scholarly journals PO 8719 INTRODUCING A NEW AFRICA MENINGITIS NETWORK – A NORTH-SOUTH COLLABORATION

2019 ◽  
Vol 4 (Suppl 3) ◽  
pp. A63.1-A63
Author(s):  
Mosepele Mosepele ◽  
Cecilia Kanyama ◽  
David Meya ◽  
Fiona Cresswell ◽  
Timothee Chammard ◽  
...  
Keyword(s):  
Treatment Strategies ◽  
Sub Saharan Africa ◽  
High Dose ◽  
Diagnostic Strategies ◽  
Cns Infections ◽  
Study Protocols ◽  
Sub Saharan ◽  
Novel Treatment Strategies ◽  
Set Up ◽  
Randomised Controlled

BackgroundCentral nervous system infections, including meningitis, continue to cause significant morbidity in Africa. HIV has contributed to the epidemiology of CNS infections in this setting. Notable advances in the study of CNS infections by several groups have demonstrated the utility of new diagnostic strategies and impact of novel treatment strategies. However, efforts to coordinate meningitis research in Africa, and between Africa and the rest of the world remain very limited.MethodsIn a bid to promote a coordinated study of CNS infections across Africa, and in collaboration with other meningitis groups globally, the researchers of the AMBITION study (High Dose Ambisome on a Fluconazole Backbone for Cryptococcal Meningitis Induction Therapy in Sub-saharan Africa: A Randomised Controlled Non-inferiority Trial) are leveraging the EDCTP support for the AMBITION trial to set up an Africa Meningitis Trials Network.ResultsThe Africa Meningitis Trials Network (AMNET) was launched in Malawi in early 2018. Main achievements since the launch of the network, include an internal review of meningitis research across network sites and launch of the network website. The network also has two study protocols pending ethics review at all sites. These studies will provide much needed information on resources available for meningitis care, research and provide a baseline epidemiology of meningitis in Africa.ConclusionAMNET provides a rare opportunity for investigators interested in meningitis research to leverage the ongoing AMBITION trial to conduct Africa-wide preliminary research on meningitis. The network is recruiting additional members in Africa and globally to collaborate on meningitis research, and also apply for research funding to support meningitis work. Anyone interested in knowing more about the network should contact the AMNET communications officer, Ms Phum’lani Machao, [email protected]

scholarly journals A longitudinal observational study of aetiology and long-term outcomes of sepsis in Malawi revealing the key role of disseminated tuberculosis

2021 ◽  
Author(s):  
Joseph M Lewis ◽  
Madlitso Mphasa ◽  
Lucy Keyala ◽  
Rachel Banda ◽  
Emma L Smith ◽  
...  
Keyword(s):  
Hiv Infection ◽  
Broad Spectrum ◽  
Treatment Strategies ◽  
Case Definition ◽  
Sub Saharan Africa ◽  
Tertiary Centre ◽  
Modifiable Factors ◽  
Sub Saharan ◽  
Novel Treatment Strategies ◽  
Bayesian Logistic Regression

Abstract Background Sepsis protocols in sub-Saharan Africa (sSA) are typically extrapolated from high-income settings, yet sepsis in sSA is likely caused by distinct pathogens and may require novel treatment strategies. Data to guide such strategies are lacking. We aimed to define causes and modifiable factors associated with sepsis outcome in Blantyre, Malawi to inform design of treatment strategies tailored to sSA. Methods We recruited 225 adults meeting a sepsis case-definition defined by fever and organ dysfunction, in an observational cohort study at a single tertiary centre. Aetiology was defined using culture, antigen detection, serology and PCR. Effect of treatments on 28-day outcomes were assessed by Bayesian logistic regression. Results 143/213 (67%) of participants were HIV-infected. We identified a diagnosis in 145/225 (64%) participants: most commonly tuberculosis (34%) followed by invasive bacterial (17%) and arboviral infections (13%) and malaria (9%) Tuberculosis was associated with HIV infection whereas malaria and arboviruses with the absence of HIV infection. Antituberculous chemotherapy was associated with survival (aOR 28-day death 0.17 [95% CrI 0.05-0.49] for receipt of antituberculous therapy). Of those with confirmed aetiology, 83% received the broad-spectrum antibacterial ceftriaxone but it would be expected to be active in only 24%. Conclusions Sepsis in Blantyre, Malawi, is caused by a range of pathogens; the majority are not susceptible to the broad-spectrum antibacterials that most patients receive. HIV status is a key determinant of aetiology. Novel antimicrobial strategies for sepsis tailored to sSA – including consideration of empiric antitubercular therapy in the HIV-infected - should be developed and trialed.

