scholarly journals Risk Factors for Hemorrhagic and Ischemic Stroke in Sub-Saharan Africa

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Gertrude Namale ◽  
Onesmus Kamacooko ◽  
Alison Kinengyere ◽  
Laetitia Yperzeele ◽  
Patrick Cras ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Case Series ◽  
Pooled Analysis ◽  
Case Control ◽  
Sub Saharan Africa ◽  
Cochrane Central Register ◽  
Case Control Studies ◽  
Pooled Prevalence ◽  
Sub Saharan

Introduction. In sub-Saharan Africa (SSA), there is a significant burden of ischemic stroke (IS) and hemorrhagic stroke (HS), although data on risk factors for each type are sparse. In this systematic review we attempt to characterize the risk factors. Methods. We systematically reviewed (PubMed, EMBASE, WHOLIS, Google Scholar, Wiley online, and the Cochrane Central Register of Controlled Trials (CENTRAL)) case-control studies and case series from 1980 to 2016 that reported risk factors for IS and/or HS in SSA. For each risk factor we calculated random-effects pooled odds ratios (ORs) for case-control studies and pooled prevalence estimates for case series. Results. We identified 12 studies, including 4,387 stroke patients. Pooled analysis showed that patients who had diabetes (OR = 2.39; 95% CI: 1.14–5.03) and HIV (OR = 2.46 (95% CI: 1.59–3.81) were at a significantly greater risk of suffering from all stroke types. There were insufficient data to examine these factors by stroke type. Among case series, the pooled prevalence of hypertension was higher for HS than for IS (73.5% versus 62.8%), while diabetes mellitus (DM) and atrial fibrillation (AF) were more prevalent among IS compared to HS (15.9% versus 10.6% and 9.6% versus 2.3%, respectively). Conclusions. There remain too few data from SSA to reliably estimate the effect of various factors on the risk of IS and HS. Furthermore, the vast majority of cases were identified in hospital and so are unlikely to be representative of the totality of stroke cases in the community.

scholarly journals Prevalence of active convulsive epilepsy in sub-Saharan Africa and associated risk factors: cross-sectional and case-control studies

2013 ◽  
Vol 12 (3) ◽  
pp. 253-263 ◽  
Author(s):  
Anthony K Ngugi ◽  
Christian Bottomley ◽  
Immo Kleinschmidt ◽  
Ryan G Wagner ◽  
Angelina Kakooza-Mwesige ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control ◽  
Sub Saharan Africa ◽  
Case Control Studies ◽  
Cross Sectional ◽  
Sub Saharan ◽  
Associated Risk Factors

scholarly journals Inflammatory bowel disease in sub-Saharan Africa: a protocol of a prospective registry with a nested case–control study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e039456
Author(s):  
Leolin Katsidzira ◽  
Wisdom F Mudombi ◽  
Rudo Makunike-Mutasa ◽  
Bahtiyar Yilmaz ◽  
Annika Blank ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Case Control Study ◽  
Alpha Diversity ◽  
Case Control ◽  
Sub Saharan Africa ◽  
Inflammatory Bowel ◽  
Sub Saharan ◽  
Nested Case Control ◽  
Control Study

IntroductionThe epidemiology of inflammatory bowel disease (IBD) in sub-Saharan Africa is poorly documented. We have started a registry to determine the burden, phenotype, risk factors, disease course and outcomes of IBD in Zimbabwe.Methods and analysisA prospective observational registry with a nested case–control study has been established at a tertiary hospital in Harare, Zimbabwe. The registry is recruiting confirmed IBD cases from the hospital, and other facilities throughout Zimbabwe. Demographic and clinical data are obtained at baseline, 6 months and annually. Two age and sex-matched non-IBD controls per case are recruited—a sibling or second-degree relative, and a randomly selected individual from the same neighbourhood. Cases and controls are interviewed for potential risk factors of IBD, and dietary intake using a food frequency questionnaire. Stool is collected for 16S rRNA-based microbiota profiling, and along with germline DNA from peripheral blood, is being biobanked. The estimated sample size is 86 cases and 172 controls, and the overall registry is anticipated to run for at least 5 years. Descriptive statistics will be used to describe the demographic and phenotypic characteristics of IBD, and incidence and prevalence will be estimated for Harare. Risk factors for IBD will be analysed using conditional logistic regression. For microbial analysis, alpha diversity and beta diversity will be compared between cases and controls, and between IBD phenotypes. Mann-Whitney U tests for alpha diversity and Adonis (Permutational Multivariate Analysis of Variance) for beta diversity will be computed.Ethics and disseminationEthical approval has been obtained from the Parirenyatwa Hospital’s and University of Zimbabwe’s research ethics committee and the Medical Research Council of Zimbabwe. Findings will be discussed with patients, and the Zimbabwean Ministry of Health. Results will be presented at scientific meetings, published in peer reviewed journals, and on social media.Trial registration numberNCT04178408.

