scholarly journals A SARS-CoV-2 Surveillance System in Sub-Saharan Africa: Modeling Study for Persistence and Transmission to Inform Policy (Preprint)

2020 ◽  
Author(s):  
Lori Ann Post ◽  
Salem T Argaw ◽  
Cameron Jones ◽  
Charles B Moss ◽  
Danielle Resnick ◽  
...  
Keyword(s):  
Public Health ◽  
South Africa ◽  
Food Insecurity ◽  
Generalized Method Of Moments ◽  
The United States ◽  
Sub Saharan Africa ◽  
Reporting Practices ◽  
Data Limitations ◽  
The World ◽  
Sub Saharan

BACKGROUND Since the novel coronavirus emerged in late 2019, the scientific and public health community around the world have sought to better understand, surveil, treat, and prevent the disease, COVID-19. In sub-Saharan Africa (SSA), many countries responded aggressively and decisively with lockdown measures and border closures. Such actions may have helped prevent large outbreaks throughout much of the region, though there is substantial variation in caseloads and mortality between nations. Additionally, the health system infrastructure remains a concern throughout much of SSA, and the lockdown measures threaten to increase poverty and food insecurity for the subcontinent’s poorest residents. The lack of sufficient testing, asymptomatic infections, and poor reporting practices in many countries limit our understanding of the virus’s impact, creating a need for better and more accurate surveillance metrics that account for underreporting and data contamination. OBJECTIVE The goal of this study is to improve infectious disease surveillance by complementing standardized metrics with new and decomposable surveillance metrics of COVID-19 that overcome data limitations and contamination inherent in public health surveillance systems. In addition to prevalence of observed daily and cumulative testing, testing positivity rates, morbidity, and mortality, we derived COVID-19 transmission in terms of speed, acceleration or deceleration, change in acceleration or deceleration (jerk), and 7-day transmission rate persistence, which explains where and how rapidly COVID-19 is transmitting and quantifies shifts in the rate of acceleration or deceleration to inform policies to mitigate and prevent COVID-19 and food insecurity in SSA. METHODS We extracted 60 days of COVID-19 data from public health registries and employed an empirical difference equation to measure daily case numbers in 47 sub-Saharan countries as a function of the prior number of cases, the level of testing, and weekly shift variables based on a dynamic panel model that was estimated using the generalized method of moments approach by implementing the Arellano-Bond estimator in R. RESULTS Kenya, Ghana, Nigeria, Ethiopia, and South Africa have the most observed cases of COVID-19, and the Seychelles, Eritrea, Mauritius, Comoros, and Burundi have the fewest. In contrast, the <i>speed</i>, <i>acceleration</i>, <i>jerk</i>, <i>and 7-day persistence</i> indicate rates of COVID-19 transmissions differ from observed cases. In September 2020, Cape Verde, Namibia, Eswatini, and South Africa had the highest speed of COVID-19 transmissions at 13.1, 7.1, 3.6, and 3 infections per 100,0000, respectively; Zimbabwe had an acceleration rate of transmission, while Zambia had the largest rate of deceleration this week compared to last week, referred to as a <i>jerk</i>. Finally, the 7-day persistence rate indicates the number of cases on September 15, 2020, which are a function of new infections from September 8, 2020, decreased in South Africa from 216.7 to 173.2 and Ethiopia from 136.7 to 106.3 per 100,000. The statistical approach was validated based on the regression results; they determined recent changes in the pattern of infection, and during the weeks of September 1-8 and September 9-15, there were substantial country differences in the evolution of the SSA pandemic. This change represents a decrease in the transmission model R value for that week and is consistent with a de-escalation in the pandemic for the sub-Saharan African continent in general. CONCLUSIONS Standard surveillance metrics such as daily observed new COVID-19 cases or deaths are necessary but insufficient to mitigate and prevent COVID-19 transmission. Public health leaders also need to know where COVID-19 transmission rates are accelerating or decelerating, whether those rates increase or decrease over short time frames because the pandemic can quickly escalate, and how many cases today are a function of new infections 7 days ago. Even though SSA is home to some of the poorest countries in the world, development and population size are not necessarily predictive of COVID-19 transmission, meaning higher income countries like the United States can learn from African countries on how best to implement mitigation and prevention efforts. INTERNATIONAL REGISTERED REPORT RR2-10.2196/21955

scholarly journals A SARS-CoV-2 Surveillance System in Sub-Saharan Africa: Modeling Study for Persistence and Transmission to Inform Policy

