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1.
Lancet Glob Health ; 12(8): e1278-e1287, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39030059

RESUMO

BACKGROUND: The absence of high-quality comprehensive civil registration and vital statistics systems across many settings in Africa has led to little empirical data on causes of death in the region. We aimed to use verbal autopsy data to provide comparative, population-based estimates of cause-specific mortality among adolescents and adults in eastern and southern Africa. METHODS: In this surveillance study, we harmonised verbal autopsy and residency data from nine health and demographic surveillance system (HDSS) sites in Kenya, Malawi, Tanzania, South Africa, Uganda, and Zimbabwe, each with variable coverage from Jan 1, 1995, to Dec 31, 2019. We included all deaths to adolescents and adults aged 12 or over that were residents of the study sites and had a verbal autopsy conducted. InSilicoVA, a probabilistic model, was used to assign cause of death on the basis of the signs and symptoms reported in the verbal autopsy. Levels and trends in all-cause and cause-specific mortality rates and cause-specific mortality fractions were calculated, stratified by HDSS site, sex, age, and calendar periods. FINDINGS: 52 484 deaths and 5 157 802 person-years were reported among 1 071 913 individuals across the nine sites during the study period. 47 961 (91·4%) deaths had a verbal autopsy, of which 46 570 (97·1%) were assigned a cause of death. All-cause mortality generally decreased across the HDSS sites during this period, particularly for adults aged 20-59 years. In many of the HDSS sites, these decreases were driven by reductions in HIV and tuberculosis-related deaths. In 2010-14, the top causes of death were: road traffic accidents, HIV or tuberculosis, and meningitis or sepsis in adolescents (12-19 years); HIV or tuberculosis in adults aged 20-59 years; and neoplasms and cardiovascular disease in adults aged 60 years and older. There was greater between-HDSS and between-sex variation in causes of death for adolescents compared with adults. INTERPRETATION: This study shows progress in reducing mortality across eastern and southern Africa but also highlights age, sex, within-HDSS, and between-HDSS differences in causes of adolescent and adult deaths. These findings highlight the importance of detailed local data to inform health needs to ensure continued improvements in survival. FUNDING: National Institute of Child Health and Human Development of the US National Institutes of Health.


Assuntos
Autopsia , Causas de Morte , Humanos , Adolescente , Causas de Morte/tendências , Masculino , Feminino , Adulto , Adulto Jovem , Autopsia/estatística & dados numéricos , Pessoa de Meia-Idade , África Austral/epidemiologia , África do Sul/epidemiologia , África Oriental/epidemiologia , Vigilância da População/métodos , Quênia/epidemiologia , Criança , Uganda/epidemiologia , Malaui/epidemiologia , Tanzânia/epidemiologia , Zimbábue/epidemiologia
2.
Trop Med Int Health ; 29(8): 739-751, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38961819

RESUMO

OBJECTIVES: The objective of this study is to assess the outcomes of children, adolescents and young adults with HIV reported as lost to follow-up, correct mortality estimates for children, adolescents and young adults with HIV for unascertained outcomes in those loss to follow-up (LTFU) based on tracing and linkage data separately using data from the International epidemiology Databases to Evaluate AIDS in Southern Africa. METHODS: We included data from two different populations of children, adolescents and young adults with HIV; (1) clinical data from children, adolescents and young adults with HIV aged ≤24 years from Lesotho, Malawi, Mozambique, Zambia and Zimbabwe; (2) clinical data from children, adolescents and young adults with HIV aged ≤14 years from the Western Cape (WC) in South Africa. Outcomes of patients lost to follow-up were available from (1) a tracing study and (2) linkage to a health information exchange. For both populations, we compared six methods for correcting mortality estimates for all children, adolescents and young adults with HIV. RESULTS: We found substantial variations of mortality estimates among children, adolescents and young adults with HIV reported as lost to follow-up versus those retained in care. Ascertained mortality was higher among lost and traceable children, adolescents and young adults with HIV and lower among lost and linkable than those retained in care (mortality: 13.4% [traced] vs. 12.6% [retained-other Southern Africa countries]; 3.4% [linked] vs. 9.4% [retained-WC]). A high proportion of lost to follow-up children, adolescents and young adults with HIV had self-transferred (21.0% and 47.0%) in the traced and linked samples, respectively. The uncorrected method of non-informative censoring yielded the lowest mortality estimates among all methods for both tracing (6.0%) and linkage (4.0%) approaches at 2 years from ART start. Among corrected methods using ascertained data, multiple imputation, incorporating ascertained data (MI(asc.)) and inverse probability weighting with logistic weights were most robust for the tracing approach. In contrast, for the linkage approach, MI(asc.) was the most robust. CONCLUSIONS: Our findings emphasise that lost to follow-up is non-ignorable and both tracing and linkage improved outcome ascertainment: tracing identified substantial mortality in those reported as lost to follow-up, whereas linkage did not identify out-of-facility deaths, but showed that a large proportion of those reported as lost to follow-up were self-transfers.