scholarly journals Estimating the impact of pneumococcal conjugate vaccines on childhood pneumonia in sub-Saharan Africa: A systematic review

2019 ◽  
Author(s):  
Chukwuemeka Onwuchekwa ◽  
Edem Bassey ◽  
Victor Williams ◽  
Emmanuel Oga
Keyword(s):  
Systematic Review ◽  
Pneumococcal Pneumonia ◽  
Data Extraction ◽  
Case Control ◽  
Sub Saharan Africa ◽  
Case Control Studies ◽  
Childhood Pneumonia ◽  
Vaccine Impact ◽  
Sub Saharan ◽  
The Impact

AbstractBackgroundThe impact of pneumococcal conjugate vaccine introduction in reducing the incidence of childhood pneumonia has not been well documented in sub-Saharan Africa. Many studies evaluating vaccine impact have used invasive pneumococcal disease or pneumococcal pneumonia as an outcome.ObjectiveTo estimate the impact of routine administration of 10-valent and 13-valent PCV on the incidence of pneumonia in children under five years of age in sub-Saharan Africa.Data sourcesA systematic review was conducted between 16 and 31 July 2019. The review was registered on PROSPERO with registration number CRD42019142369. The literature search was conducted in indexed databases including Medline and Embase, grey literature databases and online libraries of two universities. Manual search of the references of included studies was performed to identify additional relevant studies. The search strategy combined pneumococcal conjugate vaccine, pneumonia and child as search concepts.Study selectionStudies investigating the impact of 10- or13-valent PCV on childhood pneumonia in a sub-Saharan African country were eligible for inclusion. Case-control, cohort, pre-post and time-series study designs were eligible for inclusion. Exclusion criteria were use of 7- or 9-valent PCV, systematic review studies, clinical trials and record publication prior to 2009.Data extractionIndependent data extraction was conducted. Key variables include year study conducted, type of study design, type of PCV used and year of introduction, reported PCV coverage, outcome measure evaluated and the effect measure.Data synthesisEight records were included in the final analysis, 6 records were pre-post or time-series studies, 1 was a case-control study and 1 report combined pre-post and case-control studies. Vaccine impact measured as percentage reduction in risk (%RR) of clinical pneumonia was mostly small and non-significant. The risk reduction was more significant and consistent on radiological and pneumococcal pneumonia. Vaccine effectiveness reported in case-control studies was mostly non-significant.ConclusionEvidence of the positive impact of routine infant pneumococcal vaccination on pneumonia in sub-Saharan Africa is weak. There is a need for more research in this area to evaluate the influence of pathogen or serotype replacement in pneumonia after PCV introduction. Ongoing surveillance is also required to establish the long term trend in pneumonia epidemiology after PCV introduction.

scholarly journals Sero-prevalence of human immunodeficiency virus–hepatitis B virus (HIV–HBV) co-infection among pregnant women attending antenatal care (ANC) in sub-Saharan Africa (SSA) and the associated risk factors: a systematic review and meta-analysis

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Hussein Mukasa Kafeero ◽  
Dorothy Ndagire ◽  
Ponsiano Ocama ◽  
Abdul Walusansa ◽  
Hakim Sendagire
Keyword(s):  
Risk Factors ◽  
Sensitivity Analysis ◽  
Antenatal Care ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Pooled Prevalence ◽  
Meta Regression ◽  
Sub Saharan ◽  
Meta Analyses ◽  
Pregnant Mothers

