Where there is no local author: a network bibliometric analysis of authorship parasitism among research conducted in sub-Saharan Africa

IntroductionAuthorship parasitism (ie, no authors affiliated with the country in which the study took place) occurs frequently in research conducted in low-income and middle-income countries, despite published recommendations defining authorship criteria. The objective was to compare characteristics of articles exhibiting authorship parasitism in sub-Saharan Africa to articles with author representation from sub-Saharan African countries.MethodsA bibliometric review of articles indexed in PubMed published from January 2014 through December 2018 reporting research conducted in sub-Saharan Africa was performed. Author affiliations were assigned to countries based on regular expression algorithms. Choropleth maps and network diagrams were created to determine where authorship parasitism occurred, and multivariable logistic regression was used to determine associated factors.ResultsOf 32 061 articles, 14.8% (n=4754) demonstrated authorship parasitism, which was most common among studies from Somalia (n=175/233, 75.1%) and Sao Tome and Principe (n=20/28, 71.4%). Authors affiliated with USA and UK institutions were most commonly involved in articles exhibiting authorship parasitism. Authorship parasitism was more common in articles: published in North American journals (adjusted OR (aOR) 1.26, 95% CI 1.07 to 1.50) than in sub-Saharan African journals, reporting work from multiple sub-Saharan African countries (aOR 8.41, 95% CI 7.30 to 9.68) compared with work from upper-middle income sub-Saharan African countries, with <5 authors (aOR 14.46, 95% CI 12.81 to 16.35) than >10 authors, and was less common in articles published in French (aOR 0.60, 95% CI 0.41 to 0.85) than English.ConclusionsAuthorship parasitism was common in articles reporting research conducted in sub-Saharan Africa. There were reliable predictors of authorship parasitism. Investigators and institutions in high-income countries, as well as funding agencies and journals should promote research from sub-Saharan Africa, including its publication, in a collaborative and equitable manner.

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P1586Research network in Africa (RNA): antihypertensive drugs strategies in 12 African countries

European Heart Journal ◽

10.1093/eurheartj/ehz748.0346 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

A Kane ◽

P Cavagna ◽

I B Diop ◽

B Gaye ◽

J B Mipinda ◽

...

Keyword(s):

Blood Pressure ◽

Low Income ◽

Democratic Republic ◽

Antihypertensive Drugs ◽

Sub Saharan Africa ◽

Low Income Countries ◽

African Countries ◽

Middle Income ◽

Middle Income Countries ◽

Sub Saharan

Abstract Background High Blood Pressure is the worldwide leading global burden of disease risk factor. In Sub-Saharan Africa, the number of adults with raised blood pressure has alarmingly increased from 0.59 to 1.13 billion between 1975 and 2015. Blood pressure-lowering medicines are cornerstone of cardiovascular risk reduction. Data on management of anti-hypertensive drugs in sub-Saharan Africa are squarce. Purpose Our study aims to describe antihypertensive drugs strategies in Africa. Methods We conducted a cross-sectional survey in urban clinics during outpatient consultation specialized in hypertension cardiology departments of 29 medical centers from 17 cities across 12 African countries (Benin, Cameroon, Congo, Democratic Republic of Congo, Gabon, Guinea, Ivory Coast, Mauritania, Mozambic, Niger, Senegal, Togo). Data were collected on demographics, treatment and standardized BP measures were made among the hypertensive patients attending the clinics. Country income was retrieved from the World Bank database. All analyses were performed through scripts developed in the R software (3.4.1 (2017–06–30)). Results A total of 2198 hypertensive patients (58.4±11.8 years; 39.9% male) were included. Among whom 2123 (96.6%) had at least one antihypertensive drug. Overall, 30.8% (n=653) received monotherapy and calcium-channel blockers (49.6%) were the most common monotherapy prescribed follow by diuretics (18.7%). Two-drug strategies were prescribed for 927 patients (43.6%). Diuretics and Angiotensin-converting enzyme inhibitors was the combination most frequently prescribed (33.7%). Combination of three drugs or more was used in 25.6% (n=543) of patients. The proportion of drugs strategies differed significantly according to countries (p<0.001), monotherapy ranged from 12.7% in Niger to 47.1% in Democratic Republic of the Congo (figure). Furthermore we observed a significantly difference of strategies between low and middle income countries (55.3% and 44.7% of monotherapy respectively) (p<0.001). According to hypertension grades 1, 2 and 3, the proportion of three-drugs or more combination was 25%, 28% and 34% in middle-income and lower in low-income countries (18%, 19% and 25%). Furthermore, Grade 3 hypertension in low income countries was still treated with monotherapy (36%) instead of 19% in middle income countries (p<0.01). Antihypertensive strategies by country Conclusion Our study described antihypertensive drugs use across 12 sub-Saharan countries, and identified disparities specific to the income context. Inequity in access to drugs combination is a serious barrier to tackle the burden of hypertension in Africa.

