People In sub-Saharan Africa Research Articles

The protein transition—environmental footprints of farmed fish, microalgae and chicken for food, a case study in Kenya

AbstractChallenges of land scarcity, climate change and water shortage are contributing to escalating the shortage of protein rich food in sub-Saharan Africa. In Kenya a total of 27.8% of the population was undernourished, and a total of 72.3% were categorised as moderately or severe food insecure in 2021–2022. The need to investigate alternative protein sources with less impacts on land, water and climate change, which potentially could replace, at least some of the current production of livestock as the main protein source, is getting increasingly urgent. The main aim of this study is therefore to conduct an environmental footprint analysis of favourable protein production systems in Kenya to evaluate environmental impacts on land, water, and climate. The methodological approach used in this study is referred to as environmental footprint analysis, which is applied to assess; (1) farmed fish in ponds, (2) farmed fish in solar based affordable recirculation aquaculture systems (A-RAS), (3) dried spirulina (Arthrospira Platensis), and (4) chicken from semi-intensive farms. The results show that the most promising alternatives to cattle production are dried spirulina produced in ponds, followed by fish produced in affordable recirculation systems (A-RAS) run on solar energy. Spirulina fully replacing beef production would reduce water usage with 34.7 billion m3/year, land/water surface area with 34.8 thousand km2/year, and GHG emission with 28.2 megaton CO2eq/year. For fish farmed in A-RAS, such replacement would reduce water, land and emissions with 30.7 billion m3/year, 32.0 thousand km2/ year and 23.0 megaton CO2eq/year, respectively. This study illustrates that it is possible to tackle urgent challenges of food and nutrition security for millions of people in sub-Saharan Africa and worldwide with a sustainable protein transition towards a more sustainable, inclusive production system of small-scale farmers, if making use of alternative protein sources, such as from solar based A-RAS and microalgae.

Validating a cassava production spatial disaggregation model in sub-Saharan Africa.

Cassava is a staple in the diet of millions of people in sub-Saharan Africa, as it can grow in poor soils with limited inputs and can withstand a wide range of environmental conditions, including drought. Previous studies have shown that the distribution of rural populations is an important predictor of cassava density in sub-Saharan Africa's landscape. Our aim is to explore relationships between the distribution of cassava from the cassava production disaggregation models (CassavaMap and MapSPAM) and rural population density, looking at potential differences between countries and regions. We analysed various properties of cassava cultivations collected from surveys at 69 locations in Côte d'Ivoire and 87 locations in Uganda conducted between February and March 2018. The relationships between the proportion of surveyed land under cassava cultivation and rural population and settlement data were examined using a set of generalized additive models within each country. Information on rural settlements was aggregated around the survey locations at 2, 5 and 10 km circular buffers. The analysis of the original survey data showed no significant correlation between rural population and cassava production in both MapSPAM and CassavaMap. However, as we aggregate settlement buffers around the survey locations using CassavaMap, we find that at a large scale this model does capture large-scale variations in cassava production. Moreover, through our analyses, we discovered country-specific spatial trends linked to areas of higher cassava production. These analyses are useful for validating disaggregation models of cassava production. As the certainty that existing cassava production maps increases, analyses that rely on the disaggregation maps, such as models of disease spread, nutrient availability from cassava with respect to population in a region, etc. can be performed with increased confidence. These benefit social and natural scientists, policymakers and the population in general by ensuring that cassava production estimates are increasingly reliable.

Prevalence Rates and Predictors for Smoking Cigarettes Among Adolescents Attending School in Bissau, Guinea-Bissau

Substance use is a growing problem among young people in sub-Saharan Africa who increasingly adopt the habit of smoking cigarettes. The aim was to analyse prevalence rates and identify predictors for cigarette smoking among school-attending adolescents in Bissau, Guinea-Bissau. In June 2017, a survey questionnaire was implemented in 16 schools in a class-based, random sample of 2039 adolescents aged 14–19 (52% girls). The chi-square (p < 0.05) and odds ratios (OR) were calculated with 95% confidence intervals (CI). Potential explanatory variables for the dependent variables were introduced into a multinomial logistic regression model, and p-values were transformed to LogWorth values. The prevalence rate for lifetime smoking experience was 14.8%, 4.0% for occasional smoking (<30 days), and 2.4% for daily smoking. The most significant predictors for cigarette smoking included having friends who smoke, being a boy, attending a private school, smoking initiation at a young age, other substance use, and violent behaviour. It is imperative to initiate preventive actions against smoking and other use of tobacco in Guinea-Bissau. Considering the significant impact of the peer group, policymakers need to engage young people in developing primary prevention strategies to curb the use of tobacco and other substances.

