Schistosomiasis in infants and pre-school-aged children in sub-Saharan Africa: implication for control

Parasitology ◽  
2012 ◽  
Vol 139 (7) ◽  
pp. 835-841 ◽  
Author(s):  
UWEM F. EKPO ◽  
AKINOLA S. OLUWOLE ◽  
ENIOLA M. ABE ◽  
HANNAH E. ETTA ◽  
FRANCISCA OLAMIJU ◽  
...  
Keyword(s):  
Sub Saharan Africa ◽  
African Countries ◽  
Schistosomiasis Control ◽  
School Aged Children ◽  
Control Programmes ◽  
Sub Saharan ◽  
Receive Treatment ◽  
Available Information ◽  
And Control

SUMMARYUntil recently, the epidemiology and control of schistosomiasis in sub-Saharan Africa have focused primarily on infections in school-aged children and to a lesser extent on adults. Now there is growing evidence and reports of infection in infants and pre-school-aged children (⩽6 years old) in Ghana, Kenya, Mali, Niger, Nigeria and Uganda, with reported prevalence from 14% to 86%. In this review, we provide available information on the epidemiology, transmission and control of schistosomiasis in this age group, generally not considered or included in national schistosomiasis control programmes that are being implemented in several sub-Saharan African countries. Contrary to previous assumptions, we show that schistosomiasis infection starts from early childhood in many endemic communities and factors associated with exposure of infants and pre-school-aged children to infection are yet to be determined. The development of morbidity early in childhood may contribute to long-term clinical impact and severity of schistosomiasis before they receive treatment. Consistently, these issues are overlooked in most schistosomiasis control programmes. It is, therefore, necessary to review current policy of schistosomiasis control programmes in sub-Saharan Africa to consider the treatment of infant and pre-school-aged children and the health education to mothers.

scholarly journals Competing interests, clashing ideas and institutionalizing influence: insights into the political economy of malaria control from seven African countries

2020 ◽  
Author(s):  
Justin Parkhurst ◽  
Ludovica Ghilardi ◽  
Jayne Webster ◽  
Robert W Snow ◽  
Caroline A Lynch
Keyword(s):  
Decision Making ◽  
Malaria Control ◽  
Qualitative Interviews ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Health Community ◽  
Control Programmes ◽  
Control Decision ◽  
Sub Saharan ◽  
Economic Considerations

Abstract This article explores how malaria control in sub-Saharan Africa is shaped in important ways by political and economic considerations within the contexts of aid-recipient nations and the global health community. Malaria control is often assumed to be a technically driven exercise: the remit of public health experts and epidemiologists who utilize available data to select the most effective package of activities given available resources. Yet research conducted with national and international stakeholders shows how the realities of malaria control decision-making are often more nuanced. Hegemonic ideas and interests of global actors, as well as the national and global institutional arrangements through which malaria control is funded and implemented, can all influence how national actors respond to malaria. Results from qualitative interviews in seven malaria-endemic countries indicate that malaria decision-making is constrained or directed by multiple competing objectives, including a need to balance overarching global goals with local realities, as well as a need for National Malaria Control Programmes to manage and coordinate a range of non-state stakeholders who may divide up regions and tasks within countries. Finally, beyond the influence that political and economic concerns have over programmatic decisions and action, our analysis further finds that malaria control efforts have institutionalized systems, structures and processes that may have implications for local capacity development.

scholarly journals Electronic Cigarettes for Curbing the Tobacco-Induced Burden of Noncommunicable Diseases: Evidence Revisited with Emphasis on Challenges in Sub-Saharan Africa

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Jobert Richie N. Nansseu ◽  
Jean Joel R. Bigna
Keyword(s):  
Tobacco Smoking ◽  
Electronic Cigarettes ◽  
Sub Saharan Africa ◽  
Noncommunicable Diseases ◽  
Quit Smoking ◽  
Sub Saharan ◽  
Never Smokers ◽  
Second Hand Smoking ◽  
And Control

