scholarly journals Area-based sampling for an epidemiological study on injury patterns and risk factors in a low-income urban setting in sub-Saharan Africa

2013 ◽  
Author(s):  
Michael L Wilson ◽  
Stephen P. Seifert
Keyword(s):  
Children And Adolescents ◽  
Epidemiological Study ◽  
Low Income ◽  
Census Data ◽  
Dar Es Salaam ◽  
Urban Setting ◽  
Sub Saharan Africa ◽  
Injury Patterns ◽  
Middle Income ◽  
Sub Saharan

Unintentional injuries represent an important health threat to the lives of children and adolescents world-wide. The epidemic of injury and resulting harm such as disability or death, are likely to be the most severe in the low- and middle-income countries of the African continent. The following paper is intended to document an area-based sampling method designed to facilitate an epidemiological study to examine injury patterns among children and adolescents in Dar es Salaam, Tanzania. We used official census data and geographic information system software to create a series of area maps for Dar es Salaam city. Then, based on these maps, we identified population clusters for sampling based on area population density.

scholarly journals Area-based sampling for an epidemiological study on injury patterns and risk factors in a low-income urban setting in sub-Saharan Africa

2013 ◽  
Author(s):  
Michael L Wilson ◽  
Stephen P. Seifert
Keyword(s):  
Children And Adolescents ◽  
Epidemiological Study ◽  
Low Income ◽  
Census Data ◽  
Dar Es Salaam ◽  
Urban Setting ◽  
Sub Saharan Africa ◽  
Injury Patterns ◽  
Middle Income ◽  
Sub Saharan

Unintentional injuries represent an important health threat to the lives of children and adolescents world-wide. The epidemic of injury and resulting harm such as disability or death, are likely to be the most severe in the low- and middle-income countries of the African continent. The following paper is intended to document an area-based sampling method designed to facilitate an epidemiological study to examine injury patterns among children and adolescents in Dar es Salaam, Tanzania. We used official census data and geographic information system software to create a series of area maps for Dar es Salaam city. Then, based on these maps, we identified population clusters for sampling based on area population density.

scholarly journals Gestational weight gain in low-income and middle-income countries: a modelling analysis using nationally representative data

2020 ◽  
Vol 5 (11) ◽  
pp. e003423
Author(s):  
Dongqing Wang ◽  
Molin Wang ◽  
Anne Marie Darling ◽  
Nandita Perumal ◽  
Enju Liu ◽  
...  
Keyword(s):  
Weight Gain ◽  
North Africa ◽  
Low Income ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Middle Income Countries ◽  
Gestational Weight ◽  
Latin America And Caribbean ◽  
Nationally Representative ◽  
Sub Saharan

IntroductionGestational weight gain (GWG) has important implications for maternal and child health and is an ideal modifiable factor for preconceptional and antenatal care. However, the average levels of GWG across all low-income and middle-income countries of the world have not been characterised using nationally representative data.MethodsGWG estimates across time were computed using data from the Demographic and Health Surveys Program. A hierarchical model was developed to estimate the mean total GWG in the year 2015 for all countries to facilitate cross-country comparison. Year and country-level covariates were used as predictors, and variable selection was guided by the model fit. The final model included year (restricted cubic splines), geographical super-region (as defined by the Global Burden of Disease Study), mean adult female body mass index, gross domestic product per capita and total fertility rate. Uncertainty ranges (URs) were generated using non-parametric bootstrapping and a multiple imputation approach. Estimates were also computed for each super-region and region.ResultsLatin America and Caribbean (11.80 kg (95% UR: 6.18, 17.41)) and Central Europe, Eastern Europe and Central Asia (11.19 kg (95% UR: 6.16, 16.21)) were the super-regions with the highest GWG estimates in 2015. Sub-Saharan Africa (6.64 kg (95% UR: 3.39, 9.88)) and North Africa and Middle East (6.80 kg (95% UR: 3.17, 10.43)) were the super-regions with the lowest estimates in 2015. With the exception of Latin America and Caribbean, all super-regions were below the minimum GWG recommendation for normal-weight women, with Sub-Saharan Africa and North Africa and Middle East estimated to meet less than 60% of the minimum recommendation.ConclusionThe levels of GWG are inadequate in most low-income and middle-income countries and regions. Longitudinal monitoring systems and population-based interventions are crucial to combat inadequate GWG in low-income and middle-income countries.

