scholarly journals Vulnerable groups at increased risk of COVID-19 in sub-Saharan Africa: The case of the HIV population

2020 ◽  
Author(s):  
Marília Nepomuceno
Keyword(s):  
Latin America ◽  
Age Structure ◽  
Risk Profile ◽  
Sub Saharan Africa ◽  
Vulnerable Groups ◽  
High Burden ◽  
Increased Risk ◽  
High Prevalence ◽  
Sub Saharan ◽  
Living With Hiv

More recently, COVID-19 infection is advancing fast towards different settings. Regions with a high burden of infectious diseases such as HIV, malaria, and dengue including Latin America and Africa are experiencing an increasing number of confirmed cases and deaths. Since the age structure and the distribution of relevant co-morbidities varies substantially by country, the risk profile for COVID-19 could be very different in countries with high prevalence of individuals living with HIV.

scholarly journals Vulnerable groups at increased risk of COVID-19 in sub-Saharan Africa: The case of the HIV population

2020 ◽  
Author(s):  
Marília Nepomuceno
Keyword(s):  
Latin America ◽  
Age Structure ◽  
Risk Profile ◽  
Sub Saharan Africa ◽  
Vulnerable Groups ◽  
High Burden ◽  
Increased Risk ◽  
High Prevalence ◽  
Sub Saharan ◽  
Living With Hiv

More recently, the COVID-19 infection is advancing fast towards different settings. Regions with a high burden of infectious diseases such as HIV, malaria, and dengue including Latin America and Africa are experiencing an increasing number of confirmed cases and deaths. Since the age structure and the distribution of relevant co-morbidities varies substantially by country, the risk profile for COVID-19 could be very different in countries with high prevalence of individuals living with HIV.

scholarly journals Management of TB/HIV co-infection: the state of the evidence

2020 ◽  
Vol 54 (3) ◽  
pp. 186-196
Author(s):  
Kwasi Torpey ◽  
Adwoa Agyei-Nkansah ◽  
Lily Ogyiri ◽  
Audrey Forson ◽  
Margaret Lartey ◽  
...  
Keyword(s):  
National Level ◽  
Hiv Treatment ◽  
The State ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Increased Risk ◽  
Mdr Tb ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Hiv Negative

Tuberculosis (TB) and HIV are strongly linked. There is a 19 times increased risk of developing active TB in people living with HIV than in HIV-negative people with Sub-Saharan Africa being the hardest hit region. According to the WHO, 1.3 million people died from TB, and an additional 300,000 TB-related deaths among people living with HIV. Although some progress has been made in reducing TB-related deaths among people living with HIV due to the evolution of diagnostics, treatment and antiretroviral HIV treatment, multi drug resistant TB is becoming a source of worry. Though significant progress has been made at the national level, understanding the state of the evidence and the challenges will better inform the national response of the opportunities for improved patient outcomes.Keywords: Tuberculosis, management, HIV, MDR TB, GhanaFunding: None

scholarly journals Risk for COVID-19 among Migrants from different areas of the World in Spain: A population-based cohort study in a country with universal health coverage

2020 ◽  
Author(s):  
Carlos Guijarro ◽  
Elia Pérez-Fernández ◽  
Beatriz González-Piñeiro ◽  
Victoria Meléndez ◽  
Maria José Goyanes ◽  
...  
Keyword(s):  
Latin America ◽  
Universal Health Coverage ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Health Coverage ◽  
Relative Risks ◽  
Increased Risk ◽  
The World ◽  
Sub Saharan ◽  
Universal Health

