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1.
Bull World Health Organ ; 98(6): 394-405, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32514213

RESUMO

Objective: To investigate whether sub-Saharan African countries have succeeded in reducing wealth-related inequalities in the coverage of reproductive, maternal, newborn and child health interventions. Methods: We analysed survey data from 36 countries, grouped into Central, East, Southern and West Africa subregions, in which at least two surveys had been conducted since 1995. We calculated the composite coverage index, a function of essential maternal and child health intervention parameters. We adopted the wealth index, divided into quintiles from poorest to wealthiest, to investigate wealth-related inequalities in coverage. We quantified trends with time by calculating average annual change in index using a least-squares weighted regression. We calculated population attributable risk to measure the contribution of wealth to the coverage index. Findings: We noted large differences between the four regions, with a median composite coverage index ranging from 50.8% for West Africa to 75.3% for Southern Africa. Wealth-related inequalities were prevalent in all subregions, and were highest for West Africa and lowest for Southern Africa. Absolute income was not a predictor of coverage, as we observed a higher coverage in Southern (around 70%) compared with Central and West (around 40%) subregions for the same income. Wealth-related inequalities in coverage were reduced by the greatest amount in Southern Africa, and we found no evidence of inequality reduction in Central Africa. Conclusion: Our data show that most countries in sub-Saharan Africa have succeeded in reducing wealth-related inequalities in the coverage of essential health services, even in the presence of conflict, economic hardship or political instability.


Assuntos
Disparidades em Assistência à Saúde/economia , Serviços de Saúde Materno-Infantil/organização & administração , África , África ao Sul do Saara , Conflitos Armados , Humanos , Serviços de Saúde Materno-Infantil/economia , Política , Pobreza , Fatores de Tempo
2.
Bull World Health Organ ; 98(6): 420-425, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32514216

RESUMO

Several resolutions, endorsed by the World Health Assembly and the United Nations General Assembly, articulate the need to improve the availability, quality and safety of organ and tissue donation and transplantation, as well as to prevent and combat trafficking in human organs. Here we assessed the implementation of these resolutions pertaining to organ and tissue donations and transplantations by sending out a questionnaire to all 47 countries in the World Health Organization African Region. From 33 countries that provided data, we identified several obstacles and challenges. Compared to other regions, there are very limited data on organ donation and transplantation. Most countries are lacking legal and regulatory frameworks, since they did not yet establish a specific or comprehensive legislation covering donation and transplantation of human organs and tissues. Countries also have a poor national capacity to perform organ and tissue transplantations and the organization and management of national programmes are weak. Funding, both from domestic and external sources, is insufficient to implement effective transplantations programmes and patients have inadequate financial protection. To address these challenges, we propose that countries and partners should develop and implement policies, strategies, plans and regulatory frameworks for all aspects of organ and tissue donations and transplantations, including fighting against organ trafficking and transplant tourism. Where donation and transplantation programmes exist, stakeholders should develop the skills of human resources, adopt technical standards and quality management procedures to improve donation and transplantation of human organs and tissues.


Assuntos
Transplante de Órgãos/legislação & jurisprudência , Transplante de Órgãos/normas , Obtenção de Tecidos e Órgãos/organização & administração , Obtenção de Tecidos e Órgãos/normas , África , Humanos , Turismo Médico/legislação & jurisprudência , Obtenção de Tecidos e Órgãos/legislação & jurisprudência , Organização Mundial da Saúde
3.
Global Health ; 16(1): 51, 2020 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-32580728

RESUMO

The COVID-19 pandemic has ushered in a new climate of uncertainty which is fuelling protectionism and playing into nationalist narratives. Globalisation is under significant threat as governments scramble to reduce their vulnerability to the virus by limiting global trade and flows of people. With the imposition of border closures and strict migration measures, there have been major disruptions in Africa's global supply chains with adverse impacts on employment and poverty. The African economies overly reliant on single export-orientated industries, such as oil and gas, are expected to be severely hit. This situation is further aggravated by tumbling oil prices and a lowered global demand for African non-oil products. The agricultural sector, which should buffer these shocks, is also being affected by the enforcement of lockdowns which threaten people's livelihoods and food security. Lockdowns may not be the answer in Africa and the issue of public health pandemic response will need to be addressed by enacting context-specific policies which should be implemented in a humane way. In addressing the socioeconomic impact of COVID-19 on African nations, we argue that governments should prioritize social protection programmes to provide people with resources to maintain economic productivity while limiting job losses. International funders are committing assistance to Africa for this purpose, but generally as loans (adding to debt burdens) rather than as grants. G20 agreement so suspend debt payments for a year will help, but is insufficient to fiscal need. Maintaining cross-border trade and cooperation to continue generating public revenues is desirable. New strategies for diversifying African economies and limiting their dependence on external funding by promoting trade with a more regionalised (continental) focus as promoted by the African Continental Free Trade Agreement, while not without limitations, should be explored. While it is premature to judge the final economic and death toll of COVID-19, African leaders' response to the pandemic, and the support they receive from wealthier nations, will determine its eventual outcomes.