Assuntos
Infecções por HIV , Perda de Seguimento , Humanos , Adolescente , Infecções por HIV/tratamento farmacológico , Infecções por HIV/mortalidade , Criança , Adulto Jovem , África Austral/epidemiologia , Masculino , Feminino , Pré-Escolar , Lactente , Fármacos Anti-HIV/uso terapêutico , Adulto
3.
Glob Chang Biol ; 30(6): e17344, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38837566

RESUMO

Hosting 1460 plant and 126 vertebrate endemic species, the Great Escarpment (hereafter, Escarpment) forms a semi-circular "amphitheater" of mountains girdling southern Africa from arid west to temperate east. Since arid and temperate biota are usually studied separately, earlier studies overlooked the biogeographical importance of the Escarpment as a whole. Bats disperse more widely than other mammalian taxa, with related species and intraspecific lineages occupying both arid and temperate highlands of the Escarpment, providing an excellent model to address this knowledge gap. We investigated patterns of speciation and micro-endemism from modeled past, present, and future distributions in six clades of southern African bats from three families (Rhinolophidae, Cistugidae, and Vespertilionidae) having different crown ages (Pleistocene to Miocene) and biome affiliations (temperate to arid). We estimated mtDNA relaxed clock dates of key divergence events across the six clades in relation both to biogeographical features and patterns of phenotypic variation in crania, bacula and echolocation calls. In horseshoe bats (Rhinolophidae), both the western and eastern "arms" of the Escarpment have facilitated dispersals from the Afrotropics into southern Africa. Pleistocene and pre-Pleistocene "species pumps" and temperate refugia explained observed patterns of speciation, intraspecific divergence and, in two cases, mtDNA introgression. The Maloti-Drakensberg is a center of micro-endemism for bats, housing three newly described or undescribed species. Vicariance across biogeographic barriers gave rise to 29 micro-endemic species and intraspecific lineages whose distributions were congruent with those identified in other phytogeographic and zoogeographic studies. Although Köppen-Geiger climate models predict a widespread replacement of current temperate ecosystems in southern Africa by tropical or arid ecosystems by 2070-2100, future climate Maxent models for 13 bat species (all but one of those analyzed above) showed minimal range changes in temperate species from the eastern Escarpment by 2070, possibly due to the buffering effect of mountains to climate change.


Assuntos
Quirópteros , Mudança Climática , DNA Mitocondrial , Animais , Quirópteros/fisiologia , Quirópteros/genética , África Austral , DNA Mitocondrial/genética , DNA Mitocondrial/análise , Filogenia , Especiação Genética , Filogeografia , Distribuição Animal
4.
Glob Health Action ; 17(1): 2370102, 2024 12 31.
Artigo em Inglês | MEDLINE | ID: mdl-38932660

RESUMO

BACKGROUND: While ear, nose, and throat (ENT) diseases are a substantial threat to global health, comprehensive reviews of ENT services in Southern Africa remain scarce. OBJECTIVE: This scoping review provides a decade-long overview of ENT services in Southern Africa and identifies gaps in healthcare provision. From the current literature, we hope to provide evidence-based recommendations to mitigate the challenges faced by the resource-limited ENT service. DATA SOURCES: PubMed, Web of Science, EBSCOhost, Cochrane Library, Cochrane Library, and Scopus. REVIEW METHODS: On several databases, we conducted a comprehensive literature search on both quantitative and qualitative studies on ENT services in Southern Africa, published between 1 January 2014 and 27 February 2024. The extracted data from the analyzed studies was summarized into themes. RESULTS: Four themes in the fourteen studies included in the final analysis described the existing ENT services in Southern Africa: 1. Workforce scarcity and knowledge inadequacies, 2. Deficiencies in ENT infrastructure, equipment, and medication, 3. Inadequate ENT disease screening, management, and rehabilitation and 4. A lack of telehealth technology. CONCLUSION: The Southern African ENT health service faces many disease screening, treatment, and rehabilitation challenges, including critical shortages of workforce, equipment, and medication. These challenges, impeding patient access to ENT healthcare, could be effectively addressed by implementing deliberate policies to train a larger workforce, increase ENT funding for equipment and medication, promote telehealth, and reduce the patient cost of care.


Main findings: Ear, nose and throat (ENT) healthcare in Southern Africa faces critical shortages of workforce, equipment, and medication for disease screening, treatment and rehabilitation.Added knowledge: In this review, we identify challenges in the resource-limited Southern African ENT healthcare provision and provide evidence-based recommendations to mitigate these challenges.Global health impact for policy and action: Improving ENT service delivery in the resource-limited world requires deliberate policies that improve health worker training, expand financing and resource availability, incorporate new technology, and lower patient costs of care.