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Gestational weight gain in low-income and middle-income countries: a modelling analysis using nationally representative data

BMJ Global Health ◽

10.1136/bmjgh-2020-003423 ◽

2020 ◽

Vol 5 (11) ◽

pp. e003423

Author(s):

Dongqing Wang ◽

Molin Wang ◽

Anne Marie Darling ◽

Nandita Perumal ◽

Enju Liu ◽

...

Keyword(s):

Weight Gain ◽

North Africa ◽

Low Income ◽

Sub Saharan Africa ◽

Middle Income ◽

Middle Income Countries ◽

Gestational Weight ◽

Latin America And Caribbean ◽

Nationally Representative ◽

Sub Saharan

IntroductionGestational weight gain (GWG) has important implications for maternal and child health and is an ideal modifiable factor for preconceptional and antenatal care. However, the average levels of GWG across all low-income and middle-income countries of the world have not been characterised using nationally representative data.MethodsGWG estimates across time were computed using data from the Demographic and Health Surveys Program. A hierarchical model was developed to estimate the mean total GWG in the year 2015 for all countries to facilitate cross-country comparison. Year and country-level covariates were used as predictors, and variable selection was guided by the model fit. The final model included year (restricted cubic splines), geographical super-region (as defined by the Global Burden of Disease Study), mean adult female body mass index, gross domestic product per capita and total fertility rate. Uncertainty ranges (URs) were generated using non-parametric bootstrapping and a multiple imputation approach. Estimates were also computed for each super-region and region.ResultsLatin America and Caribbean (11.80 kg (95% UR: 6.18, 17.41)) and Central Europe, Eastern Europe and Central Asia (11.19 kg (95% UR: 6.16, 16.21)) were the super-regions with the highest GWG estimates in 2015. Sub-Saharan Africa (6.64 kg (95% UR: 3.39, 9.88)) and North Africa and Middle East (6.80 kg (95% UR: 3.17, 10.43)) were the super-regions with the lowest estimates in 2015. With the exception of Latin America and Caribbean, all super-regions were below the minimum GWG recommendation for normal-weight women, with Sub-Saharan Africa and North Africa and Middle East estimated to meet less than 60% of the minimum recommendation.ConclusionThe levels of GWG are inadequate in most low-income and middle-income countries and regions. Longitudinal monitoring systems and population-based interventions are crucial to combat inadequate GWG in low-income and middle-income countries.

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Preventing Multimorbidity with Lifestyle Interventions in Sub-Saharan Africa: A New Challenge for Public Health in Low and Middle-Income Countries

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182312449 ◽

2021 ◽

Vol 18 (23) ◽

pp. 12449

Author(s):

Ahmad Alkhatib ◽

Lawrence Achilles Nnyanzi ◽

Brian Mujuni ◽

Geofrey Amanya ◽

Charles Ibingira

Keyword(s):

Public Health ◽

Cardiovascular Disease ◽

Sub Saharan Africa ◽

Lifestyle Interventions ◽

African Countries ◽

Middle Income ◽

Non Communicable Diseases ◽

Economic Disparity ◽

Middle Income Countries ◽

Sub Saharan

Objectives: Low and Middle-Income Countries are experiencing a fast-paced epidemiological rise in clusters of non-communicable diseases such as diabetes and cardiovascular disease, forming an imminent rise in multimorbidity. However, preventing multimorbidity has received little attention in LMICs, especially in Sub-Saharan African Countries. Methods: Narrative review which scoped the most recent evidence in LMICs about multimorbidity determinants and appropriated them for potential multimorbidity prevention strategies. Results: MMD in LMICs is affected by several determinants including increased age, female sex, environment, lower socio-economic status, obesity, and lifestyle behaviours, especially poor nutrition, and physical inactivity. Multimorbidity public health interventions in LMICs, especially in Sub-Saharan Africa are currently impeded by local and regional economic disparity, underdeveloped healthcare systems, and concurrent prevalence of communicable and non-communicable diseases. However, lifestyle interventions that are targeted towards preventing highly prevalent multimorbidity clusters, especially hypertension, diabetes, and cardiovascular disease, can provide early prevention of multimorbidity, especially within Sub-Saharan African countries with emerging economies and socio-economic disparity. Conclusion: Future public health initiatives should consider targeted lifestyle interventions and appropriate policies and guidelines in preventing multimorbidity in LMICs.