Assuntos
Comércio/organização & administração , Infecções por Coronavirus/prevenção & controle , Internacionalidade , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , África/epidemiologia , Comércio/economia , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia
4.
Medicine (Baltimore) ; 99(25): e20553, 2020 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-32569176

RESUMO

There is a paucity of information on real world management of African adult patients with type 1 diabetes mellitus (T1DM). We aimed to describe a cohort of African adults with T1DM.The International Diabetes Management Practices Study is an observational survey conducted from 2005 to 2017. Data were collected in seven individual waves from countries in Asia, Africa, East Europe, and Latin America. Wave 7 was conducted from 2016 to 2017 and the African cohort included 12 countries. Questionnaires were administered to clinicians and patients. Analyses were mainly descriptive. Logistic regressions were performed to identify predictive factors for glycaemic control.A total of 788 patients were enrolled in the study. HbA1c values were available for 712 patients; only 16.6% had HbA1c values <7%. A total of 196 (24.9%) reported being hospitalized in the preceding year, with the most common reasons being diabetic ketoacidosis (58.1%, 93/160) and hypoglycaemia (31.1%; 52/167). Over half of the patients (55.4%) stated that the cost of test strips limited regular glycemic monitoring; a minority of patients (15%, 120/788) received structured diabetes education. Predictors of HbA1c <7% included patients receiving diabetes education (odds ratio [OR] [95% confidence interval, CI] = 2.707 [1.157-6.335] P = .022), following a healthy diet and exercise plan (OR [95% CI] = 2.253 [1.206-4.209], P < .001) and self-managing (monitoring glucose levels and adjusting insulin accordingly) (OR [95% CI] 2.508 [1.500-4.191] P < .001).African adults with T1DM have suboptimal glycemic control with almost one-quarter reporting hospitalization within the preceding year. Most patients felt comfortable with self-adjustment of insulin dose but said that the cost of test strips was the main factor that limited regular monitoring. Reducing direct costs of testing strips and insulin, and improving education will address major challenges within these settings.


Assuntos
Diabetes Mellitus Tipo 1/terapia , Insulina/administração & dosagem , Autogestão , Adulto , África , Idoso , Glicemia/análise , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/economia , Cetoacidose Diabética/etiologia , Feminino , Hemoglobina A Glicada/análise , Humanos , Hipoglicemia/etiologia , Insulina/economia , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
9.
Pan Afr Med J ; 35(Suppl 2): 1, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32528612

RESUMO

The epidemic of Coronavirus disease 2019 (COVID-19) in China caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has become a global concern and subsequently labeled a pandemic by the World Health Organization on March 11th. As the world mobilizes to contain the COVID-19, scientists and public health experts are increasingly alarmed about the potentially catastrophic effects of an outbreak in Africa. The establishment of Africa Centres for Disease Control and Prevention by the Africa Union in 2017 was an unprecedented move toward strengthening national responses, so far enabling all fifty member states with confirmed cases of COVID-19 to adequately respond, break chains of transmission and effectively contain the spread of SARS-CoV-2. We enter an uncertain and challenging period that may severely test the preparedness, organizational resource and resilience of African states and the fabric of their societies. However, we speculate that the fear associated with COVID-19 may also lead to some of the long-standing messages about simple measures to reduce the spread, such as hand washing, finally becoming absorbed and more universally adopted by health workers and the public. Is it possible that regardless of the terrible threat posed by SARS-CoV-2, the increased adoption of these health protection measures may result in a reduction in the spread of other infectious diseases?


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , África/epidemiologia , Infecções por Coronavirus/economia , Infecções por Coronavirus/mortalidade , Desinfecção das Mãos , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/mortalidade , Humanos , Cooperação Internacional , Pandemias/economia , Pneumonia Viral/economia , Pneumonia Viral/mortalidade , Precauções Universais
10.
J Environ Manage ; 268: 110730, 2020 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-32510451

RESUMO

Solar drying is one of the most efficient and cost-effective, renewable, and sustainable technologies to conserve agricultural products in Asian and sub-Saharan African (SSA) countries. This review paper presents the different types of solar dryers that are widely used in Africa and Asia. In addition, the pre-eminent effects of their use on product quality, as well as their economic, environmental, and social impacts, are highlighted. Since financial, external, and structural factors play a key role in the adoption and scaling of solar dryers, this paper also discusses the impact of these factors on the effectiveness of solar drying technologies in selected Asian and SSA countries.