P1586Research network in Africa (RNA): antihypertensive drugs strategies in 12 African countries

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Kane ◽  
P Cavagna ◽  
I B Diop ◽  
B Gaye ◽  
J B Mipinda ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Low Income ◽  
Democratic Republic ◽  
Antihypertensive Drugs ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
African Countries ◽  
Middle Income ◽  
Middle Income Countries ◽  
Sub Saharan

Abstract Background High Blood Pressure is the worldwide leading global burden of disease risk factor. In Sub-Saharan Africa, the number of adults with raised blood pressure has alarmingly increased from 0.59 to 1.13 billion between 1975 and 2015. Blood pressure-lowering medicines are cornerstone of cardiovascular risk reduction. Data on management of anti-hypertensive drugs in sub-Saharan Africa are squarce. Purpose Our study aims to describe antihypertensive drugs strategies in Africa. Methods We conducted a cross-sectional survey in urban clinics during outpatient consultation specialized in hypertension cardiology departments of 29 medical centers from 17 cities across 12 African countries (Benin, Cameroon, Congo, Democratic Republic of Congo, Gabon, Guinea, Ivory Coast, Mauritania, Mozambic, Niger, Senegal, Togo). Data were collected on demographics, treatment and standardized BP measures were made among the hypertensive patients attending the clinics. Country income was retrieved from the World Bank database. All analyses were performed through scripts developed in the R software (3.4.1 (2017–06–30)). Results A total of 2198 hypertensive patients (58.4±11.8 years; 39.9% male) were included. Among whom 2123 (96.6%) had at least one antihypertensive drug. Overall, 30.8% (n=653) received monotherapy and calcium-channel blockers (49.6%) were the most common monotherapy prescribed follow by diuretics (18.7%). Two-drug strategies were prescribed for 927 patients (43.6%). Diuretics and Angiotensin-converting enzyme inhibitors was the combination most frequently prescribed (33.7%). Combination of three drugs or more was used in 25.6% (n=543) of patients. The proportion of drugs strategies differed significantly according to countries (p<0.001), monotherapy ranged from 12.7% in Niger to 47.1% in Democratic Republic of the Congo (figure). Furthermore we observed a significantly difference of strategies between low and middle income countries (55.3% and 44.7% of monotherapy respectively) (p<0.001). According to hypertension grades 1, 2 and 3, the proportion of three-drugs or more combination was 25%, 28% and 34% in middle-income and lower in low-income countries (18%, 19% and 25%). Furthermore, Grade 3 hypertension in low income countries was still treated with monotherapy (36%) instead of 19% in middle income countries (p<0.01). Antihypertensive strategies by country Conclusion Our study described antihypertensive drugs use across 12 sub-Saharan countries, and identified disparities specific to the income context. Inequity in access to drugs combination is a serious barrier to tackle the burden of hypertension in Africa.

scholarly journals Is overseas volunteering beneficial to the NHS? The analysis of volunteers’ responses to a feedback questionnaire following experiences in low-income and middle-income countries

BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e017517 ◽  
Author(s):  
Daniel Yeomans ◽  
Grace Le ◽  
Hemant Pandit ◽  
Chris Lavy
Keyword(s):  
Professional Development ◽  
Low Income ◽  
Personal Development ◽  
Positive Impact ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Middle Income Countries ◽  
Feedback Questionnaire ◽  
Sub Saharan ◽  
The Uk

IntroductionLocally requested and planned overseas volunteering in low-income and middle-income countries by National Health Service (NHS) staff can have benefits for the host or receiving nation, but its impact on the professional development of NHS staff is not proven. The Knowledge and Skills Framework (KSF) and Leadership Framework (LF) are two tools used by employers as a measure of individuals' development. We have used dimensions from both tools as a method of evaluating the benefit to NHS doctors who volunteer overseas.Methods88 NHS volunteers participating with local colleagues in Primary Trauma Care and orthopaedic surgical training courses in sub-Saharan Africa were asked to complete an online self-assessment questionnaire 6 months following their return to the UK. The survey consisted of questions based on qualities outlined in both the KSF and LF.Results85 completed responses to the questionnaire were received. In every KSF domain assessed, the majority of volunteers agreed that their overseas volunteering experience improved their practice within the NHS. Self-assessed pre-course and post-course scores evaluating the LF also saw a universal increase, notably in the ‘working with others’ domain.DiscussionThere is a growing body of literature outlining the positive impact of overseas volunteering on NHS staff. Despite increasing evidence that such experiences can develop volunteers’ essential skills, individuals often find it difficult to gain support of their employers. Our study, in line with the current literature, shows that overseas volunteering by NHS staff can provide an opportunity to enhance professional and personal development. Skills gained from volunteering within international links match many of the qualities outlined in both KSF and LF, directly contributing to volunteers’ continued professional development.

