scholarly journals Diagnostic Performance of Blood Film Microscopy and PfHRP2-based RDT in a Routine Clinical Setting of a Secondary Health Facility in Ghana

2019 ◽  
pp. 1-9
Author(s):  
Francis O. Agyapong ◽  
Daniel Ansong ◽  
Alex Owusu-Ofori ◽  
Ruby Martin-Peprah
Keyword(s):  
Diagnostic Performance ◽  
Malaria Diagnosis ◽  
Blood Film ◽  
Molecular Techniques ◽  
Sub Saharan Africa ◽  
Reference Test ◽  
Paediatric Age ◽  
Sub Saharan ◽  
Low Sensitivity ◽  
High Level

Background: Malaria remains a major public health threat claiming many lives particularly in Sub-Saharan Africa. Light microscopy and RDT are the mainstay tests in the clinical settings for malaria diagnosis. Many studies report varying levels of validity of these tests compared to molecular methods like PCR. Documentation on such comparative study involving the use of molecular techniques as reference test is scanty in Ghana. This study therefore assesses the diagnostic performance of these tests compared to PCR. Methods: Blood film microscopy (thin and thick), RDT and nested PCR were run on blood samples from a total of 188 malaria suspected patients. The accuracy indices of the microscopy and RDT were calculated using the results of the PCR as the reference test. Results: A total of 188 patients were recruited with females constituting the majority 128 (68%). The paediatric age group 1-10 years carried the largest burden of malaria by means of all the 3 tests. A sensitivity of 47.37% (95% ci, 37.03 – 57.88%) was shown by both the microscopy and RDT with specificity of 93.55% (95% ci, 86.48 – 97.60) and 100% (95% ci, 96.11 – 100.00%) and kappa co – efficient of 0.41 and 0.47 respectively. Conclusion: Both microscopy and RDT exhibited high level of specificity but low sensitivity. Significant number of malaria parasitaemic patients as revealed by the PCR was missed by both the RDT and blood film microscopy and thus went undiagnosed.

scholarly journals Mapping of affordability levels for photovoltaic-based electricity generation in the solar belt of sub-Saharan Africa, East Asia and South Asia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sándor Szabó ◽  
Irene Pinedo Pascua ◽  
Daniel Puig ◽  
Magda Moner-Girona ◽  
Mario Negre ◽  
...  
Keyword(s):  
East Asia ◽  
South Asia ◽  
Electricity Generation ◽  
Sub Saharan Africa ◽  
Solar Photovoltaic ◽  
Term Operation ◽  
Sub Saharan ◽  
High Level ◽  
Do So

AbstractLack of access to modern forms of energy hampers efforts to reduce poverty. The provision of electricity to off-grid communities is therefore a long-standing developmental goal. Yet, many off-grid electrification projects neglect mid- and long-term operation and maintenance costs. When this is the case, electricity services are unlikely to be affordable to the communities that are the project’s primary target. Here we show that, compared with diesel-powered electricity generation systems, solar photovoltaic systems are more affordable to no less than 36% of the unelectrified populations in East Asia, South Asia, and sub-Saharan Africa. We do so by developing geo-referenced estimates of affordability at a high level of resolution (1 km2). The analysis illustrates the differences in affordability that may be found at the subnational level, which underscores that electrification investments should be informed by subnational data.

Poverty prevalence and negative spillovers in Sub-Saharan Africa: a focus on extreme and multidimensional poverty in the region

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Olumide Olaoye ◽  
Cleopatra Oluseye Ibukun ◽  
Mustafa Razzak ◽  
Naftaly Mose
Keyword(s):  
Generalized Method Of Moments ◽  
Spillover Effect ◽  
Multidimensional Poverty ◽  
Sub Saharan Africa ◽  
Cross Sectional ◽  
Spatial Error ◽  
Content Type ◽  
The Sustainable Development ◽  
Sub Saharan ◽  
High Level

PurposeThe paper analyses the prevalence of extreme and multidimensional poverty in line with the sustainable development agenda. In addition, the paper examines the drivers of extreme poverty while accounting for the potential spillover effect of poverty in the region.Design/methodology/approachThe study adopts the pooled OLS with Discroll-Kraay robust standard errors to control for cross-sectional dependence. In addition, given the strong potential for endogeneity of poverty index, the authors also employ the generalized method of moments (GMM), which accounts for simultaneity and endogeneity problems, and the spatial error and lag models to control for all forms of spatial and temporal dependence since the factors that affect poverty disperse across borders.FindingsThe study finds that in addition to the traditional drivers of poverty (unemployment, low per capita GDP growth and public debt), poverty in Sub-Saharan Africa is a symptom of a deeper structural problem (lack of access to water and sanitation, high level of corruption and low level of financial development, and frequent economic busts). Likewise, the results from the spatial econometric specification show, consistently across all the specifications, that there is a substantial spillover effect of poverty across the region.Originality/valueThe main novelty of the paper is that the authors investigate the “economic shrinkage hypothesis,” and examined the potential negative spillover effect of poverty in the region.

