scholarly journals A comparison of all-cause and cause-specific mortality by household socioeconomic status across seven INDEPTH network health and demographic surveillance systems in sub-Saharan Africa

2019 ◽  
Vol 12 (1) ◽  
pp. 1608013 ◽  
Author(s):  
Matthew M. Coates ◽  
Mamusu Kamanda ◽  
Alexander Kintu ◽  
Iwara Arikpo ◽  
Alberto Chauque ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
Specific Mortality ◽  
Indepth Network ◽  
Sub Saharan ◽  
Demographic Surveillance Systems ◽  
Household Socioeconomic Status

scholarly journals Geographic coverage of demographic surveillance systems for characterising the drivers of childhood mortality in sub-Saharan Africa

2018 ◽  
Vol 3 (2) ◽  
pp. e000611 ◽  
Author(s):  
C Edson Utazi ◽  
Sujit K Sahu ◽  
Peter M Atkinson ◽  
Natalia Tejedor-Garavito ◽  
Christopher T Lloyd ◽  
...  
Keyword(s):  
International Health ◽  
Childhood Mortality ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
African Countries ◽  
Factors Associated ◽  
Development Goals ◽  
Sub Saharan ◽  
Reduction Of Mortality ◽  
Demographic Surveillance Systems

A major focus of international health and development goals is the reduction of mortality rates in children under 5 years of age. Achieving this requires understanding the drivers of mortality and how they vary geographically to facilitate the targeting and prioritisation of appropriate interventions. Much of our knowledge on the causes of, and trends in, childhood mortality come from longitudinal demographic surveillance sites, with a renewed focus recently on the establishment and growth of networks of sites from which standardised outputs can facilitate broader understanding of processes. To ensure that the collective outputs from surveillance sites can be used to derive a comprehensive understanding and monitoring system for driving policy on tackling childhood mortality, confidence is needed that existing and planned networks of sites are providing a reliable and representative picture of the geographical variation in factors associated with mortality. Here, we assembled subnational data on childhood mortality as well as key factors known to be associated with it from household surveys in 27 sub-Saharan African countries. We then mapped the locations of existing longitudinal demographic surveillance sites to assess the extent of current coverage of the range of factors, identifying where gaps exist. The results highlight regions with unique combinations of factors associated with childhood mortality that are poorly represented by the current distribution of sites, such as southern Mali, central Nigeria and southern Zambia. Finally, we determined where the establishment of new surveillance systems could improve coverage.

scholarly journals Towards an appropriate ethics framework for Health and Demographic Surveillance Systems (HDSS): learning from issues faced in diverse HDSS in sub-Saharan Africa

2021 ◽  
Vol 6 (1) ◽  
pp. e004008
Author(s):  
Alex Nginyo Hinga ◽  
Sassy Molyneux ◽  
Vicki Marsh
Keyword(s):  
Ethical Issues ◽  
A Priori ◽  
Public Health Practice ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
Science Literature ◽  
Ethics Framework ◽  
Sub Saharan ◽  
Demographic Surveillance Systems ◽  
And Migration

IntroductionHealth and Demographic Surveillance Systems (HDSS) collect data on births, deaths and migration from relatively small, geographically defined populations primarily in Africa and Asia. HDSS occupy a grey area between research, healthcare and public health practice and it is unclear how ethics guidance that rely on a research-practice distinction apply to HDSS. This topic has received little attention in the literature. In this paper, based on empirical research across sub-Saharan Africa, we map out key ethical issues for HDSS and assess the relevance of current ethics guidance in relation to these findings.MethodsWe conducted a qualitative study across seven HDSS sites in sub-Saharan Africa, including individual in-depth interviews and informal discussions with 68 research staff, document reviews and non-participant observations of surveillance activities. Qualitative data analysis drew on a framework approach led by a priori and emergent themes, drawing on the wider ethics and social science literature.ResultsThere were diverse views on core ethical issues in HDSS, including regarding the strengths and challenges of community engagement, informed consent and data sharing processes. A key emerging issue was unfairness in the overall balance of benefits and burdens for residents and front-line staff when compared with other stakeholders, particularly given the socioeconomic contexts in which HDSS are generally conducted.ConclusionWe argue that HDSS operate as non-traditional epidemiologic research projects but are often governed using ethics guidance developed for traditional forms of health research. There is a need for specific ethics guidance for HDSS which prioritises considerations around fairness, cost-effectiveness, ancillary care responsibilities, longitudinality and obligations of the global community to HDSS residents.

scholarly journals The Crucial Role of Mothers and Siblings in Child Survival: Evidence From 29 Health and Demographic Surveillance Systems in Sub-Saharan Africa

