The burden and risk factors for postnatal depression and depressive symptomatology among women in Kampala

2019 ◽  
Vol 49 (3) ◽  
pp. 170-177 ◽  
Author(s):  
Margaret Nampijja ◽  
Barnabas Natamba ◽  
Richard Mpango ◽  
Eugene Kinyanda
Keyword(s):  
Risk Factors ◽  
Partner Violence ◽  
Depressive Symptomatology ◽  
Sub Saharan Africa ◽  
Increased Risk ◽  
High Prevalence ◽  
Postnatal Women ◽  
Postnatal Mothers ◽  
Dsm Iv ◽  
Sub Saharan

Major depressive disorder (MDD) is a major global health challenge and postnatal women may be at an increased risk for this disorder. Very few studies have tested this hypothesis in sub-Saharan Africa (SSA), so it is uncertain whether risk factors implicated elsewhere in the world are relevant in SSA. We explored prevalence and risk factors for MDD and depressive symptomatology among postnatal mothers in Kampala. Three hundred postnatal mothers at Nsambya Hospital were assessed for MDD using the DSM IV-based MINI; prevalence and risk factors were determined using frequencies and regressions, respectively. Four women (1.33%) had MDD; however, 94 (31%) had ‘sub-threshold’ or depressive symptomatology, with which partner violence is particularly associated. MDD is rare among postnatal women in a paying hospital in Kampala; however, the high prevalence of depressive symptomatology suggests susceptibility to MDD. Longitudinal studies should investigate this hypothesis and the susceptibility due to partner violence should guide appropriate interventions.

Intimate Partner Violence (IPV) Against HIV-Positive Women in Sub-Saharan Africa: A Mixed-Method Systematic Review and Meta-Analysis

2020 ◽  
pp. 152483802090656 ◽  
Author(s):  
Eric Y. Tenkorang ◽  
Michael Asamoah-Boaheng ◽  
Adobea Y. Owusu
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Intimate Partner Violence ◽  
Partner Violence ◽  
Meta Analysis ◽  
Intimate Partner ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Hiv Positive Women ◽  
Sub Saharan

Objectives: To systematically analyze and summarize the literature on intimate partner violence (IPV) against HIV-positive women in sub-Saharan Africa (SSA) and to identify their risk factors for IPV. Method: A comprehensive review of the literature using the Preferred Reporting Item for Systematic Review and Meta-Analysis (PRISMA) and Meta-Analyses of Observational Studies in Epidemiology (MOOSE) yielded 1,879 articles (PubMed = 1,251, Embase = 491, Web of Science = 132, and identified additional records = 5). Twenty were selected for quantitative and qualitative assessment and synthesis. We employed a random effects model with generic inverse variance method and estimated the odds ratios. Findings: Results indicated a high prevalence of physical, sexual, and emotional violence against women living with HIV/AIDS in SSA. Educational background, alcohol use, marital status, previous experiences with IPV, and employment status were identified as significant risk factors. We also assessed the methodological quality of the articles by examining publication bias and some heterogeneity statistics. Conclusion: There is limited research on IPV against HIV-positive women in SSA. However, the few existing studies agree on the importance of targeting HIV-positive women with specific interventions given their vulnerability to IPV and to address factors exacerbating these risks and vulnerabilities.

scholarly journals Sub-Saharan Women Affected by HIV/AIDS: The Perfect Storm of Risk Factors

2013 ◽  
Vol 3 (2) ◽  
pp. 8
Author(s):  
Isabel Arroyo ◽  
Sanni Yaya
Keyword(s):  
Risk Factors ◽  
Partner Violence ◽  
Incidence Rates ◽  
Sub Saharan Africa ◽  
African Women ◽  
Lower Socioeconomic Status ◽  
Lower Socioeconomic ◽  
Sub Saharan ◽  
Perfect Storm ◽  
Hiv Aids

