scholarly journals Case Report of Kikuchi-Fujimoto Disease from Sub-Saharan Africa: An Important Mimic of Tuberculous Lymphadenitis

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Karishma Sharma ◽  
Fredrick Otieno ◽  
Reena Shah
Keyword(s):  
Lupus Erythematosus ◽  
Sub Saharan Africa ◽  
African Woman ◽  
Tuberculous Lymphadenitis ◽  
Rare Form ◽  
Black African ◽  
Tb Treatment ◽  
Node Biopsy ◽  
Night Sweats ◽  
Sub Saharan

Kikuchi-Fujimoto disease (KFD) is a rare form of painful lymphadenopathy, usually cervical, which is more common in Southeast Asia and rarely reported from Africa. Symptoms are usually nonspecific (fever, night sweats, etc.), and can mimic more common diseases such as tuberculosis (TB) in endemic areas. We report a case of a 29-year-old black African woman who was admitted with headache, neck pain, fever, and lymphadenopathy. She was found to have aseptic meningitis, eventually attributed to TB based on cervical node biopsy, although further histology suggested KFD. Blood tests for systemic lupus erythematosus (SLE) were negative; she had already been commenced on anti-TB treatment and had responded well and so was continued with this therapy. She was also later diagnosed with Hashimoto’s thyroiditis 3 months after her diagnosis of KFD. Five months after stopping TB treatment, she was readmitted with the same symptoms and associated painless lymphadenopathy. Repeat biopsy was morphologically similar to that of 2017, and repeat evaluation confirmed SLE. She has since been managed by a rheumatologist and continues to do well.

Pensée 2: The “African” in Africana/Black/African and African American Studies

2009 ◽  
Vol 41 (2) ◽  
pp. 193-195 ◽  
Author(s):  
Carolyn Somerville
Keyword(s):  
Middle East ◽  
North Africa ◽  
Sub Saharan Africa ◽  
The Political ◽  
African Continent ◽  
Black African ◽  
Academic Fields ◽  
Sub Saharan ◽  
Middle East Studies ◽  
Research And Policy

In Pensée 1, “Africa on My Mind,” Mervat Hatem questions the perceived wisdom of creating the African Studies Association (focused on sub-Saharan Africa) and the Middle East Studies Association a decade later, which “institutionalized the political bifurcation of the African continent into two academic fields.” The cleaving of Africa into separate and distinct parts—a North Africa/Middle East and a sub-Saharan Africa—rendered a great disservice to all Africans: it has fractured dialogue, research, and policy while preventing students and scholars of Africa from articulating a coherent understanding of the continent.

scholarly journals A systematic review and meta-analysis of the association between integrated tuberculosis and Human Immuno-deficiency Virus therapy and tuberculosis treatment outcomes among adults in sub-Saharan Africa

2020 ◽  
Author(s):  
Benjamin Momo Kadia ◽  
Noah Fongwen Takah ◽  
Christian Akem Dimala ◽  
Victoria Simms
Keyword(s):  
Treatment Outcomes ◽  
Meta Analysis ◽  
Treatment Success ◽  
Hiv Treatment ◽  
Sub Saharan Africa ◽  
P Value ◽  
Human Immuno Deficiency Virus ◽  
Tb Treatment ◽  
All Cause Mortality ◽  
Sub Saharan

Abstract Background: Despite the scale-up of programmes integrating treatment of tuberculosis (TB) and Human Immuno-deficiency Virus (HIV) in sub-Saharan Africa (SSA), TB treatment outcomes in TB/HIV co-infected patients in the region remain sub-optimal.Objective: To summarize the available evidence on the association between integrated TB/HIV treatment and TB treatment outcomes specifically, successful treatment and all-cause mortality in TB/HIV co-infected adults in SSA.Method: A systematic review of studies published between March 2004 and 10 July 2019 was performed. Seven electronic databases including Medline, Embase and Cochrane were searched to identify interventional and observational quantitative studies reporting on integrated TB/HIV treatment in SSA. Two investigators independently screened the search output, reviewed the eligible studies, and rated the quality of eligible studies using quality assessment tools of the National Heart Lung and Blood Institute. Pooled odds ratios (ORs) were derived using random-effects meta-analysis. Heterogeneity across studies was assessed using the I2 statistic. The confidence in the pooled ORs was rated using the GRADE. The final review was reported using the PRISMA.Results: Eleven studies including 4181 participants were retained. The studies were of moderate to good quality, with 10 being quasi-experimental and cohort. Pooling of relevant studies showed that the odds of treatment success with integration was 1.1 times (95% CI: 0.93-1.29; I2=74.5%; p-value for heterogeneity=0.001) the odds of treatment success without integration and the odds of mortality with integration was 1.27 (95% CI 1.02-1.59; I2=87.3%; p-value for heterogeneity<0.0001) times the odds of mortality without integration. On sensitivity analysis, the odds of mortality with integration decreased to 1.06 (95% CI: 0.83-1.34; I2=80.1%; p-value for heterogeneity<0.0001) times the odds of mortality without integration and there was strong evidence of an association between sample size variation and heterogeneity (p=0.01). Good quality studies (4/11) tended to support the effectiveness of integrated treatment in increasing successful outcomes and decreasing mortality. Certainty in the pooled ORs was low.Conclusion: Evidence on the effect of integrated TB/HIV treatment services on treatment success and all-cause mortality in TB/HIV co-infected patients in SSA is inconclusive but the few available good quality studies tend to favour the effectiveness of these services. More robust primary studies are warranted.

