scholarly journals Towards an appropriate ethics framework for Health and Demographic Surveillance Systems (HDSS): learning from issues faced in diverse HDSS in sub-Saharan Africa

2021 ◽  
Vol 6 (1) ◽  
pp. e004008
Author(s):  
Alex Nginyo Hinga ◽  
Sassy Molyneux ◽  
Vicki Marsh
Keyword(s):  
Ethical Issues ◽  
A Priori ◽  
Public Health Practice ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
Science Literature ◽  
Ethics Framework ◽  
Sub Saharan ◽  
Demographic Surveillance Systems ◽  
And Migration

IntroductionHealth and Demographic Surveillance Systems (HDSS) collect data on births, deaths and migration from relatively small, geographically defined populations primarily in Africa and Asia. HDSS occupy a grey area between research, healthcare and public health practice and it is unclear how ethics guidance that rely on a research-practice distinction apply to HDSS. This topic has received little attention in the literature. In this paper, based on empirical research across sub-Saharan Africa, we map out key ethical issues for HDSS and assess the relevance of current ethics guidance in relation to these findings.MethodsWe conducted a qualitative study across seven HDSS sites in sub-Saharan Africa, including individual in-depth interviews and informal discussions with 68 research staff, document reviews and non-participant observations of surveillance activities. Qualitative data analysis drew on a framework approach led by a priori and emergent themes, drawing on the wider ethics and social science literature.ResultsThere were diverse views on core ethical issues in HDSS, including regarding the strengths and challenges of community engagement, informed consent and data sharing processes. A key emerging issue was unfairness in the overall balance of benefits and burdens for residents and front-line staff when compared with other stakeholders, particularly given the socioeconomic contexts in which HDSS are generally conducted.ConclusionWe argue that HDSS operate as non-traditional epidemiologic research projects but are often governed using ethics guidance developed for traditional forms of health research. There is a need for specific ethics guidance for HDSS which prioritises considerations around fairness, cost-effectiveness, ancillary care responsibilities, longitudinality and obligations of the global community to HDSS residents.

The Oxford Handbook of Islamic Archaeology

2020 ◽  
Keyword(s):  
Material Culture ◽  
Ethical Issues ◽  
Rapid Development ◽  
Global Scale ◽  
Sub Saharan Africa ◽  
Islamic Art ◽  
Sub Saharan ◽  
And Migration ◽  
Islamic Archaeology ◽  
First Time

Born from the fields of Islamic art and architectural history, the archaeological study of the Islamic societies is a relatively young discipline. With its roots in the colonial periods of the late 19th and early 20th centuries, its rapid development since the 1980s warrants a reevaluation of where the field stands today. This Handbook represents for the first time a survey of Islamic archaeology on a global scale, describing its disciplinary development and offering candid critiques of the state of the field today in the Central Islamic Lands, the Islamic West, Sub-Saharan Africa, and Asia. The international contributors to the volume address such themes as the timing and process of Islamization, the problems of periodization and regionalism in material culture, cities and countryside, cultural hybridity, cultural and religious diversity, natural resource management, international trade in the later historical periods, and migration. Critical assessments of the ways in which archaeologists today engage with Islamic cultural heritage and local communities closes the volume, highlighting the ethical issues related to studying living cultures and religions.

scholarly journals Geographic coverage of demographic surveillance systems for characterising the drivers of childhood mortality in sub-Saharan Africa

2018 ◽  
Vol 3 (2) ◽  
pp. e000611 ◽  
Author(s):  
C Edson Utazi ◽  
Sujit K Sahu ◽  
Peter M Atkinson ◽  
Natalia Tejedor-Garavito ◽  
Christopher T Lloyd ◽  
...  
Keyword(s):  
International Health ◽  
Childhood Mortality ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
African Countries ◽  
Factors Associated ◽  
Development Goals ◽  
Sub Saharan ◽  
Reduction Of Mortality ◽  
Demographic Surveillance Systems

