scholarly journals Host Blood Gene Signatures Can Detect the Progression to Severe and Cerebral Malaria

2021 ◽  
Vol 11 ◽  
Author(s):  
Mohamed Omar ◽  
Luigi Marchionni ◽  
Georg Häcker ◽  
Mohamed Tarek Badr
Keyword(s):  
Cerebral Malaria ◽  
Cohort Analysis ◽  
Public Health Problem ◽  
Machine Learning Algorithms ◽  
Sub Saharan Africa ◽  
Diagnostic Tools ◽  
Diagnostic Biomarkers ◽  
Gene Signatures ◽  
Sub Saharan ◽  
Host Blood

Malaria is a major international public health problem that affects millions of patients worldwide especially in sub-Saharan Africa. Although many tests have been developed to diagnose malaria infections, we still lack reliable diagnostic biomarkers for the identification of disease severity, especially in endemic areas where the diagnosis of cerebral malaria is very difficult and requires the exclusion of all other possible causes. Previous host and pathogen transcriptomic studies have not yielded homogenous results that can be harnessed into a reliable diagnostic tool. Here we utilized a multi-cohort analysis approach using machine-learning algorithms to identify blood gene signatures that can distinguish severe and cerebral malaria from moderate and non-cerebral cases. Using a Regularized Random Forest model, we identified 28-gene and 32-gene signatures that can reliably distinguish severe and cerebral malaria, respectively. We tested the specificity of both signatures against other common infectious diseases to ensure the signatures reliability and suitability as diagnostic markers. The severe and cerebral malaria gene-signatures were further integrated through k-top scoring pairs classifiers into ten and nine gene pairs that could distinguish severe and cerebral malaria, respectively. These signatures have various implications that can be utilized as blood diagnostic tools for malaria severity in endemic countries.

scholarly journals Low levels of frailty in HIV-positive older adults on antiretroviral therapy in northern Tanzania

2021 ◽  
Author(s):  
Clare Bristow ◽  
Grace George ◽  
Grace Hillsmith ◽  
Emma Rainey ◽  
Sarah Urasa ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
High Standard ◽  
Female Gender ◽  
Screening Tools ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Diagnostic Tools ◽  
Clinical Frailty Scale ◽  
Frailty Phenotype ◽  
Sub Saharan

Abstract There are over 3 million people in sub-Saharan Africa (SSA) aged 50 and over living with HIV. HIV and combined antiretroviral therapy (cART) exposure may accelerate the ageing in this population, and thus increase the prevalence of premature frailty. There is a paucity of data on the prevalence of frailty in an older HIV + population in SSA and screening and diagnostic tools to identify frailty in SSA. Patients aged ≥ 50 were recruited from a free Government HIV clinic in Tanzania. Frailty assessments were completed, using 3 diagnostic and screening tools: the Fried frailty phenotype (FFP), Clinical Frailty Scale (CFS) and Brief Frailty Instrument for Tanzania (B-FIT 2). The 145 patients recruited had a mean CD4 + of 494.84 cells/µL, 99.3% were receiving cART and 72.6% were virally suppressed. The prevalence of frailty by FFP was 2.758%. FFP frailty was significantly associated with female gender (p = 0.006), marital status (p = 0.007) and age (p = 0.038). Weight loss was the most common FFP domain failure. The prevalence of frailty using the B-FIT 2 and the CFS was 0.68%. The B-FIT 2 correlated with BMI (r = − 0.467, p = 0.0001) and CD4 count in females (r = − 0.244, p = 0.02). There is an absence of frailty in this population, as compared to other clinical studies. This may be due to the high standard of HIV care at this Government clinic. Undernutrition may be an important contributor to frailty. It is unclear which tool is most accurate for detecting the prevalence of frailty in this setting as levels of correlation are low.

scholarly journals Readiness of Sub-Saharan Africa Healthcare Systems for the New Pandemic, Diabetes: A Systematic Review

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Bernardo Nuche-Berenguer ◽  
Linda E. Kupfer
Keyword(s):  
Systematic Review ◽  
Health Systems ◽  
Diabetes Care ◽  
Healthcare Workers ◽  
Scale Up ◽  
Sub Saharan Africa ◽  
Diagnostic Tools ◽  
Inclusion Criteria ◽  
Care Health ◽  
Sub Saharan

