Prevalence of active convulsive epilepsy in sub-Saharan Africa and associated risk factors: cross-sectional and case-control studies

Introduction. In sub-Saharan Africa (SSA), there is a significant burden of ischemic stroke (IS) and hemorrhagic stroke (HS), although data on risk factors for each type are sparse. In this systematic review we attempt to characterize the risk factors. Methods. We systematically reviewed (PubMed, EMBASE, WHOLIS, Google Scholar, Wiley online, and the Cochrane Central Register of Controlled Trials (CENTRAL)) case-control studies and case series from 1980 to 2016 that reported risk factors for IS and/or HS in SSA. For each risk factor we calculated random-effects pooled odds ratios (ORs) for case-control studies and pooled prevalence estimates for case series. Results. We identified 12 studies, including 4,387 stroke patients. Pooled analysis showed that patients who had diabetes (OR = 2.39; 95% CI: 1.14–5.03) and HIV (OR = 2.46 (95% CI: 1.59–3.81) were at a significantly greater risk of suffering from all stroke types. There were insufficient data to examine these factors by stroke type. Among case series, the pooled prevalence of hypertension was higher for HS than for IS (73.5% versus 62.8%), while diabetes mellitus (DM) and atrial fibrillation (AF) were more prevalent among IS compared to HS (15.9% versus 10.6% and 9.6% versus 2.3%, respectively). Conclusions. There remain too few data from SSA to reliably estimate the effect of various factors on the risk of IS and HS. Furthermore, the vast majority of cases were identified in hospital and so are unlikely to be representative of the totality of stroke cases in the community.

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Inflammatory bowel disease in sub-Saharan Africa: a protocol of a prospective registry with a nested case–control study

BMJ Open ◽

10.1136/bmjopen-2020-039456 ◽

2020 ◽

Vol 10 (12) ◽

pp. e039456

Author(s):

Leolin Katsidzira ◽

Wisdom F Mudombi ◽

Rudo Makunike-Mutasa ◽

Bahtiyar Yilmaz ◽

Annika Blank ◽

...

Keyword(s):

Risk Factors ◽

Inflammatory Bowel Disease ◽

Case Control Study ◽

Alpha Diversity ◽

Case Control ◽

Sub Saharan Africa ◽

Inflammatory Bowel ◽

Sub Saharan ◽

Nested Case Control ◽

Control Study

IntroductionThe epidemiology of inflammatory bowel disease (IBD) in sub-Saharan Africa is poorly documented. We have started a registry to determine the burden, phenotype, risk factors, disease course and outcomes of IBD in Zimbabwe.Methods and analysisA prospective observational registry with a nested case–control study has been established at a tertiary hospital in Harare, Zimbabwe. The registry is recruiting confirmed IBD cases from the hospital, and other facilities throughout Zimbabwe. Demographic and clinical data are obtained at baseline, 6 months and annually. Two age and sex-matched non-IBD controls per case are recruited—a sibling or second-degree relative, and a randomly selected individual from the same neighbourhood. Cases and controls are interviewed for potential risk factors of IBD, and dietary intake using a food frequency questionnaire. Stool is collected for 16S rRNA-based microbiota profiling, and along with germline DNA from peripheral blood, is being biobanked. The estimated sample size is 86 cases and 172 controls, and the overall registry is anticipated to run for at least 5 years. Descriptive statistics will be used to describe the demographic and phenotypic characteristics of IBD, and incidence and prevalence will be estimated for Harare. Risk factors for IBD will be analysed using conditional logistic regression. For microbial analysis, alpha diversity and beta diversity will be compared between cases and controls, and between IBD phenotypes. Mann-Whitney U tests for alpha diversity and Adonis (Permutational Multivariate Analysis of Variance) for beta diversity will be computed.Ethics and disseminationEthical approval has been obtained from the Parirenyatwa Hospital’s and University of Zimbabwe’s research ethics committee and the Medical Research Council of Zimbabwe. Findings will be discussed with patients, and the Zimbabwean Ministry of Health. Results will be presented at scientific meetings, published in peer reviewed journals, and on social media.Trial registration numberNCT04178408.