A major focus of international health and development goals is the reduction of mortality rates in children under 5 years of age. Achieving this requires understanding the drivers of mortality and how they vary geographically to facilitate the targeting and prioritisation of appropriate interventions. Much of our knowledge on the causes of, and trends in, childhood mortality come from longitudinal demographic surveillance sites, with a renewed focus recently on the establishment and growth of networks of sites from which standardised outputs can facilitate broader understanding of processes. To ensure that the collective outputs from surveillance sites can be used to derive a comprehensive understanding and monitoring system for driving policy on tackling childhood mortality, confidence is needed that existing and planned networks of sites are providing a reliable and representative picture of the geographical variation in factors associated with mortality. Here, we assembled subnational data on childhood mortality as well as key factors known to be associated with it from household surveys in 27 sub-Saharan African countries. We then mapped the locations of existing longitudinal demographic surveillance sites to assess the extent of current coverage of the range of factors, identifying where gaps exist. The results highlight regions with unique combinations of factors associated with childhood mortality that are poorly represented by the current distribution of sites, such as southern Mali, central Nigeria and southern Zambia. Finally, we determined where the establishment of new surveillance systems could improve coverage.

scholarly journals The Crucial Role of Mothers and Siblings in Child Survival: Evidence From 29 Health and Demographic Surveillance Systems in Sub-Saharan Africa

Demography ◽  
2021 ◽  
Vol 58 (5) ◽  
pp. 1687-1713
Author(s):  
Philippe Bocquier ◽  
Carren Ginsburg ◽  
Ashira Menashe-Oren ◽  
Yacouba Compaoré ◽  
Mark Collinson
Keyword(s):  
Child Mortality ◽  
Birth Interval ◽  
Child Survival ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
Birth Intervals ◽  
Sub Saharan ◽  
Demographic Surveillance Systems ◽  
Older Sibling

Abstract A considerable body of research has studied the effects of siblings on child mortality through birth intervals. This research has commonly focused on older siblings. We argue that birth intervals with younger siblings may have equal or stronger effects on child mortality, even during a mother's pregnancy. Moreover, we contend that birth interval effects need to be considered only when siblings are coresident. Using longitudinal data from 29 Health and Demographic Surveillance Systems across sub-Saharan Africa, covering more than 560,000 children, we examine the proximate role of siblings and mothers in child mortality. We find that a birth interval of 24 months or more is advantageous for both older and younger siblings. The effect of a younger sibling on child mortality is more pronounced than that of an older sibling and adds to the effect of an older sibling. Moreover, child mortality is particularly low during a mother's subsequent pregnancy, contrasting the shock resulting from a younger sibling's birth. Further, we find that a mother's or sibling's absence from the household results in a higher risk of mortality, and the death of either reduces child survival up to six months before the death.

Crowdsourcing Covid-19 signals in sub-Saharan Africa: Leveraging digital contributor networks for participatory surveillance of Covid-19 symptoms and deaths (Preprint)

2020 ◽  
Author(s):  
Ngozi A Erondu ◽  
Sagal A Ali ◽  
Mohamed Ali ◽  
Schadrac C Agbla
Keyword(s):  
Public Health ◽  
Sub Saharan Africa ◽  
Specific Information ◽  
Surveillance Systems ◽  
Health Seeking ◽  
African Countries ◽  
Cross Sectional Survey ◽  
Local Networks ◽  
The World ◽  
Sub Saharan

