scholarly journals Evidence-based health security: The nexus of governance and pandemic preparedness

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R Greenhill ◽  
J Johnson ◽  
P Malone ◽  
A Westrum
Keyword(s):  
Mixed Methods ◽  
Expert Panel ◽  
State Capacity ◽  
Limit State ◽  
Sub Saharan Africa ◽  
Pandemic Preparedness ◽  
African Region ◽  
Health Security ◽  
Preparedness Planning ◽  
Sub Saharan

Abstract Background Pandemic preparedness continues to be an important focus of the global health security agenda. Many nations in the sub-Saharan African region remain at high risk for a major pandemic due to limited capacity and endemic co-morbid conditions in their populations. While the literature does suggest that state capacity influences health, no studies to date indicate an association between state capacity and pandemic disease distribution, particularly in the presence of other endemic diseases. Methods This mixed methods study will contribute to existing research by examining how economic and sociopolitical attributes of state capacity influence pandemic-prone disease distribution in sub-Saharan Africa. A convergent mixed methods design was used to collect and analyze quantitative state capacity attributes and prevention, and control using correlation in six sub-Saharan countries. Results of the quantitative study were triangulated through the use of an expert panel and results integrated for an overall interpretation and conclusion. Results Variables in the study showed statistically significant relationships between proxies of state capacity and the follow areas: control of pandemics and prevention of pandemics. The Expert Panel interviews illustrated convergence between the correlated results. Conclusions This study brought forward associations with expert confirmation suggestive of areas for national governments in sub-Saharan Africa to further review and improve. While many internal factors limit state capacity in these nations (e.g. human and fiscal resources), external funders may consider adding information from this study and other metrics to test progress. Key messages Evidence is valuable for pandemic preparedness planning. Nation state capacity is a factor in pandemic preparedness.

scholarly journals Understanding cause of stillbirth: a prospective observational multi-country study from sub-Saharan Africa

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Mamuda Aminu ◽  
Sarah Bar-Zeev ◽  
Sarah White ◽  
Matthews Mathai ◽  
Nynke van den Broek
Keyword(s):  
Sierra Leone ◽  
Cause Of Death ◽  
Expert Panel ◽  
Healthcare Providers ◽  
Sub Saharan Africa ◽  
Primary Data ◽  
Middle Income ◽  
Computer Based ◽  
Sub Saharan ◽  
Low And Middle Income

Abstract Background Every year, an estimated 2.6 million stillbirths occur worldwide, with up to 98% occurring in low- and middle-income countries (LMIC). There is a paucity of primary data on cause of stillbirth from LMIC, and particularly from sub-Saharan Africa to inform effective interventions. This study aimed to identify the cause of stillbirths in low- and middle-income settings and compare methods of assessment. Methods This was a prospective, observational study in 12 hospitals in Kenya, Malawi, Sierra Leone and Zimbabwe. Stillbirths (28 weeks or more) were reviewed to assign the cause of death by healthcare providers, an expert panel and by using computer-based algorithms. Agreement between the three methods was compared using Kappa (κ) analysis. Cause of stillbirth and level of agreement between the methods used to assign cause of death. Results One thousand five hundred sixty-three stillbirths were studied. The stillbirth rate (per 1000 births) was 20.3 in Malawi, 34.7 in Zimbabwe, 38.8 in Kenya and 118.1 in Sierra Leone. Half (50.7%) of all stillbirths occurred during the intrapartum period. Cause of death (range) overall varied by method of assessment and included: asphyxia (18.5–37.4%), placental disorders (8.4–15.1%), maternal hypertensive disorders (5.1–13.6%), infections (4.3–9.0%), cord problems (3.3–6.5%), and ruptured uterus due to obstructed labour (2.6–6.1%). Cause of stillbirth was unknown in 17.9–26.0% of cases. Moderate agreement was observed for cause of stillbirth as assigned by the expert panel and by hospital-based healthcare providers who conducted perinatal death review (κ = 0.69; p < 0.0005). There was only minimal agreement between expert panel review or healthcare provider review and computer-based algorithms (κ = 0.34; 0.31 respectively p < 0.0005). Conclusions For the majority of stillbirths, an underlying likely cause of death could be determined despite limited diagnostic capacity. In these settings, more diagnostic information is, however, needed to establish a more specific cause of death for the majority of stillbirths. Existing computer-based algorithms used to assign cause of death require revision.

The urgent need for health impact assessment: proposing a transdisciplinary approach to the e-waste crisis in sub-Saharan Africa

2017 ◽  
Vol 24 (2) ◽  
pp. 35-42 ◽  
Author(s):  
Dinah Tetteh ◽  
Lara Lengel
Keyword(s):  
Impact Assessment ◽  
Health Impact Assessment ◽  
Environmental Concern ◽  
Electronic Waste ◽  
Health Impact ◽  
Environmental Communication ◽  
Economic Benefits ◽  
Sub Saharan Africa ◽  
African Region ◽  
Sub Saharan

