Disease In sub-Saharan Africa Research Articles

A model for the control of transmission dynamics of human monkeypox disease in Sub-Saharan Africa

The Human Monkeypox virus has received significant research interest in recent times. While few researchers have studied the effects of vaccination on human-to-animal or animal-to-human Monkeypox transmission, others just studied the effects of treatment on human Monkeypox. In this article, we made the proposition of a deterministic vaccine model that deals with the dynamics of the effects of vaccination and treatment on human Monkeypox in sub-Saharan Africa. We investigated the effects of vaccination on the various epidemiological classes qualitatively. The findings from the analysis of the model are that the model possesses two equilibria, locally asymptotically stable disease-free equilibrium (DFE) when an epidemiological threshold - the effective reproductive number is less than unity, and locally asymptotically stable endemic equilibrium when the number is greater than unity. We then corroborated the theoretical findings with numerical simulations, which reveal that when the rate of vaccination is increased resulting in many newly born persons in the populace being vaccinated, the prevalence of the deadly scourge is significantly reduced, while newly born individuals that miss vaccination experience a drastic torment of the deadly disease that often occasion death. Further revelation from the simulations is that when greater efforts

Polycyclic aromatic hydrocarbons in a polyherbal drug: human health exposure-associated risk assessment study

ABSTRACT PAHs are pervasive pollutants known to bioaccumulate in environmental matrices, plants, and humans. Dr. Iguedo Goko Cleanser® is a polyherbal drug with unsubstantiated claims to treat various diseases in sub-Saharan Africa. PAHs were measured following EPA-16 PAHs guidelines using Gas Chromatography (Agilent-6890N, USA). The drug’s exposure-associated public health concerns was determined using suitable mathematical paradigms. PAHs present were acenaphthene (2.74 × 10−2), pyrene (2.7598 × 10−2), and chrysene (5.1277 × 10−2) ppm. Dietary intake of chrysene, acenaphthene and pyrene for adults, and children ranged from 2.466–4.615 × 10−3 and 1.215–2.308 × 10−3 ppm/mg/kg, respectively. B[α]Peq, EDB[α]Peq, and incremental lifetime cancer risk were determined to be 5.6777 × 10−4, 5.109912 × 10−5 and 5.3289 × 10−12, respectively. Our results suggest a high risk of non-carcinogenic adverse health effects, especially on chronic exposure among adolescents and adults, necessitating caution and/or avoidance of its chronic use. Therefore, policy formulation and implementation as regards the safety of plant-based remedies and allied products before their distribution among end-users must be ensured.

Emergence of Cardiovascular Diseases and Inclusive Organization of Care in the Health District of Biyem-Assi, Yaounde Cameroon

Healthcare financing is one of the major challenges that faces the emergence of non-communicable diseases. This study describes and analyzes the inclusive organization of cardiovascular disease care in Biyem-Assi Health District. From December 2022 to February 2023, we conducted a qualitative study in the Biyem-Assi Health District. Medical anthropology research techniques were used to collect data through interview guides. The sample consisted of patients admitted and followed during the study period. The epidemiological variables studied included age, sex, diagnosis, length of hospital stay, lifestyle, socioeconomic status, knowledge, and modalities of cardiovascular disease (CVD) management, as well as practices aimed at eradicating this scourge. Cardiovascular disease mortality is currently the highest. It affects a young population, so diagnosis is often made late. Very few international technical and financial partners have a real strategy to support prevention and management programs for non-communicable diseases, especially cardiovascular diseases. Faced with the growing incidence of cardiovascular diseases in sub-Saharan Africa, mainly in Cameroon, it is urgent to develop a response or rethink a new organization of cardiovascular disease care, involving and mobilizing numerous technical and financial partners, public authorities, and directly concerned healthcare professionals.

Knowledge of female genital schistosomiasis and urinary schistosomiasis among final-year midwifery students in the Volta Region of Ghana.

