Persons In Africa Research Articles

Scoping review of the ethical regulations for Alzheimer's Disease and Alzheimer's Disease Related Dementia research in Africa.

We conducted a scoping review to ascertain the landscape of ethics regulations for AD/ADRD research in Africa using Arksey and O'Malley's framework. We sourced regulations from the International Compilation of Human Research Standards. We included regulations from 14 countries published between 1997 and 2020. Provisions in the regulations applicable to research in AD/ADRD were part of broader sub-provisions for research such as with persons under legal disability. Regulations mostly required the appointment of Legally Authorised Representatives, as a major protection for persons with AD/ADRD. Provisions supporting capacity assessment and advance directives were only provided in regulations from five and two countries respectively. No regulation cited the Convention on the Rights of Persons with Disabilities as a foundational instrument for its provisions. In conclusion, regulations specifically applicable to research among AD/ADRD or other cognitively impaired persons in Africa are scarce and provisions in existing regulations mostly lack specificity for practical implementation.

Health intervention trials involving transgender, transabled and transracial persons in Africa: A scoping review

Health intervention trials involving transgender, transabled and transracial persons in Africa: A scoping review

Post-traumatic stress disorder and associated factors among internally displaced persons in Africa: A systematic review and meta-analysis.

Internally displaced people (IDPs), uprooted by conflict, violence, or disaster, struggle with the trauma of violence, loss, and displacement, making them significantly more vulnerable to post-traumatic stress disorder (PTSD). Therefore, we conducted a systematic review and meta-analysis to assess the prevalence and associated factors of PTSD among IDPs in Africa. A comprehensive search of electronic databases was conducted to identify relevant studies published between 2008 and 2023. The search included electronic databases such as PubMed, CABI, EMBASE, SCOPUS, CINHAL, and AJOL, as well as other search sources. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Data were extracted using Microsoft Excel, and analysis was performed using STATA 17 software. The quality of the included studies was assessed using the JBI quality appraisal tool. A random-effects model was used to estimate the pooled prevalence of PTSD and its associated factors. The funnel plot and Egger's regression test were used to assess publication bias, and I2 test statistics was used to assess heterogeneity. The protocol for this review has been registered with PROSPERO (ID: CRD42023428027). A total of 14 studies with a total of 7,590 participants met the inclusion criteria. The pooled prevalence of PTSD among IDPs in Africa was 51% (95% CI: 38.-64). Female gender (OR = 1.99, 95% CI: 1.65-2.32), no longer married (OR = 1.93, 95% CI: 1.43-2.43), unemployment (OR = 1.92, 95% CI: 1.17-2.67), being injured (OR = 1.94, 95% CI: 1.50-1.50), number of traumatic events experienced [4-7(OR = 2.09, 95% CI: 1.16-3.01), 8-11 (OR = 2.09, 95% CI: 2.18-4.12), 12-16 (OR = 5.37, 95% CI: 2.61-8.12)], illness without medical care (OR = 1.92, 95% CI: 1.41-2.29), being depressed (OR = 2.97, 95% CI: 2.07-3.86), and frequency of displacement more than once (OR = 2.13, 95% CI: 1.41-2.85) were significantly associated with an increased risk of PTSD. The findings of this systematic review and meta-analysis highlight the alarming prevalence of PTSD among IDPs in Africa. Female gender, marital status, number of traumatic events, ill health without medical care, depression, and frequency of displacement were identified as significant risk factors for PTSD. Effective interventions and the development of tailored mental health programs are needed to prevent PTSD among IDPs, focusing on the identified risk factors.

Deploying the African Union’s Legal Mechanisms for the Effective Protection of Internally Displaced Women from Sexual Violence

The problem of internal displacement is a regional challenge and cannot be left in the hands of only one country. A critical question that this paper will attempt to answer is: Does the adoption of the Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa and the African Union Convention for the Protection and Assistance of Internally Displaced Persons in Africa hold the key to the protection and assistance of conflict-induced female IDPs in Nigeria? An attempt is made to provide answers to whether human rights treaties, in fact, make any impact on the lives of people. The conclusion shall examine how African regional human rights treaties and the African Commission’s special mechanisms could be harnessed to provide the basis for systematic and coordinated action in the protection of female conflict-induced IDPs in Nigeria from sexual violence.

