scholarly journals Pharmacokinetic, Pharmacogenetic, and Other Factors Influencing CNS Penetration of Antiretrovirals

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Jacinta Nwamaka Nwogu ◽  
Qing Ma ◽  
Chinedum Peace Babalola ◽  
Waheed Adeola Adedeji ◽  
Gene D. Morse ◽  
...  
Keyword(s):  
Neurological Complications ◽  
Hiv Treatment ◽  
Sub Saharan Africa ◽  
Drug Penetration ◽  
Local Inflammation ◽  
Factors Influencing ◽  
Immunodeficiency Virus ◽  
Sub Saharan ◽  
Cns Penetration

Neurological complications associated with the human immunodeficiency virus (HIV) are a matter of great concern. While antiretroviral (ARV) drugs are the cornerstone of HIV treatment and typically produce neurological benefit, some ARV drugs have limited CNS penetration while others have been associated with neurotoxicity. CNS penetration is a function of several factors including sieving role of blood-brain and blood-CSF barriers and activity of innate drug transporters. Other factors are related to pharmacokinetics and pharmacogenetics of the specific ARV agent or mediated by drug interactions, local inflammation, and blood flow. In this review, we provide an overview of the various factors influencing CNS penetration of ARV drugs with an emphasis on those commonly used in sub-Saharan Africa. We also summarize some key associations between ARV drug penetration, CNS efficacy, and neurotoxicity.

Human immunodeficiency virus funding and access to treatment in sub-Saharan Africa

2021 ◽  
pp. 095646242110422
Author(s):  
Reuben Granich ◽  
Somya Gupta ◽  
Brian Williams
Keyword(s):  
Human Immunodeficiency Virus ◽  
Viral Suppression ◽  
Hiv Treatment ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Access To Treatment ◽  
Immunodeficiency Virus ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Hiv Funding

Human immunodeficiency virus (HIV) treatment prevents illness, death, and transmission. The 90-90-90 disease control target is only 73% of people living with HIV virally suppressed. For 2010 to 2019, we abstracted HIV funding data for 40 countries in sub-Saharan Africa (70% of global HIV burden and >99% of HIV burden in the region in 2018). During 2010–2019, there was ∼$52 billion funding for 40 countries (99% Africa HIV burden). Domestic funding ranged from $0 to $3.2 billion. PEPFAR funding was $32 billion (average $1.4 billion; range $0.089–4.3 billion) among 22 countries. Global Fund averaged $306 million ($1.9 million to $1.1 billion) for 40 countries. Among PLHIV, known HIV status averaged 80% (11% to 94%). ART coverage averaged 64% (9% to 90%). Viral suppression among PLHIV ranged from 8% to 87%. Of the 40 countries, 21 reported under 60% of PLHIV to be on treatment and 13 did not report viral suppression for 2018. Achieving 90-90-90 is feasible in challenging settings if resources are used efficiently. Despite the significant investment in the HIV response, many countries have not reached the 90-90-90 target. Greater attention to efficiency and prioritizing important targets will be required to end AIDS in Africa.

Financing Energy Access in Africa

2018 ◽  
Author(s):  
Peter Kayode Oniemola ◽  
Jane Ezirigwe
Keyword(s):  
Oil And Gas ◽  
Sub Saharan Africa ◽  
Capital Investments ◽  
Energy Access ◽  
African Countries ◽  
Sustainable Technologies ◽  
Energy Technologies ◽  
Sub Saharan ◽  
Diesel Motors

To achieve universal energy access will attract huge capital investments. If sub-Saharan Africa is to realize anything close to the ambitious goals set for its energy access, then new actors, innovative funding mechanisms and sustainable technologies will have to be attracted. Finance is needed for activities such as rural electrification, clean cooking facilities, diesel motors and generators, other renewable energy technologies, oil and gas infrastructures, etc. Finance is also needed in research and development of suitable technologies and funding options as well as investment in the capacity to formulate and implement sound energy policies. This chapter examines the varied financing options for energy access in sub-Saharan Africa. It argues that with appropriate laws in place and effective mechanism for implementation, African countries can significantly engage private sector financing, international financial institutions and foreign donors. The role of the law here will be in creating an enabling environment for financing.

Human Development Paradigm for South Asia

2018 ◽  
Keyword(s):  
South Asia ◽  
Human Development ◽  
Sub Saharan Africa ◽  
Health And Nutrition ◽  
The People ◽  
Sub Saharan ◽  
Development Paradigm

In the chapter, Haq gives a snapshot of the human progress of South Asia, comparing it with other regions. He was worried about the region beginning to lag behind all other regions, including Sub-Saharan Africa. He highlights the role of the two largest economies in the region, India and Pakistan, in financing the major investment in education, health and nutrition for the people. Haq advocates some fiscal and monetary reforms are suggested to invest in human development.

scholarly journals An increasing role of pyrethroid-resistant Anopheles funestus in malaria transmission in the Lake Zone, Tanzania

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nancy S. Matowo ◽  
Jackline Martin ◽  
Manisha A. Kulkarni ◽  
Jacklin F. Mosha ◽  
Eliud Lukole ◽  
...  
Keyword(s):  
Malaria Transmission ◽  
Anopheles Funestus ◽  
Sub Saharan Africa ◽  
North West ◽  
Vector Population ◽  
Lake Zone ◽  
Sub Saharan ◽  
Long Lasting Insecticidal Nets ◽  
Study District