scholarly journals Tuberculosis Treatment Outcomes Among Prisoners and General Population in Zomba, Malawi

2020 ◽  
Author(s):  
Victor Hamilton Singano ◽  
Esther Kip ◽  
Wilson Ching’ani ◽  
Lawrence Chiwaula
Keyword(s):  
Treatment Outcome ◽  
General Population ◽  
Treatment Outcomes ◽  
Sub Saharan Africa ◽  
Pulmonary Tb ◽  
Successful Treatment Outcome ◽  
Tb Treatment ◽  
Monitoring Tools ◽  
Unsuccessful Treatment ◽  
Sub Saharan

Abstract Background TB remains a major global health problem. it is particularly prevalent in prisons in sub-Saharan Africa. Prisoners have experienced worse TB treatment outcomes than the general population. The researchers investigated the TB treatment outcomes and pre d ictors of unsuccessful treatment outcomes among prisoners and the general population. Methods We retrospectively reviewed TB registers of prisoners and the general population diagnosed with TB from January 2011 to December 2016 at Zomba Maximum Central Prison and Zomba Central Hospital, Malawi. The study used routinely collected data extracted from national, standardized TB treatment monitoring tools. Successful treatment outcome was classified as the total for cured and completed treatment while unsuccessful treatment outcome was classified as the total of deaths and treatment failures. We used descriptive statistics to compare the demographics and TB treatment parameters among prisoners and non – prisoners and computed multivariate analysis to predict the independent factors of unsuccessful treatment outcomes. Results Of 1652 registered cases, 27% were prisoners (all males) and 72% were non-prisoners (58 % males). The median age was 35 years (IQR: 29 - 42); 76 % were Pulmonary TB cases (78 % among prisoners vs 75% among non-prisoners); 83 % were new TB cases (77% among prisoners vs 86% among non-prisoners); and 65 % were HIV positive (50 % among prisoners vs 71% among non – prisoners). Regarding treatment outcome, 1472 (89%) were cured and/or completed treatment (93% among prisoners vs 88 % among non – prisoners), 2 (0.2%) were treatment failures, 122 (8%) died (5 % among prisoners vs 8 % among non – prisoners) and 55 (3%) were not evaluated (1% among prisoners vs 4% among non – prisoners). Unsuccessful TB treatment outcomes were associated with age greater than 35 years (aOR = 0.68: 95% C.I: 0.58 – 0.80), Extra-Pulmonary TB (aOR=1.69: 95% C.I: 1.08 – 2.63) andHIV positive status (aOR = 0.63: 95 % C.I: 0.42 – 0.94). Conclusion Maximum prisons provide a stable population that can be easily monitored during TB treatment. Good TB treatment outcomes comparable to the general population can be achieved among prisoners despite the challenging prison conditions.

scholarly journals Tuberculosis Treatment Outcomes Among Prisoners and General Population in Zomba, Malawi

2020 ◽  
Author(s):  
Victor Hamilton Singano ◽  
Esther Kip ◽  
Wilson Ching’ani ◽  
Lawrence Chiwaula
Keyword(s):  
Treatment Outcome ◽  
General Population ◽  
Treatment Outcomes ◽  
Sub Saharan Africa ◽  
Pulmonary Tb ◽  
Successful Treatment Outcome ◽  
Tb Treatment ◽  
Monitoring Tools ◽  
Unsuccessful Treatment ◽  
Sub Saharan

