Level In Africa Research Articles

Inauguration of the Cameroonian Society of Human Genetics

The conjunction of "hard genetics" research centers, with well established biomedical and bioethics research groups, and the exceptional possibility to hold the 6th annual meeting of the African Society of Human Genetics (AfSHG, 13th-15th March 2009) was an excellent opportunity to get together in synergy the entire Cameroonian "DNA/RNA scientists" . This laid to the foundation of the Cameroonian Society of Human Genetics (CSHG) that was privilege to hold its inaugural meeting in conjunction to the 6th annual meeting of the AfSHG. The theme was "Human Origin, Genetic Diversity and Health". The AfSHG and CSHG invited leading African and international scientists in genomics and population genetics to review recent data and provide an understanding of the state-of-knowledge of Human Origin and Genetic Diversity. Overall one opening ceremony eight session, five keynote and guest speakers, 18 invited oral communications, 13 free oral communications, 43 posters and two social events could summarize the meeting. This year's conference was graced by the presence of one Nobel Prize winner Dr Richard Roberts (Physiology and Medicine 1993). The meeting registered up to ten contributions of Cameroonian scientists from the Diaspora (currently in USA, Belgium, Gambia, Sudan and Zimbabwe). Such Diaspora participation is an opportunity to generate collaborations with home country scientists and ultimately turn the "brain drain" to "brain circulation" that could reduce the impact of the migration of health professional from Africa. Interestingly, the personal implication of the Cameroonian Ministry of Public Heath who opened the meeting in the presence of the Secretary General of the Ministry of Higher Education and a representative of the Ministry of Scientific Research and Innovation was a wonderful opportunity for advocacy of genetic issues at the decision-makers level. Beyond our expectation, a major promise of the Cameroonian government was the creation of the National Human Genome Institute. If this goal comes true, this will be a critical step to bring more genetics for the purpose of Public Health to the Cameroonian people. The sub-Saharan African Region needs significant capacity building in the broad area of basic research in general and Genetics (especially Human Genetics) in particular. In that respect, the existence and current activities of the AfSHG and its impact at the National levels in Africa, is a major development for the continent and an initiative that needs further encouragement from the international community.

Field Vehicle Fleet Management in Humanitarian Operations: A Case-Based Approach

Transportation is the second largest overhead cost to humanitarian organizations after personnel. The international 4x4 Field Vehicle Fleet size is estimated between 70,000 and 80,000 units with a cost above $1 billion per year. Nevertheless, academic knowledge about fleet management in humanitarian operations is scarce. By using a multiple case research design we study field vehicle fleet management in 4 large international humanitarian organizations (IHO): the International Committee of the Red Cross, the International Federation of Red Cross and Red Crescent Societies, the World Food Program and World Vision International. Our field research includes more than 40 interviews at headquarters, regional and national level in Africa, the Middle East and Europe. We aim to answer three questions: 1) How do IHO manage their field vehicle fleets? 2) What are the critical factors affecting IHO field vehicle fleet management? 3) How does field vehicle fleet management affect in-country program delivery? Finally, we suggest further research areas in transportation and fleet management in humanitarian operations.

Community-directed interventions for priority health problems in Africa: results of a multicountry study

