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1.
J. venom. anim. toxins incl. trop. dis ; 29: e20230002, 2023. tab, graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1448596

RESUMO

Abstract This overview aimed to describe the situation of healthcare access in sub-Saharan Africa, excluding South Africa, during the COVID-19 pandemic. A PubMed® search from March 31, 2020, to August 15, 2022, selected 116 articles. Healthcare access and consequences of COVID-19 were assessed based on comparisons with months before its onset or an identical season in previous years. A general reduction of healthcare delivery, associated with the decline of care quality, and closure of many specialty services were reported. The impact was heterogeneous in space and time, with an increase in urban areas at the beginning of the pandemic (March-June 2020). The return to normalcy was gradual from the 3rd quarter of 2020 until the end of 2021. The impact of COVID-19 on the health system and its use was attributed to (a) conjunctural factors resulting from government actions to mitigate the spread of the epidemic (containment, transportation restrictions, closures of businesses, and places of entertainment or worship); (b) structural factors related to the disruption of public and private facilities and institutions, in particular, the health system; and (c) individual factors linked to the increase in costs, impoverishment of the population, and fear of contamination or stigmatization, which discouraged patients from going to health centers. They have caused considerable socio-economic damage. Several studies emphasized some adaptability of the healthcare offer and resilience of the healthcare system, despite its unpreparedness, which explained a return to normal activities as early as 2022 while the COVID-19 epidemic persisted. There appears to be a strong disproportion between the moderate incidence and severity of COVID-19 in sub-Saharan Africa, and the dramatic impact on healthcare access. Several articles make recommendations for lowering the socioeconomic consequences of future epidemics to ensure better management of health issues.


Assuntos
Humanos , Pandemias , COVID-19 , Acesso aos Serviços de Saúde , África Subsaariana
2.
J. Health Biol. Sci. (Online) ; 10(1): 1-7, 01/jan./2022. tab, ilus
Artigo em Inglês | LILACS | ID: biblio-1411691

RESUMO

Objective: This review determined and reports the prevalence of urinary tract infections and aetiological agents common in most sub-Saharan African countries. Methods: A literature search involved Springer, Hindawi, PubMed, Medcrave, Google Scholar, BioMed, and Elsevier databases to identify the urinary tract infection articles published between 2000 and 2021. Results: Of 111 articles obtained from databases, 22 met the qualities to be included in the study. Overall, the prevalence of UTI was 32.12% with Escherichia coli being the most commonly isolated bacteria accounting for 86.4%. Escherichia coli is found in the GIT thus, the proximity between the anus and urinary system makes the contamination easier. Conclusion: The findings of this study provide useful information for the effective intervention of urinary tract infections. Further, it is advised women wipe from front to back whenever they attend the call of nature and or during bathing.


Objetivo: Relatamos a prevalência de infecções do trato urinário e agentes etiológicos comuns na maioria dos países da África Subsaariana. Metodos: Uma pesquisa bibliográfica envolveu as bases de dados Springer, Hindawi, PubMed, Medcrave, Google Scholar, BioMed e Elsevier para identificar os artigos que abordavam infecção do trato urinário nos países da África Subsaariana, publicados entre 2000 e 2021. Resultados: Dos 111 artigos obtidos nas bases de dados, 22 atenderam aos criterios de inclusao e foram incluídos no estudo . No geral, a prevalência de UTI foi de 32,12%, sendo a Escherichia coli a bactéria mais comumente isolada, representando 86,4%. A Escherichia coli é encontrada no TGI, portanto, a proximidade entre o ânus e o sistema urinário facilita a contaminação. Conclusao: Os achados deste estudo fornecem informações úteis para a intervenção efetiva das infecções do trato urinário. Além disso, é aconselhável que as mulheres busquem fazer sua higiene intima sempre da parte da frente para trás.


