English 14 Mar 87 p 3]/12828 BULGARIANS TO REHABILITATE GERALCO—Bonifacio Saulosse, the director of Geralco, an edible oil and soap

  15. The role of decentralized systems in providing universal electricity access in Sub-Saharan Africa – A model-based approach

    NARCIS (Netherlands)

    Dagnachew, Anteneh G.; Lucas, Paul L.|info:eu-repo/dai/nl/272607444; Hof, Andries F.|info:eu-repo/dai/nl/240412397; Gernaat, David E.H.J.|info:eu-repo/dai/nl/372664636; de Boer, Harmen Sytze; van Vuuren, Detlef P.|info:eu-repo/dai/nl/11522016X

    2017-01-01

    Poverty and lack of access to electricity are highly correlated. In Sub-Saharan Africa, one of the poorest regions in the world, two in every three people have no access to electricity. This paper describes a purpose designed model to explore and project the development in the Sub-Saharan African

  16. Fatty acid compositions of preterm and term colostrum, transitional and mature milks in a sub-Saharan population with high fish intakes

    NARCIS (Netherlands)

    Kuipers, Remko S.; Luxwolda, Martine F.; Dijck-Brouwer, D. A. Janneke; Muskiet, Frits A. J.

    2012-01-01

    Background: There are no data on the fatty acid (FA) compositions of preterm and term milks for sub-Saharan African populations with advancing lactation. However, it is generally acknowledged that our ancestors evolved in sub-Saharan East-Africa, where they inhabited the land-water ecosystems.

  17. 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.

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

    Science.gov (United States)

    Winkler, Andrea Sylvia

    2012-09-01

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

  19. Migration of women from sub-Saharan Africa to Europe: the role of highly skilled women

    OpenAIRE

    Camilla Spadavecchia

    2013-01-01

    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%...

  20. Sub-Saharan Africa Report

    National Research Council Canada - National Science Library

    1987-01-01

    Partial Contents; Commerce Ministers, Trade, AIDS, Journalist, Students, Refuge Aid, Political Police, Governor, Ambassador, Arms Shipment, Boycott, Parliament, Reshuffle State, Political, Culture, Tourism Bureaus...

  1. Factors Influencing Contraceptive Use in Sub-Saharan Africa: A Systematic Review.

    Science.gov (United States)

    Blackstone, Sarah R; Nwaozuru, Ucheoma; Iwelunmor, Juliet

    2017-01-01

    The purpose of this study was to systematically review the literature regarding factors influencing contraceptive use in sub-Saharan Africa between 2005 and 2015. A total of 58 studies from twelve Sub-Saharan African countries were reviewed. Keywords were grouped using the PEN-3 cultural model. Negative factors prohibiting or reducing contraceptive use were women's misconceptions of contraceptive side-effects, male partner disapproval, and social/cultural norms surrounding fertility. Positive factors included education, employment, and communication with male partner. Increasing modern contraceptive use in Sub-Saharan Africa is a multi-faceted problem that will require community and systems wide interventions that aim to counteract negative perceptions and misinformation.

  2. 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…

  3. Tariff evasion in sub-Saharan Africa: the influence of corruption in importing and exporting countries

    NARCIS (Netherlands)

    Worku, T.; Mendoza Rodriguez, J.P.; Wielhouwer, J.L.

    2016-01-01

    Multilateral organizations recommend sub-Saharan African (SSA) countries to increase international trade in order to attain sustainable economic growth. The benefits of trade can be hampered, however, by tariff evasion. Using trade data from 2008–2014 of 31 SSA countries, we examine how the

  4. Health expenditure and child health outcomes in Sub-Saharan Africa

    African Journals Online (AJOL)

    This study sought to understand the relationship between child health outcomes and health spending while investigating lagged effects. The study employed panel data from 45 Sub-Saharan African countries between 1995 and 2011 obtained from the World Bank's World Development Indicators. Fixed and Random effect ...

  5. fee - , fnof . Food Prices and Economic Well-Being in Sub-Saharan

    African Journals Online (AJOL)

    Abstract. Over the years, Sub-Saharan Africa has been one of the regions worst hit with the deleterious effects of food insecurity owing to the soaring prices of food items. Therefore, this paper examines the effects of rising food prices on economic well-being in 31 Sub-Sahara African countries from 2001-2012 using panel ...

  6. A profile of non-farm household enterprises in Sub-Saharan Africa

    NARCIS (Netherlands)

    Nagler, Paula

    2017-01-01

    This paper provides a comprehensive descriptive profile of non-farm household enterprises in ten Sub-Saharan African countries, disaggregated by the households' consumption quintiles. Various enterprise-related aspects are covered, such as the share of households that operate an enterprise, the

  7. Democratization in sub-Saharan Africa (1989-1992) : an overview of the literature

    NARCIS (Netherlands)

    Buijtenhuijs, Rob; Rijnierse, Elly

    1993-01-01

    This report gives an overview of the literature on recent democratization processes in sub-Saharan Africa (1989-1992). The authors first deal with the basic features of African politics that can serve as a framework within which present-day democratization developments can be comprehended. Then they

  8. The Tourism–Development Nexus in sub-Saharan Africa: Progress ...

    African Journals Online (AJOL)

    In the global landscape of tourism scholarship, the region of sub-Saharan Africa is an undeveloped research focus. This article offers an overview of recent research trends, and argues that cues for an African tourism agenda should be taken from the developmental imperatives that confront the continent. The nexus of ...

  9. Withholding breast milk for HIV exposed infants in sub-Saharan Africa

    African Journals Online (AJOL)

    ... African HIV exposed infants. It is hoped that when Highly Active Antiretroviral Therapy (HAART) becomes universally accessible and available to HIV infected women in sub-Saharan Africa, breast milk HIV transmission will be a rare event and the health benefits of breastfeeding for the infant and mother will be maximized.

  10. 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

  11. Globalisation and the Internationalisation of Higher Education in Sub-Saharan Africa

    Science.gov (United States)

    Dzvimbo, Kuzvinetsa Peter; Moloi, Kholeka Constance

    2013-01-01

    In a shrinking world, in which a neo-liberal discourse has permeated sub-Saharan African higher education, critical reflection is required to assess the merits and demerits of globalisation. Research, intensive discussion and hearings conducted over a two-year period by the Task Force on Higher Education and Society, convened by the World Bank and…

  12. Military Assistance in Sub-Saharan Africa

    Science.gov (United States)

    1994-01-01

    on the wildlife habitats, reduces the animal population through poaching, and reduces another source of income, tourism . 3 Hearing before the...their livestock, and defecate. The roads between Mombassa, Kenya and Goma, Zaire are often litde more than trails of rubble, remnants of what once was...authority of four different unified commands. In sub-Saharan Africa the U.S. Central Command (CENTCOM) is responsible for Djibouti, Kenya , Ethiopia and

  13. Association of HLA class II markers with autoantibody-negative ketosis-prone atypical diabetes compared to type 2 diabetes in a population of sub-Saharan African patients.

    Science.gov (United States)

    Balti, Eric V; Ngo-Nemb, Marinette C; Lontchi-Yimagou, Eric; Atogho-Tiedeu, Barbara; Effoe, Valery S; Akwo, Elvis A; Dehayem, Mesmin Y; Mbanya, Jean-Claude; Gautier, Jean-François; Sobngwi, Eugene

    2015-01-01

    We investigated the association of HLA DRB1 and DQB1 alleles, haplotypes and genotypes with unprovoked antibody-negative ketosis-prone atypical diabetes (A(-) KPD) in comparison to type 2 diabetes (T2D). A(-) KPD and T2D sub-Saharan African patients aged 19-63 years were consecutively recruited. Patients positive for cytoplasmic islet cell, insulin, glutamic acid decarboxylase or islet antigen-2 autoantibodies were excluded. Odds ratios were obtained via logistic regression after considering alleles with a minimum frequency of 5% in the study population. Bonferroni correction was used in the case of multiple comparisons. Among the 130 participants, 35 (27%) were women and 57 (44%) were A(-) KPD. DRB1 and DQB1 allele frequencies were similar for both A(-) KPD and T2D patients; they did not confer any substantial risk even after considering type 1 diabetes susceptibility and resistance alleles. We found no association between A(-) KPD and the derived DRB1*07-DQB1*02:02 (OR: 0.55 [95%CI: 0.17-1.85], P=0.336); DRB1*11-DQB1*03:01 (OR: 2.42 [95%CI: 0.79-7.42], P=0.123); DRB1*15-DQB1*06:02 (OR: 0.87 [95%CI: 0.39-1.95], P=0.731) and DRB1*03:01-DQB1*02:01 (OR: 1.48 [95%CI: 0.55-3.96], P=0.437) haplotypes. Overall, we did not find any evidence of susceptibility to ketosis associated with DRB1 and DQB1 genotypes (all P>0.05) in A(-) KPD compared to T2D. Similar results were obtained after adjusting the analysis for age and sex. Factors other than DRB1 and DQB1 genotype could explain the propensity to ketosis in A(-) KPD. These results need to be confirmed in a larger population with the perspective of improving the classification and understanding of the pathophysiology of A(-) KPD. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. Mining and Risk of Tuberculosis in Sub-Saharan Africa

    Science.gov (United States)

    Basu, Sanjay; McKee, Martin; Lurie, Mark

    2011-01-01

    Objectives. We estimated the relationship between mining and tuberculosis (TB) among countries in sub-Saharan Africa. Methods. We used multivariate regression to estimate the contribution of mining activity to TB incidence, prevalence, and mortality, as well as rates of TB among people living with HIV, with control for economic, health system, and population confounders. Results. Mining production was associated with higher population TB incidence rates (adjusted b = 0.093; 95% confidence interval [CI] = 0.067, 0.120; with an increase of mining production of 1 SD corresponding to about 33% higher TB incidence or 760 000 more incident cases), after adjustment for economic and population controls. Similar results were observed for TB prevalence and mortality, as well as with alternative measures of mining activity. Independent of HIV, there were significant associations between mining production and TB incidence in countries with high HIV prevalence (≥ 4% antenatal HIV prevalence; HIV-adjusted B = 0.066; 95% CI = 0.050, 0.082) and between log gold mining production and TB incidence in all studied countries (HIV-adjusted B = 0.053; 95% CI = 0.032, 0.073). Conclusions. Mining is a significant determinant of countrywide variation in TB among sub-Saharan African nations. Comprehensive TB control strategies should explicitly address the role of mining activity and environments in the epidemic. PMID:20516372

  15. Sub-Saharan Africa Report.

    Science.gov (United States)

    1987-01-20

    advantage if he is identified at this point. Meanwhile, it has emerged that while Lt Gen Ian Gleeson , acting chief of the SADF, referred in a statement...American Secretary of State Mr George Shultz had praised the unpre- cedented reforms taking place in South Africa, Earlier this month he spoke of the

  16. Sub-Saharan Africa Report.

    Science.gov (United States)

    1985-12-27

    Given, by Jo-Anne Collinge 65 Consumer Boycotts Continue, by Gary van Staden 67 How 380 Victims Died 67 Troops, Armored Vehicles, by Phil Mtimkulu...the territory of people and to order people to leave if they threatened public order. The minister of civic affairs, Mr Hans Diergaardt, said in the...Johannesburg THE STAR in English 21 Nov 85 p 6 [Article by Gary van Staden ] [Text] When President Botha de- clared a state of emergency on July 21, most of

  17. 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.

  18. [Thyroid diseases in sub-Saharan Africa].

    Science.gov (United States)

    Sidibé, El Hassane

    2007-01-01

    Thyroid gland diseases vary according to the environment. In sub-Saharan Africa, they are also influenced by population isolation and the absence of food self-sufficiency, both factors affecting the onset and persistence of iodine-deficiency goiters. More cosmopolitan diseases are now added to these thyroid disorders. Women are mainly affected (94.2%), most often with euthyroid goiters (54.7%), followed by Graves disease (13.1%), hypothyroidism (8.8%), thyroiditis (6.6%), toxic multinodular goiters (6.6 %) and unclassified goiters (10%) [Gabon]. The paucity of laboratories specializing in endocrinology and of nuclear medicine facilities, the delay in diagnosis that results in compressive or recurrent goiters, and endemic goiters are all typical in Africa. In children and adolescents, death rates increase with congenital or acquired thyroiditis as with delayed physical or mental development. In this environment, thyroiditis can also be pregnancy-related. Very recent surveys show a prevalence of endemic goiters of 28.6% in the community of Sekota, Ethiopia, 64-70% in Sahel-Sudan (population aged 10-20 years), 20-29% in KwaZulu-Natal (school children), 14.3-30.2% in Namibia (school children), 0.21% (congenital hypothyroidism or cretinism) in Plateau State, Nigeria, 55.2% at Zitenga, Burkina Faso (210 persons 0-45 years), and 10% in Hararé and Wedza, Zimbabwe (newborn TSH >10.1 microIU/mL). The prevalence of goiters is 43.6% in children emigrating from Ethiopia to Israel. Millet from semi-arid zones contains apigenin at a concentration of 150 mg/kg and luteolin at 350 mg/kg, both of which can interfere with thyroid function. The harmful effects of cassava (also known as manioc) are better known: milling cassava reduces its goitrogenic potential. In addition to iodine deficiency, selenium deficiency, and the effect of the thiocyanates in cassava, ion concentrations in soil and drinking water appear to play a role. The proportion of thyroid surgery indicated for

  19. Mental and substance use disorders in Sub-Saharan Africa: predictions of epidemiological changes and mental health workforce requirements for the next 40 years

    National Research Council Canada - National Science Library

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

    2014-01-01

    .... Years lived with a disability (YLD) predictions for mental and substance use disorders for each decade from 2010 to 2050 for four Sub-Saharan African regions were calculated using Global Burden of Disease 2010 study (GBD 2010...

  20. Mental and Substance Use Disorders in Sub-Saharan Africa: Predictions of Epidemiological Changes and Mental Health Workforce Requirements for the Next 40 Years: e110208

    National Research Council Canada - National Science Library

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

    2014-01-01

    .... Years lived with a disability (YLD) predictions for mental and substance use disorders for each decade from 2010 to 2050 for four Sub-Saharan African regions were calculated using Global Burden of Disease 2010 study (GBD 2010...

  1. Youth in sub-Saharan Africa.

    Science.gov (United States)

    Blum, Robert W

    2007-09-01

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

  2. Pilot Survey of Breast Cancer Management in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Verna D.N.K. Vanderpuye

    2017-06-01

    Full Text Available Purpose: To understand the current state of breast cancer management in sub-Saharan Africa. Methods: We conducted an anonymous online survey of breast cancer management among African Organization for Research and Treatment in Cancer (AORTIC members by using a 42-question structured questionnaire in both English and French in 2013. Results: Twenty members from 19 facilities in 14 countries responded to the survey. Twelve members (60% belonged to a multidisciplinary breast cancer team. Radiotherapy equipment was available in seven facilities (36%, but equipment had down time at least once a week in four facilities. Available chemotherapy drugs included methotrexate, cyclophosphamide, fluorouracil, anthracyclines, and vincristine, whereas trastuzumab, taxanes, vinorelbine, and gemcitabine were available in few facilities. Core-needle biopsy was available in 16 facilities (84%; mammogram, in 17 facilities (89%; computed tomography scan, in 15 facilities (79%; magnetic resonance imaging, in 11 facilities (58%; and bone scans, in nine facilities (47%. It took an average of 1 to 3 weeks to report histopathology. Immunohistochemistry was available locally in eight facilities (42%, outside hospitals but within the country in seven facilities (37%, and outside the country in four facilities (21%. Thirteen facilities (68% performed axillary node dissections as part of a breast protocol. Neoadjuvant chemotherapy was the most common therapy for locally advanced breast cancer in 13 facilities (68%. In three facilities (16%, receptor status did not influence the prescription of hormone treatment. Conclusion: This pilot survey suggests that AORTIC members in sub-Saharan Africa continue to make gains in the provision of access to multidisciplinary breast cancer care, but the lack of adequate pathology and radiotherapy services is a barrier. Focused attention on in-country and regional training needs and improvement of health systems deliverables is urgently

  3. The Concept, Causes and Consequences of Failed States: A Critical Review of the Literature and Agenda for Research with Specific Reference to Sub-Saharan Africa

    OpenAIRE

    Jonathan Di John

    2010-01-01

    This article provides a critical review of recent literature that has attempted to define what a ‘failed state’ is and explains why such states emerge. It is argued that aggregate indices of ‘failure’ are misleading due to the wide variations of capacity across state functions within a polity. The focus on ranking states also distracts attention away from analyses concerning the dynamics of state capacity. Moreover, many of the definitions either compare reality to a Weberian ideal, or assume...

  4. 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.

  5. Information flows in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Chris Paterson

    2013-04-01

    Full Text Available The state of research into media and information flows in sub-Saharan Africa describes a situation marked by rapid growth of a wide range of media and distinctive geo-linguistic mediaspheres. This article focuses on two revolutions in information flow in the region: first, an expansion since the 1990s of traditional media, facilitated by satellite broadcasting and related technologies; secondly, since about 2000, the ongoing embrace of mobile telephony. It describes these developments in Lusophone, Francophone and Anglophone mediaspheres. Building on the author’s own previous research, and that of others, the article highlights the shift from asymmetrical, elite dominated communications concerning the major public affairs of the day toward increasingly symmetrical and participatory electronic communications. L’état de la recherche portant sur les flux d’information en Afrique sub-saharienne implique un contexte marqué par la croissance rapide d’un vaste panel de médias et d’espaces médiatiques géolinguistiques spécifiques. Le présent article porte sur deux révolutions liées au flux de l’information dans la région : en premier lieu l’expansion des médias traditionnels depuis les années 90, facilitée par la diffusion satellitaire et les technologies qu’elle implique ; en second lieu, l’intérêt actuel pour la téléphonie mobile qui se développe depuis les années 2000. L’article analyse ces évolutions au sein des espaces médiatiques lusophones, francophones et anglophones. Dans la continuité de notre précédente recherche, et celle développée par d’autres à ce sujet, cet article souligne le déplacement de communications asymétriques et dominées par l’élite, sur les affaires publiques majeures, vers des communications électroniques de plus en plus symétriques et participatives. O estado da pesquisa sobre o fluxo da informação na África subsaariana remete a um contexto marcado pelo r

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

    Science.gov (United States)

    Veltman, Jennifer A; Bristow, Claire C; Klausner, Jeffrey D

    2014-01-01

    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. 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. 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. 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.

  7. 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.

  8. 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.

  9. Intra-continental 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

    2012-01-01

    A highly invasive form of non-typhoidal Salmonella (iNTS) disease has been recently documented in many countries in sub-Saharan Africa. The most common Salmonella enterica serovar causing this disease is Typhimurium. We applied whole-genome sequence-based phylogenetic methods to define the population structure of sub-Saharan African invasive Salmonella Typhimurium and compared these to global Salmonella Typhimurium isolates. Notably, the vast majority of sub-Saharan invasive Salmonella Typhimurium 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 of lineage I by 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. PMID:23023330

  10. 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.

