Ecological and individual level analysis of risk factors for HIV infection in four urban populations in sub-Saharan Africa with different levels of HIV infection

AIDS ◽  
2001 ◽  
Vol 15 ◽  
pp. S15-S30 ◽  
Author(s):  
B. Auvert ◽  
A. Buvé ◽  
B. Ferry ◽  
M. Caraël ◽  
L. Morison ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hiv Infection ◽  
Sub Saharan Africa ◽  
Urban Populations ◽  
Individual Level ◽  
Sub Saharan ◽  
Different Levels ◽  
Level Analysis

Abstract MP73: Geographic Variation of Overweight and Obesity among Women in Sub-Saharan Africa: a Case Study of Nigeria

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Saverio Stranges ◽  
Ngianga-Bakwin Kandala
Keyword(s):  
Risk Factors ◽  
Geographic Variation ◽  
State Level ◽  
Demographic Variables ◽  
Overweight And Obesity ◽  
Sub Saharan Africa ◽  
Obesity Prevalence ◽  
Individual Level ◽  
Nutritional Transition ◽  
Sub Saharan

Background: Nutritional research in sub-Saharan Africa has primarily focused on under-nutrition, particularly among vulnerable population subgroups such as women and children. However, there is growing evidence of an ongoing epidemiological and nutritional transition in these settings. Objective: This study aimed to examine the geographic variation of combined overweight and obesity prevalence at the state-level among women in Nigeria, while accounting for individual-level risk factors. Methods: Our analysis was based on the 2008 Nigerian Demographic and Health Survey (NDHS), including 27,967 women aged 15 and over. Individual data were collected on socio-demographic variables, but were aggregated to the 31 states. We used a Bayesian geo-additive mixed model to map the geographic distribution of overweight/obesity at the state-level, accounting for individual-level risk factors. Results: The overall prevalence of combined overweight and obesity (body mass index ≥ 25) was 20.9%. In multivariate Bayesian geo-additive models, there were several significant associations between socio-demographic variables and prevalence of overweight/obesity. Specifically, higher education [odds ratio (OR) & 95% Credible Region (CR): 1.68 (1.38, 2.00)], higher wealth index [3.45 (2.98, 4.05)], living in urban settings [1.24 (1.14, 1.36)] and increasing age were all significantly associated with a higher prevalence of overweight/obesity. There was also a striking variation in overweight/obesity prevalence across ethnic groups and state of residence, the highest being in Cross River State, in south-eastern Nigeria [2.32 (1.62, 3.40)], the lowest in Osun State in south-western Nigeria [0.48 (0.36, 0.61)]. Conclusions: This study suggests distinct geographic patterns in the prevalence of combined overweight and obesity among Nigerian women, as well as the potential role of demographic, socio-economic and environmental factors driving the ongoing nutritional transition in these settings.

scholarly journals Sexual Risk Factors for HIV Infection in Early and Advanced HIV Epidemics in Sub-Saharan Africa: Systematic Overview of 68 Epidemiological Studies

PLoS ONE ◽  
2007 ◽  
Vol 2 (10) ◽  
pp. e1001 ◽  
Author(s):  
Li Chen ◽  
Prabhat Jha ◽  
Bridget Stirling ◽  
Sema K. Sgaier ◽  
Tina Daid ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hiv Infection ◽  
Sexual Risk ◽  
Epidemiological Studies ◽  
Sub Saharan Africa ◽  
Systematic Overview ◽  
Sub Saharan

THE DUAL BURDEN OF NUTRITION TRANSITION AMONG WOMEN IN SUB-SAHARAN AFRICA: A CASE STUDY OF UNDERWEIGHT IN NIGERIA

2015 ◽  
Vol 48 (4) ◽  
pp. 486-501 ◽  
Author(s):  
Ngianga-Bakwin Kandala ◽  
Jacques B. O. Emina
Keyword(s):  
Risk Factors ◽  
Mixed Model ◽  
Nutrition Transition ◽  
Public Health Problem ◽  
Sub Saharan Africa ◽  
Major Public Health Problem ◽  
Individual Level ◽  
Under Nutrition ◽  
Nutrition Research ◽  
Sub Saharan

