scholarly journals COVID-19 in Uganda: Predicting the impact of the disease and public health response on disease burden

2020 ◽  
Author(s):  
David Bell ◽  
Kristian Schultz Hansen ◽  
Agnes N. Kiragga ◽  
Andrew Kambugu ◽  
John Kissa ◽  
...  
Keyword(s):  
Public Health ◽  
Population Structure ◽  
Maternal Mortality ◽  
Disease Burden ◽  
Sub Saharan Africa ◽  
Lead Author ◽  
Mortality Data ◽  
Sub Saharan ◽  
The Impact ◽  
Hiv Aids

AbstractObjectiveCOVID-19 transmission and the public health ‘lock-down’ response are now established in sub-Saharan Africa, including Uganda. Population structure and prior morbidities differ markedly between these countries from those where outbreaks were previously established. We predicted the relative impact of COVID-19 and the response in Uganda to understand whether the benefits could be outweighed by the costs.Design and settingAge-based COVID-19 mortality data from China were applied to the population structures of Uganda and countries with previously established outbreaks, comparing theoretical mortality and disability-adjusted life years (DALYs) lost. Based on recent Ugandan data and theoretical scenarios of programme deterioration, we predicted potential additional disease burden for HIV/AIDS, malaria and maternal mortality.Main outcome measuresDALYs lost and mortality.ResultsBased on population age structure alone Uganda is predicted to have a relatively low COVID-19 burden compared to equivalent transmission in China and Western countries, with mortality and DALYs lost predicted to be 12% and 19% that of Italy. Scenarios of ‘lockdown’ impact predict HIV/AIDS and malaria equivalent to or higher than that of an extensive COVID-19 outbreak. Emerging HIV/AIDS and maternal mortality data indicate that such deterioration could be occurring.ConclusionsThe results predict a relatively low COVID-19 impact on Uganda associated with its young population, with a high risk of negative impact on non-COVID-19 disease burden from a prolonged lockdown response. The results are likely to reflect the situation in other sub-Saharan populations, underlining the importance of tailoring COVID-19 responses to population structure and potential disease vulnerabilities.Transparency statementThe lead author affirms that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that there are no discrepancies from the study as originally planned.

scholarly journals The prevalence of scabies in Monrovia, Liberia: a population-based survey

2020 ◽  
Author(s):  
Shelui Collinson ◽  
Joseph Timothy ◽  
Samuel K Zayay ◽  
Karsor K Kollie ◽  
Eglantine Lebas ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Health Problem ◽  
Public Health Problem ◽  
Sub Saharan Africa ◽  
Quality Data ◽  
Local Health ◽  
Sub Saharan ◽  
The Impact

AbstractBackgroundScabies is known to be a public health problem in many settings but the majority of recent data is from rural settings in the Pacific. There is a need for high quality data from sub-Saharan Africa and peri-Urban settings to inform scale up of scabies control efforts. There have been anecdotal reports of scabies being a public health problem in Liberia but robust data are lacking.MethodsWe conducted a cross-sectional cluster-randomised prevalence survey for scabies in a peri-urban community in Monrovia, Liberia in February-March 2020. Participants underwent a standardised examination conducted by trained local health care workers. Health related quality of life (HRQoL) was assessed using age-appropriate dermatology life quality indices (DLQIs). Prevalence estimates were calculated accounting for clustering at community and household levels and associations with key demographic variables assessed through multivariable random-effects logistic regression.Results1,318 participants from 477 households were surveyed. The prevalence of scabies prevalence was 9.3% (95% CI: 6.5-13.2%), across 75 (19.7%) households; impetigo or infected scabies prevalence was 0.8% (95% CI: 0.4-1.9%). The majority (52%) of scabies cases were classified as severe. Scabies prevalence was lower in females and higher in the youngest age group; no associations were found with other collected demographic or socio-economic variables. DLQI scores indicated a very or extremely large effect on HRQoL in 29% of adults and 18% of children diagnosed with scabies.ConclusionsOur study indicates a substantial burden of scabies in this peri-Urban population in Liberia. This was associated with significant impact on quality of life, highlighting the need for action to control scabies in this population. Further work is needed to assess the impact of interventions in this context on both the prevalence of scabies and quality of life.Plain English summaryScabies is an infestation with a microscopic mite which affects many people living in low-resource tropical countries. It causes intense itching, which can lead to complications through bacterial infection and poor quality of life. To help develop global scabies control programmes, we need a better understanding of how common it is across different tropical settings. We conducted a survey to assess the burden of scabies and bacterial skin infection in a random sample of people living in a community in Monrovia, Liberia. Information about participants and their household were collected and their skin was examined; those with skin conditions were asked about its impact on quality of life.We examined 1,318 participants and found that almost 10% of people had scanies. Scabies was more common in young children, and was more common in male children than female children. We found that there was a large impact on quality of life due mostly to the itching that scabies causes and to people feeling embarrassed or sad because of their skin condition. This scabies survey is one of the first conducted across all age groups in recent years in sub-Saharan Africa and indicates a substantial burden and impact on quality of life. More work is needed to understand how common scabies is in different settings and the impact that different treatment strategies may have.