Stratifying Sepsis in Uganda Using Rapid Pathogen Diagnostics and Clinical Data: A Prospective Cohort Study

2021 ◽  
Author(s):  
Matthew J. Cummings ◽  
Barnabas Bakamutumaho ◽  
Nicholas Owor ◽  
John Kayiwa ◽  
Joyce Namulondo ◽  
...  
Keyword(s):  
Prospective Cohort ◽  
Treatment Strategies ◽  
Specific Treatment ◽  
Sub Saharan Africa ◽  
Rapid Diagnostics ◽  
Suspected Sepsis ◽  
Laboratory Capacity ◽  
Antimicrobial Management ◽  
Sub Saharan ◽  
Tb 32

The global burden of sepsis is concentrated in sub-Saharan Africa, where extensive pathogen diversity and limited laboratory capacity challenge targeted antimicrobial management of life-threatening infections. In this context, established and emerging rapid pathogen diagnostics may stratify sepsis patients into subgroups with prognostic and therapeutic relevance. In a prospective cohort of adults (age ≥18 years) hospitalized with suspected sepsis in Uganda, we stratified patients using rapid diagnostics for HIV, tuberculosis (TB), malaria, and influenza, and compared clinical characteristics and 30-day outcomes across these pathogen-driven subgroups. From April 2017 to August 2019, 301 adults were enrolled (median age, 32 years [interquartile range, 26–42 years]; female, n = 178 [59%]). A total of 157 patients (53%) were HIV infected. Sixty-one patients (20%) tested positive for malaria, 52 (17%), for TB (including 49 of 157 [31%] HIV-infected patients), and 17 (6%), for influenza. Co-infection was identified in 33 (11%) patients. The frequency of multi-organ failure, including shock and acute respiratory failure, was greatest among patients with HIV-associated TB. Mortality at 30 days was 19% among patients with malaria, 40% among patients with HIV-associated TB, 32% among HIV-infected patients without microbiological evidence of TB, 6% among patients with influenza, and 11% among patients without a pathogen identified. Despite improvements in anti-retroviral delivery, the burden of sepsis in Uganda remains concentrated among young, HIV-infected adults, with a high incidence of severe HIV-associated TB. In parallel with improvements in acute-care capacity, use of rapid pathogen diagnostics may enhance triage and antimicrobial management during emergency care for sepsis in sub-Saharan Africa, and could be used to enrich study populations when trialing pathogen-specific treatment strategies in the region.

scholarly journals Cash Transfers and Child Nutrition: Evidence from sub-Saharan Africa

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Oladayo Nathaniel Awojobi
Keyword(s):  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Child Nutrition ◽  
Cash Transfers ◽  
Cash Transfer ◽  
Sub Saharan Africa ◽  
Controlled Trials ◽  
Sub Saharan ◽  
Randomised Controlled ◽  
Nutritional Outcomes