<div class="page" title="Page 8"><div class="layoutArea"><div class="column"><p><span>This paper explores women’s health in the prevalence and incidence rates of </span><span>HIV/AIDS in sub-Saharan Africa. The risk factors presented in the literature that are hypothesized to be responsible for the increasing rates of HIV/AIDS in sub-Saharan African women are identified. Risk factors discussed include biological factors, parasites, malnutrition, lower socioeconomic status, inti- mate partner violence, war, gender inequality and lack of education. These risk factors relate to multiple determinants of health: income and social sta- tus, education and literacy, employment, physical environment, gender and culture. The authors present their perspectives on mediating this epidemic, which involves reducing the ramifications of poverty on sub-Saharan women. </span></p></div></div></div>

scholarly journals Vulnerable groups at increased risk of COVID-19 in sub-Saharan Africa: The case of the HIV population

2020 ◽  
Author(s):  
Marília Nepomuceno
Keyword(s):  
Latin America ◽  
Age Structure ◽  
Risk Profile ◽  
Sub Saharan Africa ◽  
Vulnerable Groups ◽  
High Burden ◽  
Increased Risk ◽  
High Prevalence ◽  
Sub Saharan ◽  
Living With Hiv

More recently, the COVID-19 infection is advancing fast towards different settings. Regions with a high burden of infectious diseases such as HIV, malaria, and dengue including Latin America and Africa are experiencing an increasing number of confirmed cases and deaths. Since the age structure and the distribution of relevant co-morbidities varies substantially by country, the risk profile for COVID-19 could be very different in countries with high prevalence of individuals living with HIV.

P6369Prevalence of severe hypertension in a sub-Saharan African community

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
B Gaye ◽  
A L Janeczek ◽  
X Jouven ◽  
D Luu ◽  
E Marijon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Rural Areas ◽  
Severe Hypertension ◽  
Blood Pressure Measurement ◽  
Target Organ Damage ◽  
Sub Saharan Africa ◽  
Global Health Initiative ◽  
Increased Risk ◽  
Sub Saharan

Abstract Background Individuals with SH have high 10-year risk of cardiovascular disease, especially when additional risk factors or target organ damage are present. Though some data from in-hospital or selected populations are available, there are no studies reporting community-level prevalence of Severe Hypertension (SH) in sub-Saharan Africa. Purpose Using a cross-sectional design in Abidjan (Ivory Coast), we assessed prevalence of Severe Hypertension among adults. Methods Study participants were recruited within the framework of The Heart Fund's global health initiative. Data were collected in August 2016 from 6 randomly selected sites, ensuring representativeness of both urban and rural areas. Blood pressure (BP) was measured twice, 10 minutes apart, after optimal resting time. Blood pressure measurement were standardized between sites and SH was defined as systolic blood pressure ≥180 and/or diastolic blood pressure ≥110 mmHg at both readings. Demographics and data on cardiovascular history/risk factors were collected in the field. Ethics approval for the study was obtained from the National Ethical Committee of Côte d'Ivoire and written informed consent was obtained from all adult patients. Results Among 1,785 subjects examined, 1,182 aged between 18 and 75 years were included in this analysis. The prevalence of SH was 14.1% (12.5% females vs 17.0% males; P=0.03) (Figure). Among participants with severe hypertension, 28.9% were either undiagnosed or untreated. Alarmingly, subjects at high cardiovascular risk (age ≥60 years and/or obese) had even higher prevalence of overall SH (29.6% and 24.9%, respectively) as well as undiagnosed/untreated SH (29.4% and 24.6%). SH prevalence was almost double in urban compared to rural areas (17.0% vs. 9.2%, P=0.02); however, conversely, undiagnosed/untreated SH was significantly higher in rural areas (50.4% vs 21.9%). Compared to normal bodyweight, those who were overweight and obese had a 1.95-fold (95% CI, 1.30–2.93; P<0.001)and 4.24-fold (95% CI, 2.68–6.74; P<0.001)increased odds of SH (adjusting for age and sex), respectively. Similarly, participants ≥60 years had a 6.04-fold (95% CI, 3.93–9.36; P<0.001)increased risk of undiagnosed SH compared to under 50 years. Finally, men had higher odds of SH compared to women (OR 1.71, 95% CI, 1.19–2.47; P=0.004). Figure 1 Conclusion(s) Our community-based study revealed very high prevalence of SH among adults in Abidjan area, with almost one out of every seven having SH. This underscores SH as a growing public health problemin sub-Saharan Africa.More concerning, a significant (almost one third) proportion of them were either undiagnosed or untreated.

