Rotavirus

2021 ◽  
Author(s):  
Sultan Mahmood
Keyword(s):  
Rna Virus ◽  
Sub Saharan Africa ◽  
Oral Rehydration ◽  
Degree Of Protection ◽  
Rotavirus Vaccines ◽  
Increased Risk ◽  
Hygiene Measures ◽  
Primary Means ◽  
Sub Saharan ◽  
Health System Responsiveness

Rotavirus is a double-stranded RNA virus that causes vomiting and diarrhea among children under 5 years. The main cause of mortality from rotavirus gastroenteritis (RVGE) is dehydration if not corrected appropriately with oral rehydration salts (ORS). Though the prevalence of RVGE is similar across countries and socio-economic groups, the higher mortality in Sub-Saharan Africa and South Asia is presumably due to poor awareness and poor health system responsiveness rather than poor hygiene. Enzyme immunoassays are the most commonly used tools for diagnosis of RVGE from stool samples. ORS and zinc remain the mainstay of treatment. Water, sanitation and hygiene measures did not appear to be very effective leaving vaccination among young children as the primary means of prevention. 4 WHO prequalified live attenuated, oral vaccines are available with different efficacy in high- versus low-mortality countries. There is a high degree of protection in countries with low RV mortality, and lower protection in countries with high RV morbidity and more fatalities. Rotavirus vaccines were associated with intussusception, though larger trials failed to establish increased risk in vaccinated groups compared to placebo recipients.

Lung function in children with sickle cell disease from Central Africa

Thorax ◽  
2019 ◽  
Vol 74 (6) ◽  
pp. 604-606 ◽  
Author(s):  
Michele Arigliani ◽  
Robert Kitenge ◽  
Luigi Castriotta ◽  
Pathy Ndjule ◽  
Vincenzo Barbato ◽  
...  
Keyword(s):  
Lung Function ◽  
Sickle Cell ◽  
Sickle Cell Anaemia ◽  
Democratic Republic ◽  
Central Africa ◽  
Sub Saharan Africa ◽  
Increased Risk ◽  
Republic Of The Congo ◽  
Sub Saharan ◽  
Restrictive Pattern

Lung function in patients with sickle cell anaemia (SCA) living in sub-Saharan Africa is largely unknown. Anthropometry and spirometry were cross-sectionally evaluated in patients with SCA (HbSS) aged 6–18 years and in schoolchildren from the Democratic Republic of the Congo. The Global Lung Initiative 2012 spirometry reference values were used. A total of 112 patients and 377 controls were included. Twenty-six per cent of patients with SCA had spirometry findings suggestive of a restrictive pattern and 41% had a FEV1 z-score <5th percentile. Wasting, increasing age and female sex were independently associated with increased risk of restrictive spirometry pattern in patients with SCA. Longitudinal studies could clarify the prognostic meaning of these findings.

scholarly journals Malaria and risk of lymphoid neoplasms and other cancer: a nationwide population-based cohort study

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Katja Wyss ◽  
Fredrik Granath ◽  
Andreas Wångdahl ◽  
Therese Djärv ◽  
Michael Fored ◽  
...  
Keyword(s):  
Cox Regression ◽  
Health Agency ◽  
Malaria Diagnosis ◽  
B Cell Lymphoma ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Lymphoid Neoplasms ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Sub Saharan