Background. Effective health systems are needed to care for the coming surge of diabetics in sub-Saharan Africa (SSA). Objective. We conducted a systematic review of literature to determine the capacity of SSA health systems to manage diabetes. Methodology. We used three different databases (Embase, Scopus, and PubMed) to search for studies, published from 2004 to 2017, on diabetes care in SSA. Results. Fifty-five articles met the inclusion criteria, covering the different aspects related to diabetes care such as availability of drugs and diagnostic tools, the capacity of healthcare workers, and the integration of diabetes care into HIV and TB platforms. Conclusion. Although chronic care health systems in SSA have developed significantly in the last decade, the capacity for managing diabetes remains in its infancy. We identified pilot projects to enhance these capacities. The scale-up of these pilot interventions and the integration of diabetes care into existing robust chronic disease platforms may be a feasible approach to begin to tackle the upcoming pandemic in diabetes. Nonetheless, much more work needs to be done to address the health system-wide deficiencies in diabetes care. More research is also needed to determine how to integrate diabetes care into the healthcare system in SSA.

scholarly journals A brief review on features of falciparum malaria during pregnancy

2017 ◽  
Author(s):  
Alexandre Manirakiza ◽  
Eugène Serdouma ◽  
Richard Norbert Ngbalé ◽  
Sandrine Moussa ◽  
Samuel Gondjé ◽  
...  
Keyword(s):  
Falciparum Malaria ◽  
Public Health Problem ◽  
Malaria In Pregnancy ◽  
Sub Saharan Africa ◽  
Malaria During Pregnancy ◽  
Concurrent Infections ◽  
Tropical Areas ◽  
Sub Saharan ◽  
Protection Against Infection ◽  
In Pregnancy

Malaria in pregnancy is a serious public health problem in tropical areas. Frequently, the placenta is infected by accumulation of Plasmodium falciparum-infected erythrocytes in the intervillous space. Falciparum malaria acts during pregnancy by a range of mechanisms, and chronic or repeated infection and co-infections have insidious effects. The susceptibility of pregnant women to malaria is due to both immunological and humoral changes. Until a malaria vaccine becomes available, the deleterious effects of malaria in pregnancy can be avoided by protection against infection and prompt treatment with safe, effective antimalarial agents; however, concurrent infections such as with HIV and helminths during pregnancy are jeopardizing malaria control in sub-Saharan Africa.

scholarly journals Factors associated with oral cavity cancers in Sub-Saharan Africa: Summary of the literature

2021 ◽  
Vol 1 (2) ◽  
pp. 34-41
Author(s):  
A Dieng ◽  
AD Faye ◽  
MM Ndiaye ◽  
G Diop ◽  
A Bouazé ◽  
...  
Keyword(s):  
Oral Cavity ◽  
Public Health Problem ◽  
Epidemiological Data ◽  
Sub Saharan Africa ◽  
Factors Associated ◽  
Manual Search ◽  
African Populations ◽  
Localization Strategy ◽  
Sub Saharan ◽  
Oral Cavity Cancers

INTRODUCTION: Oral cavity cancers are now a public health problem according to WHO epidemiological data. There are several risk factors or factors associated with cancers of the oral cavity but they vary according to geographic regions. OBJECTIVE: The objective of this study was to identify factors associated with cancers of the oral cavity in Sub-Saharan African populations through a systematic literature review. METHODOLOGY: Using the data available for the period from January 1980 to December 2019, a synthesis of the literature was carried out. The literature localization strategy included an electronic search of the MEDLINE, EMBASE and GOOGLE SCHOLAR databases from 1980 to 2019 and a manual search of the list of references of articles identified by snowballing. The data were extracted independently by two researchers on an Excel© spreadsheet. Parameters collected from each study were author, country, type of study, period of study, size, age, gender, and factors studied. RESULTS: Out of 1,318 articles found, 24 were selected. The data contained 17,290 patients including 8,229 men, i.e. a male / female sex-ratio of 0.91. Factors studied were tobacco, alcohol, diet, infection, genetics and social factors. CONCLUSION: The results reported showed that several factors are associated with the occurrence of oral cavity cancers in Sub-Saharan Africa. There is a need to conduct further studies with more structured methodologies for more convincing results.

