scholarly journals Colorectal Adenocarcinoma in East Africa: A Narrative Literature Review

2020 ◽  
pp. 1-11
Author(s):  
Richard Wismayer
Keyword(s):  
East Africa ◽  
Colorectal Adenocarcinoma ◽  
Significant Proportion ◽  
Developed Countries ◽  
East African ◽  
African Countries ◽  
Female Ratio ◽  
Male Female Ratio ◽  
The Usa ◽  
Narrative Literature Review

This paper is a review of work done on colorectal adenocarcinoma in East Africa showing geographic spread, age and sex ratios, clinical presentation, management and predominant histopathology. A steady increased incidence of CRC in East African countries is currently being documented however this is associated with a higher CRC-associated morbidity and mortality. Whilst the male: Female ratio varies between 1.2:1 to 1.88:1, up to 38% of CRC diagnosis are in patients younger than 40 years, in contrast to only 1.9% of CRC patients in Western developed countries such as the USA. Generally rectal carcinoma is more common than colon carcinoma and abdomino-perineal resections are commonly performed in up to between 54% - 71% due to the advanced stage of presentation of rectal tumours in East Africa. The late stage presentation and delayed effective treatment in East Africa may result in a higher morbidity in CRC patients. Interestingly there is a significant incidence of mucinous adenocarcinoma sub-groups compared to Western developed countries which carry a poor prognosis. A significant proportion of CRC patients have been found to have histological and demographic features which suggest that MSI-tumours and these tumours are more common in younger patients. However only a few authors have looked at the possibility of mismatch repair mutations in the genetic aetiopathogenesis of colorectal adenocarcinoma in East Africa.

Defamation in East Africa

1973 ◽  
Vol 17 (1) ◽  
pp. 66-93 ◽  
Author(s):  
R. W. Hodgin
Keyword(s):  
East Africa ◽  
East African ◽  
African Countries ◽  
English Law

The purpose of this article is to review the application of the English law of defamation in the East African countries (Uganda, Kenya, Tanzania) and to assess the possible contribution of the Kenya Defamation Act, 1970.

Revisiting African States Participation in the WTO Dispute Settlement through Intra-Africa RTA Dispute Settlement

2013 ◽  
Vol 6 (2) ◽  
Author(s):  
Malebakeng Forere
Keyword(s):  
Developing Countries ◽  
Dispute Settlement ◽  
Developed Countries ◽  
Dispute Settlement Mechanism ◽  
East African ◽  
African Countries ◽  
Trade Disputes ◽  
East African Community ◽  
Wto Dispute Settlement ◽  
Southern Africa Development Community

AbstractWhereas developed countries were the main players in the GATT dispute settlement mechanism, the era of the WTO saw a sharp increase in the developing countries’ participation in trade disputes. Thus, developing countries are active complainants and defendants in the WTO dispute settlement processes. Nevertheless, African states are still marginalised, and this situation has attracted attention of many scholars. As a result, scholars in the field have come up with many reasons to explain why African states do not appear as either complainants or respondents. The reasons for Africa’s non-participation have been argued to include cost of WTO litigation relative to the gains, low trade volumes, legal knowledge and non-integration of African countries in the WTO system. This article seeks to contribute to the existing literature on Africa’s non-participation in the WTO dispute settlement. The goal in this article is to confirm or dispel assumptions that African states have interests that they need to safeguard through dispute settlement but are inhibited from doing so because of the reasons mentioned above. Unlike other studies, the determination on Africa’s non-participation in the WTO dispute settlement will be approached from African states’ participation in intra-Africa RTA dispute settlement mechanisms. While there are six intra-Africa RTAs notified to the WTO, this work focuses on only two – East African Community and Southern Africa Development Community.

scholarly journals Analysis of main risk factors contributing to obesity in the region of East Africa: meta-analysis

2020 ◽  
Vol 20 (1) ◽  
pp. 248-256
Author(s):  
Lenka Mařincová ◽  
Simona Šafaříková ◽  
Radka Cahlíková
Keyword(s):  
Risk Factors ◽  
East Africa ◽  
Meta Analysis ◽  
Obesity Prevalence ◽  
East African ◽  
African Region ◽  
African Countries ◽  
Chi Square ◽  
Chi Square Test ◽  
Risk Ratios

