scholarly journals Geographical distribution of risk factors for invasive non-typhoidal Salmonella at the subnational boundary level in sub-Saharan Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jung-Seok Lee ◽  
Vittal Mogasale ◽  
Florian Marks ◽  
Jerome Kim
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Case Fatality ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Health Concern ◽  
Risk Level ◽  
Accurate Estimation ◽  
Risk Areas ◽  
Sub Saharan

Abstract Background Invasive non-typhoidal Salmonella (iNTS) is a growing health-concern in many parts of sub-Saharan Africa. iNTS is associated with fatal diseases such as HIV and malaria. Despite high case fatality rates, the disease has not been given much attention. The limited number of population-based surveillance studies hampers accurate estimation of global disease burden. Given the lack of available evidence on the disease, it is critical to identify high risk areas for future surveillance and to improve our understanding of iNTS endemicity. Methods Considering that population-based surveillance data were sparse, a composite index called the iNTS risk factor (iNRF) index was constructed based on risk factors that commonly exist across countries. Four risk factors associated with the prevalence of iNTS were considered: malaria, HIV, malnutrition, and safe water. The iNRF index was first generated based on the four risk factors which were collected within a 50 km radius of existing surveillance sites. Pearson product-moment correlation was used to test statistical associations between the iNRF index and the prevalence of iNTS observed in the surveillance sites. The index was then further estimated at the subnational boundary level across selected countries and used to identify high risk areas for iNTS. Results While the iNRF index in some countries was generally low (i.e. Rwanda) or high (i.e. Cote d’Ivoire), the risk-level of iNTS was variable not only by country but also within a country. At the provincial-level, the highest risk area was identified in Maniema, the Democratic Republic of Congo, whereas Dakar in Senegal was at the lowest risk. Conclusions The iNRF index can be a useful tool to understand the geographically varying risk-level of iNTS. Given that conducting a population-based surveillance study requires extensive human and financial resources, identifying high risk areas for iNTS prior to a study implementation can facilitate an appropriate site-selection process in the future.

scholarly journals The seasonality of cholera in sub-Saharan Africa

2021 ◽  
Author(s):  
Javier Perez-Saez ◽  
Justin Lessler ◽  
Elizabeth C. Lee ◽  
Francisco J. Luquero ◽  
Espoir B. Malembaka ◽  
...  
Keyword(s):  
Large Scale ◽  
Task Force ◽  
Case Fatality ◽  
Sub Saharan Africa ◽  
Health Concern ◽  
National Differences ◽  
Sub Saharan ◽  
Eastern And Southern Africa ◽  
Positive Correlations ◽  
Gates Foundation

Background Cholera remains a major threat in Sub-Saharan Africa (SSA) where some of the highest case fatality risks are reported. Knowing in what months and where cholera tends to occur across the continent can aid in improving efforts to eliminate cholera as a public health concern; though largely due to lack of unified large-scale datasets, no continent-wide estimates exist. In this study we aim to estimate cholera seasonality across SSA. Methods We leverage the Global Task Force on Cholera Control (GTFCC) global cholera database with statistical models to synthesize data across spatial and temporal scale in order to infer the seasonality of excess suspected cholera occurrence in SSA. We developed a Bayesian statistical model to infer the monthly risk of excess cholera at the first and/or second administrative levels. Seasonality patterns were then grouped into spatial clusters. Finally, we studied the association between seasonality estimates and hydro-climatic variables. Findings The majority of studied countries (24/34) have seasonal patterns in excess cholera, corresponding to approximately 85% of the SSA population. Most countries (19/24) also had sub-national differences in seasonality patterns, with strong differences in seasonality strength between regions. Seasonality patterns clustered into two macro-regions (West Africa and the Sahel vs. Eastern and Southern Africa), which were composed of sub-regional clusters with varying degrees of seasonality. Exploratory association analysis found most consistent and positive correlations between cholera seasonality and precipitation, and to a lesser extent with temperature and flooding. Interpretation Widespread cholera seasonality in SSA offers opportunities for intervention planning. Further studies are needed to study the association between cholera and climate. Funding The NASA Applied Sciences Program and the Bill and Melinda Gates Foundation.