AbstractObjectiveTo evaluate the COVID-19 incidence among migrants from different areas of the world as compared to Spaniards living in AlcorcónDesignPopulation-based cohort analysis of the cumulative incidence of PCR-confirmed COVID-19 cases until April 25 (2020) among adult residents at Alcorcón (Spain) attended at the only public hospital serving this city. Crude incident rates for Spaniards and migrants from different areas of the world were estimated. Age and sex-adjusted relative risks for COVID19 were estimated by negative bomial regression.SettingUniversity public Hospital at Alcorcón, Madrid, SpainParticipantsAll adult residents living in Alcorcon classified by their country and region of the world of origin.Main outcomePCR confirmed COVID-19.ResultsPCR confirmed COVID-19 cumulative incidence was 6.81 cases per 1000 inhabitants among residents of Alcorcón. The crude incidence among migrants (n=20419) was higher than among Spaniards (n=131599): 8.81 and 6.51 and per 1000 inhabitants respectively (p<0.001).By regions of the world, crude cumulative COVID-19 incidence rates were: European Union 2.38, Asia 2.01,, Northern Africa 3.59, East ern Europe 4.37, Sub-Saharan Africa 11.24, Caribbean 18.26 and Latin-America 20.77 8 per 1000 inhabitants. Migrant residents were markedly younger than Spaniards (median age 52 vs 73 years, p<0.001). By negative binomial regression, adjusted for age and sex, relative risks (RR) for COVID-19 were not significantly different from Spaniards for individuals from Europe, Asia or Northern Africa. In contrast, there was an increased risk for Sub-Saharan Africa (RR 3.66, 95% confidence interval (CI) 1.42-9.41, p=0.007), Caribbean (RR 6.35, 95% CI 3.83-10.55, p<0.001) and Latin-America (RR 6.92, 95% CI 4.49-10.67, p <0.001).ConclusionsThere was a marked increased risk for COVID-19 among migrants from Sub-Saharan Africa, Caribbean and Latin-America residing in Spain. The reasons underlying this increased risk and health and social implications deserve further attention.What is known about the topicRecent reports suggest an increased burden of COVID-19 among migrants or ethnic minorities in the United Kingdom and the USA, particularly regarding mortality. Reports have failed to dissociate clinical outcomes from differences in access to medical care or pre-existing medical conditions. There is no information regarding COVID risk for latinos in countries with universal health coverageWhat this study addMigrants from subsaharian Africa resident in Spain exhibit an increased risk for COVID-19. This risk is further increased for migrants from the Caribbean and Latin-America and cannot be attributed to unequal access to medical care. Studies in countries with universal health coverage may help to dissociate COVID burden in migrants and ethnic populations from access to health care.

scholarly journals Factors associated with unsuppressed viremia in women living with HIV on lifelong ART in a multi-country cohort study: US-PEPFAR PROMOTE study

2019 ◽  
Author(s):  
Patience Atuhaire ◽  
Sherika Hanley ◽  
Nonhlanhla Yende-Zuma ◽  
Jim Aizire ◽  
Lynda Stranix-Chibanda ◽  
...  
Keyword(s):  
Cohort Study ◽  
Scale Up ◽  
Sub Saharan Africa ◽  
African Women ◽  
Targeted Interventions ◽  
Factors Associated ◽  
Women Living With Hiv ◽  
Increased Risk ◽  
Sub Saharan ◽  
Living With Hiv

AbstractBackgroundDespite recent efforts to scale-up lifelong combination antiretroviral therapy (cART) in sub-Saharan Africa, high rates of unsuppressed viremia persist among cART users, and many countries in the region fall short of the UNAIDS 2020 target to have 90% virally suppressed. We sought to determine the factors associated with unsuppressed viremia (defined for the purpose of this study as >200 copies/ml) among African women on lifelong cART.MethodsThis analysis was based on baseline data of the PROMOTE longitudinal cohort study at 8 sites in Uganda, Malawi, Zimbabwe and South Africa. The study enrolled 1987 women living with HIV who initiated lifelong cART at least 1 year previously to assesses long-term safety and effectiveness of cART. Socio-demographic, clinical, and cART adherence data were collected. We used multivariable Poisson regression with robust variance to identify factors associated with unsuppressed viremia.ResultsAt enrolment, 1947/1987 (98%) women reported taking cART. Of these, HIV-1 remained detectable in 293/1934 (15%), while 216/1934 (11.2%) were considered unsuppressed (>200 copies/ml). The following factors were associated with an increased risk of unsuppressed viremia: not having household electricity (adjusted prevalence rate ratio (aPRR) 1.74, 95% confidence interval (CI) 1.28-2.36, p<0.001); self-reported missed cART doses (aPRR 1.63, 95% CI 1.24-2.13, p<0.001); recent hospitalization (aPRR 2.48, 95% CI 1.28-4.80, p=0.007) and experiencing abnormal vaginal discharge in the last three months (aPRR 1.88; 95% CI 1.16-3.04, p=0.010). Longer time on cART (aPRR 0.75, 95% CI 0.64-0.88, p<0.001) and being older (aPRR 0.77, 95% CI 0.76-0.88, p<0.001) were associated with reduced risk of unsuppressed viremia.ConclusionSocioeconomic barriers such as poverty, not being married, young age, and self-reported missed doses remain key predictors of unsuppressed viremia. Targeted interventions are needed to improve cART adherence among women living with HIV with this risk factor profile.