Acceptability and use of HIV self-testing among young people in sub-Saharan Africa: a mixed methods systematic review

BackgroundYoung people (YP) are disproportionately affected by the HIV pandemic in sub-Saharan Africa (SSA), but testing rates remain low despite global targets of testing 95% of people with HIV infection by 2030. HIV self-testing (HIVST) has been recently introduced to reach high-risk population groups such as these. Thus, synthesis of emerging evidence on the acceptability and use of HIVST among YP in SSA is needed so that comprehensive information can be generated to inform policy and practice.MethodsWe employed a mixed methods systematic review of quantitative and qualitative literature reporting on HIVST among YP involving any design and published in English by 31st of October 2023. The review synthesized quantitative evidence on acceptability and use of HIVST, and qualitative evidence on perspectives of YP about HIVST. We searched databases of published articles (e.g. MEDLINE, CINAHL) and Gray literature sources (e.g. Google, Google Scholar). The concepts for the search included self-testing, HIV/AIDS, and countries in SSA. Two authors independently screened, retrieved full-text, and assessed quality of the studies.ResultsA total of 4150 studies were retrieved and 32 studies were finally included in the review. Acceptability of HIVST computed from a single item asking YP on their preference or willingness or demand for HIVST was moderate (34–67%) to high (≥ 67%) among YP in SSA. Nine of the fourteen studies that reported on acceptability found high acceptability of HIVST. Use of HIVST ranged from 0.8 to 100% while in most studies the use rate was below 50%. Key barriers to HIVST use were coping with a positive test in the absence of counselling and support, physical discomfort, and cost of kits. Perceived enablers included perceptions of HIVST as promoting personal empowerment and autonomy; privacy and confidentiality; and convenience in location, time, and skill.ConclusionsHIVST was highly accepted but not well utilized among YP in SSA. YP showed diversified needs with mixed preferences for location, and modalities of service provision. Overall, the review identified heterogeneous evidence in terms of methods, population, outcome measures, and results. The review was registered in the International Prospective Registry of Systematic Reviews (PROSPERO: ID = CRD42021278919).

Influence of socio-contextual factors on the link between traditional and new media use, and young people’s sexual risk behaviour in Sub-Saharan Africa: a secondary data analysis

BackgroundTraditional and new media use links to young people’s sexual risk behaviour. The social contexts of young people’s daily lives that influence media use and sexual risk behaviour are often investigated as independent causal mechanisms. We examined the link between media use and young people’s sexual risk behaviour, considering the intersecting socio-contextual factors in Sub-Saharan Africa.MethodsAge-adjusted bivariate logistic regression models tested the association between traditional media (TV, radio, and newspapers), and new media (mobile phone and online) use and sexual risk behaviour using the Demographic and Health Surveys from six Sub-Saharan African countries among unmarried sexually active youths, aged 15–24 years. Multivariate logistic regression models ascertained the media sources that had an additional influence on young people’s sexual risk behaviour, after accounting for socio-contextual factors, and knowledge about HIV and other sexually transmitted infections.ResultsSocio-contextual factors attenuated the association between media use and young people’s sexual risk behaviour in many countries. However, those who did not have access to new and traditional media were more likely to use unreliable contraceptive methods or not use contraception. Adolescents in Nigeria who did not own phones were 89% more likely to use unreliable contraceptive methods or not use any methods [(AOR = 1.89 (1.40–2.56), p < .001)], those in Angola who did not read newspapers had higher odds of not using contraception or used unreliable methods [(aOR = 1.65 (1.26–2.15), p < .001)]. Young people in Angola (aOR = 0.68 (0.56–0.83), p < .001), Cameroon [(aOR = 0.66 (0.51–0.84), p < .001)], Nigeria [(aOR = 0.72 (0.56–0.93), p = .01)], and South Africa [(aOR = 0.69 (0.49–0.98), p = .03)] who did not own phones were less likely to have 2 or more sexual partners compared to those who owned phones. Lack of internet access in Mali was associated with lower odds of having 2 or more sexual partners (aOR = 0.45 (0.29–0.70), p < .001). Traditional media use was significantly associated with transactional sex in many countries.ConclusionsMedia use is linked to sexual risk behaviour among young people in Sub-Saharan Africa. Socioeconomic inequalities, levels of globalization, as well as rural–urban disparities in access to media, underscore the need to deliver tailored and targeted sexual risk reduction interventions to young people using both traditional and new media.