Assuntos
Otorrinolaringopatias , Humanos , África Austral , Otorrinolaringopatias/terapia , Otolaringologia/organização & administração , Atenção à Saúde/organização & administração , Acessibilidade aos Serviços de Saúde/organização & administração
5.
Surg Endosc ; 38(8): 4415-4421, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38890173

RESUMO

BACKGROUND: With the primary objective of addressing the disparity in global surgical care access, the College of Surgeons of East, Central, and Southern Africa (COSECSA) trains surgeons. While sufficient operative experience is crucial for surgical training, the extent of utilization of minimally invasive techniques during COSECSA training remains understudied. METHODS: We conducted an extensive review of COSECSA general surgery trainees' operative case logs from January 1, 2015, to December 31, 2020, focusing on the utilization of minimally invasive surgical procedures. Our primary objective was to determine the prevalence of laparoscopic procedures and compare this to open procedures. We analyzed the distribution of laparoscopic cases across common indications such as cholecystectomy, appendicitis, and hernia operations. Additionally, we examined the impact of trainee autonomy, country development index, and hospital type on laparoscopy utilization. RESULTS: Among 68,659 total cases, only 616 (0.9%) were laparoscopic procedures. Notably, 34 cases were conducted during trainee external rotations in countries like the United Kingdom, Germany, and India. Gallbladder and appendix pathologies were most frequent among the 582 recorded laparoscopic cases performed in Africa. Laparoscopic cholecystectomy accounted for 29% (276 of 975 cases), laparoscopic appendectomy for 3% (76 of 2548 cases), and laparoscopic hernia repairs for 0.5% (26 of 5620 cases). Trainees self-reported lower autonomy for laparoscopic (22.5%) than open cases (61.5%). Laparoscopy usage was more prevalent in upper-middle-income (2.7%) and lower-middle-income countries (0.8%) compared with lower-income countries (0.5%) (p < 0.001). Private (1.6%) and faith-based hospitals (1.5%) showed greater laparoscopy utilization than public hospitals (0.5%) (p < 0.001). CONCLUSIONS: The study highlights the relatively low utilization of minimally invasive techniques in surgical training within the ECSA region. Laparoscopic cases remain a minority, with variations observed based on specific diagnoses. The findings suggest a need to enhance exposure to minimally invasive procedures to ensure well-rounded training and proficiency in these techniques.


Assuntos
Laparoscopia , Humanos , Laparoscopia/educação , Laparoscopia/estatística & dados numéricos , África Oriental , África Austral/epidemiologia , África Central , Apendicectomia/estatística & dados numéricos , Apendicectomia/educação , Apendicectomia/métodos , Colecistectomia Laparoscópica/educação , Colecistectomia Laparoscópica/estatística & dados numéricos , Herniorrafia/educação , Herniorrafia/estatística & dados numéricos , Herniorrafia/métodos , Cirurgia Geral/educação , Cirurgia Geral/estatística & dados numéricos
6.
J Ethnopharmacol ; 332: 118361, 2024 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-38763369

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: For the first time in two decades, a comprehensive, up-to-date overview of the medicinal and ritual plants of southern Africa is presented. This data is analysed and compared with a previous survey done in 2002. STUDY AIM: The main aim is to update the checklist of medicinal and ritual plants of southern Africa and to determine the number of new records since 2002. We also provide a high-level perspective on the selection of medicinal and ritual plant species in southern Africa, a taxonomic analysis of the new checklist as well as a chronological perspective on the citation of medicinal and ritual species before and after 2002. MATERIALS AND METHODS: The most recently published medicinal and ritual plants checklist for southern Africa was reviewed and updated. A wide range of ethnobotanical literature, including books, field guides and electronic journals, was used. All calculations were done by using formulas and functions in Microsoft Excel and R Studio. RESULTS: 4120 medicinal and ritual taxa and 3784 medicinal and ritual species have been recorded. Compared with the 2002 checklist, there are 1239 new taxa (1228 new species). A strong correlation between available taxa and selected medicinal taxa exists on order level, which corresponds with the results of an analysis done in 2008. The top 10 species-rich medicinal plant families of southern Africa are Asteraceae, Fabaceae, Apocynaceae, Euphorbiaceae, Asphodelaceae, Malvaceae, Lamiaceae, Poaceae, Rutaceae and Rubiaceae. Different patterns of plant family representation can be seen across certain cultural healing systems of southern Africa. The species popularity (number of citations) of Hypoxis hemerocallidea Fisch. & C.A.Mey. Has increased substantially after 2002. Other medicinal and ritual plant species have been consistently researched, such as Artemisia afra Jacq. ex Willd., Carpobrotus edulis (L.) L.Bolus, Aloe ferox Mill., Leonotis leonurus (L.) R.Br. and Gunnera perpensa L. CONCLUSIONS: The numerous new medicinal and ritual plant records that have been reported in the last two decades provide evidence of an incompletely documented ethnobotanical heritage that urgently requires documentation. Patterns of taxonomic diversity on family level indicate distinctive differences between cultural healing systems. Signs of the adaptability and dynamics of traditional healing systems in southern Africa can be seen in the changes in the citation of species over time.