10.2196/24248 ◽  
2020 ◽  
Vol 22 (11) ◽  
pp. e24248
Author(s):  
Lori Ann Post ◽  
Salem T Argaw ◽  
Cameron Jones ◽  
Charles B Moss ◽  
Danielle Resnick ◽  
...  
Keyword(s):  
Public Health ◽  
South Africa ◽  
Food Insecurity ◽  
Generalized Method Of Moments ◽  
The United States ◽  
Sub Saharan Africa ◽  
Reporting Practices ◽  
Data Limitations ◽  
The World ◽  
Sub Saharan

Background Since the novel coronavirus emerged in late 2019, the scientific and public health community around the world have sought to better understand, surveil, treat, and prevent the disease, COVID-19. In sub-Saharan Africa (SSA), many countries responded aggressively and decisively with lockdown measures and border closures. Such actions may have helped prevent large outbreaks throughout much of the region, though there is substantial variation in caseloads and mortality between nations. Additionally, the health system infrastructure remains a concern throughout much of SSA, and the lockdown measures threaten to increase poverty and food insecurity for the subcontinent’s poorest residents. The lack of sufficient testing, asymptomatic infections, and poor reporting practices in many countries limit our understanding of the virus’s impact, creating a need for better and more accurate surveillance metrics that account for underreporting and data contamination. Objective The goal of this study is to improve infectious disease surveillance by complementing standardized metrics with new and decomposable surveillance metrics of COVID-19 that overcome data limitations and contamination inherent in public health surveillance systems. In addition to prevalence of observed daily and cumulative testing, testing positivity rates, morbidity, and mortality, we derived COVID-19 transmission in terms of speed, acceleration or deceleration, change in acceleration or deceleration (jerk), and 7-day transmission rate persistence, which explains where and how rapidly COVID-19 is transmitting and quantifies shifts in the rate of acceleration or deceleration to inform policies to mitigate and prevent COVID-19 and food insecurity in SSA. Methods We extracted 60 days of COVID-19 data from public health registries and employed an empirical difference equation to measure daily case numbers in 47 sub-Saharan countries as a function of the prior number of cases, the level of testing, and weekly shift variables based on a dynamic panel model that was estimated using the generalized method of moments approach by implementing the Arellano-Bond estimator in R. Results Kenya, Ghana, Nigeria, Ethiopia, and South Africa have the most observed cases of COVID-19, and the Seychelles, Eritrea, Mauritius, Comoros, and Burundi have the fewest. In contrast, the speed, acceleration, jerk, and 7-day persistence indicate rates of COVID-19 transmissions differ from observed cases. In September 2020, Cape Verde, Namibia, Eswatini, and South Africa had the highest speed of COVID-19 transmissions at 13.1, 7.1, 3.6, and 3 infections per 100,0000, respectively; Zimbabwe had an acceleration rate of transmission, while Zambia had the largest rate of deceleration this week compared to last week, referred to as a jerk. Finally, the 7-day persistence rate indicates the number of cases on September 15, 2020, which are a function of new infections from September 8, 2020, decreased in South Africa from 216.7 to 173.2 and Ethiopia from 136.7 to 106.3 per 100,000. The statistical approach was validated based on the regression results; they determined recent changes in the pattern of infection, and during the weeks of September 1-8 and September 9-15, there were substantial country differences in the evolution of the SSA pandemic. This change represents a decrease in the transmission model R value for that week and is consistent with a de-escalation in the pandemic for the sub-Saharan African continent in general. Conclusions Standard surveillance metrics such as daily observed new COVID-19 cases or deaths are necessary but insufficient to mitigate and prevent COVID-19 transmission. Public health leaders also need to know where COVID-19 transmission rates are accelerating or decelerating, whether those rates increase or decrease over short time frames because the pandemic can quickly escalate, and how many cases today are a function of new infections 7 days ago. Even though SSA is home to some of the poorest countries in the world, development and population size are not necessarily predictive of COVID-19 transmission, meaning higher income countries like the United States can learn from African countries on how best to implement mitigation and prevention efforts. International Registered Report Identifier (IRRID) RR2-10.2196/21955

