scholarly journals Using mobile phone data to reveal risk flow networks underlying the HIV epidemic in Namibia

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Eugenio Valdano ◽  
Justin T. Okano ◽  
Vittoria Colizza ◽  
Honore K. Mitonga ◽  
Sally Blower
Keyword(s):  
Large Scale ◽  
Control Strategies ◽  
Sub Saharan Africa ◽  
Mobile Phone Data ◽  
Mathematical Framework ◽  
Sub Saharan ◽  
Administrative Units ◽  
Large Scale Networks ◽  
Living With Hiv ◽  
Very High

AbstractTwenty-six million people are living with HIV in sub-Saharan Africa; epidemics are widely dispersed, due to high levels of mobility. However, global elimination strategies do not consider mobility. We use Call Detail Records from 9 billion calls/texts to model mobility in Namibia; we quantify the epidemic-level impact by using a mathematical framework based on spatial networks. We find complex networks of risk flows dispersed risk countrywide: increasing the risk of acquiring HIV in some areas, decreasing it in others. Overall, 40% of risk was mobility-driven. Networks contained multiple risk hubs. All constituencies (administrative units) imported and exported risk, to varying degrees. A few exported very high levels of risk: their residents infected many residents of other constituencies. Notably, prevalence in the constituency exporting the most risk was below average. Large-scale networks of mobility-driven risk flows underlie generalized HIV epidemics in sub-Saharan Africa. In order to eliminate HIV, it is likely to become increasingly important to implement innovative control strategies that focus on disrupting risk flows.

HIV/AIDS

2020 ◽  
pp. 901-933
Author(s):  
Sarah Fidler ◽  
Timothy E.A. Peto ◽  
Philip Goulder ◽  
Christopher P. Conlon
Keyword(s):  
Large Scale ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
African Countries ◽  
Global Pandemic ◽  
The People ◽  
Reduce Life Expectancy ◽  
Sub Saharan ◽  
Living With Hiv ◽  
The Impact

Since its discovery in 1983, the human immunodeficiency virus (HIV) has been associated with a global pandemic that has affected more than 78 million people and caused more than 39 million deaths. Globally, 36.9 million (34.3–41.4 million) people were living with HIV at the end of 2013. An estimated 0.8% of adults aged 15–49 years worldwide are living with HIV, although the burden of the epidemic continues to vary considerably between countries and regions. Sub-Saharan Africa remains most severely affected, with nearly 1 in every 20 adults living with HIV and accounting for nearly 71% of the people living with HIV worldwide. The impact of HIV in some African countries has been sufficient to reverse population growth and reduce life expectancy into the mid-30s, although HIV incidence has declined in some of these high-prevalence countries. However, there are large-scale HIV epidemics elsewhere (e.g. India, the Russian Federation, and Eastern Europe).

scholarly journals Intestinal Schistosomiasis and Giardiasis Co-Infection in Sub-Saharan Africa: Can a One Health Approach Improve Control of Each Waterborne Parasite Simultaneously?

2020 ◽  
Vol 5 (3) ◽  
pp. 137 ◽  
Author(s):  
John Archer ◽  
Lisa O’Halloran ◽  
Hajri Al-Shehri ◽  
Shannan Summers ◽  
Tapan Bhattacharyya ◽  
...  
Keyword(s):  
Disease Surveillance ◽  
Large Scale ◽  
One Health ◽  
Control Strategies ◽  
Integrated Control ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
Intestinal Schistosomiasis ◽  
Sanitation And Hygiene ◽  
Sub Saharan

Both intestinal schistosomiasis and giardiasis are co-endemic throughout many areas of sub-Saharan Africa, significantly impacting the health of millions of children in endemic areas. While giardiasis is not considered a neglected tropical disease (NTD), intestinal schistosomiasis is formally grouped under the NTD umbrella and receives significant advocacy and financial support for large-scale control. Although there are differences in the epidemiology between these two diseases, there are also key similarities that might be exploited within potential integrated control strategies permitting tandem interventions. In this review, we highlight these similarities and discuss opportunities for integrated control of giardiasis in low and middle-income countries where intestinal schistosomiasis is co-endemic. By applying new, advanced methods of disease surveillance, and by improving the provision of water, sanitation and hygiene (WASH) initiatives, (co)infection with intestinal schistosomiasis and/or giardiasis could not only be more effectively controlled but also better understood. In this light, we appraise the suitability of a One Health approach targeting both intestinal schistosomiasis and giardiasis, for if adopted more broadly, transmission of both diseases could be reduced to gain improvements in health and wellbeing.

scholarly journals Precision Agriculture for Resource Use Efficiency in Smallholder Farming Systems in Sub-Saharan Africa: A Systematic Review