Caregiving practices for older persons in Africa: Changing trends and implications for transformative social work

Caregiving practices for older persons in Africa: Changing trends and implications for transformative social work

The implementation of the Kampala Convention in Cameroon: trends, challenges and opportunities

This contribution examines the implementation of the African Union Convention for the Protection and Assistance of Internally Displaced Persons in Africa (Kampala Convention) by relevant actors in Cameroon. It highlights the fact that there is a considerable gap between the legal provisions of the Kampala Convention and their practical application in Cameroon. On this basis, it argues that there is an urgent need to take necessary measures to reduce or close such a gap and thus improve the plight of the more than a million civilians who had been internally displaced as a result of deadly attacks by non-state armed groups in the far North region, growing violence in the English-speaking North-West and South-West regions and natural disasters. The approach envisaged to achieve this demonstration is articulated in three stages. First, the article sheds light onthe huge scale of internal displacement in Cameroon and on the precarious situations of those who are victims of it. Then, through a critical approach, it discusses the limitations and difficulties that prevent the Kampala Convention from fully contributing to the improvement of the lot of IDPs in Cameroon. Finally, with an approach centred around making suggestions for law reform, the article puts forward possible solutions aimed at strengthening the implementation of the Kampala Convention in Cameroon.

Cryptococcosis in Africa: What the data tell us.

Cryptococcosis is a neglected tropical disease and the main cause of fungal-related deaths in HIV-positive persons in Africa. It is an AIDS-defining illness that has almost surpassed tuberculosis (TB) in mortality despite wide coverage with antiretroviral therapy. What is known about the cryptococcosis burden in Africa is from estimations based on data from a few studies on the infection burden and associated complications. Consequently, the projected implications of cryptococcosis in Africa have been based on these estimations. This systematic review is aimed at providing unique and up-to-date data on the burden of cryptococcosis in Africa using published hospital-based research data on cryptococcosis in HIV infected and uninfected persons. The review also focused on providing temporal data on the availability of diagnostic and therapeutic options for cryptococcosis in Africa. From our results, about 40 948 cases of cryptococcosis were reported in Africa from 1969 to 2021, and the highest prevalence of cryptococcosis was from southern Africa. The most isolated species was Cryptococcus neoformans 42.4% (17 710/41 801) and only 1.3% (549/41 801) isolates were C. gattii. C. neoformans (serotype A) VN I 64.5% (918/1522) was the most prevalent serotype in Africa, while C. gattii (serotype C) VG IV was thought to pose a huge danger. However, C. neoformans (serotype A) VN I continued to be the major threat in Africa. Due to the limited availability of molecular typing methods and the widespread use of culture, direct microscopy, and serological techniques for diagnosis, 23 542 isolates were uncharacterised. Amphotericin B and flucytosine combination therapy is highly recommended for treatment of cryptococcal meningitis. However, these drugs are expensive and remain largely unavailable in most African countries. Amphotericin B requires laboratory facilities to monitor for toxicity. Although fluconazole monotherapy is the readily available treatment option for cryptococcosis, drug resistance, and high mortality have been recorded in majority of cases in Africa. The lack of awareness and paucity of published data on cryptococcosis are likely to have contributed to the underestimation of cases in Africa and led to underprioritisation of this important disease.

Exploring the displacement induced changes in social convoys and support for older women in displacement (OWD) in Abuja, Nigeria

AbstractThe world is witnessing a dramatic increase in displaced persons in Africa, Asia, South America, and, most recently, Europe. Within this population of violence‐induced displacement are older women, a group that is mostly unseen because research and relief initiatives primarily target younger women and children. This study aimed to explore the changes in the convoys and support for older women in displacement (OWD). Qualitative data were collected from nine OWD using art‐based convoys of concentric circles and interviews. The collected data were analysed in themes, and findings revealed that while there has been intervention from formal organisations to fill the displacement‐induced support gap, supports are still limited, sporadic, not focused on the peculiar needs of OWD, not guided by any framework, and mainly material in design. The study concluded by recommending sustainable support to help OWD become empowered to cope effectively without aid.