Crowdsourcing Covid-19 signals in sub-Saharan Africa: Leveraging digital contributor networks for participatory surveillance of Covid-19 symptoms and deaths (Preprint)

2020 ◽  
Author(s):  
Ngozi A Erondu ◽  
Sagal A Ali ◽  
Mohamed Ali ◽  
Schadrac C Agbla
Keyword(s):  
Public Health ◽  
Sub Saharan Africa ◽  
Specific Information ◽  
Surveillance Systems ◽  
Health Seeking ◽  
African Countries ◽  
Cross Sectional Survey ◽  
Local Networks ◽  
The World ◽  
Sub Saharan

BACKGROUND In sub-Saharan Africa, underreporting of cases and deaths has been attributed to various factors including, weak disease surveillance, low health-seeking behaviour of flu like symptoms, and stigma of Covid-19. There is evidence that SARS-CoV-2 spread mimics transmission patterns of other countries across the world. Since the Covid-19 pandemic has changed the way research can be conducted and in light of restrictions on travel and risks to in-person data collection, innovative approaches to collecting data must be considered. Nearly 50% of Africa’s population is a unique mobile subscriber and it is one of the fastest growing smart-phone marketplaces in the world; hence, mobile phone platforms should be considered to monitor Covid-19 trends in the community. OBJECTIVE We demonstrate the use of digital contributor platforms to survey individuals about cases of flu-like symptoms and instances of unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia, and Zimbabwe. METHODS Rapid cross-sectional survey of individuals with severe flu and pneumonia symptoms and unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia and Zimbabwe RESULTS Using a non-health specific information platform, we found COVID-19 signals in five African countries, specifically: •Across countries, nearly half of the respondents (n=739) knew someone who had severe flu or pneumonia symptoms in recent months. •One in three respondents from Somalia and one in five from Zimbabwe respondents said they knew more than five people recently displaying flu and/or pneumonia symptoms. •In Somalia there were signals that a large number of people might be dying outside of health facilities, specifically in their homes or in IDP or refugee camps. CONCLUSIONS Existing digital contributor platforms with local networks are a non-traditional data source that can provide information from the community to supplement traditional government surveillance systems and academic surveys. We demonstrate that using these distributor networks to for community surveys can provide periodic information on rumours but could also be used to capture local sentiment to inform public health decision-making; for example, these insights could be useful to inform strategies to increase confidence in Covid19 vaccine. As Covid-19 continues to spread somewhat silently across sub-Saharan Africa, regional and national public health entities should consider expanding event-based surveillance sources to include these systems.

A Comparative Analysis of South Africa as a Semi-Industrialised Developing Country

1988 ◽  
Vol 26 (3) ◽  
pp. 473-493 ◽  
Author(s):  
J. B. Knight
Keyword(s):  
South Africa ◽  
Developing Economies ◽  
Developed Countries ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
The World Bank ◽  
The World ◽  
Per Capita ◽  
Sub Saharan ◽  
Industrialised Countries

South Africa has neither a developed nor a typical underdeveloped economy. Too often it has been wrongly classified, along with, say, Australia and New Zealand, as one of the peripheral developed countries, because only a part of the economy and population have the characteristics we associate with that group. Yet its economy is distinctly different from others in sub-Saharan Africa. South Africa falls squarely into the category which the World Bank classifies as ‘upper middle-income’ developing economies, with G.N.P. per capita in 1982 ranging from $2,000 to $7,000 and averaging $2,500, thereby including South Africa, with $2,700.1 (By contrast, Kenya's G.N.P. per capita was $400 and Britain's $10,000). The World Bank's group includes Algeria, Argentina, Brazil, Chile, Mexico, South Korea, Venezuela, and Yugoslavia. South Africa shares many structural economic characteristics with these semi-industrialised countries.