Female genital schistosomiasis (FGS) is a gynaecological complication of urinary schistosomiasis (US) with an estimated burden of 20-120 million cases in endemic areas. A neglected sexual and reproductive health disease in sub-Saharan Africa, FGS increases susceptibility to sexually transmitted infections including cervical cancer and infertility among other morbidities. However, there appears to be limited FGS knowledge among practicing and pre-service health providers with implications for control. We assessed FGS awareness among final-year midwifery students who would soon be delivering primary maternal and reproductive health care. A cross-sectional study was conducted among 193 randomly selected final-year students from all three midwifery training institutions in the Volta region of Ghana in August/September, 2022. Data on participants' demographics and knowledge of the transmission, signs and symptoms, complications, treatment and prevention of both FGS and US were collected using structured questionnaires. Summary statistics were presented as frequencies, proportions and percentages. Only 23.3% (44/189) of participants had heard about FGS compared to 64% (123/192) for US. Of the former, 42 (95%), 40 (91%) and 36 (81.8%) respectively identified genital itching/burning sensation, bloody vaginal discharge and pelvic pain/pain during intercourse as part of the symptoms of FGS. Less than a third (13/44) and about half (25/44) of those who indicated hearing about FGS knew it can be a risk for ectopic pregnancies and infertility respectively. Majority of these participants, 40 (91%), wrongly selected antibiotics as treatment for FGS while 9 indicated it is prevented by sleeping in insecticide-treated nets. Awareness of FGS was limited among the study participants. The high prevalence of knowledge of some FGS symptoms related to the genitalia needs cautious interpretation. Health care training institutions must make deliberate efforts to highlight FGS in the training of midwives as the condition has diagnostic and management implications for some sexual and reproductive health conditions.

Evaluation of Interactions between Malaria Vector Control Practices and Demographic Parameters in Selected Communities in Abia State, South-East, Nigeria

Malaria, transmitted by Anopheles mosquitoes has become a debilitating and burdensome disease in Sub-Saharan Africa and conventional practices such as Long-Lasting Insecticide Treated Nets (LLITNs), and Indoor Residual Spraying (IRS) and unconventional practices are usually employed as malaria vector control measures. Hence, the objective of this paper was to evaluate the interactions that exist between these control practices and demographic parameters in selected communities across Ikwuano, Osisioma and Ohafia Local Government Areas (LGAs) of Abia State, South-East, Nigeria using multi-stage sampling technique with five hundred and ten structured questionnaires. Data obtained reveals that the predominant control practices were IRS (325; 63.7%), although it was used in combination with other control methods. This was followed by screening of windows with net (221; 43.3%), whereas only a few respondents used LLITNs. Respondent’s LGA, level of education, type of dwelling structure and household size had significant relationship with most of the malaria vector control practices/perceptions (P < 0.05). However, gender had no significant relationship with any of the malaria vector control practices/perceptions (P > 0.05). Effectiveness (306; 60.0%) was the major reason behind choice of method practiced. Respondents also chose methods that were cheap (175; 34.3%) and prevented contact with mosquitoes (154; 30.2%), but attested to not being aware of any recent Government/Non-Governmental (NGO) mosquito control intervention (386; 75.7%). Considering the low ownership and usage of LLITNs in Abia, efforts should be made towards more distribution. Control programs are advised to consider LGA, level of education, household size, and type of dwelling structure during the design and deployment of interventions.

Parkinson's Disease in Sub-Saharan Africa: Pesticides as a Double-Edged Sword.

Long-term exposure to pesticides used in agriculture is increasingly being identified as a risk factor for developing Parkinson's disease. How chronic pesticide exposure might contribute to the growth of Parkinson's disease in the mainly agricultural communities of Sub-Saharan Africa has thus far received limited attention. There are specific concerns in this area of the world: aging of the population, in combination with chronic exposure to widely used pesticides, including those that have been restricted elsewhere in the world because of neurotoxicity and other health risks. Of interest, the prevalence of Parkinson's disease among specific (semi)nomadic populations in Tanzania seems very low, possibly due to their lack of exposure to agricultural chemicals. But at the same time, pesticides have also brought important benefits to this part of the world. Specifically, in Sub-Saharan Africa, pesticides have been directly helpful in preventing and controlling famine and in containing major human infectious diseases. This creates a complex risk-benefit ratio to the use of pesticides within a global perspective, and urgently calls for the development and implementation of affordable alternatives for areas such as Sub-Saharan Africa, including non-neurotoxic compounds and non-chemical alternatives for the use of pesticides.

Trypanosomes and Gut Microbiota Interactions in Triatomine bugs and Tsetse Flies: A vectorial perspective.

