scholarly journals Adolescents and age of consent to HIV testing: an updated review of national policies in sub-Saharan Africa

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e049673
Author(s):  
Magdalena Barr-DiChiara ◽  
Mandikudza Tembo ◽  
Lisa Harrison ◽  
Caitlin Quinn ◽  
Wole Ameyan ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Data Extraction ◽  
Central Africa ◽  
Sub Saharan Africa ◽  
Parental Consent ◽  
Eligibility Criteria ◽  
Age Of Consent ◽  
Key Population ◽  
Sub Saharan ◽  
Eastern And Southern Africa

ObjectivesIn sub-Saharan Africa (SSA) where HIV burden is highest, access to testing, a key entry point for prevention and treatment, remains low for adolescents (aged 10–19). Access may be hampered by policies requiring parental consent for adolescents to receive HIV testing services (HTS). In 2013, the WHO recommended countries to review HTS age of consent policies. Here, we investigate country progress and policies on age of consent for HIV testing.DesignComprehensive policy review.Data sourcesPolicies addressing HTS were obtained through searching WHO repositories and governmental and non-governmental websites and consulting country and regional experts.Eligibility criteriaHTS policies published by SSA governments before 2019 that included age of consent.Data extraction and synthesisData were extracted on HTS age of consent including exceptions based on risk and maturity. Descriptive analyses of included policies were disaggregated by Eastern and Southern Africa (ESA) and Western and Central Africa (WCA) subregions.ResultsThirty-nine policies were reviewed, 38 were eligible; 19/38 (50%) permitted HTS for adolescents ≤16 years old without parental consent. Of these, six allowed HTS at ≥12 years old, two at ≥13, two at ≥14, five at ≥15 and four at ≥16. In ESA, 71% (n=15/21) allowed those of ≤16 years old to access HTS, while only 24% (n=6/25) of WCA countries allowed the same. Maturity exceptions including marriage, sexual activity, pregnancy or key population were identified in 18 policies. In 2019, 63% (n=19/30) of policies with clear age-based criteria allowed adolescents of 12–16 years old to access HIV testing without parental consent, an increase from 37% (n=14/38) in 2013.ConclusionsWhile many countries in SSA have revised their HTS policies, many do not specify age of consent. Revision of SSA consent to HTS policies, particularly in WCA, remains a priority to achieve the 2025 goal of 95% of people with HIV knowing their status.

scholarly journals Publication practices of sub-Saharan African Cochrane authors: a bibliometric study

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e051839
Author(s):  
Lawrence Mbuagbaw ◽  
Anel Schoonees ◽  
Joy Oliver ◽  
Dachi Arikpo ◽  
Solange Durão ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Data Extraction ◽  
Sub Saharan Africa ◽  
Bibliometric Study ◽  
Test Accuracy ◽  
Eligibility Criteria ◽  
Cochrane Reviews ◽  
Publication Practices ◽  
Sub Saharan ◽  
Overviews Of Systematic Reviews

IntroductionCochrane Africa (https://africa.cochrane.org/) aims to increase Cochrane reviews addressing high priority questions in sub-Saharan Africa (SSA). Researchers residing in SSA, despite often drawing on Cochrane methods, training or resources, conduct and publish systematic reviews outside of Cochrane. Our objective was to investigate the extent to which Cochrane authors from SSA publish Cochrane and non-Cochrane reviews.MethodsWe conducted a bibliometric study of systematic reviews and overviews of systematic reviews from SSA, first by identifying SSA Cochrane authors, then retrieving their first and last author systematic reviews and overviews from PubMed (2008 to April 2019) and using descriptive analyses to investigate the country of origin, types of reviews and trends in publishing Cochrane and non-Cochrane systematic reviews over time. To be eligible, a review had to have predetermined objectives, eligibility criteria, at least two databases searched, data extraction, quality assessment and a first or last author with a SSA affiliation.ResultsWe identified 657 Cochrane authors and 757 eligible systematic reviews. Most authors were from South Africa (n=332; 51%), followed by Nigeria (n=126; 19%). Three-quarters of the reviews (71%) were systematic reviews of interventions. The intervention reviews were more likely to be Cochrane reviews (60.3% vs 39.7%). Conversely, the overviews (23.8% vs 76.2%), qualitative reviews (14.8% vs 85.2%), diagnostic test accuracy reviews (16.1% vs 83.9%) and the ‘other’ reviews (11.1% vs 88.9%) were more likely to be non-Cochrane reviews. During the study period, the number of non-Cochrane reviews increased more than the number of Cochrane reviews. About a quarter of the reviews covered infectious disease topics.ConclusionCochrane authors from SSA are increasingly publishing a diverse variety of systematic reviews and overviews of systematic reviews, often opting for non-Cochrane journals.