Abstract Background: TB remains a major global health problem. It is particularly prevalent in prisons in sub-Saharan Africa due to overcrowding, malnutrition, high HIV prevalence and insufficient medical services. Prisoners have experienced worse TB treatment outcomes than the general population. The researchers investigated the TB treatment outcomes and predictors of unsuccessful treatment outcomes among prisoners and the general population in Zomba, Malawi. Methods: We retrospectively reviewed TB registers of prisoners and the general population diagnosed with TB from January 2011 to December 2016 at Zomba Maximum Central Prison and Zomba Central Hospital, Malawi. The study used routinely collected data extracted from national, standardized TB treatment monitoring tools. Successful treatment outcome was classified as the total for cured and completed treatment while unsuccessful treatment outcome was classified as the total of deaths and treatment failures. We used descriptive statistics to compare the demographics and TB treatment parameters among prisoners and non – prisoners and computed multivariate analysis to predict the independent factors of unsuccessful treatment outcomes.Results : Of 1652 registered cases, 27% were prisoners (all males) and 72% were non-prisoners (58 % males). The median age was 35 years (IQR: 29 - 42); 76 % were Pulmonary TB cases (78 % among prisoners vs 75% among general population); 83 % were new TB cases (77% among prisoners vs 86% among general population); and 65 % were HIV positive (50 % among prisoners vs 71% among general population). Regarding treatment outcome, 1472 (89%) were cured and/or completed treatment (93% among prisoners vs 88 % among general population), 2 (0.2%) were treatment failures, 122 (8%) died (5 % among prisoners vs 8 % among general population) and 55 (3%) were not evaluated (1% among prisoners vs 4% among general population). Unsuccessful TB treatment outcomes were associated with age greater than 35 years (aOR = 0.68: 95% C.I: 0.58 – 0.80), Extra-Pulmonary TB (aOR=1.69: 95% C.I: 1.08 – 2.63) andHIV positive status (aOR = 0.63: 95 % C.I: 0.42 – 0.94).Conclusion: Maximum prisons provide a stable population that can be easily monitored throughout the course of TB treatment. Good TB treatment outcomes which are comparable to the general population can be achieved among Malawian prisoners despite the challenging prison conditions.

scholarly journals Disseminated Histoplasmosis; A Threat in Advanced HIV Disease Population in Sub-Saharan Africa?

2021 ◽  
pp. 115-144
Author(s):  
Christine E. Mandengue ◽  
Bassey Ewa Ekeng ◽  
Rita O. Oladele
Keyword(s):  
Histoplasma Capsulatum ◽  
Clinical Stage ◽  
Sub Saharan Africa ◽  
World Health ◽  
Hiv Disease ◽  
African Countries ◽  
Tb Treatment ◽  
Disseminated Histoplasmosis ◽  
Sub Saharan ◽  
Advanced Hiv Disease

Background: Histoplasmosis is a neglected acquired immune deficiency syndrome (AIDS)-defining disease in sub-Saharan African countries, which is commonly misdiagnosed as tuberculosis (TB) due to similar imagery and clinical features; patients usually receive presumptive anti-TB treatment that is considered as anti-TB treatment failure. Patients with advanced human immunodeficiency virus (HIV) disease (AHD), CD4<200/mm3 or World Health Organisation clinical stage 3 or 4, develop disseminated histoplasmosis (DH) diagnosed at a late stage or at post-mortem, owing to poor clinical suspicion, lack of rapid diagnosis tools to offer rapid and accurate results, and non-availability and accessibility of appropriate antifungal medications. We report 31 cases of DH amongst patients with AHD in sub-Saharan African population from the literature, highlighting the challenging care issue in sub-Saharan Africa. Results: Out of 31 reported cases 64.51% (20/31) were caused by Histoplasma capsulatum var capsulatum, 48.38% (15/31) being immigrants in Europe, Canada and Japan, with 41.93% (13/31) mortality, and 6 cases having no reported outcome. The poor index of suspicion on the part of clinicians; the lack of skilled laboratory personnel and rapid and accurate diagnosis tools of histoplasmosis for a proper detection of either classical or African histoplasmosis coexisting in many sub-Saharan African countries; and the non-availability and accessibility of appropriate antifungal medications were the most challenges in caring DH in advanced HIV disease population in sub-Saharan Africa. Conclusion: there is a need for prompt and routine screening of advanced HIV disease patients in sub-Saharan Africa for histoplasmosis as an AIDS-defining illness.

