scholarly journals The impact, cost and cost‐effectiveness of oral pre‐exposure prophylaxis in sub‐Saharan Africa: a scoping review of modelling contributions and way forward

2019 ◽  
Vol 22 (9) ◽  
Author(s):  
Kelsey K Case ◽  
Gabriela B Gomez ◽  
Timothy B Hallett
Keyword(s):  
Cost Effectiveness ◽  
Scoping Review ◽  
Sub Saharan Africa ◽  
Sub Saharan ◽  
Exposure Prophylaxis ◽  
The Impact ◽  
Impact Cost

scholarly journals The impact and cost‐effectiveness of community‐basedHIVself‐testing in sub‐Saharan Africa: a health economic and modelling analysis

2019 ◽  
Vol 22 (S1) ◽  
pp. e25243 ◽  
Author(s):  
Valentina Cambiano ◽  
Cheryl C Johnson ◽  
Karin Hatzold ◽  
Fern Terris‐Prestholt ◽  
Hendy Maheswaran ◽  
...  
Keyword(s):  
Health Economic ◽  
Cost Effectiveness ◽  
Sub Saharan Africa ◽  
Modelling Analysis ◽  
Sub Saharan ◽  
The Impact

scholarly journals The Place of Spiritual and Traditional Beliefs in Stroke Rehabilitation in Sub-Saharan Africa: A Scoping Review

2019 ◽  
pp. 1-16
Author(s):  
Martins Chidi Nweke ◽  
Eze Christian Kanayo
Keyword(s):  
Scoping Review ◽  
Stroke Rehabilitation ◽  
Selection Process ◽  
Traditional Approach ◽  
Holistic Approach ◽  
Sub Saharan Africa ◽  
Health Seeking ◽  
Traditional Beliefs ◽  
Sub Saharan ◽  
The Impact

Aims: This systematic scoping review aimed at mapping evidence available on the impact of spiritual and traditional beliefs on perception of stroke vis-a-vis stroke rehabilitation in sub-Saharan Africa. Study Design: Systematic scoping review. Place and Duration of Study: This study was conducted in June, 2019 as a preliminary step to study underway in the University of Nigeria Enugu Campus. Methodology: Literature search was undertaken of PubMed, CINAHL, EBSCOhost Academic Search Complete and PsycINFO. The selection process was aided with use of EndNote X8. A total of 17 peer-reviewed articles were included. Thematic contents analysis was done using NVIVO 12. Five emerging themes were synthesized. Results show that a small but significant number of the respondents possessed poor knowledge and perception of stroke, and this affected the health seeking behaviors. Results: Although many of the participants would seek formal healthcare when a stroke occurs, some believed stroke is purely a spiritual event and should be addressed spiritually, while a few advocated for integration of traditional and orthodox healthcare approaches. Being a clinical worker, educated or a Christian was associated with good knowledge of stroke. For the participants who preferred spiritual or traditional approach to formal healthcare, traditional or religious inclination, level of education, hospital cost and hospital-related ill-treatment are the propelling factors. Conclusion: Spiritual and traditional beliefs possess a significant place in stroke rehabilitation in sub-Saharan Africa. We commend that holistic approach with a spiritual component be adopted in stroke rehabilitation across sub-Saharan Africa.

scholarly journals The impact of geographic targeting of oral cholera vaccination in sub-Saharan Africa: a modeling study

2019 ◽  
Author(s):  
Elizabeth C. Lee ◽  
Andrew S. Azman ◽  
Joshua Kaminsky ◽  
Sean M. Moore ◽  
Heather S. McKay ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Sub Saharan Africa ◽  
Population Projections ◽  
World Health ◽  
Water And Sanitation ◽  
Sub Saharan ◽  
Near Term ◽  
Cholera Vaccination ◽  
Vaccination Campaigns ◽  
The Impact