To determine the extent to which the community-directed approach used in onchocerciasis control in Africa could effectively and efficiently provide integrated delivery of other health interventions. A three-year experimental study was undertaken in 35 health districts from 2005 to 2007 in seven research sites in Cameroon, Nigeria and Uganda. Four trial districts and one comparison district were randomly selected in each site. All districts had established ivermectin treatment programmes, and in the trial districts four other established interventions - vitamin A supplementation, use of insecticide-treated nets, home management of malaria and short-course, directly-observed treatment for tuberculosis patients - were progressively incorporated into a community-directed intervention (CDI) process. At the end of each of the three study years, we performed quantitative evaluations of intervention coverage and provider costs, as well as qualitative assessments of the CDI process. With the CDI strategy, significantly higher coverage was achieved than with other delivery approaches for all interventions except for short-course, directly-observed treatment. The coverage of malaria interventions more than doubled. The district-level costs of delivering all five interventions were lower in the CDI districts, but no cost difference was found at the first-line health facility level. Process evaluation showed that: (i) participatory processes were important; (ii) recurrent problems with the supply of intervention materials were a major constraint to implementation; (iii) the communities and community implementers were deeply committed to the CDI process; (iv) community implementers were more motivated by intangible incentives than by external financial incentives. The CDI strategy, which builds upon the core principles of primary health care, is an effective and efficient model for integrated delivery of appropriate health interventions at the community level in Africa.

EGY-Africa: Addressing the digital divide for science in Africa

Adoption of information and communication technologies and access to the Internet is expanding in Africa, but because of the rapid growth elsewhere, a Digital Divide between Africa and the rest of the world exists, and the gap is growing. In many sub-Saharan African countries, education and research sector suffers some of the worst deficiencies in access to the Internet, despite progress in development of NRENs - National Research and Education (cyber) Networks. By contrast, it is widely acknowledged in policy statements from the African Union, the UN, and others that strength in this very sector provides the key to meeting and sustaining Millennium Development Goals. Developed countries with effective cyber-capabilities proclaim the benefits to rich and poor alike arising from the Information Revolution. This is but a dream for many scientists in African institutions. As the world of science becomes increasingly Internet-dependent, so they become increasingly isolated. eGY-Africa is a bottom-up initiative by African scientists and their collaborators to try to reduce this Digital Divide by a campaign of advocacy for better institutional facilities. Four approaches are being taken. The present status of Internet services, problems, and plans are being mapped via a combination of direct measurement of Internet performancemore » (the PingER Project) and a questionnaire-based survey. Information is being gathered on policy statements and initiatives aimed at reducing the Digital Divide, which can be used for arguing the case for better Internet facilities. Groups of concerned scientists are being formed at the national, regional levels in Africa, building on existing networks as much as possible. Opinion in the international science community is being mobilized. Finally, and perhaps most important of all, eGY-Africa is seeking to engage with the many other programs, initiatives, and bodies that share the goal of reducing the Digital Divide - either as a direct policy objective, or indirectly as a means to an end, such as the development of an indigenous capability in science and technology for national development. The expectation is that informed opinion from the scientific community at the institutional, national, and international levels can be used to influence the decision makers and donors who are in a position to deliver better Internet capabilities.« less

A Tale of Two Countries: HIV Among Core Groups in Togo

To describe the epidemiology of HIV among core groups in Togo. We enumerated sex workers (SWs) and conducted cross-sectional surveys of SWs and their clients in 2003 in Lomé and in 2005 in the whole country. Sex work was concentrated in Lomé, which comprised 15% of the population, but 52% of the 5397 SWs enumerated in Togo in 2005 and 68% of the estimated 101,376 men who had bought sex in the year before the 2005 survey. HIV prevalence among SWs was highest in Lomé (45.4% in 2005) and progressively decreased from south to north. A similar geographical pattern was seen for clients (8.3% were HIV infected in Lomé in 2005) and had already been reported for pregnant women. In Lomé, the population attributable fraction of prevalent cases of HIV acquired during transactional sex was estimated at 32%; in the rest of the country, this was only 2%. This is the first study quantifying sex work at a national level in Africa. Variations in HIV prevalence within Togo, with a north-south gradient among SWs, their clients, and pregnant women, may to a large extent reflect the concentration of the sex trade within Lomé. Prostitution played only a modest a role in HIV dynamics outside Lomé.