scholarly journals Vulnerable groups at increased risk of COVID-19 in sub-Saharan Africa: The case of the HIV population

2020 ◽  
Author(s):  
Marília Nepomuceno
Keyword(s):  
Latin America ◽  
Age Structure ◽  
Risk Profile ◽  
Sub Saharan Africa ◽  
Vulnerable Groups ◽  
High Burden ◽  
Increased Risk ◽  
High Prevalence ◽  
Sub Saharan ◽  
Living With Hiv

More recently, COVID-19 infection is advancing fast towards different settings. Regions with a high burden of infectious diseases such as HIV, malaria, and dengue including Latin America and Africa are experiencing an increasing number of confirmed cases and deaths. Since the age structure and the distribution of relevant co-morbidities varies substantially by country, the risk profile for COVID-19 could be very different in countries with high prevalence of individuals living with HIV.

scholarly journals Burden of depressive symptoms and non-alcohol substance abuse; and their association with alcohol use and partner violence: a cross-sectional study in four sub-Saharan Africa countries

2018 ◽  
Vol 5 ◽  
Author(s):  
F. Bajunirwe ◽  
S. Maling ◽  
H.-O. Adami ◽  
I. O. Ajayi ◽  
J. Volmink ◽  
...  
Keyword(s):  
Risk Factors ◽  
Substance Abuse ◽  
Depressive Symptoms ◽  
Alcohol Use ◽  
Partner Violence ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Sectional Study ◽  
Cross Sectional ◽  
Sub Saharan

In sub-Saharan Africa, there are limited data on burden of non-alcohol substance abuse (NAS) and depressive symptoms (DS), yet potential risk factors such as alcohol and intimate partner violence (IPV) are common and NAS abuse may be the rise. The aim of this study was to measure the burden of DS and NAS abuse, and determine whether alcohol use and IPV are associated with DS and/or NAS abuse. We conducted a cross-sectional study at five sites in four countries: Nigeria (nurses), South Africa (teachers), Tanzania (teachers) and two sites in Uganda (rural and peri-urban residents). Participants were selected by simple random sampling from a sampling frame at each of the study sites. We used a standardized tool to collect data on demographics, alcohol use and NAS use, IPV and DS and calculated prevalence ratios (PR). We enrolled 1415 respondents and of these 34.6% were male. DS occurred among 383 (32.3%) and NAS use among 52 (4.3%). In the multivariable analysis, being female (PR  =  1.49, p  =  0.008), NAS abuse (PR  =  2.06, p  =  0.02) and IPV (PR  =  2.93, p < 0.001) were significantly associated with DS. Older age [odds ratio (OR) = 0.31, p < 0.001)], female (OR = 0.48, p  =  0.036) were protective of NAS but current smokers (OR = 2.98, p < 0.001) and those reporting IPV (OR  =  2.16, p  =  0.024) were more likely to use NAS. Longitudinal studies should be done to establish temporal relationships with these risk factors to provide basis for interventions.

scholarly journals Intimate Partners Violence in Sub-Saharan Africa: Review of Risk Factors and Impacts

2021 ◽  
pp. 1-19
Author(s):  
Victoria Matatio Elia Guli ◽  
Nigatu Regassa Geda
Keyword(s):  
Risk Factors ◽  
Partner Violence ◽  
Local Governments ◽  
Drinking Behavior ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Considerable Proportion ◽  
Wide Range ◽  
Sub Saharan ◽  
Google Search

