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1.
Ann Glob Health ; 90(1): 16, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38435470

RESUMO

Despite the commendable progress made in addressing global health challenges and threats such as child mortality, HIV/AIDS, and Tuberculosis, many global health organizations still exhibit a Global North supremacy attitude, evidenced by their choice of leaders and executors of global health initiatives in low- and middle-income countries (LMICs). While efforts by the Global North to support global health practice in LMICs have led to economic development and advancement in locally led research, current global health practices tend to focus solely on intervention outcomes, often neglecting important systemic factors such as intellectual property ownership, sustainability, diversification of leadership roles, and national capacity development. This has resulted in the implementation of practices and systems informed by high-income countries (HICs) to the detriment of knowledge systems in LMICs, as they are deprived of the opportunity to generate local solutions for local problems. From their unique position as international global health fellows located in different African countries and receiving graduate education from a HIC institution, the authors of this viewpoint article assess how HIC institutions can better support LMICs. The authors propose several strategies for achieving equitable global health practices; 1) allocating funding to improve academic and research infrastructures in LMICs; 2) encouraging effective partnerships and collaborations with Global South scientists who have lived experiences in LMICs; 3) reviewing the trade-related aspects of intellectual property Rights (TRIPS) agreement; and 4) achieving equity in global health funding and education resources.


Assuntos
Síndrome de Imunodeficiência Adquirida , Saúde Global , Criança , Humanos , África , Altruísmo , Mortalidade da Criança
2.
PeerJ ; 12: e17020, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38435989

RESUMO

The morphological characterisation of Diplozoidae spp. is highly reliant on the details of the sclerotised components of the hooks and clamps in the haptor. Only six species of Paradiplozoon (Diplozoinae) have been described from Africa, four of which have adequate morphological and even comparative ITS2 rDNA data available. However, the descriptions of Paradiplozoon ghanense (Thomas, 1957) and Paradiplozoon aegyptense (Fischthal & Kuntz, 1963) lack essential taxonomic information, specifically the details for their haptoral sclerites. As such, all available material from museum collections for these two species were studied using light microscopy to supplement the original morphometric descriptions. The holotype and paratypes of P. aegyptense were studied, but only voucher material for P. ghanense could be sourced. However, this voucher material for P. ghanense was deposited by the species authority and bore a striking resemblance to the illustrations and collection details from the original description. They were thus identified as the type series for the taxon, with a lectotype and paralectotype designated. Both P. ghanense and P. aegyptense could be readily distinguished from other taxa based on the supplementary data generated here, supporting their distinctness. The haptoral sclerites of P. aegyptense were most similar to those of Paradiplozoon krugerense Dos Santos & Avenant-Oldewage, 2016, also described from Labeo spp., while the sclerites of P. ghanense were most similar to Paradiplozoon bingolense Civánová, Koyun & Koubková, 2013 and Paradiplozoon iraqense Al-Nasiri & Balbuena, 2016. Additionally, a voucher of P. aegyptense collected from the alestid type host of P. ghanense was reidentified as the latter species here. This greatly simplified the known host specificity for Paradiplozoon spp. in Africa, with P. aegyptense now exclusively reported from Cypriniformes (Cyprinidae and Danionidae), and P. ghanense restricted to Characiformes (Alestidae). The occurrence of all diplozoids from non-cyprinoid hosts was also investigated and several records of diplozoids occurring on non-cyprinoid hosts were collated and scrutinised. Excluding the two instances of diplozoids described and exclusively occurring on Characiformes fishes (P. ghanense and Paradiplozoon tetragonopterini (Sterba, 1957)), most other non-cyprinoid collections appear sporadic and unsubstantiated, but warrant further investigation supported by diligent taxonomic data. Even though the morphometric descriptions of both P. ghanense and P. aegyptense were fully reported on here, additional material will be needed to study their genetic profiles and phylogeny.