  11. Cancer of childhood in sub-Saharan Africa

    Science.gov (United States)

    Stefan, Cristina; Bray, Freddie; Ferlay, Jacques; Liu, Biying; Maxwell Parkin, D

    2017-01-01

    Measurement of incidence rates of childhood cancer in Africa is difficult. The study ‘Cancer of Childhood in sub Saharan Africa’ brings together results from 16 population-based registries which, as members of the African Cancer Registry Network (AFCRN), have been evaluated as achieving adequate coverage of their target population. The cancers are classified according to the third revision of the International Classification of Childhood Cancer (ICCC-3) and recorded rates in Africa are compared with those in childhood populations in the UK, France, and the USA. It is clear that, in many centres, lack of adequate diagnostic and treatment facilities leads to under-diagnosis (and enumeration) of leukaemias and brain cancers. However, for several childhood cancers, incidence rates in Africa are higher than those in high-income countries. This applies to infection-related cancers such as Kaposi sarcoma, Burkitt lymphoma, Hodgkin lymphoma and hepatocellular carcinoma, and also to two common embryonal cancers - retinoblastoma and nephroblastoma. These (and other) observations are unlikely to be artefact, and are of considerable interest when considering possible aetiological factors, including ethnic differences in risk (and hence genetic/familial antecedents). The data reported are the most extensive so far available on the incidence of cancer in sub Saharan Africa, and clearly indicate the need for more resources to be devoted to cancer registration, especially in the childhood age range, as part of an overall programme to improve the availability of diagnosis and treatment of this group of cancers, many of which have—potentially—an excellent prognosis. PMID:28900468

  12. Land-related conflicts in Sub-Saharan Africa

    African Journals Online (AJOL)

    Sub-Saharan Africa has a history of land dispossession and contestation which have resulted in various types of inequalities and a skewed distribution of land resources. Land in Sub-Saharan Africa has been subject to conflict, conquest, expropriation and exploitation thus resulting in the many discrepancies that exist today ...

  13. HIV transmission during paediatric health care in sub- Saharan ...

    African Journals Online (AJOL)

    HIV transmission during paediatric health care in sub- Saharan Africa – risks and evidence. David Gisselquist, John J Potterat, Stuart Brody. Abstract. Health care systems in sub-Saharan Africa are challenged not only to improve care for the increasing number of HIV-infected children, but also to prevent transmission of HIV ...

  14. Empowering Youth for Sub-Saharan Africa's Development | Betchoo ...

    African Journals Online (AJOL)

    At this critical time of development in sub-Saharan Africa where the continent's growth actually makes it a region of great potential, it would be vital to integrate the youth in the development of the youngest continent in the world. Long-time considered as the continent of all worries and social threats, sub-Saharan Africa has ...

  15. Diversity and distribution of avian haemosporidians in sub-Saharan Africa: an inter-regional biogeographic overview.

    Science.gov (United States)

    Outlaw, Diana C; Harvey, Johanna A; Drovetski, Sergei V; Voelker, Gary

    2017-04-01

    The diversity of avian malaria parasites is much greater than 20th century morphologists realized and virtually every study in this field in the last 15 years has uncovered previously undocumented diversity at multiple levels within the taxonomic hierarchy. Despite this explosion of knowledge, there remain vast sampling gaps, both geographically and host-taxonomically, which makes characterizing patterns of diversity extremely challenging. Here, we summarize the current state of knowledge of sub-Saharan African avian malaria parasite diversity, focusing on avian hosts endemic to Africa. The relative proportions of the parasite genera included here, Plasmodium, Haemoproteus (including Parahaemoproteus) and Leucocytozoon, varied between regions, in part due to habitat preferences of the insect vectors of these genera, and in part we believe due to sampling bias. Biogeographic regions of sub-Saharan Africa harbour about the same proportion of endemic to shared parasite lineages, but there appears to be no phylogenetic structuring across regions. Our results highlight the sampling problem that must be addressed if we are to have a detailed understanding of parasite diversity in Africa. Without broad sampling within and across regions and hosts, using both molecular tools and microscopy, conclusions about parasite diversity, host-parasite interactions or even transmission dynamics remain extremely limited.

  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. The significance of citation impact indicators of research performance in the developing countries of sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Japhet Bakuwa

    2014-07-01

    Full Text Available This paper argues that Sub-Saharan Africa needs to produce more journals indexed by ISI Web of Science (WoS. Researchers from the region should also publish in other ISI indexed, reputable and high impact journals such as Nature and Science. Inevitably, this will make Sub-Saharan African researchers visible and globally competitive. The Sub- Saharan African region has only about 40 journals out of over 12 000 journals that have been indexed by the ISI Web of Science (WoS. Arguably, ranking of universities across the globe and qualification for Nobel Prizes are determined by metrics-based evaluation of research performance. Sub-Saharan Africa is poorly represented on the world university rankings. The region has also produced only six Nobel Prize award winners from 1901 to 2010. In the same period, USA, UK and Germany produced 326, 116 and 102 recipients respectively. While there are some limitations on the use of citation indicators to evaluate research output, this researcher argues that citation impact indicators of research performance provide policymakers, researchers and funding agencies with an objective measure for assessing research performance and therefore are of great significance in the developing countries of Sub-Saharan Africa.

  18. 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...

  19. Breast Cancer in Sub-Saharan Africa: Challenges and Opportunities to Reduce Mortality.

    Science.gov (United States)

    Pace, Lydia E; Shulman, Lawrence N

    2016-06-01

    : The objective of this review is to describe existing data on breast cancer incidence and mortality in low- and middle-income countries (LMICs), in particular in sub-Saharan Africa; identify the limitations of these data; and review what is known about breast cancer control strategies in sub-Saharan African countries and other LMICs. Available estimates demonstrate that breast cancer incidence and mortality are rising in LMICs, including in Africa, although high-quality data from LMICs (and particularly from sub-Saharan Africa) are largely lacking. Case fatality rates from breast cancer appear to be substantially higher in LMICs than in high-income countries. Significant challenges exist to developing breast cancer control programs in LMICs, perhaps particularly in sub-Saharan Africa, and the most effective strategies for treatment and early detection in the context of limited resources are uncertain. High-quality research on breast cancer incidence and mortality and implementation research to guide effective breast cancer control strategies in LMICs are urgently needed. Enhanced investment in breast cancer research and treatment in LMICs should be a global public health priority. The numbers of new cases of breast cancer, and breast cancer deaths per year, in low- and middle-income countries are rising. Engagement by the international breast cancer community is critical to reduce global disparities in breast cancer outcomes. Cancer specialists and institutions in high-income countries can serve as key partners in training initiatives, clinical care, protocol and program development, and research. This article provides an overview of what is known about breast cancer incidence, mortality, and effective strategies for breast cancer control in sub-Saharan Africa and identifies key gaps in the literature. This information can help guide priorities for engagement by the global cancer community. ©AlphaMed Press.

  20. Epidemiology of Glaucoma in Sub-Saharan Africa: Prevalence, Incidence and Risk Factors

    OpenAIRE

    Kyari, Fatima; Abdull, Mohammed M.; Bastawrous, Andrew; Gilbert, Clare E.; Faal, Hannah

    2013-01-01

    Purpose: The purpose of this study is to review the epidemiology of different types of glaucoma relevant to Sub-Saharan Africa (SSA) and to discuss the evidence regarding the risk factors for onset and progression of glaucoma, including risk factors for glaucoma blindness. Methods: Electronic databases (PubMed, MedLine, African Journals Online- AJOL) were searched using the full text, Medical Subject Headings (MeSH) terms, author(s) and title to identify publications since 1982 in the foll...

  1. Corruption and trust in political institutions in sub-Saharan Africa

    OpenAIRE

    Lavallée, Emmanuelle; Razafindrakoto, Mireille; Roubaud, François

    2008-01-01

    (english) This paper analyzes the impact of corruption on the extent of trust in political institutions using a rich collection of comparable data provided by the Afrobarometer surveys conducted in 18 sub-Saharan African countries. More specifically, we set out to test the “efficient grease” hypothesis that corruption can strengthen citizens’ trust since bribe paying and clientelism open the door to otherwise scarce and inaccessible services and subsidies, and that this increases institutiona...

  2. Corruption in Sub-Saharan Africa: Towards a more holistic approach ...

    African Journals Online (AJOL)

    Corruption in Sub-Saharan Africa: Towards a more holistic approach. Munyae M. Mulinge, Gwen N. Lesetedi. Abstract. (Af. J. Political Science: 2001 7(1): 51-78). Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/ajps.v7i1.27324 · AJOL African ...

  3. The Philip's Curve in Sub-Saharan Africa: Evidence from Panel Data Analysis

    OpenAIRE

    Esu, Godwin; Atan, Johnson

    2017-01-01

    In this study, we attempted the assessment of the validity of the Philip’s curve hypothesis in the Sub-Saharan African region. We employed a panel data technique of analysis, drawing data from twenty-nine countries in the region. The data spanned 24 years (1991 to 2015). The annual data for unemployment rate and inflation rate for these countries were obtained from World Development Indicators (WDI) (2016). The inflation rate was captured using the consumer price index (CPI), while unemployme...

  4. The political economy of urban food security in Sub-Saharan Africa

    OpenAIRE

    Maxwell, Daniel G.

    1998-01-01

    Sub-Saharan African cities in the late 1990s face a daunting set of problems including rapid growth, increasing poverty, deteriorating infrastructure, and inadequate capacity for service provision. However, even as a renewed debate is shaping up around issues of urban development, there is little attention given to the question of urban food security and nutrition. Whereas in the 1970s and 1980s, urban food problems in Africa commanded political attention, the nature of urban food insecurity ...

  5. The impact of exporting and export destination on manufacturing wages: Evidence for sub-Saharan Africa

    OpenAIRE

    Milner, Chris; Tandrayen, Verena

    2004-01-01

    Since the late 1980's many Sub-Saharan African governments, under the auspices of the World Bank and IMF, have embarked on substantial reform programmes aimed at liberalising trade and expanding exports. There has been a large literature exploring aggregate export and growth response to trade liberalisation, but relatively little empirical work on the labour market effects of these programmes. This paper seeks to provide insights into the individual wage effects of the trade-status of firms. ...

  6. Colonial Legacy, Communist Nostalgia and Failure of Democracy in Sub-Saharan Africa

    Science.gov (United States)

    2011-03-29

    local African people. The discovery of resources such as gold, diamonds and rubber encouraged the influx of Europeans to Sub-Saharan Africa...different system of colonial rule to govern its colonies. The British colonies included British Somaliland, Botswana , Cameroon, Gambia, Ghana, Kenya, Lesotho...firms, agro-industries, mines , and factories were nationalized with the owners who were mostly foreign being compensated.53 In reality the

  7. Analysis of host responses to Mycobacterium tuberculosis antigens in a multi-site study of subjects with different TB and HIV infection states in sub-Saharan Africa.

    Directory of Open Access Journals (Sweden)

    Jayne S Sutherland

    Full Text Available Tuberculosis (TB remains a global health threat with 9 million new cases and 1.4 million deaths per year. In order to develop a protective vaccine, we need to define the antigens expressed by Mycobacterium tuberculosis (Mtb, which are relevant to protective immunity in high-endemic areas.We analysed responses to 23 Mtb antigens in a total of 1247 subjects with different HIV and TB status across 5 geographically diverse sites in Africa (South Africa, The Gambia, Ethiopia, Malawi and Uganda. We used a 7-day whole blood assay followed by IFN-γ ELISA on the supernatants. Antigens included PPD, ESAT-6 and Ag85B (dominant antigens together with novel resuscitation-promoting factors (rpf, reactivation proteins, latency (Mtb DosR regulon-encoded antigens, starvation-induced antigens and secreted antigens.There was variation between sites in responses to the antigens, presumably due to underlying genetic and environmental differences. When results from all sites were combined, HIV- subjects with active TB showed significantly lower responses compared to both TST(- and TST(+ contacts to latency antigens (Rv0569, Rv1733, Rv1735, Rv1737 and the rpf Rv0867; whilst responses to ESAT-6/CFP-10 fusion protein (EC, PPD, Rv2029, TB10.3, and TB10.4 were significantly higher in TST(+ contacts (LTBI compared to TB and TST(- contacts fewer differences were seen in subjects with HIV co-infection, with responses to the mitogen PHA significantly lower in subjects with active TB compared to those with LTBI and no difference with any antigen.Our multi-site study design for testing novel Mtb antigens revealed promising antigens for future vaccine development. The IFN-γ ELISA is a cheap and useful tool for screening potential antigenicity in subjects with different ethnic backgrounds and across a spectrum of TB and HIV infection states. Analysis of cytokines other than IFN-γ is currently on-going to determine correlates of protection, which may be useful for vaccine

  8. 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.

  9. Breast-feeding in sub-Saharan Africa: outlook for 2000.

    Science.gov (United States)

    Walker, A R; Adam, F I

    2000-09-01

    The World Health Organization (WHO) has stressed that 1.5 million infants die annually, unnecessarily, from deprival or from insufficiency of breast milk. Hence, the need for its maximal use, very particularly in impoverished populations, such as those in sub-Saharan Africa. In many developed populations, a generation ago the practice was very low, but now it has risen considerably. In contrast, in Africa and in most developing populations, despite the far greater need for breast-feeding, the practice is tending to decrease, especially among urban mothers. While the most common reasons given concern insufficiency of breast milk and employment of mothers, the latter, especially urban mothers, are under strong and increasing pressure to use proprietary replacement foods. These are often made up unsatisfactorily and are contaminated. Also influential are the often less than enthusiastic, and confusing, attitudes of staff at clinics and hospitals, albeit, due in part to their very heavy workloads. Additionally, there is society's relatively indifferent attitude to breast-feeding. Currently, a hugely adverse factor is the danger of human immunodeficiency virus (HIV) transference from seropositive mothers to their infants - in some African countries almost half of antenatal mothers are infected. Chances of early control of the infection are remote. However, apart from this danger, and from the pressure from replacement food companies, the outlook for breast-feeding practice in many African countries is unlikely to improve significantly until greater encouragement is given from State, local and other health authorities.

  10. 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.

  11. Sub-Saharan Africa: beyond the health worker migration crisis?

    Science.gov (United States)

    Connell, John; Zurn, Pascal; Stilwell, Barbara; Awases, Magda; Braichet, Jean-Marc

    2007-05-01

    Migration of skilled health workers from sub-Saharan African countries has significantly increased in this century, with most countries becoming sources of migrants. Despite the growing problem of health worker migration for the effective functioning of health care systems there is a remarkable paucity and incompleteness of data. Hence, it is difficult to determine the real extent of migration from, and within, Africa, and thus develop effective forecasting or remedial policies. This global overview and the most comprehensive data indicate that the key destinations remain the USA and the UK, and that major sources are South Africa and Nigeria, but in both contexts there is now greater diversity. Migrants move primarily for economic reasons, and increasingly choose health careers because they offer migration prospects. Migration has been at considerable economic cost, it has depleted workforces, diminished the effectiveness of health care delivery and reduced the morale of the remaining workforce. Countries have sought to implement national policies to manage migration, mitigate its harmful impacts and strengthen African health care systems. Recipient countries have been reluctant to establish effective ethical codes of recruitment practice, or other forms of compensation or technology transfer, hence migration is likely to increase further in the future, diminishing the possibility of achieving the United Nations millennium development goals and exacerbating existing inequalities in access to adequate health care.

  12. Transfusion Medicine in Sub-Saharan Africa: Conference Summary.

    Science.gov (United States)

    Dzik, Walter Sunny; Kyeyune, Dorothy; Otekat, Grace; Natukunda, Bernard; Hume, Heather; Kasirye, Phillip G; Ddungu, Henry; Kajja, Isaac; Dhabangi, Aggrey; Mugyenyi, Godfrey R; Seguin, Claire; Barnes, Linda; Delaney, Meghan

    2015-07-01

    In November 2014, a 3-day conference devoted to transfusion medicine in sub-Saharan Africa was held in Kampala, Uganda. Faculty from academic institutions in Uganda provided a broad overview of issues pertinent to transfusion medicine in Africa. The conference consisted of lectures, demonstrations, and discussions followed by 5 small group workshops held at the Uganda Blood Transfusion Service Laboratories, the Ugandan Cancer Institute, and the Mulago National Referral Hospital. Highlighted topics included the challenges posed by increasing clinical demands for blood, the need for better patient identification at the time of transfusion, inadequate application of the antiglobulin reagent during pretransfusion testing, concern regarding proper recognition and evaluation of transfusion reactions, the expanded role for nurse leadership as a means to improve patient outcomes, and the need for an epidemiologic map of blood usage in Africa. Specialty areas of focus included the potential for broader application of transcranial Doppler and hydroxyurea therapy in sickle cell disease, African-specific guidelines for transfusion support of cancer patients, the challenges of transfusion support in trauma, and the importance of African-centered clinical research in pediatric and obstetric transfusion medicine. The course concluded by summarizing the benefits derived from an organized quality program that extended from the donor to the recipient. As an educational tool, the slide-audio presentation of the lectures will be made freely available at the International Society of Blood Transfusion Academy Web site: http://www.isbtweb.org/academy/. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Cutting bread or cutting throats? Findings from a new database on religion, violence and peace in Sub-Saharan Africa, 1990 to 2008

    OpenAIRE

    Basedau, Matthias; Strüver, Georg; Vüllers, Johannes

    2011-01-01

    Despite the religious diversity in sub-Saharan Africa and the religious overtones in a number of African conflicts, social science research has inadequately addressed the question of how and to what extent religion matters for conflict in Africa. This paper presents an innovative data inventory on religion and violent conflict in all sub-Saharan countries for the period 1990-2008 that seeks to contribute to filling the gap. The data underscore that religion has to be accounted for in conflict...

  14. Cutting Bread or Cutting Throats? – Findings from a New Database on Religion, Violence and Peace in Sub-Saharan Africa

    OpenAIRE

    Matthias Basedau; Georg Strüver; Johannes Vüllers

    2011-01-01

    Despite the religious diversity in sub-Saharan Africa and the religious overtones in a number of African conflicts, social science research has inadequately addressed the question of how and to what extent religion matters for conflict in Africa. This paper presents an innovative data inventory on religion and violent conflict in all sub-Saharan countries for the period 1990–2008 that seeks to contribute to filling the gap. The data underscore that religion has to be accounted for in conflict...

  15. 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?.

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

    Science.gov (United States)

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

    2013-02-13

    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.

  17. Aetiologies of non-malaria febrile episodes in children under 5 years in sub-Saharan Africa

    NARCIS (Netherlands)

    Kiemde, Francois; Spijker, René; Mens, Petra F.; Tinto, Halidou; Boele, Michael; Schallig, Henk D. F. H.

    2016-01-01

    ObjectivesTo provide an overview of the most frequent aetiologies found in febrile episodes of children under 5 years from sub-Saharan Africa. MethodsMEDLINE and EMBASE were searched for publications in English and French on non-malaria fever episodes in African children under 5 years of age, which

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

    Science.gov (United States)

    Gray, Kenneth R.; Credle, Sid Howard

    1996-01-01

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

  19. Can sub-Saharan Africa feed itself?

    Science.gov (United States)

    van Ittersum, Martin K; van Bussel, Lenny G J; Wolf, Joost; Grassini, Patricio; van Wart, Justin; Guilpart, Nicolas; Claessens, Lieven; de Groot, Hugo; Wiebe, Keith; Mason-D'Croz, Daniel; Yang, Haishun; Boogaard, Hendrik; van Oort, Pepijn A J; van Loon, Marloes P; Saito, Kazuki; Adimo, Ochieng; Adjei-Nsiah, Samuel; Agali, Alhassane; Bala, Abdullahi; Chikowo, Regis; Kaizzi, Kayuki; Kouressy, Mamoutou; Makoi, Joachim H J R; Ouattara, Korodjouma; Tesfaye, Kindie; Cassman, Kenneth G

    2016-12-27

    Although global food demand is expected to increase 60% by 2050 compared with 2005/2007, the rise will be much greater in sub-Saharan Africa (SSA). Indeed, SSA is the region at greatest food security risk because by 2050 its population will increase 2.5-fold and demand for cereals approximately triple, whereas current levels of cereal consumption already depend on substantial imports. At issue is whether SSA can meet this vast increase in cereal demand without greater reliance on cereal imports or major expansion of agricultural area and associated biodiversity loss and greenhouse gas emissions. Recent studies indicate that the global increase in food demand by 2050 can be met through closing the gap between current farm yield and yield potential on existing cropland. Here, however, we estimate it will not be feasible to meet future SSA cereal demand on existing production area by yield gap closure alone. Our agronomically robust yield gap analysis for 10 countries in SSA using location-specific data and a spatial upscaling approach reveals that, in addition to yield gap closure, other more complex and uncertain components of intensification are also needed, i.e., increasing cropping intensity (the number of crops grown per 12 mo on the same field) and sustainable expansion of irrigated production area. If intensification is not successful and massive cropland land expansion is to be avoided, SSA will depend much more on imports of cereals than it does today.