BACKGROUND In sub-Saharan Africa, underreporting of cases and deaths has been attributed to various factors including, weak disease surveillance, low health-seeking behaviour of flu like symptoms, and stigma of Covid-19. There is evidence that SARS-CoV-2 spread mimics transmission patterns of other countries across the world. Since the Covid-19 pandemic has changed the way research can be conducted and in light of restrictions on travel and risks to in-person data collection, innovative approaches to collecting data must be considered. Nearly 50% of Africa’s population is a unique mobile subscriber and it is one of the fastest growing smart-phone marketplaces in the world; hence, mobile phone platforms should be considered to monitor Covid-19 trends in the community. OBJECTIVE We demonstrate the use of digital contributor platforms to survey individuals about cases of flu-like symptoms and instances of unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia, and Zimbabwe. METHODS Rapid cross-sectional survey of individuals with severe flu and pneumonia symptoms and unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia and Zimbabwe RESULTS Using a non-health specific information platform, we found COVID-19 signals in five African countries, specifically: •Across countries, nearly half of the respondents (n=739) knew someone who had severe flu or pneumonia symptoms in recent months. •One in three respondents from Somalia and one in five from Zimbabwe respondents said they knew more than five people recently displaying flu and/or pneumonia symptoms. •In Somalia there were signals that a large number of people might be dying outside of health facilities, specifically in their homes or in IDP or refugee camps. CONCLUSIONS Existing digital contributor platforms with local networks are a non-traditional data source that can provide information from the community to supplement traditional government surveillance systems and academic surveys. We demonstrate that using these distributor networks to for community surveys can provide periodic information on rumours but could also be used to capture local sentiment to inform public health decision-making; for example, these insights could be useful to inform strategies to increase confidence in Covid19 vaccine. As Covid-19 continues to spread somewhat silently across sub-Saharan Africa, regional and national public health entities should consider expanding event-based surveillance sources to include these systems.

Characteristics Associated With Migration Among Older Women and Men in Rural Malawi

2017 ◽  
Vol 25 (4) ◽  
pp. 283-308 ◽  
Author(s):  
Jacob Kendall ◽  
Philip Anglewicz
Keyword(s):  
Physical Health ◽  
Older Women ◽  
Religious Affiliation ◽  
Older Men ◽  
Household Size ◽  
Sub Saharan Africa ◽  
Older Individuals ◽  
Before And After ◽  
Sub Saharan ◽  
And Migration

The older population in sub-Saharan Africa is growing rapidly, but little is known about the migration patterns of older individuals in this setting. In this article, we identify the determinants of migration for older individuals in a rural African setting. To do so, we use rare longitudinal data with information for older individuals both before and after migration. We first identify premigration factors associated with moving in the future and then identify differences in characteristics between migrants and nonmigrants after migration. In addition to basic sociodemographic information, we examine differences between migrants and nonmigrants in land ownership, number of lifetime marriages, number of living offspring, previous migration experience, household size, social and religious participation, and religious affiliation. Results show that (a) migration in older age is related to marriage, health and HIV status, household size, and religion; (b) older women who are HIV-positive are more likely to move, and older men with better physical health are more likely to move; (c) older female migrants have worse postmigration physical health; and (d) the relationship between health and migration for older men disappears after migration.

scholarly journals Historical and current distribution, population size and possible migration routes of the Blue Swallow Hirundo atrocaerulea in Africa

2010 ◽  
Vol 20 (3) ◽  
pp. 240-254 ◽  
Author(s):  
STEVEN W. EVANS ◽  
H. BOUWMAN
Keyword(s):  
Population Size ◽  
Democratic Republic ◽  
Sub Saharan Africa ◽  
Total Current ◽  
Migration Routes ◽  
Breeding Grounds ◽  
Republic Of The Congo ◽  
Migratory Routes ◽  
Sub Saharan ◽  
And Migration

SummaryThe Blue Swallow Hirundo atrocaerulea is restricted to sub-Saharan Africa, its population size previously estimated at fewer than 1,500 pairs, and is classified as Vulnerable. A better understanding of its current distributional range, population size, protection status and migration routes would improve our ability to conserve the species and the grassland and wetland habitat on which it depends. We now estimate that the Blue Swallow population in the 1850s may have numbered between 1,560 and 2,300 pairs. Based on an assessment of available data, we now estimate the total current Blue Swallow population at 1,006 pairs or 2,012 individuals, an estimated 36–56% decline over the last 150 years. There may be three separate Blue Swallow sub-populations and seven separate migratory routes between their breeding and non-breeding grounds. The Blue Swallow’s range in South Africa and Swaziland has contracted by 74%. The majority of Blue Swallows occupy unprotected areas on their non-breeding grounds in the Democratic Republic of the Congo, Uganda and Kenya. The Blue Swallow population in Africa will continue to decline unless the causes of reduction in Blue Swallow habitat quantity and quality can be stopped and sufficient and additional habitat set aside to sustain viable Blue Swallow populations throughout their range.

