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.

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 Impact of the World Health Organization Essential Newborn Package on Newborn Care Practices and Survival Rates in Sub-Saharan Africa: A Systematic Literature Review

2019 ◽  
Vol 9 (1) ◽  
pp. 19-29
Author(s):  
Andy Emmanuel ◽  
Victoria Kain ◽  
Elizabeth Forster
Keyword(s):  
Systematic Review ◽  
Health Workers ◽  
Newborn Care ◽  
Sub Saharan Africa ◽  
World Health ◽  
Essential Newborn Care ◽  
The World ◽  
Sub Saharan ◽  
Health Organization ◽  
The Impact

Sub-Saharan Africa, has the highest child mortality rate in the world (World Health Organization [WHO], 2016). However, there is a paucity of current systematic reviews on the impact of essential newborn care interventions in Africa. Therefore, the aim of this systematic review was to summarize evidence about the impact of essential newborn care interventions in Africa. Numerous databases were searched to retrieve articles that reported interventions in newborn care in Africa. The search was limited to the English language and to articles published between 2007 and 2017. Nine articles were selected for inclusion in this systematic review. Overall, these papers demonstrated an increase in performance of health workers (between 8 and 400%) following a test of knowledge, while health workers practical performance increased by 34%. Moreover, neonatal mortality was reduced by 45%, while perinatal mortality was reduced by 30%. Training healthcare workers is one of the most effective ways of improving newborn care and neonatal survival in Africa. However, there is a need for additional evidence to support this, because none of the reviewed studies assessed the impact of training by examining variables such as trainees' satisfaction with training, the knowledge and skills developed, and the health outcomes achieved.

scholarly journals Impact of Covid-19 on Stock Market in Sub-Saharan Africa

2021 ◽  
Vol 1 (2) ◽  
pp. 41-70
Author(s):  
Saifullahi Adam Bayero ◽  
Babangida Danladi Safiyanu ◽  
Zaitun Sanusi Bakabe
Keyword(s):  
Stock Markets ◽  
Negative Impact ◽  
Virus Disease ◽  
Selection Criterion ◽  
Sub Saharan Africa ◽  
World Health ◽  
African Countries ◽  
The World ◽  
Sub Saharan ◽  
The Impact

Corona virus disease (COVID-19) which was declared by the World Health Organization as a global pandemic caused serious economic problem to all the countries including Sub-Saharan Africa. Given the negative impact of COVID19 on the world economy, this paper examined the impact of COVID19 related cases and death on stock exchange markets volatility in Sub-Saharan African countries. The study used the number of reported cases and death from four Sub-Saharan African countries viz Nigeria, South Africa, Kenya, and Botswana, reported cases and death from China and U.S. and all share index as a proxy of stock markets in four countries from 28 February 2020 to 21 December 2020. The study estimated GARCH 11, TGARCH 11, and EGARCH 11 since the variables are heteroskadestic in nature which makes the application of ARCH lausible; the selection criterion was based on Akaike, Schwarz, and Hannan info Criteria. The result shows that COVID19 confirmed cases and death do not affect the operation of the stock markets in Sub-Saharan African countries, but the volatility of the markets has increased within the period of analysis. Furthermore, Botswana and Kenya stock markets were affected by external cases from China. We therefore recommended that stock markets stakeholders in Sub-Saharan Africa should be more concern about health safety measures and be ready for any future pandemic that might affect the markets.

scholarly journals A Darwinian outlook on schistosomiasis elimination

2020 ◽  
Author(s):  
Frederik Van den Broeck ◽  
Joost Vanoverbeeke ◽  
Katja Polman ◽  
Tine Huyse
Keyword(s):  
Genetic Diversity ◽  
Infection Intensity ◽  
Time Frame ◽  
Sub Saharan Africa ◽  
World Health ◽  
Neutral Evolution ◽  
Sub Saharan ◽  
Health Organization ◽  
Long Term Impact ◽  
The Impact