Background: Intimate Partner Violence (IPV) against women is one of the most known public health concerns. The depth of the problem varies across regions and different settings. The purpose of this scooping review is to assess the overall prevalence and risk factors of IPV in the context of Sub-Saharan Africa (SSA). Methods: The review was conducted based on 24 articles selected from PubMed and google search. The selection considered only those conducted in SSA based on a representative sample size of women of reproductive age (15-49), published in peer-reviewed journals in the last ten years, and those having resemblance in study design and conceptualization of IPV. Results: While slight methodological variations exist among the individual studies, nearly all the reported prevalence of IPV were unacceptably high. The lifetime experience of IPV ranged from about 20% in some societies to more than 75% in other settings. Physical and emotional violence were the most frequently reported type of IPV. One common feature of all studies reviewed is that they all recognized the important role of women’s attitude (acceptance) towards their experience of IPV. Good proportion (ranging between 33-57%) of women justified IPV more often than men do. The studies further documented a wide range of risk factors associated with IPV, more importantly, low maternal and paternal education, partner's alcohol drinking behavior, childhood experience of domestic violence, and certain household and community/cultural factors. Conclusion: Given considerable proportion of women experienced one or more forms of IPV in most settings in SSA, national and local governments have a long way to go in preventing or reducing its occurrence in their geographic areas if they must meet SDG 3 (i.e., better health of children and women). Since IPV is embedded in most cultures; concerned authorities should establish appropriate norms, enhance women's status, and ensure proper implementation of policies and laws on abuse. Community reflections, mass education/ behavioral change communications are essential in this endeavor.

scholarly journals Interpersonal violence in peacetime Malawi

2018 ◽  
Vol 3 (1) ◽  
pp. e000252 ◽  
Author(s):  
Rebecca G Maine ◽  
Brittney Williams ◽  
Jennifer A Kincaid ◽  
Gift Mulima ◽  
Carlos Varela ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Interpersonal Violence ◽  
Partner Violence ◽  
Sub Saharan Africa ◽  
Collective Violence ◽  
Level Of Evidence ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Trauma Victims ◽  
Sub Saharan

BackgroundThe contribution of interpersonal violence (IPV) to trauma burden varies greatly by region. The high rates of IPV in sub-Saharan Africa are thought to relate in part to the high rates of collective violence. Malawi, a country with no history of internal collective violence, provides an excellent setting to evaluate whether collective violence drives the high rates of IPV in this region.MethodsThis is a retrospective review of a prospective trauma registry from 2009 through 2016 at Kamuzu Central Hospital in Lilongwe, Malawi. Adult (>16 years) victims of IPV were compared with non-intentional trauma victims. Log binomial regression determined factors associated with increased risk of mortality for victims of IPV.ResultsOf 72 488 trauma patients, 25 008 (34.5%) suffered IPV. Victims of IPV were more often male (80.2% vs. 74.8%; p<0.001), younger (median age: 28 years (IQR: 23–34) vs. 30 years (IQR: 24–39); p<0.001), and were more often admitted at night (47.4% vs. 31.9%; p<0.001). Of the IPV victims, 16.5% admitted alcohol use, compared with only 4.4% in other trauma victims (p<0.001). In regression modeling, compared with extremity injuries, head injuries (3.14, 2.24–4.39; p<0.001) and torso injuries (4.32, 2.98–6.27; p<0.001) had increased risk of mortality. Compared with other or unknown mechanisms, penetrating injuries also had increased risk of mortality (1.46, 95% CI 1.17 to 1.81, p=0.001). Alcohol use was associated with a lower risk of mortality (0.54, 95% CI 0.39 to 0.75; p<0.001).DiscussionEven in a sub-Saharan country that never experienced internal collective violence, IPV injury rates are high. Public health efforts to measure and address alcohol use, and studies to determine the role of “mob justice,” poverty, and intimate partner violence in IPV, in Malawi are needed.Level of evidenceLevel III.

Risk factors for gametocyte carriage in uncomplicated falciparum malaria in children

Parasitology ◽  
2004 ◽  
Vol 129 (3) ◽  
pp. 255-262 ◽  
Author(s):  
A. SOWUNMI ◽  
B. A. FATEYE ◽  
A. A. ADEDEJI ◽  
F. A. FEHINTOLA ◽  
T. C. HAPPI
Keyword(s):  
Risk Factors ◽  
Antimalarial Drug ◽  
Multiple Regression Model ◽  
Sub Saharan Africa ◽  
Asexual Parasite ◽  
Southwestern Nigeria ◽  
Gametocyte Carriage ◽  
Duration Of Illness ◽  
Increased Risk ◽  
Sub Saharan