scholarly journals Prenatal care coverage and correlates of HIV testing in sub-Saharan Africa: Insight from demographic and health surveys of 16 countries

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242001
Author(s):  
Oluwafemi Emmanuel Awopegba ◽  
Amarachi Kalu ◽  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Anthony Idowu Ajayi
Keyword(s):  
Prenatal Care ◽  
Pregnant Women ◽  
Hiv Testing ◽  
Health Surveys ◽  
Central Africa ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
West And Central Africa ◽  
Sub Saharan ◽  
Ssa Countries

Background Prenatal screening of pregnant women for HIV is central to eliminating mother-to-child-transmission (MTCT) of HIV. While some countries in sub-Saharan Africa (SSA) have scaled up their prevention of MTCT programmes, ensuring a near-universal prenatal care HIV testing, and recording a significant reduction in new infection among children, several others have poor outcomes due to inadequate testing. We conducted a multi-country analysis of demographic and health surveys (DHS) to assess the coverage of HIV testing during pregnancy and also examine the factors associated with uptake. Methods We analysed data of 64,933 women from 16 SSA countries with recent DHS datasets (2015–2018) using Stata version 16. Adjusted and unadjusted logistic regression models were used to examine correlates of prenatal care uptake of HIV testing. Statistical significance was set at p<0.05. Results Progress in scaling up of prenatal care HIV testing was uneven across SSA, with only 6.1% of pregnant women tested in Chad compared to 98.1% in Rwanda. While inequality in access to HIV testing among pregnant women is pervasive in most SSA countries and particularly in West and Central Africa sub-regions, a few countries, including Rwanda, South Africa, Zimbabwe, Malawi and Zambia have managed to eliminate wealth and rural-urban inequalities in access to prenatal care HIV testing. Conclusion Our findings highlight the between countries and sub-regional disparities in prenatal care uptake of HIV testing in SSA. Even though no country has universal coverage of prenatal care HIV testing, East and Southern African regions have made remarkable progress towards ensuring no pregnant woman is left untested. However, the West and Central Africa regions had low coverage of prenatal care testing, with the rich and well educated having better access to testing, while the poor rarely tested. Addressing the inequitable access and coverage of HIV testing among pregnant women is vital in these sub-regions.

scholarly journals HIV trends and disparities by gender and urban–rural residence among adolescents in sub-Saharan Africa

2021 ◽  
Vol 18 (S1) ◽  
Author(s):  
Réka Maulide Cane ◽  
Dessalegn Y. Melesse ◽  
Nkomba Kayeyi ◽  
Adom Manu ◽  
Yohannes Dibaba Wado ◽  
...  
Keyword(s):  
Southern Africa ◽  
Hiv Transmission ◽  
Central Africa ◽  
Hiv Prevalence ◽  
Sub Saharan Africa ◽  
Average Annual Rate ◽  
Urban Rural ◽  
West And Central Africa ◽  
Sub Saharan ◽  
Eastern And Southern Africa

