scholarly journals Community-acquired Invasive Bacterial Disease in Urban Gambia, 2005–2015: A Hospital-based Surveillance

2019 ◽  
Vol 69 (Supplement_2) ◽  
pp. S105-S113 ◽  
Author(s):  
Saffiatou Darboe ◽  
Uduak Okomo ◽  
Abdul-Khalie Muhammad ◽  
Buntung Ceesay ◽  
Mamadou Jallow ◽  
...  

Abstract Background. Invasive bacterial diseases cause significant disease and death in sub-Saharan Africa. Several are vaccine preventable, although the impact of new vaccines and vaccine policies on disease patterns in these communities is poorly understood owing to limited surveillance data. Methods. We conducted a hospital-based surveillance of invasive bacterial diseases in The Gambia where blood and cerebrospinal fluid (CSF) samples of hospitalized participants were processed. Three surveillance periods were defined in relation to the introduction of pneumococcal conjugate vaccines (PCVs), before (2005- 2009), during (2010–2011) and after (2012–2015) PCV introduction. We determined the prevalences of commonly isolated bacteria and compared them between the different surveillance periods. Results. A total of 14 715 blood and 1103 CSF samples were collected over 11 years; overall, 1045 clinically significant organisms were isolated from 957 patients (972 organisms [6.6%] from blood and 73 [6.6%] from CSF). The most common blood culture isolates were Streptococcus pneumoniae (24.9%), Staphylococcus aureus (22.0%), Escherichia coli (10.9%), and nontyphoidal Salmonella (10.0%). Between the pre-PCV and post-PCV eras, the prevalence of S. pneumoniae bacteremia dropped across all age groups (from 32.4% to 16.5%; odds ratio, 0.41; 95% confidence interval, .29–.58) while S. aureus increased in prevalence, becoming the most prevalent bacteria (from 16.9% to 27.2%; 1.75; 1.26–2.44). Overall, S. pneumoniae (53.4%), Neisseria meningitidis (13.7%), and Haemophilus influenzae (12.3%) were the predominant isolates from CSF. Antimicrobial resistance to common antibiotics was low. Conclusions. Our findings demonstrate that surveillance data on the predominant pathogens associated with invasive disease is necessary to inform vaccine priorities and appropriate management of patients.

Author(s):  
RL van Zyl

Sub-Saharan Africa has to contend with many challenges, including inadequate healthcare systems, lack of optimal sanitation, and clean water and food. All of these contribute to malnutrition and an increased risk of infections, including parasitism by cestodes and trematodes. Schistosomiasis is a category-2 notifiable trematode (fluke) infection, whereas cestode (tapeworm) infections need not be reported to the South African Department of Health. Epidemiological data for helminthiasis in South Africa is scant, with a paucity of publications on the South African scenario. As such, a complete picture of the impact of helminth infections on all age groups in South Africa does not exist. These parasitic diseases not only have an impact on socio economic development of a country, community and families, but also contribute to the chronic and detrimental effects on the health and nutritional status of the host, including the impaired development of children. In order to break the cycle of poverty and disease, a strong education drive is required in schools and communities to provide effective strategies and guidelines on preventative measures that result in avoidance of exposure to infective stages of Schistosoma and Taenia tapeworms. Also, it is imperative that healthcare professionals are able to recognise the signs and symptoms, so that interventions can be promptly initiated. The current anthelmintic treatments available in South Africa are effective against cestodes and trematodes, with no drug resistance having being reported. The need for compliancy when taking anthelmintic drugs must be emphasised.


2020 ◽  
Author(s):  
Se Eun Park ◽  
Duy Thanh Pham ◽  
Gi Deok Pak ◽  
Ursula Panzner ◽  
Ligia Maria Cruz Espinoza ◽  
...  

