COVID-19 vaccine hesitancy in KwaZulu-Natal, South Africa: A survey of unvaccinated adults

Background: Concerns and misconceptions surrounding coronavirus disease 2019 (COVID-19) vaccines may account for vaccine hesitancy and low uptake. Aim: To determine prevalence of COVID-19 vaccine hesitancy, vaccine-related misconceptions, and predictors of vaccine hesitancy among South Africans. Setting: Community setting in five districts in KwaZulu- Natal province. Methods: Between August 20, 2021, and September 27, 2021, we conducted a cross-sectional survey, interviewing 300 unvaccinated adults amid the national vaccination campaign. Predictors of hesitancy were identified through multivariable logistic regression analysis. Results: Participants had a median age of 29 years (IQR: 23­39), 86.7% were Black African, 63.2% were male, 53.3% resided in rural communities, and 59.3% (95% CI: 53.8% ­ 64.9%) were classified as vaccine hesitant. The primary reason for not vaccinating was a lack of trust in the vaccine (62.1%). Factors associated with reduced vaccine hesitancy included age (participants aged 35­49 years: OR: 0.28, 95% CI: 0.18­0.64, p = 0.003; participants over 50 years: OR: 0.18, 95% CI: 0.07­0.47, p = 0.0004), previous COVID-19 infection (OR: 0.31, 95% CI: 0.11­0.87, p = 0.03), and receiving vaccine information from healthcare workers (OR: 0.32, 95% CI: 0.10­1.0, p = 0.05). Unemployed (OR: 2.14, 95% CI: 1.1­4.2, p = 0.03) and self-employed individuals (OR: 2.98, 95% CI: 1.27­7.02, p = 0.01) were more likely to be vaccine hesitant. Conclusion: COVID-19 vaccine hesitancy rates are high in KwaZulu-Natal. Uptake could be enhanced by healthcare workers leading information campaigns with messages targeting younger individuals, the unemployed, and the self-employed. Contribution: This survey provides evidence to improve COVID-19 vaccination uptake in South Africa.

Psychological distress among South African healthcare workers during the COVID-19 pandemic

Background: The COVID-19 pandemic has placed immense pressure on healthcare workers (HCWs). Objectives: This study sought to find the prevalence and factors associated with psychological distress among HCWs in South Africa during the beginning phases of COVID-19 and make relevant recommendations. Method: The survey was administered online through a data-free platform. Data were benchmarked to the national population of over 500 000 healthcare professionals in South Africa. Multiple logistic regressions were used to determine association between psychological distress and potential explanatory variables. Results: A total of 7607 healthcare professionals participated in the study (1760 nurses, 2843 medical practitioners and 3004 other healthcare professionals). Half of the nurses, 41% of medical practitioners and 47% of other healthcare professionals were classified as psychologically distressed. Those who were of older age, provided with well-being support services and having a positive outlook on the healthcare system were significantly less likely to be distressed. Being female medical practitioners and female other healthcare professions, requesting routine counselling, being concerned about not having enough leave and that their life insurance policy did not cover COVID-19 were more likely to be distressed. Conclusion: Psychological well-being of HCWs in South Africa is at risk. We recommend that psychological distress of HCWs be routinely assessed and that routine counselling, well-being support services, appropriate hazardous leave and insurance be provided to all HCWs. Contribution: This study adds to the literature on the psychological distress faced by HCWs in South Africa during COVID-19.

The function of competitive intelligence in South African insurance post-COVID-19 outbreak

Background: Competitive intelligence (CI) involves monitoring competitors and providing organizations with actionable and meaningful intelligence. Some studies have focused on the role of CI in other industries post-COVID-19 pandemic. Objectives: This article aims to examine the impact of COVID-19 on the South African insurance sector and how the integration of CI and related technologies can sustain the South African insurance sector post-COVID-19 epidemic. Method: Qualitative research with an exploratory-driven approach was used to examine the impact of the COVID-19 pandemic on the South African insurance sector. Qualitative secondary data analyses were conducted to measure insurance claims and death benefits paid during the COVID-19 pandemic. Results: The research findings showed that the COVID-19 pandemic significantly impacted the South African insurance industry, leading to a reassessment of pricing, products, and risk management. COVID-19 caused disparities in death benefits and claims between provinces; not everyone was insured. Despite challenges, South African insurers remained well-capitalised and attentive to policyholders. Integrating CI and analytical technologies could enhance the flexibility of prevention, risk management, and product design. Conclusion: COVID-19 requires digital transformation and CI for South African insurers' competitiveness. Integrating artificial intelligence (AI), big data (BD), and CI enhances value, efficiency, and risk assessments. Contribution: This study highlights the importance of integrating CI strategies and related technologies into South African insurance firms' operations to aid in their recovery from the COVID-19 crisis. It addresses a research gap and adds to academic knowledge in this area.