Repellent activity of alligator pepper, Aframomum melegueta, and ginger, Zingiber officinale, against the maize weevil, Sitophilus zeamais

The repellent activity of alligator pepper, Aframomum melegueta, and ginger, Zingiber officinale (Zingiberaceae), against the maize weevil, Sitophilus zeamais (Coleoptera: Curculionidae), was investigated in four-way olfactometer bioassays. Results showed that vacuum distilled A. melegueta and Z. officinale extracts were repellent towards adult S. zeamais both in the absence and the presence of maize, Zea mays, grains. Bioassay-guided liquid chromatographic fractionation of the distillates showed that fractions containing oxygenated compounds accounted for the repellent activity. Coupled gas chromatography–mass spectrometry (GC–MS), followed by GC peak enhancement and enantioselective GC using authentic compounds, identified 3 major compounds in the behaviourally active fractions of A. melegueta and Z. officinale to be ( S)-2-heptanol, ( S)-2-heptyl acetate and ( R)-linalool in a ratio of 1:6:3, and 1,8-cineole, neral and geranial in a ratio of 5.48:1:2.13, respectively. The identification of these behaviourally active compounds provides the scientific basis for the observed repellent properties of A. melegueta and Z. officinale, and demonstrates the potential for their use in stored-product protection at the small-scale farmer level in Africa.

Perspectives on Higher Education in Africa: Fieldnotes on Trends, Themes, Challenges and Opportunities

These reflections are the result of interviews with several individuals who have taught and studied at the university level in Africa. These observations are concerned with the profession of both student and professor in higher education in Africa. An analysis of higher education from both the student and professor perspective follows. It goes on to examine the historical origins of African universities, from colonial-era to present. The New Partnership for African Development (NEPAD) and the issues NEPAD seeks to redress to understand historical trends as well as contemporary challenges and opportunities for the university professor and student in Africa are explored.

Using remotely sensed night-time light as a proxy for poverty in Africa

BackgroundPopulation health is linked closely to poverty. To assess the effectiveness of health interventions it is critical to monitor the spatial and temporal changes in the health indicators of populations and outcomes across varying levels of poverty. Existing measures of poverty based on income, consumption or assets are difficult to compare across geographic settings and are expensive to construct. Remotely sensed data on artificial night time lights (NTL) have been shown to correlate with gross domestic product in developed countries.MethodsUsing national household survey data, principal component analysis was used to compute asset-based poverty indices from aggregated household asset variables at the Administrative 1 level (n = 338) in 37 countries in Africa. Using geographical information systems, mean brightness of and distance to NTL pixels and proportion of area covered by NTL were computed for each Administrative1 polygon. Correlations and agreement of asset-based indices and the three NTL metrics were then examined in both continuous and ordinal forms.ResultsAt the Administrative 1 level all the NTL metrics distinguished between the most poor and least poor quintiles with greater precision compared to intermediate quintiles. The mean brightness of NTL, however, had the highest correlation coefficient with the asset-based wealth index in continuous (Pearson correlation = 0.64, p < 0.01) and ordinal (Spearman correlation = 0.79, p < 0.01; Kappa = 0.64) forms.ConclusionMetrics of the brightness of NTL data offer a robust and inexpensive alternative to asset-based poverty indices derived from survey data at the Administrative 1 level in Africa. These could be used to explore economic inequity in health outcomes and access to health interventions at sub-national levels where household assets data are not available at the required resolution.

Recent Trends in the World Economy: A Case Study of Africa

This article provides the recent economic growth performance of the world in general and African continent in particular. The paper further examines recent economic performance at the continental and sub-regional levels in Africa. It discusses disparities in growth performance and the factors behind the observed disparities across countries and sub-regions. The data has been analysed and presented with a conviction that it gives a better understanding to the researchers to make a further study in this area. It also provides some insights for the policy makers in Africa.Â

How efficient are African electricity companies? Evidence from the Southern African countries