The Theology of Emergency: Welfare Reform, US Foreign Aid and the Faith-Based Initiative

2014 ◽  
Vol 32 (2) ◽  
pp. 53-77 ◽  
Author(s):  
Melinda Cooper
Keyword(s):  
Public Health ◽  
Foreign Aid ◽  
Service Providers ◽  
The United States ◽  
Sub Saharan Africa ◽  
Health Crisis ◽  
Emergency Relief ◽  
Faith Based ◽  
Social Authority ◽  
Sub Saharan

This article addresses the rise of faith-based emergency relief by examining the US President’s Emergency Plan for HIV/AIDS (PEPFAR), a public health intervention focused on the AIDS epidemic in sub-Saharan Africa. It argues that the theological turn in humanitarian aid serves to amplify ongoing dynamics in the domestic politics of sub-Saharan African states, where social services have assumed the form of chronic emergency relief and religious organizations have come to play an increasingly prominent role in the provision of such services. In the context of an ongoing public health crisis, PEPFAR has institutionalized the social authority of the Pentecostal and charismatic churches, leading to a semantic confluence between the postcolonial politics of emergency and the Pentecostal/Pauline theology of kairos or event. Far from being confined to the space of foreign aid, however, the faith-based turn in humanitarianism is in keeping with ongoing reforms in domestic social policy in the United States. While on the one hand the sustained welfare programmes of the New Deal and Great Society have been dismantled in favour of a system of emergency relief, on the other hand the federal government has intensified its moral, pedagogical and punitive interventions into the lives of the poor. The wilful transfer of welfare services to overtly religious service providers has played a decisive role in this process. The article concludes with a critical appraisal of the links between African and North American Pentecostal-evangelical churches and questions the revolutionary mission ascribed to Pauline political theology in recent political theory.

scholarly journals Angola - an Oil Dependant Country in Sub-Saharan Africa

2016 ◽  
Vol 9 (35) ◽  
pp. 233-242
Author(s):  
Boris Baumgartner
Keyword(s):  
South Africa ◽  
World Economy ◽  
Sub Saharan Africa ◽  
African Countries ◽  
The Third ◽  
The World ◽  
Sub Saharan ◽  
The One ◽  
Rich Countries ◽  
Essential Problem

Abstract The Sub-Saharan Africa belongs to the most underdeveloped regions in the world economy. This region consists of forty nine countries but it’s world GDP share is only a small percentage. There are some very resource rich countries in this region. One of them is Angola. This former Portuguese colony has one of the largest inventories of oil among all African countries. Angola recorded one of the highest growth of GDP between 2004-2008 from all countries in the world economy and nowadays is the third biggest economy in Sub-Saharan Africa after Nigeria and South Africa. The essential problem of Angola is the one-way oriented economy on oil and general on natural resources. Angola will be forced to change their one-way oriented economy to be more diversified and competitive in the future.

scholarly journals Evaluation of an ICD logging system to supplement an EMR in a Sub-Saharan country

2018 ◽  
Vol 7 (2) ◽  
pp. 8
Author(s):  
Araba A. Wubah ◽  
Jean A. Yankson ◽  
Cameron Sumpter ◽  
Fred Rawlins ◽  
Dean Sutphin ◽  
...  
Keyword(s):  
United States ◽  
Developing Country ◽  
Medical Center ◽  
The United States ◽  
Sub Saharan Africa ◽  
World Health ◽  
Medical Documentation ◽  
The World ◽  
Sub Saharan ◽  
College Of Osteopathic Medicine

Adoption of electronic medical records (EMRs) has been spotty and sluggish in the world, including the United States, despite the multiple benefits of medical technology and informatics. Though there are difficulties in establishing and maintaining an EMR system in a developing country, it is not impossible. The International Classification of Diseases (ICD) Logger, called CREDO (Clinical Rotation Evaluation and Documentation Organizer), developed by Edward Via College of Osteopathic Medicine (VCOM), provides a straightforward, economical EMR system to use in a developing country, such as Ghana. However, with a recently established EMR system developed locally and being used at the target new hospital, Healthwise Medical Center, the aim of the study was to use the common medical documentation language of the World Health Organization (WHO) ICD-10 codes to add value to the local EMR. This demonstration enabled the comparison of medical encounters in Ghana to those in the United States, specifically in Appalachia where VCOM students typically do their clinical rotations. We also evaluated the issues and tested the CREDO ICD Logger as a simple, stand-alone EMR system. Therefore, by collecting ICD data twice weekly from Ghana, a data point in Sub-Saharan Africa, it became possible to compare a public health snapshot of developing countries and sites in the United States.