Assuntos
Infecções Urinárias , Sistema Urinário , Prevalência , África Subsaariana , PubMed , Infecções
3.
Dement. neuropsychol ; 15(3): 339-349, Sept. 2021. tab
Artigo em Inglês | LILACS | ID: biblio-1339786

RESUMO

ABSTRACT In sub-Saharan Africa (SSA),cognitive screening is complicated by both cultural and educational factors, and the existing normative values may not be applicable. The Identification of Dementia in Elderly Africans (IDEA) cognitive screen is a low-literacy measure with good diagnostic accuracy for dementia. Objective: The aim of this study is to report normative values for IDEA and other simple measures [i.e., categorical verbal fluency, the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) 10-word list] in representative community-dwelling older adults in SSA. Methods: Individuals aged ≥60 years resident in 12 representative villages in Kilimanjaro, Tanzania and individuals aged ≥65 years resident within three communities in Akinyele Local Government Area, Oyo State, Nigeria underwent cognitive screening. The normative data were generated by the categories of age, sex, and education. Results: A total of 3,011 people in Tanzania (i.e., 57.3% females and 26.4% uneducated) and 1,117 in Nigeria (i.e., 60.3% females and 64.5% uneducated) were screened. Individuals with higher age, lower education, and female gender obtained lower scores. The 50th decile values for IDEA were 13 (60-64 years) vs. 8/9 (above 85 years), 10-11 uneducated vs. 13 primary educated, and 11/12 in females vs. 13 in males. The normative values for 10-word list delayed recall and categorical verbal fluency varied with education [i.e., delayed recall mean 2.8 [standard deviation (SD) 1.7] uneducated vs. 4.2 (SD 1.2) secondary educated; verbal fluency mean 9.2 (SD 4.8) uneducated vs. 12.2 (SD 4.3) secondary educated], substantially lower than published high-income country values. Conclusions: The cut-off values for commonly used cognitive screening items should be adjusted to suit local normative values, particularly where there are lower levels of education.


RESUMO Na África Subsaariana (ASS), a triagem cognitiva é complicada por fatores culturais e educacionais, além dos valores normativos existentes poderem não ser aplicáveis. O rastreio cognitivo Identification of Dementia in Elderly Africans (IDEA) é uma medida para níveis baixos de alfabetização com boa acurácia diagnóstica para demência. Objetivo: Relatar os valores normativos para a IDEA e outras medidas simples (fluência verbal categórica, a lista de 10 palavras do Consortium to Establish a Registry for Alzheimer's Disease (CERAD) em idosos residentes na comunidade, representativos da ASS. Métodos: Indivíduos com idade ≥60 residentes em 12 comunidades representativas em Kilimanjaro, Tanzânia e indivíduos com idade ≥65 anos residentes em três comunidades na área governamental de Akinyele, Estado de Oyo, Nigéria, foram submetidos à triagem cognitiva. Os dados normativos foram gerados por faixas etárias, sexo e escolaridade. Resultados: Um total de 3.011 pessoas na Tanzânia (57,3% mulheres, 26,4% sem educação) e 1.117 na Nigéria (60,3% mulheres, 64,5% sem educação) foram examinadas. Os indivíduos com idade mais alta, menor escolaridade e mulheres obtiveram escores mais baixos. Os valores do percentil 50 para a IDEA foram 13 (60-64 anos) vs. 8/9 (85+ anos), 10-11 para analfabetos vs. 13 com educação primária e 11/12 em mulheres vs. 13 em homens. Os valores normativos para a evocação tardia da lista de 10 palavras e a fluência verbal categórica variaram com a educação (evocação tardia 2,8 (SD 1,7) para os sem educação, vs. 4,2 (SD 1,2) para com educação secundária; fluência verbal 9,2 (DP 4,8) para os sem educação vs. 12,2 (SD 4.3) para os com ensino médio, substancialmente inferior aos valores publicados em países de alta renda. Conclusões: Os valores de corte para testes de triagem cognitiva comumente usados devem ser ajustados para se adequar aos valores normativos locais, particularmente em níveis baixos de educação.


Assuntos
Humanos , Programas de Rastreamento , Cognição , Educação , Tanzânia , África Subsaariana , Nigéria
5.
Appl. cancer res ; 40: 1-3, Oct. 19, 2020. tab, graf
Artigo em Inglês | LILACS, Inca | ID: biblio-1281353