2021 ◽  
Vol 13 (3) ◽  
pp. 1158
Author(s):  
Cecilia M. Onyango ◽  
Justine M. Nyaga ◽  
Johanna Wetterlind ◽  
Mats Söderström ◽  
Kristin Piikki
Keyword(s):  
Resource Use ◽  
Precision Agriculture ◽  
Large Scale ◽  
English Language ◽  
Management Practices ◽  
Smallholder Farmers ◽  
Management Strategies ◽  
Sub Saharan Africa ◽  
Smallholder Farming ◽  
Sub Saharan

Opportunities exist for adoption of precision agriculture technologies in all parts of the world. The form of precision agriculture may vary from region to region depending on technologies available, knowledge levels and mindsets. The current review examined research articles in the English language on precision agriculture practices for increased productivity among smallholder farmers in Sub-Saharan Africa. A total of 7715 articles were retrieved and after screening 128 were reviewed. The results indicate that a number of precision agriculture technologies have been tested under SSA conditions and show promising results. The most promising precision agriculture technologies identified were the use of soil and plant sensors for nutrient and water management, as well as use of satellite imagery, GIS and crop-soil simulation models for site-specific management. These technologies have been shown to be crucial in attainment of appropriate management strategies in terms of efficiency and effectiveness of resource use in SSA. These technologies are important in supporting sustainable agricultural development. Most of these technologies are, however, at the experimental stage, with only South Africa having applied them mainly in large-scale commercial farms. It is concluded that increased precision in input and management practices among SSA smallholder farmers can significantly improve productivity even without extra use of inputs.

scholarly journals Relationships with caregivers and mental health outcomes among adolescents living with HIV: a prospective cohort study in South Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yulia Shenderovich ◽  
Mark Boyes ◽  
Michelle Degli Esposti ◽  
Marisa Casale ◽  
Elona Toska ◽  
...  
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Cohort Study ◽  
Mental Health Problems ◽  
Health Problems ◽  
Sub Saharan Africa ◽  
Depression Symptoms ◽  
Sub Saharan ◽  
Positive Caregiving ◽  
Living With Hiv

Abstract Background Mental health problems may impact adherence to anti-retroviral treatment, retention in care, and consequently the survival of adolescents living with HIV. The adolescent-caregiver relationship is an important potential source of resilience. However, there is a lack of longitudinal research in sub-Saharan Africa on which aspects of adolescent-caregiver relationships can promote mental health among adolescents living with HIV. We draw on a prospective longitudinal cohort study undertaken in South Africa to address this question. Methods The study traced adolescents aged 10–19 initiated on antiretroviral treatment in government health facilities (n = 53) within a health district of the Eastern Cape province. The adolescents completed standardised questionnaires during three data collection waves between 2014 and 2018. We used within-between multilevel regressions to examine the links between three aspects of adolescent-caregiver relationships (caregiver supervision, positive caregiving, and adolescent-caregiver communication) and adolescent mental health (depression symptoms and anxiety symptoms), controlling for potential confounders (age, sex, rural/urban residence, mode of infection, household resources), n=926 adolescents. Results Improvements in caregiver supervision were associated with reductions in anxiety (0.98, 95% CI 0.97–0.99, p=0.0002) but not depression symptoms (0.99, 95% CI 0.98–1.00, p=.151), while changes in positive caregiving were not associated with changes in mental health symptoms reported by adolescents. Improvements in adolescent-caregiver communication over time were associated with reductions in both depression (IRR=0.94, 95% CI 0.92–0.97, p<.0001) and anxiety (0.91, 95% CI 0.89–0.94, p<.0001) symptoms reported by adolescents. Conclusions Findings highlight open and supportive adolescent-caregiver communication and good caregiver supervision as potential factors for guarding against mental health problems among adolescents living with HIV in South Africa. Several evidence-informed parenting programmes aim to improve adolescent-caregiver communication and caregiver supervision, and their effect on depression and anxiety among adolescents living with HIV should be rigorously tested in sub-Saharan Africa. How to improve communication in other settings, such as schools and clinics, and provide communication support for caregivers, adolescents, and service providers through these existing services should also be considered.

scholarly journals Prevalence of mastitis in Nigerian livestock: a Review

2020 ◽  
Vol 1 (1) ◽  
pp. 20-29
Author(s):  
Hussaini Ojagefu Adamu ◽  
Rahimat Oshuwa Hussaini ◽  
Cedric Obasuyi ◽  
Linus Irefo Anagha ◽  
Gabriel Oscy Okoduwa
Keyword(s):  
Control Strategies ◽  
Dairy Farms ◽  
Livestock Production ◽  
Sub Saharan Africa ◽  
Economic Losses ◽  
Ecological Development ◽  
Management Plans ◽  
Sub Saharan ◽  
Control And Management ◽  
The Impact