  20. Paediatric challenges in Sub-Saharan Africa

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    Robert Hilliard

    2016-01-01

    Full Text Available The United Nations Millennium Development Goals (MDGs project is coming to an end in 2015 and is being replaced by ambitious and aspirational Sustainable Development Goals (SDGs. Although the MDGs have been nearly achieved, this is not true in Sub-Saharan Africa where there is still unnecessarily high infant and childhood mortality and where there are many challenges to providing modern child health care. To achieve the SDGs in the next fifteen years, in low-income countries, national ministries of health and community health leaders will need to set reasonable goals and quality improvement projects. Attention needs to paid to economical, evidence-based effective health care; to education of children and youth and of health professional; health promotion and prevention of illness; a balance between expensive health care in large urban hospitals and community health projects; and most importantly to the social determinants of health. But the SDGs are achievable with coordinated and sustained national commitments and increased financial commitments from Western countries.

  1. Students' and junior doctors' preparedness for the reality of practice in sub-Saharan Africa.

    Science.gov (United States)

    Frambach, Janneke M; Manuel, Beatriz A F; Fumo, Afonso M T; Van Der Vleuten, Cees P M; Driessen, Erik W

    2015-01-01

    Evidence tailored to sub-Saharan Africa on outcomes of innovations in medical education is needed to encourage and advance their implementation in this region. To investigate preparedness for practice of students and graduates from an innovative and a conventional medical curriculum in a sub-Saharan African context. Using mixed methods we compared junior doctors and fifth-year students from two Mozambican medical schools: one with an innovative problem- and community-based curriculum and one with a conventional lecture- and discipline-based curriculum. A questionnaire on professional competencies was administered, semi-structured interviews were conducted, and work diaries were collected. The findings were integrated in a conceptual model. Six areas of tension between global health care ideals and local health care practice emerged from the data that challenged doctors' motivation and preparedness for practice. Four elements of the innovative curriculum equipped students and graduates with skills, attitudes and competencies to better cope with these tensions. Students and graduates from the innovative curriculum rated significantly higher levels on various competencies and expressed more satisfaction with the curriculum and its usefulness for their work. An innovative problem- and community-based curriculum can improve sub-Saharan African doctors' motivation and preparedness to tackle the challenges of health care practice in this region.

  2. X-linked MTMR8 diversity and evolutionary history of sub-Saharan populations.

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    Damian Labuda

    Full Text Available The genetic diversity within an 11 kb segment of the MTMR8 gene in a sample of 111 sub-Saharan and 49 non-African X chromosomes was investigated to assess the early evolutionary history of sub-Saharan Africans and the out-of-Africa expansion. The analyses revealed a complex genetic structure of the Africans that contributed to the emergence of modern humans. We observed partitioning of two thirds of old lineages among southern, west/central and east African populations indicating ancient population stratification predating the out of Africa migration. Age estimates of these lineages, older than coalescence times of uniparentally inherited markers, raise the question whether contemporary humans originated from a single population or as an amalgamation of different populations separated by years of independent evolution, thus suggesting a greater antiquity of our species than generally assumed. While the oldest sub-Saharan lineages, ~500 thousand years, are found among Khoe-San from southern-Africa, a distinct haplotype found among Biaka is likely due to admixture from an even older population. An East African population that gave rise to non-Africans underwent a selective sweep affecting the subcentromeric region where MTMR8 is located. This and similar sweeps in four other regions of the X chromosome, documented in the literature, effectively reduced genetic diversity of non-African chromosomes and therefore may have exacerbated the effect of the demographic bottleneck usually ascribed to the out of Africa migration. Our data is suggestive, however, that a bottleneck, occurred in Africa before range expansion.

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

    Science.gov (United States)

    Velayati, Ali-Akbar; Bakayev, Valerii; Bahadori, Moslem; Tabatabaei, Seyed-Javad; Alaei, Arash; Farahbood, Amir; Masjedi, Mohammad-Reza

    2007-10-01

    The pandemic of HIV/AIDS in sub-Saharan Africa and the rise of epidemics in Asia to the previously unforeseen level are likely to have global social, economic, and political impacts. In this emergency, it is vital to reappraise the weight of powerful religious and cultural factors in spreading the disease. The role of Islam in shaping values, norms, and public policies in North African states is to be appreciated for the lowest HIV prevalence in their populations. Yet, the place of religion in prevention of the disease diffusion is not fully understood nor worldwide acknowledged by the primary decision makers. Another topic, which has received little attention to date, despite the abundance of literature concerning the unfortunate Africa's anti-AIDS campaign, is an issue of colonial past. To better comprehend the share of both traits in diverse spread of HIV in sub-Saharan Africa, we studied the correlation between Muslim and Christian proportions in the state's population and HIV rate. By this method, Muslim percentage came out as a potential predictor of HIV prevalence in a given state. In another approach, most subcontinental countries were clustered by colocalization and similarity in their leading religion, colonial past, and HIV seroprevalence starting from barely noticeable (0.6 - 1.2%, for Mauritania, Senegal, Somalia, and Niger) and low levels (1.9 - 4.8%, for Mali, Eritrea, Djibouti, Guinea, Guinea-Bissau, Burkina-Faso, and Chad) for Muslim populated past possessions of France and Italy, in the northern part of the subcontinent. Former territories of France, Belgium, Portugal, and the UK formed two other groups of the countries nearing the equator with Catholic prevailing (Democratic Republic of Congo, Republic of Congo, Rwanda, Gabon, and Burundi) or mixed populations comprising Christian, Muslim, and indigenous believers (Benin, Ghana, Uganda, Togo, Angola, Nigeria, Liberia, Kenya, Cameroon, Côte d'Ivoire, and Sierra-Leone), which covered the HIV

  4. What Explains Economic Underdevelopment in Sub-Saharan Africa

    Science.gov (United States)

    2015-12-01

    climate causes undue harm to the human body. Such tropical diseases as malaria only compound the problem. Infant mortality is high due in part to...is unlimited 12b. DISTRIBUTION CODE 2 13. ABSTRACT (maximum 200 words) This thesis examines the causes of slow economic growth in Sub-Saharan...LEFT BLANK v ABSTRACT This thesis examines the causes of slow economic growth in Sub-Saharan Africa. In particular, it attempts to identify the

  5. Labor productivity and employment gaps in Sub-Saharan Africa.

    Science.gov (United States)

    McCullough, Ellen B

    2017-02-01

    Drawing on a new set of nationally representative, internationally comparable household surveys, this paper provides an overview of key features of structural transformation - labor allocation and labor productivity - in four African economies. New, micro-based measures of sector labor allocation and cross-sector productivity differentials describe the incentives households face when allocating their labor. These measures are similar to national accounts-based measures that are typically used to characterize structural change. However, because agricultural workers supply far fewer hours of labor per year than do workers in other sectors in all of the countries analyzed, productivity gaps shrink by half, on average, when expressed on a per-hour basis. Underlying the productivity gaps that are prominently reflected in national accounts data are large employment gaps, which call into question the productivity gains that laborers can achieve through structural transformation. Furthermore, agriculture's continued relevance to structural change in Sub-Saharan Africa is highlighted by the strong linkages observed between rural non-farm activities and primary agricultural production.

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

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    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. Sub-Saharan Africa thirty years hence.

    Science.gov (United States)

    Wheeler, J

    1986-11-01

    By the year 2015, Sub-Saharan Africa's population will probably rise from a 1985 level of about 460 million to about 1.1 billion. Today Africa's population is growing at a rate of roughly 3% a year, with exceptionally high growth rates in some countries. The leaders of Africa, and those who wish to help Africa, confront difficult and urgent problems of drought, political and military conflict, accumulated debt, lower commodity prices, and other factors of immediate and important concern. Africa has given education a high priority and should be as well known for its success in increasing school enrollment as it is for its relative failures in other areas. A projected population of 1.1 billion people and a fertility rate down to 30/1000 by the year 2015 suggests that the number of children old enough to enter primary school will be of the order of 30 million a year at this time. The working-age population will grow from 235 million now to perhaps 600 million in 30 years. The urban population has been growing at about 6% a year--twice the pace of population increase. All of these situations will have an effect on environment, water, and health. Coping with Africa's burgeoning population in terms of children in school, the demand on health systems, the need for jobs, achieving an adequate diet, the provision of basic urban services, and all the rest, is an extraordinary challenge. While the government's role is critical, success at the sectoral level almost always means cost recovery, administration decentralized to the community or to the private sector, and program implementation that does not burden the budget.

  8. Accreditation in a sub Saharan medical school: a case study at Makerere University.

    Science.gov (United States)

    Galukande, Moses; Opio, Kenneth; Nakasujja, Noeline; Buwembo, William; Kijjambu, Stephen C; Dharamsi, Shafik; Luboga, Sam; Sewankambo, Nelson K; Woollard, Robert

    2013-05-24

    Of more than the 2,323 recognized and operating medical schools in 177 countries (world wide) not all are subjected to external evaluation and accreditation procedures. Quality Assurance in medical education is part of a medical school's ethical responsibility and social accountability. Pushing this agenda in the midst of resource limitation, numerous competing interests and an already overwhelmed workforce were some of the challenges faced but it is a critical element of our medical profession's social contract. This analysis paper highlights the process of standard defining for Medical Education in a typically low resourced sub Saharan medial school environment. The World Federation for Medical Education template was used as an operating point to define standards. A wide range of stakeholders participated and meaningfully contributed in several consensus meetings. Effective participatory techniques were used for the information gathering process and analysis. Standards with a clear intent to enhance education were set through consensus. A cyclic process of continually measuring, judging and improving all standards was agreed and defined. Examples of the domains tackled are stated. Our efforts are good for our patients, our communities and for the future of health care in Uganda and the East African region.

  9. 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.

  10. 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. Copyright © 2012 Elsevier B.V. All rights

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

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    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

  12. Explaining adherence success in sub-Saharan Africa: an ethnographic study.

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    Norma C Ware

    2009-01-01

    Full Text Available Individuals living with HIV/AIDS in sub-Saharan Africa generally take more than 90% of prescribed doses of antiretroviral therapy (ART. This number exceeds the levels of adherence observed in North America and dispels early scale-up concerns that adherence would be inadequate in settings of extreme poverty. This paper offers an explanation and theoretical model of ART adherence success based on the results of an ethnographic study in three sub-Saharan African countries.Determinants of ART adherence for HIV-infected persons in sub-Saharan Africa were examined with ethnographic research methods. 414 in-person interviews were carried out with 252 persons taking ART, their treatment partners, and health care professionals at HIV treatment sites in Jos, Nigeria; Dar es Salaam, Tanzania; and Mbarara, Uganda. 136 field observations of clinic activities were also conducted. Data were examined using category construction and interpretive approaches to analysis. Findings indicate that individuals taking ART routinely overcome economic obstacles to ART adherence through a number of deliberate strategies aimed at prioritizing adherence: borrowing and "begging" transport funds, making "impossible choices" to allocate resources in favor of treatment, and "doing without." Prioritization of adherence is accomplished through resources and help made available by treatment partners, other family members and friends, and health care providers. Helpers expect adherence and make their expectations known, creating a responsibility on the part of patients to adhere. Patients adhere to promote good will on the part of helpers, thereby ensuring help will be available when future needs arise.Adherence success in sub-Saharan Africa can be explained as a means of fulfilling social responsibilities and thus preserving social capital in essential relationships.

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

    Science.gov (United States)

    Bakare, Muideen O; Munir, Kerim M; Bello-Mojeed, Mashudat A

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Muideen O. Bakare

    2014-01-01

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

  15. 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. Project HOPE—The People-to-People Health Foundation, Inc.

  16. Enhancing Human Resources and Use of Appropriate Training for Maternal and Perinatal Survival in SubSaharan Africa (ETATMBA)

    OpenAIRE

    Ellard, DR; DAVIES, D; F. Griffiths; Kandala, NB; Mazuguni, F.; Shemdoe, A.; Chimwaza, W; Chiwandira, C; Mbaruku, G.; Bergström, S; Kamwendo, F; Mhango, C.; Peile, E; Quenby, S.; Simkiss, D

    2014-01-01

    There is a chronic shortage of medical doctors in many Sub-Saharan African countries and indeed many of these countries have very little to spend on healthcare. As a consequence levels of maternal and neonatal mortality still very high and many are struggling to meet the WHO Millennium development goals. Many African countries like Malawi have a cadre of health workers called Non Physician Clinicians (NPCs) who are trained by the Ministry of Health and are often the most experienced health wo...

  17. Motor Neuron Diseases in Sub-Saharan Africa: The Need for More Population-Based Studies

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    Emmanuel Quansah

    2015-01-01

    Full Text Available Motor neuron diseases (MNDs are devastating neurological diseases that are characterised by gradual degeneration and death of motor neurons. Major types of MNDs include amyotrophic lateral sclerosis (ALS and spinal muscular atrophy (SMA. These diseases are incurable, with limited disease-modifying treatment options. In order to improve MND-based biomedical research, drug development, and clinical care, population-based studies will be important. These studies, especially among less-studied populations, might identify novel factors controlling disease susceptibility and resistance. To evaluate progress in MND research in Africa, we examined the published literature on MNDs in Sub-Saharan Africa to identify disease prevalence, genetic factors, and other risk factors. Our findings indicate that the amount of research evidence on MNDs in Sub-Saharan Africa is scanty; molecular and genetics-based studies are particularly lacking. While only a few genetic studies were identified, these studies strongly suggest that there appear to be population-specific causes of MNDs among Africans. MND genetic underpinnings vary among different African populations and also between African and non-African populations. Further studies, especially molecular, genetic and genomic studies, will be required to advance our understanding of MND biology among African populations. Insights from these studies would help to improve the timeliness and accuracy of clinical diagnosis and treatment.

  18. Epidemiology of obesity and overweight in sub-Saharan Africa: a protocol for a systematic review and meta-analysis.

    Science.gov (United States)

    Biadgilign, Sibhatu; Mgutshini, Tennyson; Haile, Demewoz; Gebremichael, Bereket; Moges, Yonatan; Tilahun, Kelemu

    2017-11-25

    Globally, overweight and obesity were estimated to cause 3.4 million deaths, 3.9% of years of life lost and 3.8% of disability-adjusted life years in 2010. Despite the fact that obesity and overweight is a problem of high-income countries, low- and middle-income countries (LMICs), in particular urban settings of sub-Saharan African countries, face the challenge of an increasing trend. The aim of this systematic review and meta-analysis will be to determine the prevalence of obesity and overweight individuals in sub-Saharan Africa and to help guide policy planners in the decision-making process for the increase in non-communicable diseases in Africa. A comprehensive systematic review and meta-analysis of published studies on the prevalence of obesity and overweight in sub-Saharan Africa will be conducted. A computerised internet search using Medline/PubMed, Google Scholar and EMBASE databases and reference lists of previous prevalence studies and detailed search strategy and cross-checking of reference lists of published peer-reviewed articles will be conducted to identify all epidemiological and/or clinical studies published in English and French. We will use the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement for reporting. The overall effect (pooled estimated effect size) of the prevalence of obesity and overweight will be analysed using the Der Simonian-Laird random effects meta-analysis (random effects model) and the obesity proportion (with 95% CI) will be measured. The underlying work is based on systematic reviews of published data and thus doed not require ethical review approval. The findings of the systematic review will be disseminated in different conferences and seminars and will be published in a reputable and refereed international peer-reviewed journal. CRD42017064942. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is

  19. Building the Capacity to Build Capacity in e-Health in Sub-Saharan Africa: The KwaZulu-Natal Experience

    Science.gov (United States)

    2012-01-01

    Abstract Background: Sub-Saharan Africa has a disproportionate burden of disease and an extreme shortage of health workers. There are already too few doctors to train doctors in specialities and sub-specialties. E-health is seen as a possible solution through distance education, telemedicine, and computerized health information systems but there are few people trained in e-health. We describe 12 years of experience at the University of KwaZulu-Natal (UKZ-N) in education and training in postgraduate medical disciplines, medical informatics, and telemedicine. Medical Education: Videoconferencing of seminars and grand rounds to regional training hospitals commenced in 2001 and has grown to 40 h of interactive conferencing taking place weekly during academic terms involving over 33,000 participants in 2010. Videoconferenced sessions are directly recorded to DVD and DVDs are sent to other medical schools in Africa that do not have the infrastructure to directly connect. E-health Education: Students and academic staff were initially sent to the United States for training in medical informatics and workshops were held in South Africa for people from sub-Saharan Africa. This led to the development of postgraduate academic programs in medical informatics and telemedicine at UKZ-N. African students were then brought to UKZ-N for training. The model was changed from UKZ-N to students and staff based at their home universities with the aim of building capacity in the staff at partner institutions so that they can in time offer their own e-health academic programs. Conclusions: The need for capacity development in all aspects of e-health in sub-Saharan Africa is great and innovative solutions are required. PMID:22150714

  20. Stock Exchange Development and Economic Growth in Sub-Saharan Africa (SSA)

    OpenAIRE

    Zhang, Yu Yvette; Boadu, Frederick O.

    2012-01-01

    Several countries in Sub-Saharan Africa (SSA) embraced the structural adjustment programs (SAPs) suggested by the World Bank and the International Monetary Fund (IMF) in the 1980s. SAPs entail three main transitions: (1) from state control to market-led development; (2) from authoritarianism to rule of law, and (3) from central control to constitutionalism (Cass, 1991). The transitions are interrelated and form the main pillars of a market economy to promote growth in SSA. As a part of SAPs, ...

  1. Cardiometabolic Health in African Immigrants to the United States: A Call to Re-examine Research on African-descent populations.

    Science.gov (United States)

    Commodore-Mensah, Yvonne; Himmelfarb, Cheryl Dennison; Agyemang, Charles; Sumner, Anne E

    2015-08-07

    In the 20th century, Africans in Sub-Saharan Africa had lower rates of cardiometabolic disease than Africans who migrated. However, in the 21st century, beyond infectious diseases, the triple epidemics of obesity, diabetes and hypertension have taken hold in Africa. Therefore, Africans are acquiring these chronic diseases at different rates and different intensity prior to migration. To ensure optimal care and health outcomes, the United States practice of grouping all African-descent populations into the "Black/African American" category without regard to country of origin masks socioeconomic and cultural differences and needs re-evaluation. Overall, research on African-descent populations would benefit from a shift from a racial to an ethnic perspective. To demonstrate the value of disaggregating data on African-descent populations, the epidemiologic transition, social, economic, and health characteristics of African immigrants are presented.

  2. Testing times: trends in availability, price, and market share of malaria diagnostics in the public and private healthcare sector across eight sub-Saharan African countries from 2009 to 2015.

    Science.gov (United States)

    Hanson, Kara; Goodman, Catherine

    2017-05-19

    The World Health Organization guidelines have recommended that all cases of suspected malaria should receive a confirmatory test with microscopy or a malaria rapid diagnostic test (RDT), however evidence from sub-Saharan Africa (SSA) illustrates that only one-third of children under five with a recent fever received a test. The aim of this study was to evaluate availability, price and market share of microscopy and RDT from 2009/11 to 2014/15 in 8 SSA countries, to better understand barriers to improving access to malaria confirmatory testing in the public and private health sectors. Repeated national cross-sectional quantitative surveys were conducted among a sample of outlets stocking anti-malarial medicines and/or diagnostics. In total, 169,655 outlets were screened. Availability of malaria blood testing among all screened public health facilities increased significantly between the first survey wave in 2009/11 and the most recent in 2014/15 in Benin (36.2, 85.4%, p sector in Zambia (90.9%), Benin (90.3%), Madagascar (84.5%), Katanga (74.3%), mainland Tanzania (73.5%), Uganda (71.8%), Nigeria (68.4%), Kenya (53.2%) and Kinshasa (51.9%). In the anti-malarial stocking private sector, significant increases in availability of diagnostic tests among private for-profit facilities were observed between the first and final survey rounds in Kinshasa (82.1, 94.0%, p sector price of RDT for a child was equal to the price of pre-packaged quality-assured artemisinin-based combination therapy (QAACT) treatment for a two-year old child in some countries, and 1.5-2.5 times higher in others. Median private sector QAACT price for an adult varied from having parity with an RDT for an adult to being up to 2 times more expensive. The exception was in both Kinshasa and Katanga, where the median price of QAACT was less expensive than RDTs. Significant strides have been made in the availability of testing, mainly through the widespread distribution of RDT, and especially in public

  3. The converging burdens of infectious and non-communicable diseases in rural-to-urban migrant Sub-Saharan African populations: a focus on HIV/AIDS, tuberculosis and cardio-metabolic diseases.

