scholarly journals The Burden of Infectious Diseases: A Trend Appraisal in Sub-Saharan Africa Regional Trade Blocs

2021 ◽  
Vol 2 (3) ◽  
pp. 104-122
Author(s):  
Olufunmilayo Olayemi Jemiluyi ◽  
Rebecca Folake Bank-Ola
Keyword(s):  
Human Immunodeficiency Virus ◽  
Infectious Diseases ◽  
Prevalence Rate ◽  
Sub Saharan Africa ◽  
Development Indicators ◽  
Trade Blocs ◽  
Immunodeficiency Virus ◽  
Two Measures ◽  
Sub Saharan ◽  
Southern Africa Development Community

Purpose: The study aimed at presenting a comparative appraisal of the trends of the two most prevalent infectious diseases bedeviling the region: human immunodeficiency virus (HIV) and tuberculosis (TB). Subject & Methods: Data on fourteen ECOWAS member countries and also fourteen member countries of the SADC bloc. This represents about 93.3% and 87.5% membership of the ECOWAS and SADC blocs respectively. Although the choice of sample size is determined largely by the availability of data, the choices were carefully made to maximize available observation. The data were sourced from World Development Indicators online database published by the World Bank. We use two measures of infectious diseases: the prevalence rate of human immunodeficiency virus and the incidence of tuberculosis. Results: The HIV prevalence rates and incidence of TB were uneven in the two selected trade blocs. The magnitude and the severity of the diseases varied. The burden of both diseases was higher for SADC and lesser for ECOWAS. The average prevalence rate of HIV in the SADC bloc over the study period was 600% of the prevalence rate in ECOWAS (SADC = 12.5%, ECOWAS = 2.1%). Likewise, in the same period, the average TB incidence per 100,000 people was 578.8 and 181.7 respectively in the SADC and ECOWAS blocs. Conclusions: The study finds that the magnitude and severity of the diseases vary widely between the Economic Community of West Africa States (ECOWAS) and the Southern Africa Development Community (SADC) trade blocs. And, while concerted efforts at curbing the diseases have yielded results, there is still much to be done in both blocs.

scholarly journals A Randomized Switch From Nevirapine-Based Antiretroviral Therapy to Single Tablet Rilpivirine/Emtricitabine/Tenofovir Disoproxil Fumarate in Virologically Suppressed Human Immunodeficiency Virus-1-Infected Rwandans

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Sean E. Collins ◽  
Philip M. Grant ◽  
Francois Uwinkindi ◽  
Annie Talbot ◽  
Eric Seruyange ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Antiretroviral Therapy ◽  
Tenofovir Disoproxil Fumarate ◽  
Sub Saharan Africa ◽  
Current Therapy ◽  
Virologic Suppression ◽  
Open Label ◽  
Immunodeficiency Virus ◽  
Sub Saharan ◽  
Hiv 1

Abstract Background.  Many human immunodeficiency virus (HIV)-infected patients remain on nevirapine-based antiretroviral therapy (ART) despite safety and efficacy concerns. Switching to a rilpivirine-based regimen is an alternative, but there is little experience with rilpivirine in sub-Saharan Africa where induction of rilpivirine metabolism by nevirapine, HIV subtype, and dietary differences could potentially impact efficacy. Methods.  We conducted an open-label noninferiority study of virologically suppressed (HIV-1 ribonucleic acid [RNA] < 50 copies/mL) HIV-1-infected Rwandan adults taking nevirapine plus 2 nucleos(t)ide reverse-transcriptase inhibitors. One hundred fifty participants were randomized 2:1 to switch to coformulated rilpivirine-emtricitabine-tenofovir disoproxil fumarate (referenced as the Switch Arm) or continue current therapy. The primary efficacy endpoint was HIV-1 RNA < 200 copies/mL at week 24 assessed by the US Food and Drug Administration Snapshot algorithm with a noninferiority margin of 12%. Results.  Between April and September 2014, 184 patients were screened, and 150 patients were enrolled; 99 patients switched to rilpivirine-emtricitabine-tenofovir, and 51 patients continued their nevirapine-based ART. The mean age was 42 years and 43% of participants were women. At week 24, virologic suppression (HIV-1 RNA level <200 copies/mL) was maintained in 93% and 92% in the Switch Arm versus the continuation arm, respectively. The Switch Arm was noninferior to continued nevirapine-based ART (efficacy difference 0.8%; 95% confidence interval, −7.5% to +12.0%). Both regimens were generally safe and well tolerated, although 2 deaths, neither attributed to study medications, occurred in participants in the Switch Arm. Conclusions.  A switch from nevirapine-based ART to rilpivirine-emtricitabine-tenofovir disoproxil fumarate had similar virologic efficacy to continued nevirapine-based ART after 24 weeks with few adverse events.

Hepatitis B virus activity in untreated hepatitis B e antigen–negative human immunodeficiency virus–hepatitis B virus co-infected patients from sub-Saharan Africa

2019 ◽  
Vol 113 (8) ◽  
pp. 437-445
Author(s):  
Anders Boyd ◽  
Menan Gerard Kouamé ◽  
Laura Houghtaling ◽  
Raoul Moh ◽  
Delphine Gabillard ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Hbv Dna ◽  
Sub Saharan Africa ◽  
Hepatitis B E Antigen ◽  
Hiv Rna ◽  
B Virus ◽  
Immunodeficiency Virus ◽  
Sub Saharan

Abstract Background In human immunodeficiency virus (HIV) and hepatitis B virus (HBV) co-infected patients from sub-Saharan Africa with hepatitis B e antigen (HBeAg)-negative status, data are limited on the evolution of HBV activity when antiretroviral treatment (ART) is absent. Methods A total of 43 HBeAg-negative co-infected patients not indicated for ART (per concomitant World Health Organization recommendations) were followed during participation in a randomized controlled trial in Côte d’Ivoire. Chronic HBeAg-negative phases were classified at yearly visits and defined as ‘infection’ (HBV DNA ≤10 000 copies/mL and normal alanine aminotransferase [ALT]) or ‘hepatitis’ (HBV DNA >10 000 copies/mL and/or above normal ALT). Dispersion in HBV DNA and ALT levels during follow-up was assessed using interquartile range (IQR) regression. Results During a median 25 months (IQR 19–31), 17 (40%) patients consistently had ‘infection’, 5 (12%) consistently had ‘hepatitis’ and 21 (48%) fluctuated between phases. Wider dispersion in HBV DNA over time was associated with higher baseline HIV RNA (p=0.02) and higher baseline HBV DNA levels (p=0.008), while wider dispersion in ALT was associated with higher baseline HIV RNA (p<0.001), higher baseline ALT levels (p=0.02) and baseline hepatitis surface antigen >4.0 log10 IU/mL (p=0.02). Conclusions HBV activity is common with HBeAg-negative status, whose variation is partly linked to HIV replication. Fluctuations in disease phase make it difficult to assess the risk of morbidity and mortality after ART initiation.

scholarly journals Stroke in Human Immunodeficiency Virus-infected Individuals in Sub-Saharan Africa (SSA): A Systematic Review

2018 ◽  
Vol 27 (7) ◽  
pp. 1828-1836 ◽  
Author(s):  
Amir Abdallah ◽  
Jonathan L. Chang ◽  
Cumara B. O'Carroll ◽  
Abdu Musubire ◽  
Felicia C. Chow ◽  
...  
Keyword(s):  
Systematic Review ◽  
Human Immunodeficiency Virus ◽  
Sub Saharan Africa ◽  
Immunodeficiency Virus ◽  
Sub Saharan
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