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Is overseas volunteering beneficial to the NHS? The analysis of volunteers’ responses to a feedback questionnaire following experiences in low-income and middle-income countries

BMJ Open ◽

10.1136/bmjopen-2017-017517 ◽

2017 ◽

Vol 7 (10) ◽

pp. e017517 ◽

Cited By ~ 5

Author(s):

Daniel Yeomans ◽

Grace Le ◽

Hemant Pandit ◽

Chris Lavy

Keyword(s):

Professional Development ◽

Low Income ◽

Personal Development ◽

Positive Impact ◽

Sub Saharan Africa ◽

Middle Income ◽

Middle Income Countries ◽

Feedback Questionnaire ◽

Sub Saharan ◽

The Uk

IntroductionLocally requested and planned overseas volunteering in low-income and middle-income countries by National Health Service (NHS) staff can have benefits for the host or receiving nation, but its impact on the professional development of NHS staff is not proven. The Knowledge and Skills Framework (KSF) and Leadership Framework (LF) are two tools used by employers as a measure of individuals' development. We have used dimensions from both tools as a method of evaluating the benefit to NHS doctors who volunteer overseas.Methods88 NHS volunteers participating with local colleagues in Primary Trauma Care and orthopaedic surgical training courses in sub-Saharan Africa were asked to complete an online self-assessment questionnaire 6 months following their return to the UK. The survey consisted of questions based on qualities outlined in both the KSF and LF.Results85 completed responses to the questionnaire were received. In every KSF domain assessed, the majority of volunteers agreed that their overseas volunteering experience improved their practice within the NHS. Self-assessed pre-course and post-course scores evaluating the LF also saw a universal increase, notably in the ‘working with others’ domain.DiscussionThere is a growing body of literature outlining the positive impact of overseas volunteering on NHS staff. Despite increasing evidence that such experiences can develop volunteers’ essential skills, individuals often find it difficult to gain support of their employers. Our study, in line with the current literature, shows that overseas volunteering by NHS staff can provide an opportunity to enhance professional and personal development. Skills gained from volunteering within international links match many of the qualities outlined in both KSF and LF, directly contributing to volunteers’ continued professional development.

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The Causal Relationship Between China-Africa Trade, China OFDI, and Economic Growth of African Countries

SAGE Open ◽

10.1177/21582440211064899 ◽

2021 ◽

Vol 11 (4) ◽

pp. 215824402110648

Author(s):

Emma Serwaa Obobisa ◽

Haibo Chen ◽

Emmanuel Caesar Ayamba ◽

Claudia Nyarko Mensah

Keyword(s):

Economic Growth ◽

Low Income ◽

Negative Impact ◽

Empirical Studies ◽

Generalized Least Squares ◽

Causal Link ◽

Sub Saharan Africa ◽

African Countries ◽

Middle Income ◽

Sub Saharan

Recently, China has emerged as the largest trading partner and a significant source of investment in the African continent. Although there is consent on the increasing importance of China and Africa’s economic partnership, there are many controversies on how it affects African countries. Debates on China in Africa have, however, relied on grandiloquence rather than empirical studies. This study explores the causal link between China-Africa trade, China’s outward foreign direct (OFDI), and economic growth of 24 Sub-Saharan Africa countries from 1999 to 2018. The aggregated panel is classified into upper-middle-income, low-middle income, and low-income Sub-Saharan African countries. In the long run, key findings from the feasible generalized least squares (FGLS) estimator unveiled that; (i) China-Africa trade negatively contributes to economic growth among all panels. (ii) China’s OFDI improves economic growth in the low middle and low-income African countries whereas a significant negative liaison is evidenced in the upper-middle-income African countries. (iii) Labor force have a negative impact on economic growth whiles gross capital formation is evidenced to positively impact economic growth at all the panels. The Dumitrescu and Hurlin Granger causality unveiled a one-sided causal link from China-Africa trade to economic growth at all panels. The study proposes policy recommendations based on the results.