Assuntos
Comportamento Ritualístico , Etnobotânica , Medicinas Tradicionais Africanas , Plantas Medicinais , Plantas Medicinais/classificação , África Austral , Medicinas Tradicionais Africanas/métodos , Humanos , Fitoterapia , Etnofarmacologia
7.
Int J Infect Dis ; 145: 107081, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38701914

RESUMO

OBJECTIVES: To evaluate diagnostic yield and feasibility of integrating testing for TB and COVID-19 using molecular and radiological screening tools during community-based active case-finding (ACF). METHODS: Community-based participants with presumed TB and/or COVID-19 were recruited using a mobile clinic. Participants underwent simultaneous point-of-care (POC) testing for TB (sputum; Xpert Ultra) and COVID-19 (nasopharyngeal swabs; Xpert SARS-CoV-2). Sputum culture and SARS-CoV-2 RT-PCR served as reference standards. Participants underwent ultra-portable POC chest radiography with computer-aided detection (CAD). TB infectiousness was evaluated using smear microscopy, cough aerosol sampling studies (CASS), and chest radiographic cavity detection. Feasibility of POC testing was evaluated via user-appraisals. RESULTS: Six hundred and one participants were enrolled, with 144/601 (24.0%) reporting symptoms suggestive of TB and/or COVID-19. 16/144 (11.1%) participants tested positive for TB, while 10/144 (6.9%) tested positive for COVID-19 (2/144 [1.4%] had concurrent TB/COVID-19). Seven (7/16 [43.8%]) individuals with TB were probably infectious. Test-specific sensitivity and specificity (95% CI) were: Xpert Ultra 75.0% (42.8-94.5) and 96.9% (92.4-99.2); Xpert SARS-CoV-2 66.7% (22.3-95.7) and 97.1% (92.7-99.2). Area under the curve (AUC) for CAD4TB was 0.90 (0.82-0.97). User appraisals indicated POC Xpert to have 'good' user-friendliness. CONCLUSIONS: Integrating TB/COVID-19 screening during community-based ACF using POC molecular and radiological tools is feasible, has a high diagnostic yield, and can identity probably infectious persons.


Assuntos
COVID-19 , SARS-CoV-2 , Humanos , COVID-19/diagnóstico , COVID-19/epidemiologia , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Programas de Rastreamento/métodos , Testes Imediatos , Escarro/microbiologia , Escarro/virologia , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Tuberculose/diagnóstico por imagem , África Austral/epidemiologia , Sensibilidade e Especificidade , Estudos de Viabilidade , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/diagnóstico por imagem , Tuberculose Pulmonar/epidemiologia
8.
Mol Phylogenet Evol ; 197: 108104, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38750676

RESUMO

Barking geckos (genus Ptenopus) are terrestrial, burrowing lizards endemic to southern Africa, currently with three recognised species. Two species are range-restricted (P. kochi and P. carpi) and display clear differences in substrate preference (soft sand vs. hard gravel). The third and most widespread species, P. garrulus, occurs on a variety of substrates of differing hardness, across potential geographic barriers, and over a steep climatic gradient. Variations in morphology and advertisement calls indicates that P. garrulus may be a species complex. Two subspecies of P. garrulus are currently recognised: P. g. maculatus and P. g. garrulus. To investigate species boundaries, we produced the first comprehensive phylogeny for the genus. We used a novel application of multiple regression on matrices models to assess multiple environmental drivers of diversification, as contrasted to isolation by distance. We show that P. kochi, P. carpi, and P. g. garrulus are valid species, but that P. g. maculatus is a paraphyletic complex of five previously unrecognised taxa. Specialisation onto different substrates was likely the main driver of divergence, with parapatric occurrence of two to four clades occurring at each of the three substrate transition zones identified a priori. The region encompasses diverse bioclimatic regions and potential geographic barriers, and these likely played a role in some divergence events.


