Factors associated with high-risk HPV positivity in a low-resource setting in sub-Saharan Africa

2014 ◽  
Vol 210 (1) ◽  
pp. 81.e1-81.e7 ◽  
Author(s):  
Sheona M. Mitchell ◽  
Musa Sekikubo ◽  
Christine Biryabarema ◽  
Josaphat J.K. Byamugisha ◽  
Malcolm Steinberg ◽  
...  
Keyword(s):  
High Risk ◽  
Sub Saharan Africa ◽  
Factors Associated ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Sub Saharan ◽  
High Risk Hpv

scholarly journals Humanitarian Surgical Missions in Times of COVID-19: Recommendations to Safely Return to a Sub-Saharan Africa Low-Resource Setting

2021 ◽  
Author(s):  
Víctor Lopez-Lopez ◽  
Ana Morales ◽  
Elisa García-Vazquez ◽  
Miguel González ◽  
Quiteria Hernandez ◽  
...  
Keyword(s):  
Sub Saharan Africa ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Sub Saharan

scholarly journals Calibration of the Epilepsy Questionnaire for Use in a Low-Resource Setting

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Joseph O. Yaria ◽  
Adesola Ogunniyi
Keyword(s):  
Health Sector ◽  
Sub Saharan Africa ◽  
Health Providers ◽  
Good Test ◽  
Retest Reliability ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Sub Saharan ◽  
Test Retest Reliability

Background. Burden of epilepsy in sub-Saharan Africa is huge in the midst of shortage of human resource in its health sector. Using skilled staff to supervise and support lower level healthcare workers providing frontline primary healthcare is a pragmatic coping solution. But, lower level health providers face enormous challenges due to absent clinical algorithms or pragmatic rapid diagnostic tests. Objective. This study aimed to determine if the use of an epilepsy questionnaire in a traditional clinical setting would improve semiological details obtained and diagnostic accuracy. Methods. A prospective study was conducted involving patients diagnosed with epilepsy each with an eye witness who had regularly witnessed the seizures. Routine seizure history from clinical documentation and an interviewer-based questionnaire were compared. The data obtained were assessed for content, accuracy, intermethod and test-retest reliability. Results. Sixty-seven patients with a median age of 24 years were recruited. Routine seizure history had obtained less semiological details with inadequate description of nonmotor manifestations and lateralizing motor details. The questionnaire-obtained history showed higher accuracy for generalized onset seizure (0.83 vs. 0.56) and focal onset seizures (0.79 vs. 0.59). The questionnaire-obtained history also had good test-retest reliability for various semiological domains except automatisms. Conclusions. Routine seizure histories are not standardized. The use of a questionnaire goes a long way in improving semiology description in a low-resource setting and guides the health provider on what details to focus on. The use of epilepsy questionnaires should, therefore, be considered to improve semiology, especially in nonspecialist settings.

scholarly journals A Tanzanian Boy with Molecularly Confirmed X-Linked Adrenoleukodystrophy

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
M. C. J. Dekker ◽  
A. M. Sadiq ◽  
R. Mc Larty ◽  
R. M. Mbwasi ◽  
M. A. A. P. Willemsen ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Clinical History ◽  
Sub Saharan Africa ◽  
Adrenal Failure ◽  
Low Resource ◽  
Radiological Features ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Sub Saharan ◽  
Resource Environment

Adrenoleukodystrophy (ALD) is an X-linked peroxisomal disorder with classical features, which can be also recognised in a low resource setting. It had been described in various populations across the globe, but very few cases have been reported from Africa. In a boy with features of a progressive central nervous system condition and adrenal failure, ABCD1 gene screening was performed based on a clinical history and basic radiological features which were compatible with ALD. A common ABCD1 mutation was identified in this patient, which is the first report of genetically confirmed ALD in Sub-Saharan Africa. ALD is likely under recognised in those areas where there is no neurologist. This genetic confirmation widens geographical distribution of ABCD1-associated disease, and illustrates recognisability of this disorder, even when encountered in a low-resource environment.

scholarly journals Reversible deafness and blindness in a patient with cryptococcal meningitis in Tanzania

2015 ◽  
Vol 7 (4) ◽  
Author(s):  
Matt Douglas-Vail ◽  
Taylor Bechamp ◽  
Simran Gohal ◽  
Robert Soegtrop ◽  
Sarah Vitali ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Hearing Loss ◽  
Cryptococcal Meningitis ◽  
Sub Saharan Africa ◽  
Cerebrospinal Fluid Drainage ◽  
Raised Intracranial Pressure ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Sub Saharan

Cryptococcal meningitis is a common and devastating complication of advanced HIV, and is most prevalent in low resource settings in sub Saharan Africa. Raised intracranial pressure is one of the hallmarks of the disease, which can lead to visual and hearing loss and ultimately death. We present the case of a patient with visual and hearing impairment secondary to Cryptococcal meningitis successfully managed by serial cerebrospinal fluid drainage. This case highlights some of the challenges of managing this severe opportunistic infection in a low resource setting.

