Quantifying the under-estimation of cervical Cancer in remote regions of Tanzania

Abstract Background Cervical cancer is the most common cancer among women in Sub-Saharan countries, including Tanzania. While early detection and diagnosis are available in some parts of this large country, radiotherapy has been only available at the Ocean Road Cancer Institute (ORCI), in the capital city of Dar es Salaam and is just starting in a few regions. Methods The objective of this study was to compare the observed incidence of cervical cancer for the two remote regions of Mwanza in western Tanzania and Mbeya in southern Tanzania, based on their patients treated at the ORCI from 2011 to 2014. Results: The number patients referred and treated at ORCI were (120 from Mwanza, and 171 from Mbeya, representing 24.6 and 32.8% of the patients histopathologically confirmed in the two sites, respectively. The results showed significant underestimation of cervical cancer in the two regions. The vast majority of patients who were histopathologically-confirmed in their local regions (73.92% from Mwanza and 65.1% from Mbeya), but did not receive the needed radiotherapy treatment at the ORCI. The estimated incidence for the two regions based on the number of patients treated at the ORCI were underestimated by 53.9% for Mwanza and 68.9% for Mbeya. Conclusions Local establishment of radiotherapy treatment facilities in remote regions in Tanzania and similar other low-income countries is essential for providing effective treatment and improving survival of diagnosed cervical cancer patients. Linkage between the records of local remote hospitals and the main cancer treatment center in the capital city can also help support the emerging the population-based cancer registry at ORCI.

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Curtailing Covid-19 on a Dollar-a-Day in Malawi: Implications for the Ongoing Pandemic

10.1101/2021.03.16.21253632 ◽

2021 ◽

Author(s):

Iliana V. Kohler ◽

Fabrice Kämpfen ◽

Alberto Ciancio ◽

James Mwera ◽

Victor Mwapasa ◽

...

Keyword(s):

Public Health ◽

Low Income ◽

Population Based ◽

Community Leadership ◽

Pivotal Role ◽

Low Income Countries ◽

Effective Response ◽

Trust In Institutions ◽

Primary Prevention Strategy ◽

Sub Saharan

AbstractUtilizing population-based data from the Covid-19 phone survey (N = 2, 262) of the Malawi Longitudinal Study of Families and Health (MLSFH) collected during June 2nd–August 17th, 2020, we investigate behavioral, economic and social responses to Covid-19 and focus on the crucial role that community leadership and trust in institutions play towards shaping these responses. We argue that the effective response of Malawi to limit the spread of the virus was facilitated by the engagement of local leaders to mobilize communities to adapt and adhere to Covid-19 prevention strategies. Village heads (VHs) played pivotal role in shaping individual’s knowledge about the pandemic and the adaption of preventive health behaviors and were crucial for mitigating the negative economic and health consequences of the pandemic. We further show that trust in institutions is of particular importance in shaping individuals’ behavior during the pandemic, and these findings highlight the pivotal role of community leadership in fostering better compliance and adoption of public health measures essential to contain the virus. Overall, our findings point to distinctive patterns of pandemic response in a low-income sub-Saharan African rural population that emphasized local leadership as mediators of public health messages and policies. These lessons from the first pandemic wave remain relevant as in many low-income countries behavioral responses to Covid-19 will remain the primary prevention strategy for a foreseeable future.

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Mapping evidence on management of cervical cancer in sub-Saharan Africa: scoping review protocol

Systematic Reviews ◽

10.1186/s13643-021-01740-3 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Petmore Zibako ◽

Mbuzeleni Hlongwa ◽

Nomsa Tsikai ◽

Sarah Manyame ◽

Themba G. Ginindza

Keyword(s):

