Search Our Scientific Publications & Authors

J Clin Psychopharmacol 2021 Apr 8. Epub 2021 Apr 8.

From the Division of Clinical Pharmacology, Department of Medicine Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University Computational Biology Division, Integrative Biomedical Sciences Wellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Diseases and Molecular Medicine Centre for Infectious Disease Epidemiology Research, School of Public Health and Family Medicine, University of Cape Town Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Background: Clozapine may cause life-threatening hematological side effects (HSEs). Hematological side effect incidence data from Sub-Saharan Africa are lacking. Furthermore, clozapine reduces cellular immunity, and it is unknown whether clozapine is a risk factor for tuberculosis or whether HIV is a risk factor for developing HSEs. Read More

Front Neurol 2021 25;12:627761. Epub 2021 Mar 25.

School of Medicine Primary Care Center Versus Arthritis Keele University, Staffordshire, United Kingdom.

Sub-Saharan Africa (SSA) is projected to have a rapid increase in the number of people living with dementia by 2050. Yet, there is currently no robust evidence on the risk factors for dementia in the sub-region that could inform context specific interventions. We conducted a systematic review and meta-analysis of observational studies to determine the dominant and modifiable risk factors for dementia in SSA. Read More

Malar J 2021 Apr 9;20(1):178. Epub 2021 Apr 9.

Medical Research Council Biostatistics Unit, Cambridge, UK.

Background: Prompt detection and appropriate treatment of malaria prevents severe disease and death. The quality of care for adult malaria in-patients is not well documented in sub-Saharan Africa, particularly in Uganda. The study sought to describe the patterns of malaria diagnosis and treatment among adult in-patients admitted to the medical and gynaecological wards of Uganda's 1790-bed Mulago National Referral Hospital from December 2013 to April 2014. Read More

Brain Behav 2021 Apr 9:e02096. Epub 2021 Apr 9.

INSERM U955 Translational Neuropsychiatry, Créteil, France.

Objective: To explore the sociodemographic characteristics that might explain the increased incidence of psychosis among immigrants and their descendants in France.

Methods: Data were collected for all subjects with first contact for psychosis aged between 18 and 64 years, in two catchment areas in the Paris region. Incidence rates (IR) and incidence rate ratios (IRR) were adjusted for gender and age. Read More

Demography 2021 Feb;58(1):295-320

Population, Family and Reproductive Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Although many studies have examined the influence of women's fertility preferences on subsequent fertility behavior and the role of contraceptive use intentions on unmet need, very few have explored their concurrent effects on contraceptive use dynamics. This study examines the independent concurrent effects of women's fertility preferences and contraceptive intentions on subsequent adoption and discontinuation, treating pregnancy as a competing risk factor that may alter contraceptive need. The data are derived from a 2018 follow-up survey of a 2014 national sample of 3,800 Ugandan female respondents of childbearing age. Read More

Glob Heart 2021 Mar 19;16(1):19. Epub 2021 Mar 19.

Department of Chemical Pathology, National Health Laboratory Service, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, ZA.

Background: Obesity and adipose tissue distribution contribute to an increased risk of cardiovascular disease (CVD) by promoting atherosclerosis. This association has been poorly studied in sub-Saharan Africa (SSA) despite the rising prevalence of cardiovascular disease.

Objectives: We determined the association between various adiposity phenotypes and carotid intima-media thickness (CIMT), a proxy of subclinical atherosclerosis, in a large SSA population. Read More

Nat Rev Genet 2021 Apr 8. Epub 2021 Apr 8.

Infectious Disease and Microbiome Program, Broad Institute, Cambridge, MA, USA.

Almost 20 years have passed since the first reference genome assemblies were published for Plasmodium falciparum, the deadliest malaria parasite, and Anopheles gambiae, the most important mosquito vector of malaria in sub-Saharan Africa. Reference genomes now exist for all human malaria parasites and nearly half of the ~40 important vectors around the world. As a foundation for genetic diversity studies, these reference genomes have helped advance our understanding of basic disease biology and drug and insecticide resistance, and have informed vaccine development efforts. Read More

BMC Med 2021 04 9;19(1):89. Epub 2021 Apr 9.

Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy.

Background: COVID-19 spread may have a dramatic impact in countries with vulnerable economies and limited availability of, and access to, healthcare resources and infrastructures. However, in sub-Saharan Africa, a low prevalence and mortality have been observed so far.

