scholarly journals Systematic Identification of Correlates of HIV-1 Infection: An X-Wide Association Study in Zambia

2017 ◽  
Author(s):  
Chirag J. Patel ◽  
Jay Bhattacharya ◽  
John P.A. Ioannidis ◽  
Eran Bendavid
Keyword(s):  
Association Study ◽  
Univariate Analysis ◽  
Area Under The Curve ◽  
Risk Groups ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
History Of ◽  
Nationally Representative ◽  
Sub Saharan ◽  
Hiv 1

AbstractBackgroundHIV-1 remains the leading cause of death among adults in Sub-Saharan Africa, and over 1 million people are infected annually. Better identification of at-risk groups could benefit prevention and treatment programmes. We systematically identified factors related to HIV-1 infection in two nationally representative cohorts of women that participated in Zambia’s Demographic and Health Surveys (DHS).MethodsWe conducted a comprehensive analysis to identify and replicate the association of 1,415 social, economic, environmental, and behavioral indicators with HIV-1 status. We used the 2007 and 2013-2014 DHS surveys conducted among 5,715 and 15,433 Zambian women, respectively (727 indicators in 2007; 688 in 2013-2014; 688 in both). We used false discovery rate criteria to identify indicators that are strongly associated with HIV-1 in univariate and multivariate models in the entire population, as well as in subgroups stratified by wealth, residence, age, and history of HIV-1 testing.FindingsIn the univariate analysis we identified 102 and 182 variables that are associated with HIV-1 in the 2007 and 2013-2014 surveys, respectively, among which 79 were associated in both. Variables that were associated with HIV-1 status in all full-sample models (unadjusted and adjusted) as well as in at least 17 out of 18 subgroups include being formerly in a union (adjusted OR 2007 2.8, p<10−16; 2013-2014 2.8, p<10−29), widowhood (adjusted OR 2007 3.7, p<10−12; 2013-2014 4.2, p<10−30), history of genital ulcers in the last 12 months (adjusted 2007 OR 2.4, p<10−5; 2013-2014 2.2, p<10−6), and having a woman for the head of the household (2007 OR 1.7, p<10−7; 2013-2014 OR 2.1, p<10−26), while owning a bicycle (adjusted 2007 OR 0.6, p<10−6; 2013-2014 0.6, p<10−8) and currently breastfeeding (adjusted 2007 OR 0.5, p<10−9; 2013-2014 0.4, p<10−26) were associated with decreased risk. Using the identified variables, area under the curve for HIV-1 positivity ranged from 0.76 to 0.82.InterpretationOur X-wide association study in Zambian women identifies multiple under-recognized factors correlated with HIV-1 infection in 2007 and 2013-2014, including widowhood, breastfeeding, and being the head of the household. These variables could be used to improve HIV-1 testing and identification programs.

scholarly journals Detection of Early HIV-1 Infection among Febrile Persons and Blood Donors in Oyo State, Nigeria

2020 ◽  
Author(s):  
Babatunde A. Olusola ◽  
David O. Olaleye ◽  
Georgina N. Odaibo
Keyword(s):  
Blood Donors ◽  
Risk Groups ◽  
Sub Saharan Africa ◽  
Transmission Risk ◽  
Limited Information ◽  
Antibody Elisa ◽  
Sub Saharan ◽  
Antigen Antibody ◽  
Hiv 1 ◽  
Rapid Antibody

AbstractAbout 37.9 million persons are infected with HIV globally resulting in 770,000 deaths. Over 50% of this infection and deaths occur in Sub-Saharan Africa with countries like Nigeria greatly affected. The country also has one of the highest rate of new infections globally. Diverse HIV-1 subtypes have been identified in the country. Febrile persons and blood donors pose a great transmission risk in the country especially during the early stages of infection. HIV-1 rapid kits are routinely used for diagnosis among the general population and high risk groups. However, there is limited information on the usefulness of HIV rapid kits for early detection especially in areas where diverse HIV-1 subtypes circulate. In this study, the prevalence of early HIV-1 infection as well as circulating HIV-1 subtypes among febrile persons and blood donors were determined. Furthermore, the sensitivity of a widely used HIV-1 rapid antibody kit was compared with those of Antigen/Antibody ELISA based methods. Participants were recruited from selected hospitals in Ibadan and Saki, Nigeria. The prevalence of early HIV infection among 1028 febrile persons (Ibadan: 2.22%; Saki: 1.36%) and blood donors (5.07%) studied were significantly different (P<0.03674). CRF02_AG was the predominant subtype detected with more diverse HIV-1 subtypes observed among febrile persons compared to blood donors. About 1.2% of the samples detected on Antibody based ELISA methods were undetectable on the HIV-1 rapid antibody kit. Genetic diversity of HIV-1 strains among infected individuals in Oyo State, Nigeria is still relatively high. This diversity is likely impacting on diagnosis.