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The prevalence, awareness, management and control of hypertension in men and women in Benin, West Africa: the TAHES study

BMC Cardiovascular Disorders ◽

10.1186/s12872-019-01273-7 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Ileana Desormais ◽

Salimanou Ariyoh Amidou ◽

Yessito Corine Houehanou ◽

Stephan Dismand Houinato ◽

Gwladys Nadia Gbagouidi ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Large Population ◽

Community Dwelling ◽

Sub Saharan Africa ◽

Rural Setting ◽

World Health ◽

Cross Sectional ◽

Men And Women ◽

Sub Saharan

Abstract Background Due to epidemiological transitions, Sub-Saharan Africa is facing a growing burden of non-communicable diseases, including cardiovascular diseases (CVDs). Among their risk factors, hypertension is a major determinant of CVDs, but the prevalence and level of awareness and management of this condition are poorly studied in African populations. The aim of this study was to determine the prevalence of hypertension and identify its associated risk factors as well as the awareness and management of this condition in a community-dwelling cohort in Benin. Methods A cross-sectional door-to-door study was conducted in the population over the age of 25 years in Tanve, a rural setting in Benin. The questionnaire and anthropometric measurements of the World Health Organization STEPWISE survey were used. Blood pressure was measured using standard procedures. Results The sample included 1777 subjects (60.9% females, mean age was 42.5 ± 16.5 years). The prevalence of hypertension was 32.9%, similar in men (32.8%) and women (33.0%, p = 0.9342). Age and obesity were significantly associated with hypertension. Less than half (42%) of hypertensive people were aware about their condition and only 46.3% of them were treated. Awareness ratios differed between men and women (respectively 32.9% vs. 47.5%; p = 0.0039) and was not influenced by age, education, occupation, marital status or income. Female sex was the only factor associated with better controlled HTN, independent of socio-economic parameters. Conclusion This large population-based study confirms the high prevalence, low awareness, and low control of hypertension in men and women in sub-Saharan Africa. Only half of the populations with hypertension are aware of their hypertension, indicating a high burden of undiagnosed and un-controlled high blood pressure in these populations.

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Comparative analysis of lactic acidosis induced by linezolid and vancomycin therapy using cohort and case–control studies of incidence and associated risk factors

European Journal of Clinical Pharmacology ◽

10.1007/s00228-017-2377-1 ◽

2017 ◽

Vol 74 (4) ◽

pp. 405-411 ◽

Cited By ~ 3

Author(s):

Nobuaki Mori ◽

Yoshio Kamimura ◽

Yuki Kimura ◽

Shoko Hirose ◽

Yasuko Aoki ◽

...

Keyword(s):

Risk Factors ◽

Comparative Analysis ◽

Lactic Acidosis ◽

Case Control ◽

Case Control Studies ◽

Vancomycin Therapy ◽

Associated Risk Factors

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Risk factors for chronic fatigue syndrome/myalgic encephalomyelitis: a systematic scoping review of multiple predictor studies

Psychological Medicine ◽

10.1017/s0033291707001602 ◽

2007 ◽

Vol 38 (7) ◽

pp. 915-926 ◽

Cited By ~ 15

Author(s):

S. Hempel ◽

D. Chambers ◽

A.-M. Bagnall ◽

C. Forbes

Keyword(s):

Risk Factors ◽

Chronic Fatigue Syndrome ◽

Scoping Review ◽

Chronic Fatigue ◽

Case Control ◽

Myalgic Encephalomyelitis ◽

Case Control Studies ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Fatigue Syndrome