Methods: We collected data on individuals' social contacts in the South West Shewa Zone (SWSZ) of Ethiopia across geographical contexts characterized by heterogeneous population density, work and travel opportunities, and access to primary care. Read More

Glob Chang Biol 2021 Apr 8. Epub 2021 Apr 8.

African Plant Nutrition Institute, Benguerir, Morocco.

Improved nitrogen (N) use is key to future food security and environmental sustainability. While many regions still experience N shortages, agriculture is the leading global emitter of N O due to losses exacerbated by N surpluses in other regions. In order to sustainably maintain or increase food production, farmers and their advisors need a comprehensive and actionable understanding of how nutrient management affects both yield and N O emissions, particularly in tropical and subtropical agroecosystems. Read More

Reprod Health 2021 Apr 6;18(1):75. Epub 2021 Apr 6.

Department of Health Policy and Management, School of Public Health, The University of Zambia, Lusaka, Zambia.

Background: Despite global and regional policies that promote the reduction of adolescent fertility through ending early marriages and reducing early child-bearing, adolescent fertility remains high in most sub-Saharan countries. This study aimed to explore the competing discourses that shape adolescent fertility control in Zambia.

Methods: A qualitative case study design was adopted, involving 33 individual interviews and 9 focus group discussions with adolescents and other key-informants such as parents, teachers and policymakers. Read More

BMC Health Serv Res 2021 Apr 6;21(1):305. Epub 2021 Apr 6.

Department of Medicine, Greys Hospital, Pietermaritzburg, KwaZulu-Natal, South Africa.

Background: Cryptococcal meningitis in HIV-infected patients in sub-Saharan Africa accounts for three-quarters of the global cases and 135,000 deaths per annum. Current treatment includes the use of fluconazole and amphotericin B. Recent evidence has shown that the synergistic use of flucytosine improves efficacy and reduces toxicity, however affordability and availability has hampered access to flucytosine in many countries. Read More

PLoS One 2021 6;16(4):e0249567. Epub 2021 Apr 6.

Vanderbilt Institute of Global Health (VIGH), Nashville, Tennessee, United States of America.

Background: HIV-positive persons of African descent are disproportionately affected by chronic kidney disease (CKD). Deterioration to end-stage kidney disease (ESKD) also occurs in this population at a higher frequency. There remains a lot to learn about the genetic susceptibility to CKD in HIV positive patients, and the pathophysiology of progression to ESKD. Read More

AIDS 2021 May;35(6):911-919

Division of HIV, Infectious Diseases & Global Medicine, University of California, San Francisco, California, USA.

Objective: Sub-Saharan Africa faces twin epidemics of HIV and noncommunicable diseases including hypertension. Integrating hypertension care into chronic HIV care is a global priority, but cost estimates are lacking. In the SEARCH Study, we performed population-level HIV/hypertension testing, and offered integrated streamlined chronic care. Read More

Trop Med Int Health 2021 Apr 4. Epub 2021 Apr 4.

Center of Infectious Diseases, Virology, Heidelberg University Hospital, Heidelberg, Germany.

Objectives: This study investigated the molecular epidemiology of respiratory syncytial virus (RSV) among febrile children with acute respiratory tract infection in Ghana, Gabon, Tanzania and Burkina Faso between 2014-2017 as well as the evolution and diversification of RSV strains from other sub-Saharan countries.

Methods: Pharyngeal swabs were collected at four study sites (Agogo, Ghana: n=490; Lambaréné, Gabon: n=182; Mbeya, Tanzania: n=293; Nouna, Burkina Faso: n=115) and analysed for RSV and other respiratory viruses using rtPCR. For RSV positive samples, sequence analysis of the second hypervariable region of the G-gene was performed. Read More

Cytokine 2021 Apr 1:155489. Epub 2021 Apr 1.

Centre for HIV and STIs, National Institute for Communicable Diseases, Johannesburg, South Africa; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

A single nucleotide polymorphism (SNP), 251 bases upstream from the IL-8 transcription start (-251A>T, rs4073), has been extensively investigated in cancers and inflammatory and infectious diseases in predominantly European and Asian populations. We sequenced the IL-8 gene of 109 black and 32 white South African (SA) individuals and conducted detailed characterization of gene variation and haplotype structure. IL-8 production in phytohaemagglutinin (PHA)-stimulated peripheral blood mononuclear cells (PBMCs) of a subset (black: N = 22; white: N = 32) of these individuals was measured using ELISA. Read More

Trop Med Int Health 2021 Apr 4. Epub 2021 Apr 4.

Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Japan.

Background: In 2017, 785 million people globally lacked access to basic services of drinking water and 2 billion people lived without basic sanitation services. Most of these people live in low- and lower-middle-income countries in South Asia, South-East Asia, and Sub-Saharan Africa. To monitor the progress towards universal access to water and sanitation, this study aimed to predict the coverage of access to basic drinking water supply and sanitation (WSS) services as well as the reduction in the practice of open defecation by 2030, under two assumptions: following the current trends and accelerated poverty reduction. Read More

J Stroke Cerebrovasc Dis 2021 Mar 31;30(6):105712. Epub 2021 Mar 31.

Serviço de Neurologia, Departamento de Neurociências e Saúde Mental, Hospital Santa Maria- CHULN, Lisboa, Portugal; Faculdade de Medicina, Universidade de Lisboa. Electronic address:

Background: The clinical epidemiology of cerebral venous thrombosis (CVT) in Sub-Saharan Africa is unknown. Such information may be relevant for service planning, prevention and for adapting existing CVT management guidelines to that zone of the World.

Aims: Systematic review to describe the demography, associated conditions, clinical and neuroimaging features, treatment and outcome of CVT in Sub-Saharan Africa. Read More

Int J Gynaecol Obstet 2021 Apr 3. Epub 2021 Apr 3.

Maternal, Fetal, Newborn & Child Health Care Strategies Research Centre, University of Pretoria, Pretoria, South Africa.

Background: Sub-Saharan Africa (SSA) has the biggest maternal mortality burden, but the region lacks accurate data.

Objective: We reviewed methods historically used to measure maternal mortality in SSA to inform future study methods.

Search Strategy: We searched databases: PubMed, Medline, WorldCat and CINHAL, using keywords "maternal mortality", "pregnancy-related death", "reproductive age mortality", "ratio", "rate" and "risk", using Boolean operators "OR" and "AND" to combine the search terms. Read More

Antibiotics (Basel) 2021 Mar 22;10(3). Epub 2021 Mar 22.

Institute for Infection Control and Infectious Diseases, University Medical Center Göttingen, 37075 Göttingen, Germany.

Wound infections are common medical problems in sub-Saharan Africa but data on the molecular epidemiology are rare. Within this study we assessed the clonal lineages, resistance genes and virulence factors of Gram-negative bacteria isolated from Ghanaian patients with chronic wounds. From a previous study, 49 , 21 complex members and 12 were subjected to whole genome sequencing. Read More

Vaccines (Basel) 2021 Mar 19;9(3). Epub 2021 Mar 19.

International Vaccine Institute, Seoul 08826, Korea.

Typhoid fever remains a significant health problem in sub-Saharan Africa, with incidence rates of >100 cases per 100,000 person-years of observation. Despite the prequalification of safe and effective typhoid conjugate vaccines (TCV), some uncertainties remain around future demand. Real-life effectiveness data, which inform public health programs on the impact of TCVs in reducing typhoid-related mortality and morbidity, from an African setting may help encourage the introduction of TCVs in high-burden settings. Read More

Int J Environ Res Public Health 2021 Mar 4;18(5). Epub 2021 Mar 4.

Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan 430071, China.

The HIV/AIDS incidence rates have decreased in African countries although the rates are still high in Sub-Saharan Africa. Our study aimed to examine the long-term trend of the overall HIV/AIDS incidence rates in four countries of the central region of Africa, using data from the Global Burden of Diseases (GBD) 2019 study. The Age-Period-Cohort statistical model analysis was used to measure the trends of HIV/AIDS incidence rates in each of the four countries. Read More

Diagnostics (Basel) 2021 Mar 15;11(3). Epub 2021 Mar 15.

Microbiology Department, Clínica Universidad de Navarra, 31008 Pamplona, Spain.

The World Health Organization has established an elimination plan for hepatitis C virus (HCV) by 2030. In Sub-Saharan Africa (SSA) access to diagnostic tools is limited, and a number of genotype 4 subtypes have been shown to be resistant to some direct-acting antivirals (DAAs). This study aims to analyze diagnostic assays for HCV based on dried blood spots (DBS) specimens collected in Kinshasa and to characterize genetic diversity of the virus within a group of mainly HIV positive patients. Read More

Cancers (Basel) 2021 Mar 18;13(6). Epub 2021 Mar 18.

Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.

Approximately 91% of the world's children living with HIV (CLWH) are in sub-Saharan Africa (SSA). Living with HIV confers a risk of developing HIV-associated cancers. To determine the incidence and risk factors for cancer among CLWH, we conducted a nested case-control study of children 0-18 years from 2004-2014 at five centers in four SSA countries. Read More

Int J Environ Res Public Health 2021 03 9;18(5). Epub 2021 Mar 9.

Libera Università Maria SS. Assunta, 00100 Rome, Italy.

Eighty percent of people with stroke live in low- to middle-income nations, particularly in sub-Saharan Africa (SSA) where stroke has increased by more than 100% in the last decades. More than one-third of all epilepsy-related deaths occur in SSA. HIV infection is a risk factor for neurological disorders, including stroke and epilepsy. Read More

Int J Environ Res Public Health 2021 Mar 2;18(5). Epub 2021 Mar 2.

Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, 1105 AZ Amsterdam, The Netherlands.

(1) Background: Sub-Saharan African migrants residing in high-income countries are more affected by cardiovascular diseases (CVDs) and associated risk factors than host populations for unclear reasons. The aim was to explore the associations of religion and religious affiliations with CVD risk among Ghanaian non-migrants and migrants in Europe. (2) Methods: The 10-year CVD risk was estimated using pooled cohort equations for 3004 participants from the cross-sectional Research on Obesity and Diabetes among African Migrants (RODAM) study. Read More

Toxins (Basel) 2021 Mar 11;13(3). Epub 2021 Mar 11.

International Rice Research Institute, Eastern and Southern African Region Office, P.O. BOX 30709, 00100 Nairobi, Kenya.

Multiple mycotoxins were tested in milled rice samples ( = 200) from traders at different milling points within the Mwea Irrigation Scheme in Kenya. Traders provided the names of the cultivar, village where paddy was cultivated, sampling locality, miller, and month of paddy harvest between 2018 and 2019. Aflatoxin, citrinin, fumonisin, ochratoxin A, diacetoxyscirpenol, T2, HT2, and sterigmatocystin were analyzed using ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). Read More

Pan Afr Med J 2020 16;37:352. Epub 2020 Dec 16.

Centre for Research on Filariasis and Other Tropical Diseases, Yaoundé, Cameroon.

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is responsible for the development of a highly contagious disease called coronavirus disease (COVID-19). Ten months after the onset of the pandemic, America and Europe remain the most affected regions. Initially, experts predicted that Africa, the poorest continent with the most vulnerable population and health system, would be greatly affected by the ongoing outbreak. Read More

Glob Health Sci Pract 2021 04 1;9(1):177-186. Epub 2021 Apr 1.

Bill & Melinda Gates Institute for Population and Reproductive Health, Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

There is an urgent need for data to inform coronavirus disease (COVID-19) pandemic response efforts. At the same time, the pandemic has created challenges for data collection, one of which is interviewer training in the context of social distancing. In sub-Saharan Africa, in-person interviewer training and face-to-face data collection remain the norm, requiring researchers to think creatively about transitioning to remote settings to allow for safer data collection that respects government guidelines. Read More

Malar J 2021 Apr 1;20(1):174. Epub 2021 Apr 1.

College of Health Sciences, Center for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), Addis Ababa University, P.O. Box 9086, Addis Ababa, Ethiopia.

Background: The emergence of artemisinin resistance in Southeast Asia and Plasmodium falciparum kelch13 propeller gene mutations in sub-Saharan African pose the greatest threat to global efforts to control malaria. This is a critical concern in Uganda, where artemisinin-based combination therapy (ACT) is the first-line treatment for uncomplicated falciparum. The objective of this study was to compare the efficacy and safety of dihydroartemisinin-piperaquine (DHA-PQ) and artemether-lumefantrine (AL) for the treatment of uncomplicated falciparum malaria in Ugandan children. Read More

PLoS One 2021 1;16(4):e0249465. Epub 2021 Apr 1.

Global Health Interdisciplinary Unit, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University, Kyoto City, Kyoto, Japan.

Background: Fishing communities in many Sub-Saharan African countries are a high-risk population group disproportionately affected by the HIV epidemic. In Uganda, literature on HIV in fishing communities has grown extensively since the first country's documented case of HIV in a fishing community in 1985. The current study describes the status of the HIV burden, prevention, and treatment in Ugandan fishing communities. Read More