Prevalence and determinants of burnout among South African doctors during the COVID-19 pandemic

Background: Burnout, resulting from chronic workplace stress that has been unsuccessfully managed, has previously been documented in doctors. The coronavirus disease 2019 (COVID-19) pandemic has increased occupational challenges faced by doctors, potentiating their risk for burnout. Aim: This study aimed to determine the prevalence and determinants of burnout among medical doctors during the COVID-19 pandemic. Setting: Three public sector hospitals in Gqeberha, South Africa. Methods: A cross-sectional study of 260 voluntary participants was conducted. Participants completed self-administered electronic questionnaires. Logistic regression analysis was performed to explore the determinants of burnout. Results: The prevalence of burnout in this study was 78%. Burnout was significantly associated with being a medical intern or community-service medical officer (adjusted odd ratio [AOR] = 6.72, 1.71­26.40), being in the lowest income band (AOR = 10.78, 2.55­45.49), and using alcohol to manage work-related stress (AOR = 3.01, 1.12­8.04). Job-related factors associated with burnout were experiencing high conflict at work (AOR = 5.04, 1.92­13.20) and high role ambiguity and role conflict (AOR = 4.49, 1.98­10.18). Low support at work (AOR = 9.99, 3.66­27.23), medium job satisfaction (AOR = 5.38, 2.65­10.93) and medium support at work (AOR = 3.39, 1.71­6.73) were positively associated with burnout. Participants with medium (AOR = 0.28, 0.10­0.80) and high levels of resilience (AOR = 0.08, 0.03­0.25) were protected against burnout. Coronavirus disease 2019-related factors were not significantly associated with burnout. Conclusion: The burnout prevalence among South African medical doctors at public hospitals during the COVID-19 pandemic was high and strongly associated with job stress factors. Contribution: Given the increased prevalence of burnout among doctors and the strong associations with job stress factors, mitigation of burnout requires targeted organisational interventions.

Mental health services in Gauteng, South Africa: A proxy evaluation using pharmaceutical data

Background: South African legislation advocates for equitable access to mental healthcare services integrated into general healthcare settings. Mental, neurological, and substance use (MNS) disorders are often comorbid. Pharmacoepidemiology provides indirect evidence of service provision for conditions amenable to medicine treatment. Aim: The study aims to evaluate medicine procurement for MNS disorders at different service levels in the health system. Setting: The Public health sector, Gauteng province formed the setting for the study. Method: A secondary analysis of the Gauteng pharmaceutical database was conducted using Anatomic Therapeutic Chemical (ATC) and defined daily dose (DDD) methodology. Anatomic Therapeutic Chemical classes of medicines for MNS disorders were included. Defined daily doses and costs were calculated per 1000 population served by each facility and service level. Statistical comparisons were made using chi-square testing. Results: General healthcare settings accounted for 90% (R118 638 248) and specialised hospitals for 10% (R13 685 032) of expenditure on medicines for MNS disorders, procuring 94% (n = 49 442 474) and 6% (n = 3 311 528) of DDDs, respectively. Although district clinics procured 60% of DDDs, they procured the least per 1000 population served, whereas district hospitals procured the most. For almost all ATC classes, procurement differed significantly between municipalities at every service level and between specialised hospitals. Conclusion: In Gauteng province, most medicines for MNS disorders are procured by general healthcare services, but access to care may not be equitable. While population coverage at district clinics appears low, district hospitals may experience the greatest care burden. Research regarding quality of care at each service level is recommended. Contribution: This study provides insight into service provision for MNS disorders.

