scholarly journals Disseminated Histoplasmosis; A Threat in Advanced HIV Disease Population in Sub-Saharan Africa?

2021 ◽  
pp. 115-144
Author(s):  
Christine E. Mandengue ◽  
Bassey Ewa Ekeng ◽  
Rita O. Oladele
Keyword(s):  
Histoplasma Capsulatum ◽  
Clinical Stage ◽  
Sub Saharan Africa ◽  
World Health ◽  
Hiv Disease ◽  
African Countries ◽  
Tb Treatment ◽  
Disseminated Histoplasmosis ◽  
Sub Saharan ◽  
Advanced Hiv Disease

Background: Histoplasmosis is a neglected acquired immune deficiency syndrome (AIDS)-defining disease in sub-Saharan African countries, which is commonly misdiagnosed as tuberculosis (TB) due to similar imagery and clinical features; patients usually receive presumptive anti-TB treatment that is considered as anti-TB treatment failure. Patients with advanced human immunodeficiency virus (HIV) disease (AHD), CD4<200/mm3 or World Health Organisation clinical stage 3 or 4, develop disseminated histoplasmosis (DH) diagnosed at a late stage or at post-mortem, owing to poor clinical suspicion, lack of rapid diagnosis tools to offer rapid and accurate results, and non-availability and accessibility of appropriate antifungal medications. We report 31 cases of DH amongst patients with AHD in sub-Saharan African population from the literature, highlighting the challenging care issue in sub-Saharan Africa. Results: Out of 31 reported cases 64.51% (20/31) were caused by Histoplasma capsulatum var capsulatum, 48.38% (15/31) being immigrants in Europe, Canada and Japan, with 41.93% (13/31) mortality, and 6 cases having no reported outcome. The poor index of suspicion on the part of clinicians; the lack of skilled laboratory personnel and rapid and accurate diagnosis tools of histoplasmosis for a proper detection of either classical or African histoplasmosis coexisting in many sub-Saharan African countries; and the non-availability and accessibility of appropriate antifungal medications were the most challenges in caring DH in advanced HIV disease population in sub-Saharan Africa. Conclusion: there is a need for prompt and routine screening of advanced HIV disease patients in sub-Saharan Africa for histoplasmosis as an AIDS-defining illness.

scholarly journals Individual, community and societal correlates of insecticide treated net use among pregnant women in sub-Saharan Africa: a multi-level analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Edward Kwabena Ameyaw
Keyword(s):  
Pregnant Women ◽  
Sub Saharan Africa ◽  
World Health ◽  
Health Concern ◽  
Maternal And Newborn Health ◽  
African Countries ◽  
The World ◽  
Itn Use ◽  
Multi Level ◽  
Sub Saharan

Abstract Background Malaria in pregnancy is a crucial public health concern due to the enormous risk it poses to maternal and newborn health. The World Health Organisation therefore recommends insecticide-treated net (ITN) for pregnant women. The world over, sub-Saharan Africa bears the highest prevalence of malaria and its associated complications. This study investigated the individual, community and society level factors associated with ITN use among pregnant women in sub-Saharan Africa. Methods The study was conducted with Demographic and Health Survey data of 21 sub-Saharan African countries. A total of 17,731 pregnant women who possessed ITN participated in the study. Descriptive computation of ITN use by survey country and socio-demographic characteristics was conducted. Further, five multi-level binary logistic regression models were fitted with MLwiN 3.05 package in STATA. The Markov Chain Monte Carlo (MCMC) estimation procedure was used in estimating the parameters whilst the Bayesian Deviance Information Criterion was used for the model fitness test. Results On average, 74.2% pregnant women in SSA used ITN. The highest prevalence of ITN use occurred in Mali (83.7%) whilst the least usage occurred in Namibia (7%). Women aged 30–34 were more likely to use ITN compared with those aged 45–49 [aOR = 1.14; Crl = 1.07–1.50]. Poorest women were less probable to use ITN relative to richest women [aOR = 0.79; Crl = 0.70–0.89]. Compared to women who did not want their pregnancies at all, women who wanted their pregnancies [aOR = 1.06; Crl = 1.04–1.19] were more probable to use ITN. Women in male-headed households had higher likelihood of ITN use compared to those from female-headed households [aOR = 1.28; Crl = 1.19–1.39]. On the whole, 38.1% variation in ITN use was attributable to societal level factors whilst 20.9% variation was attributable to community level factors. Conclusion The study has revealed that in addition to individual level factors, community and society level factors affect ITN use in SSA. In as much as the study points towards the need to incorporate community and societal variations in ITN interventions, active involvement of men can yield better outcome for ITN utilisation interventions in SSA.

