scholarly journals The genomic epidemiology of multi-drug resistant invasive non-typhoidal Salmonella in selected sub-Saharan African countries

2021 ◽  
Vol 6 (8) ◽  
pp. e005659
Author(s):  
Se Eun Park ◽  
Duy Thanh Pham ◽  
Gi Deok Pak ◽  
Ursula Panzner ◽  
Ligia Maria Cruz Espinoza ◽  
...  
Keyword(s):  
Phylogenetic Analyses ◽  
Population Based ◽  
West African ◽  
Sub Saharan Africa ◽  
Fluoroquinolone Resistance ◽  
Drug Resistant ◽  
African Countries ◽  
Genetic Characteristics ◽  
Sub Saharan ◽  
The Impact

BackgroundInvasive non-typhoidal Salmonella (iNTS) is one of the leading causes of bacteraemia in sub-Saharan Africa. We aimed to provide a better understanding of the genetic characteristics and transmission patterns associated with multi-drug resistant (MDR) iNTS serovars across the continent.MethodsA total of 166 iNTS isolates collected from a multi-centre surveillance in 10 African countries (2010–2014) and a fever study in Ghana (2007–2009) were genome sequenced to investigate the geographical distribution, antimicrobial genetic determinants and population structure of iNTS serotypes–genotypes. Phylogenetic analyses were conducted in the context of the existing genomic frameworks for various iNTS serovars. Population-based incidence of MDR-iNTS disease was estimated in each study site.ResultsSalmonella Typhimurium sequence-type (ST) 313 and Salmonella Enteritidis ST11 were predominant, and both exhibited high frequencies of MDR; Salmonella Dublin ST10 was identified in West Africa only. Mutations in the gyrA gene (fluoroquinolone resistance) were identified in S. Enteritidis and S. Typhimurium in Ghana; an ST313 isolate carrying blaCTX-M-15 was found in Kenya. International transmission of MDR ST313 (lineage II) and MDR ST11 (West African clade) was observed between Ghana and neighbouring West African countries. The incidence of MDR-iNTS disease exceeded 100/100 000 person-years-of-observation in children aged <5 years in several West African countries.ConclusionsWe identified the circulation of multiple MDR iNTS serovar STs in the sampled sub-Saharan African countries. Investment in the development and deployment of iNTS vaccines coupled with intensified antimicrobial resistance surveillance are essential to limit the impact of these pathogens in Africa.

scholarly journals The genomic epidemiology of multi-drug resistant nontyphoidal Salmonella causing invasive disease in sub-Saharan Africa

2020 ◽  
Author(s):  
Se Eun Park ◽  
Duy Thanh Pham ◽  
Gi Deok Pak ◽  
Ursula Panzner ◽  
Ligia Maria Cruz Espinoza ◽  
...  
Keyword(s):  
Salmonella Enterica ◽  
Invasive Disease ◽  
West African ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Gyra Gene ◽  
Multi Centre Study ◽  
Genetic Characteristics ◽  
Sub Saharan ◽  
The Impact