scholarly journals HPV Genotypes and Epidemiology in Women With Cervical Cancer in Senegal

2019 ◽  
Author(s):  
kHADIDIATOU NIANE ◽  
Cheikh Tidiane DIAGNE ◽  
Gora DIOP ◽  
Ndongo DIA ◽  
Cheikh TALLA ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
High Risk ◽  
Causes Of Death ◽  
Common Type ◽  
Sub Saharan Africa ◽  
Multiple Infections ◽  
Hpv Genotypes ◽  
Hpv Types ◽  
Sub Saharan

Abstract BackgroundIn sub-Saharan Africa, cervical cancer is increasing steadily, with more than 75,000 new cases and nearly 50,000 deaths a year (Mboumba et al., 2017). In Senegal, pathologies such as cervical cancer are at the top of the causes of death and Human papillomavirus (HPV) is the aetilogical agent (Steenbergen et al., 2005). MethodsThe aim of the study is to analyze the distribution of HPV among Senegalese women with cervical cancer. Main objectives of this study are to identify the HPV types associated or “co-associated” with cervical oncogenesis in Senegal. The correlations with risk factors of cervix carcinogenesis, with risk factors, were analyze too. Cervical biopsies were performed on women hospitalized at Aristide Hospital Le Dantec-Julio Curie Institute. Three methods has been used to detect HPV genotypes - SANGERsequencing genotyping (Applied BioSystems), PCR real-time approach technique (HPV 16 & 18 RealTime PCR kit) (www.bioneer.co.kr) and the genotyping approach from Chippron (HPV kit 3.5 LCDArray) ([email protected]). Results It this study, patients had multiple infections (co-infections) at all, and the majority of coinfections was High-risk types (HR-HPV types). The most common type of HPV in our study were 16 (34.37%), 18 (23.29%), 45 (10.75%), 33 (9.94%), 59 (9.09%), (3.97%) and 31 (3.69%). Among co-infections detected in different regions of Senegal among women with cervical cancer, we found that HPV types 16 and 18 had the highest prevalence. In the Dakar region, which had the highest number of cases, a prevalence of 17.89% of HR-HPV co-infections was noted. ConclusionPolygamy represents a cofactor in the occurrence of cervical cancer in Senegalese women. No association between HPV-High Risk co-infections and cancer stages.

scholarly journals Phenotyping Stroke in Sub-Saharan Africa: Stroke Investigative Research and Education Network (SIREN) Phenomics Protocol

2015 ◽  
Vol 45 (2) ◽  
pp. 73-82 ◽  
Author(s):  
Albert Akpalu ◽  
Fred Stephen Sarfo ◽  
Bruce Ovbiagele ◽  
Rufus Akinyemi ◽  
Mulugeta Gebregziabher ◽  
...  
Keyword(s):  
Risk Factors ◽  
Brain Research ◽  
Evidence Base ◽  
Sub Saharan Africa ◽  
Health Concern ◽  
Community Based ◽  
Emerging Risk ◽  
Sub Saharan ◽  
Research And Education ◽  
Education Network