The Application of International Humanitarian Law in the Resolution of a Complex Humanitarian Crisis: A Case Study of the Tigray National Regional State of the Federal Democratic Republic of Ethiopia

The subject of the study is the specifics of the application of international humanitarian law (IHL) to the resolution of the humanitarian crisis in the Ethiopian state of Tigray. Crimes against humanity committed by Ethiopian and Eritrean troops in the conditions of warfare have been studied. It is argued that according to Article 3 of the II Additional Protocol to the Geneva Convention on the Protection of Victims of War, the federal center of Ethiopia, which protects the sovereignty of the State, acts correctly by suppressing the rebels of Tigray. However, this is in contradiction with the UN Security Council resolution on the situation with human rights and the human situation in Ethiopia and the 2021 Human Rights Council resolution S-33/1 “The situation of human rights in Ethiopia” indicating Ethiopia’s violation of its international legal obligations with respect to civilians in armed conflict and IHL norms. Thus, the operation of IHL on the territory of the state is objectively suspended. The provisions and priorities of Refugee Law are considered separately in relation to the specifics of the refugee situation in Ethiopia, in particular the specifics of the Kampala Convention for the Protection and Assistance of Internally Displaced Persons in Africa of 2009. It was found that both the federal authorities and the opposing belligerents controlling the settlements of internally displaced persons on the territory of Ethiopia, do not fulfill their obligations under the Сonvention, which refers to the need for urgent further development of regional international treaties on assistance to forced migrants.

Stroke in Africa: A systematic review and meta-analysis of the incidence and case-fatality rates.

The burden of stroke (a leading cause of disability and mortality) in Africa appears to be increasing, but a systematic review of the best available data to support or refute this observation is lacking. To determine the incidence and 1-month case-fatality rates from high-quality studies of stroke epidemiology among Africans. We searched and retrieved eligible articles on stroke epidemiology among indigenous Africans in bibliographic databases (MEDLINE, ScienceDirect, Google Scholar, and Cochrane library) using predefined search terms from the earliest records through January 2022. Methodological assessment of eligible studies was conducted using the Newcastle-Ottawa scale. Pooling of incidence and case-fatality rates was performed via generalized linear models (Poisson-Normal random-effects model). Of the 922 articles retrieved, 14 studies were eligible for inclusion. The total number of stroke cases was 2568, with a population denominator (total sample size included in population-based registries or those who agreed to participate in door-to-door community studies) of 3,384,102. The pooled crude incidence rate of stroke per 100,000 persons in Africa was 106.49 (95% confidence interval (CI) = 58.59-193.55), I2 = 99.6%. The point estimate of the crude incidence rate was higher among males, 111.33 (95% CI = 56.31-220.12), I2 = 99.2%, than females, 91.14 (95% CI = 47.09-176.37), I2 = 98.9%. One-month case-fatality rate was 24.45 (95% CI = 16.84-35.50), I2 = 96.8%, with lower estimates among males, 22.68 (95% CI = 18.62-27.63), I2 = 12.9%, than females, 27.57 (95% CI = 21.47-35.40), I2 = 51.6%. The burden of stroke in Africa remains very high. However, little is known about the dynamics of stroke epidemiology among Africans due to the dearth of high-quality evidence. Further continent-wide rigorous epidemiological studies and surveillance programs using the World Health Organization STEPwise approach to Surveillance (WHO STEPS) framework are needed.