Demography ◽  
2021 ◽  
Vol 58 (5) ◽  
pp. 1687-1713
Author(s):  
Philippe Bocquier ◽  
Carren Ginsburg ◽  
Ashira Menashe-Oren ◽  
Yacouba Compaoré ◽  
Mark Collinson
Keyword(s):  
Child Mortality ◽  
Birth Interval ◽  
Child Survival ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
Birth Intervals ◽  
Sub Saharan ◽  
Demographic Surveillance Systems ◽  
Older Sibling

Abstract A considerable body of research has studied the effects of siblings on child mortality through birth intervals. This research has commonly focused on older siblings. We argue that birth intervals with younger siblings may have equal or stronger effects on child mortality, even during a mother's pregnancy. Moreover, we contend that birth interval effects need to be considered only when siblings are coresident. Using longitudinal data from 29 Health and Demographic Surveillance Systems across sub-Saharan Africa, covering more than 560,000 children, we examine the proximate role of siblings and mothers in child mortality. We find that a birth interval of 24 months or more is advantageous for both older and younger siblings. The effect of a younger sibling on child mortality is more pronounced than that of an older sibling and adds to the effect of an older sibling. Moreover, child mortality is particularly low during a mother's subsequent pregnancy, contrasting the shock resulting from a younger sibling's birth. Further, we find that a mother's or sibling's absence from the household results in a higher risk of mortality, and the death of either reduces child survival up to six months before the death.

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.

scholarly journals PO 8581 ZOONOTIC VIRAL ANTIGENS SURVEILLANCE IN HEALTHY POPULATIONS LIVING IN LAMBARÉNÉ, GABON

2019 ◽  
Vol 4 (Suppl 3) ◽  
pp. A58.2-A58
Author(s):  
Emmanuel Bache ◽  
Marguerite M Loembe ◽  
Selidji T Agnandji
Keyword(s):  
Disease Transmission ◽  
Disease Surveillance ◽  
Vaccine Trial ◽  
Viral Rna ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
Rt Pcr ◽  
Zoonotic Infections ◽  
Viral Antigens ◽  
Sub Saharan

BackgroundWorldwide, viral zoonotic infections such as filoviruses, flaviviruses, nairoviruses and arenaviruses cause self-limiting to severe diseases. They are endemic in sub-Saharan Africa, causing sporadic outbreaks warranting the development of sustainable surveillance systems. In Gabon, Ebola outbreaks occurred from 1994 to 2002 causing 214 human cases and 150 deaths, while Dengue, Zika and Chikungunya virus outbreaks occurred between 2007 and 2010. Beyond these outbreaks, little is known about the epidemiology. Recently, in collaboration with the Japanese government, the Research and Health Ministries of Gabon supported the implementation of a biosecurity level-3 (BSL-3) laboratory at CERMEL in Lambaréné as a zoonotic disease surveillance unit. Start-off involved antigen detection and characterisation of circulating antibodies to targeted viral antigens in healthy populations. This study reports data from healthy participants (18–50 years) in a phase I rVSV-ZEBOV-GP Ebola vaccine trial.MethodsHundred-six (106) baseline samples were screened for Ebola, Dengue (serotypes) 1–4 and Chikungunya viral RNA by RT-PCR on serum. IgG ELISA on plasma was used to identify antibodies against: Zaire-Ebola-(EBOV-GP and EBOV-VP40), Marburg-(MARV-GP and MARV-VP40), Crimean Congo Haemorrhagic Fever-(CCHFV-GP), Lasa-(LASV-GPC and LASV-NP), Yellow Fever-(YFV-NS1), West-Nile-(WNV-NS1), Zika virus-(ZIKV-NS1), Chikungunya-(CHIKV-VLP) and Dengue-(DENV1-NS1,DENV2-NS1,DENV3-NS1,DENV4-NS1) virus antigens.ResultsNo viral RNA was isolated by RT-PCR in 106 samples. About 9% (10/106), 3% (3/106), 6% (6/106), 24% (25/106), 51% (54/106), 38% (40/106) and 36% (38/106) participants were seropositive for antibodies specific to EBOV-GP, MARV-GP, CCHFV-GP, YFV-NS1, WNV-NS1, ZIKV-NS1 and CHIKV-VLP, respectively. Twelve percent (12%; 13/106) of participants possessed antibodies specific to Zika, Chikungunya and Dengue 1–4 antigens. Six percent (6%; 6/106) of participants were seropositive for EBOV-GP and CCHFV-GP.ConclusionWe found antibodies to viral zoonotic infections among our healthy volunteers. Further assays, including neutralisation assays are being performed to ascertain the specificity of the antibodies. These findings, once confirmed, will provide insights into disease surveillance, vaccine trial designs, evaluation of post-vaccine immune responses, variability in adverse events and overall disease transmission patterns.

scholarly journals Landscape analysis – assessing countries' readiness to scale up nutrition actions in the WHO African region

