scholarly journals Reconciling model predictions with low reported cases of COVID-19 in Sub-Saharan Africa: Insights from Madagascar

2020 ◽  
Author(s):  
Michelle V Evans ◽  
Andres V Garchitorena ◽  
Rado JL Rakotonanahary ◽  
John M Drake ◽  
Benjamin Andriamihaja ◽  
...  
Keyword(s):  
Sub Saharan Africa ◽  
Case Detection ◽  
Detection Rates ◽  
Health Crisis ◽  
Policy Interventions ◽  
Early Implementation ◽  
Imported Cases ◽  
Sub Saharan ◽  
Age Structured ◽  
Water And Sanitation Infrastructure

The COVID-19 pandemic has wreaked havoc globally, and there has been a particular concern for sub-Saharan Africa (SSA), where models suggest that the majority of the population will become infected. Conventional wisdom suggests that the continent will bear a higher burden of COVID-19 for the same reasons it suffers high burdens of other infectious diseases: ecology, socio-economic conditions, lack of water and sanitation infrastructure, and weak health systems. However, so far SSA has reported lower incidence and fatalities compared to the predictions of standard models and the experience of other regions of the world. There are three leading explanations, each with very different implications for the final epidemic burden: (1) low case detection, (2) differences in COVID-19 epidemiology (e.g. low R0), and (3) policy interventions. The low number of cases to date have led some SSA governments to relax these policy interventions. Will this result in a resurgence of cases? To understand how to interpret the lower-than-expected COVID-19 case data in Madagascar, we use a simple age-structured model to explore each of these explanations and predict the epidemic impact associated with them. We show that the current incidence of COVID-19 cases can be explained by any combination of the late introduction of first imported cases, early implementation of non-pharmaceutical interventions (NPIs), and low case detection rates. This analysis reinforces that Madagascar, along with other countries in SSA, remains at risk of an impending health crisis. If NPIs remain enforced, up to 50,000 lives may be saved. Even with NPIs, without vaccines and new therapies, COVID-19 could infect up to 30% of the population, making it the largest public health threat in Madagascar until early 2021, hence the importance of conducting clinical trials and continually improving access to healthcare.

A cholera outbreak among semi-nomadic pastoralists in northeastern Uganda: epidemiology and interventions

2011 ◽  
Vol 140 (8) ◽  
pp. 1376-1385 ◽  
Author(s):  
M. J. CUMMINGS ◽  
J. F. WAMALA ◽  
M. EYURA ◽  
M. MALIMBO ◽  
M. E. OMEKE ◽  
...  
Keyword(s):  
Female Gender ◽  
Sub Saharan Africa ◽  
Cholera Outbreak ◽  
Community Based ◽  
Nomadic Pastoralists ◽  
Sub Saharan ◽  
Water And Sanitation Infrastructure ◽  
Sanitation Infrastructure ◽  
Village Health Teams

SUMMARYIn sub-Saharan Africa, many nomadic pastoralists have begun to settle in permanent communities as a result of long-term water, food, and civil insecurity. Little is known about the epidemiology of cholera in these emerging semi-nomadic populations. We report the results of a case-control study conducted during a cholera outbreak among semi-nomadic pastoralists in the Karamoja sub-region of northeastern Uganda in 2010. Data from 99 cases and 99 controls were analysed. In multivariate analyses, risk factors identified were: residing in the same household as another cholera case [adjusted odds ratio (aOR) 6·67, 95% confidence interval (CI) 2·83–15·70], eating roadside food (aOR 2·91, 95% CI 1·24–6·81), not disposing of children's faeces in a latrine (aOR 15·76, 95% CI 1·54–161·25), not treating drinking water with chlorine (aOR 3·86, 95% CI 1·63–9·14), female gender (aOR 2·43, 95% CI 1·09–5·43), and childhood age (10–17 years) (aOR 7·14, 95% CI 1·97–25·83). This is the first epidemiological study of cholera reported from a setting of semi-nomadic pastoralism in sub-Saharan Africa. Public health interventions among semi-nomadic pastoralists should include a two-faceted approach to cholera prevention: intensive health education programmes to address behaviours inherited from insecure nomadic lifestyles, as well as improvements in water and sanitation infrastructure. The utilization of community-based village health teams provides an important method of implementing such activities.