Institutional Culture and the Welfare of the Aged Population in Arusha District, Tanzania

The rising number of elderly persons in Africa and the need to provide them with support within state and non-state institutions require that the institutions meet the the standards set by international and national conventions on elderly persons welfare. It is in this vein that the current study aimed at determining the role of institutional culture on the welfare of the aged population in Arusha rural district, Tanzania. To achieve this, it explored the role of traditional perceptions on the welfare of the elderly in Arusha rural district, explored how different institutional care plans on the elderly affect their well being in Arusha rural district, and investigated the role of different institutional stakeholders on the welfare of the elderly population in Arusha rural district. The research used Culture Care Diversity and Universality and Social Exclusion theories. The study used mixed Convergent research design under mixed method research approach. It targeted 48,480 elderly persons, 15 local government administrators, 10 non-state actors, and 50 relatives to the elderly. Questionnaire, interview guide, and FGD were used. Data was analyzed through descriptive and inferential statistics. The study found that traditional community perception, institutional care plans, and stakeholder involvement had a positive relation on the welfare of the older population in Arusha Rural District in Tanzania. It concluded that, elderly persons faced societal stereotypes and traditional beliefs that negatively affected their welfare. It also concluded that, the government offices in the area did not provide friendly and timely care services for the elderly persons.

Integrated healthcare approach can curb the increasing cases of cryptococcosis in Africa.

Cryptococcosis is a neglected tropical infection and a major cause of morbidity and mortality, especially in HIV–positive persons in Africa. Efforts to manage HIV infection have not had any significant impact on the fatalities due to cryptococcosis. An integrated healthcare approach that includes universal care coverage for Africans, expanded national care guidelines to include CrAg screening for vulnerable groups in all African countries, collaborative research, infection surveillance, and data sharing within Africa will mark a turnaround point.

Now That We Have Moved in Words, Can We Move in Action? the AU, Member States and African Union Protocol on the Free Movement of Persons in Africa

Now That We Have Moved in Words, Can We Move in Action? the AU, Member States and African Union Protocol on the Free Movement of Persons in Africa

Screening COVID-19 Suspected Cases and Determining the Associated Factors.

BackgroundThe incidence of corona-virus-positive persons in Africa, notably in Ethiopia, is rapidly increasing, leading to enhanced analyses. Even though the majority of people exhibit COVID-19's key symptoms, many refuse to go to the hospital to have the virus tested. This study aims to assess probable COVID-19 participants and the related characteristics among residents of Northwest Ethiopian municipal towns.MethodsThis project contains participants enlisted from Northwest Ethiopia municipal towns, and a cross-sectional data collection approach was employed. A total of 1,288 arbitrarily designated contestants accomplished an actively screening test questionnaire that was used to assess whether the participants were suspected of coronavirus. The statistical analysis Chi-square test and a binary logistic regression were implemented.ResultsAmong the 1,288 designated contestants, 788 (61.2%) of them were men. About 77.5% of the participants were from orthodox religion and 12.2% live in the rural area permanently. As compared to female participants (45.9%), the number of suspected male participants (54.1%) was higher. As compared to societies in Woldya municipal town, populations in Bahir Dar (aOR = 0.101;95% CI = 0.065,0.156), Gondar (aOR = 0.072;95% CI = 0.043,0.122), and Debre Markos (aOR = 0.368;95% CI = 0.271,0.501) municipal town were less likely to be suspected of COVID-19. Equated to the employed contestants, unemployed contestants had lower odds of being suspected of COVID-19 (aOR = 0.147; 95% CI = 0.1160.186).ConclusionThe prevalence of suspected cases of coronavirus in Northwest Ethiopia was considerably high. The city of residence, work status, hospital use, marital status, permanent residence, and source of information were important determinants of suspected cases of coronavirus. Thus, timely diagnosis of suspected cases of coronavirus and taking the appropriate remedial action help to reduce the spread and mortality rate.