scholarly journals A comparison of the efficacy of microscopy versus rapid diagnostic testing in sub-Saharan Africa

2014 ◽  
Vol 83 (2) ◽  
pp. 10-12
Author(s):  
Lauren Prufer
Keyword(s):  
Diagnostic Testing ◽  
Sub Saharan Africa ◽  
Rapid Diagnostic Testing ◽  
Low Resource ◽  
Resource Setting ◽  
Appropriate Treatment ◽  
Low Resource Setting ◽  
Sub Saharan ◽  
Treatment And Diagnosis

Despite advances in treatment and diagnosis, malaria continues to cause a significant number of deaths, particularly in African children.1 Optimized diagnostic and follow-up testing is required for appropriate treatment and eventual eradication of malarial disease in sub-Saharan Africa. Microscopy is compared to rapid diagnostic testing (RDT) for use in a low-resource setting.

scholarly journals Challenges of Human Papillomavirus Infection and Associated Diseases in Low-Resource Countries

2018 ◽  
Vol 142 (6) ◽  
pp. 696-699 ◽  
Author(s):  
Michael Chukwugoziem Nweke ◽  
Clement Abu Okolo ◽  
Yara Daous ◽  
Olukemi Ayotunde Esan
Keyword(s):  
Human Papillomavirus ◽  
High Risk ◽  
Developed Countries ◽  
Hpv Infection ◽  
Sub Saharan Africa ◽  
Morbidity And Mortality ◽  
Infection Prevalence ◽  
Screening Programs ◽  
Low Resource ◽  
Sub Saharan

Context.— The prevalence of human papillomavirus (HPV) infection varies worldwide. The high-risk viruses are usually associated with cancers of the cervix, vagina, and vulva in women, cancer of the penis in men, and cancers of the anus, tonsils, oropharynx, and base of the tongue in both sexes. Objectives.— To review literature about the challenges and burden associated with HPV infection in low-resource (ie, developing) countries, focusing on sub-Saharan Africa. To review the prevention, incidence, prevalence, morbidity, and mortality of HPV infections in sub-Saharan Africa. To review the therapy and management of HPV infections in low-resource countries in comparison to developed countries. Data Sources.— Peer-reviewed literature and experience of some of the authors. Conclusions.— Sub-Saharan Africa has high HPV infection prevalence rates, with predominance of high-risk subtypes 16, 18, and 45. The difficulty of access to health care has led to higher morbidity and mortality related to HPV-related cancers. Improvement in screening programs will help in monitoring the spread of HPV infections. Survival studies can be more informative if reliable cancer registries are improved. HPV vaccination is not yet widely available and this may be the key to curtailing the spread of HPV infections in resource-poor countries.

scholarly journals HPV Genotypes and Epidemiology in Women With Cervical Cancer in Senegal.

2020 ◽  
Author(s):  
KHADIDIATOU NIANE ◽  
Cheikh Tidiane DIAGNE ◽  
Gora DIOP ◽  
Ndongo DIA ◽  
Cheikh TALLA ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
High Risk ◽  
Causes Of Death ◽  
Common Type ◽  
Sub Saharan Africa ◽  
Multiple Infections ◽  
Hpv Genotypes ◽  
Hpv Types ◽  
Sub Saharan ◽  
High Risk Hpv

Abstract Background Cases of cervical cancer are increasing steadily in sub-Saharan Africa, with over 75,000 new cases and nearly 50,000 deaths a year (Mboumba et al., 2017). In Senegal, pathologies such as cervical cancer are one of the top causes of death and the Human papillomavirus (HPV) is its aetiological agent (Steenbergen et al., 2005). Methods The aim of the study is to analyse the distribution of HPV among Senegalese women with cervical cancer. The main objective of this study is to identify the HPV types associated or “co-associated” with cervical oncogenesis in Senegal. The correlations with the risk factors of cervin carcinogenesis were analysed as well. Cervical biopsies were performed on the women admitted to Aristide Hospital Le Dantec-Julio Curie Institute. Three methods were used to detect HPV genotypes: SANGER sequencing genotyping (Applied BioSystems), PCR real-time approach technique (HPV 16 & 18 RealTime PCR kit) (www.bioneer.co.kr) and the genotyping approach from Chippron (HPV kit 3.5 LCDArray) ([email protected]). Results In this study, the sample had multiple infections (co-infections), and a majority of the coinfections were high-risk types (HR-HPV types). The most common type of HPV in our study were 16 (34.37%), 18 (23.29%), 45 (10.75%), 33 (9.94%), 59 (9.09%), (3.97%) and 31 (3.69%). Among the co-infections detected in different regions of Senegal in women with cervical cancer, we found that HPV types 16 and 18 had the highest prevalence. In the Dakar region, which had the highest number of cases, a prevalence of 17.89% of HR-HPV co-infections was found. Conclusion Polygamy could represent a cofactor in the occurrence of cervical cancer in Senegalese women. No association was found between high-risk HPV co-infections and cancer stages. However, an increase of our cohort would be necessary to affirm these hypotheses.