RESUMO

Background: Cervical cancer is a prominently diagnosed form of cancer in several resource-constrained settings particularly within the sub-Saharan African region. Globally, Africa region has the highest incidence and mortality rates of cervical cancer. The high prevalence has been attributed to several factors including lack of awareness of the disease. The aim of this paper is to explore the prevalence and factors associated with awareness of cervical cancer among women of reproductive age in Republic of Benin and Zimbabwe, sub-Saharan Africa. Methods: We used population-based cross-sectional data from Benin Demographic and Health Survey (BDHS) and Zimbabwe Demographic and Health Survey (ZDHS) respectively. BDHS 2017­18 and ZDHS - 2015 are the 5th and 6th rounds of the surveys respectively. About 15,928 and 9955 women aged 15­49 years were included in this study respectively. The awareness of cervical cancer among women of reproductive age in Benin and Zimbabwe was measured dichotomously; yes (if a woman heard of cervical cancer) vs. no (if a woman has not heard of cervical cancer). All significant variables from the bivariate analysis were included in the multivariable logistic regression model to calculate the adjusted odds ratios (AOR) with corresponding 95% confidence interval. Results: While majority (79.2%) of women from Zimbabwe have heard about cervical cancer, only about one-tenth (10.2%) of their Beninese counterparts have heard about the disease. Advanced maternal age, having formal education, use of internet, having professional/technical/managerial occupation significantly increased the odds of awareness of cervical cancer after adjusting for other confounders. However, in Benin, women who resided in the rural area and those of Islamic belief had 20% (AOR = 0.80; 95%CI: 0.64, 0.99) and 35% (AOR = 0.65; 95%CI: 0.50, 0.86) reduction in the odds of awareness of cervical cancer respectively, when compared with women from urban residence and Christianity. Results from the predictive marginal effects showed that, assuming the distribution of all factors remained the same among women, but every woman is an urban dweller, we would expect 11.0 and 81.0% level of awareness of cervical cancer; If everywoman had higher education, we would expect 20.0 and 90% level of awareness of cervical cancer and if instead the distribution of other maternal factors were as observed and other covariates remained the same among women, but all women were in the richest household wealth quintile, we would expect about 11.0 and 83.0% level of awareness of cervical cancer, among women of reproductive age from Benin and Zimbabwe respectively. Conclusion: The study has revealed that socio-demographical factors including geographical location and selected economic factors explained the inequality in distribution of women's awareness on cervical cancer in both countries. Designing an effective population-based health education and promotion intervention programs on cervical cancer will be a great way forward to improving women's awareness level on cervical cancer.


Assuntos
Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Neoplasias do Colo do Útero , Conhecimentos, Atitudes e Prática em Saúde , Benin , Educação em Saúde , Prevalência , Estudos Transversais , África Subsaariana
6.
Hist. ciênc. saúde-Manguinhos ; 27(supl.1): 123-144, Sept. 2020.
Artigo em Inglês | LILACS | ID: biblio-1134095

RESUMO

Abstract Tracing the pathways of cooperation in health in sub-Saharan Africa from hesitant exchanges to institutionalized dimensions from the 1920s to the early 1960s, this article addresses regional dynamics in health diplomacy which have so far been under-researched. The evolution thereof from early beginnings with the League of Nations Health Organization to the Commission for Technical Assistance South of the Sahara and the World Health Organization's Regional Office for Africa, shows how bilateral dimensions were superseded by WHO's multilateral model of regional cooperation in health. Alignments, divergences, and outcomes are explored with respect to the strategies and policies pursued by colonial powers and independent African states regarding inter-regional relations, and their implications for public health and epidemiological interventions.


Resumo Trilhando os caminhos da cooperação sanitária na África subsaariana, de intercâmbios incertos a dimensões institucionalizadas dos anos 1920 até início dos anos 1960, este artigo aborda a dinâmica regional na diplomacia sanitária que, até o momento, carece de pesquisas. A evolução, desde os primórdios da Organização da Saúde da Liga das Nações até a Cooperação Técnica na África Subsaariana e o Escritório Regional da África da OMS, demonstra como dimensões bilaterais foram substituídas pelo modelo multilateral da OMS de cooperação sanitária regional. São analisados alinhamentos, divergências e resultados de estratégias e políticas empregados por potências coloniais e Estados africanos independentes em relações inter-regionais, bem como suas implicações em intervenções epidemiológicas e de saúde pública.


Assuntos
História do Século XX , Administração em Saúde Pública/história , Congressos como Assunto/história , Diplomacia/história , Cooperação Internacional/história , Organização Mundial da Saúde/história , África Subsaariana , Colonialismo/história
7.
Rev. cuba. med. trop ; 71(1): e311, ene.-abr. 2019. graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1093547