scholarly journals PO 8581 ZOONOTIC VIRAL ANTIGENS SURVEILLANCE IN HEALTHY POPULATIONS LIVING IN LAMBARÉNÉ, GABON

2019 ◽  
Vol 4 (Suppl 3) ◽  
pp. A58.2-A58
Author(s):  
Emmanuel Bache ◽  
Marguerite M Loembe ◽  
Selidji T Agnandji
Keyword(s):  
Disease Transmission ◽  
Disease Surveillance ◽  
Vaccine Trial ◽  
Viral Rna ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
Rt Pcr ◽  
Zoonotic Infections ◽  
Viral Antigens ◽  
Sub Saharan

BackgroundWorldwide, viral zoonotic infections such as filoviruses, flaviviruses, nairoviruses and arenaviruses cause self-limiting to severe diseases. They are endemic in sub-Saharan Africa, causing sporadic outbreaks warranting the development of sustainable surveillance systems. In Gabon, Ebola outbreaks occurred from 1994 to 2002 causing 214 human cases and 150 deaths, while Dengue, Zika and Chikungunya virus outbreaks occurred between 2007 and 2010. Beyond these outbreaks, little is known about the epidemiology. Recently, in collaboration with the Japanese government, the Research and Health Ministries of Gabon supported the implementation of a biosecurity level-3 (BSL-3) laboratory at CERMEL in Lambaréné as a zoonotic disease surveillance unit. Start-off involved antigen detection and characterisation of circulating antibodies to targeted viral antigens in healthy populations. This study reports data from healthy participants (18–50 years) in a phase I rVSV-ZEBOV-GP Ebola vaccine trial.MethodsHundred-six (106) baseline samples were screened for Ebola, Dengue (serotypes) 1–4 and Chikungunya viral RNA by RT-PCR on serum. IgG ELISA on plasma was used to identify antibodies against: Zaire-Ebola-(EBOV-GP and EBOV-VP40), Marburg-(MARV-GP and MARV-VP40), Crimean Congo Haemorrhagic Fever-(CCHFV-GP), Lasa-(LASV-GPC and LASV-NP), Yellow Fever-(YFV-NS1), West-Nile-(WNV-NS1), Zika virus-(ZIKV-NS1), Chikungunya-(CHIKV-VLP) and Dengue-(DENV1-NS1,DENV2-NS1,DENV3-NS1,DENV4-NS1) virus antigens.ResultsNo viral RNA was isolated by RT-PCR in 106 samples. About 9% (10/106), 3% (3/106), 6% (6/106), 24% (25/106), 51% (54/106), 38% (40/106) and 36% (38/106) participants were seropositive for antibodies specific to EBOV-GP, MARV-GP, CCHFV-GP, YFV-NS1, WNV-NS1, ZIKV-NS1 and CHIKV-VLP, respectively. Twelve percent (12%; 13/106) of participants possessed antibodies specific to Zika, Chikungunya and Dengue 1–4 antigens. Six percent (6%; 6/106) of participants were seropositive for EBOV-GP and CCHFV-GP.ConclusionWe found antibodies to viral zoonotic infections among our healthy volunteers. Further assays, including neutralisation assays are being performed to ascertain the specificity of the antibodies. These findings, once confirmed, will provide insights into disease surveillance, vaccine trial designs, evaluation of post-vaccine immune responses, variability in adverse events and overall disease transmission patterns.

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