Disease In African Countries Research Articles

Diagnostic serology test comparison for Q fever and Rift Valley fever in humans and livestock from pastoral communities.

Q fever (QF) and Rift Valley fever (RVF) are endemic zoonotic diseases in African countries, causing significant health and economic burdens. Accurate prevalence estimates, crucial for disease control, rely on robust diagnostic tests. While enzyme-linked immunosorbent assays (ELISA) are not the gold standard, they offer rapid, cost-effective, and practical alternatives. However, varying results from different tests and laboratories can complicate comparing epidemiological studies. This study aimed to assess the agreement of test results for QF and RVF in humans and livestock across different laboratory conditions and, for humans, different types of diagnostic tests. We measured inter-laboratory agreement using concordance, Cohen's kappa, and prevalence and bias-adjusted kappa (PABAK) on 91 human and 102 livestock samples collected from rural regions in Chad. The serum aliquots were tested using ELISA in Chad, and indirect immunofluorescence assay (IFA) (for human QF and RVF) and ELISA (for livestock QF and RVF) in Switzerland and Germany. Additionally, we examined demographic factors influencing test agreement, including district, setting (village vs. camp), sex, age, and livestock species of the sampled individuals. The inter-laboratory agreement ranged from fair to moderate. For humans, QF concordance was 62.5%, Cohen's kappa was 0.31, RVF concordance was 81.1%, and Cohen's kappa was 0.52. For livestock, QF concordance was 92.3%, Cohen's kappa was 0.59, RVF concordance was 94.0%, and Cohen's kappa was 0.59. Multivariable analysis revealed that QF test agreement is significantly higher in younger humans and people living in villages compared to camps and tends to be higher in livestock from Danamadji compared to Yao, and in small ruminants compared to cattle. Additionally, RVF agreement was found to be higher in younger humans. Our findings emphasize the need to consider sample conditions, test performance, and influencing factors when conducting and interpreting epidemiological seroprevalence studies.

Metabolic syndrome among patients with cardiovascular disease in Africa: A systematic review and meta-analysis

IntroductionMetabolic syndrome, a frequent precursor to many cardiovascular illnesses, is prevalent in Africa. Currently, research on the prevalence of metabolic syndrome among cardiovascular disease patients is limited to diabetic, HIV/AIDS, and psychiatric populations. As a result, there is a lack of systematic evidence on the prevalence of metabolic syndrome among individuals with cardiovascular disease in African countries, and there is no realistic picture of the continent's prevalence of metabolic syndrome among individuals with cardiovascular disease. This systematic review aimed to estimate the prevalence of metabolic syndrome among individuals with cardiovascular disease. MethodsThis systematic review and meta-analysis is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines. Systematic electronic searches using databases such as African Journal Online, Google Scholar, PubMed, and the Wiley Online Library were performed from March 15 to April 20, 2024, to retrieve all relevant primary articles reporting the prevalence of metabolic syndrome among patients with cardiovascular disease in Africa. The extracted data were entered into Microsoft Excel and analyzed using STATA version 11 (STATA Corp., LLC) to estimate the pooled prevalence. Heterogeneity was tested using the Q statistic, and the I2 test was used to identify possible inter-study variations. ResultsThe initial search identified 1804 articles, which were cataloged in citation management software (EndNote X 7). The current meta-analysis showed that the overall prevalence of metabolic syndrome among patients with cardiovascular disease was 38.96 % (95 % CI: 30.51–47.42, I2 = 73.2 %) according to the NCEP-ATP III criteria. The analysis revealed moderate heterogeneity between the included articles. As a result, a random effect model, specifically the Der-Simonian and Laird (D + L) random model, was used to estimate the pooled prevalence of metabolic syndrome among patients with cardiovascular disease. ConclusionThe prevalence of metabolic syndrome is increasing at an alarming rate and is high in Africa. Therefore, policymakers, clinicians, and concerned stakeholders should develop effective strategies for the control, prevention, and management of metabolic syndrome.

Increasing Respiratory Diseases in African Countries Require Attention from Concerned Agencies

Increasing Respiratory Diseases in African Countries Require Attention from Concerned Agencies

Modeling the spread of Mpox viral disease in African countries using a Bayesian hierarchical model

Modeling the spread of Mpox viral disease in African countries using a Bayesian hierarchical model

Consequences of geographical accessibility to post-exposure treatment for rabies and snakebite in Africa: a mini review.