Triatomines (kissing bugs) and tsetse flies (genus: Glossina) are natural vectors of Trypanosoma cruzi and Trypanosoma brucei, respectively. T. cruzi is the causative agent of Chagas disease, endemic in Latin America, while T. brucei causes African sleeping sickness disease in sub-Saharan Africa. Both triatomines and tsetse flies are host to a diverse community of gut microbiota that co-exist with the parasites in the gut. Evidence has shown that the gut microbiota of both vectors plays a key role in parasite development and transmission. However, knowledge on the mechanism involved in parasite-microbiota interaction remains limited and scanty. Here, we attempt to analyse Trypanosoma spp. and gut microbiota interactions in tsetse flies and triatomines, with a focus on understanding the possible mechanisms involved by reviewing published articles on the subject. We report that interactions between Trypanosoma spp. and gut microbiota can be both direct and indirect. In direct interactions, the gut microbiota directly affects the parasite via the formation of biofilms and the production of anti-parasitic molecules, while on the other hand, Trypanosoma spp. produces antimicrobial proteins to regulate gut microbiota of the vector. In indirect interactions, the parasite and gut bacteria affect each other through host vector-activated processes such as immunity and metabolism. Although we are beginning to understand how gut microbiota interacts with the Trypanosoma parasites, there is still a need for further studies on functional role of gut microbiota in parasite development to maximize the use of symbiotic bacteria in vector and parasite control.

In Silico Comparison of Bioactive Compounds Characterized from Azadirachta indica with an FDA-Approved Drug against Schistosomal Agents: New Insight into Schistosomiasis Treatment.

The burden of human schistosomiasis, a known but neglected tropical disease in Sub-Saharan Africa, has been worrisome in recent years. It is becoming increasingly difficult to tackle schistosomiasis with praziquantel, a drug known to be effective against all Schistosoma species, due to reports of reduced efficacy and resistance. Therefore, this study seeks to investigate the antischistosomal potential of phytochemicals from Azadirachta indica against proteins that have been implicated as druggable targets for the treatment of schistosomiasis using computational techniques. In this study, sixty-three (63) previously isolated and characterized phytochemicals from A. indica were identified from the literature and retrieved from the PubChem database. In silico screening was conducted to assess the inhibitory potential of these phytochemicals against three receptors (Schistosoma mansoni Thioredoxin glutathione reductase, dihydroorotate dehydrogenase, and Arginase) that may serve as therapeutic targets for schistosomiasis treatment. Molecular docking, ADMET prediction, ligand interaction, MMGBSA, and molecular dynamics simulation of the hit compounds were conducted using the Schrodinger molecular drug discovery suite. The results show that Andrographolide possesses a satisfactory pharmacokinetic profile, does not violate the Lipinski rule of five, binds with favourable affinity with the receptors, and interacts with key amino acids at the active site. Importantly, its interaction with dihydroorotate dehydrogenase, an enzyme responsible for the catalysis of the de novo pyrimidine nucleotide biosynthetic pathway rate-limiting step, shows a glide score and MMGBSA of -10.19 and -45.75 Kcal/mol, respectively. In addition, the MD simulation shows its stability at the active site of the receptor. Overall, this study revealed that Andrographolide from Azadirachta indica could serve as a potential lead compound for the development of an anti-schistosomal drug.

Energy poverty and respiratory health in Sub-Saharan Africa: Effects and transmission channels

This paper analyses the effect of energy poverty on respiratory health for a sample of 34 sub-Saharan African countries over the period 2000–2020. Using ordinary least squares (OLS), fixed effect, Driscoll-Kraay, Lewbel 2SLS, Kiviet and S-GMM, the results provide strong evidence of a negative and significant effect of access to electricity and access to clean energy for cooking on respiratory disease in sub-Saharan Africa. This result remained robust to changes in the variables of interest and to alternative estimation techniques. Furthermore, the results showed the existence of a non-linear relationship between energy indicators and respiratory diseases, including a U-shape and an N-shape. Based on these results, we encourage policy makers to better orient their energy policies towards the least polluting sectors in sub-Saharan Africa. In this way, the respiratory health of the inhabitants of sub-Saharan Africa can be improved.