Abstract Background Malaria is associated with Burkitt lymphoma among children in Sub-Saharan Africa. No longitudinal studies have assessed the long-term risk of other lymphoma or cancer overall. Here, we investigated the risk of lymphoid neoplasms and other cancer after malaria. Methods We included 4125 patients diagnosed with malaria in Sweden in 1987–2015, identified either through the National Surveillance Database at the Public Health Agency of Sweden, the National Inpatient and Outpatient Register, or by reports from microbiology departments. A comparator cohort (N = 66,997) matched on sex, age and birth region was retrieved from the general population and an additional cohort with all individuals born in Sub-Saharan Africa registered in the Total Population Register in 1987–2015 (N = 171,756). Incident lymphomas and other cancers were identified through linkage with the Swedish Cancer Register. Hazard ratios (HRs) were assessed using Cox regression with attained age as the timescale. Results A total of 20 lymphoid neoplasms and 202 non-haematological cancers were identified among malaria patients during a mean follow-up of 13.3 and 13.7 years, respectively. The overall risk of lymphoid neoplasms was not significantly increased (hazard ratio [HR] 1.24, 95% confidence interval [CI] 0.79–1.94), neither did we find any association with all-site non-haematological cancer (HR 0.89, 95% CI 0.77–1.02). However, in the Sub-Saharan Africa cohort, we observed an increased risk of lymphoid neoplasms after malaria diagnosis (HR 2.39, 95% CI 1.06–5.40), but no difference in the risk of other cancer (HR 1.01, 95% CI 0.70–1.45). The association could not be explained by co-infection with HIV or chronic hepatitis B or C, since the risk estimate was largely unchanged after excluding patients with these comorbidities (HR 2.63, 95% CI 1.08–6.42). The risk became more pronounced when restricting analyses to only including non-Hodgkin and Hodgkin lymphomas (HR 3.49, 95% CI 1.42–8.56). Conclusion Individuals born in malaria-endemic areas and diagnosed with malaria in Sweden had an increased risk of lymphoid neoplasms, especially B cell lymphoma. There was no association with cancer overall nor did single malaria episodes confer an increased risk in travellers.

scholarly journals Risk and protective factors for suicidal ideation and behaviour in Rwandan children

2015 ◽  
Vol 207 (3) ◽  
pp. 262-268 ◽  
Author(s):  
Lauren C. Ng ◽  
Catherine M. Kirk ◽  
Frederick Kanyanganzi ◽  
Mary C. Smith Fawzi ◽  
Vincent Sezibera ◽  
...  
Keyword(s):  
Mental Health ◽  
Suicidal Ideation ◽  
Mental Health Problems ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Hiv Status ◽  
Increased Risk ◽  
Matched Case ◽  
Sub Saharan ◽  
Control Study

BackgroundSuicide is a leading cause of death for young people. Children living in sub-Saharan Africa, where HIV rates are disproportionately high, may be at increased risk.AimsTo identify predictors, including HIV status, of suicidal ideation and behaviour in Rwandan children aged 10–17.MethodMatched case–control study of 683 HIV-positive, HIV-affected (seronegative children with an HIV-positive caregiver), and unaffected children and their caregivers.ResultsOver 20% of HIV-positive and affected children engaged in suicidal behaviour in the previous 6 months, compared with 13% of unaffected children. Children were at increased risk if they met criteria for depression, were at high-risk for conduct disorder, reported poor parenting or had caregivers with mental health problems.ConclusionsPolicies and programmes that address mental health concerns and support positive parenting may prevent suicidal ideation and behaviour in children at increased risk related to HIV.

scholarly journals Chemoprophylaxis and vaccination in preventing subsequent cases of meningococcal disease in household contacts of a case of meningococcal disease: a systematic review

2015 ◽  
Vol 143 (11) ◽  
pp. 2259-2268 ◽  
Author(s):  
L. TELISINGHE ◽  
T. D. WAITE ◽  
M. GOBIN ◽  
O. RONVEAUX ◽  
K. FERNANDEZ ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Ratio ◽  
Meningococcal Disease ◽  
Index Case ◽  
Sub Saharan Africa ◽  
Number Needed To Treat ◽  
Household Contacts ◽  
Increased Risk ◽  
Sub Saharan