Alcohol consumption and associated factors among customers in Local Beer bars in South Africa: a Cross-Sectional Study

Background:Present study total participants were 700 males and females included with different age group and different education level. Topics of discussion included typical drinking reasons- Daily Habitual, stress, emotions type/mood (happy/Sad), burden, and party and the drink type like only beer, only whisky/vodka/wine and both. Methods:The legal age of wine purchase in South Africa is 18 years and on. We have analysed the age groups 18-25, 26-45, and 45-65, with the interviews having the general questions regarding the reason of drinking. Preliminary bar visits were carried out in ten bars and restaurants to develop and identify any potential problems with the planned data collection protocols and to determine which specific reason were common in bar customers will emphasized during the main study. Bar and restaurant visits in the main study began in June 2021 and were completed in March 2022, bar visits were made from 3 p.m. to 10 p.m. on nights randomly. Results: The customers we studies having majority of males than female observed. In daily habitual is high in age of 26-45 41.57%, in stress high rate is in unemployed of 57.71%, in workload burden alcohol consumption is age group 26-45 of 51.71%, in Party criteria age group 57.85%, In Emotions type/mood (happy/Sad) alcohol consumption is in category unemployed of 83%. Conclusion: Support the need for additional research to develop effective prevention and intervention strategies to reduce high-risk alcohol

Clinical outcome and incidence of inhibitor development in severe hemophilia patients receiving low-dose prophylaxis: a 3-year follow-up study in Senegal, West Africa

ABSTRACT Introduction: In Africa, where access to diagnosis and treatment of hemophilia is the lowest in the world, prophylaxis is rarely used in preference to on-demand treatment. There are limited data of prophylaxis treatment from sub-Saharan Africa. The aim of this study was to evaluate clinical outcomes and inhibitor development in people with hemophilia receiving low-dose prophylaxis (LDP) in a sub-Saharan African setting. Methods: We conducted a three-year prospective study. A once or twice weekly prophylaxis regimen of 25 IU/kg of rFVIIIFc or 30 IU/kg of rFIXFc was given to Hemophilia A and B, respectively. We evaluated clinical outcomes and inhibitors occurrence, determined by screening and titration using the Nijmegen technique. Results: A total of 15 patients were included in the LDP regimen. The mean age was 6.3 years (1.5 - 10). A significant reduction was noted in the annualized bleeding rate, from 7.53 to 1.33 (p = 0.0001); the annualized joint bleeding rate passed from 3.6 to 1.4 (p = 0.001) and the proportion of severe bleeding, from 86.1% to 16.7% (p = 0.0001). The Hemophilia Joint Health Score (HJHS) moved from 9.6 to 3.4 (p = 0.0001) and the Functional Independence Score in Hemophilia (FISH) improved from 25.8 to 30.9 (p = 0.0001). School absenteeism decreased from 7.33% to 2.59%. Adherence to prophylaxis was 89.5% versus 60%. Consumption was 580 IU/kg/year versus 1254.6 IU/kg/year before and after prophylaxis, respectively. Incidence of inhibitors was 23% (3 /13 HA). Conclusion: The LDP in Hemophilia improves the clinical outcome without a surplus risk of inhibitor development. Using extended half-life clotting factor concentrates (CFCs) is better for prophylaxis in resource-limited countries, as they allow better compliance in treatment.

Factors associated with delayed diagnosis among sub-Saharan African women

Breast cancer incidence in sub-Saharan Africa is among the lowest in the world; however, mortality is as high as in high-incidence countries because of poor survival rates. Most breast cancer patients in sub-Saharan Africa are diagnosed at advanced stages after prolonged symptomatic periods. Understanding the reasons why women in sub-Saharan Africa seek care after the onset of symptoms is essential to promoting early diagnosis and ultimately improve their cancer survival.

Analysis of Otorhinolaryngology Practices-Challenges of Specialists and Facilties-in sub-Saharan Africa