Introduction. This review examines whether electronic cigarettes (e-cigs) implementation or vulgarization in sub-Saharan Africa (SSA) could be helpful in curtailing the toll of tobacco smoking in the region. Discussion. There are about 1.3 billion smokers worldwide, with nearly 80% of them living in developing countries where the burden of tobacco-related illnesses and deaths is the heaviest. Studies report that e-cigs may facilitate smoking cessation, reduction, or abstinence and may pose only a small fraction of the risks of traditional tobacco cigarettes; e-cigs may also considerably reduce second-hand smoking. Thereby, implementation of e-cig use could help to substantially reduce the burden driven by tobacco smoking in SSA, in a particular context of lack of regulations and control policies towards this threat. However, the evidence is not clear on whether e-cigs are risk-free, especially if used in the long term. Conclusions. On the whole, if e-cigs were to be introduced in SSA, they should be strictly recommended to current and/or ex-smokers as a method to quit smoking or prevent relapse and never-smokers should be strongly encouraged to avoid using these devices. Bans on sales of e-cigs to youngsters should be legislated, e-cig advertisements prohibited, and their usage continuously controlled and monitored.

scholarly journals African agriculture in the context of COVID-19: Finding salvation in the devil

2020 ◽  
Vol 15 (4) ◽  
pp. 302-310
Author(s):  
Guy Blaise Nkamleu ◽  
Keyword(s):  
Agricultural Development ◽  
Agricultural Sector ◽  
Food System ◽  
Free Trade Area ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Agriculture Sector ◽  
Sub Saharan ◽  
The Impact

The world is facing unprecedented challenges from COVID-19, which is disrupting lives and livelihoods. The pandemic could profoundly affect the African continent and wipe out hard-won development gains, as sub-Saharan Africa heads into its first recession in 25 years. Beyond the multispatial impact of the coronavirus in Africa, its effects on the agriculture and food system is of particular interest, as food security could be the most affected area and, at the same time, agriculture could be the sector that could help African economies recover quicker from the impact of COVID19. This paper supports the view that COVID-19, as devilish as it may be, offers an opportunity to revive interest in the agricultural sector. The COVID-19 pandemic has placed immense pressures on African countries to raise additional resources, and consequently Africa’s growing public debt is again coming back to the centre stage of the global debate. The conversation on African debt sustainability has begun to dominate the scene and will flood the debate in the near term. While the observed, growing calls for debt relief for African countries are legitimate, we support in this paper that one should not divert attention from the long-term solutions needed to strengthen Africa’s resilience. These long-term solutions lie where they always have: in agriculture. With COVID-19, shipping agricultural inputs and food products from other continents to Africa has become disrupted and is accelerating the trend towards shortening supply chains. This will leave a potential market for inputs and food produced on the continent. COVID-19, together with the launching of the African Continental Free Trade Area (AfCFTA), have aligned the stars in favour of a decisive transformation of the agriculture sector on the continent. Agriculturalists and development experts need to be aware of their responsibility at this time, as they need to advocate for the topic of agricultural development to return to the centre and the heart of the agenda of discussions on how to respond to the consequences of Covid-19 in Africa. In this sense, and unexpectedly, COVID-19 is an opportunity for the agricultural sector.

Evaluation and application of potential schistosome-associated morbidity markers within large-scale mass chemotherapy programmes

Parasitology ◽  
2009 ◽  
Vol 136 (13) ◽  
pp. 1789-1799 ◽  
Author(s):  
J. P. WEBSTER ◽  
A. KOUKOUNARI ◽  
P. H. L. LAMBERTON ◽  
J. R. STOTHARD ◽  
A. FENWICK
Keyword(s):  
Large Scale ◽  
Primary Objective ◽  
Current Control ◽  
African Countries ◽  
Intensity Measures ◽  
Ongoing Research ◽  
Schistosomiasis Control ◽  
Control Programmes ◽  
Sub Saharan ◽  
Tools And Techniques