Human rights education and the plight of vulnerable groups with specific reference to people with albinism in Tanzania

2020 ◽  
Vol 20 (2-3) ◽  
pp. 137-155
Author(s):  
John Cantius Mubangizi ◽  
Ines Kajiru
Keyword(s):  
Human Rights ◽  
Legal Framework ◽  
Sub Saharan Africa ◽  
Vulnerable Groups ◽  
Human Rights Education ◽  
Specific Reference ◽  
Human Beings ◽  
High Prevalence ◽  
The World ◽  
Sub Saharan

Although all human beings are vulnerable, some are more vulnerable than others, for example, people with albinism. Similarly, although albinism occurs in all parts of the world, it is more prevalent in some societies than in others. For example, Tanzania, in common with other countries in sub-Saharan Africa, has a high prevalence of albinism. Apart from being subjected to blatant discrimination and abuse, people with albinism suffer atrocious attacks sometimes resulting in death. This paper explores the nature and extent of discrimination and human rights violations of people with albinism in Tanzania in the context of the relevant legal framework available for their protection. Using people with albinism in Tanzania as a proxy, the paper argues that there is a need for human rights education not only to empower vulnerable people to defend and protect their rights but also to sensitize societies to respect and not violate the rights of such people. The paper concludes with several recommendations that apply to people with albinism in Tanzania as much as they would apply to any vulnerable group anywhere else in the world.

The burden and risk factors for postnatal depression and depressive symptomatology among women in Kampala

2019 ◽  
Vol 49 (3) ◽  
pp. 170-177 ◽  
Author(s):  
Margaret Nampijja ◽  
Barnabas Natamba ◽  
Richard Mpango ◽  
Eugene Kinyanda
Keyword(s):  
Risk Factors ◽  
Partner Violence ◽  
Depressive Symptomatology ◽  
Sub Saharan Africa ◽  
Increased Risk ◽  
High Prevalence ◽  
Postnatal Women ◽  
Postnatal Mothers ◽  
Dsm Iv ◽  
Sub Saharan

Major depressive disorder (MDD) is a major global health challenge and postnatal women may be at an increased risk for this disorder. Very few studies have tested this hypothesis in sub-Saharan Africa (SSA), so it is uncertain whether risk factors implicated elsewhere in the world are relevant in SSA. We explored prevalence and risk factors for MDD and depressive symptomatology among postnatal mothers in Kampala. Three hundred postnatal mothers at Nsambya Hospital were assessed for MDD using the DSM IV-based MINI; prevalence and risk factors were determined using frequencies and regressions, respectively. Four women (1.33%) had MDD; however, 94 (31%) had ‘sub-threshold’ or depressive symptomatology, with which partner violence is particularly associated. MDD is rare among postnatal women in a paying hospital in Kampala; however, the high prevalence of depressive symptomatology suggests susceptibility to MDD. Longitudinal studies should investigate this hypothesis and the susceptibility due to partner violence should guide appropriate interventions.