    Science.gov (United States)

    Peer, Nasheeta

    2015-01-01

    Africa has the unenviable challenge of dealing with a double burden of disease: infectious diseases (IDs) such as HIV/AIDS and tuberculosis are high while non-communicable diseases (NCDs) are rapidly rising in the region. Populations with increased susceptibility to both include migrants. This review highlights the susceptibility of rural-to-urban migrants in Sub-Saharan Africa to the IDs of HIV/AIDS and tuberculosis, and to NCDs, particularly cardiovascular diseases. The disruption that occurs with migration is often accompanied by unhealthy exposures and environments. These include partaking in risky sexual practices and a subsequent greater risk for HIV infection in migrants than the general populations which contributes to the spread of the disease. Migrants frequently work and live in conditions that are poorly ventilated and overcrowded with suboptimal sanitation which increases their risk for tuberculosis. Considering that migrants have an increased risk of acquiring both HIV/AIDS and tuberculosis, and in view of the interaction between these diseases, they are likely to be at high risk for co-infection. They are also likely to facilitate the geographical spread of these infections and serve as conduits of disease dissemination to rural areas. Changes in lifestyle behaviours that accompany migration and urbanisation are exemplified primarily by shifts in physical activity and dietary patterns which promote the development of obesity, diabetes, hypertension and cardiovascular diseases. Urban living and employment is generally less physically exerting than rural routines; when migrants relocate from their rural residence they adapt to their new environment by significantly reducing their physical activity levels. Also, nutritional patterns among migrants in urban centres change rapidly with a shift to diets higher in fat, sugar and salt. Consequently, increases in weight, blood pressure and glucose levels have been reported within a year of migration

  4. Men's Attitudes Towards Contraception in Sub-Saharan Africa.

    Science.gov (United States)

    Bietsch, Kristin E

    2015-09-01

    This paper examines male attitudes towards family planning in Sub-Saharan Africa. Studying attitudes is ideal as they can be calculated for all men, at any point in their lives, regardless of marital status, sexual activity, or fertility desires. We find that positive attitudes towards family planning have increased across Sub-Saharan Africa in the last two decades. We analyze both the association of positive attitudes with a variety of demographic characteristics (age, marital status, education, and religion) and the relationships with multiple forms of discussion about family planning (radio, television, friends, and partners). We find higher approval at older ages and higher levels of education, and lower levels of approval among Muslims compared to Christians. Interactions between characteristics and discussion of family planning. demonstrate that hearing or talking about contraception has different associations for different groups. This paper offers a new way to explore fertility and reproductive health in Sub-Saharan Africa.

  5. Medicinal plants: An invaluable, dwindling resource in sub-Saharan Africa.

    Science.gov (United States)

    Moyo, Mack; Aremu, Adeyemi O; Van Staden, Johannes

    2015-11-04

    The use of plant species for different therapeutic/medicinal purposes is well-entrenched in sub-Saharan Africa. To provide a critical and updated review of the enormous medicinal plant heritage in sub-Saharan Africa with regards to the abundance, importance, conservation status and potential means to help sustain their availability for future generations. A comprehensive literature search involving different online databases, books and theses were conducted in order to obtain, collate and synthesize available information on various fundamental aspects pertaining to African medicinal plants. African biodiversity hotspots are endowed with a high level of endemic species with a significant portion possessing medicinal value. Apart from the extensive ethnobotanical uses of medicinal plants found in Africa, scientific validation of their biological potential such as antimicrobial, antioxidant, anti-inflammatory and anti-diabetic properties have been recognized. Together with the demand arising from their biological efficacies, other anthropogenic factors are exerting conservation strains of the wild population of these medicinal plants. Even though researchers have acknowledged the importance and value of conserving these medicinal plants, several challenges have hampered these efforts on the Continent as a whole. The rich flora occurring in sub-Saharan Africa suggests enormous potential for discovery of new chemical entity with therapeutic value. However, concerted efforts focused on documenting the conservation status of African medicinal plants are pertinent. Application of different biotechnological techniques is needed to sustain these valuable botanical entities, especially to meet increasing pharmaceutical demand. Most importantly, increased public enlightenment and awareness may help eradicate the prejudice against cultivation of medicinal plants. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Bogaert Isa

    2007-07-01

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

  7. Research Ethics Capacity Building in Sub-Saharan Africa: A Review of NIH Fogarty-Funded Programs 2000–2012

    Science.gov (United States)

    Ndebele, Paul; Wassenaar, Douglas; Benatar, Solomon; Fleischer, Theodore; Kruger, Mariana; Adebamowo, Clement; Kass, Nancy; Hyder, Adnan A.; Meslin, Eric M.

    2014-01-01

    The last fifteen years have witnessed a significant increase in investment in research ethics capacity development throughout the world. We examine nine research ethics training programs that are focused on Sub-Saharan Africa and supported by the US National Institutes of Health. We collected data from grants awards’ documents and annual reports supplemented by questionnaires completed by the training program directors. Together, these programs provided long-term training in research ethics to 275 African professionals, strengthened research ethics committees in 19 countries in Sub-Saharan Africa, and created research ethics curricula at many institutions and bioethics centers within Africa. Trainees’ leadership resulted in new national systems and policies on research ethics, human tissue storage and export, and methods of monitoring compliance with research ethics guidelines. Training programs adapted to challenges that arose due to varied trainees’ background knowledge in ethics, duration of time available for training, spoken and written English language skills, administrative obstacles, and the need to sustain post-training research ethics activities. Our report showcases the development of awareness of research ethics and building/strengthening of basic research ethics infrastructure in Sub-Saharan Africa. Nevertheless, the increasing amount and complexity of health research being conducted in Sub-Saharan Africa suggests the need for continued investment in research ethics capacity development in this region. This paper is part of a collection of papers analyzing the Fogarty International Center’s International Research Ethics Education and Curriculum Development program. PMID:24782070

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

    DEFF Research Database (Denmark)

    Hansen, Henrik; Rand, John

    2014-01-01

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

  9. 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...... 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...

  10. Antiretroviral therapy improves cognitive impairment in HIV+ individuals in sub-Saharan Africa.

    Science.gov (United States)

    Sacktor, N; Nakasujja, N; Skolasky, R; Robertson, K; Wong, M; Musisi, S; Ronald, A; Katabira, E

    2006-07-25

    Highly active antiretroviral therapy (HAART) can improve cognitive performance in some patients with HIV-associated cognitive impairment in the United States. The effect of HAART on HIV dementia in sub-Saharan Africa is largely unknown. To evaluate neuropsychological test and functional performance in HIV+ individuals after 3 and 6 months of HAART in Uganda. Twenty-three HIV+ individuals receiving HAART also received a detailed clinical history, neuropsychological testing, and a functional assessment. Follow-up evaluations were performed at 3 and 6 months after baseline. Longitudinal changes in the HIV dementia stage, the mean Z score for each neuropsychological test, and the Karnofsky Functional Performance Scale were evaluated at 3 and 6 months. The mean (SD) CD4 cell count improved from 71 (15) at baseline to 161 (30) at 3 months (p = 0.005) and 222 (46) at 6 months (p dementia stage and in tests of verbal memory, psychomotor speed, and executive functioning after 3 and 6 months of HAART (p < 0.001 at 6 months for each neuropsychological test). There was also improvement in the Karnofsky Functional Performance Scale at both 3 and 6 months after the initiation of HAART (p < 0.001). Highly active antiretroviral therapy (HAART) can be associated with improvement in neurocognitive and functional performance in HIV+ individuals in sub-Saharan Africa. These results suggest that HAART, if available in areas with limited resources in sub-Saharan Africa, should be provided for patients with HIV-associated cognitive impairment.

  11. Systems approach to animal health services delivery in sub-Saharan Africa: the case of privatisation.

    Science.gov (United States)

    Mlangwa, J E; Kisauzi, D N

    1994-09-01

    The theory of privatisation is first reviewed with respect to animal health care in sub-Saharan Africa. Then, using the systems approach advocated in an accompanying paper, the authors argue that the nature of animal production systems obtaining in any economy is of central importance in determining the type and mixture of animal health services delivery systems present. These are influenced, in turn, by the demand placed on the production system by consumers, the levels of consumer income and the policies enacted by governments. The authors compare the situation in sub-Saharan Africa with that in developed countries, especially the United States of America. Theory would predict that privatisation of veterinary services in sub-Saharan Africa will be evolutionary rather than revolutionary, even with deliberate policies to encourage privatisation. In regard to personnel, private services would be much easier to develop on the basis of auxiliaries and technicians, rather than self-employed veterinarians and their associates. Hasty or wholesale privatisation, involving the creation of a cadre of self-employed veterinarians will, in the face of market failure, result in a reduction in the services available to low input/low output production systems. The general level of animal health care provided to certain types of producers will thus be lower than currently available. These theoretical predictions are borne out in practice.

  12. Sub-Saharan Africa at the global education market: role of South Africa

    Directory of Open Access Journals (Sweden)

    Ramil Ravilevich Asmyatullin

    2016-12-01

    Full Text Available This article is dedicated to the development of the higher education in Sub-Saharan countries, particularly to the topic of internationalization of education. Most African countries have underdeveloped education systems. The quality and availability of higher education is a formidable obstacle for economic and social development. There is a growing demand for higher education in the SSA, but national education systems can’t cope fully with it. Hence many students go abroad, mostly in other African countries. The article focuses on the position of South Africa in the global and regional education market. As it’s a regional leader in this field South Africa attracts more than a half of international students within the Sub-Saharan Africa. The main reasons why African students choose South Africa are geographic proximity, familiar culture, lack of wanted higher education programs in their countries. However, there are as well disadvantages like xenophobia and race discrimination. South Africa has become a leader in Africa in the field of higher education, but it plays still small part at a global scale.

  13. Neurology training in sub-Saharan Africa: A survey of people in training from 19 countries.

    Science.gov (United States)

    Mateen, Farrah J; Clark, Sarah J; Borzello, Mia; Kabore, Jean; Seidi, Osheik

    2016-06-01

    To provide a comprehensive understanding of neurology training from the sub-Saharan African perspective. A 40-question survey was distributed to attendees of the 7th annual sub-Saharan African neurology teaching course in Khartoum, Sudan (2015). Themes included the student body, faculty, curriculum, assessment and examinations, technology, and work hours and compensation. Of 19 responding countries, 10 had no formal neurology training programs; Burkina Faso, Cameroon, Republic of the Congo, and Mozambique had an adult neurology program; Ethiopia, Madagascar, Nigeria, Senegal, and South Africa had adult and pediatric neurology programs (training duration range = 3-6 years). There was a median of 2.5 full-time neurologists on the teaching faculty at the respondents' training institutions (neurologists on-faculty:in-country ratio = 0.48), with the lowest ratios in Sudan and Nigeria. Neurology was perceived to be a competitive specialty for entrance in 57% of countries, with 78% of respondents reporting a requisite entrance examination. Ninety-five percent had access to a personal smartphone, 62% used the Internet more than occasionally, and 60% had access to online neurology journals. The average number of weekly work hours was 51 (range = 40-75), and average monthly salary among those earning income was 1,191 USD (range = 285-3,560). Twenty percent of respondents reported paying for training. The most common barriers to neurology postgraduate education were few training programs and lack of training in neurodiagnostic tests. Among 17 reporting countries, there is an estimated average of 0.6 neurologists per million people. Neurology training programs in sub-Saharan Africa are relatively limited in number and have several unmet needs including a small cadre of faculty and an opportunity to standardize curricula and financing of programs. Ann Neurol 2016;79:871-881. © 2016 American Neurological Association.

  14. 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

  15. Development and poverty in sub-Saharan Africa

    DEFF Research Database (Denmark)

    Addison, Tony; Pikkarainen, Ville; Rönkkö, Risto

    2017-01-01

    This paper puts sub-Saharan Africa’s economic development into perspective. While much did not go as hoped for at independence, much of the region has been on a more promising development trajectory since the mid-1990s, as we illustrate using growth, poverty, and human development indicators. We...

  16. Democratic Governance in Sub-Saharan Africa | Eberlei | Ghana ...

    African Journals Online (AJOL)

    Twenty years into sub-Saharan Africa's democratic renewal, an understanding of democratic governance has become established among political actors in the region. Democratic governance is characterised by: legitimation of governmental power through elections, legitimation of governmental politics through ...

  17. Boosting food security in sub-Saharan Africa through cassava ...

    African Journals Online (AJOL)

    It is further argues that this can only be achievable if certain factors that can help to strengthen the expansion of cassava production as a food security crop in Nigeria in particular and Sub-Saharan Africa in general are put into adequate consideration. Some of these are proper implementation of cassava initiative ...

  18. Men's Attitudes Towards Contraception in Sub-Saharan Africa

    African Journals Online (AJOL)

    AJRH Managing Editor

    Methods. Data for this paper are from the Demographic and. Health Surveys conducted in Sub-Saharan Africa. DHS has conducted surveys of men, independent of marital status, in the region since 1991. Inclusions of questions regarding attitudes towards and communication about family planning vary across surveys.

  19. science granting councils initiative in sub-saharan africa ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Dorine Odongo

    Briefly describe your organization, its vision and mission, its interest in STI issues, and its interest in forging long-term relationships with Science Granting Councils in Sub-Saharan Africa (SSA).1 Which regions (Eastern, Southern, Central or West Africa) and countries has your organization worked in? 1 The Initiative is keen ...

  20. Abortion and Contraceptive Use in Sub-Saharan Africa: How ...

    African Journals Online (AJOL)

    Erah

    Based on available evidence, this review article posits that contemporary use of abortion in sub-Saharan Africa often substitutes for and sometimes surpasses modern contraceptive practice. Some studies and some data sets indicate that this occurs not only among adolescents but also within older age groups. In several ...

  1. Capabilities, innovation and entrepreneurship in sub-Saharan Africa

    NARCIS (Netherlands)

    Kroesen, J.O.; Romijn, H

    2015-01-01

    This paper takes a capability approach to analyze the role of entrepreneurship in the socio-economic development of present-day Sub Saharan Africa. The paper zooms in on the nature of the capabilities that are built through the development of entrepreneurship; the key challenges to the development

  2. Neonatal hypothermia in sub-Saharan Africa: A review | Onalo ...

    African Journals Online (AJOL)

    Pertinent books and monographs were accessed. Data in formats inaccessible to the reviewer were excluded. Result and Conclusion: Neonatal hypothermia is a major condition of public health importance in countries of sub- Saharan Africa. Awareness of the burden of the disease is still low in some communities.

  3. Soyabean response to rhizobium inoculation across sub-Saharan Africa

    NARCIS (Netherlands)

    Heerwaarden, van Joost; Baijukya, Frederick; Kyei-Boahen, Stephen; Adjei-nsiah, Samuel; Ebanyat, Peter; Kamai, Nkeki; Wolde-Meskel, Endalkachew; Kanampiu, Fred; Vanlauwe, Bernard; Giller, Ken

    2017-01-01

    Improving bacterial nitrogen fixation in grain legumes is central to sustainable intensification of agriculture in sub-Saharan Africa. In the case of soyabean, two main approaches have been pursued: first, promiscuous varieties were developed to form effective symbiosis with locally abundant

  4. Climate change impacts in Sub-Saharan Africa

    NARCIS (Netherlands)

    Serdeczny, Olivia; Adams, Sophie; Baarsch, Florent; Coumou, Dim; Robinson, Alexander; Hare, William; Schaeffer, Michiel; Perrette, Mahé; Reinhardt, Julia

    2017-01-01

    The repercussions of climate change will be felt in various ways throughout both natural and human systems in Sub-Saharan Africa. Climate change projections for this region point to a warming trend, particularly in the inland subtropics; frequent occurrence of extreme heat events; increasing

  5. Factors affecting contraceptive use in Sub-Saharan Africa

    National Research Council Canada - National Science Library

    National Research Council Staff

    1993-01-01

    ...-SAHARAN AFRICA Working Group on Factors Affecting Contraceptive Use Panel on the Population Dynamics of Sub-Saharan Africa Committee on Population Commission on Behavioral and Social Sciences and Education National Research Council NATIONAL ACADEMY PRESS Washington, D.C. 1993 Copyrightoriginal retained, the be not from cannot book, paper original howeve...

  6. Sub-Saharan Africa | IDRC - International Development Research ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Over the years, sub-Saharan Africa has experienced a prolonged development crisis, fuelled by complex ethnic, social, and political realities. The region suffers from weak governments, corruption, and mismanagement of resources. Its overburdened water systems are under increasing stress from fast-growing urban areas, ...

  7. Managing Endometriosis in sub-Saharan Africa: Emerging Concepts ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    Endometriosis is a gynaecological disorder that is characterized by the growth of endometrial tissue outside the uterine cavity1. In developed countries, it occurs in up to 20% of women of reproductive age and is a common cause of pelvic pain and infertility1,2. In sub-Saharan Africa, epidemiological data on the prevalence ...

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

    NARCIS (Netherlands)

    Pell, C.L.

    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

  9. Information and Networks in Asia and Sub-Saharan Africa ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    This project seeks to provide capacity-building support to develop and implement the Information and Networks in Asia and Sub-Saharan Africa (INASSA) research program. INASSA is focused on producing credible, high-quality evidence on the influence of digital initiatives in the areas of governance, science, learning, ...

  10. Plantation Forestry in Sub Saharan Africa: Silvicultural, Ecological ...

    African Journals Online (AJOL)

    This paper discusses the potentials of meeting the wood demand and achieving SFM in Sub-Saharan Africa (SSA) through the establishment of forest plantations. The paper reviews forest plantation ownership and distribution patterns in SSA and the factors –silvicultural, ecological, and economic that affect supply and ...

  11. 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...

  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

  13. Making the Most of Commodities Program (sub-Saharan Africa ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    On the other hand, they pose a significant threat to governance, macroeconomic management, industrial development, the environment and the sociopolitical fabric. Sub-Saharan Africa needs to develop a strategic response to the boom in commodities prices, which has already been more long-lived and less volatile than ...

  14. SME Adoption of Enterprise Systems in Sub-Saharan Africa

    DEFF Research Database (Denmark)

    Adisa, Femi; Isabalija, Stephen R.

    of any information system. SMEs constitute a majority of all organizations in most Sub Saharan economies, thus their importance to the socioeconomic development and empowerment of the region cannot be overemphasized. However, the absence of literature and focused research into factors that influence...

  15. HIV transmission during paediatric health care in sub- Saharan ...

    African Journals Online (AJOL)

    Health care systems in sub-Saharan Africa are challenged not only to improve care for the increasing number of HIV-infected children, but also to prevent transmission of HIV to other children and health care workers through contaminated medical procedures and needlestick accidents. HIV-infected children aged to 1 year ...

  16. Vaccines to Combat Livestock Diseases in Sub-Saharan Africa ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Infectious diseases are especially problematic in sub-Saharan Africa, where livestock production accounts for up to 25% of national income. ... La pleuropneumonie contagieuse des bovins est une maladie d'origine bactérienne qui a de graves conséquences sur l'économie et le commerce en Afrique subsaharienne.