Endoscopic diagnosis of gastric and oesophageal cancer in Lusaka, Zambia: a retrospective analysis

IntroductionThere are uncertainties surrounding the spectrum of upper gastrointestinal (UGI) diseases in sub-Saharan Africa. This is mainly due to the limitations of data collection and recording. We previously reported an audit of UGI endoscopic diagnoses in Zambia spanning from 1977 to 2014. We now have extended this analysis to include subsequent years, in order to provide a more comprehensive picture of how the diagnoses have evolved over 4 decades.MethodsWe combined data collected from the endoscopy unit at the University Teaching Hospital (UTH) in Lusaka during a previous review with that collected from the beginning of 2015 to the end of 2021. Since 2015, an electronic data base of endoscopy reports at the UTH was kept. The electronic data base was composed of drop-down menus that allowed for standardised reporting of findings. Collected data were coded by two experienced endoscopists and analysed.ResultsIn total, the analysis included 25,849 endoscopic records covering 43 years. The number of endoscopic procedures performed per year increased drastically in 2010. With the exception of the last 2 years, the proportion of normal endoscopies also increased during the time under review. In total, the number of gastric cancer (GC) cases was 658 (3%) while that of oesophageal cancer (OC) was 1168 (5%). The number of GC and OC diagnoses increased significantly over the period under review, (p < 0.001 for both). For OC the increase remained significant when analysed as a percentage of all procedures performed (p < 0.001). Gastric ulcers (GU) were diagnosed in 2095 (8%) cases, duodenal ulcers (DU) in 2276 (9%) cases and 239 (1%) had both ulcer types. DU diagnosis showed a significantly decreasing trend over each decade (p < 0.001) while GU followed an increasing trend (p < 0.001).ConclusionsUGI endoscopic findings in Lusaka, Zambia, have evolved over the past four decades with a significant increase of OC and GU diagnoses. Reasons for these observations are yet to be established.

Extracellular Vesicles: Translational Agenda Questions forThree Protozoan Parasites.

The protozoan parasites Plasmodium falciparum, Leishmania spp. and Trypanosoma cruzi continue to exert a significant toll onthe disease landscape of the human population in sub-Saharan Africa and Latin America. Control measures have helped reduce the burden of their respective diseases-malaria, leishmaniasis and Chagas disease-in endemic regions. However, the need for new drugs, innovative vaccination strategies and molecular markers of disease severity and outcomes has emerged because of developing antimicrobial drug resistance, comparatively inadequate or absent vaccines, and a lack of trustworthy markers of morbid outcomes. Extracellular vesicles (EVs) have been widely reported to play a role in the biology and pathogenicity of P. falciparum, Leishmania spp. and T. cruzi ever since they were discovered. EVs are secreted by a yet to be fully understood mechanism in protozoans into the extracellular milieu and carry a cargo of diverse molecules that reflect the originator cell's metabolic state. Although our understanding of the biogenesis and function of EVs continues to deepen, the question of how EVs in P. falciparum, Leishmania spp. and T. cruzi can serve as targets for a translational agenda into clinical and public health interventions is yet to be fully explored. Here, as a consortium of protozoan researchers, we outline a plan for future researchers and pose three questions to direct an EV's translational agenda in P. falciparum, Leishmania spp. and T. cruzi. We opine that in the long term, executing this blueprint will help bridge the current unmet needs of these medically important protozoan diseases in sub-Saharan Africa and Latin America.

Geohelminthiases: Soil contamination and associated physicochemical parameters favouring ova dispersion in public schools in Ondo State, Nigeria.

Geohelminth infections are common diseases in sub-Saharan Africa and are a major contributor to setbacks in the socioeconomic and health status of people. This study assessed parasite ova/larvae dispersion in public schools and the associated physicochemical parameters in Akungba Akoko, Ondo Statestate, Nigeria. A total number of five hundred and sixteen (516) soil samples were collected from all the public primary schools (6) in the study area and examination was done in triplicate in all the primary schools in the community using standard procedures, a total of six thousand and twenty-eight (6,028) parasites were recovered after laboratory analyses; hookworm larvae n=2210 (36.66%), followed by Trichuris trichiura n=1572 (26.08%), hookworm ova, n= 1001 (16.61%), Strongyloides stercoralis ova, n= 636 (10.55%) and Ascaris lumbricoides ova, n= 600 (9.95%). The physico-chemical parameters of soil samples at different cardinal points within and around the study area revealed the highest pH (7.82 and the highest electrical conductivity (612.54mS/cm, soil temperature ranged from 22.61 and 26.08 and the highest total dissolved solid was 337.72ppm. Correlation analyses carried out on the recovered parasites with physicochemical parameters revealed that hookworm larvae showed a positive correlation with temperature, with a weak negative correlation with electrical conductivity and total dissolved solids, and Trichuris trichiura had a significant negative correlation with pH and total dissolved solids. The other parasites also showed varying correlations with the physicochemical parameters. Based on these findings, environmental modifications are recommended as an effective preventive measure. Harnessing the results of the physicochemical parameters in relation to the parasites, mass chemotherapy of schoolchildren, health education campaigns, improved sanitary conditions, provision of toilet facilities, and personal hygiene are equally recommended.