AbstractAnopheles funestus is playing an increasing role in malaria transmission in parts of sub-Saharan Africa, where An. gambiae s.s. has been effectively controlled by long-lasting insecticidal nets. We investigated vector population bionomics, insecticide resistance and malaria transmission dynamics in 86 study clusters in North-West Tanzania. An. funestus s.l. represented 94.5% (4740/5016) of all vectors and was responsible for the majority of malaria transmission (96.5%), with a sporozoite rate of 3.4% and average monthly entomological inoculation rate (EIR) of 4.57 per house. Micro-geographical heterogeneity in species composition, abundance and transmission was observed across the study district in relation to key ecological differences between northern and southern clusters, with significantly higher densities, proportions and EIR of An. funestus s.l. collected from the South. An. gambiae s.l. (5.5%) density, principally An. arabiensis (81.1%) and An. gambiae s.s. (18.9%), was much lower and closely correlated with seasonal rainfall. Both An. funestus s.l. and An. gambiae s.l. were similarly resistant to alpha-cypermethrin and permethrin. Overexpression of CYP9K1, CYP6P3, CYP6P4 and CYP6M2 and high L1014S-kdr mutation frequency were detected in An. gambiae s.s. populations. Study findings highlight the urgent need for novel vector control tools to tackle persistent malaria transmission in the Lake Region of Tanzania.

Adoption of improved cassava varieties in Nigeria: Insights from DNA fingerprinting versus self-reporting varietal identification approaches

2021 ◽  
pp. 003072702199003
Author(s):  
Patience Ifeyinwa Opata ◽  
Oguejiofor Joseph Okorie ◽  
Juliana Chinasa Iwuchukwu ◽  
Chukwuma Otum Ume ◽  
Oyakhilomen Oyinbo
Keyword(s):  
Measurement Errors ◽  
Empirical Studies ◽  
Sub Saharan Africa ◽  
Limited Attention ◽  
Adoption Studies ◽  
Hidden Hunger ◽  
Varietal Identification ◽  
Sub Saharan ◽  
Cassava Varieties

Much of the empirical studies on crop varietal adoption in Sub-Saharan Africa relied on self-reported adoption in farm-household surveys, which is prone to measurement errors. In addition, farmers’ perceptions of consumption-related varietal traits in adoption studies has received limited attention compared with production-related traits. Using DNA-based and self-reported adoption measures, we analyze the adoption of improved cassava varieties (ICVs) with a focus on the extent of varietal misidentification, the sensitivity of the drivers of adoption to varietal misidentification and the role of farmers’ perceptions of biofortification trait in adoption decisions. We find that the adoption rate of ICVs is relatively high using both DNA-based and self-reported adoption measures, but there is notable misclassification in varietal adoption. We find that the mismatch in DNA-based and self-reported adoption measures leads to some variation in the factors that influence the likelihood and intensity of adoption of ICVs. This suggests that appropriate varietal identification helps in better understanding of the drivers of adoption. In addition, we find that despite the observed varietal misclassification, farmers’ perceptions of biofortification trait is significantly correlated with the probability and intensity of adoption of ICVs using both DNA-based and self-reported varietal identification. This suggests that inclusion of biofortification trait in cassava matters for both the likelihood and extent of adoption of ICVs. The latter lends credence to the emerging policy interests in breeding programs for biofortified crops to address hidden hunger in Nigeria.

scholarly journals Factors influencing access to and utilisation of youth-friendly sexual and reproductive health services in sub-Saharan Africa: a systematic review

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Lesley Rose Ninsiima ◽  
Isabel Kazanga Chiumia ◽  
Rawlance Ndejjo
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Sexual And Reproductive Health ◽  
Health Workers ◽  
Sub Saharan Africa ◽  
Inclusion Criteria ◽  
Reproductive Health Services ◽  
Factors Influencing ◽  
Sub Saharan ◽  
Youth Friendly

Abstract Background Despite the global agreements on adolescents’ sexual and reproductive health and rights, access to and utilisation of these services among the youth/adolescents remain unsatisfactory in low- and middle-income countries which are a significant barrier to progress in this area. This review established factors influencing access and utilisation of youth-friendly sexual and reproductive health services (YFSRHS) among the youth in sub-Saharan Africa to inform programmatic interventions. Methodology A systematic review of studies published between January 2009 and April 2019 using PubMed, Web of Science, EMBASE, Medline, and Cochrane Library, and Google Scholar databases was conducted. Studies were screened based on the inclusion criteria of barriers and facilitators of implementation of YFSRHS, existing national policies on provision of YFSRHS, and youth’s perspectives on these services. Findings A total of 23,400 studies were identified through database search and additional 5 studies from other sources. After the full-text screening, 20 studies from 7 countries met the inclusion criteria and were included in the final review. Structural barriers were the negative attitude of health workers and their being unskilled and individual barriers included lack of knowledge among youth regarding YFSRHS. Facilitators of utilisation of the services were mostly structural in nature which included community outreaches, health education, and policy recommendations to improve implementation of the quality of health services and clinics for adolescents/youth to fit their needs and preferences. Conclusion Stakeholder interventions focusing on implementing YFSRHS should aim at intensive training of health workers and put in place quality implementation standard guidelines in clinics to offer services according to youth’s needs and preferences. In addition, educating the youth through community outreaches and health education programs for those in schools can facilitate utilisation and scale up of the service.

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