scholarly journals A Systematic Review of the Incremental Costs of Implementing a New Vaccine in the Expanded Program of Immunization in Sub-Saharan Africa

2019 ◽  
Vol 4 (2) ◽  
pp. 238146831989454
Author(s):  
Joe Brew ◽  
Christophe Sauboin
Keyword(s):  
Systematic Review ◽  
Data Collection ◽  
Interquartile Range ◽  
Sub Saharan Africa ◽  
World Health ◽  
African Countries ◽  
Vaccine Type ◽  
Sub Saharan ◽  
Health Organization ◽  
The Cost

Background. The World Health Organization is planning a pilot introduction of a new malaria vaccine in three sub-Saharan African countries. To inform considerations about including a new vaccine in the vaccination program of those and other countries, estimates from the scientific literature of the incremental costs of doing so are important. Methods. A systematic review of scientific studies reporting the costs of recent vaccine programs in sub-Saharan countries was performed. The focus was to obtain from each study an estimate of the cost per dose of vaccine administered excluding the acquisition cost of the vaccine and wastage. Studies published between 2000 and 2018 and indexed on PubMed could be included and results were standardized to 2015 US dollars (US$). Results. After successive screening of 2119 titles, and 941 abstracts, 58 studies with 80 data points (combinations of country, vaccine type, and vaccination approach–routine v. campaign) were retained. Most studies used the so-called ingredients approach as costing method combining field data collection with documented unit prices per cost item. The categorization of cost items and the extent of detailed reporting varied widely. Across the studies, the mean and median cost per dose administered was US$1.68 and US$0.88 with an interquartile range of US$0.54 to US$2.31. Routine vaccination was more costly than campaigns, with mean cost per dose of US$1.99 and US$0.88, respectively. Conclusion. Across the studies, there was huge variation in the cost per dose delivered, between and within countries, even in studies using consistent data collection tools and analysis methods, and including many health facilities. For planning purposes, the interquartile range of US$0.54 to US$2.31 may be a sufficiently precise estimate.

scholarly journals What sub-Saharan African countries can learn from malaria elimination in China

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Abubakar Olaitan Badmos ◽  
Aishat Jumoke Alaran ◽  
Yusuff Adebayo Adebisi ◽  
Oumnia Bouaddi ◽  
Zainab Onibon ◽  
...  
Keyword(s):  
Significant Proportion ◽  
Sub Saharan Africa ◽  
World Health ◽  
Western Pacific Region ◽  
African Region ◽  
African Countries ◽  
African Context ◽  
Sub Saharan ◽  
Health Organization ◽  
Global Reduction

AbstractMalaria is one of the most devastating diseases plaguing the sub-Saharan African region since time immemorial. In spite of a global reduction in mortality rates, a significant proportion of deaths due to malaria is still accounted for in the region. China recently joined the 40 countries declared malaria free by the World Health Organization and became the first country in the WHO Western Pacific Region to be awarded the certification. We commented on the strategies employed by China to eliminate malaria, address challenges facing malaria control in sub-Saharan Africa, and derive lessons that could be learned in the sub-Saharan African context.

scholarly journals Knowledge, attitude, perception, and preventative practices towards COVID-19 in sub-Saharan Africa: A scoping review

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249853
Author(s):  
Ugochinyere Ijeoma Nwagbara ◽  
Emmanuella Chinonso Osual ◽  
Rumbidzai Chireshe ◽  
Obasanjo Afolabi Bolarinwa ◽  
Balsam Qubais Saeed ◽  
...  
Keyword(s):  
Scoping Review ◽  
Positive Attitude ◽  
Grey Literature ◽  
Further Education ◽  
Sub Saharan Africa ◽  
World Health ◽  
African Countries ◽  
Preventive Practices ◽  
Adequate Knowledge ◽  
Sub Saharan

Background Knowledge, attitudes, perception, and preventative practices regarding coronavirus- 2019 (COVID-19) are crucial in its prevention and control. Several studies have noted that the majority of people in sub-Saharan African are noncompliant with proposed health and safety measures recommended by the World Health Organization (WHO) and respective country health departments. In most sub-Saharan African countries, noncompliance is attributable to ignorance and misinformation, thereby raising questions about people’s knowledge, attitudes, perception, and practices towards COVID-19 in these settings. This situation is particularly of concern for governments and public health experts. Thus, this scoping review is aimed at mapping evidence on the knowledge, attitudes, perceptions, and preventive practices (KAP) towards COVID-19 in sub-Saharan Africa (SSA). Methods Systematic searches of relevant articles were performed using databases such as the EBSCOhost, PubMed, Science Direct, Google Scholar, the WHO library and grey literature. Arksey and O’Malley’s framework guided the study. The risk of bias for included primary studies was assessed using the Mixed Method Appraisal Tool (MMAT). NVIVO version 10 was used to analyse the data and a thematic content analysis was used to present the review’s narrative account. Results A total of 3037 eligible studies were identified after the database search. Only 28 studies met the inclusion criteria after full article screening and were included for data extraction. Studies included populations from the following SSA countries: Ethiopia, Nigeria, Cameroon, Uganda, Rwanda, Ghana, Democratic Republic of Congo, Sudan, and Sierra Leone. All the included studies showed evidence of knowledge related to COVID-19. Eleven studies showed that participants had a positive attitude towards COVID-19, and fifteen studies showed that participants had good practices towards COVID-19. Conclusions Most of the participants had adequate knowledge related to COVID-19. Despite adequate knowledge, the attitude was not always positive, thereby necessitating further education to convey the importance of forming a positive attitude and continuous preventive practice towards reducing contraction and transmission of COVID‐19.