Association between type of contraceptive use and haemoglobin status among women of reproductive age in 24 sub-Saharan Africa countries

2018 ◽  
Vol 45 (1) ◽  
pp. 54-60 ◽  
Author(s):  
Samson Gebremedhin ◽  
Anteneh Asefa
Keyword(s):  
Contraceptive Use ◽  
Secondary Data ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Hormonal Contraceptives ◽  
Demographic And Health Surveys ◽  
Barrier Methods ◽  
Oral Contraceptive Pills ◽  
Nationally Representative ◽  
Sub Saharan

BackgroundLittle is known whether contraceptive methods differentially modify women’s risk of anaemia or not. We compared the haemoglobin status of women currently using different fertility regulation methods in sub-Saharan Africa (SSA) where anaemia is a major concern.MethodsWe conducted the study based on the secondary data of 24 nationally representative demographic and health surveys carried out recently in SSA. The data of 105 532 women were included in the analysis. In the original surveys, respondents were selected using multistage sampling techniques and haemoglobin was determined using the HemoCue analyser. The association between method of contraception and anaemia status was determined via a mixed-effects logistic regression model adjusted for potential confounders. The outputs are presented using adjusted odds ratio (AOR) with 95% CI.ResultsThe mean (±SD deviation) haemoglobin was 12.3 (±1.7) g/dl and 36.7% of the women had anaemia. Current use of modern contraceptives, as compared with non-use, was associated with a 25% reduction (AOR=0.75 (95% CI: 0.73 to 0.78)) in the odds of anaemia. Comparison among individual modern methods showed, as compared with current barrier methods users, use of injectables (AOR=0.62 (95% CI: 0.57 to 0.67)), oral contraceptive pills (OCP) (AOR=0.62 (95% CI: 0.57 to 0.66)) and implants (AOR=0.63 (95% CI: 0.58 to 0.70)) were significantly associated with reduced odds of anaemia. With reference to women with less than 12 months of use, the odds were significantly reduced by about a quarter among women with more than 12 months of OCP or injectables use.ConclusionThe use of hormonal contraceptives is associated with lower odds of anaemia.

scholarly journals Recent Underweight and Overweight Trends by Rural–Urban Residence among Women in Low- and Middle-Income Countries

2014 ◽  
Vol 145 (2) ◽  
pp. 352-357 ◽  
Author(s):  
Lindsay M Jaacks ◽  
Meghan M Slining ◽  
Barry M Popkin
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Urban Residence ◽  
African Countries ◽  
Middle Income ◽  
Rate Of Increase ◽  
Nationally Representative ◽  
Sub Saharan

AbstractBackground: Long-term trends mask critical recent dynamics in the prevalence of under- and overweight.Objective: The objective of this study was to compare annualized prevalence rates of both under- and overweight among nonpregnant women aged 19–49 y during the periods covering 1) the 1990s–the early 2000s and 2) the early 2000s–the late 2000s or early 2010s, by rural–urban residence.Methods: Data are from nationally representative surveys (29 Demographic and Health Surveys and 4 national surveys). Standardized protocols were used to measure weight and height. Underweight was defined as body mass index (BMI) < 18.5 kg/m2 and overweight as BMI ≥ 25 kg/m2.Results: From the 1990s to the early 2000s, most countries were making progress on decreasing the prevalence of underweight, especially in rural areas. Although many countries continued to make progress more recently, several countries in Sub-Saharan Africa that previously had a decreasing prevalence of underweight now have an increasing prevalence of underweight. For example, in rural areas of Senegal, the prevalence of underweight decreased 0.23% annually between 1992 and 2005, then increased 1.60% annually between 2005 and 2010. Meanwhile, the prevalence of overweight is increasing in nearly all countries, and in approximately half of all countries, the rate of increase is greater in rural areas than in urban areas. Although underweight persists as more prevalent than overweight in rural areas of many East Asian, South Asian, and Sub-Saharan African countries, the ratio of underweight to overweight in many countries has decreased over time, indicating that this trend is reversing.Conclusions: Select countries in Sub-Saharan Africa may be more susceptible to food crises and should be targets for intervention. At the same time, global health efforts need to focus on preventing overweight, particularly in rural areas, which are quickly catching up to their urban counterparts.

scholarly journals The Role of Phylogenetics in Discerning HIV-1 Mixing among Vulnerable Populations and Geographic Regions in Sub-Saharan Africa: A Systematic Review

