scholarly journals Relative Burdens of the COVID-19, Malaria, Tuberculosis, and HIV/AIDS Epidemics in Sub-Saharan Africa

2021 ◽  
Author(s):  
David Bell ◽  
Kristian Schultz Hansen
Keyword(s):  
South Africa ◽  
Disease Burden ◽  
Sub Saharan Africa ◽  
Health Priorities ◽  
Public Health Response ◽  
Age Related ◽  
Life Years ◽  
African Populations ◽  
Sub Saharan ◽  
Hiv Aids

COVID-19 has had considerable global impact; however, in sub-Saharan Africa, it is one of several infectious disease priorities. Prioritization is normally guided by disease burden, but the highly age-dependent nature of COVID-19 and that of other infectious diseases make comparisons challenging unless considered through metrics that incorporate life-years lost and time lived with adverse health. Therefore, we compared the 2020 mortality and disability-adjusted life-years (DALYs) lost estimates for malaria, tuberculosis, and HIV/AIDS in sub-Saharan African populations with more than 12 months of COVID-19 burden (until the end of March 2021) by applying known age-related mortality to United Nations estimates of the age structure. We further compared exacerbations of disease burden predicted from the COVID-19 public health response. Data were derived from public sources and predicted exacerbations were derived from those published by international agencies. For sub-Saharan African populations north of South Africa, the estimated recorded COVID-19 DALYs lost in 2020 were 3.7%, 2.3%, and 2.4% for tuberculosis, HIV/AIDS, and malaria, respectively. Predicted exacerbations of these diseases were greater than the estimated COVID-19 burden. Including South Africa and Lesotho, COVID-19 DALYs lost were < 12% of those for other compared diseases; furthermore, the mortality of compared diseases were dominated in all age groups younger than 65 years. This analysis suggests the relatively low impact of COVID-19. Although all four epidemics continue, tuberculosis, HIV/AIDS, and malaria remain far greater health priorities based on their disease burdens. Therefore, resource diversion to COVID-19 poses a high risk of increasing the overall disease burden and causing net harm, thereby further increasing global inequities in health and life expectancy.

scholarly journals Relative burdens of the COVID-19, malaria, tuberculosis and HIV/AIDS epidemics in sub-Saharan Africa in 2020

2021 ◽  
Author(s):  
DAVID BELL ◽  
Kristian Schultz Hansen
Keyword(s):  
Public Health ◽  
South Africa ◽  
Sub Saharan Africa ◽  
Public Health Response ◽  
Health Response ◽  
Life Years ◽  
African Populations ◽  
Life Years Lost ◽  
Sub Saharan ◽  
Hiv Aids

Objectives: While the COVID-19 pandemic has had considerable global impact, recorded mortality in sub-Saharan Africa has been relatively low. Ensuring the public health response creates overall benefit is therefore critical. However, the highly age-dependent nature of COVID-19 mortality makes comparisons of disease burden challenging unless considered in terms of metrics that incorporate life years lost and time lived in adverse health. We therefore assessed the relative disease burdens of COVID-19 and the three major epidemic-causing pathogens; malaria, tuberculosis and HIV/AIDS, in sub-Saharan Africa. Design: We compared estimates of 2020 disease burdens in sub-Saharan African populations in terms of mortality and Disability-Adjusted Life Years lost (DALYs) for COVID-19, malaria, tuberculosis and HIV/AIDS, applying known age-related mortality to UN estimates of sub-Saharan population age structure. We further compared exacerbations of these diseases predicted to occur through the COVID-19 public health response. Data was derived from public sources, predicted disease exacerbations from those published by international agencies. Main outcome measures: Mortality and DALYs lost Results: For sub-Saharan African populations north of South Africa, recorded COVID-19 DALYs lost in 2020 was 2.0%, 1.2% and 1.3% of those estimated for tuberculosis, HIV/AIDS and malaria respectively. The predicted exacerbations alone of each of these comparator diseases were greater than the estimated COVID-19 burden. Including South Africa and Lesotho, COVID-19 DALYs lost were ≤6% of each of these predicted disease burdens and dominated by them in all age groups below 70 years. Conclusions: The analysis here suggests a relatively low impact from COVID-19. While all four epidemics continue, concentration on COVID-19 runs a high risk of increasing the overall health burden, further increasing global inequities in health and life expectancy, and needs to be guided by clear economic evaluation.

