scholarly journals Estimating the burden of cardiovascular risk in community dwellers over 40 years old in South Africa, Kenya, Burkina Faso and Ghana

2021 ◽  
Vol 6 (1) ◽  
pp. e003499
Author(s):  
Ryan G Wagner ◽  
Nigel J Crowther ◽  
Lisa K Micklesfield ◽  
Palwende Romauld Boua ◽  
Engelbert A Nonterah ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
South African ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Cvd Risk ◽  
Genomic Studies ◽  
Sub Saharan ◽  
Context Specific ◽  
The Impact

IntroductionCardiovascular disease (CVD) risk factors are increasing in sub-Saharan Africa. The impact of these risk factors on future CVD outcomes and burden is poorly understood. We examined the magnitude of modifiable risk factors, estimated future CVD risk and compared results between three commonly used 10-year CVD risk factor algorithms and their variants in four African countries.MethodsIn the Africa-Wits-INDEPTH partnership for Genomic studies (the AWI-Gen Study), 10 349 randomly sampled individuals aged 40–60 years from six sites participated in a survey, with blood pressure, blood glucose and lipid levels measured. Using these data, 10-year CVD risk estimates using Framingham, Globorisk and WHO-CVD and their office-based variants were generated. Differences in future CVD risk and results by algorithm are described using kappa and coefficients to examine agreement and correlations, respectively.ResultsThe 10-year CVD risk across all participants in all sites varied from 2.6% (95% CI: 1.6% to 4.1%) using the WHO-CVD lab algorithm to 6.5% (95% CI: 3.7% to 11.4%) using the Framingham office algorithm, with substantial differences in risk between sites. The highest risk was in South African settings (in urban Soweto: 8.9% (IQR: 5.3–15.3)). Agreement between algorithms was low to moderate (kappa from 0.03 to 0.55) and correlations ranged between 0.28 and 0.70. Depending on the algorithm used, those at high risk (defined as risk of 10-year CVD event >20%) who were under treatment for a modifiable risk factor ranged from 19.2% to 33.9%, with substantial variation by both sex and site.ConclusionThe African sites in this study are at different stages of an ongoing epidemiological transition as evidenced by both risk factor levels and estimated 10-year CVD risk. There is low correlation and disparate levels of population risk, predicted by different risk algorithms, within sites. Validating existing risk algorithms or designing context-specific 10-year CVD risk algorithms is essential for accurately defining population risk and targeting national policies and individual CVD treatment on the African continent.

scholarly journals Cardiovascular Risk Factor mapping and distribution among adults in Mukono and Buikwe districts in Uganda: small area analysis

2020 ◽  
Author(s):  
Geofrey Musinguzi ◽  
Rawlance Ndejjo ◽  
Isaac Ssinabulya ◽  
Hilde Bastiaens ◽  
Harm van Marwijk ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Low Income ◽  
Small Area ◽  
Sub Saharan Africa ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Generalized Linear Modelling ◽  
Sub Saharan

Abstract Introduction Sub-Saharan Africa (SSA) is experiencing an increasing burden of Cardiovascular Diseases (CVDs). Modifiable risk factors including hypertension, diabetes, obesity, central obesity, sedentary behaviours, smoking, poor diet (characterised by inadequate vegetable and fruit consumption), and psychosocial stress are attributable to the growing burden of CVDs. Small geographical area mapping and analysis of these risk factors for CVD is lacking in most of sub-Saharan Africa and yet such data has the potential to inform monitoring and exploration of patterns of morbidity, health-care use, and mortality, as well as the epidemiology of risk factors. In the current study, we map and describe the distribution of the CVD risk factors in 20 parishes in two neighbouring districts in Uganda. Methods A baseline survey benchmarking a type-2 hybrid stepped wedge cluster randomised trial design was conducted in December 2018 and January 2019. A sample of 4372 adults aged 25-70 years was drawn from 3689 randomly selected households across 80 villages in 20 parishes in Mukono and Buikwe districts in Uganda. Descriptive statistics and generalized linear modelling controlled for clustering were conducted for this analysis in Stata 13.0, and a visual map showing risk factor distribution developed in QGIS. Results Mapping the prevalence of selected CVD risk factors indicated substantial gender and small area geographic heterogeneity. Patterns and clustering were observed for some major risk factors for CVDs including hypertension, physical inactivity, smoking, and risk factor combination. Prevalence of unhealthy diet was very high across all parishes with no significant observable differences across areas. Conclusion Modifiable cardiovascular risk factors are common in this low income context. Moreover, across small area geographic setting, it appears significant differences in distribution of risk factors exist. These differences suggest that underlying drivers such as sociocultural, environmental and economic determinants may be promoting or inhibiting the observed risk factor prevalences which should be further explored.

scholarly journals Cardiovascular Risk Factor mapping and distribution among adults in Mukono and Buikwe districts in Uganda: small area analysis