Preferences for Hypertension Care in Malawi: A Discrete Choice Experiment Among People Living with Hypertension, With and Without HIV.

Hypertension is the most common non-communicable disease diagnosed among people in sub-Saharan Africa. However, little is known about client preferences for hypertension care. We performed a discrete choice experiment in Malawi among people with hypertension, with and without HIV. Participants were asked to select between two care scenarios, each with six attributes: distance, waiting time, provider friendliness, individual or group care, antihypertensive medication supply, and antihypertensive medication dispensing frequency (three versus one month). Eight choice sets (each with two scenarios) were presented to each individual. Mixed effects logit models quantified preferences for each attribute. Estimated model coefficients were used to predict uptake of hypothetical models of care. Between July 2021 and April 2022 we enrolled 1003 adults from 14 facilities in Malawi; half were living with HIV and on ART for a median of 11years. Median age of respondents was 57years (IQR 49-63), 58.2% were female, and median duration on antihypertensive medications was 4years (IQR 2-7). Participants strongly preferred seeing a provider alone versus in a group (OR 11.3, 95% CI 10.4-12.3), with stronger preference for individual care among those with HIV (OR 15.4 versus 8.6, p < 0.001). Three-month versus monthly dispensing was also strongly preferred (OR 4.2; 95% CI 3.9-4.5). 72% of respondents would choose group care if all other facility attributes were favorable, although PLHIV were less likely to make this trade-off (66% versus 77%). These findings have implications for the scale-up of hypertension care in Malawi and similar settings.

A Comprehensive Review of the Ethnobotanical Uses, Pharmacological, and Toxicological Profiles of Piper capense L.f. (Piperaceae)

Commonly known as wild pepper, Piper capense (P. capense) is a culinary herb mainly used as a secret in preparation of “Nkui” and “Nah poh” in Bayangam, West Cameroon. However, it also has many interesting pharmacological properties, which is why the people of sub-Saharan Africa so highly prize it for the treatment of multiple human pathologies. This study aimed to highlight the traditional uses, phytochemical composition, biological activities, and toxicological profile of the P. capense plant, to draw the attention of pharmaceutical companies to its enormous potential for the development of future phyto- or pharmaceutical products. Documentary research was meticulously carried out in the Web of Sciences, Scopus, Pubmed/Medline, and Google Scholar databases according to PRISMA 2020 guidelines. The results show that extracts and compounds isolated from Piper capense have interesting anticancer, antibacterial, antimalarial, hypoglycemic, anti-epileptic, and antidepressant activities. Methanolic extracts and essential oils from P. capense exhibit no harmful effects when directly applied to normal human hepatocytes, umbilical cord cells, intestinal cells, and keratinocyte cell lines. Additionally, methanolic extracts administered acutely or subchronically at low doses (≤250 mg/kg body weight) in Wistar rats also demonstrate no adverse effects. In conclusion, given its interesting activities, P. capense is a viable option for developing new antimalarial, anticancer, antibacterial, hypoglycemic, anti-epileptic, and antidepressant drugs. However, many avenues still need to be explored before translation into drugs.

Prevalence and correlates of frailty among older people with and without HIV in rural Uganda.

The relationship between HIV and frailty, a predictor of poor outcomes in the face of stressors, remains unknown in older people in sub-Saharan Africa. We analysed data from the Quality of Life and Ageing with HIV in Rural Uganda cohort study to estimate the prevalence and correlates of frailty among older people with HIV (PWH) on long-term antiretroviral therapy and among age and sex-similar HIV-uninfected comparators. Frailty was defined as a self-report of 3 or 4 (and pre-frailty as 1 or 2) of the following phenotypic variables: weight loss, exhaustion, low activity, and slowness. We estimated the prevalence of frailty and pre-frailty and fitted logistic regression models to estimate the association between HIV and frailty, adjusting for sociodemographic factors, depression, and other comorbidities. We enrolled 599 participants (49% women) with a mean age of 58 years. PWH had a similar prevalence of frailty (8.1% vs. 10.9%, p=0.24) but a lower prevalence of pre-frailty (54.2% vs. 63.2%, p=0.03) compared with their HIV-uninfected comparators. In multivariable regression models, people with depression (AOR 7.52 [95% CI: 3.67-15.40], p<0.001) and those with ≥1 comorbidities (AOR 3.15 [95% CI: 1.71-3.82], p<0.001) were more likely to be frail. HIV serostatus was not significantly associated with frailty (AOR 0.71 [95% CI: 0.37-1.34], p=0.29). Older PWH had a similar prevalence of frailty as those without HIV. These findings call for additional study of the factors that contribute to the robustness of older PWH in sub-Saharan Africa.