scholarly journals Preparedness and Response Efforts to Fight against COVID-19 in Sub-Saharan Africa: Challenges and Opportunities

2020 ◽  
Vol 5 (2) ◽  
Keyword(s):  
Sub Saharan Africa ◽  
World Health ◽  
African Countries ◽  
Global Pandemic ◽  
Laboratory Facility ◽  
The World ◽  
Challenges And Opportunities ◽  
Sub Saharan ◽  
The Moment ◽  
Health Organization

In late December the World Health Organization declared COVID-19 as global pandemic and needs international concern. As the novel corona virus rages through the world and spreads rapidly Africa is the least-affected continent at the moment. Sub-Saharan Africa is the home of more than one billion populations with fragile health system which is prone for the epidemic to occur. But Ebola experience left many African countries better prepared. We were searching all sources of the website related to preparation and prevention of COVID-19 in sub-Sahara Africa countries. Most African countries have established laboratory facility and implement the recommendations that terminate the outbreak COVID-19.

scholarly journals Impact of Covid-19 on Stock Market in Sub-Saharan Africa

2021 ◽  
Vol 1 (2) ◽  
pp. 41-70
Author(s):  
Saifullahi Adam Bayero ◽  
Babangida Danladi Safiyanu ◽  
Zaitun Sanusi Bakabe
Keyword(s):  
Stock Markets ◽  
Negative Impact ◽  
Virus Disease ◽  
Selection Criterion ◽  
Sub Saharan Africa ◽  
World Health ◽  
African Countries ◽  
The World ◽  
Sub Saharan ◽  
The Impact

Corona virus disease (COVID-19) which was declared by the World Health Organization as a global pandemic caused serious economic problem to all the countries including Sub-Saharan Africa. Given the negative impact of COVID19 on the world economy, this paper examined the impact of COVID19 related cases and death on stock exchange markets volatility in Sub-Saharan African countries. The study used the number of reported cases and death from four Sub-Saharan African countries viz Nigeria, South Africa, Kenya, and Botswana, reported cases and death from China and U.S. and all share index as a proxy of stock markets in four countries from 28 February 2020 to 21 December 2020. The study estimated GARCH 11, TGARCH 11, and EGARCH 11 since the variables are heteroskadestic in nature which makes the application of ARCH lausible; the selection criterion was based on Akaike, Schwarz, and Hannan info Criteria. The result shows that COVID19 confirmed cases and death do not affect the operation of the stock markets in Sub-Saharan African countries, but the volatility of the markets has increased within the period of analysis. Furthermore, Botswana and Kenya stock markets were affected by external cases from China. We therefore recommended that stock markets stakeholders in Sub-Saharan Africa should be more concern about health safety measures and be ready for any future pandemic that might affect the markets.

scholarly journals Advanced HIV Disease among Males and Females Initiating HIV Care in Rural Ethiopia

2019 ◽  
Vol 18 ◽  
pp. 232595821984719 ◽  
Author(s):  
Alan Raymond Lifson ◽  
Sale Workneh ◽  
Abera Hailemichael ◽  
Richard Fleming MacLehose ◽  
Keith Joseph Horvath ◽  
...  
Keyword(s):  
Sub Saharan Africa ◽  
World Health ◽  
Hiv Care ◽  
Stage Iii ◽  
Baseline Survey ◽  
Local Health ◽  
Hiv Disease ◽  
Rural Ethiopia ◽  
District Hospitals ◽  
Advanced Hiv Disease

Despite recommendations for rapidly initiating HIV treatment, many persons in sub-Saharan Africa present to care with advanced HIV disease. Baseline survey and clinical data were collected on 1799 adults newly enrolling at 32 district hospitals and local health HIV clinics in rural Ethiopia. Among those with complete HIV disease information, advanced HIV disease (defined as CD4 count <200 cells/mm3 or World Health Organization [WHO] HIV clinical stage III or IV disease) was present in 66% of males and 56% of females ( P < .001). Males (compared to females) had lower CD4 counts (287 cells/mm3 versus 345 cells/mm3), lower body mass index (19.3 kg/m2 versus 20.2 kg/m2), and more WHO stage III or IV disease (46% versus 37%), ( P < .001). Men reported more chronic diarrhea, fevers, cough, pain, fatigue, and weight loss ( P < .05). Most initiating care in this resource-limited setting had advanced HIV disease. Men had poorer health status, supporting the importance of earlier diagnosis, linkage to care, and initiation of antiretroviral therapy.