Viruses ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1174
Author(s):  
George M. Nduva ◽  
Jamirah Nazziwa ◽  
Amin S. Hassan ◽  
Eduard J. Sanders ◽  
Joakim Esbjörnsson
Keyword(s):  
Risk Group ◽  
Risk Groups ◽  
Phylogenetic Inference ◽  
Sub Saharan Africa ◽  
Transmission Dynamics ◽  
Source Attribution ◽  
Transmission Networks ◽  
Sub Saharan ◽  
Hiv 1

To reduce global HIV-1 incidence, there is a need to understand and disentangle HIV-1 transmission dynamics and to determine the geographic areas and populations that act as hubs or drivers of HIV-1 spread. In Sub-Saharan Africa (sSA), the region with the highest HIV-1 burden, information about such transmission dynamics is sparse. Phylogenetic inference is a powerful method for the study of HIV-1 transmission networks and source attribution. In this review, we assessed available phylogenetic data on mixing between HIV-1 hotspots (geographic areas and populations with high HIV-1 incidence and prevalence) and areas or populations with lower HIV-1 burden in sSA. We searched PubMed and identified and reviewed 64 studies on HIV-1 transmission dynamics within and between risk groups and geographic locations in sSA (published 1995–2021). We describe HIV-1 transmission from both a geographic and a risk group perspective in sSA. Finally, we discuss the challenges facing phylogenetic inference in mixed epidemics in sSA and offer our perspectives and potential solutions to the identified challenges.

scholarly journals Trends in obesity by socioeconomic status among non-pregnant women aged 15–49 y: a cross-sectional, multi-dimensional equity analysis of demographic and health surveys in 11 sub-Saharan Africa countries, 1994–2015

2020 ◽  
Author(s):  
Oghenebrume Wariri ◽  
Jacob Albin Korem Alhassan ◽  
Godwin Mark ◽  
Oyinkansola Adesiyan ◽  
Lori Hanson
Keyword(s):  
Health Surveys ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Women Of Reproductive Age ◽  
Or Education ◽  
Cross Sectional ◽  
Nationally Representative ◽  
Sub Saharan ◽  
Ssa Countries

Abstract Background Global obesity estimates show a steadily increasing pattern across socioeconomic and geographical divides, especially among women. Our analysis tracked and described obesity trends across multiple equity dimensions among women of reproductive age (15–49 y) in 11 sub-Saharan African (SSA) countries during 1994–2015. Methods This study consisted of a cross-sectional series analysis using nationally representative demographic and health surveys (DHS) data. The countries included were Cameroon, Comoros, Congo, Cote d'Ivoire, Ghana, Kenya, Lesotho, Nigeria, Senegal, Zambia and Zimbabwe. The data reported are from a reanalysis conducted using the WHO Health Equity Assessment Toolkit that assesses inter- and intra-country health inequalities across socioeconomic and geographical dimensions. We generated equiplots to display intra- and inter-country equity gaps. Results There was an increasing trend in obesity among women of reproductive age across all 11 SSA countries. Obesity increased unequally across wealth categories, place of residence and educational measures of inequality. The wealthiest, most educated and urban dwellers in most countries had a higher prevalence of obesity. However, in Comoros, obesity did not increase consistently with increasing wealth or education compared with other countries. The most educated and wealthiest women in Comoros had lower obesity rates compared with their less wealthy and less well-educated counterparts. Conclusion A window of opportunity is presented to governments to act structurally and at policy level to reduce obesity generally and prevent a greater burden on disadvantaged subpopulation groups in sub-Saharan Africa.

Christianity in the Twentieth Century

2019 ◽  
Author(s):  
Brian Stanley
Keyword(s):  
Latin America ◽  
Racial Identity ◽  
Sub Saharan Africa ◽  
Central Importance ◽  
Regional Survey ◽  
History Of Christianity ◽  
The World ◽  
History Of ◽  
Sub Saharan ◽  
Different Parts

This book charts the transformation of one of the world's great religions during an age marked by world wars, genocide, nationalism, decolonization, and powerful ideological currents, many of them hostile to Christianity. The book traces how Christianity evolved from a religion defined by the culture and politics of Europe to the expanding polycentric and multicultural faith it is today—one whose growing popular support is strongest in sub-Saharan Africa, Latin America, China, and other parts of Asia. The book sheds critical light on themes of central importance for understanding the global contours of modern Christianity, illustrating each one with contrasting case studies, usually taken from different parts of the world. Unlike other books on world Christianity, this one is not a regional survey or chronological narrative, nor does it focus on theology or ecclesiastical institutions. The book provides a history of Christianity as a popular faith experienced and lived by its adherents, telling a compelling and multifaceted story of Christendom's fortunes in Europe, North America, and across the rest of the globe. It demonstrates how Christianity has had less to fear from the onslaughts of secularism than from the readiness of Christians themselves to accommodate their faith to ideologies that privilege racial identity or radical individualism.