Abstract Background There is plenitude of information on HIV infection among pregnant mothers attending antenatal care (ANC) in sub-Saharan Africa. However, the epidemiology of HBV–HIV co-infections in the same cohort is not clear despite the common route of transmission of both viruses. The aim of our study was to synthesize data on the prevalence of HBV–HIV co-infection among pregnant women attending ANC in Sub-Saharan Africa to assist in the design of public health interventions to mitigate the challenge. Methods The study was done in tandem with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) standards and the Cochran’s Q test, I2 statistics for heterogeneity and the prevalence were calculated using commercially available software called MedCalcs (https://www.medcalc.org). A random effect model was used to pool the prevalence since all the heterogeneities were high (≥ 78%) and Phet < 0.05 indicated significant heterogeneities. The risk factors and risk differences for HBV–HIV co-infection were analyzed. Any likely sources of heterogeneity were analyzed through sensitivity analysis, meta-regression and sub-group analysis. All analyses were done at 95% level of significance and a P < 0.05 was considered significant. Results The overall pooled prevalence of HBV–HIV co-infection among pregnant mothers in sub-Saharan Africa was low 3.302% (95%CI = 2.285 to 4.4498%) with heterogeneities (I2) of 97.59% (P > 0.0001). Within regional sub group meta-analyses, West Africa had significantly higher prevalence of 5.155% (95% = 2.671 to 8.392%) with heterogeneity (I2) of 92.25% (P < 0.0001) than any other region (P < 0.001). Articles published from 2004–2010 had significantly higher prevalence of 6.356% (95% = 3.611 to 9.811%) with heterogeneity (I2) 91.15% (P < 0.0001) compared to those published from 2011 to 2019 (P < 0.001). The HIV positive cohort had significantly higher prevalence of HBV–HIV co-infection of 8.312% (95% CI = 5.806 to 11.22%) with heterogeneity (I2)94.90% (P < 0.0001) than the mothers sampled from the general population with a prevalence of 2.152% (95% CI = 1.358 to 3.125%) (P < 0.001). The overall and sub group analyses had high heterogeneities (I2 > 89%, P < 0.0001) but was reduced for South Africa (I2) = 78.4% (P = 0.0314). Age, marital status and employment were independent factors significantly associated with risk of HBV–HIV co-infection (P < 0.001) but not extent of gravidity and education level (P > 0.05). After meta-regression for year of publication and sample size for HBsAg positivity, the results were not significantly associated with HBV pooled prevalence for sample size (P = 0.146) and year of publication (P = 0.560). Following sensitivity analysis, the HBsAg pooled prevalence slightly increased to 3.429% (95% CI = 2.459 to 4.554%) with heterogeneity I2 = 96.59% (95% CI = 95.93 to 97.14%), P < 0.0001 Conclusion There is an urgent need for routine HBV screening among HIV positive pregnant mothers attending antenatal care in sub-Saharan Africa to establish the extent of HBV–HIV co-infection in this cohort. Future studies need to investigate the putative risk factors for HBV–HIV co-infection and prioritize plausible control strategies.

scholarly journals Risk factors for vaginal fistula symptoms in Sub-Saharan Africa: a pooled analysis of national household survey data

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Mathieu Maheu-Giroux ◽  
Véronique Filippi ◽  
Nathalie Maulet ◽  
Sékou Samadoulougou ◽  
Marcia C. Castro ◽  
...  
Keyword(s):  
Risk Factors ◽  
Survey Data ◽  
Household Survey ◽  
Pooled Analysis ◽  
Sub Saharan Africa ◽  
Vaginal Fistula ◽  
National Household Survey ◽  
Household Survey Data ◽  
Sub Saharan

scholarly journals Sachet water consumption as a risk factor for cholera in urban settings: Findings from a case control study in Kinshasa, Democratic Republic of the Congo during the 2017–2018 outbreak

2021 ◽  
Vol 15 (7) ◽  
pp. e0009477
Author(s):  
Placide Mbala-Kingebeni ◽  
Florian Vogt ◽  
Berthe Miwanda ◽  
Tresor Sundika ◽  
Nancy Mbula ◽  
...  
Keyword(s):  
Risk Factors ◽  
Democratic Republic ◽  
Case Control Study ◽  
Case Control ◽  
Sub Saharan Africa ◽  
P Value ◽  
Republic Of The Congo ◽  
Sub Saharan ◽  
Context Specific ◽  
Control Study