RESUMO

El sarcoma de Kaposi se ha convertido en uno de los tumores más prevalentes en África tras la epidemia de VIH, que afecta de una manera similar a hombres y mujeres. El retraso diagnóstico y el limitado acceso a tratamiento antirretroviral o quimioterapia condicionan el pronóstico de los pacientes que lo padecen. En este artículo se realiza una revisión sobre la referida enfermedad, con el objetivo de describir sus aspectos más relevantes en los últimos años en África, como son su epidemiología, caractéristicas clínicas y opciones terapéuticas existentes. Este tumor es provocado por la infección por virus herpes humano tipo 8, que resulta más prevalente en las zonas rurales del continente africano. Se postula la transmisión a través de la saliva como la vía más importante de contagio en África. La inmunodepresión que causa el VIH favorece el efecto oncogénico del virus. La forma epidémica de SK se manifiesta inicialmente como lesiones hiperpigmentadas o violáceas en la piel, que pueden extenderse a linfáticos o mucosas y a nivel sistémico, principalmente a pulmón o aparato digestivo. El síndrome de reconstitución inmune sistémica puede complicar la evolución del paciente. El inicio temprano de la terapia antirretroviral resulta imprescindible. Además, el pronóstico de los pacientes mejora con la suma de tratamiento quimioterápico con doxorrubicina, vincristina, etopóxido o bleomicina principalmente(AU)


Kaposi sarcoma (KS) has become one of the most prevalent tumors in Africa after the HIV epidemic. KS affects both men and women. Diagnostic delay and limited access to antiretroviral treatment or chemotherapy have an impact on the prognosis of KS patients. A review was conducted about KS with the purpose of describing its most outstanding characteristics in recent years in Africa, such as its epidemiology, clinical features, and existing therapeutic options. This tumor is caused by infection with human herpesvirus 8, which is more prevalent in rural areas of the African continent. Transmission via saliva was found to be the most important transmission route in Africa. HIV-related immunosuppression fosters the oncogenic effect of the virus. The epidemic form of KS initially presents as hyperpigmented or violet-colored skin lesions which may extend to lymph nodes or mucosae, or systemically, mainly to the lungs or the digestive tract. Systemic immune reconstitution syndrome may complicate the patient's evolution. Early start of antiretroviral therapy is indispensable. Additionally, prognosis improves with chemotherapy with doxorubicin, vincristine, etoposide or bleomycin, mainly(AU)


Assuntos
Humanos , Sarcoma de Kaposi/tratamento farmacológico , Sarcoma de Kaposi/epidemiologia , Neoplasias Cutâneas/complicações , África Subsaariana/epidemiologia , Herpesvirus Humano 8/patogenicidade , Terapia Antirretroviral de Alta Atividade/métodos
8.
J. venom. anim. toxins incl. trop. dis ; 25: e.20190083, 2019. map
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1484763

RESUMO

Snakebite is a critical public health issue in tropical countries, particularly in Africa, where 20% of snakebites globally occur. In 2017, the WHO added snakebite envenoming to the category A of neglected tropical diseases. In 2019, thanks to broad institutional and international NGO support, including strong mobilization of African experts and governments, WHO launched a strategy for prevention and control of snakebite envenoming with more ambitious goals. In sub-Saharan Africa, accessibility of antivenoms and symptomatic, adjuvant or replacement therapy is a priority. Several antivenoms are available but their evaluation has not been properly carried out and they remain expensive. To date, there are no manufacturers of antivenom in sub-Saharan Africa (except in South Africa), which requires their importation from other continents. The lack of experience in antivenom choice and its use by health authorities, health personnel and population largely explains the shortage in sub-Saharan Africa. The deficiency of epidemiological data does not allow the implementation of appropriate and efficient care. It is crucial to strengthen the health system which does not have the necessary means for emergency management in general and envenoming in particular. Providing peripheral health centers with antivenoms would decrease complications and deaths. The motivation of communities at risk, identified through the epidemiological data, would be to reduce the delay in consultation that is detrimental to the efficiency of treatment. Partnerships need to be coordinated to optimize resources from international institutions, particularly African ones, and share the burden of treatment costs among all stakeholders. We propose here a project of progressive implementation of antivenom manufacturing in sub-Saharan Africa. The various steps, from the supply of...