SummaryIn sub-Saharan Africa, nutrition research has primarily focused on under-nutrition, particularly among vulnerable children. However, there is increasing evidence of an emerging nutrition transition with extremely high rates of obesity, and malnutrition in women may be a problem that is insufficiently recognized and inadequately documented. This analysis was based on the 2008 Nigerian Demographic and Health Survey (NDHS), which included 27,967 women aged 15–49 years. Individual-level data were collected for socio-demographic characteristics and aggregated to the country’s 37 states. A Bayesian geo-additive mixed model was used to map the geographic distribution of under-nutrition at the state level, accounting for individual-level risk factors. The results reveal that 12.0% of the population were underweight, while 20.9% were either overweight or obese, based on BMI. The northern states of Sokoto and Yobe/Borno and the southern state of Delta had the highest prevalence of underweight, while states in the centre had the lowest underweight prevalence. Underweight women were more likely to be from poorer households compared with their counterparts from the richest wealth index, which were consistently associated with lower odds of being underweight (posterior odds ratio (POR) and 95% credible region (CR): 0.56 [0.46, 0.70]). On the other hand Muslim women (1.61 [1.10, 2.23]), those of traditional religion (2.12 [1.44, 3.00]), those from the Fulani ethnic group (2.90 [1.64, 5.55]) and those living in Yobe state were all consistently associated with higher odds of being underweight. This study demonstrates that underweight is a major public health problem in Nigeria affecting adult females in the northern states of Nigeria. Identifying risk factors and the need to account for sex, spatial and socio-cultural issues are crucial to develop and implement evidence-informed strategies and interventions for lifestyle health promotion.

Undernutrition and HIV Infection in Sub-Saharan Africa: Health Outcomes and Therapeutic Interventions

2021 ◽  
Vol 18 (2) ◽  
pp. 87-97
Author(s):  
Hubaida Fuseini ◽  
Ben A. Gyan ◽  
George B. Kyei ◽  
Douglas C. Heimburger ◽  
John R. Koethe
Keyword(s):  
Hiv Infection ◽  
Health Outcomes ◽  
Sub Saharan Africa ◽  
Therapeutic Interventions ◽  
Sub Saharan

scholarly journals Predictors of lost to follow up from antiretroviral therapy among adults in sub-Saharan Africa: a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Hafte Kahsay Kebede ◽  
Lillian Mwanri ◽  
Paul Ward ◽  
Hailay Abrha Gesesew
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Care Services ◽  
Validity Assessment ◽  
Sub Saharan ◽  
Lost To Follow Up

Abstract Background It is known that ‘drop out’ from human immunodeficiency virus (HIV) treatment, the so called lost-to-follow-up (LTFU) occurs to persons enrolled in HIV care services. However, in sub-Saharan Africa (SSA), the risk factors for the LTFU are not well understood. Methods We performed a systematic review and meta-analysis of risk factors for LTFU among adults living with HIV in SSA. A systematic search of literature using identified keywords and index terms was conducted across five databases: MEDLINE, PubMed, CINAHL, Scopus, and Web of Science. We included quantitative studies published in English from 2002 to 2019. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for methodological validity assessment and data extraction. Mantel Haenszel method using Revman-5 software was used for meta-analysis. We demonstrated the meta-analytic measure of association using pooled odds ratio (OR), 95% confidence interval (CI) and heterogeneity using I2 tests. Results Thirty studies met the search criteria and were included in the meta-analysis. Predictors of LTFU were: demographic factors including being: (i) a male (OR = 1.2, 95% CI 1.1–1.3, I2 = 59%), (ii) between 15 and 35 years old (OR = 1.3, 95% CI 1.1–1.3, I2 = 0%), (iii) unmarried (OR = 1.2, 95% CI 1.2–1.3, I2 = 21%), (iv) a rural dweller (OR = 2.01, 95% CI 1.5–2.7, I2 = 40%), (v) unemployed (OR = 1.2, 95% CI 1.04–1.4, I2 = 58%); (vi) diagnosed with behavioral factors including illegal drug use(OR = 13.5, 95% CI 7.2–25.5, I2 = 60%), alcohol drinking (OR = 2.9, 95% CI 1.9–4.4, I2 = 39%), and tobacco smoking (OR = 2.6, 95% CI 1.6–4.3, I2 = 74%); and clinical diagnosis of mental illness (OR = 3.4, 95% CI 2.2–5.2, I2 = 1%), bed ridden or ambulatory functional status (OR = 2.2, 95% CI 1.5–3.1, I2 = 74%), low CD4 count in the last visit (OR = 1.4, 95% CI 1.1–1.9, I2 = 75%), tuberculosis co-infection (OR = 1.2, 95% CI 1.02–1.4, I2 = 66%) and a history of opportunistic infections (OR = 2.5, 95% CI 1.7–2.8, I2 = 75%). Conclusions The current review identifies demographic, behavioral and clinical factors to be determinants of LTFU. We recommend strengthening of HIV care services in SSA targeting the aforementioned group of patients. Trial registration Protocol: the PROSPERO Registration Number is CRD42018114418

scholarly journals Inflammatory bowel disease in sub-Saharan Africa: a protocol of a prospective registry with a nested case–control study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e039456
Author(s):  
Leolin Katsidzira ◽  
Wisdom F Mudombi ◽  
Rudo Makunike-Mutasa ◽  
Bahtiyar Yilmaz ◽  
Annika Blank ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Case Control Study ◽  
Alpha Diversity ◽  
Case Control ◽  
Sub Saharan Africa ◽  
Inflammatory Bowel ◽  
Sub Saharan ◽  
Nested Case Control ◽  
Control Study