A Systems Approach for Sustainably Reducing Childhood Diarrheal Deaths in Developing Countries

2016 ◽  
pp. 1208-1227
Author(s):  
Monica Gray
Keyword(s):  
Developing Countries ◽  
Low Income ◽  
Systems Approach ◽  
Developed Countries ◽  
Lessons Learned ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Health Crisis ◽  
Industrialized Nations ◽  
Sub Saharan

Diarrhea is the second leading cause of death and is the major cause of malnutrition in children under age 5 worldwide. More than 50 percent of the cases occur in developing countries, particularly in sub-Saharan Africa and Southeast Asia. Open defecation, substandard fecal disposal systems, and contaminated water supplies are the typical causes of diarrheal diseases. This public health crisis in low income countries mirrors the experiences of today's industrialized nations two centuries ago. The lessons learned from their sanitary evolution can be instructive in charting a sustainable path towards saving the lives of almost 2 million children annually. In this chapter a case study of Cuba's sanitary reformation is also presented to showcase successes, similar to those of developed countries, within a developing country and economically challenging context.

scholarly journals Child abuse and neglect in sub-Saharan Africa

1997 ◽  
Vol 21 (6) ◽  
pp. 336-338 ◽  
Author(s):  
O. O. Famuyiwa
Keyword(s):  
Child Abuse ◽  
Child Abuse And Neglect ◽  
Sub Saharan Africa ◽  
Cultural Norms ◽  
Case Detection ◽  
Research Perspectives ◽  
Abuse And Neglect ◽  
Sub Saharan

Child abuse could be defined from predominantly legal, clinical and research perspectives, and attempts at an integrative enunciation are fraught with over-inclusiveness. Meadow (1989) proposed that a child is considered to be abused if he or she is treated by an adult in a way that is unacceptable in a given culture at a given time. This definition usefully incorporates the essential issues including secularity and diversity of socio-cultural norms which often create controversy in case detection and are particularly relevant to the debate.

scholarly journals Imported Plasmodium vivax Malaria in the Russian Federation from Western Sub-Saharan Africa

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Alla Baranova ◽  
Vladimir Sergiev ◽  
Lola Morozova ◽  
Natalia Turbabina ◽  
Evgeny Morozov
Keyword(s):  
Plasmodium Vivax ◽  
Russian Federation ◽  
Sub Saharan Africa ◽  
The Past ◽  
African People ◽  
Western Africa ◽  
Plasmodium Vivax Malaria ◽  
Imported Cases ◽  
The Russian Federation ◽  
Sub Saharan

Background. Imported cases of Plasmodium vivax malaria from western Africa are reported annually in the Russian Federation. Infected native African people moving from western Africa for different purposes (students, businessmen, specialists, etc.) or Russian citizens (tourists, diplomats, businessmen, etc.) incubate the pathogen until reaching their Russian destination. Methods. All imported and other confirmed malaria cases and the associated Plasmodium species recorded over the past twenty years throughout the Russian Federation were inventoried. These data were included in the national register. The data of imported malaria cases were analysed according to the species of Plasmodium, case origin, dates of importation, and patient nationality. Results. A total of 267 P. vivax-infected patients who contracted the disease in western Africa were diagnosed in the Russian Federation from 1984 to 2017. Among them, 3 cases had mixed infections (2 with P. vivax + P. falciparum and 1 P. vivax + P. ovale). Conclusion. Our data reveal an existing risk of contracting P. vivax infections in towns of West sub-Saharan Africa despite the absence of local P. vivax infection records.

The Theology of Emergency: Welfare Reform, US Foreign Aid and the Faith-Based Initiative

2014 ◽  
Vol 32 (2) ◽  
pp. 53-77 ◽  
Author(s):  
Melinda Cooper
Keyword(s):  
Public Health ◽  
Foreign Aid ◽  
Service Providers ◽  
The United States ◽  
Sub Saharan Africa ◽  
Health Crisis ◽  
Emergency Relief ◽  
Faith Based ◽  
Social Authority ◽  
Sub Saharan

This article addresses the rise of faith-based emergency relief by examining the US President’s Emergency Plan for HIV/AIDS (PEPFAR), a public health intervention focused on the AIDS epidemic in sub-Saharan Africa. It argues that the theological turn in humanitarian aid serves to amplify ongoing dynamics in the domestic politics of sub-Saharan African states, where social services have assumed the form of chronic emergency relief and religious organizations have come to play an increasingly prominent role in the provision of such services. In the context of an ongoing public health crisis, PEPFAR has institutionalized the social authority of the Pentecostal and charismatic churches, leading to a semantic confluence between the postcolonial politics of emergency and the Pentecostal/Pauline theology of kairos or event. Far from being confined to the space of foreign aid, however, the faith-based turn in humanitarianism is in keeping with ongoing reforms in domestic social policy in the United States. While on the one hand the sustained welfare programmes of the New Deal and Great Society have been dismantled in favour of a system of emergency relief, on the other hand the federal government has intensified its moral, pedagogical and punitive interventions into the lives of the poor. The wilful transfer of welfare services to overtly religious service providers has played a decisive role in this process. The article concludes with a critical appraisal of the links between African and North American Pentecostal-evangelical churches and questions the revolutionary mission ascribed to Pauline political theology in recent political theory.