This paper is a first attempt at documenting efficiency levels in Africa's electricity firms, their evolution and the sources of this evolution. The analysis is based on a sample of 12 operators providing services in the 12 country members of the Southern Africa Power Pool. We focus on the changes in total factor productivity (TFP) of the largest operators in each country between 1998 and 2005. We then rely on a data envelopment analysis (DEA) decomposition to identify the sources of the changes in TFP. The results suggest fairly comparable levels of efficiency in the region and performance levels and evolution quite independent of the degree of vertical integration, the presence of a private actor or the main sources of energy supply. The analysis suggest that although the companies have not made significant improvements during the period of analysis in using their capital and human assets, they have done much better in adopting better technologies and better commercial practices. No clear correlation could be associated with the adoption of reforms during the last decade and data limitations impede a more refined assessment of the impact of reforms on efficiency at this stage.

Insertion of intrauterine contraceptive device post delivery

Intrauterine contraceptive devices (IUCD) have been used throughout the world for more than three decades. The highest prevalence of IUCD use is in Russia and China (33%). The use is low in England and Wales (5%) and USA (<2%). In sub-Saharan Africa levels are generally the lowest in the world. Recurrent scientific evidence showed that the IUCD is highly effective safe convenient cheaper and low maintenance method of contraception. The most widely used contraceptive method amongst post-partum women all over the world and in particular the South African public sector is the progestogen injectable. It is used by 49% of women immediately after delivery. IUCDs are the popular method of postpartum contraceptive in Mexico China and Egypt. Most of insertions of IUCDs in women who have recently given birth is after six weeks. Postpartum IUCD insertion began in 1960 but was followed by mixed success rate which was influenced by a variety of factors such as timing of insertion counselling provider training and programmatic support. Term delivery provides an ideal opportunity to address the need for contraception especially with women with limited access to medical care. In South Africa and other developing countries were health care facilities are limited the concept of IUCD insertion post-partum is appealing in areas were patients find it difficult to visit health facilities. (excerpt)

Mapping theoretical and practical issues in the relationship between ICTs and Africa’s socioeconomic development

The relationship between new information and communication technologies (ICTs) and socioeconomic development has remained largely a subject of academic debate. While some researchers believe the new technologies represent the tonic that Africa needs to boost economic growth, other researchers are less sanguine. This paper maps out the debate in the literature, including perceived and real impact of new technologies on Africa’s social and economic development. The paper examines also the current and emerging issues relating to new technologies’ adoption and use in Africa, as well as the problems associated with the technologies in developing African countries. Based on evidence drawn from successful diffusion and use of new technologies at micro and macro levels in Africa, Southeast Asia and Canada, the author takes the position that there is a strong link between uptake of new technologies and the socioeconomic growth and development of different countries and communities. The issues examined in this paper provide a research-based framework for the analysis of the impact of ICTs on the socioeconomic development of Africa.

Formulating Migration Policy at the Regional, Sub-Regional and National Levels in Africa

Formulating Migration Policy at the Regional, Sub-Regional and National Levels in Africa

Cosmopolitan peacekeeping and peacebuilding in Sierra Leone: what can Africa contribute?

The article is organized into two main parts. First, it presents the termination of the conflict in Sierra Leone as a case-study to examine the degree to which cosmopolitan values connecting peacekeeping and peacebuilding are (or are not) evident. The case-study looks at the United Nations Mission in Sierra Leone (UNAMSIL) as a model of successful peacekeeping in the sense that everyday security was provided for the people of Sierra Leone through the deployment of a robust peacekeeping mission. This assessment needs to be qualified in relation to serious deficits still to be addressed in post-conflict peacebuilding, yet the success of this mission does provide encouragement for those who see the construction of a cosmopolitan security architecture for Africa as both desirable and achievable. Second, it explores the degree to which an appropriate model of cosmopolitan peacekeeping might emerge at regional and continental levels in Africa through the development of the African Standby Force (ASF). What the case-study presented here and the survey of the African Union (AU)/ASF in the second part of the article have in common is that taken together, they provide some evidence to suggest that, however fragile, the AU is beginning to define an agenda that represents a continent wide and, in that sense at least, a cosmopolitan response to African security issues.