IntroductionThe epidemiology of inflammatory bowel disease (IBD) in sub-Saharan Africa is poorly documented. We have started a registry to determine the burden, phenotype, risk factors, disease course and outcomes of IBD in Zimbabwe.Methods and analysisA prospective observational registry with a nested case–control study has been established at a tertiary hospital in Harare, Zimbabwe. The registry is recruiting confirmed IBD cases from the hospital, and other facilities throughout Zimbabwe. Demographic and clinical data are obtained at baseline, 6 months and annually. Two age and sex-matched non-IBD controls per case are recruited—a sibling or second-degree relative, and a randomly selected individual from the same neighbourhood. Cases and controls are interviewed for potential risk factors of IBD, and dietary intake using a food frequency questionnaire. Stool is collected for 16S rRNA-based microbiota profiling, and along with germline DNA from peripheral blood, is being biobanked. The estimated sample size is 86 cases and 172 controls, and the overall registry is anticipated to run for at least 5 years. Descriptive statistics will be used to describe the demographic and phenotypic characteristics of IBD, and incidence and prevalence will be estimated for Harare. Risk factors for IBD will be analysed using conditional logistic regression. For microbial analysis, alpha diversity and beta diversity will be compared between cases and controls, and between IBD phenotypes. Mann-Whitney U tests for alpha diversity and Adonis (Permutational Multivariate Analysis of Variance) for beta diversity will be computed.Ethics and disseminationEthical approval has been obtained from the Parirenyatwa Hospital’s and University of Zimbabwe’s research ethics committee and the Medical Research Council of Zimbabwe. Findings will be discussed with patients, and the Zimbabwean Ministry of Health. Results will be presented at scientific meetings, published in peer reviewed journals, and on social media.Trial registration numberNCT04178408.

scholarly journals Estimating the burden of cardiovascular risk in community dwellers over 40 years old in South Africa, Kenya, Burkina Faso and Ghana

2021 ◽  
Vol 6 (1) ◽  
pp. e003499
Author(s):  
Ryan G Wagner ◽  
Nigel J Crowther ◽  
Lisa K Micklesfield ◽  
Palwende Romauld Boua ◽  
Engelbert A Nonterah ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
South African ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Cvd Risk ◽  
Genomic Studies ◽  
Sub Saharan ◽  
Context Specific ◽  
The Impact

IntroductionCardiovascular disease (CVD) risk factors are increasing in sub-Saharan Africa. The impact of these risk factors on future CVD outcomes and burden is poorly understood. We examined the magnitude of modifiable risk factors, estimated future CVD risk and compared results between three commonly used 10-year CVD risk factor algorithms and their variants in four African countries.MethodsIn the Africa-Wits-INDEPTH partnership for Genomic studies (the AWI-Gen Study), 10 349 randomly sampled individuals aged 40–60 years from six sites participated in a survey, with blood pressure, blood glucose and lipid levels measured. Using these data, 10-year CVD risk estimates using Framingham, Globorisk and WHO-CVD and their office-based variants were generated. Differences in future CVD risk and results by algorithm are described using kappa and coefficients to examine agreement and correlations, respectively.ResultsThe 10-year CVD risk across all participants in all sites varied from 2.6% (95% CI: 1.6% to 4.1%) using the WHO-CVD lab algorithm to 6.5% (95% CI: 3.7% to 11.4%) using the Framingham office algorithm, with substantial differences in risk between sites. The highest risk was in South African settings (in urban Soweto: 8.9% (IQR: 5.3–15.3)). Agreement between algorithms was low to moderate (kappa from 0.03 to 0.55) and correlations ranged between 0.28 and 0.70. Depending on the algorithm used, those at high risk (defined as risk of 10-year CVD event >20%) who were under treatment for a modifiable risk factor ranged from 19.2% to 33.9%, with substantial variation by both sex and site.ConclusionThe African sites in this study are at different stages of an ongoing epidemiological transition as evidenced by both risk factor levels and estimated 10-year CVD risk. There is low correlation and disparate levels of population risk, predicted by different risk algorithms, within sites. Validating existing risk algorithms or designing context-specific 10-year CVD risk algorithms is essential for accurately defining population risk and targeting national policies and individual CVD treatment on the African continent.

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