scholarly journals Chemoprophylaxis and vaccination in preventing subsequent cases of meningococcal disease in household contacts of a case of meningococcal disease: a systematic review

2015 ◽  
Vol 143 (11) ◽  
pp. 2259-2268 ◽  
Author(s):  
L. TELISINGHE ◽  
T. D. WAITE ◽  
M. GOBIN ◽  
O. RONVEAUX ◽  
K. FERNANDEZ ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Ratio ◽  
Meningococcal Disease ◽  
Index Case ◽  
Sub Saharan Africa ◽  
Number Needed To Treat ◽  
Household Contacts ◽  
Increased Risk ◽  
Sub Saharan

SUMMARYHousehold contacts of an index case of invasive meningococcal disease (IMD) are at increased risk of acquiring disease. In revising WHO guidance on IMD in sub-Saharan Africa, a systematic review was undertaken to assess the effect of chemoprophylaxis and of vaccination in preventing subsequent cases of IMD in household contacts following an index case. A literature search for systematic reviews identified a single suitable review on chemoprophylaxis in 2004 (three studies meta-analysed). A search for primary research papers published since 2004 on chemoprophylaxis and without a date limit on vaccination was therefore undertaken. There were 2381 studies identified of which two additional studies met the inclusion criteria. The summary risk ratio for chemoprophylaxis vs. no chemoprophylaxis (four studies) in the 30-day period after a case was 0·16 [95% confidence interval (CI) 0·04-0·64, P = 0·008]; the number needed to treat to prevent one subsequent case was 200 (95% CI 111-1000). A single quasi-randomized trial assessed the role of vaccination. The risk ratio for vaccination vs. no vaccination at 30 days was 0·11 (95% CI 0·01–2·07, P = 0·14). The results support the use of chemoprophylaxis to prevent subsequent cases of IMD in household contacts of a case. Conclusions about the use of vaccination could not be drawn.

scholarly journals Maternal obesity and severe preeclampsia among immigrant women: a mediation analysis

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Siddiqui ◽  
C Deneux-Tharaux ◽  
D Luton ◽  
T Schmitz ◽  
L Mandelbrot ◽  
...  
Keyword(s):  
Immigrant Women ◽  
Severe Preeclampsia ◽  
Sub Saharan Africa ◽  
Mediation Effect ◽  
Place Of Birth ◽  
Increased Risk ◽  
Causal Pathway ◽  
Prepregnancy Obesity ◽  
Sub Saharan

Abstract Background Severe preeclampsia is known to be associated with both maternal place of birth and obesity. However, the role of prepregnancy obesity has not been well elucidated on the causal pathway between maternal origin and severe preeclampsia. We aimed to test for and quantify a mediation effect of obesity in this association. Methods A secondary analysis of the PreCARE prospective French cohort of pregnant women (n = 9,579). Adjusted path analysis logistic regression models tested for a mediation effect of obesity in the association between maternal place of birth and severe preeclampsia. Adjusted odds ratios and 95% confidence intervals for the total exposure-outcome association and for the direct and indirect/obesity-mediated components were calculated in addition to an estimate of the indirect/obesity-mediated effect. Results 95 (0.99%) women developed severe preeclampsia: 47.6% were non-European immigrants, 16.3% were born in Sub-Saharan Africa, and 12.6% were obese. Obesity was both associated with Sub-Saharan African place of birth and severe preeclampsia. Women from Sub-Saharan Africa had an increased risk of severe preeclampsia compared to European-born mothers (aOR 2.53, 95% CI 1.39-4.58). The obesity-mediated effect of the association was 18% (aOR 1.18, 95%CI 1.03-1.35). Conclusions Sub-Saharan African immigrant women have a two-fold higher risk of developing severe preeclampsia as compared to European-born women, one-fifth of which is mediated by prepregnancy obesity. Our results provide estimates of the benefit of decreasing obesity among at-risk women. Key messages Obesity, a modifiable risk factor, is a target for interventions to prevent severe preeclampsia among immigrant women from Sub-Saharan Africa. Future investigations should focus on better elucidating the role of other modifiable mediators such as interaction with the health care system and quality of prenatal care.

scholarly journals A meta-analysis on the role of children in SARS-CoV-2 in household transmission clusters

2020 ◽  
Author(s):  
Yanshan Zhu ◽  
Conor J Bloxham ◽  
Katina D Hulme ◽  
Jane E Sinclair ◽  
Zhen Wei Marcus Tong ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Risk Ratio ◽  
Attack Rate ◽  
Index Case ◽  
Meta Analysis ◽  
Household Contacts ◽  
Household Transmission ◽  
Potential Vaccine ◽  
Index Cases

Abstract The role of children in the spread of SARS-CoV-2 remains highly controversial. To address this issue, we performed a meta-analysis of the published literature on household SARS-CoV-2 transmission clusters (n=213 from 12 countries). Only 8 (3.8%) transmission clusters were identified as having a paediatric index case. Asymptomatic index cases were associated with a lower secondary attack in contacts than symptomatic index cases (estimate risk ratio [RR], 0.17; 95% confidence interval [CI], 0.09-0.29). To determine the susceptibility of children to household infections the secondary attack rate (SAR) in paediatric household contacts was assessed. The secondary attack rate in paediatric household contacts was lower than in adult household contacts (RR, 0.62; 95% CI, 0.42-0.91). These data have important implications for the ongoing management of the COVID-19 pandemic, including potential vaccine prioritization strategies.