Background: More than 95% of the population in sub-Saharan Africa (S.S.A.) does not have ready access to safe, affordable surgical care, and there is a desperate need for E.N.T. (ear, nose, and throat), audiology, and speech therapy services. Therefore, from an international outlook, the most significant challenge confronting hearing and cancer care delivery is not high-technology and high-cost medicine but the lack of access to even the most elementary E.N.T. care Materials and Methods: A literature search for studies on the analysis of trends and outcomes of otorhinolaryngology practices in sub-Saharan Africa was performed using Google Scholar search database, PubMed, Medline, and ScienceDirect. The bibliographies of included studies were also searched for additional references. About 95 articles were identified. Twenty-one articles were considered suitable for the review. The whole residents of the 22Results: countries illustrated in a study reviewed were 720,500,000; this symbolizes 75% of the population of sub-Saharan Africa. Among the 22 countries that were tested, 847 ENT surgeons, 580 audiologists, 906 speech therapists, 264 ENT clinical officers, and 320 oncologists were reported. When data have combined the sample, the regional ratio was 1.2 million people per E.N.T. surgeon, 0.8 million people per audiologist, and 1.3 million people per speech therapist. Conclusion: Basic E.N.T. and airway-related interventions are possible in most countries that responded; life-saving procedures such as tracheostomy (and tracheostomy tubes), bronchoscopy, and balloon dilatation were not readily available in all countries. Access to hearing screening was very poor in most countries, highlighting the undocumented burden of disease of hearing loss in Africa and other LMICs, estimated at 5% of the world's population

Etiology of Chronic Kidney Disease in Nigeria and Management Challenges

The prevalence of chronic kidney disease (CKD) is increasing globally and is one of the noncommunicable diseases associated with increase mortality globally in the last two decades. The prevalence of CKD in Nigeria, it is 1.6% to 12.4%. Ninety percent of end-stage renal disease (ESRD) patients are said to die within 3 months of commencing dialysis. Indices are even worse in resource poor countries like Nigeria where prevention and adequate intervention are usually hampered by funds. In regions like Nigeria, it will be cheaper to prevent CKD than treating its complications. Hence, it is important to identify the common etiologies of CKD in Nigeria and prevent or promptly address them before causing irreversible damage to the kidneys. The most common cause of CKD in Nigeria includes hypertension, glomerulonephritis and diabetes mellitus. Many of these etiologies are preventable/treatable and should be looked for as a major way to reduce the incidence of CKD in Nigeria. Challenges identified in Nigeria, propagating CKD include westernization, inadequate manpower, late presentation, diagnostic challenge and poorly equipped facilities. Interventions like encouraging healthy lifestyle, making available essential drugs, training of health personnel, subsidized cost of treatment, legislation and policies to curb drug abuse. Therefore, resource-poor settings should focus on creating more awareness and making legislations and/or policies focused on these preventable causes of CKD as this is more realistic and effective in these settings.

Was the Impact of the COVID-19 Pandemic in Africa underestimated?

@#The COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has had a profound impact on the world. At the time of writing this article, almost 760 million cases have been confirmed globally with over 6.5 million deaths recorded. Africa had lower numbers of confirmed cases and deaths as compared to other regions despite initial fears of the devastating effect that the pandemic would have on the vulnerable continent. Many theories exist to explain why this was so. However, low testing rates, amidst other factors, have raised concerns about the possible underestimation of the impact of the Covid-19 pandemic in Africa.

COVID-19 impacts on healthcare access in sub-Saharan Africa: an overview

Abstract This overview aimed to describe the situation of healthcare access in sub-Saharan Africa, excluding South Africa, during the COVID-19 pandemic. A PubMed® search from March 31, 2020, to August 15, 2022, selected 116 articles. Healthcare access and consequences of COVID-19 were assessed based on comparisons with months before its onset or an identical season in previous years. A general reduction of healthcare delivery, associated with the decline of care quality, and closure of many specialty services were reported. The impact was heterogeneous in space and time, with an increase in urban areas at the beginning of the pandemic (March-June 2020). The return to normalcy was gradual from the 3rd quarter of 2020 until the end of 2021. The impact of COVID-19 on the health system and its use was attributed to (a) conjunctural factors resulting from government actions to mitigate the spread of the epidemic (containment, transportation restrictions, closures of businesses, and places of entertainment or worship); (b) structural factors related to the disruption of public and private facilities and institutions, in particular, the health system; and (c) individual factors linked to the increase in costs, impoverishment of the population, and fear of contamination or stigmatization, which discouraged patients from going to health centers. They have caused considerable socio-economic damage. Several studies emphasized some adaptability of the healthcare offer and resilience of the healthcare system, despite its unpreparedness, which explained a return to normal activities as early as 2022 while the COVID-19 epidemic persisted. There appears to be a strong disproportion between the moderate incidence and severity of COVID-19 in sub-Saharan Africa, and the dramatic impact on healthcare access. Several articles make recommendations for lowering the socioeconomic consequences of future epidemics to ensure better management of health issues.