2020 ◽  
Author(s):  
Geofrey Musinguzi ◽  
Rawlance Ndejjo ◽  
Isaac Ssinabulya ◽  
Hilde Bastiaens ◽  
Harm van Marwijk ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Low Income ◽  
Small Area ◽  
Sub Saharan Africa ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Generalized Linear Modelling ◽  
Sub Saharan

Abstract Introduction Sub-Saharan Africa (SSA) is experiencing an increasing burden of Cardiovascular Diseases (CVDs). Modifiable risk factors including hypertension, diabetes, obesity, central obesity, sedentary behaviours, smoking, poor diet (characterised by inadequate vegetable and fruit consumption), and psychosocial stress are attributable to the growing burden of CVDs. Small geographical area mapping and analysis of these risk factors for CVD is lacking in most of sub-Saharan Africa and yet such data has the potential to inform monitoring and exploration of patterns of morbidity, health-care use, and mortality, as well as the epidemiology of risk factors. In the current study, we map and describe the distribution of the CVD risk factors in 20 parishes in two neighbouring districts in Uganda. Methods A baseline survey benchmarking a type-2 hybrid stepped wedge cluster randomised trial design was conducted in December 2018 and January 2019. A sample of 4372 adults aged 25-70 years was drawn from 3689 randomly selected households across 80 villages in 20 parishes in Mukono and Buikwe districts in Uganda. Descriptive statistics and generalized linear modelling controlled for clustering were conducted for this analysis in Stata 13.0, and a visual map showing risk factor distribution developed in QGIS. Results Mapping the prevalence of selected CVD risk factors indicated substantial gender and small area geographic heterogeneity. Patterns and clustering were observed for some major risk factors for CVDs including hypertension, physical inactivity, smoking, and risk factor combination. Prevalence of unhealthy diet is very high across all parishes with no significant observable difference. Conclusion Modifiable cardiovascular risk factors are common in this low income context. Moreover, across small area geographic setting, it appears significant differences in distribution of risk factors exist. These differences suggest that underlying drivers such as sociocultural, environmental and economic determinants may be promoting or inhibiting the observed risk factor prevalences which should be further explored.

scholarly journals Cardiovascular Risk Factor mapping and distribution among adults in Mukono and Buikwe districts in Uganda: small area analysis

2019 ◽  
Author(s):  
Geofrey Musinguzi ◽  
Rawlance Ndejjo ◽  
Isaac Ssinabulya ◽  
Hilde Bastiaens ◽  
Harm van Marwijk ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
Low Income ◽  
Small Area ◽  
Sub Saharan Africa ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Generalized Linear Modelling ◽  
Sub Saharan

Abstract Introduction Sub-Saharan Africa (SSA) is experiencing an increasing burden of Cardiovascular Diseases (CVDs). Modifiable risk factors including hypertension, diabetes, obesity, central obesity, sedentary behaviours, smoking, poor diet (characterised by inadequate vegetable and fruit consumption), and psychosocial stress are attributable to the growing burden of CVDs. Small geographical area mapping and analysis of these risk factors for CVD is lacking in most of sub-Saharan Africa and yet such data has the potential to inform monitoring and exploration of patterns of morbidity, health-care use, and mortality, as well as the epidemiology of risk factors. In the current study, we map and describe the distribution of the CVD risk factors in 20 parishes in two neighbouring districts in Uganda. Methods A baseline survey benchmarking a type-2 hybrid stepped wedge cluster randomised trial design was conducted in December 2018 and January 2019. A sample of 4372 adults aged 25-70 years was drawn from 3689 randomly selected households across 80 villages in 20 parishes in Mukono and Buikwe districts in Uganda. Descriptive statistics and generalized linear modelling controlled for clustering were conducted for this analysis in Stata 13.0, and a visual map showing risk factor distribution developed in QGIS. Results Mapping the prevalence of selected CVD risk factors indicated substantial gender and small area geographic heterogeneity. Patterns and clustering were observed for some major risk factors for CVDs including hypertension, physical inactivity, smoking, and risk factor combination. Prevalence of unhealthy diet is very high across all parishes with no significant observable difference. Conclusion Modifiable cardiovascular risk factors are common in this low income context. Moreover, across small area geographic setting, it appears significant differences in distribution of risk factors exist. These differences suggest that underlying drivers such as sociocultural, environmental and economic determinants may be promoting or inhibiting the observed risk factor prevalences which should be further explored.

scholarly journals Conservation research output in sub-Saharan Africa is increasing, but only in a few countries

Oryx ◽  
2020 ◽  
pp. 1-10
Author(s):  
P. Christy Pototsky ◽  
Will Cresswell
Keyword(s):  
South African ◽  
Agricultural Land ◽  
Research Output ◽  
Sub Saharan Africa ◽  
Search Term ◽  
African Countries ◽  
Research Papers ◽  
North American Country ◽  
Conservation Research ◽  
Sub Saharan