Assuntos
Humanos , Animais , Antivenenos/administração & dosagem , Doenças Negligenciadas , Mordeduras de Serpentes/prevenção & controle , África Subsaariana
9.
São Paulo med. j ; 136(5): 454-463, Sept.-Oct. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-979382

RESUMO

ABSTRACT BACKGROUND: While the global prevalence of obesity is rapidly increasing, this pandemic has received less attention in sub-Saharan Africa, particularly in the light of the persistent undernutrition that exists in the context of maternal and child health. We aimed to describe obesity trends among women of childbearing age over recent decades, along with trends in over and undernutrition among children under five years of age, in sub-Saharan African countries. DESIGN AND SETTING: Ecological study with temporal trend analysis in 13 sub-Saharan African countries. METHODS: This was a description of temporal trends in nutritional status: adult obesity, childhood overweight, low height-for-age (stunting), low weight-for-height (wasting), low weight-for-age (underweight) and low birth weight. Publicly available data from repeated cross-sectional national surveys (demographic and health surveys and multiple-indicator cluster surveys) were used. We chose 13 sub-Saharan African countries from which at least four surveys conducted since 1993 were available. We investigated women aged 15-49 years and children under five years of age. RESULTS: In multilevel linear models, the prevalence of obesity increased by an estimated 6 percentage points over 20 years among women of childbearing age, while the prevalence of overweight among children under 5 years old was stable. A major decrease in stunting and, to a lesser extent, wasting accompanied these findings. CONCLUSIONS: The upward trend in obesity among women of childbearing age in the context of highly prevalent childhood undernutrition suggests that the focus of maternal and child health in sub-Saharan Africa needs to be expanded to consider not only nutritional deficiencies but also nutritional excess.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Magreza/epidemiologia , Estado Nutricional , Desnutrição/epidemiologia , Obesidade/epidemiologia , Fatores Socioeconômicos , Fatores de Tempo , Peso ao Nascer , Recém-Nascido de Baixo Peso , Prevalência , Estudos Transversais , África Subsaariana/epidemiologia , Sobrepeso/epidemiologia , Análise Espaço-Temporal , Transtornos do Crescimento/epidemiologia
10.
Rev. Soc. Bras. Med. Trop ; 51(5): 578-583, Sept.-Oct. 2018. tab
Artigo em Inglês | LILACS | ID: biblio-957468

RESUMO

Abstract INTRODUCTION: Here, we conducted an epidemiological study of hepatitis B virus (HBV) mono-infected and asymptomatic malaria/HBV coinfected immigrants and further discussed the possibility of malaria disease modifying the clinical presentation of HBV infection. METHODS: A total of 195 African immigrants were examined for HBV infection or coinfection with HBV and asymptomatic malaria. HBV infection was diagnosed using serological tests and confirmed by PCR; furthermore, we performed a pan-Plasmodium-specific-nucleic-acid-sequence-based-amplification (NASBA) assay to detect asymptomatic malaria infection. The stage/grade of the liver disease was determined using echotomography and elastometry. RESULTS: PCR-NASBA results confirmed that 62 of 195 subjects (31.8%) were positive for Plasmodium infection, whereas 41 of 195 subjects (21%) tested positive for HBV chronic hepatitis (HBV-DNA positive). Among the HBV-positive subjects, 26 (63.4%) of them were mono-infected patients (Group A), whereas 15 (36.6%) patients had HBV chronic hepatitis and asymptomatic malaria coinfections (Group B). The HBV-DNA median levels were 1.4×105IU/mL in HBV-mono-infected patients and 2.0×105IU/mL in coinfected patients. Echotomography and hepatic elastometry presented similar findings for both groups of patients. CONCLUSIONS: Coinfected patients seem to present with the same clinical symptoms of the liver disease as HBV mono-infected patients.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Emigrantes e Imigrantes/estatística & dados numéricos , Infecções Assintomáticas/epidemiologia , Coinfecção/epidemiologia , Hepatite B/epidemiologia , Malária/epidemiologia , Estudos de Coortes , África Subsaariana/etnologia , Hepatite B/diagnóstico , Itália/epidemiologia , Malária/diagnóstico
11.
Int. arch. otorhinolaryngol. (Impr.) ; 19(2): 135-140, Apr-Jun/2015. tab, graf
Artigo em Inglês | LILACS | ID: lil-747143