Assuntos
Caraciformes , Cipriniformes , Trematódeos , Animais , Humanos , África , População Negra
3.
PeerJ ; 12: e16993, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38436006

RESUMO

Introduction: Major sporting tournaments may be associated with increased birth rates 9 months afterwards, possibly due to celebratory sex. The influence of major sporting tournaments on birth patterns remains to be fully explored. Methods: Studies that examined the relationship between such events and altered birth metrics (number of births and/or birth sex ratio (male/total live births)) 9(±1) months later were sought in PubMed and Scopus and reported via standard guidelines. Database searches were conducted up to 7 November 2022. Results: Five events led to increased birth metrics 9(±1) months later and these included the Super Bowl, the 2009 UEFA Champions League, the 2010 FIFA World Cup, the 2016 UEFA Euros and the 2019 Rugby World Cup. Several la Liga soccer matches also had effects. With a few exceptions, major American football, Association football (soccer) and Rugby apex tournaments in Africa, North America, Asia and Europe were associated with increases in the number of babies born and/or in the birth sex ratio 9(±1) months following notable team wins and/or hosting the tournament. Furthermore, unexpected losses by teams from a premier soccer league were associated with a decline in births 9 months on. Conclusions: This systematic review establishes that major sporting tournaments have a notable impact on birth patterns, influencing both birth rates and sex ratios. Emotional intensification during these events likely triggers hormonal shifts, driving changes in sexual activity and subsequently shaping birth rates, often positively, about 9 months later. The context is crucial, especially when a region/country hosts a major single-sport tournament or participates for the first time, as population excitement is likely to be at its peak. These findings hold significance for healthcare planning and highlight the role of societal events in shaping demographic trends. PROSPERO registration: CRD42022382971.


Assuntos
Coeficiente de Natalidade , Futebol Americano , Rugby , Futebol , Humanos , África
4.
Pediatr Transplant ; 28(2): e14690, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38436145

RESUMO

Adolescents and Young Adults (AYAs) with chronic kidney disease (CKD) have challenges unique to this developmental period, with increased rates of high-risk behavior and non-adherence to therapy which may impact the progression of kidney disease and their requirement for kidney replacement therapy (KRT). Successful transition of AYA patients are particularly important in low- and middle-income countries (LMICs) where KRT is limited, rationed or not available. Kidney AYA transition clinics have the potential to improve clinical outcomes but there is a paucity of data on the clinical translational impact of these clinics in Africa. This review is a reflection of the 20-year growth and development of the first South African kidney AYA transition clinic. We describe a model of care for patients with CKD, irrespective of etiology, aged 10-25 years, transitioning from pediatric to adult nephrology services. This unique service was established in 2002 and re-designed in 2015. This multidisciplinary integrated transition model has improved patient outcomes, created peer support groups and formed a training platform for future pediatric and adult nephrologists. In addition, an Adolescent Centre of Excellence has been created to compliment the kidney AYA transition model of care. The development of this transition pathway challenges and solutions are explored in this article. This is the first kidney AYA transition clinic in Africa. The scope of this service has expanded over the last two decades. With limited resources in LMICs, such as KRT, the structured transition of AYAs with kidney disease is not only possible but essential. It is imperative to preserve residual kidney function, maximize the kidney allograft lifespan and improve adherence, to enable young individuals an opportunity to lead productive lives.


Assuntos
Rim , Insuficiência Renal Crônica , Adolescente , Humanos , Adulto Jovem , Criança , Insuficiência Renal Crônica/terapia , África , Nefrologistas , Grupo Associado
5.
Afr J Reprod Health ; 28(2): 9-12, 2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38425043

RESUMO

With advances in clinical knowledge and changing norms for health services delivery, lifelong learning is essential for practitioners of sexual and reproductive health. Clinical topics should be complemented by various items, such as communications and management, to optimise the provision of care. Aiming to update knowledge, improve skills and enhance competence, professional development can take the form of diverse modalities ranging from the reading of professional journals through attendance at meetings to formal participation in schemes organised by licensing authorities. Already mandatory in numerous countries in Africa, continuing professional development is assuming more importance for medical, nursing, and midwifery practitioners.