Background: Over a few decades obesity has become a major global health problem. Its prevalence worldwide has more than doubled since 1980. The situation is expected to worsen in the future, especially in the developing countries that experience nutrition transition due to economic growth. It contributes to reduction in malnutrition which supports an increase in obesity prevalence. Objectives: The aim of this study was to analyse the predictors of obesity in the region of East Africa. Methods: Meta-analysis of existing studies was used in order to find the different risk factors and their significance in obesity development. Data extracted from 16 published academic research articles described the situation in East African countries. The significance of the effect of each variable was tested by means of an asymptotic chi-square test, or Fisher's exact (factorial) test and the risk ratios were calculated. Results: Based on the chi-square test and the risk ratios of the aggregated data, three risk factors were found to be significant in the development of obesity – gender, type of residence and socio-economic status. In East African countries, women are significantly more likely to be obese. Living in an urban area and socioeconomic status are also positively associated with obesity. Because of insufficient data three other risk factors did not prove to be of any significance – alcohol consumption, smoking and education level. Conclusion: Conclusions of this meta-analysis confirm world trends but we also found results that are not in line with them (e.g. education). This meta-analysis confirms the huge existing research gap concerning obesity predictors in the East African region. Keywords: Obesity; meta-analysis; East Africa. 

scholarly journals An Analysis of Public-Private Partnerships in East Africa

2020 ◽  
Vol 11 (5) ◽  
pp. 152
Author(s):  
Lukamba Muhiya Tshombe ◽  
Thekiso Molokwane ◽  
Alex Nduhura ◽  
Innocent Nuwagaba
Keyword(s):  
Developed Countries ◽  
Public Private Partnerships ◽  
Infrastructure Development ◽  
East African ◽  
African Region ◽  
African Countries ◽  
Scientific Discussion ◽  
East African Region ◽  
Sub Saharan ◽  
The Impact

The impact of the implementation of public-private partnerships (PPPs) in the Sub-Saharan African region on infrastructure and services is becoming increasingly perceptible. A considerable number of African countries have embraced PPPs as a mechanism to finance large projects due to a constrained fiscus. At present, many financial institutions, such as the World Bank, the International Monetary Fund and the African Development Bank, which finance some of the projects, have established a department or unit that mainly focuses on infrastructure development in developing countries. The private sector in Africa is equally seen as a significant partner in the development of infrastructure. African governments need to tap into private capital to invest in infrastructure projects. This scientific discussion provides an analysis of PPPs in the East African region. This article selected a number of countries to illustrate PPP projects in the sub-region. The analysis of this study illustrates that the East African region represents unique and valuable public-private partnership lessons in different countries. This study also traces the origins of PPPs to more than a century ago where developed countries completed some of their projects using the same arrangement. This paper further demonstrates that the application of PPPs is always characterised by three factors, namely a country, a sector and a project. Experts in the field often refer to these elements as layers, which usually precede any successful PPP.

scholarly journals Complete basic childhood vaccination and associated factors among children aged 12–23 months in East Africa: a multilevel analysis of recent demographic and health surveys

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Getayeneh Antehunegn Tesema ◽  
Zemenu Tadesse Tessema ◽  
Koku Sisay Tamirat ◽  
Achamyeleh Birhanu Teshale
Keyword(s):  
East Africa ◽  
Multilevel Analysis ◽  
Birth Interval ◽  
Associated Factors ◽  
Wealth Index ◽  
Childhood Vaccination ◽  
Demographic And Health Surveys ◽  
East African ◽  
African Countries ◽  
Vaccine Preventable Diseases