scholarly journals Willingness to Pay for Condoms among Men in Sub-Saharan Africa

2018 ◽  
Vol 16 (1) ◽  
pp. 34 ◽  
Author(s):  
William Evans ◽  
Kuyosh Kadirov ◽  
Ibou Thior ◽  
Ramakrishnan Ganesan ◽  
Alec Ulasevich ◽  
...  
Keyword(s):  
Public Health ◽  
Willingness To Pay ◽  
Condom Use ◽  
Sub Saharan Africa ◽  
Linear Regression Models ◽  
African Countries ◽  
Donor Funding ◽  
Sub Saharan ◽  
Tool Building ◽  
Hiv Aids

HIV/AIDS and other sexually transmitted infections (STIs) continue to be among the greatest public health threats worldwide, especially in sub-Saharan Africa (SSA). Condom use remains an essential intervention to eradicate AIDS, and condom use is now higher than ever. However, free and subsidized condom funding is declining. Research on how to create healthy markets based on willingness to pay for condoms is critically important. This research has three primary aims: (1) willingness of free condom users in five African countries to pay for socially marketed condoms; (2) the relationship between specific population variables and condom brand marketing efforts and willingness to pay; and (3) potential opportunities to improve condom uptake. Nationally representative samples of at least 1200 respondents were collected in Kenya, Nigeria, South Africa, Zambia, and Zimbabwe. We collected data on a range of demographic factors, including condom use, sexual behavior, awareness of condom brands, and willingness to pay. We estimated multivariate linear regression models and found that free condom users are overwhelmingly willing to pay for condoms overall (over 90% in Nigeria) with variability by country. Free users were consistently less willing to pay for condoms if they had a positive identification with their free brand in Kenya and Zimbabwe, suggesting that condom branding is a critical strategy. Ability to pay was negatively correlated with willingness, but users who could not obtain free condoms were willing to pay for them in Kenya and Zimbabwe. In a landscape of declining donor funding, this research suggests opportunities to use scarce funds for important efforts such as campaigns to increase demand, branding of condoms, and coordination with commercial condom manufacturers to build a healthy total market approach for the product. Free condoms remain an important HIV/AIDS prevention tool. Building a robust market for paid condoms in SSA is a public health priority.

Tuberculosis in association with HIV/AIDS emerges as a major nonobstetric cause of maternal mortality in Sub-Saharan Africa

2010 ◽  
Vol 108 (3) ◽  
pp. 181-183 ◽  
Author(s):  
John Grange ◽  
Miriam Adhikari ◽  
Yusuf Ahmed ◽  
Peter Mwaba ◽  
Keertan Dheda ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Sub Saharan Africa ◽  
Sub Saharan ◽  
Hiv Aids

scholarly journals The impact of the availability of antiretroviral therapy on personal and community fear of HIV/AIDS, and HIV prevention practices in Rwimi, Uganda: A mixed-method study

2018 ◽  
Vol 1 (1) ◽  
pp. 1-14
Author(s):  
Nicole Naadu Ofosu ◽  
L. Duncan Saunders ◽  
Gian Jhangri ◽  
Afif Alibhai
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Prevention ◽  
Immune Deficiency Syndrome ◽  
Deficiency Syndrome ◽  
Sub Saharan Africa ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Sub Saharan ◽  
The Impact ◽  
Hiv Aids

The impact of the widespread availability of antiretroviral therapy (ART) on the human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) related attitudes, behaviours and practices of the general population in Sub-Saharan Africa is understudied. We assessed the impact of ART availability on the fear of HIV/ AIDS (measured at both community and personal levels) and HIV prevention practices in Rwimi, Uganda using a cross-sectional survey. The fear of HIV/AIDS was described as a perceived threat to either self and/or community regarding the risk of contracting the disease, whereby the higher the perception of the threat, the greater the fear. We assessed associations between the outcomes of the dependent variables on both the community and personal fear of HIV/AIDS, and the independent variables of HIV/AIDS-related knowledge and demographics. Qualitative data was also generated from focus group discussions (FGD) on the context of the fear of HIV/AIDS and HIV pre- vention practices. The majority of participants (89.4%; males - 86.8%; females - 90.8%) felt that ART availability has reduced the fear of HIV/AIDS in the community. In contrast, fewer participants (22.4%; males - 24.4%; females – 21.2%) mentioned that their personal fear of HIV/AIDS has been reduced with the availability of ART. From the qualitative study, factors identified as influencing the fear of HIV/AIDS included stigma, fear of infection, and the inconvenience of being on ART. Although fear of HIV/AIDS persists, the fear is reduced because of the availability of life-prolonging ART. HIV prevention practices are influenced by socio-cultural norms (gender roles, relationship dynamics, power and trust), which, we argue, should be considered when de-signing sustainable HIV/AIDS prevention programs.

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