Properties of new exotic traditional Chinese medicinal Vernonia amygdalina leaves:a literature research / 中国中药杂志

The leaves of Vernonia amygdalina Delile of the family Asteraceae(also known as "bitter leaf"), rich in biological activities, are used as both medicine and food for a long time in West tropical Africa. They have been introduced into Southeast Asia and Fujian and Guangdong provinces of China in recent years. However, little is known about the properties of the plant in traditional Chinese medicine(TCM), which limits its combination with other Chinese medicinal herbs. In this study, 473 articles on V. amygdalina leaves were selected from PubMed, Web of Science, CNKI, Wanfang Data and VIP to summarize their components, pharmacological effects and clinical research. V. amygdalina leaves presented anti-microbial, hypoglycemic, anti-hypertensive, lipid-lowering, anti-tumor, anti-inflammatory, antioxidant, and other pharmacological effects. On the basis of the theory of TCM properties, the leaves were inferred to be cold in property and bitter and sweet in flavor, acting on spleen, liver, stomach and large intestine and with the functions of clearing heat, drying dampness, purging fire, removing toxin, killing insects and preventing attack of malaria. They can be used to treat dampness-heat diarrhea, interior heat and diabetes, malaria, insect accumulation and eczema(5-10 g dry leaves by decoction per day and an appropriate amount of crushed fresh leaves applying to the affected area for external use). Due to the lack of TCM properties, V. amygdalina leaves are rarely used medicinally in China. The determination of medicinal properties of the leaves is conducive to the introduction of new exotic medicinal herbs and the development of new TCM resources, which facilitated further clinical application and research and development of Chinese medicinal herbs.

Study on African herbal medicine registration management measures and TCM registration strategy in Africa / 国际中医中药杂志

African herbal medicine is widely utilized with a long history. Most African countries have legalized herbal medicine and established a registration and listing mechanism. The present study firstly described the historical exchange and modern trade of TCM between China and Africa, and briefly described the herbal medicine registration management system of African countries from the regulations and guidelines of herbal medicine management and registration management institutions. Then it compared and analyzed the differences of registration systems in African countries from the following aspects: application materials, registration path, quality control and production, effectiveness evidence and food supplements, as well as summarizing the common points of African herbal medicine registration management. The registration strategy of TCM includes assessing the risk of registered investment, building a multilateral and diversified cooperation network between China and Africa, adhering to integrity and innovation, and promoting the international development of TCM, so as to form a standardized registration path of TCM in Africa and expand the TCM market in Africa.

Mental health of AIDS Orphans in Sub-Saharan Africa: A narrative literature review / 国際保健医療

  Objectives  In Sub-Saharan Africa, acquired immunodeficiency syndrome (AIDS) orphans account for a large proportion; however, their mental health problems have been overlooked. We presented an investigation of literature to provide a comprehensive overview of associated factors of mental health among AIDS orphans in Sub-Saharan Africa. Methods  Databases (PubMed and Japan Medical Abstracts Society) were searched by using relevant keywords including AIDS orphans, Sub-Saharan Africa, mental health, psychological support, education, and poverty. A total of nine papers met the inclusion criteria and were included in this literature review.Results  AIDS orphans were at high risk of various mental disorders relevant to low self-esteem, anxiety, and depression. Associated factors of the mental health of AIDS orphans were classified into the following three categories: psycho-social-cultural factors such as social discrimination, abuse, and bullying etc.; physical environmental and economic factors such as education, lack of foster care, and poverty etc; and family and community relevant factors such as lack of connection and social support from family and school etc. Regarding psycho-social-cultural factors, AIDS orphans experienced more abuse, social discrimination, and social stigma, especially those who were living in poverty. AIDS orphans living in the urban experienced severe bullying. Regarding family and community factors, due to the loss of parents and changes in living environment, AIDS orphans who were living in households headed by children tend to experience depression, anxiety, fear, and stigma. The loss of a parent resulted in lower academic performance and limited access resources including inadequate mental health services, which consequently led to poor development and adverse health outcomes in AIDS orphans including poor psychosocial well-being. Regarding environmental and economic factors. Lack of care from caregivers and parental mental health were also shown to be related to child development and mental health in AIDS orphans. Regarding physical environmental and economic factors, limited available social support in the physical environment where AIDS orphans lived was associated with impaired development and mental health. Poverty led to AIDS orphans being affected by food shortage and malnutrition (e.g., stunting), child labor, as well as risky sexual behaviors towards female AIDS orphans. Better social support from caregivers and teachers had a positive impact on the mental health of AIDS orphans. With regard to education, AIDS orphans have a high school dropout rate, resulting in fewer school connections. School connections have been shown to be an important protective factor for AIDS orphans’ mental health. Conclusions  This review identified risk and protective factors of mental health among AIDS orphans in sub-Saharan Africa. Our results, especially the positive influence of social support, encourage the development of effective mental health care programs for AIDS orphans in sub-Saharan Africa. The results suggest looking at various problems that AIDS orphans are facing from multiple perspectives.

