The potential impact of the demographic transition in the Senegal-Gambia region of sub-Saharan Africa on the burden of infectious disease and its potential synergies with control programmes: the case of hepatitis B

AbstractAfrica continues to experience the highest infectious disease burden despite an increase in investments. These include investments in malaria, HIV/AIDS, tuberculosis, as well as in communicable diseases. The global targets are to reduce the burden of these diseases through improved surveillance, prevention of outbreaks, effective case management, elimination and eventually, eradication. Achieving these targets, however, is limited by the poor geographic descriptions of the disease burden. Of the big five infectious disease burdens, malaria is the most advanced in terms of mapping its distribution. Malaria cartography has since formed the evidence-base for the design of many national malaria control programmes. This chapter focuses on malaria as an example, demonstrating its geographical descriptions. The availability of georeferenced malaria case data whether based on prevalence or incidence indicators has been used extensively in the mapping of geographical extents at national and sub-national scales. However, routine surveillance data is emerging as a valuable methodology of tracking burden in sub-Saharan Africa. A particular focus of this chapter is the use of routine national health systems surveillance data to describe, at a fine-scale, the distribution of malaria. However, routine data can be applied to the cartographic description of other diseases beyond malaria. The methodological aspects of burden estimation from routine surveillance platforms and cartography are highlighted.

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Competing interests, clashing ideas and institutionalizing influence: insights into the political economy of malaria control from seven African countries

Health Policy and Planning ◽

10.1093/heapol/czaa166 ◽

2020 ◽

Author(s):

Justin Parkhurst ◽

Ludovica Ghilardi ◽

Jayne Webster ◽

Robert W Snow ◽

Caroline A Lynch

Keyword(s):

Decision Making ◽

Malaria Control ◽

Qualitative Interviews ◽

Sub Saharan Africa ◽

African Countries ◽

Health Community ◽

Control Programmes ◽

Control Decision ◽

Sub Saharan ◽

Economic Considerations

Abstract This article explores how malaria control in sub-Saharan Africa is shaped in important ways by political and economic considerations within the contexts of aid-recipient nations and the global health community. Malaria control is often assumed to be a technically driven exercise: the remit of public health experts and epidemiologists who utilize available data to select the most effective package of activities given available resources. Yet research conducted with national and international stakeholders shows how the realities of malaria control decision-making are often more nuanced. Hegemonic ideas and interests of global actors, as well as the national and global institutional arrangements through which malaria control is funded and implemented, can all influence how national actors respond to malaria. Results from qualitative interviews in seven malaria-endemic countries indicate that malaria decision-making is constrained or directed by multiple competing objectives, including a need to balance overarching global goals with local realities, as well as a need for National Malaria Control Programmes to manage and coordinate a range of non-state stakeholders who may divide up regions and tasks within countries. Finally, beyond the influence that political and economic concerns have over programmatic decisions and action, our analysis further finds that malaria control efforts have institutionalized systems, structures and processes that may have implications for local capacity development.

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Spectrum-Malaria: a user-friendly projection tool for health impact assessment and strategic planning by malaria control programmes in sub-Saharan Africa

Malaria Journal ◽

10.1186/s12936-017-1705-3 ◽

2017 ◽

Vol 16 (1) ◽

Cited By ~ 7

Author(s):

Matthew Hamilton ◽

Guy Mahiane ◽

Elric Werst ◽

Rachel Sanders ◽

Olivier Briët ◽

...

Keyword(s):

Strategic Planning ◽

Impact Assessment ◽

Malaria Control ◽

Health Impact Assessment ◽

Health Impact ◽

Sub Saharan Africa ◽

Control Programmes ◽

Sub Saharan ◽

User Friendly

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Untreated highly viraemic pregnant women from Asia or sub-Saharan Africa often transmit hepatitis B virus despite serovaccination to newborns

Liver International ◽

10.1111/liv.12561 ◽

2014 ◽

Vol 35 (2) ◽

pp. 409-416 ◽

Cited By ~ 12

Author(s):

Pierre Sellier ◽

Sarah Maylin ◽

Rishma Amarsy ◽

Marie-Christine Mazeron ◽

Lucile Larrouy ◽

...

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Pregnant Women ◽

Sub Saharan Africa ◽

B Virus ◽

Sub Saharan

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Treatment of chronic hepatitis B in sub-Saharan Africa: 1-year results of a pilot program in Ethiopia

BMC Medicine ◽

10.1186/s12916-018-1229-x ◽

2018 ◽

Vol 16 (1) ◽

Cited By ~ 6

Author(s):

Hailemichael Desalegn ◽

Hanna Aberra ◽

Nega Berhe ◽

Bitsatab Mekasha ◽

Kathrine Stene-Johansen ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Sub Saharan Africa ◽

Pilot Program ◽

Sub Saharan

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Demographic Transition in Sub-Saharan Africa: Implications for Demographic Dividend

Demographic Dividends: Emerging Challenges and Policy Implications ◽

10.1007/978-3-319-32709-9_4 ◽

2016 ◽

pp. 61-82 ◽

Cited By ~ 1

Author(s):

Yoonjoung Choi

Keyword(s):

Demographic Transition ◽

Sub Saharan Africa ◽

Demographic Dividend ◽

Sub Saharan

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Evaluating survey designs for targeting preventive chemotherapy against Schistosoma haematobium and Schistosoma mansoni across Sub-Saharan Africa: a geostatistical analysis and modelling study

10.21203/rs.3.rs-36950/v3 ◽

2020 ◽

Author(s):

Kimberly Fornace ◽

Claudio Fronterrè ◽

Fiona M Fleming ◽

Hope Simpson ◽

Honorat Zoure ◽

...