SUMMARYHousehold contacts of an index case of invasive meningococcal disease (IMD) are at increased risk of acquiring disease. In revising WHO guidance on IMD in sub-Saharan Africa, a systematic review was undertaken to assess the effect of chemoprophylaxis and of vaccination in preventing subsequent cases of IMD in household contacts following an index case. A literature search for systematic reviews identified a single suitable review on chemoprophylaxis in 2004 (three studies meta-analysed). A search for primary research papers published since 2004 on chemoprophylaxis and without a date limit on vaccination was therefore undertaken. There were 2381 studies identified of which two additional studies met the inclusion criteria. The summary risk ratio for chemoprophylaxis vs. no chemoprophylaxis (four studies) in the 30-day period after a case was 0·16 [95% confidence interval (CI) 0·04-0·64, P = 0·008]; the number needed to treat to prevent one subsequent case was 200 (95% CI 111-1000). A single quasi-randomized trial assessed the role of vaccination. The risk ratio for vaccination vs. no vaccination at 30 days was 0·11 (95% CI 0·01–2·07, P = 0·14). The results support the use of chemoprophylaxis to prevent subsequent cases of IMD in household contacts of a case. Conclusions about the use of vaccination could not be drawn.

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 Helminths in South Africa: management of cestode and trematode infections in humans

2020 ◽  
pp. 33-38
Author(s):  
RL van Zyl
Keyword(s):  
South Africa ◽  
South African ◽  
Age Groups ◽  
Signs And Symptoms ◽  
Epidemiological Data ◽  
Sub Saharan Africa ◽  
The South ◽  
Increased Risk ◽  
Sub Saharan ◽  
The Impact

Sub-Saharan Africa has to contend with many challenges, including inadequate healthcare systems, lack of optimal sanitation, and clean water and food. All of these contribute to malnutrition and an increased risk of infections, including parasitism by cestodes and trematodes. Schistosomiasis is a category-2 notifiable trematode (fluke) infection, whereas cestode (tapeworm) infections need not be reported to the South African Department of Health. Epidemiological data for helminthiasis in South Africa is scant, with a paucity of publications on the South African scenario. As such, a complete picture of the impact of helminth infections on all age groups in South Africa does not exist. These parasitic diseases not only have an impact on socio economic development of a country, community and families, but also contribute to the chronic and detrimental effects on the health and nutritional status of the host, including the impaired development of children. In order to break the cycle of poverty and disease, a strong education drive is required in schools and communities to provide effective strategies and guidelines on preventative measures that result in avoidance of exposure to infective stages of Schistosoma and Taenia tapeworms. Also, it is imperative that healthcare professionals are able to recognise the signs and symptoms, so that interventions can be promptly initiated. The current anthelmintic treatments available in South Africa are effective against cestodes and trematodes, with no drug resistance having being reported. The need for compliancy when taking anthelmintic drugs must be emphasised.

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 Generation of Simian Rotavirus Reassortants with VP4- and VP7-Encoding Genome Segments from Human Strains Circulating in Africa Using Reverse Genetics

Viruses ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 201 ◽  
Author(s):  
Alexander Falkenhagen ◽  
Corinna Patzina-Mehling ◽  
Ashish K. Gadicherla ◽  
Amy Strydom ◽  
Hester G. O’Neill ◽  
...  
Keyword(s):  
Cell Culture ◽  
Disease Burden ◽  
Reverse Genetics ◽  
Sub Saharan Africa ◽  
Rotavirus A ◽  
Virus Particles ◽  
Rotavirus Vaccines ◽  
Human Rotavirus ◽  
Sub Saharan ◽  
Infants And Young Children

Human rotavirus A (RVA) causes acute gastroenteritis in infants and young children. The broad use of two vaccines, which are based on RVA strains from Europe and North America, significantly reduced rotavirus disease burden worldwide. However, a lower vaccine effectiveness is recorded in some regions of the world, such as sub-Saharan Africa, where diverse RVA strains are circulating. Here, a plasmid-based reverse genetics system was used to generate simian RVA reassortants with VP4 and VP7 proteins derived from African human RVA strains not previously adapted to cell culture. We were able to rescue 1/3 VP4 mono-reassortants, 3/3 VP7 mono-reassortants, but no VP4/VP7 double reassortant. Electron microscopy showed typical triple-layered virus particles for the rescued reassortants. All reassortants stably replicated in MA-104 cells; however, the VP4 reassortant showed significantly slower growth compared to the simian RVA or the VP7 reassortants. The results indicate that, at least in cell culture, human VP7 has a high reassortment potential, while reassortment of human VP4 from unadapted human RVA strains with simian RVA seems to be limited. The characterized reassortants may be useful for future studies investigating replication and reassortment requirements of rotaviruses as well as for the development of next generation rotavirus vaccines.