Electronic waste (e-waste) is a growing health and environmental concern in developing countries. In the sub-Saharan African region e-waste is considered a crisis with no end in sight yet; there is lack of structures and regulations to manage the problem. In this article, we discuss the potential of Health Impact Assessment (HIA) in addressing the health, environmental, and social impacts of e-waste in sub-Saharan Africa. We draw from environmental policy, environmental communication, global health policy, and health communication to argue that managing e-waste could be framed as ongoing HIA where all the steps of HIA are performed on a rolling basis with input from local communities. Further, we suggest that HIA should be infused into recycling legislation to help streamline the practice in order to make it safe for health and the environment and to maximize the economic benefits.

scholarly journals Reflections on Climate Change and Public Health in Africa in an Era of Global Pandemic

2021 ◽  
Author(s):  
Edlyne Eze Anugwom
Keyword(s):  
Public Health ◽  
Climate Change ◽  
Health Planning ◽  
Full Range ◽  
Good Health ◽  
Sub Saharan Africa ◽  
Health Security ◽  
Mitigation And Adaptation ◽  
Global Pandemic ◽  
Sub Saharan

The study examined the impact of climate change on public health provisioning in Sub-Saharan Africa. In addition to recognising the multifarious influence of climate change on health, it argues that the quest for global health security can only be achieved against the backdrop of concerted mainstreaming of climate change response into public heath provisioning, especially in the developing world. Adapting to climate change and mitigating its impact would logically require integrating it into public health planning, programming and interventions. Therefore, if health security entails provisioning and catering to the full range of health needs of people, climate change given its undoubted implications for health should be in the forefront of health security globally. Despite the global discourse of climate change and health security, tangible actions and programmes at different levels are needed to achieve the goals of good health and effective health security. This is no less the case now that the pandemic has challenged and stretched health institutions and provisions. However, the complex and intertwining effects of climate change and its manifold nexus with public health and health security can easily be apprehended through the systems perspective. There is the need for both radicalization of the public health system in Sub-Saharan Africa and concerted efforts across disciplines and actors to achieve effective climate change mitigation and adaptation and thus further strengthen health security.

scholarly journals Imported bancroftian filariasis discovered in a patient infected with Plasmodium falciparum: First case of concomitant parasitism in the Al-Buraimi Governorate, Oman

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Muhammad Muqeet Ullah ◽  
Ahmed Yar Mohammed Dawood Al Balushi ◽  
Nader Rahid Salim Al Aliyani ◽  
Biju Kalarikkal ◽  
Reeher Ian C. Miranda ◽  
...  
Keyword(s):  
Wuchereria Bancrofti ◽  
Sub Saharan Africa ◽  
Global Burden ◽  
Bancroftian Filariasis ◽  
African Region ◽  
Laboratory Findings ◽  
Anopheles Species ◽  
First Case ◽  
Nigerian Woman ◽  
Sub Saharan

Malaria and lymphatic filariasis (LF) are endemic in tropical and subtropical regions of sub-Saharan Africa, Asia, and Central and South America. Ninety-two percent (200 million) of malaria cases in 2017 were detected in the WHO African Region. This accounts for approximately 30% of the global burden of LF disease and includes 405.9 million people at risk in 39 out of 46 member countries. Anopheles species of mosquitoes transmit Wuchereria bancrofti in most parts of Africa. Our case of a 23-year-old Nigerian woman highlights incidental laboratory findings showing the first malaria/filariasis coinfection in the governorate (province). This coinfection was ascertained during the usual medical screening before recruitment in Oman, which is routinely conducted for every expatriate.

scholarly journals Early estimates of COVID-19 infections in small, medium and large population clusters

2020 ◽  
Vol 5 (9) ◽  
pp. e003055
Author(s):  
Amir Siraj ◽  
Alemayehu Worku ◽  
Kiros Berhane ◽  
Maru Aregawi ◽  
Munir Eshetu ◽  
...  
Keyword(s):  
Large Population ◽  
Face Mask ◽  
Sub Saharan Africa ◽  
Contact Tracing ◽  
Local Context ◽  
African Region ◽  
Social Distancing ◽  
Population Sizes ◽  
Sub Saharan ◽  
The Impact

IntroductionSince its emergence in late December 2019, COVID-19 has rapidly developed into a pandemic in mid of March with many countries suffering heavy human loss and declaring emergency conditions to contain its spread. The impact of the disease, while it has been relatively low in the sub-Saharan Africa (SSA) as of May 2020, is feared to be potentially devastating given the less developed and fragmented healthcare system in the continent. In addition, most emergency measures practised may not be effective due to their limited affordability as well as the communal way people in SSA live in relative isolation in clusters of large as well as smaller population centres.MethodsTo address the acute need for estimates of the potential impacts of the disease once it sweeps through the African region, we developed a process-based model with key parameters obtained from recent studies, taking local context into consideration. We further used the model to estimate the number of infections within a year of sustained local transmissions under scenarios that cover different population sizes, urban status, effectiveness and coverage of social distancing, contact tracing and usage of cloth face mask.ResultsWe showed that when implemented early, 50% coverage of contact tracing and face mask, with 33% effective social distancing policies can bringing the epidemic to a manageable level for all population sizes and settings we assessed. Relaxing of social distancing in urban settings from 33% to 25% could be matched by introduction and maintenance of face mask use at 43%.ConclusionsIn SSA countries with limited healthcare workforce, hospital resources and intensive care units, a robust system of social distancing, contact tracing and face mask use could yield in outcomes that prevent several millions of infections and thousands of deaths across the continent.

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