scholarly journals The relative importance and stability of disease burden causes over time: summarizing regional trends on disease burden for 290 causes over 28 years

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Henry Dyson ◽  
Raf Van Gestel ◽  
Eddy van Doorslaer
Keyword(s):  
Disease Burden ◽  
Respiratory Infections ◽  
Sub Saharan Africa ◽  
Regional Trends ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Causes Of Disease ◽  
Sub Saharan ◽  
Disease Study ◽  
Over Time

Abstract Background Since the Global Burden of Disease study (GBD) has become more comprehensive, data for hundreds of causes of disease burden, measured using Disability Adjusted Life Years (DALYs), have become increasingly available for almost every part of the world. However, undergoing any systematic comparative analysis of the trends can be challenging given the quantity of data that must be presented. Methods We use the GBD data to describe trends in cause-specific DALY rates for eight regions. We quantify the extent to which the importance of ‘major’ DALY causes changes relative to ‘minor’ DALY causes over time by decomposing changes in the Gini coefficient into ‘proportionality’ and ‘reranking’ indices. Results The fall in regional DALY rates since 1990 has been accompanied by generally positive proportionality indices and reranking indices of negligible magnitude. However, the rate at which DALY rates have been falling has slowed and, at the same time, proportionality indices have tended towards zero. These findings are clearest where the focus is exclusively upon non-communicable diseases. Notably, large and positive proportionality indices are recorded for sub-Saharan Africa over the last decade. Conclusion The positive proportionality indices show that disease burden has become less concentrated around the leading causes over time, and this trend has become less prominent as the DALY rate decline has slowed. The recent decline in disease burden in sub-Saharan Africa is disproportionally driven by improvements in DALY rates for HIV/AIDS, as well as for malaria, diarrheal diseases, and lower respiratory infections.

scholarly journals Global and regional impacts of alcohol use on public health: Emphasis on alcohol policies

2020 ◽  
Vol 26 (4) ◽  
pp. 652-661
Author(s):  
Seung Ha Park ◽  
Dong Joon Kim
Keyword(s):  
Public Health ◽  
Sub Saharan Africa ◽  
Health Priorities ◽  
Alcohol Policies ◽  
Alcohol Control ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Harmful Use ◽  
Sub Saharan ◽  
Harmful Use Of Alcohol

Alcohol is a well-known risk factor for premature morbidity and mortality. The per capita alcohol consumption of the world’s population rose from 5.5 L in 2005 to 6.4 L in 2010 and was still at the level of 6.4 L in 2016. Alcohol-attributable deaths and disability-adjusted life years (DALYs) declined from 2000 to 2016 by 17.9% and 14.5%, respectively. However, these gains observed in the alcohol-attributable burden have proportionally not kept pace with the total health gains during the same period. In 2016, 3.0 million deaths worldwide and 132 million DALYs were attributable to alcohol, responsible for 5.3% of all deaths and 5.0% of all DALYs. These burdens are the highest in the regions of Eastern Europe and sub-Saharan Africa. The alcohol-attributable burden is particularly heavy among young adults, accounting for 7.2% of all premature mortalities. Among the disease categories to which alcohol is related, injuries, digestive diseases, and cardiovascular diseases are the leading causes of the alcohol-attributable burden. To reduce the harmful use of alcohol in a country, the ‘whole of government’ and ‘whole of society’ approaches are required with the implementation of evidence-based alcohol control policies, the pursuit of public health priorities, and the adoption of appropriate policies over a long period of time. In this review, we summarize previous efforts to investigate the alcohol-attributable disease burden and the best ways to protect against harmful use of alcohol and promote health.

scholarly journals Disease burden and the role of pharmacogenomics in African populations

2017 ◽  
Vol 2 ◽  
Author(s):  
K. L. Mpye ◽  
A. Matimba ◽  
K. Dzobo ◽  
S. Chirikure ◽  
A. Wonkam ◽  
...  
Keyword(s):  
Disease Burden ◽  
Individual Variability ◽  
Sub Saharan Africa ◽  
Drug Side Effects ◽  
Quality Healthcare ◽  
Therapeutic Drugs ◽  
African Populations ◽  
The Status ◽  
Sub Saharan