This paper summarises the arguments and counterarguments within the scientific discussion on cash transfers and child nutrition. The main purpose of the research is to assess the effectiveness of cash transfers in improving nutritional outcomes in vulnerable children in sub-Saharan Africa. Systematisation of the literary sources indicates that studies have justified cash transfer as social-income support that addresses a vital social determinant of health (income) for children in low-and-middle-income countries. The methodological basis of this study is a systematic review that searched a wide range of academic and grey literature databases, including PubMed, Cochrane Library and Google Scholar. This study included cluster-randomised controlled trials (R.C.T.s), randomised controlled trials, quasi-experimental studies, mixed-methods studies, and non-randomised cluster trials. Studies included in this systematic review were screened for their eligibility. The systematic review uses the Cochrane data collection form to extract data from the included studies. It was not feasible to statistically combine the results of the studies due to the heterogeneity of most of the studies. Preferably, the review employs a narrative synthesis to present the estimated effects of cash transfers on children’s nutritional outcomes. The systematic review presents the results of data synthesis, of which eleven studies met the inclusion criteria. Overall, the evidence from the systematic review indicates that cash transfer programmes targeted at children effectively improve anthropometric and nutritional outcomes. Further research is needed to spell out the multiple pathways to how cash transfers improve children’s nutritional outcomes. Moreover, this systematic review shows the importance of cash transfers in improving child nutrition. Policymakers should continue to employ institutional mechanisms to strengthen the nutritional status of children, especially the vulnerable ones since cash transfer intervention is a temporary measure.

Sub-Saharan Africa in XXIth Century: Opportunities and Risks of Development (the end)

2013 ◽  
pp. 95-109
Author(s):  
G. Irishin
Keyword(s):  
Social Economic ◽  
African State ◽  
Sub Saharan Africa ◽  
Strategy Formulation ◽  
Modern Development ◽  
Sub Saharan ◽  
Set Up

This publication presents the regular content of the scientific workshop "Modern Development Problems", which takes place in the Center for Development and Modernization Studies at IMEMO RAN. Several key problems are set up and analyzed in the report delivered at the workshop, namely: the influence of globalization on social-economic processes in Sub-Saharan Africa, a concept and strategy formulation by the African elite, as well as the role of an African state and regional formations in its realization.

Commercial production of Nile tilapia on Lake Kariba, Zimbabwe.

2020 ◽  
Author(s):  
Keyword(s):  
Private Equity ◽  
Production Management ◽  
Raw Materials ◽  
Fish Farm ◽  
Sub Saharan Africa ◽  
Net Income ◽  
Manufacturing Companies ◽  
Lake Kariba ◽  
Sub Saharan ◽  
Set Up

Abstract Lake Harvest Aquaculture (Pvt) Ltd was first developed into a freshwater tilapia fish farm business in 1996 on premises that originally farmed freshwater prawns owned by one of Zimbabwe's food companies, Cairns Foods Ltd. The farm was set up in 1997 and, ten years later, has grown to a 3000-tonne fish farm where tilapia are produced primarily for processing and export to European and regional markets. The original targeted projections for production and net income of the farm were proving accurate until 2001 when the macro-economy began to shrink. Low production on crop farms due to inadequate resources and drought brought a shortage of raw materials to the feed manufacturing companies. The continuous downward trend in feed production affected the company as it failed to support its growing fish biomass. The feed and economy problems resulted in a decision by the board to stop expansion of the business in 2002. Lake Harvest business was set up at a cost of US $10,000,000. The business was externally funded by the Commonwealth Development Corporation (CDC Group plc) and Comafin, a pan-African private equity fund, before the share holding structure changed in 2002. The major costs were encountered on the installation and mooring of cages, and the construction of a fish processing factory. Six sites were installed, each costing around US $350,000, including boats. The processing factory cost around US $4,000,000. The objectives of this case study are to: * Provide a scenario and overview of Lake Harvest Aquaculture as a company growing tilapia in cages in Lake Kariba, Zimbabwe. * Provide a means of assessment and learning for those considering developing cage-based aquaculture in sub-Saharan Africa. All of the main activities carried out at Lake Harvest will be described in the same sequence as followed on-farm; production, management, and sale of the final product: * Breeding * Feeding * Sampling * Diving * Harvesting * Processing * Marketing.