scholarly journals Prise En Charge Des Péritonites Aiguës Dans Un Hôpital De District En Afrique Sub-saharienne : Cas Du Bénin

2017 ◽  
Vol 13 (36) ◽  
pp. 388
Author(s):  
Bio Tamou Sambo ◽  
Salako Alexandre Allodé ◽  
Didier Sewadé Wekpon ◽  
Djifid Morel Séto ◽  
Montcho Adrien Hodonou ◽  
...  
Keyword(s):  
Mortality Rate ◽  
District Hospital ◽  
Public Health Problem ◽  
Sub Saharan Africa ◽  
Prise En Charge ◽  
Prospective Data ◽  
Acute Peritonitis ◽  
Generalized Peritonitis ◽  
Sub Saharan ◽  
Surgery Department

Introduction: Peritonitis remains a public health problem in Africa. We aim to describe the epidemiological, etiological and therapeutic aspects of acute peritonitis in a district hospital in Sub Saharan Africa. Methods: This was a descriptive study with prospective data collection over a period of 15 months from May 1 st 2015 to July 31st 2016 in Bembereke district hospital. It has taken into account all the patients managed in the general surgery department for acute generalized peritonitis that has been confirmed at laparotomy. Results: Fifty-three patients, 38 men (71.7 %) and 15 women (28.3 %) had been registered. The average age of the patients was 19.8 ± 16.9 years. The main etiologies were: non-traumatic ileal perforation from typhoid infection 52.8%; perforated gastric or duodenal ulcer 17%; complicated appendicitis and abdominal traumas 11.3% each one. Twenty nine patients (54.7%) have been operated by a surgeon and the 24 remaining (45.3%) by a general practitioner with surgical skills. Twenty one patients (39.6%) had postoperative complications of which 11 cases of parietal suppurations (52.4%). The mortality rate was 11.3%. The mean hospital stay was 22.5 ± 4 days. Conclusion: In northern-Benin, peritonitis remains dominated by the complications of typhoid fever. The mortality rate remains high. Prevention requires good hygiene and awareness of early consultations.

scholarly journals Prevalence of Anemia and Undernutrition of Adolescent Females in Selected Schools in Ghana

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Marina Aferiba Tandoh ◽  
Abigail Owusuaa Appiah ◽  
Anthony Kwaku Edusei
Keyword(s):  
Public Health Problem ◽  
Cross Sectional Study ◽  
Adolescent Females ◽  
Sub Saharan Africa ◽  
Health And Wellness ◽  
Cross Sectional ◽  
High Prevalence ◽  
Sub Saharan ◽  
Poor Nutrition ◽  
Prevalence Of Anemia

Anemia among adolescent females is a major worldwide public health problem which should be given appropriate attention. Half of all anemic cases are caused by iron deficiency. In addition to anemia, poor nutrition is also a challenge in sub-Saharan Africa. This study determined the prevalence of anemia and undernutrition among adolescent females in school. A cross-sectional study was conducted among 151 adolescent females in four basic schools in the Ahafo region of Ghana. The hemoglobin level and anthropometry measures of participants were taken to determine their anemic and nutritional status. The prevalence of anemia among adolescent females in school was 50.3%. Out of the 151 participants, 6.6%, 19.9%, and 23.8% were severely anemic, moderately anemic, or mildly anemic, respectively. Only 2% of the participants were underweight, but the rate of stunting was 26.5%. The notable high prevalence of anemia that was found among adolescent females was correlated with other health and wellness concerns. Anemia and under nutrition negatively affect academic performance, productivity, and general wellbeing of adolescents; therefore, effective measures should be put in place to correct and eradicate these nutritional problems.

scholarly journals The prevalence of scabies in Monrovia, Liberia: a population-based survey

2020 ◽  
Author(s):  
Shelui Collinson ◽  
Joseph Timothy ◽  
Samuel K Zayay ◽  
Karsor K Kollie ◽  
Eglantine Lebas ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Health Problem ◽  
Public Health Problem ◽  
Sub Saharan Africa ◽  
Quality Data ◽  
Local Health ◽  
Sub Saharan ◽  
The Impact