SUMMARYSchistosomiasis is a poverty-related chronic disease that affects over 240 million people across 78 countries worldwide. In order to control the disease, the World Health Organization (WHO) recommends the drug praziquantel against all forms of schistosomiasis. Mass Drug Administration (MDA) programs with praziquantel are successful on the short-term as they reduce the prevalence and infection intensity after treatment, and thus instantly relieve the patient from the burden of its disease. However, epidemiological and genetic studies suggest that current school-based interventions may have little or no long-term impact on parasite transmission. Here, we adopt a Darwinian approach to understand the impact of MDA on the neutral evolution of Schistosoma parasites and assess its potential to eliminate schistosomiasis. We develop a finite island model to simulate the impact of repeated treatments on the genetic diversity of schistosome populations locally (within each host, i.e. infrapopulation) and regionally (within all hosts combined, i.e. component population). We show that repeated treatments induced strong and lasting declines in parasite infrapopulation sizes, resulting in concomitant genetic bottlenecks within the treated individuals. However, parasite genetic diversity recovered quickly in a few generations due to re-infection, and there was little or no impact of treatment on the genetic diversity of the component population when treatment coverage was 95% or lower. This was mainly due to parasite infrapopulations of the untreated host individuals that acted as reservoirs of genetic diversity, sustaining the diversity of the component population. Hence, lasting declines in parasite genetic diversity were only observed when coverage of treatment was 100%, resulting in population crashes after a minimum of six treatment rounds. We argue that achieving a full coverage of treatment is highly challenging for most endemic regions in sub-Saharan Africa, and conclude that MDA alone has little potential to achieve elimination within a conceivable time frame. Our results raise skepticism about the current WHO goals of elimination of schistosomiasis by 2025.

scholarly journals Optimal frequency of rabies vaccination campaigns in Sub-Saharan Africa

2016 ◽  
Vol 283 (1842) ◽  
pp. 20161211 ◽  
Author(s):  
Alyssa M. Bilinski ◽  
Meagan C. Fitzpatrick ◽  
Charles E. Rupprecht ◽  
A. David Paltiel ◽  
Alison P. Galvani
Keyword(s):  
Virus Transmission ◽  
Sub Saharan Africa ◽  
World Health ◽  
Transmission Model ◽  
Sub Saharan ◽  
Health Organization ◽  
The Cost ◽  
Vaccination Campaigns ◽  
Monetary Savings ◽  
Rabies Vaccination

Rabies causes more than 24 000 human deaths annually in Sub-Saharan Africa. The World Health Organization recommends annual canine vaccination campaigns with at least 70% coverage to control the disease. While previous studies have considered optimal coverage of animal rabies vaccination, variation in the frequency of vaccination campaigns has not been explored. To evaluate the cost-effectiveness of rabies canine vaccination campaigns at varying coverage and frequency, we parametrized a rabies virus transmission model to two districts of northwest Tanzania, Ngorongoro (pastoral) and Serengeti (agro-pastoral). We found that optimal vaccination strategies were every 2 years, at 80% coverage in Ngorongoro and annually at 70% coverage in Serengeti. We further found that the optimality of these strategies was sensitive to the rate of rabies reintroduction from outside the district. Specifically, if a geographically coordinated campaign could reduce reintroduction, vaccination campaigns every 2 years could effectively manage rabies in both districts. Thus, coordinated campaigns may provide monetary savings in addition to public health benefits. Our results indicate that frequency and coverage of canine vaccination campaigns should be evaluated simultaneously and tailored to local canine ecology as well as to the risk of disease reintroduction from surrounding regions.

scholarly journals Mental Health and Psychosocial Support During COVID-19: A Review of Health Guidelines in Sub-Saharan Africa