How migration shapes modern contraceptive use among urban young women: Evidence from six African countries.

Internal migration is an important part of the transition to adulthood for many young people in sub-Saharan Africa. This study examines how migration, in relation to marriage and parenthood, impacts modern contraceptive use and health facility visits amongst young urban women. We draw on Performance Monitoring for Action (PMA) surveys conducted in Burkina Faso, Côte d'Ivoire, Democratic Republic of Congo, Kenya, Nigeria, and Uganda (2019-2022). Our analysis is unique in being able to adjust for whether women wanted to get pregnant soon. Our sample includes women ages 15-24 years currently residing in urban areas (n = 6,225). We conducted logistic regression models clustered by village level identifier to explore the sequence of life events and the timing of migration in relation to current modern contraceptive use and recent health facility visit, a proxy for engagement with formal health services. The timing of migration matters more than the sequence of these life events. Young urban women who experienced both migration and a birth, regardless of the order, had increased contraceptive use and recent health facility visit, compared to women who had only experienced one event or neither. Young women who migrated in the past year had 24% lower odds of using a modern method (Odds Ratio = 0.76; 95% confidence interval 0.63, 0.91), adjusting for demographic factors and adjusting for fertility preference (Wanting to get pregnant soon). Having had a birth was highly significant for health facility visit and among women who had had a birth, those who migrated in the last year had lower odds of a recent visit (OR = 0.68, 95% CI 0.41, 0.89). Results suggest an initially disruptive effect of migration. Our results suggest young women who recently migrated to urban areas may need additional support in accessing contraception and formal health services for themselves or their children.

The political economy of mini-grid electricity development and innovation in Kenya

Accessible and affordable energy services are a prerequisite for socioeconomic growth and poverty reduction. Yet it is estimated that 600 million people in sub-Saharan Africa will not have access to electricity in 2030. Recent research suggests that universal access to electricity will be achieved through a mix of centralized and decentralized systems and that the diffusion of these technologies is a socio-technical process involving multiple actors. These actors include firms, networks, energy users, and government agencies that interact within a political landscape to deliver innovation within energy service systems. Thus, factors related to the political economy can impact the process of innovation and warrant analysis. This study aims to provide an analysis of the political economy factors that can influence the emergence of mini grid electricity development in the African context exemplified in Kenya as a case study. The study uses the Technology Innovation Systems (TIS) lens as an analytical framework to provide a critical analysis of how political economy factors have influenced the development of mini grid electricity in Kenya. The result shows that despite the presence of some favorable conditions for innovation, political economy factors significantly impede the deployment of mini grids in Kenya. Power and vested interests have created negative competition between public and private developers, limiting knowledge and information diffusion between actors and stalling mini grid developments where they are most needed.

Nutrition for Older Adults With Osteoarthritis: Empowering People in Sub-Saharan Africa With Information for Self-Management in Line With Core Guideline Recommendations

Nutrition for Older Adults With Osteoarthritis: Empowering People in Sub-Saharan Africa With Information for Self-Management in Line With Core Guideline Recommendations

Chronic Conditions and Multimorbidity Among Middle-Aged and Elderly Peri-Urban Dwellers in Dar es Salaam, Tanzania.