Assuntos
Lagartos , Filogenia , Animais , Lagartos/genética , Lagartos/classificação , DNA Mitocondrial/genética , Especiação Genética , Análise de Sequência de DNA , África Austral , Teorema de Bayes , Modelos Genéticos
9.
Sci Rep ; 14(1): 11071, 2024 05 14.
Artigo em Inglês | MEDLINE | ID: mdl-38745036

RESUMO

The southern coast of Africa is one of the few places in the world where water temperatures are predicted to cool in the future. This endemism-rich coastline is home to two sister species of kelps of the genus Ecklonia maxima and Ecklonia radiata, each associated with specific thermal niches, and occuring primarily on opposite sides of the southern tip of Africa. Historical distribution records indicate that E. maxima has recently shifted its distribution ~ 70 km eastward, to sites where only E. radiata was previously reported. The contact of sister species with contrasting thermal affinities and the occurrence of mixed morphologies raised the hypothesis that hybridization might be occurring in this contact zone. Here we describe the genetic structure of the genus Ecklonia along the southern coast of Africa and investigate potential hybridization and cryptic diversity using a combination of nuclear microsatellites and mitochondrial markers. We found that both species have geographically discrete genetic clusters, consistent with expected phylogeographic breaks along this coastline. In addition, depth-isolated populations were found to harbor unique genetic diversity, including a third Ecklonia lineage. Mito-nuclear discordance and high genetic divergence in the contact zones suggest multiple hybridization events between Ecklonia species. Discordance between morphological and molecular identification suggests the potential influence of abiotic factors leading to convergent phenotypes in the contact zones. Our results highlight an example of cryptic diversity and hybridization driven by contact between two closely related keystone species with contrasting thermal affinities.


Assuntos
Variação Genética , Kelp , Filogenia , Kelp/genética , Kelp/classificação , Filogeografia , Repetições de Microssatélites/genética , Hibridização Genética , DNA Mitocondrial/genética , África Austral
10.
Syst Parasitol ; 101(3): 32, 2024 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-38647716

RESUMO

Seven species belonging to Pennellidae are reported from marine teleosts caught off southern Africa. Additionally, complete re-descriptions are provided for Propeniculus stromatei and Sarcotretes scopeli. Examination of Lernaeenicus gonostomae, deposited in the Iziko South African Museum, indicated that it has the morphological features of Sarcotretes rather than Lernaeenicus and thus should be moved to Sarcotretes i.e. S. gonostomae n. comb. for which a re-description is also provided. Reports of new host records include those of Pennella instructa from Seriola lalandi; Propeniculus stromatei from Rhabdosargus holubi and Pomadasys commersonnii; Sarcotretes scopeli from Nansenia tenera, and Sarcotretes longirostris from Centrolophus niger. New geographical records include those of P. instructa, P. stromatei, S. scopeli, S. longirostris, and L. longiventris off southern Africa. Additionally, an attempt to estimate the evolutionary relationships amongst some genera is done from partial COI sequences deposited in Genbank.


Assuntos
Copépodes , Especificidade da Espécie , Animais , Copépodes/classificação , Copépodes/anatomia & histologia , Feminino , África Austral , África do Sul , Peixes/parasitologia
11.
J Cancer Policy ; 40: 100477, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38593950

RESUMO

BACKGROUND: Cervical cancer poses a significant burden, particularly in low-and-middle income countries (LMIC) with limited access to healthcare. High-income countries have made progress in prevention, while LMIC face unacceptably high incidence and mortality rates, often lacking official screening recommendations. We analysed the presence and content of cervical cancer screening guidelines for the secondary prevention of cervical cancer in the Southern African Development Community (SADC) and compared it to the current World Health Organization (WHO) guidelines for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention. METHODS: A review of national cervical cancer guidelines across the SADC region was conducted. Data was obtained from government websites, international cancer control platforms, and WHO resources. Search terms included "cervical cancer" and "cervical cancer control guidelines", amongst others. There were no limitations on publication years, and the most recent versions of the guidelines were analysed, regardless of language. Each guideline was assessed for specific screening and treatment recommendations, in relation to the current WHO guidelines. Points were assigned for each data element. RESULTS: While most countries contributed data to this analysis there was a notable absence of adherence to the WHO guidelines. The most common screening method was naked eye visual inspection. There was a consensus on the age of screening initiation. Most countries recommended treatment by cryotherapy and loop excision. CONCLUSION: Effective cervical cancer screening programmes, guided by evidence-based recommendations, can enhance early intervention and outcomes. This study highlights the need for standardized and evidence-based cervical cancer screening guidelines in the SADC region, to reduce the burden of cervical cancer and improve the health outcomes of women in these areas.