Abstract Background Complete childhood vaccination remains poor in Sub-Saharan Africa, despite major improvement in childhood vaccination coverage worldwide. Globally, an estimated 2.5 million children die annually from vaccine-preventable diseases. While studies are being conducted in different East African countries, there is limited evidence of complete basic childhood vaccinations and associated factors in East Africa among children aged 12–23 months. Therefore, this study aimed to investigate complete basic childhood vaccinations and associated factors among children aged 12–23 months in East Africa. Methods Based on the Demographic and Health Surveys (DHSs) of 12 East African countries (Burundi, Ethiopia, Comoros, Uganda, Rwanda, Tanzania, Mozambique, Madagascar, Zimbabwe, Kenya, Zambia, and Malawi), secondary data analysis was performed. The study included a total weighted sample of 18,811 children aged 12–23 months. The basic childhood vaccination coverage was presented using a bar graph. Multilevel binary logistic regression analysis was fitted for identifying significantly associated factors because the DHS has a hierarchical nature. The Intra-class Correlation Coefficient (ICC), Median Odds Ratio (MOR), Proportional Change in Variance (PCV), and deviance (−2LLR) were used for checking model fitness, and for model comparison. Variable with p-value ≤0.2 in the bi-variable multilevel analysis were considered for the multivariable analysis. In the multivariable multilevel analysis, the Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were reported to declare the significance and strength of association with full vaccination. Results Complete basic childhood vaccination in East Africa was 69.21% (95% CI, 69.20, 69.21%). In the multivariable multilevel analysis; Mothers aged 25–34 years (AOR = 1.21, 95% CI: 1.10, 1.32), mothers aged 35 years and above (AOR = 1.50, 95% CI: 1.31, 1.71), maternal primary education (AOR = 1.26, 95% CI: 1.15, 1.38), maternal secondary education and above (AOR = 1.54, 95% CI: 1.36, 1.75), husband primary education (AOR = 1.25, 95% CI: 1.13, 1.39), husband secondary education and above (AOR = 1.24, 95% CI: 1.11, 1.40), media exposure (AOR = 1.23, 95% CI: 1.13, 1.33), birth interval of 24–48 months (AOR = 1.28, 95% CI: 1.15, 1.42), birth interval greater than 48 months (AOR = 1.35, 95% CI: 1.21, 1.50), having 1–3 ANC visit (AOR = 3.24, 95% CI: 2.78, 3.77), four and above ANC visit (AOR = 3.68, 95% CI: 3.17, 4.28), PNC visit (AOR = 1.34, 95% CI: 1.23, 1.47), health facility delivery (AOR = 1.48, 95% CI: 1.35, 1.62), large size at birth 1.09 (AOR = 1.09, 95% CI: 1.01, 1.19), being 4–6 births (AOR = 0.83, 95% CI: 0.75, 0.91), being above the sixth birth (AOR = 0.60, 95% CI: 0.52, 0.70), middle wealth index (AOR = 1.16, 95% CI: 1.06, 1.28), rich wealth index (AOR = 1.20, 95% CI: 1.09, 1.33), community poverty (AOR = 1.21, 95% CI: 1.11, 1.32) and country were significantly associated with complete childhood vaccination. Conclusions In East Africa, full basic childhood vaccine coverage remains a major public health concern with substantial differences across countries. Complete basic childhood vaccination was significantly associated with maternal age, maternal education, husband education, media exposure, preceding birth interval, number of ANC visits, PNC visits, place of delivery, child-size at birth, parity, wealth index, country, and community poverty. Public health interventions should therefore target children born to uneducated mothers and fathers, poor families, and those who have not used maternal health services to enhance full childhood vaccination to reduce the incidence of child mortality from vaccine-preventable diseases.

Major Depression: Does a Gender-Based Down-Rating of Suicide Risk Challenge Its Diagnostic Validity?

2001 ◽  
Vol 35 (3) ◽  
pp. 322-328 ◽  
Author(s):  
George W. Blair-West ◽  
Graham W. Mellsop
Keyword(s):  
Major Depression ◽  
Suicide Risk ◽  
Prima Facie ◽  
Depressive Illness ◽  
Prima Facie Case ◽  
Atypical Depression ◽  
Female Ratio ◽  
Male Female Ratio ◽  
The Usa ◽  
Gender Based

Objective: This paper will summarize the authors' research that disproved the accepted lifetime suicide risk in major depression. It will then explore the pivotal issue of gender in understanding suicide risk in depression and raise questions as to whether this is adequately reflected in the current diagnostic construct of this condition. Method: The methods of two recent papers published by the authors are briefly recounted. In the first of these papers, an age-specific algorithm was developed to reflect the necessary mathematical relationship between the prevalence of major depression, total population suicide rates and suicide risk in depression. It allowed for deaths in each age group from other causes, corrected for official underreporting, and was calculated on the entire population of the USA. In the second paper this methodology was further refined and applied to gender and age data. Results: The suicide risk in major depression as it is currently defined diagnostically is of the order of 3.4% rather than the previously accepted figure of 15%. However, a single figure is misleading as it averages two highly disparate figures of almost 7% for men and only 1% for women. In youths (< age 25) the male : female ratio is even higher (10:1). Conclusions: Among sufferers of major depression, men and those who have been hospitalized have a much greater risk of suicide. These findings are sensitive to diagnostic inclusivity (the algorithm's denominator) which raises the question as to whether women with a depressive illness are more likely to be correctly identified than male sufferers? An argument is made for a gender-based nosological revision of the diagnostic criteria. In the interim, given the treatable morbidity of depression and the availability of safe, welltolerated antidepressants, there is a prima facie case for lowering our threshold of treatment in men and youths presenting with a history of anger dyscontrol, or substance abuse, who have decompensated from previous levels of functioning and who show features of either typical or atypical depression.

