Research priorities to inform “Treat All” policy implementation for people living withHIVin sub‐Saharan Africa: a consensus statement from the International epidemiology Databases to EvaluateAIDS(IeDEA)

PurposeThe objectives of the International epidemiology databases to evaluate AIDS (IeDEA) are to (i) evaluate the delivery of combination antiretroviral therapy (ART) in children, adolescents and adults in sub-Saharan Africa, (ii) to describe ART regimen effectiveness, durability and tolerability, (iii) to examine HIV-related comorbidities and coinfections and (iv) to examine the pregnancy-related and HIV-related outcomes of women on ART and their infants exposed to HIV or ART in utero or via breast milk.ParticipantsIeDEA is organised in four regions (Central, East, Southern and West Africa), with 240 treatment and care sites, six data centres at African, European and US universities, and almost 1.4 million children, adolescents and adult people living with HIV (PLWHIV) enrolled.Findings to dateThe data include socio-demographic characteristics, clinical outcomes, opportunistic events, treatment regimens, clinic visits and laboratory measurements. They have been used to analyse outcomes in PLWHIV-1 or PLWHIV-2 who initiate ART, including determinants of mortality, of switching to second-line and third-line ART, drug resistance, loss to follow-up and the immunological and virological response to different ART regimens. Programme-level estimates of mortality have been corrected for loss to follow-up. We examined the impact of coinfection with hepatitis B and C, and the epidemiology of different cancers and of (multidrug resistant) tuberculosis, renal disease and of mental illness. The adoption of ‘Treat All’, making ART available to all PLWHIV regardless of CD4+ cell count or clinical stage was another important research topic.Future plansIeDEA has formulated several research priorities for the ‘Treat All’ era in sub-Saharan Africa. It recently obtained funding to set up sentinel sites where additional data are prospectively collected on cardiometabolic risks factors as well as mental health and liver diseases, and is planning to create a drug resistance database.

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Traversing the cascade: urgent research priorities for implementing the ‘treat all’ strategy for children and adolescents living with HIV in sub-Saharan Africa

Journal of Virus Eradication ◽

10.1016/s2055-6640(20)30344-7 ◽

2018 ◽

Vol 4 ◽

pp. 40-46 ◽

Cited By ~ 7

Author(s):

Leslie A. Enane ◽

Mary-Ann Davies ◽

Valériane Leroy ◽

Andrew Edmonds ◽

Edith Apondi ◽

...

Keyword(s):

Children And Adolescents ◽

Research Priorities ◽

Sub Saharan Africa ◽

Sub Saharan ◽

Treat All ◽

Living With Hiv

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Cohort profile: The International epidemiology Databases to Evaluate AIDS (IeDEA) in sub-Saharan Africa, 2012-2019

10.1101/19010231 ◽

2019 ◽

Cited By ~ 1

Author(s):

Frédérique Chammartin ◽

Cam Ha Dao Ostinelli ◽

Kathryn Anastos ◽

Antoine Jaquet ◽

Ellen Brazier ◽

...

Keyword(s):