AbstractBackgroundIn May 2018, the World Health Assembly committed to reducing worldwide cholera deaths by 90% by 2030. Oral cholera vaccine (OCV) plays a key role in reducing the near-term risk of cholera, although global supplies are limited. Characterizing the potential impact and cost-effectiveness of mass OCV deployment strategies is critical for setting expectations and developing cholera control plans that maximize chances of success.Methods and FindingsWe compared the projected impacts of vaccination campaigns across sub-Saharan Africa from 2018 through 2030 when targeting geographically according to historical cholera burden and risk factors. We assessed the number of averted cases, deaths, disability-adjusted life-years, and cost-effectiveness with models that account for direct and indirect vaccine effects and population projections over time. Under current vaccine supply projections, an approach optimized to targeting by historical burden is projected to avert 828,971 (95% CI: 803,370-859,980) cases (equivalent to 34.0% of projected cases; 95% CI: 33.2-34.8). An approach that balances logistical feasibility with targeting historical burden is projected to avert 617,424 (95% CI: 599,150-643,891) cases. In contrast, approaches optimized for targeting locations with limited access to water and sanitation are projected to avert 273,939 (95% CI: 270,319-277,002) and 109,817 (95% CI: 103,735-114,110) cases, respectively. We find that the most logistically feasible targeting strategy costs $1,843 (95% CI: 1,328-14,312) per DALY averted during this period and that effective geographic targeting of OCV campaigns can have a greater impact on cost-effectiveness than improvements to vaccine efficacy and moderate increases in coverage. Although our modeling approach did not project annual changes in baseline cholera risk or incorporate immunity from natural cholera infection, our estimates of the relative performance of different vaccination strategies should be robust to these factors.ConclusionsOur study suggests that geographic targeting is critical to the cost-effectiveness and impact of oral cholera vaccination campaigns. Districts with the poorest access to improved water and sanitation are not the same as districts with the greatest historical cholera incidence. While OCV campaigns can improve cholera control in the near-term, without rapid progress in developing water and sanitation services, our results suggest that vaccine use alone are unlikely to allow us to achieve the 2030 goals.

Mobile messaging support versus usual care for people with type 2 diabetes in sub-Saharan Africa: a protocol for a multicentre randomized controlled trial (StAR2D) (Preprint)

2018 ◽  
Author(s):  
Andrew Farmer ◽  
Kirsten Bobrow ◽  
Natalie Leon ◽  
Nicola Williams ◽  
Enita Phiri ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cost Effectiveness ◽  
Health Outcomes ◽  
Usual Care ◽  
Text Messaging ◽  
Sub Saharan Africa ◽  
Sub Saharan ◽  
The Impact ◽  
Sms Text Messaging

UNSTRUCTURED Background: Health outcomes for people treated for type 2 diabetes could be substantially improved in sub-Saharan Africa. Failure to take medicines regularly to treat diabetes has been identified as a major problem. Resources to identify and support patients who are not making best use of medicine in low and middle-income settings are scarce. Mobile phones are widely available in these settings including among people with diabetes, and linked technologies such as SMS-text messaging have shown promise in delivering low-cost interventions efficiently. However, evidence that these interventions will work when carried out at a larger scale, and of the extent to which they will improve health outcomes when added to usual care is limited. Methods: We will carry out a randomised clinical trial in two contrasting settings in sub-Saharan Africa, Cape Town in South Africa and Lilongwe in Malawi, to provide information about the impact of sending brief automated messages via SMS text-messaging. The messages will advise people about the benefits of their diabetes treatment and offer motivation and encouragement around lifestyle and use of medication. We will allocate patients using a randomly-generated assignment plan to receive either intervention messages, or an active control. We will follow up people for twelve months measuring important risk factors for poor health outcomes and complications in diabetes so we can estimate potential health benefits, including HbA1c as a marker for long-term blood glucose control and blood pressure control, We will record the costs of doing this, and estimate cost-effectiveness. We will also capture collection of medication and assess the reception of the intervention by participants and health care workers. Discussion: The knowledge gained will have wide application and advance the evidence base for effectiveness of mobile-phone based brief text-messaging on clinical outcomes and in large-scale, operational settings. It will provide evidence for cost-effectiveness that will further inform policy development and decision-making. We will work with a wide network that includes patients, clinicians, academics, industry, and policy makers to help us identify opportunities for informing people about the work and raise awareness of what is being developed and studied. Trial Registration: ISRCTN70768808 (Registered on 3 August 2015)

Conflicts in Biafra, Katanga and Cabinda as a result of the geopolitical legacy of colonialism

2020 ◽  
Vol 2020 (10-3) ◽  
pp. 238-246
Author(s):  
Olga Dzhenchakova
Keyword(s):  
Democratic Republic ◽  
Economic Factor ◽  
Colonial Period ◽  
Sub Saharan Africa ◽  
Negative Consequences ◽  
Post Colonial ◽  
Republic Of The Congo ◽  
Sub Saharan ◽  
The Republic ◽  
The Impact

The article considers the impact of the colonial past of some countries in sub-Saharan Africa and its effect on their development during the post-colonial period. The negative consequences of the geopolitical legacy of colonialism are shown on the example of three countries: Nigeria, the Democratic Republic of the Congo and the Republic of Angola, expressed in the emergence of conflicts in these countries based on ethno-cultural, religious and socio-economic contradictions. At the same time, the focus is made on the economic factor and the consequences of the consumer policy of the former metropolises pursuing their mercantile interests were mixed.

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