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Aging and the Rising Burden of Noncommunicable Diseases in Sub-Saharan Africa and other Low- and Middle-Income Countries: A Call for Holistic Action

The Gerontologist ◽

10.1093/geront/gnz102 ◽

2019 ◽

Vol 60 (5) ◽

pp. 806-811 ◽

Cited By ~ 4

Author(s):

Razak M Gyasi ◽

David R Phillips

Keyword(s):

Sub Saharan Africa ◽

Vulnerable Groups ◽

Noncommunicable Diseases ◽

Mortality Data ◽

African Countries ◽

Middle Income ◽

Middle Income Countries ◽

Demographic Aging ◽

Sub Saharan ◽

Low And Middle Income

Abstract Noncommunicable diseases (NCDs) are a prevalent and growing burden among older cohorts in sub-Saharan Africa and other low- and middle-income countries (LMICs) as in many wealthier parts of the world. This stems from the combined effects of factors such as demographic aging, behavioral transitions, and developmental origins of health and disease. A crucial characteristic of many NCDs is that their personal and family impacts and costs are not accurately reflected in mortality data. Their effects are often chronic and long-term and can cause morbidity, loss of work ability, and impaired quality of life over a prolonged period. Unless addressed seriously, the continuing increase of NCDs and their burden in sub-Saharan African countries and other LMICs will almost certainly undermine progress toward achieving the target of reducing by 25% premature mortality from NCDs in these countries by 2025 and also one-third reduction of NCDs target by 2030. To have any chance of meeting or even getting near to these targets, this article calls for action by national and regional governments to strengthen universal health coverage (UHC), economic empowerment of vulnerable groups, public–private partnerships, effective fiscal regulation, and public education on NCDs, their risk factors and impacts in sub-Saharan Africa in particular and most LMICs globally.

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Developing nephrology services in low income countries: a case of Tanzania

BMC Nephrology ◽

10.1186/s12882-019-1568-7 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 3

Author(s):

Francis F. Furia ◽

Jacqueline Shoo ◽

Paschal J. Ruggajo ◽

Kajiru Kilonzo ◽

Gopal Basu ◽

...

Keyword(s):

Health Care Providers ◽

Low Income ◽

Kidney Diseases ◽

Developed Countries ◽

Sub Saharan Africa ◽

Low Income Countries ◽

Care Providers ◽

African Countries ◽

Middle Income ◽

Sub Saharan

Abstract Background The burden of kidney diseases is reported to be higher in lower- and middle-income countries as compared to developed countries, and countries in sub-Saharan Africa are reported to be most affected. Health systems in most sub-Sahara African countries have limited capacity in the form of trained and skilled health care providers, diagnostic support, equipment and policies to provide nephrology services. Several initiatives have been implemented to support establishment of these services. Methods This is a situation analysis to examine the nephrology services in Tanzania. It was conducted by interviewing key personnel in institutions providing nephrology services aiming at describing available services and international collaborators supporting nephrology services. Results Tanzania is a low-income country in Sub-Saharan Africa with a population of more than 55 million that has seen remarkable improvement in the provision of nephrology services and these include increase in the number of nephrologists to 14 in 2018 from one in 2006, increase in number of dialysis units from one unit (0.03 unit per million) before 2007 to 28 units (0.5 units per million) in 2018 and improved diagnostic services with introduction of nephropathology services. Government of Tanzania has been providing kidney transplantation services by funding referral of donor and recipients abroad and has now introduced local transplantation services in two hospitals. There have been strong international collaborators who have supported nephrology services and establishment of nephrology training in Tanzania. Conclusion Tanzania has seen remarkable achievement in provision of nephrology services and provides an interesting model to be used in supporting nephrology services in low income countries.