BackgroundThe aetiology of chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is still unknown. The identification of risk factors for CFS/ME is of great importance to practitioners.MethodA systematic scoping review was conducted to locate studies that analysed risk factors for CFS/ME using multiple predictors. We searched for published and unpublished literature in 11 electronic databases, reference lists of retrieved articles and guideline stakeholder submissions in conjunction with the development of a forthcoming national UK guideline. Risk factors and findings were extracted in a concise tabular overview and studies synthesized narratively.ResultsEleven studies were identified that met inclusion criteria: two case-control studies, four cohort studies, three studies combining a cohort with a case-control study design, one case-control and twin study and one cross-sectional survey. The studies looked at a variety of demographic, medical, psychological, social and environmental factors to predict the development of CFS/ME. The existing body of evidence is characterized by factors that were analysed in several studies but without replication of a significant association in more than two studies, and by studies demonstrating significant associations of specific factors that were not assessed in other studies. None of the identified factors appear suitable for the timely identification of patients at risk of developing CFS/ME within clinical practice.ConclusionsVarious potential risk factors for the development of CFS/ME have been assessed but definitive evidence that appears meaningful for clinicians is lacking.

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Estimating the impact of pneumococcal conjugate vaccines on childhood pneumonia in sub-Saharan Africa: A systematic review

10.1101/865154 ◽

2019 ◽

Cited By ~ 2

Author(s):

Chukwuemeka Onwuchekwa ◽

Edem Bassey ◽

Victor Williams ◽

Emmanuel Oga

Keyword(s):

Systematic Review ◽

Pneumococcal Pneumonia ◽

Data Extraction ◽

Case Control ◽

Sub Saharan Africa ◽

Case Control Studies ◽

Childhood Pneumonia ◽

Vaccine Impact ◽

Sub Saharan ◽

The Impact

AbstractBackgroundThe impact of pneumococcal conjugate vaccine introduction in reducing the incidence of childhood pneumonia has not been well documented in sub-Saharan Africa. Many studies evaluating vaccine impact have used invasive pneumococcal disease or pneumococcal pneumonia as an outcome.ObjectiveTo estimate the impact of routine administration of 10-valent and 13-valent PCV on the incidence of pneumonia in children under five years of age in sub-Saharan Africa.Data sourcesA systematic review was conducted between 16 and 31 July 2019. The review was registered on PROSPERO with registration number CRD42019142369. The literature search was conducted in indexed databases including Medline and Embase, grey literature databases and online libraries of two universities. Manual search of the references of included studies was performed to identify additional relevant studies. The search strategy combined pneumococcal conjugate vaccine, pneumonia and child as search concepts.Study selectionStudies investigating the impact of 10- or13-valent PCV on childhood pneumonia in a sub-Saharan African country were eligible for inclusion. Case-control, cohort, pre-post and time-series study designs were eligible for inclusion. Exclusion criteria were use of 7- or 9-valent PCV, systematic review studies, clinical trials and record publication prior to 2009.Data extractionIndependent data extraction was conducted. Key variables include year study conducted, type of study design, type of PCV used and year of introduction, reported PCV coverage, outcome measure evaluated and the effect measure.Data synthesisEight records were included in the final analysis, 6 records were pre-post or time-series studies, 1 was a case-control study and 1 report combined pre-post and case-control studies. Vaccine impact measured as percentage reduction in risk (%RR) of clinical pneumonia was mostly small and non-significant. The risk reduction was more significant and consistent on radiological and pneumococcal pneumonia. Vaccine effectiveness reported in case-control studies was mostly non-significant.ConclusionEvidence of the positive impact of routine infant pneumococcal vaccination on pneumonia in sub-Saharan Africa is weak. There is a need for more research in this area to evaluate the influence of pathogen or serotype replacement in pneumonia after PCV introduction. Ongoing surveillance is also required to establish the long term trend in pneumonia epidemiology after PCV introduction.

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The Prevalence, Awareness, Management and Control of Hypertension in Men and Women in Benin, West Africa: the TAHES study.