SUMMARYA primary objective of schistosomiasis control programmes is to achieve, and hence also demonstrate, a quantifiable reduction in schistosome-associated morbidity as a consequence of chemotherapeutic intervention. Inherent within such an objective, it is necessary to define and validate direct and indirect indicators of schistosome-related morbidity. However, to define and thereby document such morbidity, and its reduction following treatment, may not be straightforward, particularly for intestinal schistosomiasis-induced morbidity, which is often not apparent in all but the most severe or chronic cases. Within all ‘Schistosomiasis Control Initiative’ activities, across selected sub-Saharan African countries since 2002, a range of standard and novel potential morbidity markers have been monitored and evaluated. Parasitological intensity measures, combined with haemoglobin/anaemia counts and ultrasonography, proved valuable schistosomiasis-related morbidity indicators, being both logistically practical and informative. Additional measures tested, such as albumin excretion profiles, were promising, and are subject to ongoing research, whilst some measures, such as distended stomach/umbilical circumference, anthropometrics and health questionnaires proved less reliable. These results serve to both illustrate the success of current control activities in reducing schistosome-induced morbidity, and to highlight key tools and techniques for continued application within ongoing and future mass drug administration programmes.

scholarly journals Rethinking the Top-Down Approach to Schistosomiasis Control and Elimination in Sub-Saharan Africa

2021 ◽  
Vol 9 ◽  
Author(s):  
Adeola Onasanya ◽  
Michel Bengtson ◽  
Oladimeji Oladepo ◽  
Jo Van Engelen ◽  
Jan Carel Diehl
Keyword(s):  
Integrated Approach ◽  
Sub Saharan Africa ◽  
World Health ◽  
Intersectoral Collaboration ◽  
Top Down ◽  
African Countries ◽  
Schistosomiasis Control ◽  
Active Approach ◽  
Sub Saharan ◽  
Health Organization

The control and elimination of schistosomiasis have over the last two decades involved several strategies, with the current strategy by the World Health Organization (WHO) focusing mainly on treatment with praziquantel during mass drug administration (MDA). However, the disease context is complex with an interplay of social, economic, political, and cultural factors that may affect achieving the goals of the Neglected Tropical Disease (NTD) 2021-2030 Roadmap. There is a need to revisit the current top-down and reactive approach to schistosomiasis control among sub-Saharan African countries and advocate for a dynamic and diversified approach. This paper highlights the challenges of praziquantel-focused policy for schistosomiasis control and new ways to move from schistosomiasis control to elimination in sub-Saharan Africa. We will also discuss an alternative and diversified approach that consists of a Systems Thinking Framework that embraces intersectoral collaboration fully and includes co-creating locally relevant strategies with affected communities. We propose that achieving the goals for control and elimination of schistosomiasis requires a bottom-up and pro-active approach involving multiple stakeholders. Such a pro-active integrated approach will pave the way for achieving the goals of the NTD 2021-2030 roadmap for schistosomiasis, and ultimately improve the wellbeing of those living in endemic areas.

scholarly journals Control of schistosomiasis in sub-Saharan Africa: progress made, new opportunities and remaining challenges

Parasitology ◽  
2009 ◽  
Vol 136 (13) ◽  
pp. 1665-1675 ◽  
Author(s):  
J. R. STOTHARD ◽  
L. CHITSULO ◽  
T. K. KRISTENSEN ◽  
J. UTZINGER
Keyword(s):  
Large Scale ◽  
Neglected Tropical Diseases ◽  
Monitoring And Evaluation ◽  
Sub Saharan Africa ◽  
World Health ◽  
African Countries ◽  
Schistosomiasis Control ◽  
Sub Saharan ◽  
Gates Foundation ◽  
Made In