scholarly journals Active Components from Cassia abbreviata Prevent HIV-1 Entry by Distinct Mechanisms of Action

2021 ◽  
Vol 22 (9) ◽  
pp. 5052
Author(s):  
Yue Zheng ◽  
Xian-Wen Yang ◽  
Dominique Schols ◽  
Mattia Mori ◽  
Bruno Botta ◽  
...  
Keyword(s):  
Crude Extract ◽  
Female Genital Tract ◽  
Binding Activity ◽  
Sub Saharan Africa ◽  
Active Components ◽  
Chemical Structures ◽  
3D Space ◽  
In Silico Study ◽  
Sub Saharan ◽  
Hiv 1

Cassia abbreviata is widely used in Sub-Saharan Africa for treating many diseases, including HIV-1 infection. We have recently described the chemical structures of 28 compounds isolated from an alcoholic crude extract of barks and roots ofC. abbreviata, and showed that six bioactive compounds inhibit HIV-1 infection. In the present study, we demonstrate that the six compounds block HIV-1 entry into cells: oleanolic acid, palmitic acid, taxifolin, piceatannol, guibourtinidol-(4α®8)-epiafzelechin, and a novel compound named as cassiabrevone. We report, for the first time, that guibourtinidol-(4α®8)-epiafzelechin and cassiabrevone inhibit HIV-1 entry (IC50 of 42.47 µM and 30.96 µM, respectively), as well as that piceatannol interacts with cellular membranes. Piceatannol inhibits HIV-1 infection in a dual-chamber assay mimicking the female genital tract, as well as HSV infection, emphasizing its potential as a microbicide. Structure-activity relationships (SAR) showed that pharmacophoric groups of piceatannol are strictly required to inhibit HIV-1 entry. By a ligand-based in silico study, we speculated that piceatannol and norartocarpetin may have a very similar mechanism of action and efficacy because of the highly comparable pharmacophoric and 3D space, while guibourtinidol-(4α®8)-epiafzelechin and cassiabrevone may display a different mechanism. We finally show that cassiabrevone plays a major role of the crude extract of CA by blocking the binding activity of HIV-1 gp120 and CD4.

scholarly journals Gestational weight gain in low-income and middle-income countries: a modelling analysis using nationally representative data

2020 ◽  
Vol 5 (11) ◽  
pp. e003423
Author(s):  
Dongqing Wang ◽  
Molin Wang ◽  
Anne Marie Darling ◽  
Nandita Perumal ◽  
Enju Liu ◽  
...  
Keyword(s):  
Weight Gain ◽  
North Africa ◽  
Low Income ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Middle Income Countries ◽  
Gestational Weight ◽  
Latin America And Caribbean ◽  
Nationally Representative ◽  
Sub Saharan

IntroductionGestational weight gain (GWG) has important implications for maternal and child health and is an ideal modifiable factor for preconceptional and antenatal care. However, the average levels of GWG across all low-income and middle-income countries of the world have not been characterised using nationally representative data.MethodsGWG estimates across time were computed using data from the Demographic and Health Surveys Program. A hierarchical model was developed to estimate the mean total GWG in the year 2015 for all countries to facilitate cross-country comparison. Year and country-level covariates were used as predictors, and variable selection was guided by the model fit. The final model included year (restricted cubic splines), geographical super-region (as defined by the Global Burden of Disease Study), mean adult female body mass index, gross domestic product per capita and total fertility rate. Uncertainty ranges (URs) were generated using non-parametric bootstrapping and a multiple imputation approach. Estimates were also computed for each super-region and region.ResultsLatin America and Caribbean (11.80 kg (95% UR: 6.18, 17.41)) and Central Europe, Eastern Europe and Central Asia (11.19 kg (95% UR: 6.16, 16.21)) were the super-regions with the highest GWG estimates in 2015. Sub-Saharan Africa (6.64 kg (95% UR: 3.39, 9.88)) and North Africa and Middle East (6.80 kg (95% UR: 3.17, 10.43)) were the super-regions with the lowest estimates in 2015. With the exception of Latin America and Caribbean, all super-regions were below the minimum GWG recommendation for normal-weight women, with Sub-Saharan Africa and North Africa and Middle East estimated to meet less than 60% of the minimum recommendation.ConclusionThe levels of GWG are inadequate in most low-income and middle-income countries and regions. Longitudinal monitoring systems and population-based interventions are crucial to combat inadequate GWG in low-income and middle-income countries.

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