scholarly journals Injuries among children and adolescents in a rapidly growing urban African metropolis: a cross-sectional survey of 1,968 households in Dar es Salaam, Tanzania

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e10048
Author(s):  
Mónica Alejandra Pérez Méndez ◽  
Hamisi A. Kigwangalla ◽  
Till Bärnighausen ◽  
Michael Lowery Wilson
Keyword(s):  
Children And Adolescents ◽  
Low Income ◽  
Health Workers ◽  
Dar Es Salaam ◽  
Urban Setting ◽  
Medical Attention ◽  
Injury Incidence ◽  
Child Injury ◽  
Cross Sectional ◽  
Child Characteristics

Objectives To assess the patterns and incidence of child and adolescent injury and explore associations with household deprivation and child characteristics in a low-income urban setting. Study Design Cross-sectional household survey in Dar es Salaam, Tanzania. Methods Data collection took place during July 2009. Injuries requiring medical attention were recorded with a one month period of recall. A total of 1,968 households representing 3,927 children and adolescents were visited by health workers. Gender-, age-, and type-specific injury incidence was compiled. Odds ratios were calculated to measure associations with child injury, perceived deprivation, household characteristics and child characteristics. Results One household in five reported injuries. The estimated incidence was 3.2 per 10,000 child-years. The most common identifiable injuries were falls (41%), cuts (22%) and burns (16%). Male and younger children aged 1–4 years were at higher risk (respectively OR = 1.36; p = 0.004; OR = 1.47; p ≤ 0.001). Conclusions In Dar e Salaam injuries are common. Future investigations should take into account both subjective and objective measurements of relative household deprivation and a clear criteria for the assessment of injury severity in community-based survey contexts.

scholarly journals The Causal Relationship Between China-Africa Trade, China OFDI, and Economic Growth of African Countries

SAGE Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 215824402110648
Author(s):  
Emma Serwaa Obobisa ◽  
Haibo Chen ◽  
Emmanuel Caesar Ayamba ◽  
Claudia Nyarko Mensah
Keyword(s):  
Economic Growth ◽  
Low Income ◽  
Negative Impact ◽  
Empirical Studies ◽  
Generalized Least Squares ◽  
Causal Link ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Middle Income ◽  
Sub Saharan

Recently, China has emerged as the largest trading partner and a significant source of investment in the African continent. Although there is consent on the increasing importance of China and Africa’s economic partnership, there are many controversies on how it affects African countries. Debates on China in Africa have, however, relied on grandiloquence rather than empirical studies. This study explores the causal link between China-Africa trade, China’s outward foreign direct (OFDI), and economic growth of 24 Sub-Saharan Africa countries from 1999 to 2018. The aggregated panel is classified into upper-middle-income, low-middle income, and low-income Sub-Saharan African countries. In the long run, key findings from the feasible generalized least squares (FGLS) estimator unveiled that; (i) China-Africa trade negatively contributes to economic growth among all panels. (ii) China’s OFDI improves economic growth in the low middle and low-income African countries whereas a significant negative liaison is evidenced in the upper-middle-income African countries. (iii) Labor force have a negative impact on economic growth whiles gross capital formation is evidenced to positively impact economic growth at all the panels. The Dumitrescu and Hurlin Granger causality unveiled a one-sided causal link from China-Africa trade to economic growth at all panels. The study proposes policy recommendations based on the results.

scholarly journals Evaluating the sustainability of differentiated service delivery interventions for stable ART clients in sub-Saharan Africa: a systematic review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e033156
Author(s):  
Nwanneka Ebelechukwu Okere ◽  
Lisa Urlings ◽  
Denise Naniche ◽  
Tobias F Rinke de Wit ◽  
Gabriela B Gomez ◽  
...  
Keyword(s):  
Service Delivery ◽  
Low Income ◽  
English Literature ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Differentiated Service ◽  
Middle Income ◽  
Ethical Approval ◽  
Quantitative Synthesis ◽  
Sub Saharan