Background: Invasive nontyphoidal Salmonella (iNTS) is one of the leading causes of bacteraemia in sub-Saharan Africa. Multi-drug resistance (MDR) and further resistance to third generation cephalosporins and fluoroquinolones have emerged in multiple iNTS serotypes. Molecular epidemiological investigations of nontyphoidal Salmonella are needed to better understand the genetic characteristics and transmission dynamics associated with major MDR iNTS serotypes across the continent. Methods: A total of 166 nontyphoidal Salmonella isolates causing invasive disease were collected from a multi-centre study in eight African countries between 2010 and 2014, and whole-genome sequenced to investigate the geographical distribution, antimicrobial genetic determinants and population structure of iNTS serotypes-genotypes. Phylogeographical reconstruction was further conducted in context of the existing genomic framework of iNTS serotypes Typhimurium and Enteritidis. Population-based incidence of MDR-iNTS disease was also estimated. Results: Salmonella enterica subsp. Enterica serotype Typhimurium (S. Typhimurium) sequence-type (ST) 313 and Salmonella enterica subsp. Enterica serotype Enteritidis (S. Enteritidis) ST11 were predominant, and both exhibited high frequencies of MDR. Salmonella enterica subsp. Enterica serotype Dublin (S. Dublin) ST10 emerged in West Africa. Mutations in the gyrA gene were identified in S. Enteritidis and S. Typhimurium in Ghana; and ST313 carrying blaCTX-M-15 was found in Kenya. Inter-country transmission of MDR ST313 lineage II and the West African Clade of MDR ST11 between Ghana and neighbouring countries including Mali, Burkina Faso, and Nigeria were evident. The incidence of MDR-iNTS disease exceeded 100/100,000-person years-of-observation (PYO) in children aged <5 years in several West African countries. Conclusions: Multiple MDR iNTS serotypes-sequence types, predominantly S. Typhimurium ST313 and S. Enteritidis ST11, are co-circulating in sub-Saharan Africa with evidence of transmission between West African countries. The development of safe and effective iNTS vaccines coupled with appropriate antimicrobial stewardship and adequate epidemiological monitoring are essential to limit the impact of these pathogens in Africa.


2017 ◽  
Vol 1 (6) ◽  
pp. 533-537
Author(s):  
Lorenz von Seidlein ◽  
Borimas Hanboonkunupakarn ◽  
Podjanee Jittmala ◽  
Sasithon Pukrittayakamee

RTS,S/AS01 is the most advanced vaccine to prevent malaria. It is safe and moderately effective. A large pivotal phase III trial in over 15 000 young children in sub-Saharan Africa completed in 2014 showed that the vaccine could protect around one-third of children (aged 5–17 months) and one-fourth of infants (aged 6–12 weeks) from uncomplicated falciparum malaria. The European Medicines Agency approved licensing and programmatic roll-out of the RTSS vaccine in malaria endemic countries in sub-Saharan Africa. WHO is planning further studies in a large Malaria Vaccine Implementation Programme, in more than 400 000 young African children. With the changing malaria epidemiology in Africa resulting in older children at risk, alternative modes of employment are under evaluation, for example the use of RTS,S/AS01 in older children as part of seasonal malaria prophylaxis. Another strategy is combining mass drug administrations with mass vaccine campaigns for all age groups in regional malaria elimination campaigns. A phase II trial is ongoing to evaluate the safety and immunogenicity of the RTSS in combination with antimalarial drugs in Thailand. Such novel approaches aim to extract the maximum benefit from the well-documented, short-lasting protective efficacy of RTS,S/AS01.


2020 ◽  
Vol 2020 (10-3) ◽  
pp. 238-246
Author(s):  
Olga Dzhenchakova

The article considers the impact of the colonial past of some countries in sub-Saharan Africa and its effect on their development during the post-colonial period. The negative consequences of the geopolitical legacy of colonialism are shown on the example of three countries: Nigeria, the Democratic Republic of the Congo and the Republic of Angola, expressed in the emergence of conflicts in these countries based on ethno-cultural, religious and socio-economic contradictions. At the same time, the focus is made on the economic factor and the consequences of the consumer policy of the former metropolises pursuing their mercantile interests were mixed.