2012 ◽  
Vol 12 (52) ◽  
pp. 6260-6273
Author(s):  
U Trübswasser ◽  
◽  
C Nishida ◽  
K Engesveen ◽  
F Coulibaly-Zerbo ◽  
...  
Keyword(s):  
Child Nutrition ◽  
Scale Up ◽  
Landscape Analysis ◽  
Sub Saharan Africa ◽  
World Health ◽  
Surveillance Systems ◽  
African Region ◽  
Human Resource Capacity ◽  
World Health Assembly Resolution ◽  
Sub Saharan

The purpose of this paper is to describe the use of the Landscape Analysis to assess strengths and weaknesses in combating malnutrition in Sub-Saharan Africa. The Landscape Analysis is an inter-agency initiative to assess gaps and constraints and to identify opportunities for effective nutrition actions in order to accelerate intersectoral action for improving nutrition. In-depth Country Assessments to evaluate countries' "readiness" to scale up nutrition action have been conducted since 2008 in Sub-Saharan Africa. "Readiness" was assessed in terms of the commitment and capacity of each country and the focus was high stunting burden countries. The main focus was countries with heavy burden of undernutrition. From 2008 to September 2011, a total of 14 countries had undertaken the Landscape Analysis Country Assessment. Nine of them were in Africa: Burkina Faso, Comoros, Cote d’Ivoire, Ethiopia, Ghana, Madagascar, Mali, Mozambique, and South Africa. Three additional countries (Guinea, Namibia and Tanzania) were also planning to complete the Landscape Analysis Country Assessment in early 2012. From the findings in the nine countries, the following recommendations have been made: • Existing nutrition architectures and coordination mechanisms should be strengthened and better utilized; • Nutrition needs to be mainstreamed and integrated in relevant sector policies; • Advocacy at high levels is needed to highlight the importance of the lifecourse perspective, focusing particularly on nutrition interventions from preconception until the first two years of life; • National nutrition policies need to be translated into programmatic actions; • Human resource capacity for public health nutrition needs to be built with high quality in-service trainings in the short-term and long-term strategies to provide pre-service trainings; • Community-based outreach should be strengthened by using existing channels; • National nutrition surveillance systems need to be strengthened to ensure adequate use of data for monitoring, evaluation, and planning purposes. As part of the implementation of the 2010 World Health Assembly resolution on Infant and Young Child Nutrition (WHA 63.23) WHO has proposed a process to help countries in developing scale-up plans, which incorporates the Landscape Analysis Country Assessment as a tool to help countries in undertaking the initial context mapping. The countries that have already undertaken an in-depth Country Assessment, such as the Landscape Analysis Country Assessment, are ready to move forward in implementing the next steps in developing scaling-up plans to accelerate action in nutrition. At the same time, WHO will support additional countries that have expressed interest in conducting the Country Assessment.

scholarly journals Seroprevalence of anti-SARS-CoV-2 IgG antibodies in Juba, South Sudan: a population-based study

2021 ◽  
Author(s):  
Kirsten E. Wiens ◽  
Pinyi Nyimol Mawien ◽  
John Rumunu ◽  
Damien Slater ◽  
Forrest K. Jones ◽  
...  
Keyword(s):  
Test Performance ◽  
Serological Test ◽  
South Sudan ◽  
Bayesian Regression ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
Igg Antibody ◽  
Serological Tests ◽  
Cross Sectional ◽  
Sub Saharan

AbstractBackgroundRelatively few COVID-19 cases and deaths have been reported through much of sub-Saharan Africa, including South Sudan, although the extent of SARS-CoV-2 spread remains unclear due to weak surveillance systems and few population-representative serosurveys.MethodsWe conducted a representative household-based cross-sectional serosurvey in Juba, South Sudan. We quantified IgG antibody responses to SARS-CoV-2 spike protein receptor-binding domain and estimated seroprevalence using a Bayesian regression model accounting for test performance.ResultsWe recruited 2,214 participants from August 10 to September 11, 2020 and 22.3% had anti-SARS-CoV-2 IgG titers above levels in pre-pandemic samples. After accounting for waning antibody levels, age, and sex, we estimated that 38.5% (32.1 - 46.8) of the population had been infected with SARS-CoV-2. For each RT-PCR confirmed COVID-19 case, 104 (87-126) infections were unreported. Background antibody reactivity was higher in pre-pandemic samples from Juba compared to Boston, where the serological test was validated. The estimated proportion of the population infected ranged from 30.1% to 60.6% depending on assumptions about test performance and prevalence of clinically severe infections.ConclusionsSARS-CoV-2 has spread extensively within Juba. Validation of serological tests in sub-Saharan African populations is critical to improve our ability to use serosurveillance to understand and mitigate transmission.

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