Abstract We tested if peer-reviewed conservation research output has increased in sub-Saharan African countries over the last 30 years in response to increased development. We carried out a bibliometric analysis to identify the number of conservation research papers published by national authors of 41 sub-Saharan African countries during 1987–2017, to provide an index of national conservation research output. We identified country-specific development factors influencing these totals, using general linear modelling. There were positive relationships between conservation research output and population size, GDP, literacy rate, international tourism receipts and population growth rate, and negative relationships with urban population and agricultural land cover, in total explaining 77% of variation. Thirty-eight per cent of countries contributed < 30 conservation research papers (of 12,701) in 30 years. Analysis of trends in primary authorship in a random subsample of 2,374 of these papers showed that primary authorship by sub-Saharan African authors has increased significantly over time but is now at a lower rate than primary authorship for authors from countries outside the country associated with the search term, usually a European or North American country. Overall, 46% of papers had national primary authors, but 67% of these were South African. The results show that conservation research output in sub-Saharan Africa overall is increasing but only significantly in a few countries, and is still dominated by non-national scientists, probably as a result of a lack of socio-economic development.

scholarly journals Financial Inclusion, Income Inequality and Sustainable Economic Growth in Sub-Saharan African Countries

2021 ◽  
Vol 13 (4) ◽  
pp. 1780
Author(s):  
Chima M. Menyelim ◽  
Abiola A. Babajide ◽  
Alexander E. Omankhanlen ◽  
Benjamin I. Ehikioya
Keyword(s):  
Economic Growth ◽  
Income Inequality ◽  
Financial Services ◽  
Sub Saharan Africa ◽  
Kuznets Curve ◽  
African Countries ◽  
Financial Access ◽  
Sub Saharan ◽  
Sustainable Economic Growth ◽  
The Impact

This study evaluates the relevance of inclusive financial access in moderating the effect of income inequality on economic growth in 48 countries in Sub-Saharan Africa (SSA) for the period 1995 to 2017. The findings using the Generalised Method of Moments (sys-GMM) technique show that inclusive financial access contributes to reducing inequality in the short run, contrary to the Kuznets curve. The result reveals a negative effect of financial access on the relationship between income inequality and economic growth. There is a positive net effect of inclusive financial access in moderating the impact of income inequality on economic growth. Given the need to achieve the Sustainable Development Targets in the sub-region, policymakers and other stakeholders of the economy must design policies and programmes that would enhance access to financial services as an essential mechanism to reduce income disparity and enhance sustainable economic growth.

scholarly journals A systematic review and meta-analysis reveal that Campylobacter spp. and antibiotic resistance are widespread in humans in sub-Saharan Africa

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245951
Author(s):  
Delfina F. Hlashwayo ◽  
Betuel Sigaúque ◽  
Emília V. Noormahomed ◽  
Sónia M. S. Afonso ◽  
Inácio M. Mandomando ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Meta Analysis ◽  
Random Effect ◽  
Research Priorities ◽  
Sub Saharan Africa ◽  
Cochrane Library ◽  
African Countries ◽  
Pooled Prevalence ◽  
Sub Saharan ◽  
The Impact

Introduction Campylobacter spp. are zoonotic bacteria that cause gastroenteritis in humans worldwide, whose main symptom is diarrhea. In certain cases, extra intestinal manifestations may occur, such as Guillain Barré syndrome. The bacteria cause severe diarrhea mostly in children and in immunocompromised individuals. This review aims to address the prevalence of Campylobacter spp. in humans in sub-Saharan Africa. It also aims to understand the impact of HIV in the prevalence, as well as to report data on antibiotic resistance and propose research priorities. Methods We followed PRISMA guidelines to find studies on the occurrence of Campylobacter spp. in humans in all countries from sub-Saharan Africa. Studies published between 2000 and 2020 were searched in PubMed, Cochrane Library, CINAHL, African Index Medicus, African Journals Online, Google Scholar and Science Direct. We have conducted a random-effect meta-analysis and calculated the proportion of resistant isolates to different antibiotics. Results and discussion We found 77 studies that described such occurrence in humans in 20 out of 53 sub-Saharan African countries. Campylobacter jejuni was the most prevalent species. Pooled prevalence was 9.9% (CI: 8.4%–11.6%). No major variations within the different sub-regions were found. Most studies reported Campylobacter spp. as the cause of diarrhea, mainly in children. Some studies reported the bacteria as a possible etiologic agent of acute flaccid paralysis and urinary tract infection. Campylobacter spp. presented a higher pooled prevalence in HIV infected patients, although not statistically significant. High proportions of resistant strains were reported for many antibiotics, including erythromycin and tetracycline. Conclusion Campylobacter spp. occur in sub-Saharan Africa, although information is scarce or inexistent for many countries. Research priorities should include investigation of the understudied species; extra intestinal manifestations; the impact of HIV infection and associated risk factors. Control strategies should be reinforced to contain the spread of this pathogen and drug resistance.