scholarly journals Vascularized fibula flap in the management of segmental bone loss following osteomyelitis in children at a Ugandan hospital

2021 ◽  
Vol 6 (6) ◽  
pp. 179-187
Author(s):  
Antonio Loro ◽  
Andrew Hodges ◽  
George William Galiwango ◽  
Francesca Loro
Keyword(s):  
Soft Tissue ◽  
Bone Defects ◽  
Sub Saharan Africa ◽  
Soft Tissue Envelope ◽  
Low Resource ◽  
Fibula Flap ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Vascularized Fibula ◽  
Segmental Bone

Abstract. Background: Hematogenous osteomyelitis is commonly observed in the pediatric population across sub-Saharan Africa. This retrospective case series was designed to evaluate the complications and outcomes of treatment using a vascularized fibula flap (VFF) to fill segmental bone defects secondary to osteomyelitis in children in a low-resource setting in CoRSU Rehabilitation Hospital, Uganda. Methods: Clinical notes and radiographs of children with a diagnosis of osteomyelitis that subsequently underwent a VFF procedure between October 2013 and December 2017 were reviewed. All patients were clinically and radiographically evaluated in 2019. Results: Forty-four children, with an average bone defect of 10.5 cm, were included. Eighty-four percent of children had successful VFF limb reconstruction. Integration of the graft was radiologically sound in 20.8 weeks on average. The postoperative phase was uneventful in 29 % of patients. Complications were observed in the remaining patients, including flap failure (6), donor leg neurapraxia (3), cutaneous paddle necrosis (11), graft fracture (2), skin graft loss (6), fixator failure (1) and non-union (2). Functional outcomes were rated as excellent in 13 patients, good in 14, fair in 9 and poor in 8. There was no recurrence of the bone infection in any of the enrolled children. Conclusion: Despite being a complex and demanding procedure, VFF is a good option for reconstructing post-osteomyelitis bone defects, particularly when associated with loss of soft tissue envelope. Considering the more than satisfactory functional and clinical outcomes, this procedure should be kept in mind for these complex pediatric cases of bone and soft tissue loss, even in a low-resource setting.

scholarly journals Uterine Artery Doppler Velocimetry for the Prediction of Preeclampsia among High-risk Pregnancies in Low-resource Setting: Our Experience at Aminu Kano Teaching Hospital, Kano, Nigeria

2017 ◽  
Vol 11 (3) ◽  
pp. 197-202
Author(s):  
Aliyu L Dayyabu ◽  
Murtala Yusuf ◽  
Hadiza Galadanci ◽  
Anas Ismail ◽  
Abdu H Danbatta
Keyword(s):  
High Risk ◽  
Teaching Hospital ◽  
Uterine Artery ◽  
Doppler Velocimetry ◽  
Uterine Artery Doppler ◽  
Low Resource ◽  
Uterine Arteries ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Second Trimester Screening

ABSTRACT Several Doppler studies have demonstrated an association between increased impedance to flow in uterine arteries and subsequent development of preeclampsia. This study evaluated the usefulness of uterine artery Doppler velocimetry in the prediction of preeclampsia in high-risk pregnancies. The study was a prospective cohort study carried out on 138 pregnant women attending antenatal clinic in Aminu Kano Teaching Hospital, a tertiary center in Northern Nigeria. Assessment of uterine artery blood flow by Doppler ultrasound was carried out at 20 to 24 weeks of gestation. The test was considered abnormal when the mean resistance index (RI) in the uterine arteries was .0.58 with or without diastolic notch (DN). The women were then followed up to determine those who developed preeclampsia. The prevalence of preeclampsia in this study was found to be 12.3%. Twenty one of the patients (15.2%) had high uterine artery RI (. 0.58), while 117 (84.8%) had normal RI (<0.58). The prevalence of preeclampsia was significantly higher (p < 0.05) in the group with high RI than in the group with normal RI (57.1 compared with 4.2%). Nine of the patients (6.5%) had DN, while 129 (93.5%) had no DN. The prevalence of preeclampsia was also significantly higher (p < 0.05) in the group with DN than in the group with no DN (55 compared with 9.3%). Both the sensitivity (70.5%) and specificity (92.6%) of abnormal RI in the prediction of preeclampsia were found to be high. This study confirmed the efficacy of second trimester screening for preeclampsia in high-risk pregnancies using a combination of maternal characteristics and uterine artery Doppler. How to cite this article Yusuf M, Galadanci H, Ismail A, Aliyu LD, Danbatta AH. Uterine Artery Doppler Velocimetry for the Prediction of Preeclampsia among High-risk Pregnancies in Low-resource Setting: Our Experience at Aminu Kano Teaching Hospital, Kano, Nigeria. Donald School J Ultrasound Obstet Gynecol 2017;11(3):197-202.

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