The aim of this study is to examine the qualities that auditors engaged in detecting potential fraud within multinational corporations in Sub-Saharan Africa should possess.To achieve this goal,a quantitative approach ...The aim of this study is to examine the qualities that auditors engaged in detecting potential fraud within multinational corporations in Sub-Saharan Africa should possess.To achieve this goal,a quantitative approach was used to develop and test a research model based on three theories:agency theory,attribution theory,and cognitive dissonance theory.Responses from a panel of two hundred and nine(209)auditors who conducted a legal audit mission in a Sub-Saharan multinational were analyzed using SmartPLS 3.3.3 software.The results emphasize the crucial importance of auditors’competence and continuous training in fraud detection.However,professional skepticism and time pressure were found to be non-significant in this context.This conclusion provides essential insights for auditors,highlighting the key qualities needed to effectively address fraud detection within multinational corporations in Sub-Saharan Africa.展开更多
This research paper assesses the reality of Climate-Smart Agriculture(CSA)practices’potential to promote the outcomes of sustainable food systems(SFS)within Ghana’s smallholding agriculture context.The study demon-s...This research paper assesses the reality of Climate-Smart Agriculture(CSA)practices’potential to promote the outcomes of sustainable food systems(SFS)within Ghana’s smallholding agriculture context.The study demon-strates that rural farmers generally perceive CSA’s contribution to‘food and nutrition security’and‘economic performance’as more important than CSA’s contribution to‘social equity’and‘environmental stewardship’.From a narrow perspective,the study demonstrates that farmers perceive CSA’s potential to‘prevent pest and disease outbreaks’and‘increase human capital information’as the most important contribution of CSA to SFS outcomes.In contrast,CSA’s potential to promote environmental stewardship is perceived as the least important among Ghana’s rural farmers.This enormity of displacement of smallholders’perceptions at large is motivated by de-mographic,socioeconomic and ecological factors.Moreso,the CSA for SFS outcomes narratives is driven by farmers’self-apprise,social networks and other local information dissemination agents.Furthermore,research findings suggest farmers’awareness of CSA practices and interventions is deficient owing to unmet training and information needs for approximately 82%of the CSA practices and interventions.This situation elucidates the dichotomy of CSA practices’narratives as tools for attaining food,nutrition security and economic performance to the detriment of critical issues such as increasing awareness and building farmers’capacity to engage with CSA practices while also managing socio-ecological trade-offs that emerge over time due to engagement with CSA.Critical(re)orientation is needed across the scale to drive CSA practices and interventions that confine cli-mate adaptation and food production practices within safe planetary boundaries without undermining social,economic,food and nutrition security needs.展开更多
Context: Endometriosis is a pathology that directly affects the daily lives of women with frequent impairment of their quality of life. In our environment, medical, socio-cultural, financial factors and factors relate...Context: Endometriosis is a pathology that directly affects the daily lives of women with frequent impairment of their quality of life. In our environment, medical, socio-cultural, financial factors and factors related to the organization of the health care system greatly delay its diagnosis. The objectives of the present study were to determine the diagnosis delay and to assess the quality of life before surgery of women with endometriosis using the specific Endometriosis Health Profile 5 (EHP-5) questionnaire. Methods: We carried out a descriptive, observational, retrospective study in 8 medical centers in the City of Kinshasa, from January 2019 to October 2022. A total of 80 women with endometriosis confirmed by laparoscopy (16 diagnostic and 64 operative laparoscopies) and histopathology were interviewed. We used the revised American Society for Reproductive Medicine (rASMR) classification, the Endometriosis Fertility Index (EFI) score was calculated for infertile women and the EHP-5 questionnaire to assess quality of life. Our data was entered and analyzed using Statistical Analysis Software 16.1 (STATA 16.1). Results: Diagnosis delay of endometriosis was on average 12 ± 4.3 years. The overall mean EHP-5 score of all patients showed a severe deterioration in quality of life (604 ± 235). A negative relationship was observed between the age of the patient, the diagnostic delay, and the alteration of the quality of life in patients over 36 years old and those with about 11 years of diagnostic delay presenting the slight alteration. Patients with a high social level had very severe quality impairment. Women on hormonal treatment, those with a history of pregnancy, childbirth, miscarriage and abortion had a slight and significant deterioration in quality of life (p 0.05). Conclusion: Despite some limitations, our preliminary study highlights that in sub-Saharan Africa, the diagnosis of endometriosis is delayed and associated with a severe alteration in quality of life. Moreover, diagnosis of endometriosis seems to be restricted to women with high social levels. Therefore, further efforts are required to develop a health policy to decrease delay for diagnosis with potential benefits on symptoms, quality of life, fertility while limiting stigma and psychological effects of this debilitating pathology.展开更多
