scholarly journals Optimal Approach and Strategies to Strengthen Pharmacovigilance in Sub-Saharan Africa: A Cohort Study of Patients Treated with First-Line Artemisinin-Based Combination Therapies in the Nanoro Health and Demographic Surveillance System, Burkina Faso

2020 ◽  
Vol Volume 14 ◽  
pp. 1507-1521
Author(s):  
Toussaint Rouamba ◽  
Paul Sondo ◽  
Karim Derra ◽  
Seydou Nakanabo-Diallo ◽  
Biebo Bihoun ◽  
...  
Keyword(s):  
Cohort Study ◽  
Burkina Faso ◽  
Surveillance System ◽  
Demographic Surveillance System ◽  
Sub Saharan Africa ◽  
Combination Therapies ◽  
First Line ◽  
Sub Saharan ◽  
Optimal Approach

Case Studies in Urban Health

Urban Health ◽  
2019 ◽  
pp. 332-341
Author(s):  
Alex Ezeh ◽  
Blessing Mberu
Keyword(s):  
Urban Health ◽  
Surveillance System ◽  
Urban Poverty ◽  
Large City ◽  
Demographic Surveillance System ◽  
Sub Saharan Africa ◽  
Poverty And Health ◽  
Sub Saharan ◽  
Set Up ◽  
Improve Health

A project of the Africa Population and Health Research Center (APHRC), the Nairobi Urban Health and Demographic Surveillance System was set up to provide a platform to explore the linkages between urban poverty and health and to monitor and evaluate novel implementation programs that were developed with the study communities. In this chapter, the authors draw on nearly two decades of work by APHRC among slum populations in Nairobi, Kenya, to highlight the unique health challenges of slum populations and how these are changing. The chapter summarizes various efforts to improve health in Nairobi’s informal settlements since 2000 and discusses efforts in Nairobi to improve health in a large city in sub-Saharan Africa, summarizing lessons that have been learned in improving urban health worldwide.

scholarly journals Patterns of child mortality in rural area of Burkina Faso: evidence from the Nanoro health and demographic surveillance system (HDSS)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Navideh Noori ◽  
Karim Derra ◽  
Innocent Valea ◽  
Assaf P. Oron ◽  
Aminata Welgo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Burkina Faso ◽  
Child Mortality ◽  
Surveillance System ◽  
Demographic Surveillance System ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Seasonal Effect ◽  
Wet Season ◽  
Inpatient Facility

Abstract Background Half of global child deaths occur in sub-Saharan Africa. Understanding child mortality patterns and risk factors will help inform interventions to reduce this heavy toll. The Nanoro Health and Demographic Surveillance System (HDSS), Burkina Faso was described previously, but patterns and potential drivers of heterogeneity in child mortality in the district had not been studied. Similar studies in other districts indicated proximity to health facilities as a risk factor, usually without distinction between facility types. Methods Using Nanoro HDSS data from 2009 to 2013, we estimated the association between under-5 mortality and proximity to inpatient and outpatient health facilities, seasonality of death, age group, and standard demographic risk factors. Results Living in homes 40–60 min and > 60 min travel time from an inpatient facility was associated with 1.52 (95% CI: 1.13–2.06) and 1.74 (95% CI: 1.27–2.40) greater hazard of under-5 mortality, respectively, than living in homes < 20 min from an inpatient facility. No such association was found for outpatient facilities. The wet season (July–November) was associated with 1.28 (95% CI: 1.07, 1.53) higher under-5 mortality than the dry season (December–June), likely reflecting the malaria season. Conclusions Our results emphasize the importance of geographical proximity to health care, distinguish between inpatient and outpatient facilities, and also show a seasonal effect, probably driven by malaria.

scholarly journals Mapping partner drug resistance to guide antimalarial combination therapy policies in sub-Saharan Africa

2021 ◽  
Vol 118 (29) ◽  
pp. e2100685118
Author(s):  
Hanna Y. Ehrlich ◽  
Amy K. Bei ◽  
Daniel M. Weinberger ◽  
Joshua L. Warren ◽  
Sunil Parikh
Keyword(s):  
Drug Susceptibility ◽  
Sub Saharan Africa ◽  
Combination Therapies ◽  
Wild Type ◽  
First Line ◽  
Rainfall Seasonality ◽  
Clinical Resistance ◽  
Sub Saharan ◽  
Bayesian Spatial Model ◽  
Line Drug

Resistance to artemisinin-based combination therapies (ACTs) threatens the global control of Plasmodium falciparum malaria. ACTs combine artemisinin-derived compounds with partner drugs to enable multiple mechanisms of clearance. Although ACTs remain widely effective in sub-Saharan Africa, long-standing circulation of parasite alleles associated with reduced partner drug susceptibility may contribute to the development of clinical resistance. We fitted a hierarchical Bayesian spatial model to data from over 500 molecular surveys to predict the prevalence and frequency of four key markers in transporter genes (pfcrt 76T and pfmdr1 86Y, 184F, and 1246Y) in first-level administrative divisions in sub-Saharan Africa from the uptake of ACTs (2004 to 2009) to their widespread usage (2010 to 2018). Our models estimated that the pfcrt 76T mutation decreased in prevalence in 90% of regions; the pfmdr1 N86 and D1246 wild-type genotypes increased in prevalence in 96% and 82% of regions, respectively; and there was no significant directional selection at the pfmdr1 Y184F locus. Rainfall seasonality was the strongest predictor of the prevalence of wild-type genotypes, with other covariates, including first-line drug policy and transmission intensity more weakly associated. We lastly identified regions of high priority for enhanced surveillance that could signify decreased susceptibility to the local first-line ACT. Our results can be used to infer the degree of molecular resistance and magnitude of wild-type reversion in regions without survey data to inform therapeutic policy decisions.

scholarly journals Field Lessons from a Zoonotic Disease Study in the Nairobi Health Surveillance System

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Djesika D. Amendah ◽  
Peterrock Muriuki ◽  
Nicholas Ngomi ◽  
Martin Kavao ◽  
Nelson Muhia
Keyword(s):  
Surveillance System ◽  
Clinical Care ◽  
Health Surveillance ◽  
Zoonotic Diseases ◽  
Demographic Surveillance System ◽  
Sub Saharan Africa ◽  
Resource Limited ◽  
Sub Saharan ◽  
Disease Study ◽  
And Training

We aim to disseminate field lessons gained from studying zoonotic diseases among children with diarrhea in the Nairobi Urban Health and Demographic Surveillance System. Despite the numerical importance of slums in sub-Saharan Africa, little is known on the practice of health surveillance in those resource-limited areas. Challenges and lessons gained concern sustaining community participation over the years, engaging with gatekeepers, hiring and training local fieldworkers, ensuring safety of employees and material, and offering clinical care to children with diarrhea in their households.

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