Transforming the world order amid the emerging multipolarity: Evidence from the African continent

2020 ◽  
Vol 16 (11) ◽  
pp. 2180-2198
Author(s):  
A.M. Chernysheva
Keyword(s):  
South Africa ◽  
Foreign Trade ◽  
Global Economy ◽  
World Order ◽  
Development Trend ◽  
Economic Security ◽  
Sub Saharan Africa ◽  
The World ◽  
The Usa ◽  
Sub Saharan

Subject. As the world becomes more multipolar, global leaders change their approaches to capture the areas they dominate. Currently, advocates of the Western and Eastern models clash, with the latter demonstrating a greater efficiency. Objectives. I examine the foreign trade of the countries in Sub-Saharan Africa, including South Africa, assuming that the region's countries are teetering on the edge of the Western and Eastern approaches to determining the domination area of the leading country. Methods. The study is based on the systems approach, comparative and statistical methods for reviewing exports and imports of Sub-Saharan Africa, illustrating the case of South Africa. Results. As the global economy currently develops, the multipolar world and its emergence are showed to gain momentum, with Sub-Saharan Africa actively diversifying their foreign trade. I mention the way the USA, EU, China, India and Russia influence the region and evaluate development trends in south Africa's exports and imports, setting their further development trend. Notwithstanding the noticeable impact of the USA, Sub-Saharan Africa establish regional alliances and tend to follow the course of other States, with China becoming increasingly important. Conclusions and Relevance. Transforming the world order into the multipolar format, the third-world countries should diversify their foreign trade, following multiple vectors in their economic policy, thus ensuring their own economic security and an opportunity to raise their significance regionally and internationally.

The Reverse Transfer of Technology from Sub-Saharan Africa to the United States

1987 ◽  
Vol 25 (4) ◽  
pp. 597-612 ◽  
Author(s):  
Bernard I. Logan
Keyword(s):  
United States ◽  
The United States ◽  
Relative Volume ◽  
Sub Saharan Africa ◽  
Reverse Transfer ◽  
Transfer Of Technology ◽  
The World ◽  
Trained Personnel ◽  
Sub Saharan

This study documents and evaluates the so-called ‘brain drain’ from sub-Saharan Africa to the United States during the period 1974–85. The objective is to use the available data to provide some insights into the rôle of this region in the international labour market for trained personnel. This is done by comparing the relative volume, pattern, and trend of migration to the United States from a sample of 17 countries against that for Africa as a whole, and against that for the world. The rationale for this kind of analysis rests on the need to determine the significance for all concerned of the growing transfer of technology, and to identify the factors which control the process.

Music as an Archetype in the 'Collective Unconscious'

1997 ◽  
Vol 7 (3) ◽  
pp. 187-200
Author(s):  
Anthony Palmer ◽  
Keyword(s):  
Chinese Culture ◽  
The United States ◽  
Sub Saharan Africa ◽  
Collective Unconscious ◽  
Human Beings ◽  
Religious Symbolism ◽  
The World ◽  
Cultural Conditioning ◽  
Human Psyche ◽  
Sub Saharan