scholarly journals Malaria in Tunisian Military Personnel after Returning from External Operation

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Faïda Ajili ◽  
Riadh Battikh ◽  
Janet Laabidi ◽  
Rim Abid ◽  
Najeh Bousetta ◽  
...  
Keyword(s):  
Military Personnel ◽  
Malaria Infection ◽  
Imported Malaria ◽  
Sub Saharan Africa ◽  
Military Hospital ◽  
Imported Cases ◽  
Male Patients ◽  
Sub Saharan ◽  
The Military

Introduction. Malaria had been eliminated in Tunisia since 1979, but there are currently 40 to 50 imported cases annually. Soldiers are no exception as the incidence of imported malaria is increasing in Tunisian military personnel after returning from malaria-endemic area, often in Sub-Saharan Africa. Methods. We retrospectively analyzed the clinical and biological presentations, treatment, and outcomes of 37 Tunisian military personnel hospitalized at the Department of Internal Medicine, the Military Hospital of Tunis, between January 1993 and January 2011, for imported malaria. The clinical and laboratory features were obtained from the medical records and a questionnaire was filled by the patients about the compliance of malaria prophylaxis. Results. Thirty-seven male patients, with a mean age of 41 years, were treated for malaria infection. Twenty-two were due to Plasmodium falciparum. The outcome was favourable for all patients, despite two severe access. The long-term use of chemoprophylaxis has been adopted by only 21 (51%) of expatriate military for daily stresses. Moreover, poor adherence was found in 32 patients. Conclusion. The risk of acquiring malaria infection in Tunisian military personnel can largely be prevented by the regular use of chemoprophylactic drugs combined with protective measures against mosquito bites.

scholarly journals Understanding the Interdependence and Temporal Dynamics of Smallholders’ Adoption of Soil Conservation Practices: Evidence from Nigeria

2020 ◽  
Vol 12 (7) ◽  
pp. 2736
Author(s):  
Tolulope E. Oladimeji ◽  
Oyakhilomen Oyinbo ◽  
Abubakar A. Hassan ◽  
Oseni Yusuf
Keyword(s):  
Soil Conservation ◽  
Temporal Dynamics ◽  
Animal Manure ◽  
Sub Saharan Africa ◽  
Farm Income ◽  
Conservation Practices ◽  
Policy Interventions ◽  
Adoption Decisions ◽  
Sub Saharan ◽  
Smart Agriculture

The adoption of soil conservation practices is widely recognized as essential in improving soil fertility and promoting climate-smart agriculture in general. Yet, smallholders’ adoption of soil conservation practices in Sub-Saharan Africa has not been adequately documented, especially in relation to the interdependence and temporal dynamics of adoption decisions. In this paper, we analyze the interdependence and temporal dynamics of smallholders’ adoption of soil conservation practices, such as animal manure, crop residue retention, intercropping, and crop rotation in northern Nigeria. We use data from two rounds of a farm-household panel survey among maize-based farming households and estimate econometric models, including pooled multivariate probit and random effects ordered probit. We found that there is a significant positive correlation between the soil conservation practices, suggesting that adoption decisions for these practices are interrelated and the practices are considered complements by the farmers. We found evidence of inter-temporal variability in the adoption of soil conservation practices, which suggests that some farmers do switch in and out of these practices and may likely explain the often-reported variability in maize yields. Also, we found that the farmers’ decisions to adopt soil conservation practices and the intensity of adoption are influenced by several factors, including farmer-, household-, farm-, institutional-, and biophysical-level factors. Yet, the factors that significantly influence the likelihood of adoption differ slightly from those that influence the intensity of adoption. Policy interventions to enhance the adoption intensity of conservation practices should strongly leverage important factors, such as contract farming, crop–livestock integration, and off-farm income diversification.

Dynamic inference of healthcare expenditure on economic growth in Sub-Saharan Africa: a dynamic heterogenous panel data analysis

2022 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Idris Abdullahi Abdulqadir ◽  
Bello Malam Sa'idu ◽  
Ibrahim Muhammad Adam ◽  
Fatima Binta Haruna ◽  
Mustapha Adamu Zubairu ◽  
...  
Keyword(s):  
Economic Growth ◽  
Healthcare Expenditure ◽  
Health Sector ◽  
Sub Saharan Africa ◽  
Marginal Effect ◽  
Health Crisis ◽  
Content Type ◽  
Interaction Terms ◽  
Sub Saharan ◽  
The Impact