Background: As the second leading cause of death and the leading cause of adult-onset disability, stroke is a major public health concern particularly pertinent in Sub-Saharan Africa (SSA), where nearly 80% of all global stroke mortalities occur, and stroke burden is projected to increase in the coming decades. However, traditional and emerging risk factors for stroke in SSA have not been well characterized, thus limiting efforts at curbing its devastating toll. The Stroke Investigative Research and Education Network (SIREN) project is aimed at comprehensively evaluating the key environmental and genomic risk factors for stroke (and its subtypes) in SSA while simultaneously building capacities in phenomics, biobanking, genomics, biostatistics, and bioinformatics for brain research. Methods: SIREN is a transnational, multicentre, hospital and community-based study involving 3,000 cases and 3,000 controls recruited from 8 sites in Ghana and Nigeria. Cases will be hospital-based patients with first stroke within 10 days of onset in whom neurovascular imaging will be performed. Etiological and topographical stroke subtypes will be documented for all cases. Controls will be hospital- and community-based participants, matched to cases on the basis of gender, ethnicity, and age (±5 years). Information will be collected on known and proposed emerging risk factors for stroke. Study Significance: SIREN is the largest study of stroke in Africa to date. It is anticipated that it will shed light on the phenotypic characteristics and risk factors of stroke and ultimately provide evidence base for strategic interventions to curtail the burgeoning burden of stroke on the sub-continent.

scholarly journals The seasonality of cholera in sub-Saharan Africa

2021 ◽  
Author(s):  
Francisco Javier Perez-Saez ◽  
Justin Lessler ◽  
Elizabeth C. Lee ◽  
Francisco J. Luquero ◽  
Espoir B. Malembaka ◽  
...  
Keyword(s):  
Large Scale ◽  
Task Force ◽  
Case Fatality ◽  
Sub Saharan Africa ◽  
Health Concern ◽  
National Differences ◽  
Administrative Unit ◽  
Sub Saharan ◽  
Eastern And Southern Africa ◽  
Gates Foundation

BackgroundCholera remains a major threat in Sub-Saharan Africa (SSA) where some of the highest case fatality risks are reported. Knowing in what months and where cholera tends to occur across the continent can aid in improving efforts to eliminate cholera as a public health concern; though largely due to lack of unified large-scale datasets, no continent-wide estimates exist. In this study we aim to estimate cholera seasonality across SSA. MethodsWe leverage the Global Task Force on Cholera Control (GTFCC) global cholera database with statistical models to synthesize data across spatial and temporal scale in order to infer the seasonality of excess suspected cholera occurrence in SSA. Cholera excess occurrence was defined based on exceeding previously published estimates of mean monthly cholera incidence estimates in a given administrative unit. We developed a Bayesian statistical model to infer the monthly risk of excess cholera at the first and/or second administrative levels. Seasonality patterns were then grouped into spatial clusters. Finally, we studied the association between seasonality estimates and hydro-climatic variables.FindingsWe find that the majority of studied countries (26/38) have seasonal excess cholera patterns, corresponding to ~85% of the SSA population. Most countries (20/38) also had sub-national differences in seasonality patterns, with strong differences in seasonality strength between regions. Seasonality patterns clustered into two macro-regions (West Africa and the Sahel vs. Eastern and Southern Africa), which were composed of sub-regional clusters with varying degrees of seasonality. Exploratory association analysis found most consistent and positive correlations between cholera seasonality and precipitation, and to a lesser extent with temperature and flooding.InterpretationWidespread cholera seasonality in SSA offers opportunities for intervention planning. Further studies are needed to study the association between cholera and climate. FundingThe NASA Applied Sciences Program and the Bill and Melinda Gates Foundation.

scholarly journals HPV genotypes and epidemiology in women cervical cancer in Senegal.

2020 ◽  
Author(s):  
kHADIDIATOU NIANE ◽  
Cheikh Tidiane DIAGNE ◽  
Gora DIOP ◽  
Ndongo DIA ◽  
Cheikh TALLA ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Cancer ◽  
High Risk ◽  
Causes Of Death ◽  
Common Type ◽  
Sub Saharan Africa ◽  
Multiple Infections ◽  
Hpv Genotypes ◽  
Hpv Types ◽  
Sub Saharan