Translation, cross-cultural adaptation, and psychometric properties of the Hausa version of the Insomnia Severity Index among internally displaced persons in Africa

BackgroundAlthough sleep disturbances and insomnia are common among Internally Displaced Persons (IDPs), these disorders remain largely understudied among victims fleeing ethnoreligious genocide. The Insomnia Severity Index (ISI), though a widely used measure of insomnia, has not been translated, cross-culturally adapted, nor validated in common African languages. This paper aimed to translate, adapt and validate the ISI scale into Hausa, the most widely spoken non-Indo-European language in African continent. MethodsA six-stage validation model was used for the translation and adaptation of the ISI into Hausa [(ISI-Hausa), Item-Content Validity Index (I-CVI)=0.9 to 1.0]. The tool was administered among IDPs residing in Maiduguri, North-Eastern Nigeria, from October to November 2019. A total of 281 participants from six camps were recruited via convenience sampling. The psychometric properties of the scale were assessed using an Exploratory Factor Analysis (EFA), Cronbach’s alpha (α) and Intraclass Correlation Coefficients (ICC) for determining factor structure, internal consistency and test-retest reliability, respectively. ResultsExploratory factor reduction resulted in a two-factor solution, with “ severity of insomnia ” identified as the construct for Factor 1 and “ impact of insomnia ” as the construct for Factor 2. Factor 1 consisted of four scale items and Factor 2 consisted of three items. Factor loadings for each item ranged from 0.535-0.812. The scale demonstrated acceptable internal consistency (α=0.72) and good test-retest reliability (ICC=0.72) (p<0.001). ConclusionThe ISI-Hausa scale is a psychometrically sound and culturally relevant tool for assessing the severity and impact of insomnia among Hausa speaking IDPs in Africa.

The African Union Protocol on Free Movement of Persons in Africa: development, provisions and implementation challenges

ABSTRACT:&#x0D; In 2016, the African Union launched a Common African passport to enhance free movement of persons. The essence of the free movement arrangement of the African Union is to create a united Africa while promoting continental integration in the spirit of pan-Africanism. Continental free movement of persons was also conceived as a migratory solution and as an important step towards promoting seamless borders in view of the African Union Agenda 2063. In 2018, African leaders formally adopted the Protocol on Free Movement of Persons geared towards fostering intra-continental mobility and improving the wellbeing of all African persons. This article examines the normative framework and strategies for the furtherance of free movement of persons in Africa.&#x0D; TITRE ET RÉSUMÉ EN FRANCAIS:&#x0D; Le Protocole de l’Union africaine relatif à la libre circulation des personnes en Afrique: évolution, normes et défis de mise en œuvre&#x0D; RÉSUMÉ:&#x0D; En 2016, l’Union africaine a établi un passeport africain commun pour accroitre la libre circulation des personnes. Le leitmotiv du nouveau régime juridique de l’Union africaine sur la libre circulation est de promouvoir une Afrique unie et favoriser l’intégration continentale dans l’esprit du panafricanisme. La libre circulation des personnes au niveau continental a également été conçue comme une solution migratoire et une étape importante dans l’ouverture des frontières africaines dans le cadre de l’Agenda 2063 de l’Union africaine. En 2018, les dirigeants africains ont officiellement adopté le Protocole relatif à la libre circulation des personnes visant à encourager la mobilité et à améliorer le bien-être de tous les Africains. Cet article examine le cadre normatif et les stratégies pour la promotion de la libre circulation des personnes en Afrique.

The impact of COVID-19 on the socio-economic rights of older persons in Africa: The urgency of operationalising the Protocol on the Rights of Older Persons

Since the outbreak of the COVID-19 pandemic across the world, it has been reported that older persons have suffered acute hardship and fatalities more than any other age group. According to the World Health Organisation the fatality rate among older persons is five times the global average, and the United Nations has predicted that the mortality rate could climb even higher. The situation is aggravated on the African continent as a result of a shortage of medical personnel and other resources, as well as inadequate palliative measures to address the issues around the pandemic. Despite the provisions in the African Charter on Human and Peoples' Rights and the Protocol to the African Charter on the Rights of Older Persons in Africa which seek to provide some safety nets, many of these senior citizens continue to suffer untold socioeconomic hardship. Adopting an analytical and doctrinal methodology, this article examines the Protocol, the International Covenant on Economic, Social and Cultural Rights and several United Nations policy documents aimed at realising the socio-economic rights of older persons. The article finds that there is a lack of political commitment to operationalise the provisions of the Protocol, as evinced by the limited number of countries that have ratified it since its adoption in 2016. It comparatively engages with the provisions of the Inter-American Convention on the Rights of Older Persons to argue that, beyond the normative framing of these rights in Africa, there is a need for deliberate and genuine commitment by governments in Africa, if the rights are to be realised. The article advocates international, regional and national cooperation and calls for a more liberal judicial approach, to ensure that the Protocol's 'paperisation' of the rights of older persons does not lead or continue to lead to their pauperisation.