RESUMO

Introduction Mercury poisoning causes hearing loss in humans and animals. Acute and long-term exposures produce irreversible peripheral and central auditory system damage, and mercury in its various forms of presentation in the environment is ototoxic. Objective We investigated the otoacoustic emissions responses in a riverside population exposed to environmental mercury by analyzing the inhibitory effect of the medial olivocochlear system (MOCS) on transient otoacoustic emissions (TEOAE). Methods The purpose of the research was to evaluate the entire community independently of variables of sex and age. All of the participants were born and lived in a riverside community. After otolaryngologic evaluation, participants were received tympanometry, evaluation of contralateral acoustic reflexes, pure tone audiometry, and recording of TEOAEs with nonlinear click stimulation. Hair samples were collect to measure mercury levels. Results There was no significant correlation between the inhibitory effect of the MOCS, age, and the level of mercury in the hair. Conclusions The pathophysiological effects of chronic exposure may be subtle and nonspecific and can have a long period of latency; therefore, it will be important to monitor the effects of mercury exposure in the central auditory system of the Amazon population over time. Longitudinal studies should be performed to determine whether the inhibitory effect of the MOCS on otoacoustic emissions can be an evaluation method and diagnostic tool in populations exposed to mercury. .


Assuntos
Humanos , Espondilartrite/epidemiologia , África Subsaariana/epidemiologia , Artrite Psoriásica/epidemiologia , Artrite Psoriásica/genética , Artrite Psoriásica/virologia , Artrite Reativa/epidemiologia , Artrite Reativa/genética , Artrite Reativa/virologia , Predisposição Genética para Doença , Infecções por HIV/complicações , /genética , Espondilartrite/diagnóstico , Espondilartrite/genética , Espondilartrite/virologia , Espondilite Anquilosante/epidemiologia , Espondilite Anquilosante/genética , Espondilite Anquilosante/virologia
12.
Braz. j. infect. dis ; 19(2): 196-205, Mar-Apr/2015. graf
Artigo em Inglês | LILACS | ID: lil-746503

RESUMO

Schistosomiasis, a neglected tropical disease of poverty ranks second among the most widespread parasitic disease in various nations in sub-Saharan Africa. Neglected tropical diseases are causes of about 534,000 deaths annually in sub-Saharan Africa and an estimated 57 million disability-adjusted life-years are lost annually due to the neglected tropical diseases. The neglected tropical diseases exert great health, social and financial burden on economies of households and governments. Schistosomiasis has profound negative effects on child development, outcome of pregnancy, and agricultural productivity, thus a key reason why the "bottom 500 million" inhabitants of sub-Saharan Africa continue to live in poverty. In 2008, 17.5 million people were treated globally for schistosomiasis, 11.7 million of those treated were from sub-Saharan Africa. This enervating disease has been successfully eradicated in Japan, as well as in Tunisia. Morocco and some Caribbean Island countries have made significant progress on control and management of this disease. Brazil, China and Egypt are taking steps towards elimination of the disease, while most sub-Saharan countries are still groaning under the burden of the disease. Various factors are responsible for the continuous and persistent transmission of schistosomiasis in sub-Saharan Africa. These include climatic changes and global warming, proximity to water bodies, irrigation and dam construction as well as socio-economic factors such as occupational activities and poverty. The morbidity and mortality caused by this disease cannot be overemphasized. This review is an exposition of human schistosomiasis as it affects the inhabitants of various communities in sub-Sahara African countries. It is hoped this will bring a re-awakening towards efforts to combat this impoverishing disease in terms of vaccines development, alternative drug design, as well as new point-of-care diagnostics.


Assuntos
Animais , Humanos , Esquistossomose/epidemiologia , África Subsaariana/epidemiologia , Higiene , Pobreza , Prevalência , Fatores de Risco , Saneamento , Esquistossomose/transmissão
13.
Radiol. bras ; 48(2): 69-73, Mar-Apr/2015. graf
Artigo em Inglês | LILACS | ID: lil-746617

RESUMO

Objective: To investigate the effects of dilution of paramagnetic contrast agent with iodinated contrast and xylocaine on the signal intensity during magnetic resonance arthrography, and to improve the paramagnetic contrast agent concentration utilized in this imaging modality. Materials and Methods: Samples specially prepared for the study with three different concentrations of paramagnetic contrast agent diluted in saline, iodinated contrast agent and xylocaine were imaged with fast spin echo T1-weighted sequences with fat saturation. The samples were placed into flasks and graphical analysis of the signal intensity was performed as a function of the paramagnetic contrast concentration. Results: As compared with samples of equal concentrations diluted only with saline, the authors have observed an average signal intensity decrease of 20.67% for iodinated contrast agent, and of 28.34% for xylocaine. However, the increased gadolinium concentration in the samples caused decrease in signal intensity with all the dilutions. Conclusion: Minimizing the use of iodinated contrast media and xylocaine and/or the use of a gadolinium concentration of 2.5 mmol/L diluted in saline will improve the sensitivity of magnetic resonance arthrography. .