Background Behavioural risk factors for cholera are well established in rural and semi-urban contexts, but not in densely populated mega-cities in Sub-Saharan Africa. In November 2017, a cholera epidemic occurred in Kinshasa, the Democratic Republic of the Congo, where no outbreak had been recorded for nearly a decade. During this outbreak, we investigated context-specific risk factors for cholera in an urban setting among a population that is not frequently exposed to cholera. Methodology/Principal findings We recruited 390 participants from three affected health zones of Kinshasa into a 1:1 matched case control study. Cases were identified from cholera treatment centre admission records, while controls were recruited from the vicinity of the cases’ place of residence. We used standardized case report forms for the collection of socio-demographic and behavioural risk factors. We used augmented backward elimination in a conditional logistic regression model to identify risk factors. The consumption of sachet water was strongly associated with the risk of being a cholera case (p-value 0.019), which increased with increasing frequency of consumption from rarely (OR 2.2, 95% CI 0.9–5.2) to often (OR 4.0, 95% CI 1.6–9.9) to very often (OR 4.1, 95% CI 1.0–16.7). Overall, more than 80% of all participants reported consumption of this type of drinking water. The risk factors funeral attendance and contact with someone suffering from diarrhoea showed a p-value of 0.09 and 0.08, respectively. No socio-demographic characteristics were associated with the risk of cholera. Conclusions/Significance Drinking water consumption from sachets, which are sold informally on the streets in most Sub-Saharan African cities, are an overlooked route of infection in urban cholera outbreaks. Outbreak response measures need to acknowledge context-specific risk factors to remain a valuable tool in the efforts to achieve national and regional targets to reduce the burden of cholera in Sub-Saharan Africa.

scholarly journals Recruiting population controls for case-control studies in sub-Saharan Africa: The Ghana Breast Health Study

PLoS ONE ◽  
2019 ◽  
Vol 14 (4) ◽  
pp. e0215347 ◽  
Author(s):  
Sarah J. Nyante ◽  
Richard Biritwum ◽  
Jonine Figueroa ◽  
Barry Graubard ◽  
Baffour Awuah ◽  
...  
Keyword(s):  
Case Control ◽  
Sub Saharan Africa ◽  
Health Study ◽  
Breast Health ◽  
Case Control Studies ◽  
Sub Saharan ◽  
Population Controls

scholarly journals Deep Venous Thrombosis with Pulmonary Embolism Related to IVIg Treatment: A Case Report and Literature Review

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Michael T. Flannery ◽  
Deborah Humphrey
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Case Report ◽  
Case Reports ◽  
Case Series ◽  
Ivig Therapy ◽  
Case Control ◽  
Ivig Treatment ◽  
Case Control Studies ◽  
Traditional Risk Factors

IVIg therapy has potentially been related to arterial and venous therapy. We performed an Ovid review focusing on IVIg and thrombotic events. While a few case reports were reviewed case series and case control studies were particularly reviewed in relation to thrombotic events. Outcomes demonstrate a correlation between underlying cardiovascular risk factors with predominately arterial events which typically occurred within 4–24 hours of infusion. While venous events occurred less commonly they were associated with traditional risk factors and occurred later, typically, 1–7 days following infusion of IVIg. Potential causation of thrombotic events was discussed.

scholarly journals Potential Association Between Bacterial Infections and Ischemic Stroke Based on Fifty Case-Control Studies: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Masoud Keikha ◽  
Mohsen Karbalaei
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Bacterial Infections ◽  
Meta Analysis ◽  
Case Control ◽  
Chronic Infections ◽  
Case Control Studies ◽  
Potential Association ◽  
Mycoplasma Pneumonia ◽  
H Pylori

Abstract Background: Stroke is considered as one of the most concerns in health services facilities worldwide, and occurs in two types, ischemic stroke and hemorrhagic stroke. However, almost the three quarters of stroke cases are ischemic stroke which occur in effect of several risk factors such as hypertension, obesity, atherosclerosis, diabetes mellitus, arteritis, and inflammatory response. In recent years, infectious diseases are considered as one of the most important risk factors of ischemic stroke. In this regard, some bacteria causing the chronic infections in particular Chlamydia pneumonia, Helicobacter pylori, Mycoplasma pneumonia, and Mycobacterium tuberculosis get more attended. Methods: In the present meta-analysis, we studied 50 case-control studies and evaluated potential relevance of these infections with creation and development of ischemic stroke. Results: We surveyed the information of 33,978 participants in several nested case-control studies and demonstrated that bacterial infections can increase the risk of ischemic stroke.Conclusions: In this meta-analysis we demonstrated a meaningful relationship between infection by three bacteria C. pneumoniae, H. pylori, and M. tuberculosis with occurrence of ischemic stroke.

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