SUMMARYSeveral other journal supplements have documented progress made in the control of schistosomiasis in Egypt, China and Brazil, however, with more than 97% of the schistosome infections now estimated to occur in Africa, the relevance of this special issue in Parasitology cannot be overemphasized. In total, 18 articles are presented, inclusive of a lead-editorial from the WHO highlighting a seminal resolution at the 54th World Health Assembly in 2001 that advocated de-worming. Facilitated by a US$ 30 million grant from the Bill and Melinda Gates Foundation in 2002, the Schistosomiasis Control Initiative subsequently fostered implementation of large-scale schistosomiasis (and soil-transmitted helminthiasis) control programmes in six selected African countries. From 2005, CONTRAST, a European union-funded consortium, was formed to conduct multi-disciplinary research pertaining to optimisation of schistosomiasis control. Progress made in schistosomiasis control across sub-Saharan Africa since the turn of the new millennium is reviewed, shedding light on the latest findings stemming from clinical, epidemiological, molecular and social sciences research, inclusive of public health interventions with monitoring and evaluation activities. New opportunities for integrating the control of schistosomiasis and other so-called neglected tropical diseases are highlighted, but more importantly, several opportune questions that arise from it frame the remaining challenges ahead for an enduring solution.

scholarly journals The Schistosomiasis Control Initiative (SCI): rationale, development and implementation from 2002–2008

Parasitology ◽  
2009 ◽  
Vol 136 (13) ◽  
pp. 1719-1730 ◽  
Author(s):  
A. FENWICK ◽  
J. P. WEBSTER ◽  
E. BOSQUE-OLIVA ◽  
L. BLAIR ◽  
F. M. FLEMING ◽  
...  
Keyword(s):  
Neglected Tropical Diseases ◽  
Integrated Control ◽  
Monitoring And Evaluation ◽  
Sub Saharan Africa ◽  
Preventive Chemotherapy ◽  
Schistosomiasis Control ◽  
Control Programmes ◽  
Sub Saharan ◽  
Management Approaches ◽  
Control Initiative

SUMMARYSchistosomiasis remains one of the most prevalent parasitic diseases in developing countries. After malaria, schistosomiasis is the most important tropical disease in terms of human morbidity with significant economic and public health consequences. Although schistosomiasis has recently attracted increased focus and funding for control, it has been estimated that less than 20% of the funding needed to control the disease in Africa is currently available. In this article the following issues are discussed: the rationale, development and objectives of the Schistosomiasis Control Initiative (SCI)-supported programmes; the management approaches followed to achieve implementation by each country; mapping, monitoring and evaluation activities with quantifiable impact of control programmes; monitoring for any potential drug resistance; and finally exit strategies within each country. The results have demonstrated that morbidity due to schistosomiasis has been reduced by the control programmes. While challenges remain, the case for the control of schistosomiasis has been strengthened by research by SCI teams and the principle that a national programme using ‘preventive chemotherapy’ can be successfully implemented in sub-Saharan Africa, whenever the resources are available. SCI and partners are now actively striving to raise further funds to expand the coverage of integrated control of neglected tropical diseases (NTDs) in sub-Saharan Africa.

scholarly journals Genetic characterization of G12P[6] and G12P[8] rotavirus strains in six African countries

2020 ◽  
Author(s):  
Kebareng G. Rakau ◽  
Martin M. Nyaga ◽  
Maemu P. Gededzha ◽  
Jason M. Mwenda ◽  
M. Jeffrey Mphahlele ◽  
...  
Keyword(s):  
Amino Acid Level ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Vaccine Introduction ◽  
Rotavirus Vaccination ◽  
Human Rotavirus ◽  
Sub Saharan ◽  
The Stability ◽  
Long Term Impact