Implications of WHO COVID-19 interim guideline 2020.5 on the comprehensive care for infected persons in Africa Before, during and after clinical management of cases

The novel coronavirus disease 2019 (COVID-19) is one of the biggest public health crises globally. Although Africa did not display the worst-case scenario compared to other continents, fears were still at its peak since Africa was already suffering from a heavy load of other life-threatening infectious diseases such as HIV/AIDS and malaria. Other factors that were anticipated to complicate Africa's outcomes include the lack of resources for diagnosis and contact tracing along with the low capacity of specialized management facilities per capita. The current review aims at assessing and generating discussions on the realities, and pros and cons of the WHO COVID-19 interim guidance 2020.5 considering the known peculiarities of the African continent. A comprehensive evaluation was done for COVID-19-related data published across PubMed and Google Scholar (date of the last search: August 17, 2020) with emphasis on clinical management and psychosocial aspects. Predefined filters were then applied in data screening as detailed in the methods. Specifically, we interrogated the WHO 2020.5 guideline viz-a-viz health priority and health financing in Africa, COVID-19 case contact tracing and risk assessment, clinical management of COVID-19 cases as well as strategies for tackling stigmatization and psychosocial challenges encountered by COVID-19 survivors. The outcomes of this work provide links between these vital sub-themes which may impact the containment and management of COVID-19 cases in Africa in the long-term. The chief recommendation of the current study is the necessity of prudent filtration of the global findings along with regional modelling of the global care guidelines for acting properly in response to this health threat on the regional level without exposing our populations to further unnecessary adversities.

Disability and Children as Begging Guides: For how Long Shall Children be Used as Begging Guides by Visually Impaired Persons in Africa?

This study examines the effect of using children as begging guides by people with sensory disabilities in Africa. It argues that in some African countries, visually impaired persons, especially parents and relatives, have devised the strategy of abusing their children or someone very close to them as begging guides for financial gain. While this strategy has remained a recurrent problem with severe social, economic, political, and legal implications, scientific research on addressing these implications is scarce. Given this, the article examines the rationale for using children as begging guides, its effects on the children and visually impaired parents, and mitigation strategies against abuse of children as begging guides in Africa. The qualitative research design based on key informant interviews (KIIs) complemented social exclusion and childhood theoretical underpinnings of the study. Results from (KIIs) showed that poverty, religion, cultural beliefs, financial profiteering, poor governance, breakdown in policy implementation against begging are among the rationale why children are abused and used as begging guides. The results also showed that these children experience low academic performance in school, harassment, psychological trauma, health complications from laborious trekking. At the same time, their visually impaired parents suffer from regrets and guilt of not being able to provide good parental care to their children. It concludes that good rehabilitation, vocational programmes, and prompt government supports for people with sensory disabilities would lessen the abuse and use of children as begging guides in Africa.

Protecting LGBT+ persons in Africa from torture: Challenges, opportunities, and comparative experiences

This news piece is about REDRESS' webinar held on 1 July 2021 on the protection of LGBT+ persons in Africa from torture and ill-treatment. The speakers on that occasion included (i) Victor Madrigal, the UN Independent Expert on protection against violence and discrimination based on sexual orientation and gender identity; (ii) Sibongile Ndashe, founder and Executive Director of the Initiative for Strategic Litigation in Africa (ISLA), based in South Africa; Ayo Sogunro, Manager of the Sexual Orientation, Gender identity and Sex Characteristics Unit at the Centre for Human Rights of the University of Pretoria, in South Africa; and (iv) Gabriela Oporto, from the Peruvian organisation PROMSEX.&#x0D; This news piece was written by Chris Esdaile and Renata Politi, from REDRESS.