Background.The burden of communicable and non-communicable diseases in Sub-Saharan Africa poses a challenge in achieving quality healthcare. Although therapeutic drugs have generally improved health, their efficacy differs from individual to individual. Variability in treatment response is mainly because of genetic variants that affect the pharmacokinetics and pharmacodynamics of drugs.Method.The intersection of disease burden and therapeutic intervention is reviewed, and the status of pharmacogenomics knowledge in African populations is explored.Results.The most commonly studied variants with pharmacogenomics relevance are discussed, especially in genes coding for enzymes that affect the response to drugs used for HIV, malaria, sickle cell disease and cardiovascular diseases.Conclusions.The genetically diverse African population is likely to benefit from a pharmacogenomics-based healthcare approach, especially with respect to reduction of drug side effects, and separation of responders and non-responders leading to optimized drug choices and doses for each patient.

scholarly journals The Relative Importance and Stability of Disease Burden Causes Over Time: Summarising Regional Trends on Disease Burden for 290 Causes Over 28 Years

2020 ◽  
Author(s):  
Henry Dyson ◽  
Raf Van Gestel ◽  
Eddy van Doorslaer
Keyword(s):  
Disease Burden ◽  
Respiratory Infections ◽  
Sub Saharan Africa ◽  
Regional Trends ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Causes Of Disease ◽  
Sub Saharan ◽  
Disease Study ◽  
Over Time

Abstract Background Since the Global Burden of Disease study (GBD) has become more comprehensive, data for hundreds of causes of disease burden, measured using Disability Adjusted Life Years (DALYs), have become increasingly available for almost every part of the world. However, undergoing any systematic comparative analysis of the trends can be challenging given the quantity of data that must be presented.Methods We use the GBD data to describe trends in cause-specific DALY rates for eight regions. We quantify the extent to which the importance of ‘major’ DALY causes changes relative to ‘minor’ DALY causes over time by decomposing changes in the Gini coefficient into ‘proportionality’ and ‘reranking’ indices.Results The fall in regional DALY rates since 1990 has been accompanied by generally positive proportionality indices and reranking indices of negligible magnitude. However, the rate at which DALY rates have been falling has slowed and, at the same time, proportionality indices have tended towards zero. These findings are clearest where the focus is exclusively upon non-communicable diseases. Notably, large and positive proportionality indices are recorded for sub-Saharan Africa over the last decade. Conclusion The positive proportionality indices show that disease burden has become less concentrated around the leading causes over time, and this trend has become less prominent as the DALY rate decline has slowed. The recent decline in disease burden in sub-Saharan Africa is disproportionally driven by improvements in DALY rates for HIV/AIDS, as well as for malaria, diarrheal diseases, and lower respiratory infections.

scholarly journals COVID-19 in Uganda: Predicting the impact of the disease and public health response on disease burden

2020 ◽  
Author(s):  
David Bell ◽  
Kristian Schultz Hansen ◽  
Agnes N. Kiragga ◽  
Andrew Kambugu ◽  
John Kissa ◽  
...  
Keyword(s):  
Public Health ◽  
Population Structure ◽  
Maternal Mortality ◽  
Disease Burden ◽  
Sub Saharan Africa ◽  
Lead Author ◽  
Mortality Data ◽  
Sub Saharan ◽  
The Impact ◽  
Hiv Aids