AbstractBackgroundScabies is known to be a public health problem in many settings but the majority of recent data is from rural settings in the Pacific. There is a need for high quality data from sub-Saharan Africa and peri-Urban settings to inform scale up of scabies control efforts. There have been anecdotal reports of scabies being a public health problem in Liberia but robust data are lacking.MethodsWe conducted a cross-sectional cluster-randomised prevalence survey for scabies in a peri-urban community in Monrovia, Liberia in February-March 2020. Participants underwent a standardised examination conducted by trained local health care workers. Health related quality of life (HRQoL) was assessed using age-appropriate dermatology life quality indices (DLQIs). Prevalence estimates were calculated accounting for clustering at community and household levels and associations with key demographic variables assessed through multivariable random-effects logistic regression.Results1,318 participants from 477 households were surveyed. The prevalence of scabies prevalence was 9.3% (95% CI: 6.5-13.2%), across 75 (19.7%) households; impetigo or infected scabies prevalence was 0.8% (95% CI: 0.4-1.9%). The majority (52%) of scabies cases were classified as severe. Scabies prevalence was lower in females and higher in the youngest age group; no associations were found with other collected demographic or socio-economic variables. DLQI scores indicated a very or extremely large effect on HRQoL in 29% of adults and 18% of children diagnosed with scabies.ConclusionsOur study indicates a substantial burden of scabies in this peri-Urban population in Liberia. This was associated with significant impact on quality of life, highlighting the need for action to control scabies in this population. Further work is needed to assess the impact of interventions in this context on both the prevalence of scabies and quality of life.Plain English summaryScabies is an infestation with a microscopic mite which affects many people living in low-resource tropical countries. It causes intense itching, which can lead to complications through bacterial infection and poor quality of life. To help develop global scabies control programmes, we need a better understanding of how common it is across different tropical settings. We conducted a survey to assess the burden of scabies and bacterial skin infection in a random sample of people living in a community in Monrovia, Liberia. Information about participants and their household were collected and their skin was examined; those with skin conditions were asked about its impact on quality of life.We examined 1,318 participants and found that almost 10% of people had scanies. Scabies was more common in young children, and was more common in male children than female children. We found that there was a large impact on quality of life due mostly to the itching that scabies causes and to people feeling embarrassed or sad because of their skin condition. This scabies survey is one of the first conducted across all age groups in recent years in sub-Saharan Africa and indicates a substantial burden and impact on quality of life. More work is needed to understand how common scabies is in different settings and the impact that different treatment strategies may have.

A multi-state spatio-temporal Markov model for categorized incidence of meningitis in sub-Saharan Africa

2012 ◽  
Vol 141 (8) ◽  
pp. 1764-1771 ◽  
Author(s):  
L. AGIER ◽  
M. STANTON ◽  
G. SOGA ◽  
P. J. DIGGLE
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Public Health Problem ◽  
Incidence Rates ◽  
Sub Saharan Africa ◽  
Major Public Health Problem ◽  
Temporal Dependence ◽  
Spatio Temporal ◽  
Sub Saharan ◽  
Annual Scale

SUMMARYMeningococcal meningitis is a major public health problem in the African Belt. Despite the obvious seasonality of epidemics, the factors driving them are still poorly understood. Here, we provide a first attempt to predict epidemics at the spatio-temporal scale required for in-year response, using a purely empirical approach. District-level weekly incidence rates for Niger (1986–2007) were discretized into latent, alert and epidemic states according to pre-specified epidemiological thresholds. We modelled the probabilities of transition between states, accounting for seasonality and spatio-temporal dependence. One-week-ahead predictions for entering the epidemic state were generated with specificity and negative predictive value >99%, sensitivity and positive predictive value >72%. On the annual scale, we predict the first entry of a district into the epidemic state with sensitivity 65·0%, positive predictive value 49·0%, and an average time gained of 4·6 weeks. These results could inform decisions on preparatory actions.