Abstract Background: G12 rotaviruses were first observed in sub-Saharan Africa in 2004 and since then have continued to emerge and spread across the continent and are reported as a significant human rotavirus genotype in several African countries, both prior to and after rotavirus vaccine introduction. This study investigated the genetic variability of 15 G12 rotavirus strains with either P[6] or P[8] identified between 2010 and 2014 from Ethiopia, Kenya, Rwanda, Tanzania, Togo and Zambia.Methods: The investigation was carried out by comparing VP7 and partial VP4 sequences of the African G12P[6] and G12P[8] strains with the available GenBank sequences and mapping the recognized neutralization epitopes of these strains.Results: The findings suggested that the VP7 and VP4 genes of the G12 strains circulating in African countries are homologous at the nucleotide and amino acid level, irrespective of country of origin and year of detection, although there was a unique clustering of the Ethiopian strains. The study strains shared a common ancestry with G12 strains circulating globally. Neutralization epitope mapping revealed that rotavirus VP4 P[8] genes associated with G12 had amino acids similar to those reported globally including the vaccines RotaTeq® P[8] and Rotarix®.Conclusions: It is unlikely that widespread vaccine use has driven the molecular evolution and sustainability of G12 strains in Africa. Furthermore, it is too early post vaccine introduction to indicate any effect of vaccine-induced pressure on maintaining the stability of these strains in circulation. Continuous monitoring of rotavirus genotypes is recommended to assess the long-term impact of rotavirus vaccination on the dynamic nature of rotavirus evolution on the continent.

scholarly journals Does Governance Matter In Infrastructure: Evidence From Sub-Saharan Africa

2012 ◽  
Vol 12 (1) ◽  
pp. 113
Author(s):  
Olusegun Ayodele Akanbi
Keyword(s):  
Capital Expenditure ◽  
Principal Component ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Governance Indicators ◽  
Institutional Structures ◽  
Physical Infrastructure ◽  
Productive Potential ◽  
Sub Saharan

This study empirically examines the pattern of physical infrastructure that would unlock the productive potential of sub-Saharan Africa. The estimations were carried out in a panel of 21 selected sub-Saharan African countries over the period 2000 to 2010 using the two-stage least squares (TSLS) estimation techniques. The infrastructure variable was constructed on the basis of three physical infrastructure stocks (roads, telecommunication and electricity) using the principal component analysis (PCA), and governance was measured using the worldwide governance indicators. The results conform to the findings of existing literature; namely, that real output, government capital expenditure, external balance and inflation are significant determinants of physical infrastructure in sub-Saharan Africa. The distinctive feature of the study is the significant role played by governance in explaining physical infrastructure. The results from the panel estimations reveal that investment in governance/institutional structures is a necessary first step in providing quality infrastructure stock and, hence, pro-poor, long-term economic growth for the region. Therefore, in modelling physical infrastructure, it is imperative to incorporate the important role played by governance.

scholarly journals Systematic review of hypertension prevalence and awareness in Sub-Saharan Africa

2018 ◽  
Vol 1 (1) ◽  
pp. 11-14 ◽  
Author(s):  
Eléazar Ndabarora ◽  
Clemence Nishimwe ◽  
Dariya Mukamusoni
Keyword(s):  
Preventive Measures ◽  
Sub Saharan Africa ◽  
High Rate ◽  
African Countries ◽  
High Increase ◽  
Hypertensive Patients ◽  
High Prevalence ◽  
Sub Saharan ◽  
And Control ◽  
Very High

Several studies have reported high prevalence of hypertension in Africa, but little is known on awareness and determinants of preventive measures uptake. The purpose of the review was to identify and review the studies which reported at the same time on the prevalence of hypertension and awareness among the participants in sub-Saharan Africa, and to recommend needed research studies and interventions to prevent and control hypertension increase. High prevalence of hypertension was found across sub-Saharan African countries. The increasing hypertension rate moved from 19.7% in 1990 to 30.8% in 2010, with very high increase in some sub-regions up to 77%. A low awareness was found, less than 50% and in some place less than 10%. Also a high rate of hypertensive patients who were not on treatment was found. There is a very increasing prevalence of hypertension and unawareness in sub-Saharan Africa. There is also a high rate of hypertensive patients who are not on treatment.  Studies and interventions aiming at understanding determinants of hypertension screening and treatment uptake are much recommended.

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