Trauma Intervention in Sub-Saharan African Children: A Systematic Literature Review

2017 ◽  
Vol 20 (4) ◽  
pp. 453-469
Author(s):  
Tiamo Katsonga-Phiri ◽  
Kathryn E. Grant ◽  
Molly Brown
Keyword(s):  
Mental Health ◽  
Health Resources ◽  
Sub Saharan Africa ◽  
World Health ◽  
African Countries ◽  
The People ◽  
Qualitative Systematic Review ◽  
The World ◽  
Sub Saharan ◽  
Health Organization

Sub-Saharan Africa is a part of the world that is highly affected by a large number of atrocities, causing a myriad of financial, physical health, and mental health consequences. Yet, unfortunately, according to the World Health Organization (WHO), this is also the part of the world that is least served by mental health services. In response, the WHO has created mandates to increase mental health resources and capacity in all countries. Researchers have taken on the work of introducing and adapting treatments in various sub-Saharan African countries with an aim to create sustainable, evidence-based treatment in a part of the world with high need. The current qualitative systematic review of the literature examines 20 articles that report on research conducted in sub-Saharan African countries with children who have suffered different types of traumas. This review answers questions concerning the types of treatments used, the people administering the treatments, the measures they take to adapt these treatments, and the types of outcomes that are seen. Overall, the majority of treatments being used are shown to be effective with the associated populations.

Increase in clinical prevalence of AIDS implies increase in unsafe medical injections

2009 ◽  
Vol 20 (5) ◽  
pp. 295-299 ◽  
Author(s):  
S Reid
Keyword(s):  
Hiv Infections ◽  
Transmission Efficiency ◽  
Mass Action ◽  
Sub Saharan Africa ◽  
World Health ◽  
Sub Saharan ◽  
Exposure Risks ◽  
Health Organization ◽  
A Minor ◽  
Advanced Hiv Disease

A mass action model developed by the World Health Organization (WHO) estimates that the re-use of contaminated syringes for medical care accounted for 2.5% of HIV infections in sub-Saharan Africa in 2000. The WHO's model applies the population prevalence of HIV infection rather than the clinical prevalence to calculate patients' frequency of exposure to contaminated injections. This approach underestimates iatrogenic exposure risks when progression to advanced HIV disease is widespread. This sensitivity analysis applies the clinical prevalence of HIV to the model and re-evaluates the transmission efficiency of HIV in injections. These adjustments show that no less than 12–17%, and up to 34–47%, of new HIV infections in sub-Saharan Africa may be attributed to medical injections. The present estimates undermine persistent claims that injection safety improvements would have only a minor impact on HIV incidence in Africa.

scholarly journals A Case of Disseminated Histoplasmosis Detected in Peripheral Blood Smear Staining Revealing AIDS at Terminal Phase in a Female Patient from Cameroon

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Christine Mandengue Ebenye
Keyword(s):  
Hiv Infection ◽  
Peripheral Blood ◽  
Blood Smear ◽  
Histoplasma Capsulatum ◽  
Previous History ◽  
Peripheral Blood Smear ◽  
Sub Saharan Africa ◽  
Terminal Phase ◽  
Disseminated Histoplasmosis ◽  
Sub Saharan

Histoplasmosis is endemic in the American continent and also in Sub-Saharan Africa, coexisting with the African histoplasmosis. Immunosuppressed patients, especially those with advanced HIV infection develop a severe disseminated histoplasmosis with fatal prognosis. The definitive diagnosis of disseminated histoplasmosis is based on the detection ofHistoplasma capsulatumfrom patient’ tissues samples or body fluids. Among the diagnostic tests peripheral blood smear staining is not commonly used. Nonetheless a few publications reveal thatHistoplasma capsulatumhas been discovered by chance using this method in HIV infected patients with chronic fever and hence revealed AIDS at the terminal phase. We report a new case detected in a Cameroonian woman without any previous history of HIV infection. Peripheral blood smear staining should be commonly used for the diagnosis of disseminated histoplasmosis in the Sub-Saharan Africa, where facilities for mycology laboratories are unavailable.

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