scholarly journals Incidence of HIV in Sub-Saharan Africa, 2000–2015: The Interplay Between Social Determinants and Behavioral Risk Factors

2021 ◽  
Author(s):  
Deepa Jahagirdar ◽  
Magdalene Walters ◽  
Avina Vongpradith ◽  
Xiaochen Dai ◽  
Amanda Novotney ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Incidence Rates ◽  
Sub Saharan Africa ◽  
Behavioral Risk ◽  
Hiv Incidence ◽  
Hiv Knowledge ◽  
African Countries ◽  
Final Model ◽  
Sub Saharan ◽  
Disease Study

AbstractHIV incidence in sub-Saharan Africa declined substantially between 2000 and 2015. In this analysis, we consider the relative associations of nine structural and individual determinants with this decline. A linear mixed effects model of logged HIV incidence rates versus determinants was used. The data were from mathematical modelling as part of the 2019 Global Burden of Disease Study in 43 sub-Saharan African countries. We used forwards selection to determine a single final model of HIV incidence rate. The association of economic variables and HIV knowledge with incidence was found to be driven by education, while ART coverage had the largest impact on other determinants’ coefficients. In the final model, education years per capita contributed the most to explaining variation in HIV incidence rates; a 1-year increase in mean education years was associated with a 0.39 (− 0.56; − 0.2, t = − 4.48 p < 0.01) % decline in incidence rate while a unit increase in ART coverage was associated with a 0.81 (− 1.34; − 0.28, t = − 3.01, p < 0.01) % decline in incidence rate.

scholarly journals The recent evolution of the HIV rates in Sub-Saharan Africa: Do differences still persist?

2019 ◽  
Author(s):  
antonio montañés bernal ◽  
Cristina Martínez
Keyword(s):  
Null Hypothesis ◽  
Incidence Rates ◽  
Sub Saharan Africa ◽  
Female Education ◽  
Prevalence Rates ◽  
African Countries ◽  
Total Incidence ◽  
Immunodeficiency Virus ◽  
Patterns Of Behavior ◽  
Sub Saharan

Abstract Background This paper studies the evolution of the human immunodeficiency virus (HIV) prevalence and incidence rates in Sub-Saharan African countries, paying special attention to the possible presence of a unique pattern of behavior of these variables across the mentioned countries during the 1990-2016 period. Methods We employ time series methods designed to analyze the hypothesis of convergence. We apply these tests to prevalence and incidence rates of the Sub-Saharan African countries for the 1990-2016 period. Results We cannot reject the null hypothesis of convergence for male prevalence rates and total incidence rates. By contrast, we can observe divergence in female prevalence rates, Conclusion The evolution of the male prevalence rates and incidence rates is quite similar for the Sub-Saharan countries. But, we can still find different patterns of behavior for female prevalence rates. Therefore, the recent HIV-oriented policies have not been able to control its transmission yet. We can also appreciate that some socioeconomic variables play a crucial role to explain the different behaviors of female prevalence rates, especially the level of female education. So, focusing on this variable is crucial to control this pandemia.

scholarly journals Clusters of sub-Saharan African countries based on sociobehavioural characteristics and associated HIV incidence

2019 ◽  
Author(s):  
Aziza Merzouki ◽  
Janne Estill ◽  
Erol Orel ◽  
Kali Tal ◽  
Olivia Keiser
Keyword(s):  
National Level ◽  
Principal Component ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
People Living With Hiv ◽  
Hiv Incidence ◽  
African Countries ◽  
Aggregated Data ◽  
Sub Saharan ◽  
Ssa Countries