Chronic conditions and multimorbidity affect care needs and prevention opportunities. We studied 2,246 men and women aged ≥40 years within the Dar es Salaam Urban Cohort Study from June 2017 to July 2018. Seventeen chronic conditions were assessed based on self-report, body and blood pressure measurement, blood tests, and screening instruments. Hypertension (51.3%), anemia (34.1%), obesity (32.2%), diabetes (31.6%), depressive symptoms (31.5%), low grip strength (21.2%), and ischemic heart disease (11.9%) were widespread. Multimorbidity was common (73.7%). Women had higher odds of obesity, ischemic heart disease, and high cholesterol (adjusted OR: 2.08-4.16) and lower odds of underweight, low grip strength, alcohol problems, and smoking (adjusted OR: 0.04-0.45). Ten years of age were associated with higher odds of low grip strength, cognitive problems, hypertension, kidney disease, chronic cough, diabetes, high cholesterol, ischemic heart disease, and multimorbidity (adjusted OR: 1.21-1.81) and lower odds of HIV infection (adjusted OR: 0.51). We found a higher prevalence of multimorbidity than previously estimated for middle-aged and elderly people in sub-Saharan Africa. The chronic conditions underlying multimorbidity differed by sex.

Variation in Grain Yield Losses Due to Fall Armyworm Infestation among Elite Open-Pollinated Maize Varieties under Different Levels of Insecticide Application

Maize is an important food and industrial cereal crop that serves as the main source of energy for millions of low-income people in sub-Saharan Africa (SSA), but its production and productivity are constrained by many constraints, among which the fall armyworm (FAW) is the major one. The use of insecticides is the most effective control measure for the FAW. However, excessive use of chemical insecticides has environmental and health implications, and it can be expensive for resource-poor farmers. The objective of this study was to evaluate the extent of variation in yield losses due to the FAW among some elite maize open-pollinated varieties (OPVs) under two levels of insecticide application and control (0 application). In a two-year field study, 10 elite maize OPVs were evaluated under two levels of emamectin benzoate (5% WDG) applications and the control: 75 and 150 mL of spray solution per 20 L of water. The experimental design was a randomized complete block with three replications. The data were collected on grain yield (GY) and FAW leaf damage rating (LDR). The LDR was conducted on a 1–9 scale and used to categorize the maize varieties as resistant (1–4), moderately resistant (4–6), and susceptible (6–9). Significant varietal differences were obtained for GY and LDRs. The GY of the varieties under control (0 mL), 75 and 150 mL insecticide applications ranged from 3.3 t ha−1 (DTSTR-Y SYN-13) to 4.6 t ha−1 (PVA SYN-3), from 4.5 t ha−1 (DTSTR-Y SYN-13) to 6.4 t ha−1 (PVA SYN-13), and from 4.2 t ha−1 (DTSTR-Y SYN-13) to 6 t ha−1 (DTSTR-Y SYN-14), respectively. No significant differences in GY were found between the application of 75 and 150 mL of insecticide application. The relative loss in GY among the varieties under control (0 mL) differed with an increase in the level of insecticide application. The relative GY loss at the 75 mL insecticide application ranged from 18% (PVA SYN-3) to 38% (DTSTR-Y SYN-15) with a mean of 27%, whereas at the 150 mL insecticide application, it varied from 13% (PVA SYN-3) to 42% (DTSTR-Y SYN-15), with a mean of 26%. All the varieties exhibited moderate resistance to FAW, except DTSTR-Y SYN-14, which was susceptible. The varieties PVA SYN-3 and PVA SYN-13 were the most consistent in GY across the three insecticide treatment levels. The mean performance of the varieties for FAW leaf damage ranged from 4.0 (SAMMAZ-15) to 6.2 (DTSTR-Y SYN-14), from 4.5 (SAMMAZ-15) to 6.3 (PVA SYN-6), from 4.5 (SAMMAZ-15) to 6.3 (DTSTR-Y SYN-14), and from 3.5 (SAMMAZ-15) to 5 (DTSTR-Y SYN-14) for LDR 1, LDR 2, LDR 3, and LDR 4, respectively. The use of moderately resistant varieties, combined with timely spraying of emamectin benzoate at 75 mL provided adequate management for the FAW infestation and sustained high maize grain yield.

Stroke Characteristics in the Elderly: A Hospital-Based Study in Cameroon.