Background: Invasive nontyphoidal Salmonella (iNTS) is one of the leading causes of bacteraemia in sub-Saharan Africa. Multi-drug resistance (MDR) and further resistance to third generation cephalosporins and fluoroquinolones have emerged in multiple iNTS serotypes. Molecular epidemiological investigations of nontyphoidal Salmonella are needed to better understand the genetic characteristics and transmission dynamics associated with major MDR iNTS serotypes across the continent. Methods: A total of 166 nontyphoidal Salmonella isolates causing invasive disease were collected from a multi-centre study in eight African countries between 2010 and 2014, and whole-genome sequenced to investigate the geographical distribution, antimicrobial genetic determinants and population structure of iNTS serotypes-genotypes. Phylogeographical reconstruction was further conducted in context of the existing genomic framework of iNTS serotypes Typhimurium and Enteritidis. Population-based incidence of MDR-iNTS disease was also estimated. Results: Salmonella enterica subsp. Enterica serotype Typhimurium (S. Typhimurium) sequence-type (ST) 313 and Salmonella enterica subsp. Enterica serotype Enteritidis (S. Enteritidis) ST11 were predominant, and both exhibited high frequencies of MDR. Salmonella enterica subsp. Enterica serotype Dublin (S. Dublin) ST10 emerged in West Africa. Mutations in the gyrA gene were identified in S. Enteritidis and S. Typhimurium in Ghana; and ST313 carrying blaCTX-M-15 was found in Kenya. Inter-country transmission of MDR ST313 lineage II and the West African Clade of MDR ST11 between Ghana and neighbouring countries including Mali, Burkina Faso, and Nigeria were evident. The incidence of MDR-iNTS disease exceeded 100/100,000-person years-of-observation (PYO) in children aged <5 years in several West African countries. Conclusions: Multiple MDR iNTS serotypes-sequence types, predominantly S. Typhimurium ST313 and S. Enteritidis ST11, are co-circulating in sub-Saharan Africa with evidence of transmission between West African countries. The development of safe and effective iNTS vaccines coupled with appropriate antimicrobial stewardship and adequate epidemiological monitoring are essential to limit the impact of these pathogens in Africa.

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 Plasmodium vivax from Duffy-Negative and Duffy-Positive Individuals Shares Similar Gene Pool in East Africa

2021 ◽  
Author(s):  
Daniel Kepple ◽  
Alfred Hubbard ◽  
Musab M Ali ◽  
Beka R Abargero ◽  
Karen Lopez ◽  
...  
Keyword(s):  
Plasmodium Vivax ◽  
East Africa ◽  
Sub Saharan Africa ◽  
Road Density ◽  
Genetic Characteristics ◽  
Plasmodium Vivax Malaria ◽  
Genetic Clusters ◽  
Sub Saharan ◽  
The Impact ◽  
Duffy Negative

Abstract Plasmodium vivax malaria was thought to be rare in Africa, but an increasing number of P. vivax cases reported across Africa and in Duffy-negative individuals challenges this conventional dogma. The genetic characteristics of P. vivax in Duffy-negative infections, the transmission of P. vivax in East Africa, and the impact of environments on transmission remain largely unknown. This study examined genetic and transmission features of P. vivax from 107 Duffy-negative and 305 Duffy-positive individuals in Ethiopia and Sudan. No clear genetic differentiation was found in P. vivax between the two Duffy groups, indicating between-host transmission. P. vivax from Ethiopia and Sudan showed similar genetic clusters, except samples from Khartoum, possibly due to distance and road density that inhibited parasite gene flow. This study is the first to show that P. vivax can transmit to and from Duffy-negative individuals and provides critical insights into the spread of P. vivax in sub-Saharan Africa.

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 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.

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.

Does economic freedom improve health outcomes in sub-Saharan Africa?

2020 ◽  
Vol 47 (12) ◽  
pp. 1633-1649
Author(s):  
Anand Sharma
Keyword(s):  
Mortality Rate ◽  
Life Expectancy ◽  
Health Outcomes ◽  
Economic Freedom ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Content Type ◽  
The World ◽  
Sub Saharan ◽  
The Impact

PurposeThe purpose of this study is to examine the impact of economic freedom on four key health indicators (namely, life expectancy, infant mortality rate, under-five mortality rate and neonatal mortality rate) by using a panel dataset of 34 sub-Saharan African countries from 2005 to 2016.Design/methodology/approachThe study obtains data from the World Development Indicators (WDI) of the World Bank and the Fraser Institute. It uses fixed effects regression to estimate the effect of economic freedom on health outcomes and attempts to resolve the endogeneity problems by using two-stage least squares regression (2SLS).FindingsThe results indicate a favourable impact of economic freedom on health outcomes. That is, higher levels of economic freedom reduce mortality rates and increase life expectancy in sub-Saharan Africa. All areas of economic freedom, except government size, have a significant and positive effect on health outcomes.Research limitations/implicationsThis study analyses the effect of economic freedom on health at a broad level. Country-specific studies at a disaggregated level may provide additional information about the impact of economic freedom on health outcomes. Also, this study does not control for some important variables such as education, income inequality and foreign aid due to data constraints.Practical implicationsThe findings suggest that sub-Saharan African countries should focus on enhancing the quality of economic institutions to improve their health outcomes. This may include policy reforms that support a robust legal system, protect property rights, promote free trade and stabilise the macroeconomic environment. In addition, policies that raise urbanisation, increase immunisation and lower the incidence of HIV are likely to produce a substantial improvement in health outcomes.Originality/valueExtant economic freedom-health literature does not focus on endogeneity problems. This study uses instrumental variables regression to deal with endogeneity. Also, this is one of the first attempts to empirically investigate the relationship between economic freedom and health in the case of sub-Saharan Africa.