scholarly journals Tuberculosis Treatment Outcomes Among Prisoners And Non-prisoners In Zomba, Malawi

2019 ◽  
Author(s):  
Victor Hamilton Singano ◽  
Esther Kip ◽  
Wilson Ching’ani ◽  
Lawrence Chiwaula
Keyword(s):  
Treatment Outcome ◽  
General Population ◽  
Treatment Outcomes ◽  
Sub Saharan Africa ◽  
Hiv Positive ◽  
Pulmonary Tb ◽  
Successful Treatment Outcome ◽  
Tb Treatment ◽  
Unsuccessful Treatment ◽  
Sub Saharan

Abstract Background TB remains a major global health problem. It is particularly prevalent in prisons in sub-Saharan Africa due to overcrowding, malnutrition, high HIV prevalence and insufficient medical services. Prisoners have experienced worse treatment outcomes than the general population. We investigated the TB treatment outcomes and predictors of unsuccessful treatment outcomes among prisoners and non – prisoners.Methods We retrospectively reviewed TB registers of prisoners and non - prisoners diagnosed with TB from January 2011 to December 2016 at Zomba Maximum Central Prison and Zomba Central Hospital, Malawi. The study used routinely collected data extracted from national, standardized TB treatment monitoring tools. Successful treatment outcome was classified as the total for cured and completed treatment while unsuccessful treatment outcome was classified as the total of deaths and treatment failures. We used descriptive statistics to compare the demographics and TB treatment parameters among prisoners and non – prisoners and computed multivariate analysis to predict the independent factors of unsuccessful treatment outcomes.Results Of 1652 registered cases, 27% were prisoners (all males) and 72% were non-prisoners (58% males). The median age was 35 years (IQR: 29 - 42); 76% were Pulmonary TB cases (78% among prisoners vs 75% among non-prisoners); 83% were new TB cases (77% among prisoners vs 86% among non-prisoners); and 65% were HIV positive (50% among prisoners vs 71% among non – prisoners). Regarding treatment outcome, 1472 (89%) were cured and/or completed treatment (93% among prisoners vs 88% among non – prisoners), 2(0.2%) were treatment failures, 122 (8%) died (5% among prisoners vs 8% among non – prisoners) and 55 (3%) were not evaluated (1% among prisoners vs 4% among non – prisoners). Independent factors of unsuccessful TB treatment outcomes were noted in those with age greater than 35 years (aOR = 0.68: 95% C.I: 0.58 – 0.80), Extra-Pulmonary TB (aOR=1.69: 95% C.I: 1.08 – 2.63), HIV positive status (aOR = 0.63: 95% C.I: 0.42 – 0.94).Conclusion Good TB treatment outcomes which are comparable to the general population can be achieved among Malawian prisoners despite the challenging prison conditions.

scholarly journals Cardiometabolic Health in African Immigrants to the United States: A Call to Re-examine Research on African-descent Populations

2015 ◽  
Vol 25 (3) ◽  
pp. 373 ◽  
Author(s):  
Yvonne Commodore-Mensah, PhD, RN ◽  
Cheryl Dennison Himmelfarb, PhD, ANP, RN ◽  
Charles Agyemang, PhD, MPH ◽  
Anne E. Sumner, MD
Keyword(s):  
United States ◽  
Social Economic ◽  
African Descent ◽  
African Immigrants ◽  
The United States ◽  
Sub Saharan Africa ◽  
Cardiometabolic Health ◽  
Optimal Care ◽  
Black African ◽  
Sub Saharan

<p> </p><p> In the 20th century, Africans in Sub-Saharan Africa had lower rates of cardiometabolic disease than Africans who migrated. How­ever, in the 21st century, beyond infectious diseases, the triple epidemics of obesity, diabetes and hypertension have taken hold in Africa. Therefore, Africans are acquiring these chronic diseases at different rates and different intensity prior to migration. To ensure optimal care and health outcomes, the United States practice of grouping all African-descent populations into the “Black/ African American” category without regard to country of origin masks socioeconomic and cultural differences and needs re-evalu­ation. Overall, research on African-descent populations would benefit from a shift from a racial to an ethnic perspective. To dem­onstrate the value of disaggregating data on African-descent populations, the epide­miologic transition, social, economic, and health characteristics of African immigrants are presented. <em>Ethn Dis. </em>2015;25(3):373- 380.</p>

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