The risk factors associated with gametocytaemia at presentation and after treatment with different antimalarial drug regimens were evaluated in 767 children enrolled prospectively in 5 antimalarial drug trials between July 1996 and December 2002 in a hyperendemic area of southwestern Nigeria. The children were assigned to one of 6 treatment groups: chloroquine (CQ) only; pyrimethamine-sulfadoxine (PS) only; amodiaquine (AQ) only; CQ combined with chlorpheniramine (CQCP); or PS combined with CQ (CQPS) or AQ (AQPS). At enrolment, 115 (15%) of 767 children were gametocyte carriers. During follow-up, 15·6% of all patients (i.e. 120 patients) developed patent gametocytaemia, which in 85% (102 patients) had developed by day 7 following treatment. In a multiple regression model, 4 factors were found to be independent risk factors for the presence of gametocytaemia at enrolment: male gender (adjusted odds ratio [AOR]=0·55, 95% confidence interval [CI] 0·36–0·83,P=0·005), absence of fever (AOR=1·61, 95% CI 1·05–2·5,P=0·03), duration of illness >3 days (AOR=1·57, 95% CI 1·0–2·4,P=0·047), and asexual parasite densities less than 5000/μl (AOR=0·42, 95% CI 0·24–0·73,P=0·002). The presence of patent gametocytaemia at enrolment (AOR=0·04, 95% CI 0·02–0·07,P<0·001) and recrudescence of asexual parasites within 14 days were associated with the presence of gametocytaemia 7 or 14 days after enrolment (AOR=0·5, 95% CI 0·3–0·8,P=0·007). Delay in the time taken to clear the initial parasitaemia (>2 days) was associated with increased risk of subsequent gametocyte carriage. These findings may have implications for malaria control efforts in sub-Saharan Africa where control of the disease depends almost entirely on chemotherapy.

scholarly journals Gut mucosal colonisation with extended-spectrum beta-lactamase producing Enterobacteriaceae in sub-Saharan Africa: a systematic review and meta-analysis

2019 ◽  
Vol 4 ◽  
pp. 160
Author(s):  
Joseph M. Lewis ◽  
Rebecca Lester ◽  
Paul Garner ◽  
Nicholas A. Feasey
Keyword(s):  
Risk Factors ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Beta Lactamase ◽  
Community Studies ◽  
Cross Sectional ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Increased Risk ◽  
Sub Saharan

Background: Extended-spectrum beta-lactamase producing Enterobacteriaceae (ESBL-E) threaten human health; and, in areas of sub-Saharan Africa (sSA) where carbapenems are not available, may render ESBL-E infections untreatable. Gut mucosal colonisation probably occurs before infection, making prevention of colonisation an attractive target for intervention, but the epidemiology of ESBL-E in sSA is poorly described. Objectives: Describe ESBL-E colonisation prevalence in sSA and risk factors associated with colonisation. Methods: Studies included were prospective cross-sectional or cohort studies reporting gut mucosal ESBL-E colonisation in any population in sSA. We searched PubMed and Scopus on 18 December 2018. We summarise the range of prevalence across sites and tabulated risk factors for colonisation. The protocol was registered (Prospero ID CRD42019123559). Results: From 2975 abstracts we identified 32 studies including a total of 8619 participants from a range of countries and settings. Six studies were longitudinal; no longitudinal studies followed patients beyond hospital discharge.  Prevalence varied between 5 and 84% with a median of 31%, with a relationship to setting: pooled ESBL-E colonisation in community studies was 18% (95% CI 12 to 28, 12 studies); in studies recruiting people at admission to hospital colonisation was 32% (95% CI 24 to 41% 8 studies); and for inpatients, colonisation was 55% (95% CI 49 to 60%, 7 studies). Antimicrobial use was associated with increased risk of ESBL-E colonisation, and protected water sources or water treatment by boiling may reduce risk. Conclusions: ESBL-E colonisation is common in sSA, but how people become carriers and why is not well understood. To inform the design of interventions to interrupt transmission in this setting requires longitudinal, community studies.

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