Diabetes mellitus and associated risk factors among HIV infected patients on HAART

BackgroundUnderstanding the impact of disease associations is becoming a priority in Kenya and other countries bearing the load of infectious diseases. With the increased incidences of non-communicable diseases and the endemicity of infectious diseases in Sub-Saharan Africa, their co-existence poses significant challenges to patients, health workers and an overwhelmed health sector. Classical risk factors for diabetes such as physical inactivity and unhealthy diet may not solely explain the current trends, suggesting the role of novel risk factors including infections/inflammation. HIV and its treatment have been identified as potential contributors especially to patients with family history of confirmed diabetes cases. Co-infections frequently observed during HIV infection also significantly influence both the epidemiological and pathophysiological of the link between HIV and diabetes. Understanding the correlates of HIV and diabetes is crucial to inform management and prevention strategies of the twin infections. We therefore aimed to determine the prevalence of diabetes mellitus and risk factors in a population of HIV infected patients on HAART. This study determined the association of diabetes/impaired glucose regulation in the context of HIV-1. A cross-sectional study was conducted at a comprehensive care clinic in Nairobi (Kenya). Participants were screened for diabetes and impaired glucose regulation using random blood glucose and glycated haemoglobin (HbA1c) This paper describes the prevalence of diabetes mellitus in Human Immunodeficiency Virus positive individuals and the associated risk factors. We have demonstrated that family history is a risk factor for diabetes. While age and BMI are known risk factors, they were not associated with diabetes in this study.

Identifying childhood malaria hotspots and risk factors in a Nigerian city using geostatistical modelling approach

Malaria ranks high among prevalent and ravaging infectious diseases in sub-Saharan Africa (SSA). The negative impacts, disease burden, and risk are higher among children and pregnant women as part of the most vulnerable groups to malaria in Nigeria. However, the burden of malaria is not even in space and time. This study explores the spatial variability of malaria prevalence among children under five years (U5) in medium-sized rapidly growing city of Akure, Nigeria using model-based geostatistical modeling (MBG) technique to predict U5 malaria burden at a 100 × 100 m grid, while the parameter estimation was done using Monte Carlo maximum likelihood method. The non-spatial logistic regression model shows that U5 malaria prevalence is significantly influenced by the usage of insecticide-treated nets—ITNs, window protection, and water source. Furthermore, the MBG model shows predicted U5 malaria prevalence in Akure is greater than 35% at certain locations while we were able to ascertain places with U5 prevalence > 10% (i.e. hotspots) using exceedance probability modelling which is a vital tool for policy development. The map provides place-based evidence on the spatial variation of U5 malaria in Akure, and direction on where intensified interventions are crucial for the reduction of U5 malaria burden and improvement of urban health in Akure, Nigeria.

Examining geospatial and temporal distribution of invasive non-typhoidal Salmonella disease occurrence in sub-Saharan Africa: a systematic review and modelling study

BackgroundInvasive non-typhoidal Salmonella (iNTS) disease is a significant health concern in sub-Saharan Africa. While our knowledge of a larger-scale variation is growing, understanding of the subnational variation in iNTS disease...