Abstract Background In sub-Saharan Africa, cervical cancer is increasing steadily, with more than 75,000 new cases and nearly 50,000 deaths a year (Mboumba et al., 2017). In Senegal, pathologies such as cervical cancer are at the top of the causes of death and Human papillomavirus (HPV) is the aetilogical agent (Steenbergen et al., 2005). Methods The aim of the study is to analyze the distribution of HPV among Senegalese women with cervical cancer. Main objectives of this study are to identify the HPV types associated or “co-associated” with cervical oncogenesis in Senegal. The correlations with risk factors of cervix carcinogenesis, with risk factors, were analyze too. Cervical biopsies were performed on women hospitalized at Aristide Hospital Le Dantec-Julio Curie Institute. Three methods has been used to detect HPV genotypes - SANGERsequencing genotyping (Applied BioSystems), PCR real-time approach technique (HPV 16 & 18 RealTime PCR kit) (www.bioneer.co.kr) and the genotyping approach from Chippron (HPV kit 3.5 LCDArray) ([email protected]). Results It this study, patients had multiple infections (co-infections) at all, and the majority of coinfections was High-risk types (HR-HPV types). The most common type of HPV in our study were 16 (systematically detected in more than half of our patients), 18 (44%), 45 (33%), 33 (31%), 59 (28%), 35 (12%), 31 (11%), 58 (8%), 39 and 73 (4%), 44, 54 and 68 (3%) and the rest less than 1%. . Among co-infections detected in different regions of Senegal among women with cervical cancer, we found that HPV types 16 and 18 had the highest prevalence. In the Dakar region, which had the highest number of cases, a prevalence of 17.89% of HR-HPV co-infections was noted. Conclusion Polygamy represents a cofactor in the occurrence of cervical cancer in Senegalese women. No association between HPV-High Risk co-infections and cancer stages.

Prevalence and risk factor for injury in sub-Saharan Africa: a multicountry study

2017 ◽  
Vol 24 (4) ◽  
pp. 272-278 ◽  
Author(s):  
Megan B Diamond ◽  
Shona Dalal ◽  
Clement Adebamowo ◽  
David Guwatudde ◽  
Carien Laurence ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Sub Saharan Africa ◽  
Health Concern ◽  
Rural Site ◽  
Urban Site ◽  
Injury Data ◽  
Sub Saharan ◽  
Serious Injury

IntroductionInjury-related morbidity is a neglected health concern in many low-income and middle-income countries. Most injury data in Africa have been collected from hospital-based studies, and few studies have occurred across multiple countries. Using data from a novel cohort, we examined the prevalence and incidence of serious injuries and associated risk factors across five sites in sub-Saharan Africa (SSA).MethodsA common baseline and follow-up survey was administered to participants. The study population included 1316 persons at baseline and 904 persons at follow-up. Frequencies were calculated, and logistic regression models were used to assess risk factors for injury.ResultsA total of 233 (17.7%) persons reported a serious injury at baseline and 60 (6.6%) reported a serious injury 6 months later at follow-up. Sixty-nine per cent of participants responded to the follow-up questionnaire. At baseline and follow-up, the most common cause of serious injury at urban sites was transport related, followed by poison/overdose. In rural Uganda, sharp instruments injuries were most common, followed by transport-related injuries. Living at an urban site was associated with an increased odds for serious injury compared with those at the rural site (OR: 1.83, 95% CI 1.15 to 2.90). Participants who consumed above a moderate amount of alcohol were at a higher risk of serious injury compared with those who did not consume alcohol (OR: 1.86, 95% CI 1.02 to 3.41). High level of education was an important risk factor for injury.ConclusionAt baseline and follow-up, common causes of serious injury were transport related, sharp instrument and poison/overdose. Alcohol consumption, urban location and education are important risk factors for injury. It is feasible to collect longitudinal injury data using a standardised questionnaire across multiples sites in SSA. Longitudinal data collection should be leveraged to obtain robust data on risk factors for injury in SSA.