Avec les progrès des connaissances cliniques et l'évolution des normes en matière de prestation de services de santé, l'apprentissage tout au long de la vie est essentiel pour les praticiens de la santé sexuelle et reproductive. Les sujets cliniques doivent être complétés par divers éléments, tels que la communication et la gestion, pour optimiser la prestation des soins. Visant à mettre à jour les connaissances, à améliorer les compétences et à améliorer les compétences, le développement professionnel peut prendre la forme de diverses modalités allant de la lecture de revues professionnelles à la participation à des réunions en passant par la participation formelle à des programmes organisés par les autorités chargées des licences. Déjà obligatoire dans de nombreux pays d'Afrique, la formation professionnelle continue prend de plus en plus d'importance pour les praticiens médicaux, infirmiers et obstétricaux.


Assuntos
Tocologia , Gravidez , Humanos , Feminino , África , Competência Clínica
6.
Proc Natl Acad Sci U S A ; 121(13): e2318903121, 2024 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-38466876

RESUMO

Two recently published analyses make cases for severe bottlenecking of human populations occurring in the late Early Pleistocene, one case at about 0.9 Mya based on a genomic analysis of modern human populations and the low number of hominin sites of this age in Africa and the other at about 1.1 Mya based on an age inventory of sites of hominin presence in Eurasia. Both models point to climate change as the bottleneck trigger, albeit manifested at very different times, and have implications for human migrations as a mechanism to elude extinction at bottlenecking. Here, we assess the climatic and chronologic components of these models and suggest that the several hundred-thousand-year difference is largely an artifact of biases in the chronostratigraphic record of Eurasian hominin sites. We suggest that the best available data are consistent with the Galerian hypothesis expanded from Europe to Eurasia as a major migration pulse of fauna including hominins in the late Early Pleistocene as a consequence of the opening of land routes from Africa facilitated by a large sea level drop associated with the first major ice age of the Pleistocene and concurrent with widespread aridity across Africa that occurred during marine isotope stage 22 at ~0.9 Mya. This timing agrees with the independently dated bottleneck from genomic analysis of modern human populations and allows speculations about the relative roles of climate forcing on the survival of hominins.


Assuntos
Hominidae , Animais , Humanos , Hominidae/genética , Fósseis , África , Europa (Continente) , Migração Humana
7.
BMJ Open ; 14(3): e080262, 2024 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-38458802

RESUMO

INTRODUCTION: Birth injury is a significant public health problem in Africa, with a high incidence and associated mortality and morbidity. Systematic reviews that indicate the incidence, contributing factors and outcomes of birth injury in Africa provide valuable evidence to policy-makers and programme planners for improving prevention and treatment strategies. Therefore, this review is aimed to evaluate the incidence, contributing factors and outcomes of birth injury among newborns in Africa. METHODS AND ANALYSIS: The data will be searched and extracted from JBI Database, Cochrane Database, MEDLINE/PubMed, CINAHL/EBSCO, EMBASE, PEDro, POPLINE, Proquest, OpenGrey (SIGLE), Google Scholar, Google, APA PsycInfo, Web of Science, Scopus and HINARI. Unpublished studies and grey literature will be searched from different sources. This systematic review will include quantitative observational studies, registry and census data, and experimental studies that report on the prevalence or incidence in Africa from 1 January 1990 to 30 September 2023. The Joanna Briggs Institute (JBI) quality appraisal checklist will be used to select eligible studies. Two researchers will independently appraise and extract the data from included studies and resolve discrepancies through discussion. Heterogeneity will be assessed using forest plots and the I2 statistic. If substantial heterogeneity is present, a random-effects model will be used to pool the data. Subgroup analyses will be used to explore the potential sources of heterogeneity. Publication bias will be assessed using funnel plots and Egger's regression test. The software package used to conduct the meta-analysis will be JBI SUMARI. An association will be considered significant if the p<0.05. ETHICS AND DISSEMINATION: Ethical clearance is not needed for this systematic review and the results will be shared with relevant stakeholders to maximise reach and impact. PROSPERO REGISTRATION NUMBER: CRD42023123637.