PurposeThis article investigates the dynamic implication of healthcare expenditure on economic growth in the selected ten Sub-Saharan African countries over the period 2000–2018.Design/methodology/approachThe study methodology included dynamic heterogenous panel, using mean group and pooled mean group estimators. The investigation of the healthcare expenditure and economic growth nexus was achieved while controlling the effects of investment, savings, labor force and life expectancy via interaction terms.FindingsThe results from linear healthcare expenditure have a significant positive impact on economic growth, while the nonlinear estimates through the interaction terms between healthcare expenditure and investment have a negative statistically significant impact on growth. The marginal effect of healthcare expenditure evaluated at the minimum and maximum level of investment is positive, suggesting the impact of health expenditure on growth does not vary with the level of investments. This result responds to the primary objective of the article.Research limitations/implicationsIn policy terms, the impact of investment on healthcare is essential to addressing future health crises. The impact of coronavirus disease 2019 (COVID-19) can never be separated from the shortages or low prioritization of health against other sectors of the economy. The article also provides an insight to policymakers on the demand for policy reform that will boost and make the health sector attractive to both domestic and foreign direct investment.Originality/valueGiven the vulnerability of SSA to the health crisis, there are limited studies to examine this phenomenon and first to address the needed investment priorities to the health sector infrastructure in SSA.

Introduction: Ethical Responsibilities Regarding Drugs, Patents, and Health

2005 ◽  
Vol 15 (4) ◽  
pp. 543-547 ◽  
Author(s):  
Michael P. Ryan
Keyword(s):  
Adult Population ◽  
Medical Science ◽  
International Health ◽  
Organizational Capacity ◽  
Sub Saharan Africa ◽  
Asia Pacific ◽  
Hiv Positive ◽  
International Crisis ◽  
Health Crisis ◽  
Sub Saharan

HIV/AIDS threatens international health on a scale never before seen in human history. Previous plagues and great epidemics, devastating though they were to imperial China, urbanizing Europe, and the colonizing Americas (McNeill 1998), were regionally contained. More than forty million people worldwide are HIV-positive: about half of them live in sub-Saharan Africa, where it apparently originated and where whole tribes and, indeed, most of the adult population of Botswana may very well die of the disease. (Joint UN/WHO 2004). India has another five million people who are HIV-positive, the largest number outside Africa. AIDS is spreading rapidly in China and devastating Thailand, a regional center for prostitution that spreads it further throughout the Asia-Pacific region. No part of the world is spared. The economic, social, and political impacts of this pandemic have only begun to be felt and to be considered.Modern technological and organizational capacities—jet aircraft and globetrotting business and tourist travelers—turned what would have been, in previous eras, an African regional problem into an international crisis and made AIDS exceedingly difficult to contain. Yet, the human technological and organizational capacity to confront the AIDS pandemic also makes this health crisis different from epidemics in earlier times. Medical science applied by pharmacological research has created drug therapies that can control the disease, that can not only stave off death but make productive life possible for many years. The challenge of AIDS could be met, many in the health community say, if it were not that the life-sustaining drugs are owned by private enterprises (Oxfam 2002). The doctors at Médicins Sans Frontières contend, “Patents are not god-given rights. They are tools invented to benefit society as a whole, not to line the pockets of a handful of multinational pharmaceutical companies” (MSF 2003: 2). “[T]he patent monopoly means that a higher price than necessary has to be paid for patented inventions. This is acceptable if this higher price is merely an inconvenience…. However, if the patented invention is essential (say, if it could prevent your untimely death from disease), then the price is more of a dilemma” (MSF 2003: 5). These and other critics declare that drug makers put profits ahead of people and accuse the governments that grant them patent-intellectual property rights, especially the U.S. government, of contributing to this moral bankruptcy.

scholarly journals Hypertension Education Intervention with Ugandan Nurses Working in Hospital Outpatient Clinic: A Pilot Study

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Godfrey Katende ◽  
Sara Groves ◽  
Kathleen Becker
Keyword(s):  
Pilot Study ◽  
Outpatient Clinic ◽  
Education Program ◽  
Sub Saharan Africa ◽  
Noncommunicable Diseases ◽  
Post Intervention ◽  
Health Crisis ◽  
Low Levels ◽  
Sub Saharan ◽  
And Control

Noncommunicable diseases (NCDs) pose a significant global burden in both developed and developing countries. It is estimated that, by 2025, 41.7% of males and 38.7% of females in Sub-Saharan Africa will develop high blood pressure (HBP). This is particularly true in Uganda with hypertensive prevalence rates estimated to range from 22.5% to 30.5%. Coupled with low levels of detection, treatment, and control, hypertension represents a Ugandan public health crisis. An innovative WHO-ISH education program culturally was adapted in a pilot study and focused on knowledge, skills, and attitudes (KSA) of nurses caring for hypertensive patients in an outpatient clinic. Pre-post intervention data was collected and analyzed in which significant improvements were noted on all the three outcome measures. This pilot study demonstrated that nurses’ knowledge, skills, and attitudes could be significantly improved with a multimodal education program implemented in a low resource environment.

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