Evaluation of Household Water Treatment Technologies for Cholera Eradication in Sub-Saharan Africa: Epidemiological and Economic Perspectives

Cholera has been a global pandemic in past centuries, and its persistent emergence and spread pose a significant public health challenge globally. Despite efforts to contain the disease, recurrent cholera outbreaks in sub-Saharan Africa remain a major health threat. This has attracted substantial research interest, raising questions about the effectiveness of prevention and control methods of cholera spread in sub-Saharan Africa. Addressing this health challenge by adopting a sustainable, convenient, and cost-effective intervention will improve the health, well-being, and productivity of vulnerable populations in sub-Saharan Africa. Household-level solutions, which are characterized by relatively low-cost and independence from potentially insufficient public water supply infrastructure were examined to determine their effectiveness in reducing the incidence of cholera if widely adopted across the continent. We perform a mixed-methods retrospective analysis on the Cholera epidemic data obtained from 2010 to 2016 in sub-Saharan Africa. Using an empirical epidemiological model, we estimate the performance efficacy of a suite of household water treatment (HWT) technologies. We also develop economic estimations to perform benefit–cost analyses to determine the cost effectiveness, convenience of use and durability of these products. We find that—if universally adopted—the HWT technologies evaluated here offer comparable and effective microbiological potential for eradicating cholera disease in sub-Saharan Africa but are potentially not affordable for low-income households that reside in cholera hotspots. As such, household subsidies are necessary in lowering barriers to economic access to these products. This finding provides substantial insights on the efficacy and affordability of these household water treatment technologies—insights which can inform stakeholder decisions on the applicability of this intervention in eradicating cholera.

Does Engagement in HIV Care Affect Screening, Diagnosis, and Control of Noncommunicable Diseases in Sub-Saharan Africa? A Systematic Review and Meta-analysis

Low- and middle-income countries are facing a growing burden of noncommunicable diseases (NCDs). Providing HIV treatment may provide opportunities to increase access to NCD services in under-resourced environments. We conducted a systematic review and meta-analysis to evaluate whether use of antiretroviral therapy (ART) was associated with increased screening, diagnosis, treatment, and control of diabetes, hypertension, chronic kidney disease, or cardiovascular disease among people living with HIV in sub-Saharan Africa (SSA). A comprehensive search of electronic literature databases for studies published between 01 January 2011 and 31 December 2022 yielded 26 studies, describing 13,570 PLWH in SSA, 61% of whom were receiving ART. Random effects models were used to calculate summary odds ratios (ORs) of the risk of diagnosis by ART status and corresponding 95% confidence intervals (95% CIs), where appropriate. ART use was associated with a small but imprecise increase in the odds of diabetes diagnosis (OR 1.07; 95% CI 0.71, 1.60) and an increase in the odds of hypertension diagnosis (OR 2.10, 95% CI 1.42, 3.09). We found minimal data on the association between ART use and screening, treatment, or control of NCDs. Despite a potentially higher NCD risk among PLWH and regional efforts to integrate NCD and HIV care, evidence to support effective care integration models is lacking.

In Vitro Filaricidal Properties of Aqueous Extracts of Combretum nigricans (Combretaceae) on Onchocerca ochengi (Onchocercidae).

Onchocerciasis is an endemic parasitic disease in sub-Saharan Africa that significantly impacts animal and human health. In Northern Cameroon, medicinal plants from the Combretum genus are used for onchocerciasis traditional treatment although there is no scientific evidence of their antifilarial potential. This study evaluates the in vitro macro- and microfilaricidal properties of water extracts from Combretum nigricans in Onchocerca ochengi. Material and Methods. O. ochengi microfilariae and adult male worms were recovered from cowhide fragments. Oxidative stress indicators and motility tests were used to assess the filaricidal impact. Female albino rats were used to test for acute toxicity. The contents of secondary metabolites were quantified. The bark aqueous extract was more active on macrofilariae at 1 mg/mL for 24 h (100%) than the leaf (63.9%) and root (75%) extracts at the same concentration. Likewise, a stronger microfilaricidal effect was found with this extract at 0.5 mg/mL for 1 h (100%) compared to root and leaf extracts. The dose-response effect with the bark extract gave an inhibitory concentration 50 (IC50) of 351 μg/mL vs. 113 μg/mL for flubendazole after 24 h incubation, while the microfilaricidal efficacy revealed an IC50 of 158.7 μg/mL vs. 54.09 μg/mL for ivermectin after one-hour incubation. Examining stress indicators on parasite homogenates showed that macrofilaricidal activity is associated with a significant increase in nitric oxide, glutathione, and malondialdehyde generation and a decrease in catalase activity. At 2000 mg/kg, rats showed no harm. The phytochemical investigation revealed that the barks contained more phenolic acids, condensed tannins, flavonoids, and saponins than the leaves (p < 0.001). These findings support C. nigricans' antifilarial activity and identify oxidative stress indicators as prospective treatment targets in O. ochengi. It would be interesting to conduct in vivo studies to understand their antifilarial activity better.