Assuntos
Traumatismos do Nascimento , Humanos , Recém-Nascido , Incidência , África/epidemiologia , Prevalência , Revisões Sistemáticas como Assunto , Metanálise como Assunto
8.
Nat Commun ; 15(1): 2260, 2024 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-38480725
9.
Hum Vaccin Immunother ; 20(1): 2314828, 2024 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-38439691

RESUMO

Childhood pneumonia causes a significant burden of preventable child morbidity and mortality in Chad, Guinea, Somalia/Somaliland, and South Sudan. Leaders from these countries have committed to reducing this burden and are preparing to introduce the pneumococcal conjugate vaccine (PCV) into their immunization programs. To support long-term sustainability for expected PCV introductions in settings afflicted by prolonged humanitarian crises this research explores national stakeholders' perspectives on contextual factors that may influence optimal vaccine implementation. This qualitative study used purposive sampling to identify and interview stakeholders involved in vaccine decision-making. Interview transcripts were analyzed through the framework method, an approach involving charting data into pre-populated matrices. Findings from interviews with 16 key informants from government, partner organizations, and international health agencies fit within the following four overarching themes: (1) population-level vulnerabilities to pneumonia, exacerbated by climatic risks and low levels of maternal education; (2) disease burden and the interest in enhancing surveillance to monitor vaccine impact and integrate disease control efforts; (3) policy processes, including formalizing vaccine decision-making; and (4) vaccine implementation preparation, including the conduct of robust communication campaigns, training, and cold chain upgrades. This research explores perspectives from leaders in these countries which are at pivotal moments in their journeys toward introducing PCV. Widespread commitment among leaders, in addition to financial support, will facilitate vaccine introduction. Further, fostering a shared understanding among partners about context-specific determinants of program success will help build tailored implementation strategies for each country.


Assuntos
Comunicação , Pneumonia , Criança , Humanos , Vacinas Conjugadas , África , Efeitos Psicossociais da Doença
12.
BMC Health Serv Res ; 24(1): 311, 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38454438

RESUMO

BACKGROUND: The unequal distribution of government health spending within African regional economic groupings is a significant barrier to achieving Universal Health Coverage and reaching health-related Sustainable Development targets. It also hampers the progress toward achieving the African Union's vision of an integrated and prosperous Africa, free of its heavy disease burden. Based on panel data from 36 countries nested into eight Regional Economic Communities (RECs), this study probes the effects of countries' macro-level factors on government health expenditure disparities within eight regional economic communities from 2000 to 2019. METHOD: We use the multilevel linear mixed-effect method to show whether countries' trade gains, life expectancy at birth, poverty, urbanization, information and communication technology, and population aging worsen or reduce the differences for two government health expenditure indicators. RESULTS: The insignificant effect of GDP per capita suggests that in most regional economic groupings, the health sector is still not considered a high-priority sector regarding overall government expenditures. Countries' poverty levels and urbanization increase the domestic general government health expenditure disparities as a percentage of general government expenditure within the regional groupings. However, trade gains and ICT diffusion reduce these disparities. Furthermore, the results reveal that external health expenditure per capita and life expectancy at birth positively impact within-regional inequalities in the domestic general government health expenditure per capita. In contrast, GDP per capita and trade gains tend to reduce them. CONCLUSIONS: This study enriches the research on the determinants of government health expenditure inequality in Africa. Policies that can spur growth in trade and ICT access should be encouraged. Countries should also make more efforts to reduce poverty. Governments should also develop policies promoting economic growth and planned urbanization.


Assuntos
Envelhecimento , Gastos em Saúde , Recém-Nascido , Humanos , África , Governo , Expectativa de Vida
14.
Medicine (Baltimore) ; 103(11): e37488, 2024 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-38489736

RESUMO

Surgical access remains a pressing public health concern in African nations, with a substantial portion of the population facing challenges in obtaining safe, timely, and affordable surgical care. This paper delves into the impact of health insurance schemes on surgical accessibility in Africa, exploring the barriers, challenges, and future directions. It highlights how high out-of-pocket costs, reliance on traditional healing practices, and inadequate surgical infrastructure hinder surgical utilization. Financing mechanisms often need to be more effective, and health insurance programs face resistance within the informal sector. Additionally, coverage of the poor remains a fundamental challenge, with geographical and accessibility barriers compounding the issue. Government policies, often marked by inconsistency and insufficient allocation of resources, create further obstacles. However, strategic purchasing and fund integration offer avenues for improving the efficiency of health insurance programs. The paper concludes by offering policy recommendations, emphasizing the importance of inclusive policies, streamlined financing mechanisms, coverage expansion, and enhanced strategic purchasing to bridge the surgical access gap in Africa. Decoupling entitlement from the payment of contributions, broadening the scope of coverage for outpatient medicines and related expenses, and enhancing safeguards against overall costs and charges, especially for individuals with lower incomes. Ultimately, by addressing these challenges and harnessing the potential of health insurance schemes, the continent can move closer to achieving universal surgical care and improving the well-being of its people.