10.21203/rs.2.14078/v2 ◽

2019 ◽

Author(s):

ILEANA DESORMAIS ◽

Salimanou Ariyoh Amidou ◽

Yessito Corine Houehanou ◽

Stephan Dismand Houinato ◽

Gwladys Nadia Gbagouidi ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Large Population ◽

Community Dwelling ◽

Sub Saharan Africa ◽

Rural Setting ◽

World Health ◽

Cross Sectional ◽

Men And Women ◽

Sub Saharan

Abstract Background Sub-Saharan Africa is facing a growing burden of non-communicable diseases, including cardiovascular diseases (CVDs), due to epidemiological transitions. Among their risk factors, hypertension is a major determinant of CVDs, but the prevalence and level of awareness and management of this condition are poorly studied in African populations. The aim of this study was to determine the prevalence of hypertension and identify its associated risk factors as well as the awareness and management of this condition in a community-dwelling cohort in Benin. Methods A cross-sectional door-to-door study was conducted in the population over the age of 25 years in Tanve, a rural setting in Benin. The questionnaire and anthropometric measurements of the World Health Organization STEPWISE survey were used. Blood pressure was measured using standard procedures. Results The sample included 1777 subjects (60.9% females, mean age was 42.5±16.5 years). The prevalence of hypertension was 32.9%, similar in men (32.8%) and women (33.0%, p=0.9342). Age and obesity were significantly associated with hypertension. Less than half (42%) of hypertensive people were aware about their condition and only 46.3% of them were treated. Awareness ratios differed between men and women (respectively 32.9% vs. 47.5%; p= 0.0039) and was not influenced by age, education, occupation, marital status or income. Female sex was the only factor associated with better controlled HTN, independent of socio-economic parameters. Conclusion This large population-based study confirms the high prevalence, low awareness, and low control of hypertension in men and women in sub-Saharan Africa. Only half of the populations with hypertension are aware of their hypertension, indicating a high burden of undiagnosed and un-controlled high blood pressure in these populations.

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Sachet water consumption as a risk factor for cholera in urban settings: Findings from a case control study in Kinshasa, Democratic Republic of the Congo during the 2017–2018 outbreak

PLoS Neglected Tropical Diseases ◽

10.1371/journal.pntd.0009477 ◽

2021 ◽

Vol 15 (7) ◽

pp. e0009477

Author(s):

Placide Mbala-Kingebeni ◽

Florian Vogt ◽

Berthe Miwanda ◽

Tresor Sundika ◽

Nancy Mbula ◽

...

Keyword(s):

Risk Factors ◽

Democratic Republic ◽

Case Control Study ◽

Case Control ◽

Sub Saharan Africa ◽

P Value ◽

Republic Of The Congo ◽

Sub Saharan ◽

Context Specific ◽

Control Study

Background Behavioural risk factors for cholera are well established in rural and semi-urban contexts, but not in densely populated mega-cities in Sub-Saharan Africa. In November 2017, a cholera epidemic occurred in Kinshasa, the Democratic Republic of the Congo, where no outbreak had been recorded for nearly a decade. During this outbreak, we investigated context-specific risk factors for cholera in an urban setting among a population that is not frequently exposed to cholera. Methodology/Principal findings We recruited 390 participants from three affected health zones of Kinshasa into a 1:1 matched case control study. Cases were identified from cholera treatment centre admission records, while controls were recruited from the vicinity of the cases’ place of residence. We used standardized case report forms for the collection of socio-demographic and behavioural risk factors. We used augmented backward elimination in a conditional logistic regression model to identify risk factors. The consumption of sachet water was strongly associated with the risk of being a cholera case (p-value 0.019), which increased with increasing frequency of consumption from rarely (OR 2.2, 95% CI 0.9–5.2) to often (OR 4.0, 95% CI 1.6–9.9) to very often (OR 4.1, 95% CI 1.0–16.7). Overall, more than 80% of all participants reported consumption of this type of drinking water. The risk factors funeral attendance and contact with someone suffering from diarrhoea showed a p-value of 0.09 and 0.08, respectively. No socio-demographic characteristics were associated with the risk of cholera. Conclusions/Significance Drinking water consumption from sachets, which are sold informally on the streets in most Sub-Saharan African cities, are an overlooked route of infection in urban cholera outbreaks. Outbreak response measures need to acknowledge context-specific risk factors to remain a valuable tool in the efforts to achieve national and regional targets to reduce the burden of cholera in Sub-Saharan Africa.

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