  17. Changes in women's status and fertility behaviour in Sub- Saharan ...

    African Journals Online (AJOL)

    Very little is known about the contribution of changes in women's status to fertility trends in sub-Saharan Africa (SSA). Using a linear decomposition technique, this study assessed changes in women's status and the influence on fertility levels. Demographic and Health Survey (DHS) data for 2-time periods with a minimum of ...

  18. Leptospirosis in Sub-Saharan Africa: a systematic review

    NARCIS (Netherlands)

    de Vries, Sophia G.; Visser, Benjamin J.; Nagel, Ingeborg M.; Goris, Marga G. A.; Hartskeerl, Rudy A.; Grobusch, Martin P.

    2014-01-01

    Leptospirosis is an emerging zoonotic infection worldwide, possibly due to climate change and demographic shifts. It is regarded as endemic in Sub-Saharan Africa; however, for most countries scarce epidemiological data, if any, exist. The primary objectives were to describe the prevalence of

  19. Implementation Issues in Rural Development in Sub-Saharan ...

    African Journals Online (AJOL)

    It is a credo amongst scholars cum academics all over the globe that well coordinated and elaborate programmes and policies of rural development mounted by the third world countries in sub-Saharan Africa will lift her entire citizenry from manacle of gross underdevelopment to a region of development in all facets of their ...

  20. Planning innovation for better urban communities in sub-Saharan ...

    African Journals Online (AJOL)

    Cities in the sub-Saharan Africa region present challenges to the urban and regional planning profession, city managers, leaders, educationists and dwellers ... in the region, two urban development processes can be discerned: first, the explosion of some cities particularly former colonial administrative or economic hubs ...

  1. Men's Attitudes Towards Contraception in Sub-Saharan Africa

    African Journals Online (AJOL)

    AJRH Managing Editor

    Studying attitudes is ideal as they can be calculated for all men, at any point in their lives, regardless of marital status, sexual activity, or fertility desires. ... When studying men's sexual lives in Sub-. Saharan Africa (and elsewhere), benefit ...... we see in most cases a reversal of the main effect. For those who hear about family ...

  2. Implementing focussed antenatal care in sub-Saharan Africa: an ...

    African Journals Online (AJOL)

    A SWOT Analysis framework was used to assess the situational analysis of antenatal care programmes in sub-Saharan Africa while the Walt and Gilson policy analysis triangle was used to analyse the feasibility of introducing the new WHO ANC model into the sub-region. The content of the WHO model may need to be ...

  3. 17 The Complexity of Environmental Protection in Sub-Saharan ...

    African Journals Online (AJOL)

    `123456789jkl''''#

    people to protect the human health of the sub-Saharan population and the environment from the adverse effects ... of fulfilling their role as collaborators of God in .... governments and their manufacturing and industrial firms”. The colonial governments did make efforts to arrest the rapid degradation of the environment by ...

  4. 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

  5. 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,

  6. model hpv vaccine recommendations for sub-saharan africa

    African Journals Online (AJOL)

    MEMBERS OF THE SUB-SAHARAN AFRICA CERVICAL CANCER WORKING GROUP. (Manucript N° ... of genital wart cases.[22]. Decreasing the incidence of. HPV-related cancers, in particular cervical cancer morbidity and mortality, by means such as vaccination ... lesions which are amenable to treatment and hence.

  7. Assessing the Impact of Privatization Policy on Telecommunications Sector Effectiveness and Economic Activity in Sub-Saharan Africa

    Science.gov (United States)

    Ngwa, Oneurine B.

    2012-01-01

    In recent years, privatization has been a growing phenomenon in Sub-Saharan Africa. It is viewed as an instrument used by the public sector to reduce the role of the state in the economies while enhancing the scope of private ownership and participation of goods and services (Akram et al, 2011). Researchers have noted that the telecommunication…

  8. No Longer Overlooked and Undervalued?: The Evolving Dynamics of Endogenous Educational Research in Sub-Saharan Africa

    Science.gov (United States)

    Maclure, Richard

    2006-01-01

    Multilateral donors like the World Bank and bilateral agencies such as the United States Agency for International Development (USAID) and the British Department for International Development exert a great deal of influence in international educational development--particularly in sub-Saharan Africa--both in the programs they fund and the types of…

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

    Science.gov (United States)

    Upadhyay, Ushma D; Karasek, Deborah

    2012-06-01

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

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

    Science.gov (United States)

    Oronje, Rose Ndakala; Crichton, Joanna; Theobald, Sally; Lithur, Nana Oye; Ibisomi, Latifat

    2011-12-16

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

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

    Directory of Open Access Journals (Sweden)

    Oronje Rose

    2011-12-01

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

  12. Sub-Saharan Africa - Managing Land in a Changing Climate : An Operational Perspective for Sub-Saharan Africa

    OpenAIRE

    World Bank

    2010-01-01

    Livelihoods, food security, and development processes in Sub-Saharan Africa are highly dependent on land management practices to generate natural ecosystem goods and services. Out of a total population of about 717 million people, almost 60 percent depend for their livelihood on agriculture, hunting, fishing, or forestry. However, unsustainable land management already is leading to large-s...

  13. A multi-dimensional assessment of urban vulnerability to climate change in Sub-Saharan Africa

    DEFF Research Database (Denmark)

    Herslund, Lise Byskov; Jalyer, Fatameh; Jean-Baptiste, Nathalie

    2016-01-01

    for strategic coordination and action. To better adapt to urban flooding andthereby reduce vulnerability and build resilience, we suggest working across dimensions and scales, integrating climate change issues in city-level plans and strategies and enabling local actions to initiate a ‘learning......In this paper, we develop and apply a multi-dimensional vulnerability assessment framework for understanding the impacts of climate change-induced hazards in Sub- Saharan African cities. The research was carried out within the European/African FP7 project CLimate change and Urban Vulnerability...... in Africa, which investigated climate change-induced risks, assessed vulnerability and proposed policy initiatives in five African cities. Dar es Salaam (Tanzania) was used as a main case with a particular focus on urban flooding. The multi-dimensional assessment covered the physical, institutional...

  14. Water reform in Sub-Saharan Africa: what is the difference?

    Science.gov (United States)

    Van Koppen, Barbara

    Since the early 1990s African governments took an active part in the global movement of water reform towards Integrated Water Resources Management (IWRM). The first step consisted primarily of assimilating the generic principles of IWRM. At this generic level, water reform in Sub-Saharan Africa seems quite similar to water reform elsewhere in the developed and developing world. However, in taking the second step of operationalizing generic principles into concrete actions on the ground, at least three salient differences between Sub-Saharan Africa and elsewhere emerged: (a) Africa’s relative abundance of water resources but its scarcity of economic means to harness available water resources; (b) the importance of agriculture and agricultural water development for economic growth and poverty eradication; and (c) the need for systems of water rights and financial resource mobilization that are separated and suit the African reality in which large water users are relatively few, while the bulk of water users are scattered smallholders. This paper discusses the early operationalization with regard to these three unique features and identifies lessons learnt.

  15. 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.

  16. Impact of ART on the fertility of HIV-positive women in sub-Saharan Africa.

    Science.gov (United States)

    Yeatman, Sara; Eaton, Jeffrey W; Beckles, Zosia; Benton, Lorna; Gregson, Simon; Zaba, Basia

    2016-09-01

    Understanding the fertility of HIV-positive women is critical to estimating HIV epidemic trends from surveillance data and to planning resource needs and coverage of prevention of mother-to-child transmission services in sub-Saharan Africa. In the light of the considerable scale-up in antiretroviral therapy (ART) coverage over the last decade, we conducted a systematic review of the impact of ART on the fertility outcomes of HIV-positive women. We searched Medline, Embase, Popline, PubMed and African Index Medicus. Studies were included if they were conducted in sub-Saharan Africa and provided estimates of fertility outcomes (live births or pregnancies) among women on ART relative to a comparison group. Of 2070 unique references, 18 published papers met all eligibility criteria. Comparisons fell into four categories: fertility of HIV-positive women relative to HIV-negative women; fertility of HIV-positive women on ART compared to those not yet on ART; fertility differences by duration on ART; and temporal trends in fertility among HIV-positive women. Evidence indicates that fertility increases after approximately the first year on ART and that while the fertility deficit of HIV-positive women is shrinking, their fertility remains below that of HIV-negative women. These findings, however, were based on limited data mostly during the period 2005-2010 when ART scaled up. Existing data are insufficient to characterise how ART has affected the fertility of HIV-positive women in sub-Saharan Africa. Improving evidence about fertility among women on ART is an urgent priority for planning HIV resource needs and understanding HIV epidemic trends. Alternative data sources such as antenatal clinic data, general population cohorts and population-based surveys can be harnessed to understand the issue. © 2016 John Wiley & Sons Ltd.

  17. HIV misdiagnosis in sub-Saharan Africa: performance of diagnostic algorithms at six testing sites.

    Science.gov (United States)

    Kosack, Cara S; Shanks, Leslie; Beelaert, Greet; Benson, Tumwesigye; Savane, Aboubacar; Ng'ang'a, Anne; Andre, Bita; Zahinda, Jean-Paul Bn; Fransen, Katrien; Page, Anne-Laure

    2017-07-03

    We evaluated the diagnostic accuracy of HIV testing algorithms at six programmes in five sub-Saharan African countries. In this prospective multisite diagnostic evaluation study (Conakry, Guinea; Kitgum, Uganda; Arua, Uganda; Homa Bay, Kenya; Doula, Cameroun and Baraka, Democratic Republic of Congo), samples from clients (greater than equal to five years of age) testing for HIV were collected and compared to a state-of-the-art algorithm from the AIDS reference laboratory at the Institute of Tropical Medicine, Belgium. The reference algorithm consisted of an enzyme-linked immuno-sorbent assay, a line-immunoassay, a single antigen-enzyme immunoassay and a DNA polymerase chain reaction test. Between August 2011 and January 2015, over 14,000 clients were tested for HIV at 6 HIV counselling and testing sites. Of those, 2786 (median age: 30; 38.1% males) were included in the study. Sensitivity of the testing algorithms ranged from 89.5% in Arua to 100% in Douala and Conakry, while specificity ranged from 98.3% in Doula to 100% in Conakry. Overall, 24 (0.9%) clients, and as many as 8 per site (1.7%), were misdiagnosed, with 16 false-positive and 8 false-negative results. Six false-negative specimens were retested with the on-site algorithm on the same sample and were found to be positive. Conversely, 13 false-positive specimens were retested: 8 remained false-positive with the on-site algorithm. The performance of algorithms at several sites failed to meet expectations and thresholds set by the World Health Organization, with unacceptably high rates of false results. Alongside the careful selection of rapid diagnostic tests and the validation of algorithms, strictly observing correct procedures can reduce the risk of false results. In the meantime, to identify false-positive diagnoses at initial testing, patients should be retested upon initiating antiretroviral therapy.

  18. New Findings on Child Marriage in Sub-Saharan Africa.

    Science.gov (United States)

    Petroni, Suzanne; Steinhaus, Mara; Fenn, Natacha Stevanovic; Stoebenau, Kirsten; Gregowski, Amy

    Despite increasing global attention and commitments by countries to end the harmful practice of child marriage, each year some 15 million girls marry before the age of 18. The preponderance of the evidence produced historically on child marriage comes from South Asia, where the vast majority of child brides live. Far less attention has been paid to child marriage in sub-Saharan Africa, where prevalence rates remain high. The International Center for Research on Women (ICRW) recently conducted research in Kenya, Senegal, Uganda, and Zambia to contribute to greater understanding of the drivers of child marriage in each of these contexts. Synthesizing findings from 4 diverse countries provides a useful opportunity to identify similarities and differences, as well as understandings that may be applicable to and helpful for preventing child marriage across these and other settings. Across the 4 countries, ICRW's research echoes the existing literature base in affirming that child marriage is rooted in inequitable gender norms that prioritize women's roles as wives, mothers, and household caretakers, resulting in inadequate investments by families in girls' education. These discriminatory norms interact closely with poverty and a lack of employment opportunities for girls and young women to perpetuate marriage as a seemingly viable alternative for girls. We found in the African study sites that sexual relations, unplanned pregnancy, and school dropout often precede child marriage, which differs from much of the existing evidence on child marriage from South Asia. Further, unlike in South Asia, where family members typically determine the spouse a girl will marry, most girls in the Africa study settings have greater autonomy in partner choice selection. In Senegal, increasing educational attainment and labor migration, particularly by young women, has contributed to reduced rates of child marriage for girls. Our findings suggest that improving gender equitable norms and

  19. An outlook on the Sub-Saharan Africa carbon balance

    Directory of Open Access Journals (Sweden)

    A. Bombelli

    2009-10-01

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

  20. Non-physician Clinicians – A Gain for Physicians’ Working in Sub-Saharan Africa; Comment on “Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians”

    Directory of Open Access Journals (Sweden)

    Delanyo Dovlo

    2017-02-01

    Full Text Available 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.

  1. [Premature fertility in Sub-Saharan Africa].

    Science.gov (United States)

    Locoh, T

    1994-01-01

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

  2. Curriculum Development Around Parenting Strategies to Prevent and Respond to Child Sexual Abuse in Sub-Saharan Africa: A Program Collaboration Between Families Matter! and Global Dialogues.

    Science.gov (United States)

    Miller, Kim S; Winskell, Kate; Pruitt, Kaitlyn L; Saul, Janet

    2015-01-01

    Despite widespread recognition of child sexual abuse as a serious problem in sub-Saharan Africa, few far-reaching programmatic interventions addressing child sexual abuse in this setting are currently available, and those interventions that do exist tend to focus on response rather than prevention. The Families Matter! Program is an evidence-based intervention for parents and caregivers of 9- to 12-year-olds in sub-Saharan African countries which promotes positive parenting practices and effective parent-child communication about sex-related issues. This article describes the enhancement of a new Families Matter! Program session on child sexual abuse, drawing on authentic narratives contributed by young people to the Global Dialogues from Africa youth scriptwriting competitions. Experiences are shared with a view to informing the development of interventions addressing child sexual abuse in sub-Saharan Africa.

  3. Risk Factor or Social Vaccine? The Historical Progression of the Role of Education in HIV and AIDS Infection in Sub-Saharan Africa

    Science.gov (United States)

    Baker, David P.; Collins, John M.; Leon, Juan

    2008-01-01

    Numerous epidemiological studies from the early years of the tragic HIV and AIDS pandemic in sub-Saharan Africa identified formal education as a risk factor increasing the chance of infection. Instead of playing its usual role as a preventative factor, as has been noted in many other public health cases, until the mid-1990s educated African men…

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

    Directory of Open Access Journals (Sweden)

    Pool Robert

    2011-03-01

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

  5. Determinants of antiretroviral therapy coverage in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Fumitaka Furuoka

    2015-12-01

    Full Text Available Among 35 million people living with the human immunodeficiency virus (HIV in 2013, only 37% had access to antiretroviral therapy (ART. Despite global concerted efforts to provide the universal access to the ART treatment, the ART coverage varies among countries and regions. At present, there is a lack of systematic empirical analyses on factors that determine the ART coverage. Therefore, the current study aimed to identify the determinants of the ART coverage in 41 countries in Sub-Saharan Africa. It employed statistical analyses for this purpose. Four elements, namely, the HIV prevalence, the level of national income, the level of medical expenditure and the number of nurses, were hypothesised to determine the ART coverage. The findings revealed that among the four proposed determinants only the HIV prevalence had a statistically significant impact on the ART coverage. In other words, the HIV prevalence was the sole determinant of the ART coverage in Sub-Saharan Africa.

  6. 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...

  7. 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 and infor......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...... and informality are not illuminating. The observed welfare advantage of formal sector workers essentially derives from differences in endowments and local conditions. Non-agricultural informal work can yield higher returns than formal work. The implication is that the informal sector must not be marginalized...

  8. 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.

  9. Caesarean section and subsequent fertility in sub-Saharan Africa.

    Science.gov (United States)

    Collin, S M; Marshall, T; Filippi, V

    2006-03-01

    To determine the impact of caesarean section on fertility among women in sub-Saharan Africa. Analysis of standardised cross-sectional surveys (Demographic and Health Surveys). Twenty-two countries in sub-Saharan Africa, 1993-2003. A total of 35 398 women of childbearing age (15-49 years). Time to subsequent pregnancy was compared by mode of delivery using Cox proportional hazards regression models. Natural fertility rates subsequent to delivery by caesarean section compared with natural fertility rates subsequent to vaginal delivery. The natural fertility rate subsequent to delivery by caesarean section was 17% lower than the natural fertility rate subsequent to vaginal delivery (hazard ratio = 0.83, 95% CI 0.73-0.96, P Caesarean section was also associated with prior fertility and desire for further children: among multiparous women, an interval > or =3 versus caesarean section at the index birth (OR = 1.4, 95% CI 1.1-1.7, P= 0.005); among all women, the odds of desiring further children were lower among women who had previously delivered by caesarean section (OR = 0.67, 95% CI 0.54-0.84, P Caesarean section did not appear to increase the risk of a subsequent pregnancy ending in miscarriage, abortion or stillbirth. Among women in sub-Saharan Africa, caesarean section is associated with lower subsequent natural fertility. Although this reflects findings from developed countries, the roles of pathological and psychological factors may be quite different because a much higher proportion of caesarean sections in sub-Saharan Africa are emergency procedures for maternal indication.

  10. 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.

  11. Maternal obesity and Caesarean delivery in sub-Saharan Africa.

    Science.gov (United States)

    Cresswell, Jenny A; Campbell, Oona M R; De Silva, Mary J; Slaymaker, Emma; Filippi, Veronique

    2016-07-01

    To quantify maternal obesity as a risk factor for Caesarean delivery in sub-Saharan Africa. Multivariable logistic regression analysis using 31 nationally representative cross-sectional data sets from the Demographic and Health Surveys (DHS). Maternal obesity was a risk factor for Caesarean delivery in sub-Saharan Africa; a clear dose-response relationship (where the magnitude of the association increased with increasing BMI) was observable. Compared to women of optimal weight, overweight women (BMI 25-29 kg/m(2) ) were significantly more likely to deliver by Caesarean (OR: 1.54; 95% CI: 1.33, 1.78), as were obese women (30-34.9 kg/m(2) (OR: 2.39; 95%CI: 1.96-2.90); 35-39.9 kg/m(2) (OR: 2.47 95%CI: 1.78-3.43)) and morbidly obese women (BMI ≥40 kg/m(2) OR: 3.85; 95% CI: 2.46-6.00). BMI is projected to rise substantially in sub-Saharan Africa over the next few decades and demand for Caesarean sections already exceeds available capacity. Overweight women should be advised to lose weight prior to pregnancy. Furthermore, culturally appropriate prevention strategies to discourage further population-level rises in BMI need to be designed and implemented. © 2016 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  12. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-07-01

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

  14. A contribution to study the immigration from Sub Saharan Africa to Argentina

    Directory of Open Access Journals (Sweden)

    Marta M. Maffia

    2010-07-01

    Full Text Available Even though in Argentina we have immigrants from Sub Saharan Africa arriving at the end of the Nineteenth Century and beginning of the Twentieth Century such as those from South Africa and Cape Verde, this new immigration from Senegal, Nigeria, Cameroon, Ghana, among other countries, during the last decade of the Twentieth Century and first decade of the Twenty-first Century appears in a different historical and political context. This new migration is facing legal regimes and increasingly restrictive administrative by-laws, framed in the growing economic globalization.This work is part of the first results of a research on this migration from an anthropological perspective. This study, which began in 2009, takes into account contributions made by history, political sciences, demography, among other disciplines, making use of articles written by African and Non-African social scientists. We are convinced that in this exchange of views our limitations may be overcome.