IntroductionIn 2015, WHO recommended immediate treatment for people living with HIV (PLHIV). As a result, the number of PLHIV needing antiretroviral therapy (ART) in sub-Saharan Africa (SSA) doubled from 12 million to over 25 million. This put a strain on already weak health systems and inspired the exploration of innovative service delivery models—differentiated service delivery (DSD). In DSD, services are tailored according to client clinical type and offer much-needed improvement in efficiency. The potential of achieving good outcomes for both clients and the health system plus the promise of sustainability motivates DSD promotion especially in low-income and middle-income countries. This review aims to evaluate the sustainability of DSD interventions.Methods and analysisWe will systematically review peer-reviewed English literature published between 2000 and 2019 identified by searching PubMed and EMBASE databases. Main inclusion criteria comprise studies describing DSD interventions conducted in SSA focused on stable adult ART clients, whether described alone or compared with clinic-based service delivery. Quality of included studies will be assessed employing the Down and Black’s and Joanne Briggs Institute checklists for quantitative and qualitative studies, respectively. We will apply a comprehensive sustainability framework including 40 individual constructs to evaluate, score and rank each intervention for sustainability. Narrative and quantitative synthesis will be conducted as appropriate.Ethics and disseminationNo ethical approval is required for this study as it is a review of published or publicly available data. Review results will be published in a peer-reviewed journal and presented at international conferences.PROSPERO registration numberCRD42019120891.

scholarly journals Developing nephrology services in low income countries: a case of Tanzania

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Francis F. Furia ◽  
Jacqueline Shoo ◽  
Paschal J. Ruggajo ◽  
Kajiru Kilonzo ◽  
Gopal Basu ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Low Income ◽  
Kidney Diseases ◽  
Developed Countries ◽  
Sub Saharan Africa ◽  
Low Income Countries ◽  
Care Providers ◽  
African Countries ◽  
Middle Income ◽  
Sub Saharan

Abstract Background The burden of kidney diseases is reported to be higher in lower- and middle-income countries as compared to developed countries, and countries in sub-Saharan Africa are reported to be most affected. Health systems in most sub-Sahara African countries have limited capacity in the form of trained and skilled health care providers, diagnostic support, equipment and policies to provide nephrology services. Several initiatives have been implemented to support establishment of these services. Methods This is a situation analysis to examine the nephrology services in Tanzania. It was conducted by interviewing key personnel in institutions providing nephrology services aiming at describing available services and international collaborators supporting nephrology services. Results Tanzania is a low-income country in Sub-Saharan Africa with a population of more than 55 million that has seen remarkable improvement in the provision of nephrology services and these include increase in the number of nephrologists to 14 in 2018 from one in 2006, increase in number of dialysis units from one unit (0.03 unit per million) before 2007 to 28 units (0.5 units per million) in 2018 and improved diagnostic services with introduction of nephropathology services. Government of Tanzania has been providing kidney transplantation services by funding referral of donor and recipients abroad and has now introduced local transplantation services in two hospitals. There have been strong international collaborators who have supported nephrology services and establishment of nephrology training in Tanzania. Conclusion Tanzania has seen remarkable achievement in provision of nephrology services and provides an interesting model to be used in supporting nephrology services in low income countries.

scholarly journals Acquired heart disease in low-income and middle-income countries

2017 ◽  
Vol 103 (1) ◽  
pp. 73-77 ◽  
Author(s):  
Chris Curry ◽  
Liesl Zuhlke ◽  
Ana Mocumbi ◽  
Neil Kennedy
Keyword(s):  
Heart Disease ◽  
Low Income ◽  
Burden Of Illness ◽  
Sub Saharan Africa ◽  
Endomyocardial Fibrosis ◽  
Middle Income ◽  
Mortality And Morbidity ◽  
Middle Income Countries ◽  
Acquired Heart Disease ◽  
Sub Saharan

The burden of illness associated with acquired cardiac disease in children in low-income and middle-income countries (LMIC) is significant and may be equivalent to that of congenital heart disease. Rheumatic heart disease, endomyocardial fibrosis, cardiomyopathy (including HIV cardiomyopathy) and tuberculosis are the most important causes. All are associated with poverty with the neediest children having the least access to care. The associated mortality and morbidity is high. There is an urgent need to improve cardiac care in LMIC, particularly in sub-Saharan Africa and parts of Southeast Asia where the burden is highest.

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