scholarly journals Homozygosity for TYK2 P1104A underlies tuberculosis in about 1% of patients in a cohort of European ancestry

2019 ◽  
Vol 116 (21) ◽  
pp. 10430-10434 ◽  
Author(s):  
Gaspard Kerner ◽  
Noe Ramirez-Alejo ◽  
Yoann Seeleuthner ◽  
Rui Yang ◽  
Masato Ogishi ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Genetic Basis ◽  
Sub Saharan Africa ◽  
European Ancestry ◽  
Uk Biobank ◽  
The United Kingdom ◽  
The Common ◽  
Sub Saharan ◽  
The Uk ◽  
High Level

The human genetic basis of tuberculosis (TB) has long remained elusive. We recently reported a high level of enrichment in homozygosity for the common TYK2 P1104A variant in a heterogeneous cohort of patients with TB from non-European countries in which TB is endemic. This variant is homozygous in ∼1/600 Europeans and ∼1/5,000 people from other countries outside East Asia and sub-Saharan Africa. We report a study of this variant in the UK Biobank cohort. The frequency of P1104A homozygotes was much higher in patients with TB (6/620, 1%) than in controls (228/114,473, 0.2%), with an odds ratio (OR) adjusted for ancestry of 5.0 [95% confidence interval (CI): 1.96–10.31, P = 2 × 10−3]. Conversely, we did not observe enrichment for P1104A heterozygosity, or for TYK2 I684S or V362F homozygosity or heterozygosity. Moreover, it is unlikely that more than 10% of controls were infected with Mycobacterium tuberculosis, as 97% were of European genetic ancestry, born between 1939 and 1970, and resided in the United Kingdom. Had all of them been infected, the OR for developing TB upon infection would be higher. These findings suggest that homozygosity for TYK2 P1104A may account for ∼1% of TB cases in Europeans.

scholarly journals Validity of four clinical prediction scores for pulmonary embolism in a sub-Saharan African setting: a protocol for a Cameroonian multicentre cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031322
Author(s):  
Agnès Esiéné ◽  
Paul Owono Etoundi ◽  
Joel Noutakdie Tochie ◽  
Junette Arlette Mbengono Metogo ◽  
Jacqueline Ze Minkande
Keyword(s):  
Pulmonary Embolism ◽  
Emergency Departments ◽  
Diagnostic Performance ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Receiver Operating Curve ◽  
Clinical Prediction ◽  
Sectional Study ◽  
Cross Sectional ◽  
Sub Saharan

IntroductionPulmonary embolism poses one of the most challenging diagnoses in medicine. Resolving these diagnostic difficulties is more crucial in emergency departments where fast and accurate decisions are needed for a life-saving purpose. Here, clinical pretest evaluation is an important step in the diagnostic algorithm of pulmonary embolism. Although clinical probability scores are widely used in emergency departments of sub-Saharan Africa, no study has cited their diagnostic performance in this resource-constrained environment. This study will seek to assess the performance of four routinely used clinical prediction models in Cameroonians presenting with suspicion of pulmonary embolism at the emergency department.Methods and analysisIt will be a cross-sectional study comparing the sensitivity, specificity, positive and negative predictive values and accuracy of the Wells, Simplified Wells, Revised Geneva and the Simplified Revised Geneva Scores to CT pulmonary angiography as gold standard in all consecutive consenting patients aged above 15 years admitted for clinical suspicion of pulmonary embolism to the emergency departments of seven major referral hospitals of Cameroon between 1 July 2019 and 31 December 2020. The area under the receiver operating curve, calibration plots, Hosmer and Lemeshow statistics, observed/expected event rates, net benefit and decision curve will be measured of each the clinical prediction test to ascertain the clinical score with the best diagnostic performance.Ethics and disseminationClearance has been obtained from the Institutional Review Board of the Faculty of medicine and biomedical sciences of the University of Yaounde I, Cameroon and the directorates of all participating hospitals to conduct this study. Also, informed consent will be sought from each patient or their legal next of kin and parents for minors, before enrolment into this study. The final study will be published in a peer-review journal and the findings presented to health authorities and healthcare providers.

Assessing Assets Among Street-Connected Youth: New Angles With Participatory Methods in Tanzania

2019 ◽  
Vol 34 (5) ◽  
pp. 619-651
Author(s):  
Laura R. Johnson ◽  
Christopher F. Drescher ◽  
Sophia H. Assenga ◽  
Rachel J. Marsh
Keyword(s):  
Contextual Information ◽  
Research Process ◽  
Street Youth ◽  
Sub Saharan Africa ◽  
Participatory Methods ◽  
Multiple Perspectives ◽  
Use Of Time ◽  
Northern Tanzania ◽  
Sub Saharan ◽  
High Level