2019 ◽  
Vol 22 (S1) ◽  
pp. e25243 ◽  
Author(s):  
Valentina Cambiano ◽  
Cheryl C Johnson ◽  
Karin Hatzold ◽  
Fern Terris‐Prestholt ◽  
Hendy Maheswaran ◽  
...  

2021 ◽  
Vol 13 (4) ◽  
pp. 1780
Author(s):  
Chima M. Menyelim ◽  
Abiola A. Babajide ◽  
Alexander E. Omankhanlen ◽  
Benjamin I. Ehikioya

This study evaluates the relevance of inclusive financial access in moderating the effect of income inequality on economic growth in 48 countries in Sub-Saharan Africa (SSA) for the period 1995 to 2017. The findings using the Generalised Method of Moments (sys-GMM) technique show that inclusive financial access contributes to reducing inequality in the short run, contrary to the Kuznets curve. The result reveals a negative effect of financial access on the relationship between income inequality and economic growth. There is a positive net effect of inclusive financial access in moderating the impact of income inequality on economic growth. Given the need to achieve the Sustainable Development Targets in the sub-region, policymakers and other stakeholders of the economy must design policies and programmes that would enhance access to financial services as an essential mechanism to reduce income disparity and enhance sustainable economic growth.


2021 ◽  
Vol 13 (3) ◽  
pp. 525
Author(s):  
Yann Forget ◽  
Michal Shimoni ◽  
Marius Gilbert ◽  
Catherine Linard

By 2050, half of the net increase in the world’s population is expected to reside in sub-Saharan Africa (SSA), driving high urbanization rates and drastic land cover changes. However, the data-scarce environment of SSA limits our understanding of the urban dynamics in the region. In this context, Earth Observation (EO) is an opportunity to gather accurate and up-to-date spatial information on urban extents. During the last decade, the adoption of open-access policies by major EO programs (CBERS, Landsat, Sentinel) has allowed the production of several global high resolution (10–30 m) maps of human settlements. However, mapping accuracies in SSA are usually lower, limited by the lack of reference datasets to support the training and the validation of the classification models. Here we propose a mapping approach based on multi-sensor satellite imagery (Landsat, Sentinel-1, Envisat, ERS) and volunteered geographic information (OpenStreetMap) to solve the challenges of urban remote sensing in SSA. The proposed mapping approach is assessed in 17 case studies for an average F1-score of 0.93, and applied in 45 urban areas of SSA to produce a dataset of urban expansion from 1995 to 2015. Across the case studies, built-up areas averaged a compound annual growth rate of 5.5% between 1995 and 2015. The comparison with local population dynamics reveals the heterogeneity of urban dynamics in SSA. Overall, population densities in built-up areas are decreasing. However, the impact of population growth on urban expansion differs depending on the size of the urban area and its income class.


2020 ◽  
Vol 1 (1) ◽  
pp. 20-29
Author(s):  
Hussaini Ojagefu Adamu ◽  
Rahimat Oshuwa Hussaini ◽  
Cedric Obasuyi ◽  
Linus Irefo Anagha ◽  
Gabriel Oscy Okoduwa

AbstractMastitis is a disease of livestock that directly impede livestock production and thus hindering the socio-ecological development of sub-Saharan Africa. Studies have estimated the prevalence of this disease in 30% of Africa countries, with Ethiopia having the highest prevalence. The coverage is low, despite the wide livestock and dairy farms distribution in Africa. Furthermore, estimated economic losses due to the impact of mastitis are lacking in Nigeria. The disease is endemic in Nigeria as indicated by the available data and there are no proposed management plans or control strategies. This review is thus presented to serve as a wakeup call to all parties involved to intensify efforts towards the diagnosis, control, and management of the disease in Nigeria.


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