Objetivo: Investigar, mediante quantificação da intensidade do sinal emitido em amostras, se a diluição do agente de contraste paramagnético com contraste iodado e xilocaína alteram o sinal emitido pelo meio de contraste paramagnético durante o exame de artrorressonância magnética, e aperfeiçoar a concentração de contraste paramagnético utilizada no exame. Materiais e Métodos: Foi realizada sequência de pulso fast spin eco ponderada em T1 com saturação de gordura, utilizando três diferentes concentrações de contraste paramagnético diluídas em solução salina, contraste iodado e xilocaína. As amostras foram colocadas em frascos e a análise gráfica da intensidade do sinal em função da concentração de contraste paramagnético foi realizada. Resultados: Constatou-se que as diluições de contraste paramagnético em contraste iodado e xilocaína diminuíram, em média, a intensidade do sinal em 20,67% para o contraste iodado e 28,34% para a xilocaína, em comparação com as amostras de concentração idêntica diluídas apenas em solução salina. Porém, o aumento da concentração de gadolínio nas amostras ocasionou a diminuição da intensidade do sinal emitido pelo gadolínio, para todas as diluições. Conclusão: Minimizar o uso do meio de contraste iodado e da xilocaína e/ou a utilização de uma concentração de gadolínio com 2,5 mmol/L, diluída em solução salina, irá aperfeiçoar a sensibilidade do exame de artrorressonância magnética. .


Assuntos
Internet/provisão & distribuição , África Subsaariana
16.
Ciênc. Saúde Colet. (Impr.) ; 18(12): 3553-3562, Dez. 2013.
Artigo em Português | LILACS | ID: lil-695349

RESUMO

A região Subsaariana do continente africano é onde se concentra a maior carga de doença do mundo e é a única região do planeta onde se espera que o número de pessoas pobres irá aumentar nas próximas décadas. Os países desta região, em diferentes graus, experimentam processo lento de envelhecimento populacional, mas, ao mesmo tempo, é onde a população idosa mais cresce em números absolutos. A partir de revisão da bibliografia, buscou-se destacar a situação demográfica e social em que vivem as pessoas idosas na região subsaariana e os principais desafios que se impõem aos governos locais para a superação dos complexos problemas postos a toda a sociedade. Constatou-se que as políticas públicas voltadas para este segmento populacional na região não representam prioridade e, por conseguinte, dificilmente entram na agenda atual da cooperação internacional.


The Sub-Saharan part of the African continent is the area that has the highest disease burden in the world and is the only region of the planet where it is expected that the number of poor people will increase in the coming decades. The countries of this region, to different degrees, experience slow process of population aging but at the same time, it is the are where the elderly population grows fastest in absolute numbers. Based on a review of the literature, an attempt was made to highlight the social and demographic situation in which the elderly live in the Sub-Saharan region and the main challenges faced by local governments to overcome the complex problems affecting society as a whole. It was found that public policies geared to this segment of the population in the region do not represent a priority and, consequently, are unlikely to be included in the current agenda of international cooperation.


Assuntos
Idoso , Humanos , Cooperação Internacional , Dinâmica Populacional , África Subsaariana , Efeitos Psicossociais da Doença , Pobreza
17.
Biomédica (Bogotá) ; 32(1): 103-111, ene.-mar. 2012. graf, tab
Artigo em Espanhol | LILACS | ID: lil-639816

RESUMO

Introducción. La mutación de la hemoglobina S (HbS) va acompañada por otras mutaciones en la región del cromosoma 11, conocida como conjunto de la globina beta(beta globin cluster). El patrón de combinación de estos polimorfismos da lugar a los haplotipos que se heredan junto con la mutación de la hemoglobina S, se denominan haplotipos de la mutación bs y revisten gran importancia epidemiológica y clínica. Objetivo. Determinar la frecuencia de los principales haplotipos asociados al gen HBB en pacientes colombianos heterocigotos para hemoglobina S. Materiales y métodos. En la Clínica Colsanitas se han estudiado a la fecha 1.200 muestras de sangre periférica de niños en busca de hemoglobinopatías, y se ha encontrado el rasgo falciforme como la hemoglobinopatía más frecuente. Se determinaron los haplotipos del gen HBB que presentaron la mutación beta-S en 33 niños con patrón electroforético de hemoglobina AS, mediante reacción en cadena de la polimerasa (PCR) y enzimas de restricción. Se determinaron el patrón electroforético de la hemoglobina, el nivel de hemoglobina fetal y los parámetros hematológicos de cada individuo. Resultados. Los haplotipos de la hemoglobina S encontrados con mayor frecuencia en la muestra analizada son de origen africano y su orden de aparición fue mayor para el haplotipo Bantú (36,4 %), seguido por Senegal (30,3 %), Benín (21,2 %) y Camerún (12,1 %). La electroforesis de hemoglobina confirmó el fenotipo AS; la dosificación de hemoglobina fetal mostró niveles por debajo de 1 % y los parámetros hematológicos analizados mostraron valores normales en el 100 % de los individuos. Conclusión. Los haplotipos de la HbS encontrados con mayor frecuencia en la muestra estudiada eran de origen africano y su distribución variaba de acuerdo con el lugar de prodedencia del individuo. La mayor frecuencia correspodió al haplotipo Bantú.