Street-connected adolescents in sub-Saharan Africa have been neglected in scholarly research. Extant literature is largely problem focused. This study describes strengths and assets among street-connected youth in Tanzania, using a participatory, mixed methods approach. Adolescents ( N = 38, 13-17 years) in a rehabilitation center for street youth in Northern Tanzania completed a Swahili version of the Developmental Assets Profile (DAP). They engaged in participatory activities designed to capture multiple perspectives and promote maximal engagement. A subsample of youth ( n = 8) took part in photovoice to elucidate contextual details. Although exploratory, we expected (a) participants would have lower scores on the external versus internal domain of the DAP; (b) qualitative methods would support the DAP and provide complementary, contextual information; and (c) participatory methods would be important for providing varied perspectives and engaging youth in the research process. Results revealed a moderately high level of assets, with strengths in constructive use of time and commitment to school. External assets were higher than internal assets; however, different assets were emphasized across different methods. Overall, results supported the DAP framework. The participatory approaches effectively engaged youth and illuminated the culture and context of their development.

Global prevalence and burden of HIV-associated neurocognitive disorder

Neurology ◽  
2020 ◽  
Vol 95 (19) ◽  
pp. e2610-e2621 ◽  
Author(s):  
Yunhe Wang ◽  
Moxuan Liu ◽  
Qingdong Lu ◽  
Michael Farrell ◽  
Julia M. Lappin ◽  
...  
Keyword(s):  
Data Extraction ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Neurocognitive Disorder ◽  
Cross Sectional ◽  
Asymptomatic Neurocognitive Impairment ◽  
Cd4 Cell Count ◽  
Hiv Associated Neurocognitive Disorder ◽  
Sub Saharan ◽  
High Level

ObjectiveTo characterize the prevalence and burden of HIV-associated neurocognitive disorder (HAND) and assess associated factors in the global population with HIV.MethodsWe searched PubMed and Embase for cross-sectional or cohort studies reporting the prevalence of HAND or its subtypes in HIV-infected adult populations from January 1, 1996, to May 15, 2020, without language restrictions. Two reviewers independently undertook the study selection, data extraction, and quality assessment. We estimated pooled prevalence of HAND by a random effects model and evaluated its overall burden worldwide.ResultsOf 5,588 records identified, we included 123 studies involving 35,513 participants from 32 countries. The overall prevalence of HAND was 42.6% (95% confidence interval [CI] 39.7–45.5) and did not differ with respect to diagnostic criteria used. The prevalence of asymptomatic neurocognitive impairment, mild neurocognitive disorder, and HIV-associated dementia were 23.5% (20.3–26.8), 13.3% (10.6–16.3), and 5.0% (3.5–6.8) according to the Frascati criteria, respectively. The prevalence of HAND was significantly associated with the level of CD4 nadir, with a prevalence of HAND higher in low CD4 nadir groups (mean/median CD4 nadir <200 45.2% [40.5–49.9]) vs the high CD4 nadir group (mean/median CD4 nadir ≥200 37.1% [32.7–41.7]). Worldwide, we estimated that there were roughly 16,145,400 (95% CI 15,046,300–17,244,500) cases of HAND in HIV-infected adults, with 72% in sub-Saharan Africa (11,571,200 cases, 95% CI 9,600,000–13,568,000).ConclusionsOur findings suggest that people living with HIV have a high burden of HAND in the antiretroviral therapy (ART) era, especially in sub-Saharan Africa and Latin America. Earlier initiation of ART and sustained adherence to maintain a high-level CD4 cell count and prevent severe immunosuppression is likely to reduce the prevalence and severity of HAND.

scholarly journals Improving Cooperation among Farmers for Communal Land Conservation in Ethiopia: A Public Goods Experiment

2020 ◽  
Vol 12 (21) ◽  
pp. 9290
Author(s):  
Shunji Oniki ◽  
Haftu Etsay ◽  
Melaku Berhe ◽  
Teklay Negash
Keyword(s):  
Developing Countries ◽  
Public Goods ◽  
Information Provision ◽  
Individual Characteristics ◽  
Land Conservation ◽  
Sub Saharan Africa ◽  
Natural Resource Conservation ◽  
Communal Land ◽  
Sub Saharan ◽  
High Level

Farmers in developing countries depend on communal natural resources, yet countries in Sub-Saharan Africa are facing the severe degradation of communal lands due to the so-called “tragedy of the commons”. For the sustainable management of common resources, policy interventions, such as farmer seminars, are necessary to ensure high-level cooperation among farmers for land conservation. However, the effects of this type of information provision are not well known. The purpose of this study is to examine the effects of the dissemination of conservation information on collaborative communal forest management using an economic field experiment with 936 farmers selected by random sampling from 11 villages in the northern Ethiopian Highlands. We conducted a public goods game experiment using a framework of voluntary contribution to communal land conservation with an intervention to remind participants about the consequence of their behaviors. The results show that the volunteer contribution increased after the intervention, and thereafter the decay of the contribution was slow. The results indicate that providing information about the consequences leads to a higher contribution. The effects of information provision are heterogeneous in terms of social condition, such as access to an urban area and social capital, and individual characteristics, such as wealth. These findings imply that information provision effectively improves farmer collaboration toward natural resource conservation in developing countries.

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.

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