Advanced age is an important nonmodifiable risk factor for stroke. Little data are available on stroke in older people in sub-Saharan Africa. This study aimed to determine the clinical features of stroke and identify the predictive factors for poor outcomes in this age group. A 4-month retrospective study was conducted using the Stroke Registry of Douala General Hospital. The main outcomes were mortality, poor functional recovery at 3 months (modified Rankin Scale score ≥3), and recurrence at 1 year. Factors associated with poor outcomes were determined using binary logistic regression. Survival was estimated using the Kaplan-Meier method. The significance threshold was set at p &lt; 0.05. Elderly patients represented 38.6% of all stroke cases (n = 1,260). Male represented 48.6% of the old patients. The incidence of hypertension, diabetes, previous stroke, and cardiopathies was significantly higher in older patients (p &lt; 0.05). Ischemic stroke accounted for 73.1% of stroke types. Cardiopathies, GCS 8-12, GCS &lt;8, hemorrhagic stroke, NIHSS &gt;14, and Barthel index at 1 month were independently associated with mortality. Being divorced, a modified Rankin scale score ≥3 at 1 month, and a Barthel index ≤60 at 1 month were independently associated with poor functional recovery at 3 months. Old patients represented 50% of recurrent stroke cases. Age &gt;90 years (p &lt; 0.001) and NIHSS &lt;5 were independently associated to recurrence at 1 year. Approximately two out of five stroke cases were old. Cardiopathies, hemorrhagic stroke, and data related to stroke severity contribute to poor outcomes. A management approach that considers the particularities of this age group could contribute to improving the outcomes of these patients.

Higher prevalence of kidney function impairment among older people living with HIV in Uganda.

People living with HIV (PLWH) are at risk of kidney function impairment due to HIV-related inflammation, antiretroviral therapy (ART), diabetes mellitus, and hypertension. Older persons may experience a higher burden of chronic kidney disease (CKD) as kidney function declines with increasing age. There is a paucity of data comparing the prevalence of kidney function impairment in older PLWH to that in HIV-uninfected people in sub-Saharan Africa. We conducted a cross-sectional study among people aged ≥ 60 years living with and without HIV in Kampala, Uganda who were matched 1:1 by community location. We collected data on sociodemographics, comorbidities, and HIV-related clinical characteristics. We defined kidney function impairment as an estimated glomerular filtration rate(eGFR) < 60mls/min/1.73m2 with or without proteinuria. We constructed multivariable logistic regression models to study associations between participant characteristics and kidney function impairment. We enrolled 278 people (median age 66 years); 50% were PLWH, and 51.8% were female. Overall, the prevalence of kidney function impairment was 23.0% (95% CI:18.4%-28.4%); 33.1% (95% CI: 25.7%-41.4%) versus 12.9% (95% CI: 8.3%-19.7%) among people living with and without HIV (p-value < 0.01). The prevalence of proteinuria among PLWH versus people without HIV was 43.9% (95% CI:35.8%-52.3%) versus 19.4% (95% CI:13.6%-26.9%) p-value < 0.01. Living with HIV (OR = 3.89(95% CI: 2.04-7.41), p-value < 0.01), older age (OR = 1.13, (95% CI:1.07-1.20), p-value < 0.01), female sex (OR = 1.95, (95% CI:1.06-3.62), p-value = 0.03) and a prior diagnosis of hypertension (OR = 2.19(95% CI:1.02-4.67), p-value = 0.04) were significantly associated with kidney function impairment. HIV infection is strongly associated with kidney function impairment among older PLWH. Prioritizing routine measurements of kidney function and proteinuria in older PLWH will enable early detection and institution of measures to reduce the progression of kidney disease.

Inclusive Human Development in Sub-Sahara Africa: Does the Environmental Quality Matter?

The improvement of human well-being is the fundamental objective of the scramble for environmental sustainability. This study aims to investigate the effect of environmental sustainability on inclusive human development in Sub-Saharan Africa. Through the application of a system-GMM to a sample of 49 Sub-Saharan African countries from 2010 to 2017, we found a positive and statistically significant effect of environmental sustainability on inclusive human development in Sub-Saharan countries. Thus, by growing environmentally friendly trees, employing organic manure, and refraining from farming methods that contaminate the environment and expose the soil to erosion, the people of Sub-Saharan Africa should join the global fight for environmental sustainability.

Pre-Therapeutic Assessment of Older People in Sub-Saharan Africa: Introduction to the Comprehensive Geriatric Assessment.