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Acquired heart disease in low-income and middle-income countries

Archives of Disease in Childhood ◽

10.1136/archdischild-2016-312521 ◽

2017 ◽

Vol 103 (1) ◽

pp. 73-77 ◽

Cited By ~ 4

Author(s):

Chris Curry ◽

Liesl Zuhlke ◽

Ana Mocumbi ◽

Neil Kennedy

Keyword(s):

Heart Disease ◽

Low Income ◽

Burden Of Illness ◽

Sub Saharan Africa ◽

Endomyocardial Fibrosis ◽

Middle Income ◽

Mortality And Morbidity ◽

Middle Income Countries ◽

Acquired Heart Disease ◽

Sub Saharan

The burden of illness associated with acquired cardiac disease in children in low-income and middle-income countries (LMIC) is significant and may be equivalent to that of congenital heart disease. Rheumatic heart disease, endomyocardial fibrosis, cardiomyopathy (including HIV cardiomyopathy) and tuberculosis are the most important causes. All are associated with poverty with the neediest children having the least access to care. The associated mortality and morbidity is high. There is an urgent need to improve cardiac care in LMIC, particularly in sub-Saharan Africa and parts of Southeast Asia where the burden is highest.

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Investigating into the Employment and Income Inequality Nexus in Sub-Saharan Africa

10.21203/rs.3.rs-330417/v1 ◽

2021 ◽

Author(s):

Suneila Gokhool ◽

Verena Tandrayen Ragoobur ◽

Harshana Kasseeah

Keyword(s):

Income Inequality ◽

Low Income ◽

Good Governance ◽

Ordinary Least Squares ◽

Development Stage ◽

Sub Saharan Africa ◽

Domestic Investment ◽

African Countries ◽

Middle Income ◽

Sub Saharan

Abstract This paper aims to examine the relationship between employment and income inequality in Sub-Saharan African countries. Even though the region has experienced a decade of positive economic growth, it has the second highest level of income inequality in the world. The drivers of income inequality are quantitatively investigated using data from 1991 to 2015 by the Fully Modified Ordinary Least Squares technique. The results show that employment, trade and domestic investment reduce income inequality in the region in the long term. Higher trade tends to improve income equality in middle-income countries. Alternatively, domestic investment and trade have more potential to reduce inequality in low-income economies. Controlling corruption is essential in the long run for job creation, irrespective of the development stage of the country. There is thus evidence to show that policies must be oriented to more opportunities of employment, domestic investment, trade and good governance in terms of low corruption.

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Current realities versus theoretical optima: quantifying efficiency and sociospatial equity of travel time to hospitals in low-income and middle-income countries

BMJ Global Health ◽

10.1136/bmjgh-2019-001552 ◽

2019 ◽

Vol 4 (4) ◽

pp. e001552 ◽

Cited By ~ 1

Author(s):

Kerry LM Wong ◽

Oliver J Brady ◽

Oona Maeve Renee Campbell ◽

Christopher I Jarvis ◽

Andrea Pembe ◽

...

Keyword(s):

Current Efficiency ◽

Travel Time ◽

Low Income ◽

Urban Areas ◽

African Countries ◽

Middle Income ◽

Middle Income Countries ◽

Average Travel Time ◽

Sub Saharan ◽

Aid Decision

BackgroundHaving hospitals located in urban areas where people, resources and wealth concentrate is efficient, but leaves long travel times for the rural and often poorer population and goes against the equity objective. We aimed to assess the current efficiency (mean travel time in the whole population) and equity (difference in travel time between the poorest and least poor deciles) of hospital care provision in four sub-Saharan African countries, and to compare them against their theoretical optima.MethodsWe overlaid the locations of 480, 115, 3787 and 256 hospitals in Kenya, Malawi, Nigeria and Tanzania, respectively, with high-resolution maps of travel time, population and wealth to estimate current efficiency and equity. To identify the potential optima, we simulated 7500 sets of hospitals locations based on various population and wealth weightings and percentage reallocations for each country.ResultsThe average travel time ranged from 38 to 79 min across countries, and the respective optima were mildly shorter (<15%). The observed equity gaps were wider than their optima. Compared with the best case scenarios, differences in the equity gaps varied from 7% in Tanzania to 77% in Nigeria. In Kenya, Malawi and Tanzania, narrower equity gaps without increasing average travel time were seen from simulations that held 75%–90% of hospitals at their current locations.InterpretationsCurrent hospital distribution in the four sub-Saharan African countries could be considered efficient. Simultaneous gains in efficiency and equity do not necessarily require a fundamental redesign of the healthcare system. Our analytical approach is readily extendible to aid decision support in adding and upgrading existing hospitals.

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