The making of music has been sufficiently deep and widespread diachronically and geographically to suggest a genetic imperative. C.G. Jung's 'Collective Unconscious' and the accompanying archetypes suggest that music is a psychic necessity because it is part of the brain structure. Therefore, the present view of aesthetics may need drastic revision, particularly on views of music as pleasure, ideas of disinterest, differences between so-called high and low art, cultural identity, cultural conditioning, and art-for-art's sake.All cultures, past and present, show evidence of music making. Music qua music has been a part of human expression for at least some forty-thousand years (Chailley 1964; viii) and it could well be speculated that the making of music (the voluntary effort to use tonal-temporal patterns in consistent form that are meant to express meaning) accompanied the arrival of the first human beings. As Curt Sachs states, "However far back we tracemankind, we fail to see the springing-up of music. Even the most primitive tribes are musically beyond the first attempts" (Sachs 1943; 20).Why do humans continuahy create music and include it as an integral part of culture? What is music's driving force? Why do cultures endow music with extraordinary powers? Why do human beings, individuahy and as societies, exercise preferences for specific works and genres of music? In probing these questions, I chose one aspect of Jungian psychology, that of the Collective Unconscious with its accompanying archetypes, as the basis upon which to speculate a world aesthetics of music. Once we dispense with the mechanistic and designer idea of human origins (Omstein 1991; Ch. 2), we have only the investigations of the human psyche to mine for data that could explain the myriad forms of artistic activity found the world over. An examination of human beings, I believe, must lead one ultimately to the study of human behavior and motivations, in short, to the psychology of human ethos (see, e.g., Campbell 1949 & 1976). This study wih take the following course: first, a discussion of consciousness and the Collective Unconscious, plus a discussion of archetypes; then, a description of musical archetypal substance; and finally, what I beheve is implied to form a world aesthetics of music.By comparison to Jung, Freud gives us little in the way of understanding artistic substance because for him, all artistic subject matter stems purely from the personal experiences of the artist. In comparing Freud and Jung, Stephen Larsen states that "Where Freud was deterministic, Jung was teleological; where Freud was historical, Jung was mythological" (Larsen 1992; 19). Jung drew on a much wider cross-cultural experiential and intellectual base than Freud (Philipson 1963; Part II, Sect. 1). His interests in so-cahed primitive peoples led him to Tunis, the Saharan Desert, sub-Saharan Africa, and New Mexico in the United States to visit the Pueblo Indians; visits to India and Ceylon and studies of Chinese culture all contributed to his vast knowledge of human experience. Jung constructed the cohective unconscious as a major part of the psyche with the deepest sense of tradition and myth from around the world. He was criticized because of his interests in alchemy, astrology, divination, telepathy and clairvoyance, yoga, spiritualism, mediums and seances, fortunetelling, flying saucers, religious symbolism, visions, and dreams. But he approached these subjects as a scientist, investigating the human psyche and what these subjects revealed about mental process, particularly what might be learned about the collective unconsciousness (Hall and Nordby 1973; 25 & Cohen 1975; Ch. 4). Jung's ideation, in my view, is sufficiently comprehensive to support the probe of a world aesthetics of music.

scholarly journals COVID-19 Crisis in Africa: Revisiting the Contributing Factors

2021 ◽  
Vol 1 (1) ◽  
pp. 64-67
Author(s):  
Ugochukwu A Eze ◽  
Kingsley I Ndoh ◽  
Kehinde K Kanmodi
Keyword(s):  
Disease Surveillance ◽  
Democratic Republic Of Congo ◽  
The United States ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
Contributing Factors ◽  
African Countries ◽  
The World ◽  
Control And Prevention ◽  
Sub Saharan

Abstract The COVID-19 pandemic has been a major threat to people and healthcare systems around the world. Each region of the world has had unique factors such as culture, demographics, socioeconomic and the political landscape that has either fueled or mitigated the severity of the pandemic. For example, the 2021 Indian Kumbh Mela festival fueled a devastating wave of the pandemic in India. Similarly, the pandemic in the United States has in part been fueled an epidemic of disinformation that led to a growing number of anti-vaxxers, and those who are opposed to COVID-19 prevention guidelines set by agencies like the Centers for Disease Control and Prevention. In Africa, burial practices in Liberia and the Democratic Republic of Congo once fueled the Ebola epidemic. Likewise, in the context of COVID-19, there are factors that are unique to Africa that may have either fueled or mitigated the severity of the pandemic. The anti-COVID-19 measures in many African countries significantly affected household income without commensurate deployment of palliative measures to cushion the effect. Fortunately, the pandemic has run a relatively milder course in sub-Saharan Africa—defying earlier devastating projections. Therefore, to be prepared for the next pandemic, African governments must involve critical stakeholders such as religious and traditional leaders, strengthen current disease surveillance systems and invest in systems that encourage private investments in local vaccine manufacturing.

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