scholarly journals High mortality in subjects with both diabetes and HIV in sub-Saharan Africa

AIDS ◽  
2018 ◽  
Vol 32 (14) ◽  
pp. 2083-2084
Author(s):  
Philip I. Burgess ◽  
Simon P. Harding ◽  
Petros C. Kayange ◽  
Joep van Oosterhout ◽  
Marta García-Fiñana ◽  
...  
Keyword(s):  
High Mortality ◽  
Sub Saharan Africa ◽  
Sub Saharan

scholarly journals OC 8494 DRIVING REDUCED AIDS-ASSOCIATED MENINGO-ENCEPHALITIS MORTALITY

2019 ◽  
Vol 4 (Suppl 3) ◽  
pp. A10.2-A10
Author(s):  
Angela Loyse ◽  
Godfrey S Mfinanga ◽  
Cecilia Kanyama ◽  
Charles Kounfack ◽  
Sokoine Lesikari ◽  
...  
Keyword(s):  
High Mortality ◽  
Routine Care ◽  
Sub Saharan Africa ◽  
Contributing Factors ◽  
Train The Trainer ◽  
Csf Analysis ◽  
Laboratory Capacity ◽  
Poor Access ◽  
Microbiological Techniques ◽  
Sub Saharan

BackgroundDREAMM is an implementation study aiming to reduce meningo-encephalitis related mortality. Delays in diagnosis and treatment through poor access to diagnostics and treatments are significant contributing factors to the ongoing high mortality of HIV-associated central nervous system (CNS) infections, causing up to 25% of all HIV-related deaths in sub-Saharan Africa.MethodsA before-after design is being implemented across 3 sites in Africa; Lilongwe, Malawi, Dar Es Salaam, Tanzania and Yaoundé, Cameroon. The study is composed of 3 phases: Observation, Training and Implementation.ResultsThe observation phase (audit of practice) happened between November 2016 – May 2017 in Malawi and Tanzania. Overall, 110 patients were included. Ten-week all-cause mortality was 64% (42/66) in Tanzania and 37% (13/35) in Malawi. Approximately 75% of patients were ART experienced. Across sites, 76.6% of patients presented with abnormal mental status, with a median baseline CD4 count of 50 cells/µL. Only 2/75 patients in Tanzania had a lumbar puncture ordered compared to 27/35 in Malawi. All patients in Tanzania received empirical Fluconazole monotherapy whereas almost 1/3 patients in Malawi (11/35) were treated with Amphotericin B which is not readily available in both countries.The training phase (completed in November 2017 for Malawi and Tanzania) used the train-the-trainer approach. Interactive workshops on using rapid diagnostic tests (RDTs), performing basic microbiological techniques and safe administration of medicines were chosen as the most pertinent to reducing mortality. Patient and laboratory pathways were optimised afterwards by increasing the routine laboratory capacity, performing CSF analysis, providing infectious diseases mentorship for clinicians and procuring RDTs and reagents not locally available.Implementation is underway in Malawi and Tanzania and the audit phase is scheduled for autumn in Cameroon. Upon completion, the project is expected to create a sustainable approach to reduce the high mortality of HIV-related meningo-encephalitis with the optimised patient and laboratory pathways embedded within routine care.

scholarly journals Adhesion ofPlasmodium falciparum-infected erythrocytes to human cells: molecular mechanisms and therapeutic implications

2009 ◽  
Vol 11 ◽  
Author(s):  
J. Alexandra Rowe ◽  
Antoine Claessens ◽  
Ruth A. Corrigan ◽  
Mònica Arman
Keyword(s):  
Mortality Rate ◽  
Severe Malaria ◽  
High Mortality ◽  
Molecular Mechanisms ◽  
Disease Process ◽  
Underlying Disease ◽  
Human Cells ◽  
Sub Saharan Africa ◽  
Therapeutic Implications ◽  
Sub Saharan

Severe malaria has a high mortality rate (15–20%) despite treatment with effective antimalarial drugs. Adjunctive therapies for severe malaria that target the underlying disease process are therefore urgently required. Adhesion of erythrocytes infected withPlasmodium falciparumto human cells has a key role in the pathogenesis of life-threatening malaria and could be targeted with antiadhesion therapy. Parasite adhesion interactions include binding to endothelial cells (cytoadherence), rosetting with uninfected erythrocytes and platelet-mediated clumping of infected erythrocytes. Recent research has started to define the molecular mechanisms of parasite adhesion, and antiadhesion therapies are being explored. However, many fundamental questions regarding the role of parasite adhesion in severe malaria remain unanswered. There is strong evidence that rosetting contributes to severe malaria in sub-Saharan Africa; however, the identity of other parasite adhesion phenotypes that are implicated in disease pathogenesis remains unclear. In addition, the possibility of geographic variation in adhesion phenotypes causing severe malaria, linked to differences in malaria transmission levels and host immunity, has been neglected. Further research is needed to realise the untapped potential of antiadhesion adjunctive therapies, which could revolutionise the treatment of severe malaria and reduce the high mortality rate of the disease.

scholarly journals Individual and Community-Level Factors of Perinatal Mortality in The High Mortality Regions of Ethiopia: A Multilevel Mixed-Effect Analysis

2021 ◽  
Author(s):  
Desalegn Girma ◽  
Zinie Abita ◽  
Gossa Fetene ◽  
Bamlaku Birie
Keyword(s):  
Antenatal Care ◽  
Perinatal Mortality ◽  
High Mortality ◽  
Birth Interval ◽  
Media Exposure ◽  
Sub Saharan Africa ◽  
Health Concern ◽  
Breastfeeding Initiation ◽  
Health Institutions ◽  
Sub Saharan