AbstractMastitis is a disease of livestock that directly impede livestock production and thus hindering the socio-ecological development of sub-Saharan Africa. Studies have estimated the prevalence of this disease in 30% of Africa countries, with Ethiopia having the highest prevalence. The coverage is low, despite the wide livestock and dairy farms distribution in Africa. Furthermore, estimated economic losses due to the impact of mastitis are lacking in Nigeria. The disease is endemic in Nigeria as indicated by the available data and there are no proposed management plans or control strategies. This review is thus presented to serve as a wakeup call to all parties involved to intensify efforts towards the diagnosis, control, and management of the disease in Nigeria.

scholarly journals Addressing Pediatric HIV Pretreatment Drug Resistance and Virologic Failure in Sub-Saharan Africa: A Cost-Effectiveness Analysis of Diagnostic-Based Strategies in Children ≥3 Years Old

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 567
Author(s):  
Mutita Siriruchatanon ◽  
Shan Liu ◽  
James G. Carlucci ◽  
Eva A. Enns ◽  
Horacio A. Duarte
Keyword(s):  
Drug Resistance ◽  
Cost Effectiveness ◽  
Virologic Failure ◽  
Pediatric Hiv ◽  
Sub Saharan Africa ◽  
Financial Investment ◽  
Switching Strategy ◽  
Wide Range ◽  
Sub Saharan ◽  
Living With Hiv

Improvement of antiretroviral therapy (ART) regimen switching practices and implementation of pretreatment drug resistance (PDR) testing are two potential approaches to improve health outcomes for children living with HIV. We developed a microsimulation model of disease progression and treatment focused on children with perinatally acquired HIV in sub-Saharan Africa who initiate ART at 3 years of age. We evaluated the cost-effectiveness of diagnostic-based strategies (improved switching and PDR testing), over a 10-year time horizon, in settings without and with pediatric dolutegravir (DTG) availability as first-line ART. The improved switching strategy increases the probability of switching to second-line ART when virologic failure is diagnosed through viral load testing. The PDR testing strategy involves a one-time PDR test prior to ART initiation to guide choice of initial regimen. When DTG is not available, PDR testing is dominated by the improved switching strategy, which has an incremental cost-effectiveness ratio (ICER) of USD 579/life-year gained (LY), relative to the status quo. If DTG is available, improved switching has a similar ICER (USD 591/LY) relative to the DTGstatus quo. Even when substantial financial investment is needed to achieve improved regimen switching practices, the improved switching strategy still has the potential to be cost-effective in a wide range of sub-Saharan African countries. Our analysis highlights the importance of strengthening existing laboratory monitoring systems to improve the health of children living with HIV.

scholarly journals Quantifying the Impact of Accessibility on Preventive Healthcare in Sub-Saharan Africa Using Mobile Phone Data

Epidemiology ◽  
2015 ◽  
Vol 26 (2) ◽  
pp. 223-228 ◽  
Author(s):  
Amy Wesolowski ◽  
Wendy Prudhomme O’Meara ◽  
Andrew J. Tatem ◽  
Samson Ndege ◽  
Nathan Eagle ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Sub Saharan Africa ◽  
Mobile Phone Data ◽  
Preventive Healthcare ◽  
Sub Saharan ◽  
The Impact

Intraclass Correlation Coefficients for Designing Cluster-Randomized Trials in Sub-Saharan Africa Education

2016 ◽  
Vol 40 (6) ◽  
pp. 500-525 ◽  
Author(s):  
Ben Kelcey ◽  
Zuchao Shen ◽  
Jessaca Spybrook
Keyword(s):  
Large Scale ◽  
Randomized Trials ◽  
Intraclass Correlation ◽  
Educational Interventions ◽  
Sub Saharan Africa ◽  
Design Stage ◽  
Education Outcomes ◽  
Randomized Studies ◽  
Sub Saharan ◽  
Variance Explained

Objective: Over the past two decades, the lack of reliable empirical evidence concerning the effectiveness of educational interventions has motivated a new wave of research in education in sub-Saharan Africa (and across most of the world) that focuses on impact evaluation through rigorous research designs such as experiments. Often these experiments draw on the random assignment of entire clusters, such as schools, to accommodate the multilevel structure of schooling and the theory of action underlying many school-based interventions. Planning effective and efficient school randomized studies, however, requires plausible values of the intraclass correlation coefficient (ICC) and the variance explained by covariates during the design stage. The purpose of this study was to improve the planning of two-level school-randomized studies in sub-Saharan Africa by providing empirical estimates of the ICC and the variance explained by covariates for education outcomes in 15 countries. Method: Our investigation drew on large-scale representative samples of sixth-grade students in 15 countries in sub-Saharan Africa and includes over 60,000 students across 2,500 schools. We examined two core education outcomes: standardized achievement in reading and mathematics. We estimated a series of two-level hierarchical linear models with students nested within schools to inform the design of two-level school-randomized trials. Results: The analyses suggested that outcomes were substantially clustered within schools but that the magnitude of the clustering varied considerably across countries. Similarly, the results indicated that covariance adjustment generally reduced clustering but that the prognostic value of such adjustment varied across countries.

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