Systematic Review ◽

Cervical Cancer ◽

Scoping Review ◽

Low Income ◽

Sub Saharan Africa ◽

Low Income Countries ◽

Attitudes And Practices ◽

Cancer Management ◽

Scoping Reviews ◽

Sub Saharan

Abstract Background Cancer is a non-communicable disease and is the number 2 leading cause of death globally. Among all cancers, cervical cancer is the number 1 killer of women in low-income countries (LICs). Cervical cancer is a well understood preventable cancer. The rates of cervical cancer are very varied and inversely proportional to the effectiveness of disease management policies. Management of cervical cancer includes prevention, screening, diagnosis and treatment. The main objective of this scoping review is to map the evidence on cervical cancer management in sub-Saharan Africa (SSA) to understand the coverage of cervical cancer prevention and treatment services and provide an opportunity to generate knowledge on the risk factors, attitudes and practices extendable globally. Methods and analysis This review will be guided by Arksey and O’Malley’s framework recommended for conducting scoping review studies. The Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews (PRISMA-Scr) checklist will also be completed to ensure that the review adheres to the sound methodological rigour acceptable for scoping review studies. The following electronic databases will be searched for potentially eligible articles: PubMed, Ebsco Host, Scopus and Cochrane Database of Systematic Reviews. Study screening procedures recommended by Higgins and Deeks will be followed. A narrative synthesis will be used, with data synthesised and interpreted using sifting, charting and sorting based on themes and key issues. Discussion Cervical cancer can become a disease of the past with a proper control strategy in place. It is therefore imperative to map available evidence on the management of cervical cancer to inform policy and advocacy action. More knowledge on the status quo will guide policymakers in ensuring cancer management guiding policies are formulated/updated/revised accordingly. Systematic review registration Not registered with PROSPERO (not needed). Protocol and registration This scoping review was not registered.

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Mapping Evidence on Management of Cervical Cancer in Sub-Saharan Africa: Scoping Review Protocol

10.21203/rs.3.rs-23265/v1 ◽

2020 ◽

Author(s):

Petmore Zibako ◽

Mbuzeleni Hlongwa ◽

Nomsa Tsikai ◽

Sarah Manyame ◽

Themba G Ginindza

Keyword(s):

Cervical Cancer ◽

Scoping Review ◽

Low Income ◽

Communicable Disease ◽

Sub Saharan Africa ◽

Low Income Countries ◽

Attitudes And Practices ◽

Cancer Management ◽

Scoping Reviews ◽

Sub Saharan

Abstract BackgroundCancer is a non-communicable disease, and is the number two leading cause of death globally. Among all cancers, cervical cancer is the number one killer of women in Low-Income countries (LICs). Cervical cancer is a well understood preventable cancer. The rates of cervical cancer are very varied and inversely proportional to effectiveness of disease management policies. Management of cervical cancer includes: prevention, screening, diagnosis and treatment. The main objective of this scoping review is to map evidence on cervical cancer management in sub-Saharan Africa (SSA) to understand the coverage of cervical cancer prevention and treatment services and provide an opportunity to generate knowledge on risk factors, attitudes and practices extendable globally.Methods and analysisThis review will be guided by Arksey and O’Malley’s framework recommended for conducting scoping review studies. The Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews (PRISMA-Scr) checklist will also be completed to ensure that the review adheres to sound methodological rigour acceptable for scoping review studies. The following electronic databases will be search for potentially eligible articles: PubMed, Ebsco Host, Scopus and Cochrane Database of Systematic Reviews. Study screening procedures recommended by Higgins and Deeks will be followed.DiscussionCervical cancer can become a disease of the past with a proper control strategy in place. It is therefore imperative to map available evidence on management of cervical cancer to inform policy and advocacy action. More knowledge on the status quo will guide policy makers in ensuring cancer management guiding policies are formulated/updated/ revised accordingly.Scoping review registration: Not registered with PROSPERO (not needed).Protocol and registration: This scoping review was not registered.

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Epidemiology and global burden of hypertension

ESC CardioMed ◽

10.1093/med/9780198784906.003.0061 ◽

2018 ◽

pp. 290-297

Author(s):

George A. Mensah

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Risk Factor ◽

Systolic Blood Pressure ◽

Low Income ◽

Population Based ◽

Pooled Analysis ◽

Low Income Countries ◽

Preventable Risk Factor ◽

Sub Saharan

Hypertension is the most powerful, independent, preventable risk factor for death and disability from cardiovascular diseases. It is also a leading risk factor for all-cause mortality and the largest contributor to global disability-adjusted life years (DALYs). In 2015, exposure to high systolic blood pressure (BP) accounted for 10.7 million deaths (33.2% of deaths attributed to all risk factors) and nearly 212 million DALYs or 20.9% of DALYs from all risk factors. Epidemiological research over the past half-century has confirmed that the risk from hypertension is strong, continuous, graded, and doubles for each increment of 20 mmHg systolic blood pressure (BP) or 10 mmHg diastolic BP in adults, without evidence of a threshold down to BPs as low as 115/75 mmHg. In children and adolescents, hypertension prevalence is increasing (in concert with the continuing epidemic of obesity) and raised BP in adolescents remains the strongest predictor of hypertension in adults. Over the last 25 years, the global age-standardized summary exposure to hypertension has increased for men but not for women. A pooled analysis of 1479 population-based measurements covering more than 19 million participants over four decades showed that the number of adults with hypertension increased from 594 million in 1975 to 1.13 billion in 2015. Most of the increase occurred in low- and middle-income countries. Globally, the highest BP levels have shifted from high-income countries to low-income countries in south Asia and sub-Saharan Africa while BP levels have remained persistently high in central and eastern Europe.