Drug Resistance ◽

Antiretroviral Therapy ◽

Sub Saharan Africa ◽

People Living With Hiv ◽

Loss To Follow Up ◽

Sub Saharan ◽

Treat All ◽

Living With Hiv ◽

International Epidemiology

ABSTRACTPurposeThe objectives of the International epidemiology Databases to Evaluate AIDS (IeDEA) are to (i) evaluate the delivery of combination antiretroviral therapy (ART) in children, adolescents and adults in sub-Saharan Africa, (ii) to describe ART regimen effectiveness, durability and tolerability, (iii) to examine HIV-related comorbidities and co-infections, and (iv) to examine the pregnancy- and HIV-related outcomes of women on ART and their infants exposed to HIV or antiretroviral therapy in utero or via breastmilk.ParticipantsIeDEA is organized in four regions (Central, East, Southern and West Africa), with 240 treatment and care sites, six data centres at African, European and US universities, and almost 1.4 million children, adolescents and adult people living with HIV (PLWHIV) enrolled.Findings to dateThe data include socio-demographic characteristics, clinical outcomes, opportunistic events, treatment regimens, clinic visits and laboratory measurements. They have been used to analyse outcomes in people living with HIV-1 or HIV-2 who initiate ART, including determinants of mortality, of switching to second-line and third-line ART, drug resistance, loss to follow-up and the immunological and virological response to different ART regimens. Programme-level estimates of mortality have been corrected for loss to follow-up. We examined the impact of co-infection with hepatitis B and C, and the epidemiology of different cancers and of (multi-drug resistant) tuberculosis, renal disease and of mental illness. The adoption of “Treat All”, making ART available to all PLWHIV regardless of CD4+ cell count or clinical stage was another important research topic.Future plansIeDEA has formulated several research priorities for the “Treat All” era in sub-Saharan Africa. It recently obtained funding to set up sentinel sites where additional data are prospectively collected on cardiometabolic risks factors as well as mental health and liver diseases, and is planning to create a drug resistance database.

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Management of idiopathic childhood nephrotic syndrome in sub-Saharan Africa: Ibadan consensus statement

Kidney International ◽

10.1016/j.kint.2020.07.045 ◽

2021 ◽

Vol 99 (1) ◽

pp. 59-67 ◽

Cited By ~ 1

Author(s):

Christopher Esezobor ◽

Adebowale D. Ademola ◽

Adewale E. Adetunji ◽

Emmanuel A. Anigilaje ◽

Anthony Batte ◽

...

Keyword(s):

Nephrotic Syndrome ◽

Consensus Statement ◽

Sub Saharan Africa ◽

Childhood Nephrotic Syndrome ◽

Sub Saharan

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Turkey's foreign policy implementation in sub-Saharan Africa: A post-international approach

New Perspectives on Turkey ◽

10.1017/s0896634600002065 ◽

2013 ◽

Vol 49 ◽

pp. 121-156 ◽

Cited By ~ 7

Author(s):

Volkan İpek ◽

Gonca Biltekin

Keyword(s):

Foreign Policy ◽

Policy Implementation ◽

Civil Society Organizations ◽

Sub Saharan Africa ◽

Theoretical Terms ◽

Turkish Foreign Policy ◽

Turkish Government ◽

International Theory ◽

State Actors ◽

Sub Saharan

Turkey's activism in Africa has been extensively noted. It has been argued that non-state actors like business and civil society organizations take part in Turkeys Africa initiative. Nevertheless, state/non-state interaction in Turkey's foreign policy implementation has not been accounted for in theoretical terms in Turkish foreign policy literature. This paper combines post-international theory and foreign policy implementation in looking at Turkey's foreign policy towards sub-Saharan Africa. We argue that adapting to the multi-centric world, the Turkish government has moved beyond conventional state-to-state dealings in implementing its foreign policy and increasingly relies on the cooperation of non-state actors.

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A systematic review and meta-analysis reveal that Campylobacter spp. and antibiotic resistance are widespread in humans in sub-Saharan Africa

PLoS ONE ◽

10.1371/journal.pone.0245951 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245951

Author(s):

Delfina F. Hlashwayo ◽

Betuel Sigaúque ◽

Emília V. Noormahomed ◽

Sónia M. S. Afonso ◽

Inácio M. Mandomando ◽

...

Keyword(s):