Objectives: With the ongoing epidemiological transition in sub-Saharan Africa (SSA), conditions that require invasive treatment (surgery, cancer, and anaesthesia, etc.) will become increasingly common. Comprehensive geriatric assessment (CGA) is a multidisciplinary diagnostic process aimed at identifying older people at risk of negative outcomes. It is important to know whether this approach integrates care management strategies for older people in a context where health services for older people are scarce, and staff members have little training in geriatrics. The current work is a situational analysis on the use of CGA on invasive care (cancer, surgery, etc.) among older people in SSA. Methods: We searched PubMed-MEDLINE and other sources for studies reporting on CGA and conditions requiring invasive treatment in older patients in SSA. Results/Conclusions: We found no study that had comprehensively examined CGA and invasive care in SSA. There is, however, evidence that the offer of invasive care to older people has improved in SSA. Further research is needed to explore the applicability of CGA in SSA. Similarly, more investigations are needed on the role of CGA in the care trajectories of older people in SSA, in terms of outcomes and affordability.

Adolescents and young people in sub-Saharan Africa: overcoming challenges and seizing opportunities to achieve HIV epidemic control.

Adolescents and young people in sub-Saharan Africa: overcoming challenges and seizing opportunities to achieve HIV epidemic control.

In silico prediction of candidate gene targets for the management of African cassava whitefly (Bemisia tabaci, SSA1-SG1), a key vector of viruses causing cassava brown streak disease.

Whiteflies (Bemisia tabaci sensu lato) have a wide host range and are globally important agricultural pests. In Sub-Saharan Africa, they vector viruses that cause two ongoing disease epidemics: cassava brown streak disease and cassava mosaic virus disease. These two diseases threaten food security for more than 800 million people in Sub-Saharan Africa. Efforts are ongoing to identify target genes for the development of novel management options against the whitefly populations that vector these devastating viral diseases affecting cassava production in Sub-Saharan Africa. This study aimed to identify genes that mediate osmoregulation and symbiosis functions within cassava whitefly gut and bacteriocytes and evaluate their potential as key gene targets for novel whitefly control strategies. The gene expression profiles of dissected guts, bacteriocytes and whole bodies were compared by RNAseq analysis to identify genes with significantly enriched expression in the gut and bacteriocytes. Phylogenetic analyses identified three candidate osmoregulation gene targets: two α-glucosidases, SUC 1 and SUC 2 with predicted function in sugar transformations that reduce osmotic pressure in the gut; and a water-specific aquaporin (AQP1) mediating water cycling from the distal to the proximal end of the gut. Expression of the genes in the gut was enriched 23.67-, 26.54- and 22.30-fold, respectively. Genome-wide metabolic reconstruction coupled with constraint-based modeling revealed four genes (argH, lysA, BCAT & dapB) within the bacteriocytes as potential targets for the management of cassava whiteflies. These genes were selected based on their role and essentiality within the different essential amino acid biosynthesis pathways. A demonstration of candidate osmoregulation and symbiosis gene targets in other species of the Bemisia tabaci species complex that are orthologs of the empirically validated osmoregulation genes highlights the latter as promising gene targets for the control of cassava whitefly pests by in planta RNA interference.

Characterization of food insecurity among the forced migrants in northern Nigeria

Food insecurity affects many people worldwide. More than one billion people in Sub-Saharan Africa are food insecure. About 35% of this population, representing 346 million, are food insecure because of conflicts and political unrest. About 1.6 million people forced to migrate from northern to Central Nigeria in 2018 alone are food insecure. Food insecurity reduces people’s choice, power, and opportunity to access and control their food practices. Forced migrants have difficult circumstances, including physical restrictions on food access, and cultural and financial means during the migration. However, there is little knowledge of how the forced migrants engaged and managed their food practices throughout their migration period, making the form of food insecurity they experienced poorly understood. This calls for an investigation to increase food security for forced migrants. This article draws on the investigation from an in-depth Narrative interview involving 25 people who had experienced forced migration in northern Nigeria to address this gap. Unstructured interviews were, used for data collection to allow a wide range of responses. Their responses were audio recorded and subsequently transcribed and written in English. The contextual data that resulted from transcriptions of the audio data were subjected to computer-assisted qualitative data analysis software (CAQDAS) and the data was analyzed. The study's objectives are to find out the forms of food security/insecurity experienced by the forced migrants, their experiences, and the nature of the migration. The finding revealed that violent conflicts caused by terrorists, Fulani herders, religious bigots, and communal disagreement caused forced migration in the region and resulted in short-term, intermittent, and long-term food insecurity. Short-term food insecurity was more devastating for the migrants than intermittent and long-term food insecurity.