Assuntos
Seguro Saúde , Cobertura Universal do Seguro de Saúde , Humanos , África , Renda , Governo
15.
Proc Natl Acad Sci U S A ; 121(11): e2313123121, 2024 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-38437546

RESUMO

Organized flaking techniques to obtain predetermined stone tools have been traced back to the early Acheulean (also known as mode 2) in Africa and are seen as indicative of the emergence of advanced technical abilities and in-depth planning skills among early humans. Here, we report one of the earliest known examples of prepared core technology in the archaeological record, at the Cenjiawan (CJW) site in the Nihewan basin of China, dated 1.1 Mya. The operational schemes reconstructed from the CJW refit sets, together with shaping patterns observed in the retouched tools, suggest that Nihewan basin toolmakers had the technical abilities of mode 2 hominins, and developed different survival strategies to adapt to local raw materials and environments. This finding predates the previously earliest known prepared core technology from Eurasia by 0.3 My, and the earliest known mode 2 sites in East Asia by a similar amount of time, thus suggesting that hominins with advanced technologies may have migrated into high latitude East Asia as early as 1.1 Mya.


Assuntos
Hominidae , Tecnologia , Humanos , Animais , Ásia Oriental , China , África
16.
Sci Data ; 11(1): 294, 2024 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-38485989

RESUMO

Understanding the extent and adapting to the impacts of climate change in the agriculture sector in Africa requires robust data on which technical and policy decisions can be based. However, there are no publicly available comprehensive data of which crops are suitable where under current and projected climate conditions for impact assessments and targeted adaptation planning. We developed a dataset on crop suitability of 23 major food crops (eight cereals, six legumes & pulses, six root & tuber crops, and three in banana-related family) for rainfed agriculture in Africa in terms of area and produced quantity. This dataset is based on the EcoCrop model parameterized with temperature, precipitation and soil data and is available for the historical period and until mid-century. The scenarios used for future projections are SSP1:RCP2.6, SSP3:RCP7.0 and SSP5:RCP8.5. The dataset provides a quantitative assessment of the impacts of climate change on crop production potential and can enable applications and linkages of crop impact studies to other socioeconomic aspects, thereby facilitating more comprehensive understanding of climate change impacts and assessment of options for building resilience.


Assuntos
Mudança Climática , Produtos Agrícolas , África , Agricultura , Produção Agrícola
17.
Curr Microbiol ; 81(5): 115, 2024 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-38483599

RESUMO

The diversity of bacteria associated with alpine lichens was profiled. Lichen samples belonging to the Umbilicariaceae family, commonly known as rock tripe lichens, were gathered from two distinct alpine fellfields: one situated on Mt. Brennkogel located in the Eastern European Alps (Austria), and the other on Mt. Stanley located in the Rwenzori mountains of equatorial Africa (Uganda). The primary aim of this research was to undertake a comparative investigation into the bacterial compositions, and diversities, identifying potential indicators and exploring their potential metabolisms, of these lichen samples. Bulk genomic DNA was extracted from the lichen samples, which was used to amplify the 18S rRNA gene by Sanger sequencing and the V3-V4 region of the 16S rRNA gene by Illumina Miseq sequencing. Examination of the fungal partner was carried out through the analysis of 18S rRNA gene sequences, belonging to the genus Umbilicaria (Ascomycota), and the algal partner affiliated with the lineage Trebouxia (Chlorophyta), constituted the symbiotic components. Analyzing the MiSeq datasets by using bioinformatics methods, operational taxonomic units (OTUs) were established based on a predetermined similarity threshold for the V3-V4 sequences, which were assigned to a total of 26 bacterial phyla that were found in both areas. Eight of the 26 phyla, i.e. Acidobacteriota, Actinomycota, Armatimonadota, Bacteroidota, Chloroflexota, Deinococcota, Planctomycetota, and Pseudomonadota, were consistently present in all samples, each accounting for more than 1% of the total read count. Distinct differences in bacterial composition emerged between lichen samples from Austria and Uganda, with the OTU frequency-based regional indicator phyla, Pseudomonadota and Armatimonadota, respectively. Despite the considerable geographic separation of approximately 5430 km between the two regions, the prediction of potential metabolic pathways based on OTU analysis revealed similar relative abundances. This similarity is possibly influenced by comparable alpine climatic conditions prevailing in both areas.