Rabies and snakebite envenoming are two zoonotic neglected tropical diseases (NTDs) transmitted to humans by animal bites, causing each year around 179,000 deaths and are most prevalent in Asia and Africa. Improving geographical accessibility to treatment is crucial in reducing the time from bite to treatment. This mini review aims to identify and synthesize recent studies on the consequences of distance and travel time on the victims of these diseases in African countries, in order to discuss potential joint approaches for health system strengthening targeting both diseases. A literature review was conducted separately for each disease using Pubmed, Google Scholar, and snowball searching. Eligible studies, published between 2017 and 2022, had to discuss any aspect linked to geographical accessibility to treatments for either disease in Africa. Twenty-two articles (8 on snakebite and 14 on rabies) were eligible for data extraction. No study targeted both diseases. Identified consequences of low accessibility to treatment were classified into 6 categories: (1) Delay to treatment; (2) Outcome; (3) Financial impacts; (4) Under-reporting; (5) Compliance to treatment, and (6) Visits to traditional healers. Geographical access to treatment significantly influences the burden of rabies and snakebite in Africa. In line with WHO's call for integrating approaches among NTDs, there are opportunities to model disease hotspots, assess population coverage, and optimize geographic access to care for both diseases, possibly jointly. This could enhance the management of these NTDs and contribute to achieving the global snakebite and rabies roadmaps by 2030.

The recent outbreaks of Marburg virus disease in African countries are indicating potential threat to the global public health: Future prediction from historical data

AbstractMarburg virus disease (MVD) caused by the Marburg virus has a high mortality rate. Rousettus aegyptiacus fruit bats act as the natural reservoir host of the virus. But it can also potentially be transmitted from person to person through direct contact with body secretions. The recent outbreaks have already killed seven people out of nine confirmed cases in Equatorial Guinea and five patients out of eight confirmed cases in Tanzania. In the recent past, Ghana reported three MVD cases and two associated deaths in 2022. Specific treatments or vaccines are unavailable for MVD, and supportive care is the primary treatment option. The history of MVD outbreaks and the current scenario show its potential to become an emerging threat to global public health. The recent outbreaks in Tanzania and Equatorial Guinea have already caused a high fatality rate. The absence of effective treatment and vaccines raises concerns about the potential to cause widespread harm. Besides, its capacity for human‐to‐human transmission and potential to cross the country's border could result in a multicountry outbreak. Therefore, we recommend intensive surveillance of MVD, preventative measures, and early detection to limit the spread of the disease and prevent another pandemic.

Early-onset group B streptococcal disease in African countries and maternal vaccination strategies.

Invasive group B streptococcal (GBS) disease is the commonest perinatally-acquired bacterial infection in newborns; the burden is higher in African countries where intrapartum antibiotic prophylaxis strategies are not feasible. In sub-Saharan Africa, almost one in four newborns with GBS early-onset disease will demise, and one in ten survivors have moderate or severe neurodevelopmental impairment. A maternal GBS vaccine to prevent invasive GBS disease in infancy is a pragmatic and cost-effective preventative strategy for Africa. Hexavalent polysaccharide protein conjugate and Alpha family surface protein vaccines are undergoing phase II clinical trials. Vaccine licensure may be facilitated by demonstrating safety and immunological correlates/thresholds suggestive of protection against invasive GBS disease. This will then be followed by phase IV effectiveness studies to assess the burden of GBS vaccine preventable disease, including the effect on all-cause neonatal infections, neonatal deaths and stillbirths.

Patterns of biopsy-proven kidney disease amongst South African adults from 1995 to 2017

Introduction: Little data is available on biopsy-proven kidney disease in African countries. In this study, we have described the patterns of biopsy-proven kidney disease amongst South African adults encountered over a 23-year period and report whether these have changed over time.

Monkeypox outbreak amidst COVID-19 reemergence in the European Region: Challenges, efforts, and recommendations.