Topics, Concerns, and Feelings Commented on Facebook after the First Death by COVID-19 in Mozambique / Temas, preocupaciones y sentimientos comentados en Facebook tras la primera muerte por COVID-19 en Mozambique

In Mozambique, as in other parts of the world, COVID-19 has had consequences in many areas, especially in the health sector. This study aims to analyze the comments made and discussed on Facebook after the first death from the disease, verifying the main topics, concerns, and feelings that users most expressed on that social network. Using the content analysis method, IRaMuTeQ® generated a dendrogram focused on death, diagnostic circumstances, disease prevention, and restrictive government measures. Users also raised concerns about health care professionals, family and community, and feelings of sadness. Although the feelings presented reflect the lan-guage used in comments on a social network, and it is impossible to diagnose from them, this study creates paths for further research in the area. Therefore, for the first time, it demonstrates results from a mental health study with data analyzed from a social network in Mozambique. These results can guide and alert local health entities about health communications, strategies, and attention that should be given to the mental health of individuals during this pandemic and in the long term

En Mozambique, como en otras partes del mundo, el COVID-19 trajo consecuencias en muchas áreas, principalmente en el sector de la salud. Este estudio tiene como objetivo analizar los comentarios realizados y discutidos en Facebook después de la primera muerte por la enfermedad, con el fin de verificar los principales temas, preocupaciones y sentimientos que los usuarios más expresaron en esa red social. Utilizando el método de análisis de contenido, IRaMuTeQ® generó un dendrograma con temas enfocados en las circunstancias de la muerte, las circunstancias del diagnóstico, la prevención de enfermedades, y las medidas restrictivas del gobierno. También hubo preocupaciones con los profesionales de la salud, la familia y la comunidad, además de sentimientos de tristeza. Aunque los sentimientos presentados reflejan el lenguaje utilizado en los comentarios en una red social, y no es posible dar un diagnóstico basado en ellos, este estudio abre caminos para futuras investigaciones en el área. Por lo tanto, por primera vez, se demuestra un estudio de salud mental con datos analizados en una red social en Mozambique, y puede servir como ayuda y alerta a las entidades locales de salud sobre comunicaciones de salud, estrategias y atención que se debe dar a la salud mental de las personas durante esta pandemia y a largo plazo

Seroprevalence of viral transfusion transmissible infections (HBsAg, anti-HCV, anti-HIV, Syphilis) and coinfection among healthy volunteer blood donors during 5-years in Luanda, Angola

Abstract Background The transmission of diseases by blood products continues to be a worldwide health problem, especially in Africa. Seroprevalence rates of the Hepatitis B virus (HBV), Hepatitis C virus (HCV), Human Immunodeficiency Virus (HIV), Syphilis, and Coinfection in Angola are poorly documented. This study aims to identify the seroprevalence of markers with positive results for Hepatitis B, C, HIV, Syphilis, and Coinfection in blood donors. Material and methods A retrospective study was conducted using a database of positive serological markers for these infections and coinfection in 2734 blood donors traced from 2011 to 2016 in Luanda, Angola. The Chi-Square test (χ2) or Fisher's exact test was used to evaluate serological positivity and donors' characteristics. A p-value < 0.05 was considered statistically significant. Results 2734 blood donors aged 18 to 64 (median age 32 ± 9) were screened from 2011 to 2016. 73.9 % of the donors were positive for one Transfusion-Transmitted Infection (TTI), and 5.9 % showed evidence of multiple infections. The overall seroprevalence rate was 50.2 % (1373) for HBV, 20 % (436) for Syphilis, 7 % (191) for HIV, 5.1 % (140) for HCV, and 5.8 % for coinfected donors. 2467 (90 %) were men, and 267 (10 %) were women. We identified 118 (5.8 %) coinfected donors. Of those, 40 (33.9 %) simultaneously presented Hepatitis B virus surface antigen (HBsAg)/Syphilis, 24 (20.3 %) HBsAg/HIV, 22 (18.6 %) HBsAg/HCV, 20 (16.9 %) HIV/Syphilis, 8 (6.8 %) HCV/Syphilis, and 4 (3.4 %) HIV/HCV. Conclusion A high transfusion-transmissible infection prevalence was found compared to some countries in Sub-Saharan Africa. Therefore, intensifying the screening for these transfusion-transmitted infections in blood donors is critical to ensure blood safety.