Assuntos
Detecção Precoce de Câncer , Neoplasias do Colo do Útero , Humanos , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle , Feminino , África Austral/epidemiologia , Guias de Prática Clínica como Assunto , Programas de Rastreamento , Adulto , Organização Mundial da Saúde
12.
Pan Afr Med J ; 47: 31, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38586072

RESUMO

Introduction: the Africa region was certified indigenous wild poliovirus-free in August 2020. Countries in East and Southern Africa have, during acute flaccid paralysis (AFP) and environmental surveillance (ES), detected equally concerning vaccine-derived polioviruses (VDPVs) that have not been systematically documented to guide programming in the sub-region. The study documents trends and salient observations of the VDPVs by country of detection, for 11 years from 2010 to 2021. Methods: we conducted secondary data analysis, a descriptive study design, by deploying field and laboratory of AFP and environmental surveillance databases of the 20 East and Southern African countries from 2010 to 2021. Results: a total of 318 VDPVs were reported over the study period. The majority were from AFP cases (58.8%) and the rest equally distributed between healthy community children and environmental surveillance sources. More polioviruses were detected after 2016 than during the period before. We observed that more boys were affected by VDPVs compared to girls. Children under 5 years were more affected than other age groups, with a mean age of 3.6 years. Delay of samples in the field seemed to increase the likelihood of not reporting VDPVs and not mounting timely public health detailed investigations and vaccination responses. Conclusion: the study provides useful evolutional trends of VDPVs for surveillance and vaccination programming. We also noted that the VDPV2s have been increasing after the 2016 tOPV to oral polio vaccine (bOPV) switch. The COVID-19 pandemic emergence in 2020, led to a decline in AFP, ES surveillance, and immunization activities. Our findings point to the need to implement enhanced tailored childhood immunization recovery strategies and to speed up the use of inactivated polio vaccine (IPV) to boost population immunity.


Assuntos
Poliomielite , Poliovirus , Criança , Masculino , Feminino , Humanos , Pré-Escolar , Poliomielite/epidemiologia , Poliomielite/prevenção & controle , Pandemias , alfa-Fetoproteínas , Vacina Antipólio Oral , Vacina Antipólio de Vírus Inativado , África Austral/epidemiologia
13.
Nutrients ; 16(7)2024 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-38613007

RESUMO

Selenium is an essential trace element that exists in inorganic forms (selenite and selenates) and organic forms (selenoamino acids, seleno peptides, and selenoproteins). Selenium is known to aid in the function of the immune system for populations where human immunodeficiency virus (HIV) is endemic, as studies suggest that a lack of selenium is associated with a higher risk of mortality among those with HIV. In a recent study conducted in Zambia, adults had a median plasma selenium concentration of 0.27 µmol/L (IQR 0.14-0.43). Concentrations consistent with deficiency (<0.63 µmol/L) were found in 83% of adults. With these results, it can be clearly seen that selenium levels in Southern Africa should be investigated to ensure the good health of both livestock and humans. The recommended selenium dietary requirement of most domesticated livestock is 0.3 mg Se/kg, and in humans above 19 years, anRDA (recommended daily allowance) of 55 mcg Se/per dayisis recommended, but most of the research findings of Southern African countries have recorded low levels. With research findings showing alarming low levels of selenium in soils, humans, and raw feed materials in Southern Africa, further research will be vital in answering questions on how best to improve the selenium status of Southern African soils and plants for livestock and humans to attain sufficient quantities.


Assuntos
Infecções por HIV , Selênio , Adulto , Humanos , Animais , África Austral , Zâmbia , Gado , Solo
14.
Food Res Int ; 184: 114200, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38609207

RESUMO

Various species of Southern African plants and their edible seeds have gained huge importance due to positive health aspects, and there is increasing interest to introduce such seeds as Novel Food on the international market. Especially the seeds of Schinziophyton rautanenii (manketti) and Guibourtia coleosperma (ushivi) could have great potential as a food and food ingredient. Hence, extensive analyses on the chemical composition of manketti nuts and ushivi beans including the analysis of total solids, protein and fat content, soluble carbohydrates, ash, total and free amino acids, biogenic amines and polyamines, fatty acid profile as well as the content of certain B-vitamins and tocopherols were performed. Results obtained showed a valuable nutritional composition, e.g., a true protein content of 22.6% with a ratio of essential amino acids to total amino acid composition of 48% in manketti nuts, while ushivi beans had a true protein content of 8.2% with a similar ratio of essential to total amino acids (45%). Lipid content was 54.1% in manketti nuts, ushivi beans had a value of 7.7%. In both, linoleic acid was the most abundant. Furthermore, ushivi beans had high amounts of vitamin B1 and B2.