Malaria

2011 ◽  
pp. 220-221
Author(s):  
Dr Mark Harrison
Keyword(s):  
High Risk ◽  
South America ◽  
Clinical Features ◽  
Sub Saharan Africa ◽  
Se Asia ◽  
Risk Areas ◽  
Sub Saharan ◽  
Central South

19.1 Epidemiology, 221 19.2 Usual clinical features, 222 19.3 Basis of diagnosis, 222 19.4 Therapy, 222 • Protozoal disease. • Plasmodium species - ▪ Falciparum (15%) ▪ Vivax (80%) ▪ Ovale ▪ Malariae • High-risk areas: Central/South America, SE Asia, sub-Saharan Africa. • Transmission:...

scholarly journals Estimating Individualized Absolute Risk for Esophageal Squamous Cell Carcinoma: A Population-Based Study in High-Risk Areas of China

2021 ◽  
Vol 10 ◽  
Author(s):  
Yi Shen ◽  
Shuanghua Xie ◽  
Lei Zhao ◽  
Guohui Song ◽  
Yi Shao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Squamous Cell Carcinoma ◽  
Relative Risk ◽  
High Risk ◽  
Esophageal Squamous Cell Carcinoma ◽  
Risk Model ◽  
Absolute Risk ◽  
Population Based ◽  
Risk Areas ◽  
Relative Risk Model

BackgroundEsophageal squamous cell carcinoma (ESCC) has a high incidence rate and poor prognosis. In this study, we aimed to develop a predictive model to estimate the individualized 5-year absolute risk for ESCC in Chinese populations living in the high-risk areas of China.MethodsWe developed a risk-predicting model based on the epidemiologic data from a population-based case-control study including 244 newly diagnosed ESCC patients and 1,220 healthy controls. Initially, we included easy-to-obtain risk factors to construct the model using the multivariable logistic regression analysis. The area under the ROC curves (AUC) with cross-validation methods was used to evaluate the performance of the model. Combined with local age- and sex-specific ESCC incidence and mortality rates, the model was then used to estimate the absolute risk of developing ESCC within 5 years.ResultsA relative risk model was established that included eight factors: age, sex, tobacco smoking, alcohol drinking, education, and dietary habits (intake of hot food, intake of pickled/salted food, and intake of fresh fruit). The relative risk model had good discrimination [AUC, 0.785; 95% confidence interval (CI), 0.749–0.821]. The estimated 5-year absolute risk of ESCC for individuals varied widely, from 0.0003% to 19.72% in the studied population, depending on the exposure to risk factors.ConclusionsOur model based on readily identifiable risk factors showed good discriminative accuracy and strong robustness. And it could be applied to identify individuals with a higher risk of developing ESCC in the Chinese population, who might benefit from further targeted screening to prevent esophageal cancer.

scholarly journals Part II. Analysis of data gaps pertaining toShigellainfections in low and medium human development index countries, 1984–2005

2007 ◽  
Vol 136 (5) ◽  
pp. 577-603 ◽  
Author(s):  
P. K. RAM ◽  
J. A. CRUMP ◽  
S. K. GUPTA ◽  
M. A. MILLER ◽  
E. D. MINTZ
Keyword(s):  
Human Development ◽  
Human Development Index ◽  
English Language ◽  
Age Groups ◽  
Case Fatality ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Development Index ◽  
Global Epidemiology ◽  
Sub Saharan

SUMMARYThe global incidence ofShigellainfection has been estimated at 80–165 million episodes annually, with 99% of episodes occurring in the developing world. To identify contemporary gaps in the understanding of the global epidemiology of shigellosis, we conducted a review of the English-language scientific literature from 1984 to 2005, restricting the search to low and medium human development countries. Our review yielded 11 population-based studies ofShigellaburden from seven countries. No population-based studies have been conducted in sub-Saharan Africa or in low human development countries. In studies done in all age groups,Shigellaincidence varied from 0·6 to 107 episodes/1000 person-years.S. flexneriwas the most commonly detected subgroup in the majority of studies. Case-fatality rates ranged from 0% to 2·6% in population-based studies and from 0% to 21% in facility-based studies. This review highlights the large gaps in data on the burden ofShigellainfections for low human development index countries and, more specifically, for sub-Saharan Africa.

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