Marked differences in the prevalence of chloroquine resistance between urban and rural communities in Burkina Faso

Background Chloroquine (CQ) resistance has reached high levels in Africa in recent years. Little is known about variations of resistance between urban and rural areas. Objectives To compare the rates of in vivo resistance to CQ and the prevalences of the main molecular marker for CQ resistance among young children from urban and rural areas in Burkina Faso. Methods The current analysis used the frame of a randomized controlled trial (ISRCTN27290841) on the combination CQ–methylene blue (MB) ( n = 177) compared to CQ alone ( n = 45) in young children with uncomplicated malaria. We examined clinical and parasitological failure rates as well as the prevalence of the Plasmodium falciparum chloroquine resistance transporter gene ( pfcrt) T76 mutation. Results Clinical and parasitological failure rates of CQ–MB differed significantly between urban (70%) and rural areas (29%, p < 0.0001). Likewise, CQ failure rates were higher in the urban setting. Matching this pattern, pfcrt T76 was more frequently seen among parasite strains from urban areas (81%) when compared to rural ones (64%, p = 0.01). In the presence of parasites exhibiting pfcrt T76, the odds of overall clinical failure were increased to 2.6-fold ([1.33, 5.16], p LR = 0.005). CQ was detected at baseline in 21% and 2% of children from the urban and the rural study area, respectively ( p Chi = 0.002). Conclusion Even within circumscribed geographical areas, CQ efficacy can vary dramatically. The differences in the prevalence of pfcrt T76 and in CQ failure rates are probably explained by a higher drug pressure in the urban area compared to the rural study area. This finding has important implications for national malaria policies.

Higher log position is not associated with better physical fitness in professional soccer teams in South Africa

Objective. To assess the difference in physical fitness of players in successful versus less-successful professional soccer teams in South Africa. Design. Professional soccer players (N = 140) underwent a battery of tests assessing important physiological components during the early part of their competitive season. Players were then separated into two groups on the basis of their teams' final log position in the Premier Soccer League (PSL) in South Africa. Players in successful (N = 70) and less-successful (N = 70) teams were in the top four or bottom six positions on the log respectively. Descriptive statistics (mean ± standard deviation (SD)) were calculated for each group, and independent t-tests were used to compare the means of the groups for each of the physical tests. Main outcome measures. Body composition, flexibility, muscle strength-endurance, power, speed, agility, aerobic endurance, and repeat sprint distance. Results. There were no significant differences between groups for all measures of body composition, flexibility, repeat sprint distance, and agility. Significant differences (p &lt; 0.05) were found for sit-ups, aerobic endurance, and speed, but these were generally small, not meaningful differences in performance. Players in successful squads were significantly (p &lt; 0.01) older than those in less-successful teams. Conclusions. The results demonstrate that in South Africa level of physical fitness is not higher in more-successful compared with less-successful teams in the PSL. Factors other than physical fitness may be more important in determining successful league performance and discrimi-nate better between players in teams with different levels of success. Improving professional soccer performance may require coaches and trainers to focus more attention on technical and tactical skill development in sport-specific training once an acceptable standard of fitness has been attained.. South African Journal of Sports Medicine Vol. 19 (2) 2007: pp. 40-45

Dominant factors controlling glacial and interglacial variations in the treeline elevation in tropical Africa