Assuntos
Euphorbiaceae , Fabaceae , Nozes , Sementes , África Austral , Aminoácidos
15.
BMJ Glob Health ; 9(4)2024 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-38594203

RESUMO

In 2019, there were 21 million pregnancies among adolescents aged 15-19 years globally; close to half of these pregnancies were unintended. Early and unintended pregnancy (EUP) remains a pressing concern with severe socioeconomic and health outcomes for adolescent girls aged 15-19 years, their offspring and society. In Eastern and Southern Africa (ESA), Zambia, the United Republic of Tanzania, the Democratic Republic of Congo, Malawi and Uganda have adolescent fertility rates (AFR) of more than 100 live births per 1000 adolescent girls aged 15-19 years. Ministers of Health and Education, through the ESA Ministerial Commitment, aimed to reduce EUP by 75% by 2020; the renewed ESA Ministerial Commitment aims to reduce EUP by 40% by 2030. This descriptive policy content analysis assesses the prioritisation of EUP within adolescent sexual and reproductive health and rights (ASRHR) policies. An assessment of nine countries in the region shows that EUP is a key policy priority among countries; however, other than Kenya, the majority of ASRHR policies in the region do not set out clear and costed interventions for EUP, and few have monitoring and evaluation frameworks in place. Despite AFRs declining in Kenya and strong policies in place, the gains made are at risk due to the rollback on SRHR, and the country has not renewed the ESA Ministerial Commitment. This policy content analysis points towards the gaps we are still to meet within the universal health coverage agenda: better planning, prioritisation, sound policy frameworks and long-term commitments to meet the needs of adolescents.


Assuntos
Gravidez não Planejada , Saúde Reprodutiva , Gravidez , Feminino , Adolescente , Humanos , África Austral/epidemiologia , Tanzânia , Políticas
16.
Sci Rep ; 14(1): 9151, 2024 04 21.
Artigo em Inglês | MEDLINE | ID: mdl-38644368

RESUMO

Limited commercial quality protein maize (QPM) varieties with low grain yield potential are currently grown in Eastern and Southern Africa (ESA). This study was conducted to (i) assess the performance of single-cross QPM hybrids that were developed from elite inbred lines using line-by-tester mating design and (ii) estimate the general (GCA) and specific (SCA) combining ability of the QPM inbred lines for grain yield, agronomic and protein quality traits. One hundred and six testcrosses and four checks were evaluated across six environments in ESA during 2015 and 2016. Significant variations (P ≤ 0.01) were observed among environments, genotypes and genotype by environment interaction (GEI) for most traits evaluated. Hybrids H80 and H104 were the highest-yielding, most desirable, and stable QPM hybrids. Combining ability analysis showed both additive and non-additive gene effects to be important in the inheritance of grain yield. Additive effects were more important for agronomic and protein quality traits. Inbred lines L19 and L20 depicted desirable GCA effects for grain yield. Various other inbred lines with favorable GCA effects for agronomic traits, endosperm modification, and protein quality traits were identified. These inbred lines could be utilized for breeding desirable QPM cultivars. The QPM hybrids identified in this study could be commercialized after on-farm verification to replace the low-yielding QPM hybrids grown in ESA.


Assuntos
Melhoramento Vegetal , Zea mays , Zea mays/genética , Zea mays/metabolismo , Zea mays/crescimento & desenvolvimento , Melhoramento Vegetal/métodos , África Austral , Grão Comestível/genética , Grão Comestível/crescimento & desenvolvimento , Grão Comestível/metabolismo , África Oriental , Genótipo , Cruzamentos Genéticos , Endogamia , Fenótipo , Proteínas de Plantas/genética , Proteínas de Plantas/metabolismo
17.
Nat Commun ; 15(1): 2921, 2024 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-38609362

RESUMO

The blue wildebeest (Connochaetes taurinus) is a keystone species in savanna ecosystems from southern to eastern Africa, and is well known for its spectacular migrations and locally extreme abundance. In contrast, the black wildebeest (C. gnou) is endemic to southern Africa, barely escaped extinction in the 1900s and is feared to be in danger of genetic swamping from the blue wildebeest. Despite the ecological importance of the wildebeest, there is a lack of understanding of how its unique migratory ecology has affected its gene flow, genetic structure and phylogeography. Here, we analyze whole genomes from 121 blue and 22 black wildebeest across the genus' range. We find discrete genetic structure consistent with the morphologically defined subspecies. Unexpectedly, our analyses reveal no signs of recent interspecific admixture, but rather a late Pleistocene introgression of black wildebeest into the southern blue wildebeest populations. Finally, we find that migratory blue wildebeest populations exhibit a combination of long-range panmixia, higher genetic diversity and lower inbreeding levels compared to neighboring populations whose migration has recently been disrupted. These findings provide crucial insights into the evolutionary history of the wildebeest, and tangible genetic evidence for the negative effects of anthropogenic activities on highly migratory ungulates.