Antibiotic Resistance ◽

Meta Analysis ◽

Random Effect ◽

Research Priorities ◽

Sub Saharan Africa ◽

Cochrane Library ◽

African Countries ◽

Pooled Prevalence ◽

Sub Saharan ◽

The Impact

Introduction Campylobacter spp. are zoonotic bacteria that cause gastroenteritis in humans worldwide, whose main symptom is diarrhea. In certain cases, extra intestinal manifestations may occur, such as Guillain Barré syndrome. The bacteria cause severe diarrhea mostly in children and in immunocompromised individuals. This review aims to address the prevalence of Campylobacter spp. in humans in sub-Saharan Africa. It also aims to understand the impact of HIV in the prevalence, as well as to report data on antibiotic resistance and propose research priorities. Methods We followed PRISMA guidelines to find studies on the occurrence of Campylobacter spp. in humans in all countries from sub-Saharan Africa. Studies published between 2000 and 2020 were searched in PubMed, Cochrane Library, CINAHL, African Index Medicus, African Journals Online, Google Scholar and Science Direct. We have conducted a random-effect meta-analysis and calculated the proportion of resistant isolates to different antibiotics. Results and discussion We found 77 studies that described such occurrence in humans in 20 out of 53 sub-Saharan African countries. Campylobacter jejuni was the most prevalent species. Pooled prevalence was 9.9% (CI: 8.4%–11.6%). No major variations within the different sub-regions were found. Most studies reported Campylobacter spp. as the cause of diarrhea, mainly in children. Some studies reported the bacteria as a possible etiologic agent of acute flaccid paralysis and urinary tract infection. Campylobacter spp. presented a higher pooled prevalence in HIV infected patients, although not statistically significant. High proportions of resistant strains were reported for many antibiotics, including erythromycin and tetracycline. Conclusion Campylobacter spp. occur in sub-Saharan Africa, although information is scarce or inexistent for many countries. Research priorities should include investigation of the understudied species; extra intestinal manifestations; the impact of HIV infection and associated risk factors. Control strategies should be reinforced to contain the spread of this pathogen and drug resistance.

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Non-communicable diseases and reproductive health in sub-Saharan Africa: bridging the policy-implementation gaps

Reproductive Health ◽

10.1186/s12978-020-0857-8 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Sanni Yaya ◽

K. Srikanth Reddy ◽

José M. Belizán ◽

Verónica Pingray

Keyword(s):

Reproductive Health ◽

Policy Implementation ◽

Communicable Diseases ◽

Sub Saharan Africa ◽

Non Communicable Diseases ◽

Sub Saharan ◽

Implementation Gaps

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Transfusion research priorities for blood services in sub-Saharan Africa

British Journal of Haematology ◽

10.1111/bjh.14577 ◽

2017 ◽

Vol 177 (6) ◽

pp. 855-863 ◽

Cited By ~ 13

Author(s):

Imelda Bates ◽

Oliver Hassall ◽

Tonderai Mapako

Keyword(s):

Research Priorities ◽

Sub Saharan Africa ◽

Sub Saharan

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Children and adolescents on anti-retroviral therapy in Bulawayo, Zimbabwe: How many are virally suppressed by month six?

F1000Research ◽

10.12688/f1000research.22744.1 ◽

2020 ◽

Vol 9 ◽

pp. 191

Author(s):

Silungile Moyo ◽

Ronald Thulani Ncube ◽

Hemant Deepak Shewade ◽

Solwayo Ngwenya ◽

Wedu Ndebele ◽

...

Keyword(s):

Viral Suppression ◽

Secondary Data ◽

Tertiary Hospital ◽

Sub Saharan Africa ◽

Second Line ◽

Immunodeficiency Virus ◽

Unknown Status ◽

Sub Saharan ◽

Adherence Counselling ◽

Treat All

Background: Zimbabwe is one of the countries in sub-Saharan Africa disproportionately affected by human immunodeficiency virus. In the “treat all” era, we assessed the gaps in routine viral load (VL) monitoring at six months for children (0-9 years) and adolescents (10-19 years) newly initiated on anti-retroviral therapy (ART) from January 2017 to September 2018 at a large tertiary hospital in Bulawayo. Methods: In this cohort study using secondary data, we considered first VL done within six to nine months of starting therapy as ‘undergoing VL test at six months’. We classified repeat VL≥1000 copies/ml despite enhanced adherence counselling as virally unsuppressed. Results: Of 295 patients initiated on ART, 196 (66%) were children and 99 (34%) adolescents. A total 244 (83%) underwent VL test at six months, with 161 (54%) virally suppressed, 52 (18%) unsuppressed and 82 (28%) with unknown status (due to losses in the cascade). Switch to second line was seen in 35% (18/52). When compared to children, adolescents were less likely to undergo a VL test at six months (73% versus 88%, p=0.002) and more likely to have an unknown VL status (40% versus 22%, p=0.001). Conclusion: At six months of ART, viral suppression was low and losses in the cascade high.

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