scholarly journals Genital infections by Chlamydia trachomatis-An overview

KYAMC Journal ◽  
2013 ◽  
Vol 3 (1) ◽  
pp. 244-249
Author(s):  
Syada Monira Hoque ◽  
Md Akram Hossain ◽  
Shyamal Kumar Paul ◽  
Chand Mahmud ◽  
Nazia Haque ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Sexual Behaviors ◽  
Public Health Problem ◽  
Growth Cycle ◽  
Sub Saharan Africa ◽  
Modern Trend ◽  
Genital Infections ◽  
Sub Saharan ◽  
Transmissible Disease ◽  
Chlamydial Infections

Genital infections by Chlamydia trachomatis are now recognized as highly prevalent sexually transmissible disease. In frequency, they surpass the classic sexually transmissible diseases such as syphilis and gonorrhea and thus constitute a serious public health problem. Chlamydia trachomatis is an obligate intracellular gram negative bacterium which have a unique growth cycle and are placed in their own family (Chlamydiae).Chlamydia trachomatis is now one of the most Prevalent bacteria found in classic sexually transmissible disease and as such constitutes a serious Public heath problem. World Heath Organization (WHO) estimated that 92 million new chlamydial infections occur worldwide annually affecting more women (50 Million) then men (42million). And highest chlamydial infected population were in south and South-east Asia (43million) then sub- Saharan Africa (16million)(WHO 2001).This review article is a discussion on history,epidemiology, pathogenesis, clinical features, diagnosis and modern trend of treatment, prevention of Chlamydial infections in age group. Effective delivery of prevention messages requires clientcentered counseling and education regarding specific actions that can reduce the risk for chlamydia transmission e.g., abstinence, condom use, limiting the number of sex partners,modifying sexual behaviors and vaccination.DOI: http://dx.doi.org/10.3329/kyamcj.v3i1.13660 KYAMC Journal Vol. 3, No.-1, June 2012 pp.244-249  

scholarly journals Plasmodium vivax cerebral malaria in an adult patient in Sudan

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Maowia M. Mukhtar ◽  
Omer A. Eisawi ◽  
Seth A. Amanfo ◽  
Elwaleed M. Elamin ◽  
Zeinab S. Imam ◽  
...  
Keyword(s):  
Plasmodium Vivax ◽  
Cerebral Malaria ◽  
Blood Film ◽  
Sub Saharan Africa ◽  
Measured Temperature ◽  
Neck Stiffness ◽  
The Pacific ◽  
High Parasitaemia ◽  
Brain Ct Scan ◽  
Sub Saharan

Abstract Background Plasmodium vivax infection is rising in sub-Saharan Africa, where Plasmodium falciparum is responsible for more than 90% of malaria cases. While P. vivax is identified as a major cause of severe and cerebral malaria in South east Asia, the Pacific and South America, most of the severe and cerebral cases in Africa were attributed to P. falciparum. Cases of severe malaria due to P. vivax are emerging in Africa. A few severe P. vivax cases were reported in Eastern Sudan and they were underestimated due to the lack of accurate diagnosis, low parasitaemia and seldom use of rapid diagnostic tests (RDTs). Case presentation A 60-year-old Sudanese male presented to the Al Kuwaiti hospital in the Sudan capital Khartoum. On admission, the patient was complaining of fever (measured temperature was 38 °C), sweating, chills, vomiting and confusion in the past 2 days prior to his admission. He rapidly deteriorated into a coma state within 48 h of the admission, with significant neck stiffness. He was admitted to the intensive care unit and was suspected of meningitis. Lumbar puncture was not performed since the patient was suffering from spinal cord disc. Brain CT scan was unremarkable. Several biochemical, haematological tests, and blood film for malaria were performed. The results of the laboratory tests were within the normal range except of mild elevation of the total white blood cell count and a significant decrease in the platelets count. Malaria parasites were seen in the blood film with high parasitaemia (quantified as 3 +++). The patient was diagnosed as P. vivax cerebral malaria based on the positive blood film and the amplification of P. vivax specific 499 bp amplicon using Plasmodium multi-species multiplex Polymerase Chain Reaction (PCR). The patient was treated with quinine 10 mg/kg body weight for 10 days followed by primaquine 15 mg/days PO for 2 weeks. The symptoms subsided within 48 h and the patients was cured and released from the hospital. Conclusions Plasmodium vivax is an emerging cause of cerebral malaria in adults in Sudan and should be considered in the differential diagnosis of cerebral malaria for proper management of patients.

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