  15. Cost-Effectiveness of Two Government District Hospitals in Sub-Saharan Africa.

    Science.gov (United States)

    Grimes, Caris E; Law, Rebekah; Dare, Anna; Day, Nigel; Reshamwalla, Sophie; Murowa, Michael; George, Peter M; Kamara, Thaim B; Mkandawire, Nyengo C; Leather, Andrew J M; Lavy, Christopher B D

    2017-09-01

    District hospitals in sub-Saharan Africa are in need of investment if countries are going to progress towards universal health coverage, and meet the sustainable development goals and the Lancet Commission on Global Surgery time-bound targets for 2030. Previous studies have suggested that government hospitals are likely to be highly cost-effective and therefore worthy of investment. A retrospective analysis of the inpatient logbooks for two government district hospitals in two sub-Saharan African hospitals was performed. Data were extracted and DALYs were calculated based on the diagnosis and procedures undertaken. Estimated costs were obtained based on the patient receiving ideal treatment for their condition rather than actual treatment received. Total cost per DALY averted was 26 (range 17-66) for Thyolo District Hospital in Malawi and 363 (range 187-881) for Bo District Hospital in Sierra Leone. This is the first published paper to support the hypothesis that government district hospitals are very cost-effective. The results are within the same range of the US$32.78-223 per DALY averted published for non-governmental hospitals.

  16. Nutritional status and economic development in sub-Saharan Africa, 1950-1980.

    Science.gov (United States)

    Moradi, Alexander

    2010-03-01

    How did nutritional status develop in sub-Saharan Africa during the second half of the 20th century, and what role did economic development play in nutrition and health? Aggregating data from more than 200,000 women in 28 sub-Saharan African countries, we use mean height as an indicator of net nutritional status and find that the nutritional status of 1960 birth cohorts was relatively high. This situation, however, was not sustained. In almost all countries examined, mean heights were stagnating or decreasing after the 1970 cohorts. Using regression analysis we model human growth from birth to maturity, and find that economic growth had a significant and robust influence on final adult height at two distinct periods of the life cycle: (1) in the first years of life and (2) at puberty. We conclude that the economic difficulties of the late 1970s and 1980s contributed to the decline or stagnation in heights. Copyright 2009 Elsevier B.V. All rights reserved.

  17. Origin, extend and health impacts of air pollution in Sub-Saharan Africa

    Science.gov (United States)

    Bauer, Susanne E.; Mezuman, Keren; Longo, Karla; da Silva, Arlindo

    2017-04-01

    Southern Africa produces about a third of the Earth's biomass burning aerosol particles, yet the fate of these particles, their origin, chemical composition and their influence on regional and global climate is poorly understood. These research questions motivated the NASA field campaign ORACLES (ObseRvations of Aerosols above CLouds and their intEractionS). ORACLES is a five year investigation with three Intensive Observation Periods (IOP) designed to study key processes that determine the climate impacts of African biomass burning aerosols. The first IOP has been carried out in 2016. The main focus of the field campaign are aerosol-cloud interactions, however in our first study related to this area we will investigate the aerosol plume itself, its origin, extend and its resulting health impacts. Here we will discuss results using the global mesoscale model NASA GEOS-5 in conjunction with the NASA GISS-E2 climate model to investigate climate and health impacts that are directly related to the anthropogenic fire activities in Sub-Saharan Africa. Focus will be on the SH winter seasons biomass burning events, its contribution to Sub-Saharan air pollution in relationship to other air-pollution sources and its resulting premature mortality.

  18. Women's growing desire to limit births in sub-Saharan Africa: meeting the challenge.

    Science.gov (United States)

    Van Lith, Lynn M; Yahner, Melanie; Bakamjian, Lynn

    2013-03-01

    Demographic and Health Survey data from 18 countries were analyzed to better understand the characteristics of women wishing to limit childbearing. Demand for limiting (14% of all women) is less than that that for spacing (25%) but is still substantial. The mean "demand crossover age" (the average age at which demand to limit births begins to exceed demand to space) is generally around age 33, but in some countries it is as low as 23 or 24. Young women often intend to limit their births, contrary to the assumption that only older women do. Large numbers of women have exceeded their desired fertility but do not use family planning, citing fear of side effects and health concerns as barriers. When analysis is restricted to married women, demand for limiting nearly equals that for spacing. Many women who want no more children and who use contraception, especially poor women and those with less education, use less effective temporary contraceptive methods. A sizable number of women in sub-Saharan Africa-nearly 8 million-have demand for limiting future births. Limiting births has a greater impact on fertility rates than spacing births and is a major factor driving the fertility transition. Family planning programs must prepare to meet this demand by addressing supply- and demand-side barriers to use. Meeting the growing needs of sub-Saharan African women who want to limit births is essential, as they are a unique audience that has long been overlooked and underserved.

  19. External quality assurance performance of clinical research laboratories in sub-saharan Africa.

    Science.gov (United States)

    Amukele, Timothy K; Michael, Kurt; Hanes, Mary; Miller, Robert E; Jackson, J Brooks

    2012-11-01

    Patient Safety Monitoring in International Laboratories (JHU-SMILE) is a resource at Johns Hopkins University that supports and monitors laboratories in National Institutes of Health-funded international clinical trials. To determine the impact of the JHU-SMILE quality assurance scheme in sub-Saharan African laboratories, we reviewed 40 to 60 months of external quality assurance (EQA) results of the College of American Pathologists (CAP) in these laboratories. We reviewed the performance of 8 analytes: albumin, alanine aminotransferase, creatinine, sodium, WBC, hemoglobin, hematocrit, and the human immunodeficiency virus antibody rapid test. Over the 40- to 60-month observation period, the sub-Saharan laboratories had a 1.63% failure rate, which was 40% lower than the 2011 CAP-wide rate of 2.8%. Seventy-six percent of the observed EQA failures occurred in 4 of the 21 laboratories. These results demonstrate that a system of remote monitoring, feedback, and audits can support quality in low-resource settings, even in places without strong regulatory support for laboratory quality.

  20. 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.

  1. 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.

  2. Task shifting in HIV/AIDS: opportunities, challenges and proposed actions for sub-Saharan Africa.

    Science.gov (United States)

    Zachariah, R; Ford, N; Philips, M; Lynch, S; Massaquoi, M; Janssens, V; Harries, A D

    2009-06-01

    Sub-Saharan Africa is facing a crisis in human health resources due to a critical shortage of health workers. The shortage is compounded by a high burden of infectious diseases; emigration of trained professionals; difficult working conditions and low motivation. In particular, the burden of HIV/AIDS has led to the concept of task shifting being increasingly promoted as a way of rapidly expanding human resource capacity. This refers to the delegation of medical and health service responsibilities from higher to lower cadres of health staff, in some cases non-professionals. This paper, drawing on Médecins Sans Frontières' experience of scaling-up antiretroviral treatment in three sub-Saharan African countries (Malawi, South Africa and Lesotho) and supplemented by a review of the literature, highlights the main opportunities and challenges posed by task shifting and proposes specific actions to tackle the challenges. The opportunities include: increasing access to life-saving treatment; improving the workforce skills mix and health-system efficiency; enhancing the role of the community; cost advantages and reducing attrition and international 'brain drain'. The challenges include: maintaining quality and safety; addressing professional and institutional resistance; sustaining motivation and performance and preventing deaths of health workers from HIV/AIDS. Task shifting should not undermine the primary objective of improving patient benefits and public health outcomes.

  3. Marriage, widowhood, divorce and HIV risks among women in sub-Saharan Africa.

    Science.gov (United States)

    Tenkorang, Eric Y

    2014-03-01

    Studies on associations between marriage and HIV infection among women in sub-Saharan Africa are generally inconclusive. Not enough is known about HIV risks among divorced and widowed women. This study examined the relationship between marital status and HIV infection among women in seven sub-Saharan African countries. Retrospective data from the Demographic and Health Surveys were combined with HIV biomarker data from the AIDS Indicator Survey (AIS) for analysis. Random-effects complementary log-log models were applied to examine the relationship between marital status and HIV risks controlling for theoretically relevant covariates. Compared to never-married women, widowed women were significantly more likely to be HIV positive. Similarly, married women were more likely to be infected with HIV, compared to never-married women in Lesotho and Zimbabwe. In Tanzania and Zimbabwe, divorced women had higher risks of HIV infection, compared to never-married women. Findings suggest that specific HIV programs be directed at vulnerable women, in particular those widowed. Similar programs are needed for both poorer and wealthier women.

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

    Directory of Open Access Journals (Sweden)

    Folasayo Fayose

    2016-01-01

    Full Text Available 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.

  5. How Much Will It Cost To Monitor Microbial Drinking Water Quality in Sub-Saharan Africa?

    Science.gov (United States)

    Delaire, Caroline; Peletz, Rachel; Kumpel, Emily; Kisiangani, Joyce; Bain, Robert; Khush, Ranjiv

    2017-06-06

    Microbial water quality monitoring is crucial for managing water resources and protecting public health. However, institutional testing activities in sub-Saharan Africa are currently limited. Because the economics of water quality testing are poorly understood, the extent to which cost may be a barrier to monitoring in different settings is unclear. This study used cost data from 18 African monitoring institutions (piped water suppliers and health surveillance agencies in six countries) and estimates of water supply type coverage from 15 countries to assess the annual financial requirements for microbial water testing at both national and regional levels, using World Health Organization recommendations for sampling frequency. We found that a microbial water quality test costs 21.0 ± 11.3 USD, on average, including consumables, equipment, labor, and logistics, which is higher than previously calculated. Our annual cost estimates for microbial monitoring of piped supplies and improved point sources ranged between 8 000 USD for Equatorial Guinea and 1.9 million USD for Ethiopia, depending primarily on the population served but also on the distribution of piped water system sizes. A comparison with current national water and sanitation budgets showed that the cost of implementing prescribed testing levels represents a relatively modest proportion of existing budgets (water sources in sub-Saharan Africa would cost 16.0 million USD per year, which is minimal in comparison to the projected annual capital costs of achieving Sustainable Development Goal 6.1 of safe water for all (14.8 billion USD).

  6. 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.

  7. Political determinants of progress in the MDGs in Sub-Saharan Africa

    DEFF Research Database (Denmark)

    Atti, Emma; Gulis, Gabriel

    2017-01-01

    Sub-Saharan Africa (SSA) lagged furthest behind in achieving targets for the millennium development goals (MDG). We investigate the hypothesis that its slow progress is influenced by political factors. Longitudinal data on three health MDG indicators: under-five mortality, maternal mortality...... and development assistance respectively. Cumulative progress in each group was derived and main effects tested using ANOVA. Correlation analysis was conducted between political variables - POLITY 2, fragile state index (FSI), voter turnout rates, civil liberty scores (CLS) and the health variables. Our results...

  8. Sub-Saharan Africa Report, No. 2830

    Science.gov (United States)

    1983-08-12

    Shagari, Wayas and indeed the NPN that is toying with the idea of states creation as a strategy to score cheap political point. We know the truth. The...and psychological warfare goals of terrorists are often served by the media, and violence is only part of a wider strategy of drawing atten- tion to...proceeds abroad and earn in- come. This scheme would require suffi- cient forex reserves. It would provide a counter revenue which could be set

  9. 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.

  10. A drought monitoring and forecasting system for sub-Sahara African water resources and food security: the development and implementation of a drought monitoring and seasonal hydrological forecast system for sub-Saharan Africa contributes to building capacity through technology and knowledge transfer

    National Research Council Canada - National Science Library

    Sheffield, Justin; Wood, Eric F; Chaney, Nathaniel; Guan, Kaiyu; Sadri, Sara; Yuan, Xing; Olang, Luke; Amani, Abou; Ali, Abdou; Demuth, Siegfried; Ogallo, Laban

    2014-01-01

    ... to climate and alter the storage of water on the land. In sub-Saharan Africa (SSA), droughts account for less than 20% of natural disasters but account for over 80% of the affected population (UN/ISDR 2009). Much of the continent is dependent on rain-fed agriculture, which makes it particularly susceptible to climate variability....

  11. The environmental and social influences of HIV/AIDS in sub-Saharan Africa: a focus on rural communities.

    Science.gov (United States)

    Oramasionwu, Christine U; Daniels, Kelly R; Labreche, Matthew J; Frei, Christopher R

    2011-07-01

    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.

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

    Science.gov (United States)

    Epprecht, M

    1997-01-01

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

  13. Parental investment in child health in sub-Saharan Africa: a cross-national study of health-seeking behaviour.

    Science.gov (United States)

    Uggla, Caroline; Mace, Ruth

    2016-02-01

    Parents face trade-offs between investing in child health and other fitness enhancing activities. In humans, parental investment theory has mostly been examined through the analysis of differential child outcomes, with less emphasis on the actions parents take to further a particular offspring's condition. Here, we make use of household data on health-seeking for children in a high mortality context where such behaviours are crucial for offspring survival. Using Demographic and Health Survey (DHS) data from 17 sub-Saharan African countries, we examine whether maternal factors (age, health, marital status) and child factors (birth order, health, sex, age) independently influence parental investment in health-seeking behaviours: two preventative behaviours (malaria net use and immunization) and two curative ones (treating fever and diarrhoea). Results indicate that children with lower birth order, older mothers and mothers with better health status have higher odds of investment. The effects of a child's sex and health status and whether the mother is polygynously married vary depending on the type of health-seeking behaviour (preventative versus curative). We discuss how these results square with predictions from parental investment theory pertaining to the state of mothers and children, and reflect on some potential mechanisms and directions for future research.

  14. 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

  15. 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.

  16. Agricultural input credit in Sub-Saharan Africa: Telling myth from facts.

    Science.gov (United States)

    Adjognon, Serge G; Liverpool-Tasie, Lenis Saweda O; Reardon, Thomas A

    2017-02-01

    Recent evidence shows that many Sub-Saharan African farmers use modern inputs, but there is limited information on how these inputs are financed. We use recent nationally representative data from four countries to explore input financing and the role of credit therein. A number of our results contradict "conventional wisdom" found in the literature. Our results consistently show that traditional credit use, formal or informal, is extremely low (across credit type, country, crop and farm size categories). Instead, farmers primarily finance modern input purchases with cash from nonfarm activities and crop sales. Tied output-labor arrangements (which have received little empirical treatment in the literature) appear to be the only form of credit relatively widely used for farming.

  17. Cherubism in Sub-Saharan Africa: A First Case-Report in a Child

    Science.gov (United States)

    Aloni, Michel Ntetani; Kambere, Renault Sitwaminya; Molua, Antoine; Dilu, Joseph Nzinga; Tshibassu, Pierre Manianga; Kazadi-Lukusa, Aimé; Ngiyulu, René Makuala; Kalengayi, Raphael Mbona; Ehungu, Jean Lambert Gini

    2015-01-01

    Cherubism is rare disease and has been rarely reported in African pediatric population. We report here the case of a 10-year-old child who was referred to our hospital for bilateral jaws swelling. Physical examination revealed bilateral swelling symmetry of the face. Histopathological examination of the biopsy specimen showed loose fibrous stroma, proliferating fibrous connective with tissue interspersed with multinucleated giant cells, small thin walled blood vessels and scattered sparse mononuclear inflammatory infiltrate. Our patient presented cherubism. Cherubism is rarely described in children living in sub-Saharan Africa. Genetic and molecular investigations plays an important role in diagnosis but were not available in poor resources settings in developing countries such as the Democratic Republic of Congo. PMID:25918610

  18. Cherubism in sub-Saharan Africa: a first case-report in a child

    Directory of Open Access Journals (Sweden)

    Michel Ntetani Aloni

    2015-02-01

    Full Text Available Cherubism is rare disease and has been rarely reported in African pediatric population. We report here the case of a 10-year-old child who was referred to our hospital for bilateral jaws swelling. Physical examination revealed bilateral swelling symmetry of the face. Histopathological examination of the biopsy specimen showed loose fibrous stroma, proliferating fibrous connective with tissue interspersed with multinucleated giant cells, small thin walled blood vessels and scattered sparse mononuclear inflammatory infiltrate. Our patient presented cherubism. Cherubism is rarely described in children living in sub-Saharan Africa. Genetic and molecular investigations plays an important role in diagnosis but were not available in poor resources settings in developing countries such as the Democratic Republic of Congo.

  19. Ten striking facts about agricultural input use in Sub-Saharan Africa.

    Science.gov (United States)

    Sheahan, Megan; Barrett, Christopher B

    2017-02-01

    Conventional wisdom holds that Sub-Saharan African farmers use few modern inputs despite the fact that most poverty-reducing agricultural growth in the region is expected to come largely from expanded use of inputs that embody improved technologies, particularly improved seed, fertilizers and other agro-chemicals, machinery, and irrigation. Yet following several years of high food prices, concerted policy efforts to intensify fertilizer and hybrid seed use, and increased public and private investment in agriculture, how low is modern input use in Africa really? This article revisits Africa's agricultural input landscape, exploiting the unique, recently collected, nationally representative, agriculturally intensive, and cross-country comparable Living Standard Measurement Study-Integrated Surveys on Agriculture (LSMS-ISA) covering six countries in the region (Ethiopia, Malawi, Niger, Nigeria, Tanzania, and Uganda). Using data from over 22,000 households and 62,000 agricultural plots, we offer ten potentially surprising facts about modern input use in Africa today.

  20. 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

  1. Acceptability of the Female Condom by Sub-Saharan African ...

    African Journals Online (AJOL)

    The non-intervention studies which were not linked to specific interventions, operationalized acceptability in terms of women who liked the female condom, not necessarily based on practical experience or use. Intervention studies led to a high proportion of women using the technology, rating the experiences as satisfactory, ...

  2. Biogas technology research in selected sub-Saharan African countries

    African Journals Online (AJOL)

    STORAGESEVER

    2009-01-19

    Jan 19, 2009 ... An attempt is made to pinpoint future research in critically reviewing the biogas technology research. ..... These studies were concerned with some important aspects of anaero- bic digestion of agricultural, food and industrial organic wastes digested singly or in co-digestion. Co-digestion of different ...

  3. Sub-Saharan African Military and Development Activities

    Science.gov (United States)

    2011-12-01

    West Africa, recent estimates indi- cate that as much as 40 percent of the prescrip- tion medicine for sale is counterfeit . Food security is also a major...cocaine is being trafficked from South America to Europe through West Africa every year. This is a startling figure when compared with the gross...new problems are arising here and there. Perhaps the most troubling health threat is the prevalence of counterfeit drug distribution. Throughout

  4. Field Epidemiology and Laboratory Training Programs in sub-Saharan Africa from 2004 to 2010: need, the process, and prospects

    OpenAIRE

    Peter Nsubuga; Kenneth Johnson; Christopher Tetteh; Joseph Oundo; Andrew Weathers; James Vaughan; Suzanne Elbon; Mufuta Tshimanga; Faustine Ndugulile; Chima Ohuabunwo; Michele Evering-Watley; Fausta Mosha; Obinna Oleribe; Patrick Nguku; Lora Davis

    2011-01-01

    As of 2010 sub-Saharan Africa had approximately 865 million inhabitants living with numerous public health challenges. Several public health initiatives [e.g., the United States (US) President's Emergency Plan for AIDS Relief and the US President's Malaria Initiative] have been very successful at reducing mortality from priority diseases. A competently trained public health workforce that can operate multi-disease surveillance and response systems is necessary to build upon and sustain these ...

  5. Productivity effects of higher education human capital in selected countries of Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Koye Gerry Bokana

    2017-06-01

    Full Text Available This study aimed to analyse the productivity effects of higher education enrolment (HEE, higher education output (HEO and the associated productivity gap (GP on selected countries in Sub-Saharan Africa (SSA over the period between 1981 and 2014. It was hypothesized in the study that HEE and HEO had statistically significant positive impact on productivity in the selected sub-Saharan Africa countries over the stated period. Fixed effect Least Square Dummy Variable (LSDV and a robust version of System Generalized Methods of Moment (SYSGMM were adopted as model estimating techniques. Results from the LSDV model indicated that HEE had no statistically significant positive impact on productivity growth in the twenty-one SSA countries. This non-significance was corrected in the dynamic model, but with negative effects on the growth rate of total factor productivity (TFP. The study further compared the worldwide technological frontier with those of the SSA countries under investigation and discovered that countries like Gabon, Mauritius and Swaziland ranked high, while Burundi needs to improve on its productivity determinants. The major conclusion of this study is therefore that higher education human capital should be supported with strong policy implementation, as this can have a positive impact on productivity growth.