AbstractIntroductionHIV incidence varies widely between sub-Saharan African (SSA) countries. This variation coincides with a substantial sociobehavioural heterogeneity, which complicates the design of effective interventions. In this study, we investigated how sociobehavioural heterogeneity in sub-Saharan Africa could account for the variance of HIV incidence between countries.MethodsWe analysed aggregated data, at the national-level, from the most recent Demographic and Health Surveys of 29 SSA countries [2010-2017], which included 594’644 persons (183’310 men and 411’334 women). We preselected 48 demographic, socio-economic, behavioural and HIV-related attributes to describe each country. We used Principal Component Analysis to visualize sociobehavioural similarity between countries, and to identify the variables that accounted for most sociobehavioural variance in SSA. We used hierarchical clustering to identify groups of countries with similar sociobehavioural profiles, and we compared the distribution of HIV incidence (estimates from UNAIDS) and sociobehavioural variables within each cluster.ResultsThe most important characteristics, which explained 69% of sociobehavioural variance across SSA among the variables we assessed were: religion; male circumcision; number of sexual partners; literacy; uptake of HIV testing; women’s empowerment; accepting attitude toward people living with HIV/AIDS; rurality; ART coverage; and, knowledge about AIDS. Our model revealed three groups of countries, each with characteristic sociobehavioural profiles. HIV incidence was mostly similar within each cluster and different between clusters (median(IQR); 0.5/1000(0.6/1000), 1.8/1000(1.3/1000) and 5.0/1000(4.2/1000)).

scholarly journals The Trend of HIV/AIDS Incidence and Risks Associated with Age, Period, and Birth Cohort in Four Central African Countries

2021 ◽  
Vol 18 (5) ◽  
pp. 2564
Author(s):  
Nodjimadji Tamlengar Martial ◽  
Sumaira Mubarik ◽  
Chuanhua Yu
Keyword(s):  
Incidence Rates ◽  
Sub Saharan Africa ◽  
African Countries ◽  
The Sustainable Development ◽  
Relative Risks ◽  
Republic Of The Congo ◽  
Sub Saharan ◽  
Using Data ◽  
Global Burden Of Diseases ◽  
Hiv Aids

The HIV/AIDS incidence rates have decreased in African countries although the rates are still high in Sub-Saharan Africa. Our study aimed to examine the long-term trend of the overall HIV/AIDS incidence rates in four countries of the central region of Africa, using data from the Global Burden of Diseases (GBD) 2019 study. The Age–Period–Cohort statistical model analysis was used to measure the trends of HIV/AIDS incidence rates in each of the four countries. HIV/AIDS incidence rates decreased slowly in Cameroon (CAM), Chad, and Central African Republic (CAR), but considerably in the Democratic Republic of the Congo (DRC) from 1990–2019. HIV/AIDS incidence rates in the four countries were at their peaks in the age group of 25–29 years. According to the age relative risks, individuals aged between 15 and 49 years old are at high risk of HIV/AIDS incidence in the four countries. The period and cohort relative risks have decreased in all four countries. Although CAM recorded an increase of 59.6% in the period relative risks (RRs) between 1990 and 1999, HIV/AIDS incidence has decreased dramatically in all four countries, especially after 2000. The decrease of the period RRs (relative risk) by nearly 20.6-folds and the decrease of the cohort RRs from 147.65 to almost 0.0034 in the DRC made it the country with the most significant decrease of the period and cohort RRs compared to the rest. HIV/AIDS incidence rates are decreasing in each of the four countries. Our study findings could provide solid ground for policymakers to promptly decrease HIV/AIDS incidence by strengthening the prevention policies to eliminate the public health threat of HIV/AIDS by 2030 as one of the targets of the Sustainable Development Goals (SDGs).

scholarly journals Comparative incidence of adverse drug reaction during the first and subsequent year of antiretroviral therapy in a Nigerian HIV infected cohort

2021 ◽  
Vol 21 (3) ◽  
pp. 1027-1039
Author(s):  
Isaac O Abah ◽  
Wetkos D Dayom ◽  
Dauda A Dangiwa ◽  
Roseline Aderemi-Williams ◽  
Joseph Anejo-Okopi ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Incidence Rate ◽  
Adverse Drug Events ◽  
Late Onset ◽  
Treatment Success ◽  
Incidence Rates ◽  
Sub Saharan Africa ◽  
First Year ◽  
Resource Limited ◽  
Sub Saharan