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Cervical Cancer in Sub-Saharan Africa – a multinational population-based study on treatment guideline adherence

10.1055/s-0039-1692081 ◽

2019 ◽

Author(s):

M Griesel ◽

DM Parkin ◽

C Thomssen ◽

EJ Kantelhardt

Keyword(s):

Cervical Cancer ◽

Guideline Adherence ◽

Treatment Guideline ◽

Population Based ◽

Sub Saharan Africa ◽

Population Based Study ◽

Sub Saharan

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Monetary Policy in Sub-Saharan Africa

10.1093/oso/9780198785811.001.0001 ◽

2018 ◽

Cited By ~ 1

Keyword(s):

Monetary Policy ◽

Low Income ◽

Sub Saharan Africa ◽

Low Income Countries ◽

African Countries ◽

Policy Regimes ◽

Export Prices ◽

Policy Work ◽

Sub Saharan ◽

Policy Guidance

Having broadly stabilized inflation over the past two decades, many policymakers in sub-Saharan Africa are now asking more of their monetary policy frameworks. They are looking to avoid policy misalignments and respond appropriately to both domestic and external shocks, including swings in fiscal policy and spikes in food and export prices. In many cases they are finding current regimes—often characterized as ‘money targeting’—lacking, with opaque and sometimes inconsistent objectives, inadequate transmission of policy to the economy, and difficulties in responding to supply shocks. At the same time, little existing research on monetary policy is targeted to low-income countries. What do we know about the empirics of monetary transmission in low-income countries? (How) Does monetary policy work in countries characterized by a huge share of food in consumption, underdeveloped financial markets, and opaque policy regimes? (How) Can we use methods largely derived in advanced countries to answer these questions? And (how) can we use the results to guide policymakers? This book draws on years of research and practice at the IMF and in central banks from the region to shed empirical and theoretical light on these questions and to provide practical tools and policy guidance. A key feature of the book is the application of dynamic general equilibrium models, suitably adapted to reflect key features of low-income countries, for the analysis of monetary policy in sub-Saharan African countries.

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COVID-19 pandemic: the implications of the natural history, challenges of diagnosis and management for care in sub-Saharan Africa

Beni-Suef University Journal of Basic and Applied Sciences ◽

10.1186/s43088-021-00106-x ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Lawrence Omo-Aghoja ◽

Emuesiri Goodies Moke ◽

Kenneth Kelechi Anachuna ◽

Adrian Itivere Omogbiya ◽

Emuesiri Kohworho Umukoro ◽

...

Keyword(s):

Public Health ◽

Natural History ◽

Low Income ◽

Sub Saharan Africa ◽

Low Income Countries ◽

Diagnosis And Management ◽

Severe Acute Respiratory Infection ◽

Identification Technique ◽

Sub Saharan ◽

Policies And Programs

Abstract Background Coronavirus disease (COVID-19) is a severe acute respiratory infection which has afflicted virtually almost all nations of the earth. It is highly transmissible and represents one of the most serious pandemics in recent times, with the capacity to overwhelm any healthcare system and cause morbidity and fatality. Main content The diagnosis of this disease is daunting and challenging as it is dependent on emerging clinical symptomatology that continues to increase and change very rapidly. The definitive test is the very expensive and scarce polymerase chain reaction (PCR) viral identification technique. The management has remained largely supportive and empirical, as there are no officially approved therapeutic agents, vaccines or antiviral medications for the management of the disease. Severe cases often require intensive care facilities and personnel. Yet there is paucity of facilities including the personnel required for diagnosis and treatment of COVID-19 in sub-Saharan Africa (SSA). It is against this backdrop that a review of key published reports on the pandemic in SSA and globally is made, as understanding the natural history of a disease and the documented responses to diagnosis and management is usually a key public health strategy for designing and improving as appropriate, relevant interventions. Lead findings were that responses by most nations of SSA were adhoc, paucity of public health awareness strategies and absence of legislations that would help enforce preventive measures, as well as limited facilities (including personal protective equipment) and institutional capacities to deliver needed interventions. Conclusion COVID-19 is real and has overwhelmed global health care system especially low-income countries of the sub-Sahara such as Nigeria. Suggestions for improvement of healthcare policies and programs to contain the current pandemic and to respond more optimally in case of future pandemics are made herein.

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