The knowledge of tropical palaeoclimates is crucial for understanding global climate change, because it is a test bench for general circulation models that are ultimately used to predict future global warming. A longstanding issue concerning the last glacial maximum in the tropics is the discrepancy between the decrease in sea-surface temperatures reconstructed from marine proxies and the high-elevation decrease in land temperatures estimated from indicators of treeline elevation. In this study, an improved inverse vegetation modeling approach is used to quantitatively reconstruct palaeoclimate and to estimate the effects of different factors (temperature, precipitation, and atmospheric CO(2) concentration) on changes in treeline elevation based on a set of pollen data covering an altitudinal range from 100 to 3,140 m above sea level in Africa. We show that lowering of the African treeline during the last glacial maximum was primarily triggered by regional drying, especially at upper elevations, and was amplified by decreases in atmospheric CO(2) concentration and perhaps temperature. This contrasts with scenarios for the Holocene and future climates, in which the increase in treeline elevation will be dominated by temperature. Our results suggest that previous temperature changes inferred from tropical treeline shifts may have been overestimated for low-CO(2) glacial periods, because the limiting factors that control changes in treeline elevation differ between glacial and interglacial periods.

Hunger, waiting time and transport costs: Time to confront challenges to ART adherence in Africa

Adherence levels in Africa have been found to be better than those in the US. However around one out of four ART users fail to achieve optimal adherence, risking drug resistance and negative treatment outcomes. A high demand for 2nd line treatments (currently ten times more expensive than 1st line ART) undermines the sustainability of African ART programs. There is an urgent need to identify context-specific constraints to adherence and implement interventions to address them. We used rapid appraisals (involving mainly qualitative methods) to find out why and when people do not adhere to ART in Uganda, Tanzania and Botswana. Multidisciplinary teams of researchers and local health professionals conducted the studies, involving a total of 54 semi-structured interviews with health workers, 73 semi-structured interviews with ARTusers and other key informants, 34 focus group discussions, and 218 exit interviews with ART users. All the facilities studied in Botswana, Tanzania and Uganda provide ARVs free of charge, but ART users report other related costs (e.g. transport expenditures, registration and user fees at the private health facilities, and lost wages due to long waiting times) as main obstacles to optimal adherence. Side effects and hunger in the initial treatment phase are an added concern. We further found that ART users find it hard to take their drugs when they are among people to whom they have not disclosed their HIV status, such as co-workers and friends. The research teams recommend that (i) health care workers inform patients better about adverse effects; (ii) ART programmes provide transport and food support to patients who are too poor to pay; (iii) recurrent costs to users be reduced by providing three-months, rather than the one-month refills once optimal adherence levels have been achieved; and (iv) pharmacists play an important role in this follow-up care.

Integrity of Mission in Light of the Gospel in Africa: A Perspective from an African in Diaspora

AbstractTite Tiénou, born in Côte 'Ivoire, but currently an émigré presently living and teaching in the United States, examines the integrity of mission in light of the Gospel by exploring the church as African and the implication of this for mission, the meaning of mission in Africa, the place of Africa in the world, the opportunities for the integrity of mission in Africa and the requirement of integrity for the agents of mission. Tiénou believes that mission will be fruitful at the personal and collective level in Africa to the extent that churches and missionaries make integrity a moral and ethical imperative in church and society.

The challenge of measuring quality of care at health centre level in Africa: the example of Tsholotsho health district in Matabeleland North, Zimbabwe

This study is on the evaluation of quality of health care within first line health services in rural Zimbabwe. It took place between 2001 and 2002, and consisted of a cross-sectional survey designed to compare the quality of health care on offer at a newly created health centre with that provided by the district hospital's outpatient department. The hypothesis to be tested was that the health centre offered better quality of care. A comprehensive quality of care evaluation framework was designed. The concept of patient enablement was incorporated into the study's assessment of health care delivery outcomes. The results did not provide conclusive evidence that the care offered at the health centre was better than the care on offer at the hospital OPD. The reasons for these unexpected findings are discussed in depth. They are related to the limited understanding amongst local health workers of the organisational changes introduced by the District Health Executive (DHE), together with a (European) cultural bias in the quality of care model under test. An important lesson of this study is that the notion of enablement, notwithstanding the need to put into context the tools used to measure it, was considered by the DHE as relevant in the organisation and evaluation of health care.