Monkeypox (MPX), caused by the Monkeypox virus (MPXV), is an endemic disease in African countries and is currently causing outbreaks in several European regions, amidst a recent surge in new COVID-19 cases. This can significantly impact already exhausted healthcare services, adding on to the economic and social burdens in the region. A lack of sufficient laboratory diagnostics, antivirals, vaccines may hinder effective clinical management of affected patients. Therefore, it is essential to increase awareness about MPX and its transmission among the general population, to ensure necessary precautions are taken and new cases are reported swiftly. This article discusses the impact of MPXV on the current reemergence of COVID-19 in Europe, lessons learnt during the COVID-19 pandemic and recommendations to address potential challenges.

Peripartum cardiomyopathy: Characteristics and outcomes among women seen at a referral hospital in Lusaka, Zambia.

BackgroundPeripartum cardiomyopathy (PPCM) disproportionately affects women of African descent, however knowledge about this disease in African countries is limited.ObjectivesTo describe the phenotype of women with PPCM seen at a referral hospital in Zambia and examine outcomes at 6 months.MethodsA prospective observational study describing characteristics and 6-month outcomes was performed at the University Teaching Hospital Echocardiography Lab in Lusaka, Zambia.ResultsWe enrolled 45 participants with PPCM and 38 were seen at 6-month follow up; 3 (7 %) died and 4 (9 %) were lost to follow up. Mean age was 32.9 years (SD:7.0); mean BMI was 25.3 kg/m2 (SD:4.1), mean parity was 3.4 (SD:2.2) children and twin pregnancies occurred in 4 (9 %). Median time from symptom onset to diagnosis was 60 days (IQR: 1–280). 20 (44 %) reported gestational hypertension and 10 (22 %) reported preeclampsia. Baseline median left ventricular ejection fraction (LVEF) was 36 % (IQR: 11–45), median left ventricular end-diastolic volume (LVEDV) was 150 mL (IQR: 58–229) and 79 % described New York Heart Association (NYHA) functional class IV symptoms. Median LVEF after 6 months was 49 % (IQR: 23–68; p < 0.001) and median LVEDV was 121 mL (IQR: 66–200; p < 0.001). At 6-month follow up 45 % had LVEF ≥ 50 %, 42 % had LVEDV ≤ 106 mL and 1 (3 %) had NYHA functional class IV symptoms.ConclusionsHypertension was prevalent in this cohort. Overall mortality rate was low and clinically significant improvements in cardiac parameters were seen in over 40%. Further research is needed to identify and mitigate gaps in diagnosis and management.

Reverse Dutch disease with trade costs: Prospects for agriculture in Africa's oil-rich economies

Reduced oil revenues since 2014 are stimulating tradable sectors in oil-exporting countries. I use an open economy model with internal and external trade costs to investigate the prospects for reverse Dutch disease in African countries with a comparative advantage in agriculture. While falling resource revenues lead factors of production to shift into agriculture, remote farmers can lose when trade costs make agricultural goods behave like non-tradables. Household survey data from Nigeria show a significant agricultural supply response that is correlated with exposure to international markets. Lowering trade costs and boosting agricultural productivity can help offset the lost income from oil.

Current and potential role of blockchain-based technology in managing medical records in Africa

Accurate and well-managed medical records play a major role in high-quality health care. They are a valuable asset that allows hospitals to treat patients in an effective and efficient way. They also play an important role in health care governance, providing evidence in court cases between patients and hospitals. However, in Africa, medical records are not given much academic attention. Good record-keeping has been hampered by a poor management, as well as a lack of trained personnel who understand how to record and keep these records. This study is aimed at exploring the utilisation of blockchain technology in improving medial records at African hospitals. The reserach is qualitative, comprising desktop research of secondary material and its analysis. It finds that poor medical records in hospitals contribute to the prevalence of disease in African countries, which results in funds that could be invested in development projects being diverted to health care instead. It also shows that 4IR, specifically blockchain-based technology, could play a significant role in the management of medical records in Africa. It could help staff to capture and maintain more accurate medial records, and ensure their security and longevity. Moreover, it could improve access to medical records for all health practitioners. Patients could also access their records, thus helping them to evaluate and manage their own health.