Background: Despite close to two decades of antiretroviral therapy (ART) in Nigeria, data on late on-onset ART-associated adverse drug reactions (ADRs) are sparse. Objectives: To describe early and late-onset ADRs and compare their incidence in an outpatient HIV positive Cohort on ART. Method: We described the incidence of clinical ADRs identified and documented in an outpatient clinic cohort of HIV-pos- itive patients treated between June 2004 and December 2015 at a tertiary health facility in Nigeria. Incidence rates of ADRs during the first and subsequent years of ART were compared. Results: of the 13,983 patients’ data analyzed, 9317 were females (66%), and those in the age bracket of 25 to 45 years made up 78% of the studied population. During 52,411 person-years (py) of ART, 1485 incident ADRs were recorded; Incidence rate (IR) 28.3 (95% confidence interval [CI] 26.9:29.8) ADRs per 1000 person-years (py) of ART. The IR of ADRs was about two times higher in the first year of ART compared to subsequent years of treatment; crude incidence rate ratio (IRR) 1.77 (95% CI 1.59:1.97). Anemia, hypersensitivity reactions, and nervous system disorders had 7, 23, and 5 times higher incidence, respectively, in the first year of therapy, compared to subsequent years. Conclusion: The first year of ART is the period of highest risk of ADRs. Individual and programmatic treatment success in resource-limited settings requires strategies for early identification and management of ADR during the period of greatest risk of ADRs. Keywords: Adverse drug events; antiretroviral therapy; drug toxicity; sub- Saharan Africa.

The role of mHealth in chronic disease management in Sub-Saharan Africa

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V M Pedrosa ◽  
A V Abrantes
Keyword(s):  
Information And Communication Technologies ◽  
Mobile Phones ◽  
Text Messages ◽  
Sub Saharan Africa ◽  
Behavioral Risk ◽  
African Countries ◽  
Middle Income ◽  
Individual Interviews ◽  
Information And Communication ◽  
Sub Saharan

Abstract Background The burden of non-communicable diseases has been increasing in Sub-Saharan Africa, mainly due to the adoption of behavioral risk factors by the population. At the same time, there has been an exponential growth in the information and communication technologies sector, which has attracted interest in the development of mobile health strategies (mHealth) through the potential use of mobile phones in the management of chronic conditions such as hypertension. Methods It was performed a systematic review of the literature using scientific databases (Cochrane, B On, Science Direct, and Google Scholar). Inclusion criteria included: quantitative and qualitative studies developed between 2010 and 2018 in Sub-Saharan African countries, with adult participants of both sexes, diagnosed with hypertension, with access to mobile phones and attending primary health care or outpatient appointments. Results Five studies were selected for review (four from South Africa and one from Ghana). However, only two studies managed to obtain results which proved that the use of text messages was efficient and accepted during hypertension treatment, as well as it could allow understanding the factors that influence and hinder therapeutic adherence. Those results were supported by information from a randomized trial (use of clinical comparators as evaluation of blood pressure values during a follow-up period of 12 months) and a qualitative study (self-reported changes in the knowledge and health behavior of 15 participants from focus groups and individual interviews). Conclusions There's still a lack of evidence available proving that mHealth can be efficient and feasible in Sub-Saharan Africa. However, it was possible to present a conceptual framework, adapted from the literature, which identifies potential strategies for the use of mHealth in areas of prevention and management of chronic diseases in the region. Key messages Provide guidance to improve research about the adoption of mHealth in low and middle-income countries. Promote the potential of this type of technology as a model for mutual health education.

scholarly journals Geospatial assessment of the voluntary medical male circumcision programme in Tanzania, 2011–2016

2019 ◽  
Vol 4 (6) ◽  
pp. e001922
Author(s):  
Hana Kim ◽  
Adam Branscum ◽  
F DeWolfe Miller ◽  
Diego F Cuadros
Keyword(s):  
Incidence Rate ◽  
Male Circumcision ◽  
Age Groups ◽  
Incidence Rates ◽  
Sub Saharan Africa ◽  
Voluntary Medical Male Circumcision ◽  
Cross Sectional ◽  
Medical Male Circumcision ◽  
Substantial Progress ◽  
Sub Saharan