Abstract Background Even though perinatal mortality has declined globally; it is still the major public health concern in sub-Saharan Africa countries. Ethiopia is one of the sub-Saharan countries which contribute the highest-burden of perinatal mortality with devastating in some of the regions. Therefore, this study aimed to identify the determinant factors of perinatal mortality in the high mortality regions of Ethiopia. Method: A secondary data analysis was done by using the 2016 Ethiopian Demographic and Health Survey data. A total of 4120 mothers who had been delivered at ≥ 7 months of gestational age were included. A multilevel mixed logistic regression model was fitted to identify the predictors of perinatal mortality. Finally, a statistically significant association was declared at a p-value of ≤ 0.05. Result The study found that birth interval < 2 years (AOR = 3.71, 95%CI:2.27, 6.07),having no antenatal care (AOR = 2.43,95%CI:1.15,5.38), Initiating breast feeding after 1hour(AOR = 4.01 ,95%CI:2.49,6.51), being distant from health institutions (AOR = 1.99, 95%CI: 1.24, 3.22), having previous terminated pregnancy (AOR = 4.68, 95%CI:2.76,7.86), being mothers not autonomous(AOR = 1.96, 95%CI:1.19,3.20),being no media exposure (AOR = 2.78, 95%CI:1.48,5.59),being households ≤ 4 family sizes (AOR = 4.12, 95%CI:2.19,7.79), having ≥ 6 parity (AOR = 2.48, 95%CI:1.21, 5.22) were associated with a high odds of perinatal mortality. Conclusion The study concludes that birth interval, antenatal care, time for breastfeeding initiation, distance from health institutions, previous history of a terminated pregnancy, maternal autonomy, media exposure, family size, and parity were predictors of prenatal mortality. Therefore, programmatic emphases to maternal waiting service utilization for mothers distant from health institutions and increasing media access could reduce perinatal mortality in high mortality regions of Ethiopia.

Early Motherhood, High Mortality, and HIV/AIDS Rates in Sub-Saharan Africa

2009 ◽  
Vol 24 (1-2) ◽  
pp. 39-46 ◽  
Author(s):  
Larry Gant ◽  
Kathleen M. Heath ◽  
Gray Goziem Ejikeme
Keyword(s):  
High Mortality ◽  
Sub Saharan Africa ◽  
Early Motherhood ◽  
Sub Saharan ◽  
Hiv Aids

scholarly journals High Mortality amongst Adolescents and Adults with Bacterial Meningitis in Sub-Saharan Africa: An Analysis of 715 Cases from Malawi

PLoS ONE ◽  
2013 ◽  
Vol 8 (7) ◽  
pp. e69783 ◽  
Author(s):  
Emma C. Wall ◽  
Katharine Cartwright ◽  
Matthew Scarborough ◽  
Katherine M. Ajdukiewicz ◽  
Patrick Goodson ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
High Mortality ◽  
Sub Saharan Africa ◽  
Adolescents And Adults ◽  
Sub Saharan

RTS,S/AS01, a vaccine targeting pre-erythrocytic stages of Plasmodium falciparum

2017 ◽  
Vol 1 (6) ◽  
pp. 533-537
Author(s):  
Lorenz von Seidlein ◽  
Borimas Hanboonkunupakarn ◽  
Podjanee Jittmala ◽  
Sasithon Pukrittayakamee
Keyword(s):  
Protective Efficacy ◽  
Age Groups ◽  
Sub Saharan Africa ◽  
Phase Iii ◽  
European Medicines Agency ◽  
Older Children ◽  
Pivotal Phase ◽  
Malaria Epidemiology ◽  
Maximum Benefit ◽  
Sub Saharan

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.

Mortality and Society in Sub-Saharan Africa

1993 ◽  
Vol 47 (3) ◽  
pp. 555-556
Author(s):  
Lado Ruzicka
Keyword(s):  
Sub Saharan Africa ◽  
Sub Saharan

Adolescent Suicidality as Seen in Rural Northeastern Uganda

Crisis ◽  
2011 ◽  
Vol 32 (1) ◽  
pp. 43-51 ◽  
Author(s):  
Eugene Kinyanda ◽  
Ruth Kizza ◽  
Jonathan Levin ◽  
Sheila Ndyanabangi ◽  
Catherine Abbo
Keyword(s):  
Low Socioeconomic Status ◽  
Sub Saharan Africa ◽  
Psychosocial Risk ◽  
Psychiatric Nurses ◽  
Health Concern ◽  
Cross Sectional ◽  
Childhood Experiences ◽  
Low Socioeconomic ◽  
Dsm Iv ◽  
Sub Saharan

Background: Suicidal behavior in adolescence is a public health concern and has serious consequences for adolescents and their families. There is, however, a paucity of data on this subject from sub-Saharan Africa, hence the need for this study. Aims: A cross-sectional multistage survey to investigate adolescent suicidality among other things was undertaken in rural northeastern Uganda. Methods: A structured protocol administered by trained psychiatric nurses collected information on sociodemographics, mental disorders (DSM-IV criteria), and psychological and psychosocial risk factors for children aged 3–19 years (N = 1492). For the purposes of this paper, an analysis of a subsample of adolescents (aged 10–19 years; n = 897) was undertaken. Results: Lifetime suicidality in this study was 6.1% (95% CI, 4.6%–7.9%). Conclusions: Factors significantly associated with suicidality included mental disorder, the ecological factor district of residence, factors suggestive of low socioeconomic status, and disadvantaged childhood experiences.

Sign in / Sign up

Export Citation Format

Share Document