Khat chewing and risky sexual behavior in Sub-Saharan Africa: a systematic review protocol

2013 ◽  
Vol 11 (12) ◽  
pp. 59-67 ◽  
Author(s):  
Amanuel Tesfay Gebremedhin ◽  
Hailay Abrha Gesesew ◽  
Tariku Dejene Demissie ◽  
Mirkuzie Woldie Kerie ◽  
Morankar Sudhakar
Keyword(s):  
Systematic Review ◽  
Sexual Behavior ◽  
Risky Sexual Behavior ◽  
Sub Saharan Africa ◽  
Systematic Review Protocol ◽  
Khat Chewing ◽  
Review Protocol ◽  
Sub Saharan

Financing Energy Access in Africa

2018 ◽  
Author(s):  
Peter Kayode Oniemola ◽  
Jane Ezirigwe
Keyword(s):  
Oil And Gas ◽  
Sub Saharan Africa ◽  
Capital Investments ◽  
Energy Access ◽  
African Countries ◽  
Sustainable Technologies ◽  
Energy Technologies ◽  
Sub Saharan ◽  
Diesel Motors

To achieve universal energy access will attract huge capital investments. If sub-Saharan Africa is to realize anything close to the ambitious goals set for its energy access, then new actors, innovative funding mechanisms and sustainable technologies will have to be attracted. Finance is needed for activities such as rural electrification, clean cooking facilities, diesel motors and generators, other renewable energy technologies, oil and gas infrastructures, etc. Finance is also needed in research and development of suitable technologies and funding options as well as investment in the capacity to formulate and implement sound energy policies. This chapter examines the varied financing options for energy access in sub-Saharan Africa. It argues that with appropriate laws in place and effective mechanism for implementation, African countries can significantly engage private sector financing, international financial institutions and foreign donors. The role of the law here will be in creating an enabling environment for financing.

Human Development Paradigm for South Asia

2018 ◽  
Keyword(s):  
South Asia ◽  
Human Development ◽  
Sub Saharan Africa ◽  
Health And Nutrition ◽  
The People ◽  
Sub Saharan ◽  
Development Paradigm

In the chapter, Haq gives a snapshot of the human progress of South Asia, comparing it with other regions. He was worried about the region beginning to lag behind all other regions, including Sub-Saharan Africa. He highlights the role of the two largest economies in the region, India and Pakistan, in financing the major investment in education, health and nutrition for the people. Haq advocates some fiscal and monetary reforms are suggested to invest in human development.

scholarly journals An increasing role of pyrethroid-resistant Anopheles funestus in malaria transmission in the Lake Zone, Tanzania

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nancy S. Matowo ◽  
Jackline Martin ◽  
Manisha A. Kulkarni ◽  
Jacklin F. Mosha ◽  
Eliud Lukole ◽  
...  
Keyword(s):  
Malaria Transmission ◽  
Anopheles Funestus ◽  
Sub Saharan Africa ◽  
North West ◽  
Vector Population ◽  
Lake Zone ◽  
Sub Saharan ◽  
Long Lasting Insecticidal Nets ◽  
Study District

AbstractAnopheles funestus is playing an increasing role in malaria transmission in parts of sub-Saharan Africa, where An. gambiae s.s. has been effectively controlled by long-lasting insecticidal nets. We investigated vector population bionomics, insecticide resistance and malaria transmission dynamics in 86 study clusters in North-West Tanzania. An. funestus s.l. represented 94.5% (4740/5016) of all vectors and was responsible for the majority of malaria transmission (96.5%), with a sporozoite rate of 3.4% and average monthly entomological inoculation rate (EIR) of 4.57 per house. Micro-geographical heterogeneity in species composition, abundance and transmission was observed across the study district in relation to key ecological differences between northern and southern clusters, with significantly higher densities, proportions and EIR of An. funestus s.l. collected from the South. An. gambiae s.l. (5.5%) density, principally An. arabiensis (81.1%) and An. gambiae s.s. (18.9%), was much lower and closely correlated with seasonal rainfall. Both An. funestus s.l. and An. gambiae s.l. were similarly resistant to alpha-cypermethrin and permethrin. Overexpression of CYP9K1, CYP6P3, CYP6P4 and CYP6M2 and high L1014S-kdr mutation frequency were detected in An. gambiae s.s. populations. Study findings highlight the urgent need for novel vector control tools to tackle persistent malaria transmission in the Lake Region of Tanzania.

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