Christianity in the Twentieth Century

2019 ◽  
Author(s):  
Brian Stanley
Keyword(s):  
Latin America ◽  
Racial Identity ◽  
Sub Saharan Africa ◽  
Central Importance ◽  
Regional Survey ◽  
History Of Christianity ◽  
The World ◽  
History Of ◽  
Sub Saharan ◽  
Different Parts

This book charts the transformation of one of the world's great religions during an age marked by world wars, genocide, nationalism, decolonization, and powerful ideological currents, many of them hostile to Christianity. The book traces how Christianity evolved from a religion defined by the culture and politics of Europe to the expanding polycentric and multicultural faith it is today—one whose growing popular support is strongest in sub-Saharan Africa, Latin America, China, and other parts of Asia. The book sheds critical light on themes of central importance for understanding the global contours of modern Christianity, illustrating each one with contrasting case studies, usually taken from different parts of the world. Unlike other books on world Christianity, this one is not a regional survey or chronological narrative, nor does it focus on theology or ecclesiastical institutions. The book provides a history of Christianity as a popular faith experienced and lived by its adherents, telling a compelling and multifaceted story of Christendom's fortunes in Europe, North America, and across the rest of the globe. It demonstrates how Christianity has had less to fear from the onslaughts of secularism than from the readiness of Christians themselves to accommodate their faith to ideologies that privilege racial identity or radical individualism.

Coalitional Presidentialism in Cross-Regional Perspective

2018 ◽  
Author(s):  
Paul Chaisty ◽  
Nic Cheeseman ◽  
Timothy J. Power
Keyword(s):  
Latin America ◽  
Soviet Union ◽  
Former Soviet Union ◽  
Sub Saharan Africa ◽  
The Political ◽  
Political Landscape ◽  
Case Selection ◽  
Sub Saharan ◽  
Empirical Material ◽  
Regional Perspective

This chapter introduces the three regions—sub-Saharan Africa, Latin America, and the Former Soviet Union—and the nine countries—Armenia, Benin, Brazil, Chile, Ecuador, Kenya, Malawi, Russia, and Ukraine—that provide the empirical material for the book. It introduces the two criteria used for case selection: 1) democratic competitiveness; 2) de jure and de facto constitutional provisions that empower presidents to be coalitional formateurs. It also introduces a variable that measures the salience of cross-party cooperation: the Index of Coalitional Necessity. Finally, it sketches the political landscape that has shaped the dynamics of coalitional presidentialism within each region, and it draws attention to important contextual differences between the nine country cases.

scholarly journals Multiple Mammarenaviruses Circulating in Angolan Rodents

Viruses ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 982
Author(s):  
Jana Těšíková ◽  
Jarmila Krásová ◽  
Joëlle Goüy de Bellocq
Keyword(s):  
Geographical Area ◽  
Sub Saharan Africa ◽  
Virus Diversity ◽  
High Prevalence ◽  
Biogeographical Regions ◽  
Sub Saharan ◽  
Rodent Community ◽  
High Virus ◽  
Almost All ◽  
Virus Genomes

Rodents are a speciose group of mammals with strong zoonotic potential. Some parts of Africa are still underexplored for the occurrence of rodent-borne pathogens, despite this high potential. Angola is at the convergence of three major biogeographical regions of sub-Saharan Africa, each harbouring a specific rodent community. This rodent-rich area is, therefore, strategic for studying the diversity and evolution of rodent-borne viruses. In this study we examined 290 small mammals, almost all rodents, for the presence of mammarenavirus and hantavirus RNA. While no hantavirus was detected, we found three rodent species positive for distinct mammarenaviruses with a particularly high prevalence in Namaqua rock rats (Micaelamys namaquensis). We characterised four complete virus genomes, which showed typical mammarenavirus organisation. Phylogenetic and genetic distance analyses revealed: (i) the presence of a significantly divergent strain of Luna virus in Angolan representatives of the ubiquitous Natal multimammate mouse (Mastomys natalensis), (ii) a novel Okahandja-related virus associated with the Angolan lineage of Micaelamys namaquensis for which we propose the name Bitu virus (BITV) and (iii) the occurrence of a novel Mobala-like mammarenavirus in the grey-bellied pygmy mouse (Mus triton) for which we propose the name Kwanza virus (KWAV). This high virus diversity in a limited host sample size and in a relatively small geographical area supports the idea that Angola is a hotspot for mammarenavirus diversity.

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