The State of Publishing in East Africa

LOGOS ◽  
2015 ◽  
Vol 26 (3) ◽  
pp. 23-30 ◽  
Author(s):  
Kiarie Kamau
Keyword(s):  
East Africa ◽  
Publishing Industry ◽  
Book Publishing ◽  
Digital Publishing ◽  
Practical Experience ◽  
The State ◽  
East African ◽  
African Region ◽  
African Countries ◽  
East African Region

The main aim of this paper is to examine the state of publishing in East Africa. It also attempts to review the situation in Malawi and Zambia, where the author has had practical experience in publishing and marketing. The paper focuses on the growth of the publishing industry in the East African region and how this growth has impacted on access to textbooks and trade publications. It demonstrates that there has been significant growth in the industry, especially in Kenya and Uganda. However, this growth has largely been in the area of publishing of textbooks. Funding for the rollout of curricula in the East African countries has been a blessing to publishers because the funding includes allocations for textbook purchases for both primary and secondary schools. However, this kind of publishing has sounded something of a death knell for the publication of general books such as novels and biographies. The paper also demonstrates that indigenous book-publishing firms have gained a stronger foothold in East Africa in the last ten years and edged out the multinationals. It concludes by indicating that unless the publishing model changes, general publishing will continue to be relegated to the back-burner. At the same time, publishers are challenged to embrace digital publishing, since that is where the future of publishing lies.

scholarly journals Determinants of maternal high-risk fertility behaviors and its correlation with child stunting and anemia in the East Africa region: A pooled analysis of nine East African countries

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253736
Author(s):  
Koku Sisay Tamirat ◽  
Getayeneh Antehunegn Tesema ◽  
Zemenu Tadesse Tessema
Keyword(s):  
High Risk ◽  
East Africa ◽  
Healthcare Access ◽  
Final Analysis ◽  
Fertility Behavior ◽  
Health Concern ◽  
Age At First Birth ◽  
East African ◽  
African Countries ◽  
Child Stunting

Background In low-income nations, high-risk fertility behavior is a prevalent public health concern that can be ascribed to unmet family planning needs, child marriage, and a weak health system. As a result, this study aimed to determine the factors that influence high-risk fertility behavior and its impact on child stunting and anemia. Method This study relied on secondary data sources from recent demography and health surveys of nine east African countries. Relevant data were extracted from Kids Record (KR) files and appended for the final analysis; 31,873 mother-child pairs were included in the final analysis. The mixed-effect logistic regression model (fixed and random effects) was used to describe the determinants of high-risk fertility behavior (HRFB) and its correlation with child stunting and anemia. Result According to the pooled study about 57.6% (95% CI: 57.7 to 58.2) of women had at least one high-risk fertility behavior, with major disparities found across countries and women’s residences. Women who lived in rural areas, had healthcare access challenges, had a history of abortion, lived in better socio-economic conditions, and had antenatal care follow-up were more likely to engage in high-risk fertility practices. Consequently, Young maternal age at first birth (<18), narrow birth intervals, and high birth orders were HRFBs associated with an increased occurrences of child stunting and anemia. Conclusion This study revealed that the magnitude of high-risk fertility behavior was higher in east Africa region. The finding of this study underscores that interventions focused on health education and behavioral change of women, and improvement of maternal healthcare access would be helpful to avert risky fertility behaviors. In brief, encouraging contraceptive utilization and creating awareness about birth spacing among reproductive-age women would be more helpful. Meanwhile, frequent nutritional screening and early intervention of children born from women who had high-risk fertility characteristics are mandatory to reduce the burden of chronic malnutrition.

scholarly journals Open and Distance Learning Programs for Nursing and Midwifery Education in East Africa: Protocol for a Scoping Review (Preprint)

2020 ◽  
Author(s):  
Kahabi Isangula ◽  
Grace Edwards ◽  
Tumbwene Mwansisya ◽  
Columba Mbekenga ◽  
Eunice Pallangyo ◽  
...  
Keyword(s):  
Health Care ◽  
Distance Learning ◽  
East Africa ◽  
Scoping Review ◽  
Professional Education ◽  
East African ◽  
African Countries ◽  
Midwifery Education ◽  
Open And Distance Learning ◽  
Nurses And Midwives