Abstract Background In sub-Saharan Africa HIV transmission is a major challenge in adolescents, especially among girls and those living in urban settings. Major international efforts have aimed at reducing sexual transmission of HIV. This analysis aims to assess the trends in HIV prevalence by gender in adolescents, as well as urban–rural disparities. Methods HIV prevalence data at ages 15–19 years were obtained for 31 countries with a national survey since 2010 and for 23 countries with one survey circa 2005 and a recent survey circa 2015. Country medians and average annual rates of changes were used to summarize the trends for two subregions in sub-Saharan Africa, Eastern and Southern Africa and West and Central Africa, which largely correspond with higher and lower HIV prevalence countries. Data on HIV incidence at ages 15–24 and prevalence at 5–9 and 10–14 years were reviewed from 11 recent national surveys. Trends in urban–rural disparities in HIV prevalence and selected indicators of sexual and HIV testing behaviours were assessed for females and males 15–24 years, using the same surveys. Results HIV prevalence among girls 15–19 years declined in eastern and Southern Africa from 5.7 to 2.6% during 2005–2015 (country median), corresponding with an average annual rate of reduction of 6.5% per year. Among boys, the median HIV prevalence declined from 2.1 to 1.2%. Changes were also observed in West and Central Africa where median HIV prevalence among girls decreased from 0.7 to 0.4% (average annual rate of reduction 5.9%), but not for boys (0.3%). Girl-boy differences at 10–14 years were small with a country median HIV of 1.0% and 1.3%, respectively. Urban females and males 15–24 had at least 1.5 times higher HIV prevalence than their rural counterparts in both subregions, and since the urban–rural declines were similar, the gaps persisted during 2005–2015. Conclusions HIV prevalence among adolescents declined in almost all countries during the last decade, in both urban and rural settings. The urban–rural gap persisted and HIV transmission to girls, but not boys, is still a major challenge in Eastern and Southern African countries.

scholarly journals Hearing loss in Africa: current genetic profile

2021 ◽  
Author(s):  
Samuel Mawuli Adadey ◽  
Edmond Wonkam-Tingang ◽  
Elvis Twumasi Aboagye ◽  
Osbourne Quaye ◽  
Gordon A. Awandare ◽  
...  
Keyword(s):  
North Africa ◽  
Data Extraction ◽  
Usher Syndrome ◽  
Central Africa ◽  
Sub Saharan Africa ◽  
Genetic Profile ◽  
African Countries ◽  
Registration Number ◽  
Sub Saharan ◽  
Targeted Gene Sequencing

AbstractHearing impairment (HI) is highly heterogeneous with over 123 associated genes reported to date, mostly from studies among Europeans and Asians. Here, we performed a systematic review of literature on the genetic profile of HI in Africa. The study protocol was registered on PROSPERO, International Prospective Register of Systematic Reviews with the registration number “CRD42021240852”. Literature search was conducted on PubMed, Scopus, Africa-Wide Information, and Web of Science databases. A total of 89 full-text records was selected and retrieved for data extraction and analyses. We found reports from only 17/54 (31.5%) African countries. The majority (61/89; 68.5%) of articles were from North Africa, with few reports found from sub-Saharan Africa. The most common method used in these publications was targeted gene sequencing (n = 66/111; 59.5%), and only 13.5% (n = 15/111) used whole-exome sequencing. More than half of the studies were performed in families segregating HI (n = 51/89). GJB2 was the most investigated gene, with GJB2: p.(R143W) founder variant only reported in Ghana, while GJB2: c.35delG was common in North African countries. Variants in MYO15A were the second frequently reported in both North and Central Africa, followed by ATP6V1B1 only reported from North Africa. Usher syndrome was the main syndromic HI molecularly investigated, with variants in five genes reported: USH2A, USH1G, USH1C, MYO7A, and PCDH15. MYO7A: p.(P1780S) founder variant was reported as the common Usher syndrome variant among Black South Africans. This review provides the most comprehensive data on HI gene variants in the largely under-investigated African populations. Future exomes studies particularly in multiplex families will likely provide opportunities for the discovery of the next sets of novel HI genes, and well as unreported variants in known genes to further our understanding of HI pathobiology, globally.

scholarly journals Intersectional stigma and its impact on HIV prevention and care among MSM and WSW in sub-Saharan African countries: a protocol for a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e047280
Author(s):  
Gamji M’Rabiu Abubakari ◽  
Debbie Dada ◽  
Jemal Nur ◽  
DeAnne Turner ◽  
Amma Otchere ◽  
...  
Keyword(s):  
Hiv Prevention ◽  
Data Extraction ◽  
Grey Literature ◽  
Secondary Data ◽  
Well Being ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Scoping Reviews ◽  
Sub Saharan ◽  
Meta Analyses