2021 ◽  
Vol 12 ◽  
Author(s):  
Keneilwe Molebatsi ◽  
Otsetswe Musindo ◽  
Vuyokazi Ntlantsana ◽  
Grace Nduku Wambua
Keyword(s):  
Mental Health ◽  
Psychosocial Support ◽  
Well Being ◽  
Health Needs ◽  
Sub Saharan Africa ◽  
World Health ◽  
Mental Health Needs ◽  
Sub Saharan ◽  
The Impact ◽  
Ssa Countries

The COVID-19 pandemic brought in its wake an unforeseen mental health crisis. The World Health Organization published a guideline as a way of supporting mental health and psychosocial well-being of different groups during this pandemic. The impact of the pandemic has pushed governments to put measures in place to curb not only the physical health of individuals but their mental health and psychosocial well-being as well. The aim of our paper was to review mental health guidelines of some Sub Saharan African (SSA) countries: (i) to assess their appropriateness for the immediate mental health needs at this time, (ii) to form as a basis for ongoing reflection as the current pandemic evolves. Guidelines were retrieved openly from internet search and some were requested from mental health practitioners in various SSA countries. The authors designed a semi structured questionnaire, as a self-interview guide to gain insight on the experience of COVID-19 from experts in the mental health sector in the various countries. While we used a document analysis approach to analyze the data, we made use of the Mental Health Preparedness and Action Framework to discuss our findings. We received health or mental health guidelines from 10 SSA countries. Cameroon, Kenya, South Africa, Tanzania, and Uganda all had mental health guidelines or mental health component in their health guidelines. Our experts highlight that the mental health needs of the people are of concern during this pandemic but have not been given priority. They go further to suggest that the mental health needs are slightly different during this time and requiring a different approach especially considering the measures taken to curb the spread of disease. We conclude that despite the provision of Mental Health and Psychosocial Support guidelines, gaps still exist making them inadequate to meet the mental health needs of their communities.

scholarly journals Indoor residual spraying for malaria control in Sub-Saharan Africa 1997 to 2017; an adjusted retrospective analysis

2020 ◽  
Author(s):  
Julie-Anne Tangena ◽  
Chantal M.J. Hendriks ◽  
Maria Devine ◽  
Meghan Tammaro ◽  
Anna E. Trett ◽  
...  
Keyword(s):  
Malaria Control ◽  
Malaria Incidence ◽  
Resistance Management ◽  
Indoor Residual Spraying ◽  
Control Program ◽  
Sub Saharan Africa ◽  
World Health ◽  
Policy And Practice ◽  
Sub Saharan ◽  
The Impact

Abstract Background: Indoor residual spraying (IRS) is a key tool for controlling and eliminating malaria by targeting vectors. To support the development of effective intervention strategies it is important to understand the impact of vector control tools on malaria incidence and on the spread of insecticide resistance. In 2006, the World Health Organization (WHO) stated that countries should report on coverage and impact of IRS, yet IRS coverage data are still sparse and unspecific. Here we estimated the subnational coverage of IRS across sub-Saharan Africa for the four main insecticide classes from 1997 to 2017. Methods: Data on IRS deployment were collated from a variety of sources, including the President’s Malaria Initiative spray reports and National Malaria Control program reports, for all 46 malaria-endemic countries in Sub-Saharan Africa from 1997 to 2017. The data were mapped to the applicable administrative divisions and the proportion of households sprayed for each of the four main insecticide classes; carbamates, organochlorines, organophosphates and pyrethroids was calculated. Results: We found that the number of countries implementing IRS increased considerably over time, although the focal nature of deployment means the number of people protected remains low. From 1997 to 2010, DDT and pyrethroids were commonly used, then partly replaced by carbamates from 2011 and by organophosphates from 2013. IRS deployment since the publication of resistance management guidelines has typically avoided overlap between pyrethroid IRS and ITN use. However, annual rotations of insecticide classes with differing modes of action are not routinely used. Conclusion: This study highlights the gaps between policy and practice, emphasizing the continuing potential of IRS to drive resistance. The data presented here can improve studies on the impact of IRS on malaria incidence and help to guide future malaria control efforts.

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)

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