Case Studies in Urban Health

Urban Health ◽  
2019 ◽  
pp. 332-341
Author(s):  
Alex Ezeh ◽  
Blessing Mberu
Keyword(s):  
Urban Health ◽  
Surveillance System ◽  
Urban Poverty ◽  
Large City ◽  
Demographic Surveillance System ◽  
Sub Saharan Africa ◽  
Poverty And Health ◽  
Sub Saharan ◽  
Set Up ◽  
Improve Health

A project of the Africa Population and Health Research Center (APHRC), the Nairobi Urban Health and Demographic Surveillance System was set up to provide a platform to explore the linkages between urban poverty and health and to monitor and evaluate novel implementation programs that were developed with the study communities. In this chapter, the authors draw on nearly two decades of work by APHRC among slum populations in Nairobi, Kenya, to highlight the unique health challenges of slum populations and how these are changing. The chapter summarizes various efforts to improve health in Nairobi’s informal settlements since 2000 and discusses efforts in Nairobi to improve health in a large city in sub-Saharan Africa, summarizing lessons that have been learned in improving urban health worldwide.

scholarly journals Evidence for pulmonary rehabilitation in chronic respiratory diseases in sub-Saharan Africa: a systematic review

2020 ◽  
Vol 24 (10) ◽  
pp. 991-999
Author(s):  
F. M. Bickton ◽  
C. Fombe ◽  
E. Chisati ◽  
J. Rylance
Keyword(s):  
Pulmonary Rehabilitation ◽  
Respiratory Diseases ◽  
Sub Saharan Africa ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Chronic Respiratory Diseases ◽  
Exercise Regimen ◽  
Home Based ◽  
Sub Saharan ◽  
Randomised Controlled

BACKGROUND: Pulmonary rehabilitation (PR) is a highly effective non-pharmacological treatment for patients with chronic respiratory diseases.OBJECTIVE: To synthesise the evidence for PR practice and efficacy in sub-Saharan Africa.METHODS: We searched in PubMed and Scopus for relevant studies and scanned reference lists of relevant studies from these databases for additional studies. Articles meeting the inclusion criteria were included. Pre-determined data were extracted independently by two reviewers. A narrative synthesis approach was used in the interpretation of findings.RESULTS: Six studies were included, totalling 275 participants. Indications for PR were chronic obstructive pulmonary disease, asthma, pulmonary tuberculosis and post-tuberculosis lung disease. Programmes ran for 6–12 weeks, universally incorporated exercise, and variously used home-based and hospital-based delivery models. All were interventional studies, of which two were randomised controlled trials, and primarily reported pulmonary function and exercise tolerance endpoints. Evidence for individualising the exercise regimen was available in three studies.CONCLUSIONS: There is limited evidence on PR design and efficacy in sub-Saharan Africa, but available data support its use in a variety of chronic respiratory conditions. Future studies should report core outcome sets and their individualised exercise and education regimens.

scholarly journals Research on Invasive Nontyphoidal Salmonella Disease and Developments Towards Better Understanding of Epidemiology, Management, and Control Strategies

2020 ◽  
Vol 71 (Supplement_2) ◽  
pp. S127-S129
Author(s):  
Samuel Kariuki ◽  
Ellis Owusu-Dabo
Keyword(s):  
Burden Of Illness ◽  
Control Strategies ◽  
Sub Saharan Africa ◽  
Disease Entity ◽  
Middle Income ◽  
Diagnostic Strategies ◽  
Disease Epidemiology ◽  
Middle Income Countries ◽  
Sub Saharan ◽  
And Control

Abstract During the 11th International Conference on Typhoid and Other Invasive Salmonelloses held in Hanoi, Vietnam, a number of papers were presented on the burden of disease, epidemiology, genomics, management, and control strategies for invasive nontyphoidal Salmonella (iNTS) disease, which is increasingly becoming an important public health threat in low- and middle-income countries, but especially in sub-Saharan Africa (sSA). Although there were minor variations in characteristics of iNTS in different settings (urban vs rural, country to country), it was observed that iNTS has gained greater recognition as a major disease entity in children younger than 5 years. Renewed efforts towards greater understanding of the burden of illness, detection and diagnostic strategies, and management and control of the disease in communities in sSA through the introduction of vaccines will be important.

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