IntroductionResearch has established that various forms of stigma (HIV stigma, gender non-conforming stigma and same-gender sex stigma) exist across Sub-Saharan Africa and have consequences for the utilisation of HIV prevention and care services. Stigmas are typically investigated in HIV literature individually or through investigating individual populations and the various stigmas they may face. The concept of intersectionality highlights the interconnected nature of social categorisations and their ability to create interdependent systems of discrimination based on gender, race, sexuality and so on. Drawing from perspectives on intersectionality, intersectional stigma denotes the convergence of multiple marginalised identities within an individual or a group, the experiences of stigma associated with these identities as well as the synergistic impact of these experiences on health and well-being. With respect to HIV, public health scholars can examine the impacts of intersectional stigmas on HIV prevention and care utilisation.Methods and analysisReviewers will search systematically through MEDLINE, Global Health, Embase, Scopus, Web of Science Core Collection and Africa Index Medicus and citations for quantitative studies, qualitative studies and grey literature that include data on stigma and HIV among men who have sex with men and women who have sex with women in Sub-Saharan Africa. Eligible studies will include primary or secondary data on stigma related to HIV risk factors experienced by this population. Studies will be written in French or English and be published between January 1991 and November 2020. All screening and data extraction will be performed in duplicate, and if discrepancies arise, they will be settled by GM’RA, LEN, DD or AO. Findings from this study will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews.Ethics and disseminationEthics approval is not required as there will be no human participants and no protected data will be used in this study. We will disseminate findings through peer-reviewed manuscripts, conferences and webinars.

Genetic polymorphism and population structure ofEchinococcus ortleppi

Parasitology ◽  
2016 ◽  
Vol 144 (4) ◽  
pp. 450-458 ◽  
Author(s):  
F. ADDY ◽  
M. WASSERMANN ◽  
F. BANDA ◽  
H. MBAYA ◽  
J. ASCHENBORN ◽  
...  
Keyword(s):  
Genetic Polymorphism ◽  
South America ◽  
Southern Africa ◽  
Dna Sequences ◽  
Intraspecific Variability ◽  
Sensu Stricto ◽  
Sub Saharan Africa ◽  
Geographical Regions ◽  
Sub Saharan ◽  
Eastern And Southern Africa

SUMMARYThe zoonotic cestodeEchinococcus ortleppi(Lopez-Neyra and Soler Planas, 1943) is mainly transmitted between dogs and cattle. It occurs worldwide but is only found sporadically in most regions, with the notable exception of parts of southern Africa and South America. Its epidemiology is little understood and the extent of intraspecific variability is unknown. We have analysed in the present study the genetic diversity among 178E. ortleppiisolates from sub-Saharan Africa, Europe and South America using the complete mitochondrialcox1(1608 bp) andnad1(894 bp) DNA sequences. Genetic polymorphism within the loci revealed 15cox1and sixnad1haplotypes, respectively, and 20 haplotypes of the concatenated genes. Presence of most haplotypes was correlated to geographical regions, and only one haplotype had a wider spread in both eastern and southern Africa. Intraspecific microvariance was low in comparison withEchinococcus granulosussensu stricto, despite the wide geographic range of examined isolates. In addition, the various sub-populations showed only subtle deviation from neutrality and were mostly genetically differentiated. This is the first insight into the population genetics of the enigmatic cattle adaptedEchinococcus ortleppi. It, therefore, provides baseline data for biogeographical comparison amongE. ortleppiendemic regions and for tracing its translocation paths.

scholarly journals Predictors of HIV Testing among Youth in Sub-Saharan Africa: A Cross-Sectional Study

PLoS ONE ◽  
2016 ◽  
Vol 11 (10) ◽  
pp. e0164052 ◽  
Author(s):  
Ibitola O. Asaolu ◽  
Jayleen K. Gunn ◽  
Katherine E. Center ◽  
Mary P. Koss ◽  
Juliet I. Iwelunmor ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Sectional Study ◽  
Cross Sectional ◽  
Sub Saharan