Starting to Understand the Natural History of Sickle Cell Disease in African Countries

Starting to Understand the Natural History of Sickle Cell Disease in African Countries

How do we measure the implementation of the World Health Assembly resolution on rheumatic fever and rheumatic heart disease in African countries? Rationale and design of an evidence-based scorecard.

This article aims to explain the rationale and design for developing an evidence-based scorecard to monitor country-level implementation of the 71st World Health Assembly resolution on rheumatic fever and rheumatic heart disease (RHD) in Africa. A scorecard provides a simple and reliable tool for tracking progress over time and establishing accountability mechanisms. Development of the scorecard will incorporate engaging RHD stakeholders identified and categorised at a country level. We will conduct individual interviews to understand the barriers and facilitators to implementing the resolution. The Delphi technique will facilitate structured group discussions to develop appropriate indicators. Indicators will be linked to the resolution's goals to create strategic lines of action, to inform the scorecard. The scorecard will be quantitatively validated in real-life settings. We deem that the rigor of the development process of this study will produce an evidence-based scorecard that is fit for purpose across Africa.

Impact of Climate Change on Parasitic liver Diseases in Africa

Climate change is already a reality in Africa. Many countries across Africa are classified as Least-Developed Countries (LDCs) with poor socio-economic conditions and by implication are faced with particular challenges in responding to the impacts of climate change. African countries have the least efficient public health systems in the world. Infectious disease burdens, which are sensitive to climate impacts, are highest in the sub-Saharan African region. Changes in climate will affect the spread of infectious agents as well as alter people’s disposition to these infections Climate change has the capability to drive parasitic disease incidence and prevalence worldwide. There are both direct and indirect implications of climate change on the scope and distribution of parasitic organisms and their associated vectors and host species. Currently there is lack of reviews in the literature addressing comprehensively the impact of climate change on the prevalence of parasitic liver disease in Africa. The aim of the current review is to discuss the impact of climate change on parasitic liver disease in Africa, and to detect the gaps in the research done in this field. This review is discussing the impact of climate change on some common parasitic liver diseases in Africa regarding the spread of infectious agents and the liver diseases caused by them. Conclusion: Evidences showed that climate change; including rise in ambient temperature, disturbance of rainfall, water safety, and ecological changes, leads to change in the expansion of vectors or reservoirs of infection and the burden of parasitic infections in endemic areas in Africa. In addition to the effect of man-made construction of irrigation schemes are also responsible for continued transmission of some parasitic diseases in African countries.

Digital Pathology in Cameroon.

PURPOSECancer is becoming increasingly prevalent among the group of treatable diseases in African countries. There is a shortage of clinicians and pathologists available for cancer diagnosis and treatment. These limited resources must be efficiently used to maximize the number of patients treated. One of the critical factors in treatment efficiency is the correct and timely diagnosis of specimens by pathologists. However, there is currently a significant shortage of cancer care clinicians in Africa and an even more considerable shortage of pathologists. This article presents an example in which telepathology was used to mitigate the lack of pathologists in Cameroon.METHODSThe telepathology workaround was implemented in a district hospital based in Cameroon's Adamawa region, where a European surgeon provides cancer treatment. A small histology laboratory there is run by one histotechnologist who processes surgical biopsies into histology slides. As there are no pathologists on site, these slides are digitally scanned using a mobile phone and a whole slide imaging (WSI) scanner. The slides are then shared electronically with a volunteering pathologist in Europe who provides a diagnostic report.RESULTSFrom 2018 to July 2019, specimens for 101 patients were photographed through an iPhone connected to a microscope eyepiece producing several individual images per specimen. From July 2019 to December 2020, slides from 282 patients were scanned using WSI and digitally transmitted.CONCLUSIONWSI on hematoxylin and eosin histology slides for remote diagnosis can increase cancer treatment efficacy and reduce overtreatment of tumors clinically suspicious for malignancy in under-resourced countries with a lack of pathologists.

Perceptions and Challenges Experienced by African Physicians When Prescribing Methotrexate for Rheumatic Disease: An Exploratory Study.