Perspectives from Four Stages of Development

2019 ◽  
pp. 159-178
Author(s):  
Eleanor M. Fox ◽  
Mor Bakhoum
Keyword(s):  
South African ◽  
Gold Standard ◽  
Developed Countries ◽  
The United States ◽  
Point Of View ◽  
Sub Saharan Africa ◽  
The European Union ◽  
African Countries ◽  
Sub Saharan ◽  
The Developed Countries

This chapter identifies four clusters of nations based on state of development, in order to highlight significant qualitative differences that may call for different law and policies. The first cluster comprises the least developed sub-Saharan African countries with the most resource-challenged competition authorities, such as Benin and Togo. The second cluster compromises nations that have advanced economically to a perceptibly higher level. The third cluster is a “group” of one—South Africa. With all of its challenges, the South African competition regime is as close to a gold standard as there is in sub-Saharan Africa. Finally, for comparison, the fourth cluster comprises the developed countries, led in particular by the European Union and the United States. These nations have open economies, fairly robust markets, good infrastructure, and good institutions. The chapter proceeds to identify, from the point of view of each of the clusters, the most fitting competition framework nationally and globally. The chapter proposes how the divergences can be brought into sympathy.

HIV/AIDS

2020 ◽  
pp. 901-933
Author(s):  
Sarah Fidler ◽  
Timothy E.A. Peto ◽  
Philip Goulder ◽  
Christopher P. Conlon
Keyword(s):  
Large Scale ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
African Countries ◽  
Global Pandemic ◽  
The People ◽  
Reduce Life Expectancy ◽  
Sub Saharan ◽  
Living With Hiv ◽  
The Impact

Since its discovery in 1983, the human immunodeficiency virus (HIV) has been associated with a global pandemic that has affected more than 78 million people and caused more than 39 million deaths. Globally, 36.9 million (34.3–41.4 million) people were living with HIV at the end of 2013. An estimated 0.8% of adults aged 15–49 years worldwide are living with HIV, although the burden of the epidemic continues to vary considerably between countries and regions. Sub-Saharan Africa remains most severely affected, with nearly 1 in every 20 adults living with HIV and accounting for nearly 71% of the people living with HIV worldwide. The impact of HIV in some African countries has been sufficient to reverse population growth and reduce life expectancy into the mid-30s, although HIV incidence has declined in some of these high-prevalence countries. However, there are large-scale HIV epidemics elsewhere (e.g. India, the Russian Federation, and Eastern Europe).

“Does the poor matter” in pro-poor driven sub-Saharan African cities? towards progressive and inclusive pro-poor tourism

2019 ◽  
Vol 5 (3) ◽  
pp. 392-411 ◽  
Author(s):  
Regis Musavengane ◽  
Pius Siakwah ◽  
Llewellyn Leonard
Keyword(s):  
Sustainable Development ◽  
Good Governance ◽  
Urban Tourism ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Content Type ◽  
African Cities ◽  
The Poor ◽  
Sub Saharan ◽  
The Impact

Purpose The purpose of this paper is to question the extent to which Sub-Saharan African cities are progressing towards promoting pro-poor economies through pro-poor tourism (PPT). It specifically examines how African cities are resilient towards attaining sustainable urban tourism destinations in light of high urbanization. Design/methodology/approach The methodological framework is interpretive in nature and qualitative in an operational form. It uses meta-synthesis to evaluate the causal relationships observed within Sub-Saharan African pro-poor economies to enhance PPT approaches, using Accra, Ghana, Johannesburg, South Africa, and Harare, Zimbabwe, as case studies. Findings Tourism development in Sub-Saharan Africa has been dominantly underpinned by neoliberal development strategies which threaten the sustainability of tourism in African cities. Research limitations/implications The study is limited to three Sub-Saharan African countries. Further studies may need to be done in other developing countries. Practical implications It argues for good governance through sustainability institutionalization which strengthens the regulative mechanisms, processes and organizational culture. Inclusive tourism approaches that are resilient-centered have the potential to promote urban tourism in Sub-Saharan African cities. These findings contribute to the building of strong and inclusive Institutions for Sustainable Development in the Sub-Saharan African cities to alleviate poverty. Social implications These findings contribute to the building of strong and inclusive institutions for sustainable development in the Sub-Saharan African cities to alleviate poverty. Originality/value The “poor” are always within the communities, and it takes a community to minimise the impact of poverty among the populace. The study is conducted at a pertinent time when most African government’s development policies are pro-poor driven. Though African cities provide opportunities of growth, they are regarded as centres of high inequality.

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