  6. 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.

  7. 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.

  8. 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 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.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.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.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.

  9. Physical function, grip strength and frailty in people living with HIV in sub-Saharan Africa: systematic review.

    Science.gov (United States)

    Bernard, Charlotte; Dabis, François; de Rekeneire, Nathalie

    2017-05-01

    To present the current knowledge on physical function, grip strength and frailty in HIV-infected patients living in sub-Saharan Africa, where the phenomenon is largely underestimated. A systematic search was conducted on MEDLINE, Scopus and African Index Medicus. We reviewed articles on sub-Saharan African people living with HIV (PLHIV) >18 years old, published until November 2016. Of 537 articles, 12 were conducted in six African countries and included in this review. Five articles reported information on functional limitation and one on disability. Two of these five articles reported functional limitation (low gait speed) in PLHIV. Disability was observed in 27% and 3% of PLHIV living in rural and urban places, respectively. Two of three studies reporting grip strength reported lower grip strength (nearly 4 kg) in PLHIV in comparison with uninfected patients. One study reported that PLHIV were more likely to be frail than HIV-uninfected individuals (19.4% vs. 13.3%), whereas another reported no statistical difference. Decline in physical function, grip strength and frailty are now part of the burden of PLHIV living in SSA countries, but current data are insufficient to characterise the real public health dimension of these impairments. Further studies are needed to depict this major public health challenge. As this is likely to contribute to a significant burden on the African healthcare systems and human resources in the near future, a holistic care approach should be developed to inform guidelines. © 2017 John Wiley & Sons Ltd.

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

    Science.gov (United States)

    2014-01-01

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

  11. State-civil society partnerships and sustainable urban development ...

    African Journals Online (AJOL)

    Development scholars have consistently focused on the role of non-state actors in the development process. In sub-Saharan Africa, this concern became increasingly important due to the inability of many African states to effectively guide the development process. Consequently, non-state actors have progressively ...

  12. The effectiveness of the Millennium Development Goals (MDG as global paradigm shift for poverty eradication in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Herman van der Elst

    2012-07-01

    Full Text Available Despite isolated progress there seems to be no clear-cut guideline or solution to the collective eradication of extreme poverty in sub-Saharan Africa. In an attempt to overcome the above reality, the objective of the Millennium Development Goals (MDGs is short term poverty relief to the poorest of the poor by 2015. This is to be achieved through the realisation of eight pro-poor objectives. Since 2000 there has been notable progress. Developmental organisations such as the World Bank, the International Monetary Fund (IMF and the Freedom House Index project that global poverty will have been reduced to below fifteen per cent by 2015. The MDGs can, however, currently only be perceived as partially effective because poverty relief remains restricted to mainly Latin America and South and South East Asia. This partial success is substantiated by the reality that the majority of states in sub-Saharan Africa remains subjected to a cycle of extreme poverty, which seems impossible to overcome. There is consensus amongst many researchers that none of the MDGs will be achieved in this region by 2015. This article aims to critically analyse the nature, objectives and progress of the MDGs as a global developmental paradigm shift. In order to explore future trends and identify potential solutions, an emphasis is, however, placed on the possible reasons for the slow progress of the MDGs, specifically in sub-Saharan Africa. Keywords: Global paradigm shift, new conditionality, extreme poverty, poverty eradication, sub-Saharan Africa, foreign aid, deprivation hypothesis, weak governance, free-market approach and the poverty trap Disciplines: International relations, law, political economy, politics, environmental studies, water studies, communication studies, public management and governance, education, sociology, anthropology and history.

  13. HIV/AIDS and mental health research in sub-Saharan Africa: a systematic review.

    Science.gov (United States)

    Breuer, Erica; Myer, Landon; Struthers, Helen; Joska, John A

    2011-06-01

    The relationship between mental illness and HIV/AIDS is complex and bidirectional. A significant amount of research has been performed in high-income countries but less is known about HIV and mental health in sub-Saharan Africa. The objectives of the review were to search the literature for quantitative studies conducted in sub-Saharan Africa on mental health and HIV and to critically evaluate and collate the studies in order to identify research needs and priorities. The databases Ovid, MEDLINE, PsycINFO and the Social Sciences Citation Index (SSCI) were searched for variations of search terms related to HIV/AIDS and mental health and studies limited to the populations of African countries. In addition, we hand-searched indexes of key journals and the databases of academic theses. We included 104 papers or research publications. The majority of these were published after 2005. The major topics covered were: mental-health-related HIV-risk behaviour, HIV in psychiatric populations, and mental illness in HIV-positive populations. The reported prevalence levels of mental illness among people living with HIV or AIDS (PLHIV) was high, with all but one study noting a prevalence of 19% or higher. Neurocognitive changes in adults with HIV were also prevalent, with reported deficits of up to 99% in symptomatic PLHIV and 33% in non-symptomatic PLHIV. Research on HIV in relation to mental health is increasing; however, there is a need for good-quality prospective studies to investigate the bidirectional effects of mental illness and HIV on each other.

  14. mHealth for Clinical Decision-Making in Sub-Saharan Africa: A Scoping Review.

    Science.gov (United States)

    Adepoju, Ibukun-Oluwa Omolade; Albersen, Bregje Joanna Antonia; De Brouwere, Vincent; van Roosmalen, Jos; Zweekhorst, Marjolein

    2017-03-23

    In a bid to deliver quality health services in resource-poor settings, mobile health (mHealth) is increasingly being adopted. The role of mHealth in facilitating evidence-based clinical decision-making through data collection, decision algorithms, and evidence-based guidelines, for example, is established in resource-rich settings. However, the extent to which mobile clinical decision support systems (mCDSS) have been adopted specifically in resource-poor settings such as Africa and the lessons learned about their use in such settings are yet to be established. The aim of this study was to synthesize evidence on the use of mHealth for point-of-care decision support and improved quality of care by health care workers in Africa. A scoping review of 4 peer-reviewed and 1 grey literature databases was conducted. No date limits were applied, but only articles in English language were selected. Using pre-established criteria, 2 reviewers screened articles and extracted data. Articles were analyzed using Microsoft Excel and MAXQDA. We retained 22 articles representing 11 different studies in 7 sub-Saharan African countries. Interventions were mainly in the domain of maternal health and ranged from simple text messaging (short message service, SMS) to complex multicomponent interventions. Although health workers are generally supportive of mCDSS and perceive them as useful, concerns about increased workload and altered workflow hinder sustainability. Facilitators and barriers to use of mCDSS include technical and infrastructural support, ownership, health system challenges, and training. The use of mCDSS in sub-Saharan Africa is an indication of progress in mHealth, although their effect on quality of service delivery is yet to be fully explored. Lessons learned are useful for informing future research, policy, and practice for technologically supported health care delivery, especially in resource-poor settings.

  15. 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

  16. 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

  17. Estimating the impact of birth control on fertility rate in Sub-Saharan ...

    African Journals Online (AJOL)

    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.

  18. Use of Electronic Health Records in sub-Saharan Africa: Progress ...

    African Journals Online (AJOL)

    Background: The Electronic Health Record (EHR) is a key component of medical informatics that is increasingly being utilized in industrialized nations to improve healthcare. There is limited information on the use of EHR in sub-Saharan Africa. This paper reviews availability of EHRs in sub-Saharan Africa. Methods: ...

  19. 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…

  20. Prevention, suppression, and resistance : Antiretroviral treatment for children with HIV in sub-Saharan Africa

    NARCIS (Netherlands)

    Boerma, R.S.

    2017-01-01

    This thesis describes the virological and clinical outcomes of children with HIV in sub-Saharan Africa who start antiretroviral treatment (ART). We show that pretreatment HIV drug resistance among children is a serious problem in sub-Saharan Africa and that its prevalence is increasing. Children who

  1. Review: Head and neck squamous cell carcinoma in sub-Saharan ...

    African Journals Online (AJOL)

    Aim Review the literature from 1990 to 2013 to determine known anatomic sites, risk factors, treatments, and outcomes of head and neck squamous cell carcinoma (HNSCC) in sub-Saharan Africa. Methods Using a systematic search strategy, literature pertaining to HNSCC in sub-Saharan Africa was reviewed and patient ...

  2. Sustainable agricultural intensification in Sub-Saharan Africa : design of an assessment tool

    NARCIS (Netherlands)

    Verzandvoort, S.J.E.; Beek, C.L.; Conijn, J.G.; Froebrich, J.; Jansen, H.C.; Noij, I.G.A.M.; Roest, C.W.J.; Vreke, J.; Mansfeld, van M.J.M.

    2012-01-01

    The demand for agricultural products (food, feed, fibre, and biomass for other purposes) produced in Sub-Saharan Africa (SSA) will increase for the coming decades. In addition, the global climate change will largely impact on the agricultural sector in Sub-Saharan Africa. Major challenges for the

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

    NARCIS (Netherlands)

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

    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.

  4. Epilepsy treatment in sub-Saharan Africa: closing the gap | Chin ...

    African Journals Online (AJOL)

    According to World Health Organization (WHO), the prevalence of epilepsy is highest in low- and lower middle-income countries, which include over eighty percent of the countries of sub-Saharan Africa, where the majority of people with epilepsy are not receiving appropriate care. In sub-Saharan Africa, shortages of trained ...

  5. Social media reveal that charismatic species are not the main attractor of ecotourists to sub-Saharan protected areas.

    Science.gov (United States)

    Hausmann, Anna; Toivonen, Tuuli; Heikinheimo, Vuokko; Tenkanen, Henrikki; Slotow, Rob; Di Minin, Enrico

    2017-04-10

    Charismatic megafauna are arguably considered the primary attractor of ecotourists to sub-Saharan African protected areas. However, the lack of visitation data across the whole continent has thus far prevented the investigation of whether charismatic species are indeed a key attractor of ecotourists to protected areas. Social media data can now be used for this purpose. We mined data from Instagram, and used generalized linear models with site- and country-level deviations to explore which socio-economic, geographical and biological factors explain social media use in sub-Saharan African protected areas. We found that charismatic species richness did not explain social media usage. On the other hand, protected areas that were more accessible, had sparser vegetation, where human population density was higher, and that were located in wealthier countries, had higher social media use. Interestingly, protected areas with lower richness in non-charismatic species had more users. Overall, our results suggest that more factors than simply charismatic species might explain attractiveness of protected areas, and call for more in-depth content analysis of the posts. With African countries projected to develop further in the near-future, more social media data will become available, and could be used to inform protected area management and marketing.

  6. Paediatric burn injuries in Sub Saharan Africa--an overview.

    Science.gov (United States)

    Albertyn, R; Bickler, S W; Rode, H

    2006-08-01

    Paediatric burn injuries in Sub Saharan Africa are common and often lead to devastating consequences. Unfortunately relevant and accurate data regarding these injuries is sketchy and incomplete. This paper reviews the available information on the epidemiology of paediatric burns in Africa, associated health problems and contributing environmental factors responsible for these burns. The current status of burn care, the lack of infrastructure, and traditional methods of treatment, further contribute to the unsatisfactory status of overall burn management, prevention, and rehabilitation of burn survivors. A strategy for improving burn care in Africa has been formulated. The management of childhood burns will only be successful if educational, social, fiscal and infrastructure standards are improved. Traditional beliefs and methods cannot be discarded as they play an important role in the management of these children. It is furthermore essential that local and central government organisations support these initiatives. Clearly, the children of Africa deserve better burn care.

  7. Geography versus institutions and sub-Saharan aid

    Directory of Open Access Journals (Sweden)

    Chris W. Callaghan

    2017-02-01

    Full Text Available This article sets out to review two opposing viewpoints in the literature, namely long-standing geographic versus institutionalist perspectives and their opposing predictions for development of poor countries, particularly those in sub-Saharan Africa. A special focus is on the differing predictions of the effectiveness of aid of these two perspectives. On the basis of a consideration of different literatures and final Millenium Development Report, it is argued that ‘Big Push’ theory may still offer important theoretical and practical development contributions. Arguably, these contributions echo Keynes’s legacy in their consideration of the most vulnerable and marginalised. It is also argued that a global birth lottery allocates people to countries and regions with unequal opportunities and that a normative argument can be made to justify aid to mitigate birth lottery effects.

  8. 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.

    2015-09-01

    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 science education in countries in Anglophone Sub-Saharan Africa?' The findings of the study show some significant convergence of what is valued in science education in Sub-Saharan Africa in areas such as pedagogy; English language as a medium of instruction; assessment of learning; mobility of students in the region; and in the frameworks for collaborative engagements among stakeholders in Sub-Saharan Africa. The paper concludes with a reflective end-piece calling for more case studies to help scrutinise further the influence of globalisation on science education in Sub-Saharan Africa.

  9. 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.

  10. 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.

  11. Ghana and Mali. Grade 7 Model Lesson for Standard 7.4. World History and Geography: Medieval Sub-Saharan Africa. California History-Social Science Course Models.

    Science.gov (United States)

    Zachlod, Michelle, Ed.

    California State Standard 7.4 is delineated in the following manner: "Students analyze the geographic, political, economic, religious, and social structures of the sub-Saharan civilizations of Ghana and Mali in Medieval Africa. Seventh-grade students focus on the Niger River and the growth of the Mali and Ghana empires; analyze the importance…

  12. Greenhouse gas emissions from natural ecosystems and agricultural lands in sub-Saharan Africa: synthesis of available data and suggestions for further research

    OpenAIRE

    Kim, Dong-Gill; Thomas, Andrew D.; Pelster, David; Rosenstock, Todd S; Sanz-Cobena, Alberto

    2016-01-01

    This paper summarizes currently available data on greenhouse gas (GHG) emissions from African natural ecosystems and agricultural lands. The available data are used to synthesize current understanding of the drivers of change in GHG emissions, outline the knowledge gaps, and suggest future directions and strategies for GHG emission research. GHG emission data were collected from 75 studies conducted in 22 countries (n =  244) in sub-Saharan Africa (SSA). Carbon dioxide (CO2)...

  13. Long-term Voluntary Counselling and Testing (VCT) uptake dynamics in a multi-country HIV Workplace Program in sub-Saharan Africa

    OpenAIRE

    Van Der Borght, Stefaan; Schim Van Der Loeff, Maarten Franciscus; Clevenbergh, Philippe; Kabarega, Jean Pierre; Kamo, Emmanuel; Van Cranenburgh, Katinka; Rijckborst, Henk; Lange, Joep M; Rinke De Wit, Tobias Floris

    2010-01-01

    International audience; High uptake of HIV voluntary counselling and testing (VCT) services is important for the success of HIV workplace programs in sub-Saharan Africa. From 2001 onwards Heineken, a multinational brewing company, implemented a comprehensive HIV prevention and treatment program for employees and their dependents of its African subsidiaries. Confidential in-house VCT is part of this program. VCT uptake dynamics over time, and factors associated with early uptake were studied. ...

  14. Long-term Voluntary Counselling and Testing (VCT) uptake dynamics in a multi-country HIV Workplace Program in sub-Saharan Africa

    OpenAIRE

    2010-01-01

    Abstract High uptake of HIV voluntary counselling and testing (VCT) services is important for the success of HIV workplace programs in sub-Saharan Africa. From 2001 onwards Heineken, a multinational brewing company, implemented a comprehensive HIV prevention and treatment program for employees and their dependents of its African subsidiaries. Confidential in-house VCT is part of this program. VCT uptake dynamics over time, and factors associated with early uptake were studied. Be...

  15. Field Epidemiology and Laboratory Training Programs in sub-Saharan Africa from 2004 to 2010: need, the process, and prospects

    Science.gov (United States)

    Nsubuga, Peter; Johnson, Kenneth; Tetteh, Christopher; Oundo, Joseph; Weathers, Andrew; Vaughan, James; Elbon, Suzanne; Tshimanga, Mufuta; Ndugulile, Faustine; Ohuabunwo, Chima; Evering-Watley, Michele; Mosha, Fausta; Oleribe, Obinna; Nguku, Patrick; Davis, Lora; Preacely, Nykiconia; Luce, Richard; Antara, Simon; Imara, Hiari; Ndjakani, Yassa; Doyle, Timothy; Espinosa, Yescenia; Kazambu, Ditu; Delissaint, Dieula; Ngulefac, John; Njenga, Kariuki

    2011-01-01

    As of 2010 sub-Saharan Africa had approximately 865 million inhabitants living with numerous public health challenges. Several public health initiatives [e.g., the United States (US) President's Emergency Plan for AIDS Relief and the US President's Malaria Initiative] have been very successful at reducing mortality from priority diseases. A competently trained public health workforce that can operate multi-disease surveillance and response systems is necessary to build upon and sustain these successes and to address other public health problems. Sub-Saharan Africa appears to have weathered the recent global economic downturn remarkably well and its increasing middle class may soon demand stronger public health systems to protect communities. The Epidemic Intelligence Service (EIS) program of the US Centers for Disease Control and Prevention (CDC) has been the backbone of public health surveillance and response in the US during its 60 years of existence. EIS has been adapted internationally to create the Field Epidemiology Training Program (FETP) in several countries. In the 1990s CDC and the Rockefeller Foundation collaborated with the Uganda and Zimbabwe ministries of health and local universities to create 2-year Public Health Schools Without Walls (PHSWOWs) which were based on the FETP model. In 2004 the FETP model was further adapted to create the Field Epidemiology and Laboratory Training Program (FELTP) in Kenya to conduct joint competency-based training for field epidemiologists and public health laboratory scientists providing a master's degree to participants upon completion. The FELTP model has been implemented in several additional countries in sub-Saharan Africa. By the end of 2010 these 10 FELTPs and two PHSWOWs covered 613 million of the 865 million people in sub-Saharan Africa and had enrolled 743 public health professionals. We describe the process that we used to develop 10 FELTPs covering 15 countries in sub-Saharan Africa from 2004 to 2010 as a

  16. Field Epidemiology and Laboratory Training Programs in sub-Saharan Africa from 2004 to 2010: need, the process, and prospects.