Assuntos
Ascomicetos , Clorófitas , Líquens , Líquens/microbiologia , RNA Ribossômico 16S/genética , Análise de Sequência de DNA/métodos , Filogenia , Bactérias/genética , Ascomicetos/genética , Clorófitas/genética , África
18.
Lancet Glob Health ; 12(4): e555-e556, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38485421
19.
BMC Public Health ; 24(1): 885, 2024 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-38519902

RESUMO

There is voluminous literature on Food Security in Africa. This study explicitly considers the spatio-temporal factors in addition to the usual FAO-based metrics in modeling and understanding the dynamics of food security and nutrition across the African continent. To better understand the complex trajectory and burden of food insecurity and nutrition in Africa, it is crucial to consider space-time factors when modeling and interpreting food security. The spatio-temporal anova model was found to be superior(employing statistical criteria) to the other three models from the spatio-temporal interaction domain models. The results of the study suggest that dietary supply adequacy, food stability, and consumption status are positively associated with severe food security, while average food supply and environmental factors have negative effects on Food Security and Nutrition. The findings also indicate that severe food insecurity and malnutrition are spatially and temporally correlated across the African continent. Spatio-temporal modeling and spatial mapping are essential components of a comprehensive practice to reduce the burden of severe food insecurity. likewise, any planning and intervention to improve the average food supply and environment to promote sustainable development should be regional instead of one size fit all.


Assuntos
Desnutrição , Humanos , Desnutrição/epidemiologia , Estado Nutricional , Dieta , África , Abastecimento de Alimentos/métodos , Segurança Alimentar
20.
BMC Med ; 22(1): 130, 2024 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-38519982

RESUMO

BACKGROUND: Comprehensive data on patients at high risk of sudden cardiac death (SCD) in emerging countries are lacking. The aim was to deepen our understanding of the SCD phenotype and identify risk factors for death among patients at high risk of SCD in emerging countries. METHODS: Patients who met the class I indication for implantable cardioverter-defibrillator (ICD) implantation according to guideline recommendations in 17 countries and regions underrepresented in previous trials were enrolled. Countries were stratified by the WHO regional classification. Patients were or were not implanted with an ICD at their discretion. The outcomes were all-cause mortality and SCD. RESULTS: We enrolled 4222 patients, and 3889 patients were included in the analysis. The mean follow-up period was 21.6 ± 10.2 months. There were 433 (11.1%) instances of all-cause mortality and 117 (3.0%) cases of SCD. All-cause mortality was highest in primary prevention (PP) patients from Southeast Asia and secondary prevention (SP) patients from the Middle East and Africa. The SCD rates among PP and SP patients were both highest in South Asia. Multivariate Cox regression modelling demonstrated that in addition to the independent predictors identified in previous studies, both geographic region and ICD use were associated with all-cause mortality in patients with high SCD risk. Primary prophylactic ICD implantation was associated with a 36% (HR = 0.64, 95% CI 0.531-0.802, p < 0.0001) lower all-cause mortality risk and an 80% (HR = 0.20, 95% CI = 0.116-0.343, p < 0.0001) lower SCD risk. CONCLUSIONS: There was significant heterogeneity among patients with high SCD risk in emerging countries. The influences of geographic regions on patient characteristics and outcomes were significant. Improvement in increasing ICD utilization and uptake of guideline-directed medical therapy in emerging countries is urgent. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02099721.


Assuntos
Desfibriladores Implantáveis , Humanos , Fatores de Risco , Morte Súbita Cardíaca/epidemiologia , Morte Súbita Cardíaca/prevenção & controle , África , Oriente Médio
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