Introduction. The hemoglobin S (HbS) mutation is accompanied by other mutations in the region of chromosome 11 known as "beta globin cluster". The pattern of combination of these polymorphisms giving rise to the haplotypes that co-inherit the HbS mutation, are called haplotypes bs, and are of great epidemiological and clinical significance. Objective. The frequencies of major haplotypes associated with S beta-globin gene was determined in Colombian patients heterozygous for hemoglobin S. Materials and methods. As part of the national neonatal screening program at Clínica Colsanitas, located in major cities of Colombia, nearly 1,200 children from different areas of the country were examined for hemoglobinopathies. The sickle cell trait was identified as the most common. S beta-globin gene haplotypes were determined by PCR and restriction enzymes in 33 children with AS hemoglobin electrophoretic patterns (carrier state). In addition, electrophoretic patterns of hemoglobin, fetal hemoglobin levels and hematologic parameters of each individual were identified. Results. The most frequent haplotypes in Colombia were the Bantú haplotype (36.4 %), followed by Senegal (30.3 %), Benin (21.2 %) and Cameroon (12.1 %) haplotypes. Hemoglobin electrophoresis confirmed the AS phenotype in all patients, and fetal hemoglobin levels below 1%. Other hematological parameters were normal in all cases. Conclusion. The HbS haplotypes found more frequently in the sample were of African origin, and their distribution varied according to the place of origin of the individual. The most frequent corresponded to the Bantu haplotype.


Assuntos
Feminino , Humanos , Recém-Nascido , Masculino , Anemia Falciforme/genética , Hemoglobina Falciforme/genética , Globinas beta/genética , África Subsaariana/etnologia , Anemia Falciforme/sangue , Anemia Falciforme/etnologia , Eletroforese das Proteínas Sanguíneas , Colômbia/epidemiologia , Hemoglobina Fetal/análise , Haplótipos/genética , Triagem Neonatal , Traço Falciforme/sangue , Traço Falciforme/etnologia , Traço Falciforme/genética
18.
s.l; Global Health Strategies initiatives; 2012. 109 p.
Não convencional em Inglês | LILACS, BDS | ID: biblio-848067
20.
Braz. j. med. biol. res ; 43(7): 677-680, July 2010. graf, tab
Artigo em Inglês | LILACS | ID: lil-550738

RESUMO

A 3-bp insertion/deletion polymorphism in intron 6 of GSTM3 (rs1799735, GSTM3*A/*B) affects the activity of the phase 2 xenobiotic metabolizing enzyme GSTM3 and has been associated with increased cancer risk. The GSTM3*B allele is rare or absent in Southeast Asians, occurs in 5-20 percent of Europeans but was detected in 80 percent of Bantu from South Africa. The wide genetic diversity among Africans led us to investigate whether the high frequency of GSTM3*B prevailed in other sub-Saharan African populations. In 168 healthy individuals from Angola, Mozambique and the São Tomé e Príncipe islands, the GSTM3*B allele was three times more frequent (0.74-0.78) than the GSTM3*A allele (0.22-0.26), with no significant differences in allele frequency across the three groups. We combined these data with previously published results to carry out a multidimensional scaling analysis, which provided a visualization of the worldwide population affinities based on the GSTM3 *A/*B polymorphism.


Assuntos
Feminino , Humanos , Masculino , Frequência do Gene/genética , Glutationa Transferase/genética , Polimorfismo Genético/genética , África Subsaariana , Genótipo , Polimorfismo de Fragmento de Restrição
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