    Science.gov (United States)

    Nsubuga, Peter; Johnson, Kenneth; Tetteh, Christopher; Oundo, Joseph; Weathers, Andrew; Vaughan, James; Elbon, Suzanne; Tshimanga, Mufuta; Ndugulile, Faustine; Ohuabunwo, Chima; Evering-Watley, Michele; Mosha, Fausta; Oleribe, Obinna; Nguku, Patrick; Davis, Lora; Preacely, Nykiconia; Luce, Richard; Antara, Simon; Imara, Hiari; Ndjakani, Yassa; Doyle, Timothy; Espinosa, Yescenia; Kazambu, Ditu; Delissaint, Dieula; Ngulefac, John; Njenga, Kariuki

    2011-01-01

    As of 2010 sub-Saharan Africa had approximately 865 million inhabitants living with numerous public health challenges. Several public health initiatives [e.g., the United States (US) President's Emergency Plan for AIDS Relief and the US President's Malaria Initiative] have been very successful at reducing mortality from priority diseases. A competently trained public health workforce that can operate multi-disease surveillance and response systems is necessary to build upon and sustain these successes and to address other public health problems. Sub-Saharan Africa appears to have weathered the recent global economic downturn remarkably well and its increasing middle class may soon demand stronger public health systems to protect communities. The Epidemic Intelligence Service (EIS) program of the US Centers for Disease Control and Prevention (CDC) has been the backbone of public health surveillance and response in the US during its 60 years of existence. EIS has been adapted internationally to create the Field Epidemiology Training Program (FETP) in several countries. In the 1990s CDC and the Rockefeller Foundation collaborated with the Uganda and Zimbabwe ministries of health and local universities to create 2-year Public Health Schools Without Walls (PHSWOWs) which were based on the FETP model. In 2004 the FETP model was further adapted to create the Field Epidemiology and Laboratory Training Program (FELTP) in Kenya to conduct joint competency-based training for field epidemiologists and public health laboratory scientists providing a master's degree to participants upon completion. The FELTP model has been implemented in several additional countries in sub-Saharan Africa. By the end of 2010 these 10 FELTPs and two PHSWOWs covered 613 million of the 865 million people in sub-Saharan Africa and had enrolled 743 public health professionals. We describe the process that we used to develop 10 FELTPs covering 15 countries in sub-Saharan Africa from 2004 to 2010 as a

  17. Medical education departments: a study of four medical schools in Sub-Saharan Africa.

    Science.gov (United States)

    Kiguli-Malwadde, Elsie; Talib, Zohray M; Wohltjen, Hannah; Connors, Susan C; Gandari, Jonathan; Banda, Sekelani S; Maggio, Lauren A; van Schalkwyk, Susan C

    2015-07-01

    Many African countries are investing in medical education to address significant health care workforce shortages and ultimately improve health care. Increasingly, training institutions are establishing medical education departments as part of this investment. This article describes the status of four such departments at sub-Saharan African medical schools supported by the Medical Education Partnership Initiative (MEPI). This article will provide information about the role of these institutional structures in fostering the development of medical education within the African context and highlight factors that enable or constrain their establishment and sustainability. In-depth interviews were conducted with the heads or directors of the four medical education departments using a structured interview protocol developed by the study group. An inductive approach to analysis of the interview transcripts was adopted as the texts were subjected to thematic content analysis. Medical education departments, also known as units or centers, were established for a range of reasons including: to support curriculum review, to provide faculty development in Health Professions Education, and to improve scholarship in learning and teaching. The reporting structures of these departments differ in terms of composition and staff numbers. Though the functions of departments do vary, all focus on improving the quality of health professions education. External and internal funding, where available, as well as educational innovations were key enablers for these departments. Challenges included establishing and maintaining the legitimacy of the department, staffing the departments with qualified individuals, and navigating dependence on external funding. All departments seek to expand the scope of their services by offering higher degrees in HPE, providing assistance to other universities in this domain, and developing and maintaining a medical education research agenda. The establishment of

  18. Optimizing the management of acute coronary syndromes in sub-Saharan Africa: A statement from the AFRICARDIO 2015 Consensus Team.

    Science.gov (United States)

    Kakou-Guikahue, Maurice; N'Guetta, Roland; Anzouan-Kacou, Jean-Baptiste; Kramoh, Euloge; N'Dori, Raymond; Ba, Serigne Abdou; Diao, Maboury; Sarr, Moustapha; Kane, Abdoul; Kane, Adama; Damorou, Findide; Balde, Dadhi; Diarra, Mamadou Bocary; Djiddou, Mohamed; Kimbally-Kaki, Gisèle; Zabsonre, Patrice; Toure, Ibrahim Ali; Houénassi, Martin; Gamra, Habib; Chajai, Bachir; Gerardin, Benoit; Pillière, Rémy; Aubry, Pierre; Iliou, Marie-Christine; Isnard, Richard; Leprince, Pascal; Cottin, Yves; Bertrand, Edmond; Juillière, Yves; Monsuez, Jean-Jacques

    2016-01-01

    Whereas the coronary artery disease death rate has declined in high-income countries, the incidence of acute coronary syndromes (ACS) is increasing in sub-Saharan Africa, where their management remains a challenge. To propose a consensus statement to optimize management of ACS in sub-Saharan Africa on the basis of realistic considerations. The AFRICARDIO-2 conference (Yamoussoukro, May 2015) reviewed the ongoing features of ACS in 10 sub-Saharan countries (Benin, Burkina-Faso, Congo-Brazzaville, Guinea, Ivory Coast, Mali, Mauritania, Niger, Senegal, Togo), and analysed whether improvements in strategies and policies may be expected using readily available healthcare facilities. The outcome of patients with ACS is affected by clearly identified factors, including: delay to reaching first medical contact, achieving effective hospital transportation, increased time from symptom onset to reperfusion therapy, limited primary emergency facilities (especially in rural areas) and emergency medical service (EMS) prehospital management, and hence limited numbers of patients eligible for myocardial reperfusion (thrombolytic therapy and/or percutaneous coronary intervention [PCI]). With only five catheterization laboratories in the 10 participating countries, PCI rates are very low. However, in recent years, catheterization laboratories have been built in referral cardiology departments in large African towns (Abidjan and Dakar). Improvements in patient care and outcomes should target limited but selected objectives: increasing awareness and recognition of ACS symptoms; education of rural-based healthcare professionals; and developing and managing a network between first-line healthcare facilities in rural areas or small cities, emergency rooms in larger towns, the EMS, hospital-based cardiology departments and catheterization laboratories. Faced with the increasing prevalence of ACS in sub-Saharan Africa, healthcare policies should be developed to overcome the multiple

  19. 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

    ... From the Federal Register Online via the Government Publishing Office EXPORT-IMPORT BANK Postponement Notice of Open Special Meeting of the Sub-Saharan Africa Advisory Committee of the Export-Import... for trade with Sub-Saharan Africa. Postponement: The Sub-Saharan Africa Advisory Committee of the...

  20. Modelling the impact of tectonics, surface conditions and sea surface temperatures on Saharan and sub-Saharan climate evolution

    Science.gov (United States)

    Sepulchre, Pierre; Ramstein, Gilles; Schuster, Mathieu

    2009-08-01

    Using an Atmospheric Global Circulation Model, we assess the relevance of selected atmospheric mechanisms for climate evolution of Saharan and sub-Saharan regions since the Miocene. First, we test the influence of the East-African Rift System uplift on atmospheric dynamics. Although the uplift played an important role in triggering East-African rainfall, no significant impact over central and western Africa has been detected. We also analyse the feedbacks of a giant lake on the climate of Chad basin. First results infer a negative feedback of the giant lake on the water balance, as convection is weakened by the cold water surface and as water evaporated from the lake does not feed the basin hydrological cycle. Lastly, we suggest that colder than present sea surface temperatures over the Gulf of Guinea reinforce the West-African monsoon, by enhancing the moisture advection engine via stronger thermal contrast between the ocean and the continent.

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

    Science.gov (United States)

    Funk, Luke M; Conley, Dante M; Berry, William R; Gawande, Atul A

    2013-11-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  3. Cultural significance of termites in sub-Saharan Africa.

    Science.gov (United States)

    van Huis, Arnold

    2017-01-26

    The number of termite species in the world is more than 2500, and Africa with more than 1000 species has the richest intercontinental diversity. The family Termitidae contains builders of great mounds up to 5 m high. Colonies are composed of casts: a queen, a king, soldiers and workers. Some species of termite cultivate specialised fungi to digest cellulose. Termites constitute 10% of all animal biomass in the tropics. The purpose of the study was to make an overview of how termites are utilized, perceived and experienced in daily life across sub-Saharan Africa. Ethno-entomological information on termites (Isoptera) in sub-Saharan Africa was collected by: (1) interviews with more than 300 people from about 120 ethnic groups from 27 countries in the region; (2) library studies in Africa, London, Paris and Leiden. Vernacular names relate to mounds, insects as food, the swarming, and the behaviour of termites. Swarming reproductive, soldiers and queens are collected as food. There are many different ways to harvest them. Termites can also be used as feed for poultry or as bait to catch birds and fish. The mushrooms that grow each year from the fungus gardens on the termite mounds are eaten. The soldiers, the fungus gardens and the soil of termite mounds are used for multiple medicinal purposes. Mounds and soil of termites have numerous functions: for geochemical prospecting, making bricks, plastering houses, making pots, and for storage. Termite soil is often used as fertilizer. The act of eating soil (geophagy) among women, especially those that are pregnant, is practised all over Africa. The mounds can serve as burying places and are often associated with the spiritual world, especially containing the spirits of ancestors. Termites also play a role as oracle, in superstitious beliefs, in art and literature. The following characteristics make termites so appealing: the dominance in the landscape, the social organization, the destructive power, and the provision of

  4. Health trends in Sub-Saharan Africa: conflicting evidence from infant mortality rates and adult heights.

    Science.gov (United States)

    Akachi, Yoko; Canning, David

    2010-07-01

    We investigate trends in cohort infant mortality rates and adult heights in 39 developing countries since 1961. In most regions of the world improved nutrition, and reduced childhood exposure to disease, have lead to improvements in both infant mortality and adult stature. In Sub-Saharan Africa, however, despite declining infant mortality rates, adult heights have not increased. We argue that in Sub-Saharan Africa the decline in infant mortality may have been due to interventions that prevent infant deaths rather than improved nutrition and childhood morbidity. Despite declining infant mortality, Sub-Saharan Africa may not be experiencing increases in health human capital. 2010 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

    Adejumo, Olurotimi A; Malee, Kathleen M; Ryscavage, Patrick; Hunter, Scott J; Taiwo, Babafemi O

    2015-01-01

    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 in this region. With

  6. Approaches and impact of non-academic research capacity strengthening training models in sub-Saharan Africa: a systematic review.

    Science.gov (United States)

    Mugabo, Lambert; Rouleau, Dominique; Odhiambo, Jackline; Nisingizwe, Marie Paul; Amoroso, Cheryl; Barebwanuwe, Peter; Warugaba, Christine; Habumugisha, Lameck; Hedt-Gauthier, Bethany L

    2015-06-09

    Research is essential to identify and prioritize health needs and to develop appropriate strategies to improve health outcomes. In the last decade, non-academic research capacity strengthening trainings in sub-Saharan Africa, coupled with developing research infrastructure and the provision of individual mentorship support, has been used to build health worker skills. The objectives of this review are to describe different training approaches to research capacity strengthening in sub-Saharan Africa outside academic programs, assess methods used to evaluate research capacity strengthening activities, and learn about the challenges facing research capacity strengthening and the strategies/innovations required to overcome them. The PubMed database was searched using nine search terms and articles were included if 1) they explicitly described research capacity strengthening training activities, including information on program duration, target audience, immediate program outputs and outcomes; 2) all or part of the training program took place in sub-Saharan African countries; 3) the training activities were not a formal academic program; 4) papers were published between 2000 and 2013; and 5) both abstract and full paper were available in English. The search resulted in 495 articles, of which 450 were retained; 14 papers met all inclusion criteria and were included and analysed. In total, 4136 people were trained, of which 2939 were from Africa. Of the 14 included papers, six fell in the category of short-term evaluation period and eight in the long-term evaluation period. Conduct of evaluations and use of evaluation frameworks varied between short and long term models and some trainings were not evaluated. Evaluation methods included tests, surveys, interviews, and systems approach matrix. Research capacity strengthening activities in sub-Saharan Africa outside of academic settings provide important contributions to developing in-country capacity to participate in and

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

    Science.gov (United States)

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

    2013-12-29

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

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

    Science.gov (United States)

    Kariuki, Samuel; Dougan, Gordon

    2014-09-01

    Antibacterial resistance-associated infections are known to increase morbidity, mortality, and cost of treatment, and to potentially put others in the community at higher risk of infections. In high-income countries, where the burden of infectious diseases is relatively modest, resistance to first-line antibacterial agents is usually overcome by use of second- and third-line agents. However, in developing countries where the burden of infectious diseases is high, patients with antibacterial-resistant infections may be unable to obtain or afford effective second-line treatments. In sub-Saharan Africa (SSA), the situation is aggravated by poor hygiene, unreliable water supplies, civil conflicts, and increasing numbers of immunocompromised people, such as those with HIV, which facilitate both the evolution of resistant pathogens and their rapid spread in the community. Because of limited capacity for disease detection and surveillance, the burden of illnesses due to treatable bacterial infections, their specific etiologies, and the awareness of antibacterial resistance are less well established in most of SSA, and therefore the ability to mitigate their consequences is significantly limited. © 2014 New York Academy of Sciences.

  9. 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.

  10. Problem Gambling among Young People in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Derrick Ssewanyana

    2018-02-01

    Full Text Available Gambling is a cross-cultural and global activity which typically involves the wagering of money or an item of monetary value on an outcome that is governed by chance. Although gambling is positioned as a legitimate recreational and leisure activity within sub-Saharan Africa (SSA, there is widespread recognition among healthcare professionals and policy-makers that gambling has the capacity to become dysfunctional in a minority. Emerging knowledge suggests that problem gambling is rapidly evolving in to a public health concern in SSA, especially among youth. This article focuses on problem gambling among young people in SSA with an emphasis on three key themes: (1 gambling behavior and patterns in SSA; (2 public health and socioeconomic implications of gambling in SSA; and (3 public health policies and interventions for addressing this issue. We believe that collaborative efforts between government, prevention specialists, legislators, researchers, treatment providers, and other stake holders can influence the uptake of research findings necessary to implement social policies and design effective public health intervention options to combat problem gambling and its associated implications among young people in SSA.

  11. Causes of corruption: Evidence from sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Joseph Ato Forson

    2016-11-01

    Full Text Available This study explores the causes of corruption in 22 countries in sub-Saharan Africa from 1996 to 2013. The sources of corruption are grouped into three main thematic areas – historical roots, contemporary causes and institutional causes to make way for subjective and objective measures. The subjective measures allow for assessment of the effectiveness of anticorruption policies. Using pooled OLS, fixed-effect and instrumental-variable approaches, and focusing on the perceived level of corruption as the dependent variable, we find that ethnic diversity, resource abundance and educational attainment are markedly less associated with corruption. In contrast, wage levels of bureaucrats and anticorruption measures based on government effectiveness and regulatory quality breed substantial corruption. Press freedom is found to be variedly associated with corruption. On the basis of these findings, we recommend that the fight against corruption on the continent needs to be reinvented through qualitative and assertive institutional reforms. Anticorruption policy decisions should focus on existing educational systems as a conduit for intensifying awareness of the devastating effect of corruption on sustainable national development.

  12. Rooting for food security in Sub-Saharan Africa

    Science.gov (United States)

    Guilpart, Nicolas; Grassini, Patricio; van Wart, Justin; Yang, Haishun; van Ittersum, Martin K.; van Bussel, Lenny G. J.; Wolf, Joost; Claessens, Lieven; Leenaars, Johan G. B.; Cassman, Kenneth G.

    2017-11-01

    There is a persistent narrative about the potential of Sub-Saharan Africa (SSA) to be a ‘grain breadbasket’ because of large gaps between current low yields and yield potential with good management, and vast land resources with adequate rainfall. However, rigorous evaluation of the extent to which soils can support high, stable yields has been limited by lack of data on rootable soil depth of sufficient quality and spatial resolution. Here we use location-specific climate data, a robust spatial upscaling approach, and crop simulation to assess sensitivity of rainfed maize yields to root-zone water holding capacity. We find that SSA could produce a modest maize surplus but only if rootable soil depths are comparable to that of other major breadbaskets, such as the US Corn Belt and South American Pampas, which is unlikely based on currently available information. Otherwise, producing surplus grain for export will depend on expansion of crop area with the challenge of directing this expansion to regions where soil depth and rainfall are supportive of high and consistent yields, and where negative impacts on biodiversity are minimal.

  13. 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

    2015-12-07

    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. Copyright © 2015 by the American Society of Nephrology.

  14. The urgent need for health impact assessment: proposing a transdisciplinary approach to the e-waste crisis in sub-Saharan Africa.

    Science.gov (United States)

    Tetteh, Dinah; Lengel, Lara

    2017-06-01

    Electronic waste (e-waste) is a growing health and environmental concern in developing countries. In the sub-Saharan African region e-waste is considered a crisis with no end in sight yet; there is lack of structures and regulations to manage the problem. In this article, we discuss the potential of Health Impact Assessment (HIA) in addressing the health, environmental, and social impacts of e-waste in sub-Saharan Africa. We draw from environmental policy, environmental communication, global health policy, and health communication to argue that managing e-waste could be framed as ongoing HIA where all the steps of HIA are performed on a rolling basis with input from local communities. Further, we suggest that HIA should be infused into recycling legislation to help streamline the practice in order to make it safe for health and the environment and to maximize the economic benefits.

  15. 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

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

    Science.gov (United States)

    Smith-Greenaway, Emily

    2015-11-11

    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. 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. 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. The findings demonstrate that educational attainment is generally a poor proxy for literacy, highlighting the need to measure, theorize, and study literacy as empirically distinct from education.

  17. Towards more accurate HIV testing in sub-Saharan Africa: a multi-site evaluation of HIV RDTs and risk factors for false positives.

    Science.gov (United States)

    Kosack, Cara S; Page, Anne-Laure; Beelaert, Greet; Benson, Tumwesigye; Savane, Aboubacar; Ng'ang'a, Anne; Andre, Bita; Zahinda, Jean-Paul Bn; Shanks, Leslie; Fransen, Katrien

    2017-03-24

    Although individual HIV rapid diagnostic tests (RDTs) show good performance in evaluations conducted by WHO, reports from several African countries highlight potentially significant performance issues. Despite widespread use of RDTs for HIV diagnosis in resource-constrained settings, there has been no systematic, head-to-head evaluation of their accuracy with specimens from diverse settings across sub-Saharan Africa. We conducted a standardized, centralized evaluation of eight HIV RDTs and two simple confirmatory assays at a WHO collaborating centre for evaluation of HIV diagnostics using specimens from six sites in five sub-Saharan African countries. Specimens were transported to the Institute of Tropical Medicine (ITM), Antwerp, Belgium for testing. The tests were evaluated by comparing their results to a state-of-the-art reference algorithm to estimate sensitivity, specificity and predictive values. 2785 samples collected from August 2011 to January 2015 were tested at ITM. All RDTs showed very high sensitivity, from 98.8% for First Response HIV Card Test 1-2.0 to 100% for Determine HIV 1/2, Genie Fast, SD Bioline HIV 1/2 3.0 and INSTI HIV-1/HIV-2 Antibody Test kit. Specificity ranged from 90.4% for First Response to 99.7% for HIV 1/2 STAT-PAK with wide variation based on the geographical origin of specimens. Multivariate analysis showed several factors were associated with false-positive results, including gender, provider-initiated testing and the geographical origin of specimens. For simple confirmatory assays, the total sensitivity and specificity was 100% and 98.8% for ImmunoComb II HIV 12 CombFirm (ImmunoComb) and 99.7% and 98.4% for Geenius HIV 1/2 with indeterminate rates of 8.9% and 9.4%. In this first systematic head-to-head evaluation of the most widely used RDTs, individual RDTs performed more poorly than in the WHO evaluations: only one test met the recommended thresholds for RDTs of ≥99% sensitivity and ≥98% specificity. By performing all tests

  18. External Financial Aid to Blood Transfusion Services in Sub-Saharan Africa: A Need for Reflection

    NARCIS (Netherlands)

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

    2012-01-01

    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

  19. Child labour, education, participation and economic growth in sub-Saharan Africa : an empirical study

    National Research Council Canada - National Science Library

    Mukherjee, Jaydeep

    2008-01-01

    .... This calls for serious introspection. The present study examines the interaction between child labour, education participation and per capita economic growth for Sub-Saharan Africa in a holistic framework using two-stage least squares (2SLS...

  20. The Position of Sub-Saharan Countries in the World Economy

    Directory of Open Access Journals (Sweden)

    Baumgartner Boris

    2016-06-01

    Full Text Available Most of the countries of sub-Saharan Africa belong to the most underdeveloped and poorest countries in the world economy. This region consists of forty-nine countries but at world GDP, world export, world import and inflow of foreign direct investment share only by small percent. There are some positive facts in the recent history of sub- Saharan Africa. Sub-Saharan Africa has grown faster than the world economy in the past ten years. The predictions are also positive. There is an expectation of another growth till the 2020. If the sub-Saharan countries want to keep the growth in the future they have to invest to infrastructure, in educational system, in research and science to make their economies more competitive.