scholarly journals Deconstructing the Impact of Entrepreneurship on Income Inequality in Sub-Saharan Africa Countries

2020 ◽  
Vol 34 (1) ◽  
pp. 273-284
Author(s):  
Jimoh S. Ogede
Keyword(s):  
Income Inequality ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Macroeconomic Factors ◽  
Significance Level ◽  
Long Run ◽  
Short Run ◽  
Sub Saharan ◽  
Entrepreneurial Activities ◽  
The Impact

Abstract The study examines the impacts of entrepreneurship on income inequality in a panel of 29 Sub-Saharan African countries spanning from 2004 to 2020. The paper employs a dynamic heterogeneous panel approach to differentiate between long-run and short-run impacts of entrepreneurship on income inequality. The findings establish a robust and direct nexus between entrepreneurial activities and income disparity. The results of the two entrepreneurial indicators are stable. Besides, the coefficient of the human capital is positive in the regression and statistically significant at a 5 percent significance level. The proxies for macroeconomic factors exhibit diverse signs and impact, which suggest a policy stimulus aimed at refining macroeconomic situations and also ignite prospects for households to increase their incomes.

scholarly journals African agriculture in the context of COVID-19: Finding salvation in the devil

2020 ◽  
Vol 15 (4) ◽  
pp. 302-310
Author(s):  
Guy Blaise Nkamleu ◽  
Keyword(s):  
Agricultural Development ◽  
Agricultural Sector ◽  
Food System ◽  
Free Trade Area ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Agriculture Sector ◽  
Sub Saharan ◽  
The Impact

The world is facing unprecedented challenges from COVID-19, which is disrupting lives and livelihoods. The pandemic could profoundly affect the African continent and wipe out hard-won development gains, as sub-Saharan Africa heads into its first recession in 25 years. Beyond the multispatial impact of the coronavirus in Africa, its effects on the agriculture and food system is of particular interest, as food security could be the most affected area and, at the same time, agriculture could be the sector that could help African economies recover quicker from the impact of COVID19. This paper supports the view that COVID-19, as devilish as it may be, offers an opportunity to revive interest in the agricultural sector. The COVID-19 pandemic has placed immense pressures on African countries to raise additional resources, and consequently Africa’s growing public debt is again coming back to the centre stage of the global debate. The conversation on African debt sustainability has begun to dominate the scene and will flood the debate in the near term. While the observed, growing calls for debt relief for African countries are legitimate, we support in this paper that one should not divert attention from the long-term solutions needed to strengthen Africa’s resilience. These long-term solutions lie where they always have: in agriculture. With COVID-19, shipping agricultural inputs and food products from other continents to Africa has become disrupted and is accelerating the trend towards shortening supply chains. This will leave a potential market for inputs and food produced on the continent. COVID-19, together with the launching of the African Continental Free Trade Area (AfCFTA), have aligned the stars in favour of a decisive transformation of the agriculture sector on the continent. Agriculturalists and development experts need to be aware of their responsibility at this time, as they need to advocate for the topic of agricultural development to return to the centre and the heart of the agenda of discussions on how to respond to the consequences of Covid-19 in Africa. In this sense, and unexpectedly, COVID-19 is an opportunity for the agricultural sector.

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