AbstractObjectiveCOVID-19 transmission and the public health ‘lock-down’ response are now established in sub-Saharan Africa, including Uganda. Population structure and prior morbidities differ markedly between these countries from those where outbreaks were previously established. We predicted the relative impact of COVID-19 and the response in Uganda to understand whether the benefits could be outweighed by the costs.Design and settingAge-based COVID-19 mortality data from China were applied to the population structures of Uganda and countries with previously established outbreaks, comparing theoretical mortality and disability-adjusted life years (DALYs) lost. Based on recent Ugandan data and theoretical scenarios of programme deterioration, we predicted potential additional disease burden for HIV/AIDS, malaria and maternal mortality.Main outcome measuresDALYs lost and mortality.ResultsBased on population age structure alone Uganda is predicted to have a relatively low COVID-19 burden compared to equivalent transmission in China and Western countries, with mortality and DALYs lost predicted to be 12% and 19% that of Italy. Scenarios of ‘lockdown’ impact predict HIV/AIDS and malaria equivalent to or higher than that of an extensive COVID-19 outbreak. Emerging HIV/AIDS and maternal mortality data indicate that such deterioration could be occurring.ConclusionsThe results predict a relatively low COVID-19 impact on Uganda associated with its young population, with a high risk of negative impact on non-COVID-19 disease burden from a prolonged lockdown response. The results are likely to reflect the situation in other sub-Saharan populations, underlining the importance of tailoring COVID-19 responses to population structure and potential disease vulnerabilities.Transparency statementThe lead author affirms that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that there are no discrepancies from the study as originally planned.

Burden of Peripheral Artery Disease in Sub-Saharan Africa and the Caribbean 1990 to 2015

2018 ◽  
Vol 52 (7) ◽  
pp. 520-526 ◽  
Author(s):  
Nitheesha Ganta ◽  
Shahabuddin Soherwadi ◽  
Kakra Hughes ◽  
Richard F. Gillum
Keyword(s):  
South Africa ◽  
Peripheral Artery Disease ◽  
Sub Saharan Africa ◽  
Years Of Life Lost ◽  
Care Providers ◽  
Peripheral Artery ◽  
Life Years ◽  
The Caribbean ◽  
Sub Saharan ◽  
Artery Disease

Background: The estimated global prevalence of Peripheral artery disease (PAD) increased by 24% in span of 10 years (2000-2010) from 164 to 202 million. Despite scarcity of data on PAD in sub-Saharan Africa (SSA) and the Caribbean, estimates for PAD from these regions may be helpful for health-care providers. Methods: The Global Burden of Disease Study 2015 quantified health loss from hundreds of diseases using systematic reviews and multilevel computer modeling. Estimated rates with 95% uncertainty intervals (UI) for PAD (ICD-10 I70.2) were examined for SSA and the Caribbean and compared to high-income North America (HINA). Disability-adjusted life years (DALYs) are years of healthy life lost representing total disease burden by combining years of life lost and years lived disabled. Results: In 2015, estimated age-standardized DALYs per 100,000 due to PAD for males were as follows: Caribbean (34, UI: 29-39), HINA (36, UI: 30-42), and SSA (20, UI: 14-30). In contrast, DALYs in females were as follows: Caribbean (25, UI: 20-30), HINA (28, UI: 22-36), and SSA (17, UI: 11-26). For both sexes combined, the rate in Southern SSA was 55 (46-67). This reflects the extremely high rates in South Africa (males 90, UI: 77-107; females 63, UI: 53-75). Conclusion: Estimated rate of DALYs per 100,000 was lowest in SSA. Within SSA, the rate in South Africa was highest, exceeding even HINA. Caribbean rates were intermediate.

scholarly journals Managing HIV/AIDS in the South African workplace: Just another duty?

2003 ◽  
Vol 6 (1) ◽  
pp. 25-49 ◽  
Author(s):  
David Dickinson
Keyword(s):  
South Africa ◽  
South African ◽  
Hiv And Aids ◽  
Sub Saharan Africa ◽  
New Approach ◽  
Voluntary Testing ◽  
Real Value ◽  
Sub Saharan ◽  
Aids Programme ◽  
Hiv Aids

The vast majority of HIV and AIDS cases are located in sub-Saharan Africa. AIDS constitutes a critical threat to the development of South Africa, yet the response to date has been slow and often confused. The research of ‘Deco’ is examined to outline how the company approached HIV/AIDS. Deco’s policies encouraged voluntary testing and counselling, openness and disclosure. Different HIV/AIDS programme aspects that responded in a reactive and under-resourced way and lacking access to managerial structures, had the opposite results. The very real value of AIDS volunteers’ contribution, is then described and evaluated. A new approach from both management and employees is needed in which a co-ordinated division of responsibility forms a key element in a workplace partnership to combat HIV/AIDS.

Sign in / Sign up

Export Citation Format

Share Document