The prevalence of emotional abuse in children living in Sub-Saharan Africa - A systematic review.

OBJECTIVES: This study is meant to put a focus on the prevalence of emotional abuse in low-income states like the Sub-Saharan region. METHODOLOGY: Searching PubMed, Google scholar, and web of science during February and April 2021 a total of 2264 articles were identified, 27 met the inclusion criteria. We added the results of 13 VAC (Violence Against Children and Youth) studies, conducted by UNICEF capturing information about experienced sexual, physical, or emotional violence in 13-24-year-olds, as well as 56 MIC (Multiple Indicator Cluster) studies, conducted by the CDC to research the disciplinary methods used with children aged 1-14 years in the past month by older household members. Finally, in a meta-analytic approach, we aimed to calculate a pooled estimate of the prevalence. RESULTS: The included studies depicted a wide range in prevalence rates across countries. For example, while the VAC study in Lesotho in 2018 showed low incidence rates of emotional violence (6.9 % Females, 3.8 % Males), the average prevalence recorded by the MIC study was as high as 57.8 % for females and 59.2 % for males. On average, the MIC studies displayed a higher incidence and the discrepancy of prevalence of emotional abuse between females and males was small. Calculating a pooled estimate of the prevalence was not possible, due to the heterogeneity of the data. CONCLUSIONS: In general countries displayed a high prevalence. A standardized use of a uniform definition of emotional abuse might help to display a more homogenous data set in the future, giving the opportunity for pooled estimates of prevalence.

The economic burden of treating uncomplicated hypertension in Sub-Saharan Africa: a systematic literature review.

BACKGROUND AND OBJECTIVES: Hypertension is one of the leading cardiovascular risk factors with high numbers of undiagnosed and untreated patients in Sub Saharan Africa (SSA). The health systems and affected people are often overwhelmed by the social and economic burden that comes with the disease. However, the research on the economic burden and consequences of hypertension treatment remains scare in SSA. The objective of our review was to compare different hypertension treatment costs across the continent and identify major cost drivers. MATERIAL AND METHODS: Systematic literature searches were conducted in multiple databases (e.g., PubMed, Web of Science, Google Scholar) for peer reviewed articles written in English language with a publication date from inception to Jan. 2022. We included studies assessing direct and indirect costs of hypertension therapy in SSA from a provider or user perspective. The search and a quality assessment were independently executed by two researchers. All results were converted to 2021 US Dollar. RESULTS: Of 3999 results identified in the initial search, 33 were selected for data extraction. Costs differed between countries, costing perspectives and cost categories. Only 25% of the SSA countries were mentioned in the studies, with Nigeria dominating the research with a share of 27% of the studies. We identified 15 results each from a user or provider perspective. Medication costs were accountable for the most part of the expenditures with a range from 1.70$ to 97.06$ from a patient perspective and 0.09$ to 193.55$ from a provider perspective per patient per month. Major cost drivers were multidrug treatment, inpatient or hospital care and having a comorbidity like diabetes. CONCLUSION: Hypertension poses a significant economic burden for patients and governments in SSA. Interpreting and comparing the results from different countries and studies is difficult as there are different financing methods and cost items are defined in different ways. However, our results identify medication costs as one of the biggest cost contributors. When fighting the economic burden in SSA, reducing medication costs in form of subsidies or special interventions needs to be considered. TRIAL REGISTRATION: Registration: PROSPERO, ID CRD42020220957.

Spatial analysis of tuberculosis in Douala, Cameroon: clustering and links with socio-economic status.

SETTING: Douala, the economic capital of Cameroon, with a network of 20 diagnostic and treatment centres for tuberculosis (TB). OBJECTIVE: To describe the spatial distribution of smear-positive pulmonary tuberculosis (PTB) cases in Douala, Cameroon, and to evaluate links between PTB incidence and patients' socio-economic status (SES). DESIGN: Between May 2011 and April 2012, demographic clinical characteristics and global positioning system coordinates for the residence of each consenting PTB case were collected. Spatial scan statistic was used to identify spatial clusters of tuberculosis. SES data were collected by interview during home visits. PTB patients' SES data were compared with those available for the whole urban population from a recent demographic and health survey. The correlation between PTB incidence and the mean SES of the PTB patients was examined by health area (HA). RESULTS: In total, 2132 (84%) diagnosed PTB cases were identified and interviewed. Three statistically significant spatial clusters were identified. High PTB incidence was predominantly found in HAs characterised by low SES. CONCLUSION: There is evidence of clustering of PTB cases in Douala. Clusters are mainly found in neighbourhoods of low SES. Systematic use of cluster detection techniques for regular TB surveillance in Cameroon might aid in the effective deployment of National TB Programme resources.