BACKGROUND In the face of growing modernity and the coronavirus disease 2019 (COVID-19) pandemic, open and distance learning (ODL) is considered to play an important role in increasing access to education worldwide. There is a robust evidence base demonstrating its cost effectiveness in comparison with conventional class-based teaching; however, the transition to this new paradigm of learning for nursing and midwifery courses has been difficult in low-income countries. While there are notable efforts to increase internet and education access to health care professionals, not much is known about ODL for nurses and midwives in East African countries. OBJECTIVE The objective of this scoping review is to understand whether ODL programs for nursing and midwifery education exist, the drivers of their adoption, their implementation, the topics/courses covered, their acceptability, and their impacts in East African countries. METHODS The scoping review methodology employs the framework developed by Arksey and O’Malley. Using an exploratory approach, a two-stage screening process consisting of a title and abstract scan and a full-text review will be used to determine the eligibility of articles. To be included, articles must report on an existing ODL initiative for nurses and midwives in Uganda, Tanzania, and Kenya. All articles will be independently assessed for eligibility by pairs of reviewers, and all eligible articles will be abstracted and charted in duplicate using a standardized form. RESULTS Details of ODL for nursing and midwifery education initiatives and study outcomes will be summarized in a table. The extracted data will undergo exploratory descriptive analysis, and the results will be classified into learner and clinical outcomes. CONCLUSIONS Evidence on ODL for nursing and midwifery education will inform the ongoing development and restructuring of health care professional education in East Africa amidst the COVID-19 pandemic. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/17765

scholarly journals Pooled prevalence and associated factors of chronic undernutrition among under-five children in East Africa: A multilevel analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248637
Author(s):  
Getayeneh Antehunegn Tesema ◽  
Yigizie Yeshaw ◽  
Misganaw Gebrie Worku ◽  
Zemenu Tadesse Tessema ◽  
Achamyeleh Birhanu Teshale
Keyword(s):  
East Africa ◽  
Pooled Analysis ◽  
East African ◽  
African Countries ◽  
Mixed Effect ◽  
Under Five ◽  
Under Five Children ◽  
Pooled Prevalence ◽  
Chronic Undernutrition ◽  
Size At Birth

Background Childhood undernutrition is the leading cause of under-five mortality and morbidity in the world particularly in East African countries. Although there are studies on child undernutrition in different East African countries, our search of the literature revealed that there is limited evidence of a pooled analysis of these studies. Therefore, this study aimed to investigate the pooled prevalence and associated factors of chronic undernutrition (i.e. stunting) among under-five children in East Africa. Methods A pooled analysis of the Demographic and Health Surveys (DHSs) in 12 East African countries was conducted. A total weighted sample of 79744 under-five children was included in the study. Mixed-effect logistic regression analysis was used to identify significant factors associated with chronic undernutrition since the DHS data has a hierarchical structure. The intra-class correlation coefficient (ICC), Median Odds Ratio (MOR), Likelihood Ratio (LR)-test, and deviance was used for model comparison. Variables with p-value <0.2 in the bivariable mixed-effect logistic regression analysis were considered for the multivariable analysis. In the multivariable multilevel analysis model, the Adjusted Odds Ratio (AOR) with the 95% Confidence Interval (CI) were reported for significant factors. Results The pooled prevalence of chronic undernutrition among underfive children in East Africa was 33.3% (95% CI: 32.9%, 35.6%) ranging from 21.9% in Kenya to 53% in Burundi. Children whose mothers lived in rural area (AOR = 1.11, 95% CI: 1.06, 1.16), born to mother who had no formal education (AOR = 1.42, 95% CI: 1.34, 1.50) and primary education (AOR = 1.37, 95% CI: 1.31, 1.44), being in poor household (AOR = 1.66, 95% CI: 1.58, 1.74), and middle household (AOR = 1.42, 95% CI: 1.35, 1.49), child aged 36–48 months (AOR = 1.09, 95% CI: 1.04, 1.14), being male (AOR = 1.19, 95% CI: 1.15, 1.23), 2nd - 4th birth order (AOR = 1.08, 95% CI: 1.03, 1.13), and above 4th 1.27 (AOR = 1.27, 95% CI: 1.19, 1.35), home delivery 1.09 (AOR = 1.09, 95% CI: 1.05, 1.13), small size at birth (AOR = 1.35, 95% CI: 1.29, 1.40) and being multiple births (AOR = 1.98, 95% CI: 1.81, 2.17) were associated with increased odds of stunting. While, antenatal care visit (AOR = 0.89, 95% CI: 0.86, 0.93), mothers aged 25–34 (AOR = 0.83, 95% CI: 0.79, 0.86) and ≥ 35 years (AOR = 0.76, 95% CI: 0.72, 0.81), large size at birth (AOR = 0.85, 95% CI: 0.81, 0.88), and family size >8 (AOR = 0.92, 95% CI: 0.87, 0.98) were associated with decreased odds of stunting. Conclusion The study revealed that stunting among under-five children remains a major public health problem in East Africa. Therefore, to improve child nutrition status the governmental and non-governmental organizations should design public health interventions targeting rural residents, and the poorest households. Furthermore, enhancing health facility delivery, ANC visit, and maternal health education is vital for reducing child chronic undernutrition.

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