Women in Gabon

2021 ◽  
Author(s):  
Claire H. Griffiths
Keyword(s):  
Central Africa ◽  
Early Period ◽  
Sub Saharan Africa ◽  
African Women ◽  
Female Population ◽  
History Of ◽  
Sub Saharan ◽  
Tropical Woods ◽  
New Research ◽  
Export Revenue

Gabon, a small oil-rich country straddling the equator on the west coast of Africa, is the wealthiest of France’s former colonies. An early period of colonization in the 19th century resulted in disease, famine, and economic failure. The creation of French Equatorial Africa in 1910 marked the beginning of the sustained lucrative exploitation of Gabon’s natural resources. Gabon began off-shore oil production while still a colony of France. Uranium was also discovered in the last decade of the French Equatorial African empire. Coupled with rich reserves in tropical woods, Gabon has achieved, since independence in 1960, a higher level of export revenue per capita of population than any other country in sub-Saharan Africa in the postcolonial era. However, significant inequality has characterized access to wealth through paid employment throughout the recorded history of monetized labor. While fortunes have been amassed by a minute proportion of the female population of Gabon associated with the ruling regime, and a professional female middle-class has emerged, inequalities of opportunity and reward continue to mark women’s experience of life in this little-known country of West Central Africa. The key challenge facing scholars researching the history of women in Gabon remains the relative lack of historical resources. While significant strides have been made over the past decade, research on women’s history in Francophone Africa published in English or French remains embryonic. French research on African women began to make a mark in the last decade of colonization, notably with the work of Denise Paulme, but then remained a neglected area for decades. The publication in 1994 of Les Africaines by French historian Catherine Coquery-Vidrovitch was hailed at the time as a pioneering work in French historiography. But even this new research contained no analysis of and only a passing reference to women in Gabon.

scholarly journals COMPLICATIONS OF PREGNANCY AMONG ADOLESCENTS AND ADULT MOTHERS TREATED IN A PUBLIC HOSPITAL, THE REPUBLIC OF LIBERIA: A RETROSPECTIVE COMPARATIVE STUDY

2020 ◽  
Vol 20 (3) ◽  
pp. 140-146
Author(s):  
Siti Khuzaimah Ahmad Sharoni ◽  
Alieu Sekou Konneh
Keyword(s):  
Adolescent Mothers ◽  
Pregnancy Complications ◽  
Public Hospital ◽  
Sub Saharan Africa ◽  
Eligibility Criteria ◽  
Chi Square ◽  
Chi Square Test ◽  
Sub Saharan ◽  
The Republic ◽  
Retrospective Comparative Study

Complications of pregnancy remain a serious threat in Sub-Saharan Africa despite efforts to minimise maternal mortality due to pregnancy complications, and achieve the Millennium Development Goal 5. This is a retrospective study to determine the most common pregnancy complications among adolescents compared to adults treated in a public hospital from 2015 to 2018. The researcher applied a convenience sampling method in selecting the medical records. The instrument used was adapted from previous studies and data were analysed with descriptive and chi-square test for the inferential statistics. A total of 1,265 patients met the eligibility criteria and 540 (42.7%) were adolescents. Low birth weight (n=478, 88.5%) and preterm delivery (n=496, 91.9%) were common among babies born to adolescent mothers. Pregnancy-related complications among adolescent mothers showing the prevalence of anaemia, hypertension, and malaria were 494 (84.9%), 149 (56.2%) and 193 (62.1%) respectively. Gestational diabetes was found to be high among adult mothers (n=98, 74.8%). Among adolescent mothers, the prevalence of eclampsia was 62 (78.5%) and hemorrhage 61 (53.0%). The prevalence of Intrauterine growth restriction (IUGR) was high among adolescent mothers (n=252, 80.5%). Comprehensive strategies are needed to keep girls in schools and to raise awareness and develop campaigns about using contraception properly to reduce the incidence of adolescent pregnancy as well as to minimise the incidence of pregnancy-related complications.

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