Assuntos
Antílopes , Animais , Antílopes/genética , Ecossistema , África Oriental , África Austral , Efeitos Antropogênicos
18.
PLoS One ; 19(4): e0301850, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38669230

RESUMO

BACKGROUND: Spatial analysis at different levels can help understand spatial variation of human immunodeficiency virus (HIV) infection, disease drivers, and targeted interventions. Combining spatial analysis and the evaluation of the determinants of the HIV burden in Southern African countries is essential for a better understanding of the disease dynamics in high-burden settings. METHODS: The study countries were selected based on the availability of demographic and health surveys (DHS) and corresponding geographic coordinates. We used multivariable regression to evaluate the determinants of HIV burden and assessed the presence and nature of HIV spatial autocorrelation in six Southern African countries. RESULTS: The overall prevalence of HIV for each country varied between 11.3% in Zambia and 22.4% in South Africa. The HIV prevalence rate was higher among female respondents in all six countries. There were reductions in prevalence estimates in most countries yearly from 2011 to 2020. The hotspot cluster findings show that the major cities in each country are the key sites of high HIV burden. Compared with female respondents, the odds of being HIV positive were lesser among the male respondents. The probability of HIV infection was higher among those who had sexually transmitted infections (STI) in the last 12 months, divorced and widowed individuals, and women aged 25 years and older. CONCLUSIONS: Our research findings show that analysis of survey data could provide reasonable estimates of the wide-ranging spatial structure of the HIV epidemic in Southern African countries. Key determinants such as individuals who are divorced, middle-aged women, and people who recently treated STIs, should be the focus of HIV prevention and control interventions. The spatial distribution of high-burden areas for HIV in the selected countries was more pronounced in the major cities. Interventions should also be focused on locations identified as hotspot clusters.


Assuntos
Infecções por HIV , Humanos , Feminino , Infecções por HIV/epidemiologia , Masculino , Adulto , Prevalência , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , África do Sul/epidemiologia , Análise Espacial , Zâmbia/epidemiologia , Inquéritos Epidemiológicos , África Austral/epidemiologia
19.
Yeast ; 41(5): 330-348, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38450792

RESUMO

Yeast-insect interactions are one of the most interesting long-standing relationships whose research has contributed to our understanding of yeast biodiversity and their industrial applications. Although insect-derived yeast strains are exploited for industrial fermentations, only a limited number of such applications has been documented. The search for novel yeasts from insects is attractive to augment the currently domesticated and commercialized production strains. More specifically, there is potential in tapping the insects native to southern Africa. Southern Africa is home to a disproportionately high fraction of global biodiversity with a cluster of biomes and a broad climate range. This review presents arguments on the roles of the mutualistic relationship between yeasts and insects, the presence of diverse pristine environments and a long history of spontaneous food and beverage fermentations as the potential source of novelty. The review further discusses the recent advances in novelty of industrial strains of insect origin, as well as various ancient and modern-day industries that could be improved by use yeasts from insect origin. The major focus of the review is on the relationship between insects and yeasts in southern African ecosystems as a potential source of novel industrial yeast strains for modern bioprocesses.


Assuntos
Biodiversidade , Insetos , Leveduras , Insetos/microbiologia , Animais , Leveduras/classificação , Leveduras/fisiologia , Leveduras/genética , África Austral , Fermentação , Simbiose , Microbiologia Industrial
20.
Nature ; 629(8010): 114-120, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38538797

RESUMO

Mountain ranges contain high concentrations of endemic species and are indispensable refugia for lowland species that are facing anthropogenic climate change1,2. Forecasting biodiversity redistribution hinges on assessing whether species can track shifting isotherms as the climate warms3,4. However, a global analysis of the velocities of isotherm shifts along elevation gradients is hindered by the scarcity of weather stations in mountainous regions5. Here we address this issue by mapping the lapse rate of temperature (LRT) across mountain regions globally, both by using satellite data (SLRT) and by using the laws of thermodynamics to account for water vapour6 (that is, the moist adiabatic lapse rate (MALRT)). By dividing the rate of surface warming from 1971 to 2020 by either the SLRT or the MALRT, we provide maps of vertical isotherm shift velocities. We identify 17 mountain regions with exceptionally high vertical isotherm shift velocities (greater than 11.67 m per year for the SLRT; greater than 8.25 m per year for the MALRT), predominantly in dry areas but also in wet regions with shallow lapse rates; for example, northern Sumatra, the Brazilian highlands and southern Africa. By linking these velocities to the velocities of species range shifts, we report instances of close tracking in mountains with lower climate velocities. However, many species lag behind, suggesting that range shift dynamics would persist even if we managed to curb climate-change trajectories. Our findings are key for devising global conservation strategies, particularly in the 17 high-velocity mountain regions that we have identified.


Assuntos
Altitude , Migração Animal , Biodiversidade , Mapeamento Geográfico , Aquecimento Global , Animais , África Austral , Brasil , Conservação dos Recursos Naturais , Aquecimento Global/estatística & dados numéricos , Umidade , Indonésia , Chuva , Refúgio de Vida Selvagem , Imagens de Satélites , Especificidade da Espécie , Temperatura , Fatores de Tempo
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