Keyword(s):

Cost Effectiveness ◽

Schistosoma Haematobium ◽

Sampling Strategy ◽

Sub Saharan Africa ◽

Spatial Distributions ◽

Preventive Chemotherapy ◽

School Based ◽

Control Programmes ◽

Sub Saharan ◽

Survey Designs

Abstract Background: Schistosomiasis control programmes primarily use school-based surveys to identify areas for mass drug administration of preventive chemotherapy. However, as the spatial distribution of schistosomiasis can be highly focal, transmission may not be detected by surveys implemented at districts or larger spatial units. Improved mapping strategies are required to accurately and cost-effectively target preventive chemotherapy to remaining foci across all possible spatial distributions of schistosomiasis. Methods: Here, we use geostatistical models to quantify the spatial heterogeneity of Schistosoma haematobium and S. mansoni across sub-Saharan Africa using the most comprehensive dataset available on school-based surveys. Applying this information to parameterise simulations, we assess the accuracy and cost of targeting alternative implementation unit sizes across the range of plausible schistosomiasis distributions. We evaluate the consequences of decisions based on survey designs implemented at district and subdistrict levels sampling different numbers of schools. Cost data were obtained from field surveys conducted across multiple countries and years, with cost effectiveness evaluated as the cost per correctly identified school. Results: Models identified marked differences in prevalence and spatial distributions between countries and species; however, results suggest implementing surveys at subdistrict level increase the accuracy of treatment classifications across most scenarios. While sampling intensively at the subdistrict level resulted in the highest classification accuracy, this sampling strategy resulted in the highest costs. Alternatively, sampling the same numbers of schools currently recommended at the district level but stratifying by subdistrict increased cost effectiveness.Conclusions: This study provides a new tool to evaluate schistosomiasis survey designs across a range of transmission settings. Results highlight the importance of considering spatial structure when designing sampling strategies, illustrating that a substantial proportion of children may be undertreated even when an implementation unit is correctly classified. Control programmes need to weigh the increased accuracy of more detailed mapping strategies against the survey costs and treatment priorities.

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Hepatitis B virus activity in untreated hepatitis B e antigen–negative human immunodeficiency virus–hepatitis B virus co-infected patients from sub-Saharan Africa

Transactions of the Royal Society of Tropical Medicine and Hygiene ◽

10.1093/trstmh/trz021 ◽

2019 ◽

Vol 113 (8) ◽

pp. 437-445

Author(s):

Anders Boyd ◽

Menan Gerard Kouamé ◽

Laura Houghtaling ◽

Raoul Moh ◽

Delphine Gabillard ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Hepatitis B Virus ◽

Hepatitis B ◽

Hbv Dna ◽

Sub Saharan Africa ◽

Hepatitis B E Antigen ◽

Hiv Rna ◽

B Virus ◽

Immunodeficiency Virus ◽

Sub Saharan

Abstract Background In human immunodeficiency virus (HIV) and hepatitis B virus (HBV) co-infected patients from sub-Saharan Africa with hepatitis B e antigen (HBeAg)-negative status, data are limited on the evolution of HBV activity when antiretroviral treatment (ART) is absent. Methods A total of 43 HBeAg-negative co-infected patients not indicated for ART (per concomitant World Health Organization recommendations) were followed during participation in a randomized controlled trial in Côte d’Ivoire. Chronic HBeAg-negative phases were classified at yearly visits and defined as ‘infection’ (HBV DNA ≤10 000 copies/mL and normal alanine aminotransferase [ALT]) or ‘hepatitis’ (HBV DNA >10 000 copies/mL and/or above normal ALT). Dispersion in HBV DNA and ALT levels during follow-up was assessed using interquartile range (IQR) regression. Results During a median 25 months (IQR 19–31), 17 (40%) patients consistently had ‘infection’, 5 (12%) consistently had ‘hepatitis’ and 21 (48%) fluctuated between phases. Wider dispersion in HBV DNA over time was associated with higher baseline HIV RNA (p=0.02) and higher baseline HBV DNA levels (p=0.008), while wider dispersion in ALT was associated with higher baseline HIV RNA (p<0.001), higher baseline ALT levels (p=0.02) and baseline hepatitis surface antigen >4.0 log10 IU/mL (p=0.02). Conclusions HBV activity is common with HBeAg-negative status, whose variation is partly linked to HIV replication. Fluctuations in disease phase make it difficult to assess the risk of morbidity and mortality after ART initiation.

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