ObjectiveGuidelines for methotrexate (MTX) use in rheumatic disease may not be feasible for physicians practicing in the least developed countries. We aimed to understand the experiences of MTX prescribers relating to MTX use for rheumatic disease in African countries to inform the development of culturally and geographically appropriate recommendations.MethodsAfrican physicians who self‐identified as MTX prescribers from countries classified as having a low versus a medium or high Human Development Index (L‐HDI versus MH‐HDI) participated in semistructured interviews between August 2016 and September 2017. Interviews were transcribed verbatim, coded thematically, and stratified by HDI.ResultsPhysicians (23 rheumatologists; six internists) from 29 African countries were interviewed (15 L‐HDI; 14 MH‐HDI). Identified barriers to MTX use included inconsistent MTX supply (reported by 87% L‐HDI versus 43% MH‐HDI), compounded by financial restrictions (reported by 93% L‐HDI versus 64% MH‐HDI), patient hesitancy based partly on cultural beliefs and societal roles (reported by 71%), few prescribers (reported by 33%), prevalent infections (especially viral hepatitis, tuberculosis, and human immunodeficiency virus), and both availability and cost of monitoring tests. MTX pretreatment evaluation and starting and maximal doses were similar between L‐HDI countries and MH‐HDI countries.ConclusionThe challenges of treating rheumatic disease in African countries include unreliable drug availability and cost, limited subspecialists, and patient beliefs. Adapting recommendations for MTX use in the context of prevalent endemic infections; ensuring safe but feasible MTX monitoring strategies, enhanced access to stable drug supply, and specialized rheumatology care; and improving patient education are key to reducing the burden of rheumatic diseases in L‐HDI countries.

Availability of diagnostic services and essential medicines for non-communicable respiratory diseases in African countries.

BACKGROUND:The global burden of disease due to asthma and chronic obstructive pulmonary disease (COPD) is substantial and particularly great in low- and middle-income countries, including many African countries. Management is affected by availability of diagnostic tests and essential medicines. The study aimed to explore the availability of spirometry services and essential medicines for asthma and COPD in African countries.METHOD:Questionnaires were delivered to healthcare workers at the annual meeting of the Pan African Thoracic Society Methods in Epidemiology and Clinical Research (PATS MECOR) and International Multidisciplinary Programme to Address Lung Health and TB in Africa (IMPALA). Data were analysed using simple descriptive statistics.RESULTS:A total of 37 questionnaires representing 13 African countries were returned. Spirometry availability was 73.0%. The most common reasons for non-availability were lack of knowledge of the utility of the test. Within the study sample, 33.3% faced sporadic availability due to maintenance issues. Essential medicines availability ranged from 37.8% for inhaled corticosteroid-long-acting beta-agonist inhalers to 100% for prednisolone 5 mg tablets, mainly due to supply chain problems.CONCLUSION:There is varied availability of spirometry and WHO essential medicines for COPD and asthma in African countries. Strategies are needed to improve access to basic effective care for people with noncommunicable lung disease in Africa.

Multiple enterogluteal fistulas, Crohn's disease: A case report

Crohn's disease is a type of chronic inflammatory bowel disease (IBD) of unknown etiology that may affect any part of the gastrointestinal tract from mouth to anus and shows extra-intestinal involvement. It characteristically shows skip lesions. This case report reported in 2018 describes a 40 years old Moroccan female not known to have documented evidence of significant Crohn’s disease. She was diagnosed with multiple fistulas that are a rare entity of patients with Crohn’s disease, which is itself a rare disease in African countries.

Molecular Genetics and Epidemiology of Vitiligo: A Minireview

Background and aims: Vitiligo is an acquired, idiopathic, and common depigmentation disorder of the skin that affects people of all ages and both sexes equally worldwide. Although etiology of the disease is unknown, there are theories such as environment and genetic factors. Methods: In this article, we collected and summarized the appropriate manuscripts regarding the epidemiology and genetics using the terms vitiligo and genetic epidemiology in PubMed and Google Scholar. Results: Studies showed the highest prevalence of disease in African countries, but with regard to the distribution of disease in different areas, environmental factors were as important as other causes of vitiligo, and 3 genes of FOXP3, XBP1 and TSLP had the most association with the disease. Conclusion: It seems that recognition of the genetic basis of vitiligo will supply new insight into the therapies for it. Therefore, more genetic studies are needed to discover the genes and causes linked to clinical aspects of this disease.