Assuntos
Agricultura , Luz Solar , África , Ásia , Dessecação
11.
Emerg Microbes Infect ; 9(1): 1372-1378, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32538295

RESUMO

Background: According to the World Health Organization (WHO), the outbreak of coronavirus disease in 2019 (COVID-19) has been declared as pandemic and public health emergency that infected more than 5 million people worldwide at the time of writing this protocol. Strong evidence for the burden, admission, and outcome of COVID-19 has not been published in Africa. Therefore, this protocol will be served as a guideline to conduct a systematic review and meta-analysis of the burden, admission, and outcome of COVID-19 in Africa. Methods: Published and unpublished studies on the burden, admission, and outcome of COVID-19 in Africa and written in any language will be included. Databases (PubMed / MEDLINE, Google Scholar, Google, EMBASE, Web of Science, Microsoft Academic, WHO COVID-19 database, Cochran Library, Africa Wide Knowledge, and Africa Index Medicus) from December 2019 to May 2020 will be searched. Two independent reviewers will select, screen, extract data, and assess the risk of bias. The proportion will be measured using a random-effects model. Subgroup analysis will be conducted to manage hetrogeinity. The presence of publication bias will be assessed using Egger's test and visual inspection of the funnel plots. This systematic and meta-analysis review protocol will be reported per the PRISMA-P guidelines. Conclusion: This systematic review and meta-analysis protocol will be expected to quantify the burden, admission, and outcome of COVID-19 in Africa. Systematic review registration: This protocol was submitted for registration with the International Prospective Register of Systematic Reviews (PROSPERO) in March 2020 and accepted with the registration number: CRD42020179321(https://www.crd.york.ac.uk/PROSPERO).


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/epidemiologia , Metanálise como Assunto , Pandemias , Pneumonia Viral/epidemiologia , Guias de Prática Clínica como Assunto , Revisões Sistemáticas como Assunto , África/epidemiologia , Betacoronavirus/isolamento & purificação , Defesa Civil/economia , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/economia , Infecções por Coronavirus/transmissão , Países em Desenvolvimento/economia , Humanos , Incidência , Pandemias/economia , Pneumonia Viral/diagnóstico , Pneumonia Viral/economia , Pneumonia Viral/transmissão , Organização Mundial da Saúde
15.
BMC Infect Dis ; 20(1): 412, 2020 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-32536344

RESUMO

The SARS-CoV-2, which emerged from East Asia in December 2019, has rapidly evolved into a global pandemic infecting close to 7 million people. The current uncertainties regarding its impact on Africa calls for critical monitoring of the evolution of the pandemic and correlation of factors that influence the burden of the disease. We herein discuss possible implications of SARS-CoV-2 on the African continent.


Assuntos
Infecções por Coronavirus/epidemiologia , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Incerteza , África/epidemiologia , Betacoronavirus , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Humanos , Pneumonia Viral/transmissão , Pneumonia Viral/virologia
16.
Afr J Prim Health Care Fam Med ; 12(1): e1-e3, 2020 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-32501018

RESUMO

The coronavirus disease 2019 (COVID-19) pandemic has highlighted various weaknesses in global healthcare services. The blood supply in Africa is a critical element of the healthcare service that may be significantly affected by the pandemic. By implementing principles of patient blood management, primary healthcare practitioners may play an important role in the resilience of the blood supply during the COVID-19 pandemic.


Assuntos
Segurança do Sangue , Infecções por Coronavirus/epidemiologia , Pandemias , Papel do Médico , Médicos de Atenção Primária , Pneumonia Viral/epidemiologia , África/epidemiologia , Humanos
17.
BMC Res Notes ; 13(1): 293, 2020 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-32546245

RESUMO

OBJECTIVE: Establishing a social contact data sharing initiative and an interactive tool to assess mitigation strategies for COVID-19. RESULTS: We organized data sharing of published social contact surveys via online repositories and formatting guidelines. We analyzed this social contact data in terms of weighted social contact matrices, next generation matrices, relative incidence and R[Formula: see text]. We incorporated location-specific physical distancing measures (e.g. school closure or at work) and capture their effect on transmission dynamics. All methods have been implemented in an online application based on R Shiny and applied to COVID-19 with age-specific susceptibility and infectiousness. Using our online tool with the available social contact data, we illustrate that physical distancing could have a considerable impact on reducing transmission for COVID-19. The effect itself depends on assumptions made about disease-specific characteristics and the choice of intervention(s).