Hospital-acquired gastroenteritis at a referral hospital in Gaborone, Botswana

2017 ◽  
Vol 13 (2) ◽  
Author(s):  
Henry Welch ◽  
David M. Goldfarb ◽  
Banno Moorad ◽  
Margaret Mokomane ◽  
Marek Smieja ◽  
...  
Keyword(s):  
Adverse Outcomes ◽  
Sub Saharan Africa ◽  
Severe Malnutrition ◽  
Oral Rehydration ◽  
History Of ◽  
Rehydration Solution ◽  
The Mean ◽  
Sub Saharan ◽  
Hospital Acquired ◽  
Monthly Incidence

Background: Hospital-acquired infections, including hospital-acquired gastroenteritis (HAGE), are well documented in Western countries but little is known about these infections in sub-Saharan Africa. Aim: To determine the incidence of and explore modifiable risk factors for HAGE. Methods: A prospective cohort study of children 72 hours after admission or upon admission after recent discharge for a non-GE illness. Children were followed until discharge to ascertain therapies used and adverse outcomes. Enteric pathogens were identified by multiplex PCR. Findings: Virtually all of the 32 children with HAGE were < 2 years (n=30, 94%) and most were male (n=19, 59%). Few had HIV infection (n=6, 19%), severe malnutrition (n=8, 25%), or a history of vitamin A use in the past 6 months (n=2, 6%). The mean monthly incidence of HAGE was 2.3 per 1000 patient days, and associated with the monthly number of community-acquired gastroenteritis (CAGE) admissions (IRR 1.02, 95% CI 1.00, 1.04, p=0.025). A stool pathogen was detected in 15/27 (56%) children, including norovirus (n=7, 26%) and rotavirus (n=5, 18%). Most children received oral rehydration solution (n=26, 81%), or IV fluids (n=9, 28%). Antibiotics were administered to 5 (16%) children. Two (6%) children with HAGE were admitted to the ICU and 4 (12%) died. Conclusions: We found HAGE was relatively common and associated with severe outcomes. The monthly incidence of HAGE was associated with CAGE admissions. Common pathogens included norovirus and rotavirus.

Effects of parental psychiatric and physical illness on child development

2012 ◽  
pp. 1752-1758
Author(s):  
Paul Ramchandani ◽  
Alan Stein ◽  
Lynne Murray
Keyword(s):  
Significant Proportion ◽  
Postnatal Period ◽  
Physical Illness ◽  
Sub Saharan Africa ◽  
Adult Disease ◽  
Psychiatric Illnesses ◽  
Physical Conditions ◽  
The United Kingdom ◽  
Increased Risk ◽  
Sub Saharan

A broad range of physical and psychiatric illnesses commonly affect adults of parenting age. For example, approximately 13 per cent of women are affected by depression in the postnatal period, and the prevalence of depression in parents of all ages remains high. Many parents will also experience severe physical illness; breast cancer affects approximately 1 in 12 women in the United Kingdom, about a third of whom have children of school age. Worldwide HIV has an enormous impact on adults of parenting age. In some parts of sub-Saharan Africa up to 40 per cent of women attending antenatal clinics are HIV positive. Many of these parental disorders are associated with an increased risk of adverse emotional and social development in their children, and in some cases cognitive development and physical health are also compromized. It must be emphasized that a significant proportion of children at high risk do not develop problems and demonstrate resilience, and, many parents manage to rear their children well despite their own illness. Nonetheless these risks represent a significant additional impact and burden of adult disease (both physical and psychiatric) that is often overlooked. This chapter reviews the current state of evidence regarding selected examples of psychiatric and physical conditions, from which general themes can be extracted to guide clinical practice. Some of the key mechanisms whereby childhood disturbance does or does not develop in conjunction with parental illness are considered, and strategies for management and intervention reviewed.

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