Contribution of Hepatitis D Virus in Liver Cancer Among Hepatitis B Virus Infected Populations of Central Africa: A Systematic Review and Meta-Analysis

Background and aims: Hepatocellular carcinoma (HCC) is a rampant disease in sub-Saharan Africa. Viral hepatitis is currently the most common factor in the occurrence of HCC in sub-Saharan Africa. Hepatitis B virus (HBV) causes liver disease which may or may not progress to HCC. In a dual infection with Hepatitis D virus (HDV), HCC tends to have a faster turn out. Our aim is to evaluate the influence of HDV on the risk of HCC and elaborate on factors favouring HDV infection. Methods: A review of available literature in English or French was conducted in major data bases with the search terms “liver disease”, “hepatocellular carcinoma”, “hepatitis delta and liver disease”, “hepatitis D virus infection”, “prevalence of HDV”, and “hepatitis D in Central Africa”, and each term was associated to a central African country. A meta-analysis of included publications was then performed. Results: The prevalence of HDV was 28% (95% CI). There was a higher risk of HCC in HBV-HDV dual infection (OR: 0.82 [95% CI: -0.01 to 1.65]) compared to that in HBV mono-infection. HDV genotype 1 was found to be the most prominent in central Africa, with HDV subgenotypes 1a and 1b dominating. Hepatitis delta was more prevalent in rural areas than in urban areas. Conclusion: Hepatitis D is highly prevalent in the HBV population of central Africa. The presence of HDV increases the risk of HCC. More research has to be carried out to understand how HDV speeds up liver disease and hence how to prevent it.

Prevalence, clinical presentation, and risk factors of chronic venous disease in Cameroon: A general population-based study.

Chronic venous disease is a global public health problem, with high morbidity and economic distress. There is scarcity of data on this disease in sub-Saharan Africa. We conducted the first population-based study over a period of 20months from 1st February 2020 to 30th September 2021 in the 10 regions of Cameroon. A stratify sampling method was chose to select study site. Socio-demographic data, personal and family history, anthropometric parameters, clinical signs, illustrative images, CEAP (Clinical-Etiological-Anatomical-Pathophysiological) classification revised in 2004, VCSS (venous Clinical Severity Score) and risk factor assessment score were used to construct the survey form. Chi-squared test and Fischer exact test were used to compare the prevalence of chronic venous disease across different potential risk factors (sex, age category, previous history of deep vein thrombosis, hypertension, diabetes, smoking status, obesity). Simple and multiple logistic regression models were used to obtain crude and adjusted odds ratio for risk factors associated with chronic venous insufficiency. Statistical analyses were done with R version 4.2 for Linux and the threshold for statistical significance was 0.05. A total of 6578 participants were included in the study, with a mean age of 41.09 ± 16.02years with female predominance (54.3%). The prevalence of chronic venous disease was 21.8% (95% CI: 20.8-22.9) and the prevalence of chronic venous insufficiency (C3-C6) was 7.02% (n = 462). Night cramps (43.2%), oedema (21.7%), lower limbs pain (20.4%) mostly worsens by walking and heavy legs (16.2%) were more common symptoms. The mean total venous clinical severity score was 0.69 ± 1.76 and this score had a significant positive correlation with C classification (p < .001). In the multivariate analysis, the following factors were independently associated with CVD: Male gender (aOR: 1.27; 95%CI: 1.04-1.56; p = .021), retired people (aOR: 46.9; 95% CI: 12.6-174.5; p < .001), hypertension (aOR: 289.5; 95%CI: 169.69-493.1; p < .001), diabetes (aOR: 2.19; 95% CI: 1.21-3.96; p = .009), obesity (aOR: 10.22; 95%CI: 7.67-13.62; p < .001). Smoking appears as a protective factor (aOR: 0.18; 95%CI: 0.10-0.30; p < .001). Chronic venous disease is frequent in Cameroon and main traditional cardiovascular risk factors are associated to this condition. Systematic screening of the CVD in these specific groups could reduce the burden of the disease and its economic impact.