Assuntos
Busca de Comunicante/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Disseminação de Informação/métodos , Pandemias , Pneumonia Viral/epidemiologia , Distância Social , Interface Usuário-Computador , África/epidemiologia , Ásia/epidemiologia , Betacoronavirus/isolamento & purificação , Betacoronavirus/patogenicidade , Infecções por Coronavirus/prevenção & controle , Europa (Continente)/epidemiologia , Humanos , Internet , Modelos Estatísticos , Pandemias/prevenção & controle , Peru/epidemiologia , Pneumonia Viral/prevenção & controle , Inquéritos e Questionários
18.
Ann Clin Microbiol Antimicrob ; 19(1): 21, 2020 May 23.
Artigo em Inglês | MEDLINE | ID: mdl-32446305

RESUMO

The COVID-19 pandemic has currently overtaken every other health issue throughout the world. There are numerous ways in which this will impact existing public health issues. Here we reflect on the interactions between COVID-19 and tuberculosis (TB), which still ranks as the leading cause of death from a single infectious disease globally. There may be grave consequences for existing and undiagnosed TB patients globally, particularly in low and middle income countries (LMICs) where TB is endemic and health services poorly equipped. TB control programmes will be strained due to diversion of resources, and an inevitable loss of health system focus, such that some activities cannot or will not be prioritised. This is likely to lead to a reduction in quality of TB care and worse outcomes. Further, TB patients often have underlying co-morbidities and lung damage that may make them prone to more severe COVID-19. The symptoms of TB and COVID-19 can be similar, with for example cough and fever. Not only can this create diagnostic confusion, but it could worsen the stigmatization of TB patients especially in LMICs, given the fear of COVID-19. Children with TB are a vulnerable group especially likely to suffer as part of the "collateral damage". There will be a confounding of symptoms and epidemiological data through co-infection, as happens already with TB-HIV, and this will require unpicking. Lessons for COVID-19 could be learned from the vast experience of running global TB control programmes, while the astonishingly rapid and relatively well co-ordinated response to COVID-19 demonstrates how existing programmes could be significantly improved.


Assuntos
Coinfecção/diagnóstico , Infecções por Coronavirus/diagnóstico , Controle de Infecções/métodos , Pneumonia Viral/diagnóstico , Tuberculose/diagnóstico , África , Betacoronavirus , Coinfecção/terapia , Infecções por Coronavirus/complicações , Infecções por Coronavirus/terapia , Países em Desenvolvimento , Humanos , Pulmão/patologia , Mycobacterium tuberculosis , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/terapia , Tuberculose/complicações , Tuberculose/terapia , Reino Unido
20.
J Environ Manage ; 268: 110488, 2020 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-32383652

RESUMO

Nitrogen (N) fertilizers are very important for global food self-sufficiency (FSS), particularly for Africa, where the N input in agriculture is very low. This is the first work which studies and calculates the amount of N fertilizer that each country in Africa needs to feed itself by 2050. In this study, we used five different scenarios of inorganic fertilizer N (IFN) use and human diets to calculate the amount of N fertilizer needed to achieve FSS in Africa by 2050 and analyze the changes in N budget; N losses and N use efficiency (NUE). These scenarios include 1) business as usual (BAU), 2) equitable diet (EqD; self-sufficiency), 3) an IFN input 20% less than the EqD (S1), 4) an IFN input 40% less than the EqD (S2), and 5) a 20% increase in IFN input relative to the EqD (S3). Under the BAU scenario, production trends continue as they have over the past five decades, including an unhealthy human diet. In the EqD scenario, the priority is to meet the local demand for both animal and plant proteins with a healthy human diet. Under the EqD scenario, increasing the total N input from 35 kg N ha-1 yr-1 to 181 kg N ha-1 yr-1 during 2016-2050 is needed to achieve FSS in Africa. This increase in N fertilizer use represents unprecedented N inputs to African terrestrial ecosystems - at least 52 Tg N yr-1 - which would lead to inevitable increases in N losses. We also found that the NUE would decrease from 63% during 2010-2016 to 50% by 2050, whereas the total N surplus would increase from 13 kg N ha-1 yr-1 to 90 kg N ha-1 yr-1 by 2050. The estimated gaseous emissions would increase from 8 kg N ha-1 yr-1 to 61 kg N ha-1 yr-1 by 2050. Our findings conclude that, it is very important to consider the high N losses in Africa if the EqD scenario is applied. The S1 and S2 scenarios result in much less environmental N loss, and better NUE compared with the EqD scenario. Therefore, based on these findings we can recommend the implementation of the S2 scenario with an IFN dose of 77 kg N ha-1 yr-1, in parallel with the use of modern agricultural techniques and the increased use of organic inputs.


Assuntos
Produtos Agrícolas , Nitrogênio , África , Agricultura , Animais , Ecossistema , Fertilizantes , Humanos
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