Profil lipidique associé à l'obésité chez les adolescents à Brazzaville, Congo / Lipid profile among obese adolescents in Brazzaville, Congo

Contexte & objectif. Les modifications lipidiques chez les enfants obèses en Afrique noire sont peu documentées. Les objectifs de la présente étude étaient de déterminer chez les adolescents obèses le profil lipidique, et analyser les associations entre quelques paramètres anthropométriques et lipidiques. Méthodes. L'étude transversale a été réalisée à Brazzaville auprès de 82 adolescents âgés de 11 à 18 ans, répartis en 45 sujets obèses, 17 en état de surpoids et 20 poids normal. Des mesures de la taille, du poids, du tour de taille, des plis cutanés sous-scapulaire et tricipital ont été effectuées. Des prélèvements sanguins ont permis de déterminer les concentrations en cholestérol total, cholestérol-LDL, cholestérol-HDL et triglycérides. Résultats. Les concentrations lipidiques notées chez les adolescents obèses étaient significativement supérieures à celles des sujets de poids normal : cholestérol total, 1,70 vs 1,59g/L ; cholestérol-LDL, 1,03 vs 0,88g/L ; triglycérides, 1,18 vs 0,86. Par contre, celles du cholestérol-HDL étaient significativement inférieures : 0,42 vs 0,51g/L. Une corrélation positive a été retrouvée entre le rapport tour de taille/taille et le cholestérol-HDL (r=0,75 ; p=0,031). Conclusion. Nos résultats soulignent la nécessité de renforcer la prise en charge des enfants obèses afin de prévenir les facteurs de risque potentiels des maladies cardiovasculaires à l'âge adulte

Determinants of visit-to-visit systolic blood pressure variability among Ghanaians with hypertension and diabetes mellitus

Objective: To identify the determinants of systolic blood pressure variability (SBPV) among Ghanaians. Design: We undertook a secondary analysis of data collected in a prospective study Setting: The study involved patients with hypertension and or diabetes receiving care in five hospitals in Ghana Main outcome measures: We assessed determinants of SBPV among 2,785 Ghanaian patients. We calculated the standard deviation (SD) of systolic BP recordings of 3 to 10 visits per patient over 18 months as a measure of SBPV. A multivariate linear regression analysis was fitted to identify factors independently associated with risk visit-to-visit SBP standard deviation. Results: The mean SD of individual patient visit-to-visit SBP overall was 14.8±6.3 mm Hg. Those with hypertension and diabetes had the highest SD of 15.4 ±6.2 mm Hg followed by 15.2 ±6.5 mm Hg among those with hypertension only and then 12.0 ± 5.2 mm Hg among those with diabetes only, p<0.0001. Factors independently associated with SBPV with adjusted ß coefficients (95% CI) included age: 0.06 (0.03 ­ 0.08) for each year rise in age, eGFR -0.03 (-0.05 - -0.02) for each ml/min rise, low monthly income of <210 Ghana cedis 1.45 (0.43-2.46), and secondary level of education -1.10 (-1.69, -0.50). Antihypertensive classes were associated with SBPV, the strongest associations being hydralazine 2.35 (0.03 ­ 4.68) and Methyldopa 3.08 (2.39 ­ 3.77). Conclusion: Several socio-demographic and clinical factors are associated with SBPV. Future studies should assess the contribution of SBPV to CVD outcomes among indigenous Africans and identify actionable targets.