IntroductionTanzania is one of the 14 priority countries in sub-Saharan Africa scaling up voluntary medical male circumcision (VMMC) for HIV prevention. In this study, we assessed the progress of VMMC by evaluating changes in the spatial structure of male circumcision (MC) prevalence and identifying age groups with low MC uptake.MethodsWe use data from two waves of the Demographic and Health Survey (DHS) conducted in Tanzania in 2011–2012 and 2015–2016. MC incidence rate was estimated using a method developed to calculate incidence rates from two successive cross-sectional surveys. Continuous surface maps of MC prevalence were generated for both DHS waves and compared with identified areas with high MC prevalence changes and high density of uncircumcised males.ResultsNational MC prevalence in Tanzania increased from 73.5% in 2011–2012 to 80.0% in 2015–2016. The estimated national MC incidence rate was 4.6 circumcisions per 100 person-years (py). The lowest circumcision rate was observed in males aged 20–24 years, with 0.61 circumcisions per 100 py. An estimated 1 567 253 males aged 15–49 years residing in low-MC prevalence areas were uncircumcised in 2015–2016.ConclusionTanzania has shown substantial progress in the implementation of VMMC. However, extensive spatial variation of MC prevalence still exists in the country, with some areas having an MC prevalence <60%. Here, we identified locations where VMMC needs to be intensified to reach the ~1.5 million uncircumcised males age 15–49 living in these low-MC areas, particularly for men aged 20–34.

Crowdsourcing Covid-19 signals in sub-Saharan Africa: Leveraging digital contributor networks for participatory surveillance of Covid-19 symptoms and deaths (Preprint)

2020 ◽  
Author(s):  
Ngozi A Erondu ◽  
Sagal A Ali ◽  
Mohamed Ali ◽  
Schadrac C Agbla
Keyword(s):  
Public Health ◽  
Sub Saharan Africa ◽  
Specific Information ◽  
Surveillance Systems ◽  
Health Seeking ◽  
African Countries ◽  
Cross Sectional Survey ◽  
Local Networks ◽  
The World ◽  
Sub Saharan

BACKGROUND In sub-Saharan Africa, underreporting of cases and deaths has been attributed to various factors including, weak disease surveillance, low health-seeking behaviour of flu like symptoms, and stigma of Covid-19. There is evidence that SARS-CoV-2 spread mimics transmission patterns of other countries across the world. Since the Covid-19 pandemic has changed the way research can be conducted and in light of restrictions on travel and risks to in-person data collection, innovative approaches to collecting data must be considered. Nearly 50% of Africa’s population is a unique mobile subscriber and it is one of the fastest growing smart-phone marketplaces in the world; hence, mobile phone platforms should be considered to monitor Covid-19 trends in the community. OBJECTIVE We demonstrate the use of digital contributor platforms to survey individuals about cases of flu-like symptoms and instances of unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia, and Zimbabwe. METHODS Rapid cross-sectional survey of individuals with severe flu and pneumonia symptoms and unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia and Zimbabwe RESULTS Using a non-health specific information platform, we found COVID-19 signals in five African countries, specifically: •Across countries, nearly half of the respondents (n=739) knew someone who had severe flu or pneumonia symptoms in recent months. •One in three respondents from Somalia and one in five from Zimbabwe respondents said they knew more than five people recently displaying flu and/or pneumonia symptoms. •In Somalia there were signals that a large number of people might be dying outside of health facilities, specifically in their homes or in IDP or refugee camps. CONCLUSIONS Existing digital contributor platforms with local networks are a non-traditional data source that can provide information from the community to supplement traditional government surveillance systems and academic surveys. We demonstrate that using these distributor networks to for community surveys can provide periodic information on rumours but could also be used to capture local sentiment to inform public health decision-making; for example, these insights could be useful to inform strategies to increase confidence in Covid19 vaccine. As Covid-19 continues to spread somewhat silently across sub-Saharan Africa, regional and national public health entities should consider expanding event-based surveillance sources to include these systems.

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