Impoverished sub-Saharan Africa(SSA)is under increasing environmental pressure from global environmental changes.It is now generally accepted in academic circles that economic development in SSA countries can cause en...Impoverished sub-Saharan Africa(SSA)is under increasing environmental pressure from global environmental changes.It is now generally accepted in academic circles that economic development in SSA countries can cause environmental pressure in other countries.However,there is research gap on the impact of economic assistance on environmental pressure in SSA countries and whether economic assistance causes spatial spillovers of environ-mental pressure between SSA countries.To better understand the impact of economic assistance on environmental pressures in SSA,a dynamic spatial Dubin panel model was developed.It helped us explore the spatial spillover effects of economic assistance on environmental pressures in recipient countries based on the panel data from 34 SSA countries.The results show that economic assistance had a positive stimulating effect on environmen-tal pressures of recipient countries,which means that the degree of human disturbance to the environment has deepened.Due to the regional correlation effect,neighboring countries were saddled with environmental pres-sures from the target country.Moreover,environmental pressures have time inertia,which can easily produce a snowball effect.The decomposition of effects shows that the impact of economic assistance on environmental pressures is relatively minor.Environmental pressures have spillover effects,so to deal with diffuse risks,joint regional prevention and control policies should be developed.展开更多
The relationship between environmental degradation and poverty has increasingly become the focus of national strategic decision-making in recent years.However,despite several theoretical explorations on the nexus,a de...The relationship between environmental degradation and poverty has increasingly become the focus of national strategic decision-making in recent years.However,despite several theoretical explorations on the nexus,a dearth of empirical literature on the poverty-environmental degradation nexus,specifically on Sub-Saharan Africa(SSA),still exists.In this study,we investigated the poverty-environmental degradation nexus in SSA.We hypothesized that poverty is both a cause and effect of environmental degradation,and this relationship is explained as a vicious cycle.Unlike previous studies,we employed several alternative indicators of environmental degradation to examine the poverty-environmental degradation nexus in this study.We used data from 41 countries of SSA between 1996 and 2019 and employed the generalized method of moments(GMM)approach.The findings suggest a cyclical relationship between poverty and environmental degradation in SSA,which confirms that an increase in poverty leads to an increase in environmental degradation,especially in deforestation and PM2.5 emissions.Similarly,the increase in environmental degradation positively affects poverty in SSA.We also confirmed that exogenous conditioning factors such as population growth rate,education,industrialization,and income inequality,institutional quality indicators such as governance effectiveness,control of corruption,freedom ad civil liberty,and democracy,and endogenous factors including fossil fuel energy use,fuelwood energy use,household health expenditure,infant mortality rate,and agriculture productivity influence the nexus between poverty and environmental degradation.The findings on the relationship between poverty and environmental degradation in SSA are a testimonial evidence that both poverty and environmental degradation are significant issues in SSA.Hence,poverty alleviation policies in SSA should not lead to PM2.5 emissions and deforestation,which may as well force people into a poverty-environmental degradation trap.Instead,poverty reduction policies should simultaneously achieve environmental conservation.展开更多
Background: Heart failure is a major public health challenge in sub-Saharan Africa. In patients with chronic Heart Failure and cardiac desynchrony, studies have suggested that cardiac resynchronization, can improve ca...Background: Heart failure is a major public health challenge in sub-Saharan Africa. In patients with chronic Heart Failure and cardiac desynchrony, studies have suggested that cardiac resynchronization, can improve cardiac function and the quality of life of patients. However, in Sub-Saharan Africa, very few studies have been done on cardiac resynchronization which is in its infancy. The aim of this study is to report the local data from our hospital. Method: It was a transversal, descriptive and analytical study conducted from November 2019 to September 2022 at the Cardiology Department of the Principal Hospital of Dakar. Results: Twelve patients were implanted for Cardiac Resynchronization Therapy (CRT). The sex ratio was 8 males/4 females. The average age was 67 ± 11 years. Ten patients had non-ischemic heart disease and the two others had ischemic one. All of them had NYHA III or IV scores before CRT. The Quality of Life (QOL) was judged as poor by all of the patients. The average duration of QRS was 156 ± 9 ms. 27.9% ± 5% was the mean Left Ventricular ejection fraction (LVEF). Complications occur in 3/12 patients (25%). It was one CS vein dissection, one micro LV lead dislodgement and one phrenic nerve stimulation. Nine patients, who were considered as responders, had an improvement of QOL and NYHA, the LVEF increased and the end-diastolic dimension, and the duration of the QRS interval all decreased. Two patients do not respond and one (1) who had permanent atrial fibrillation, was a secondary responder after an atrioventricular junction ablation. Conclusion: Cardiac resynchronization is a therapy that improves the QOL of patients, the LVEF and reduces the duration of the QRS interval. However, this procedure is not without risk of complications. In sub-Saharan Africa, the major challenge is to improve the financial accessibility of this therapy for the population.展开更多
Behçet’s disease (BD) is a multi-systemic vasculitis characterized by a triad made up of oral aphthosis, genital aphthosis and uveitis which may or may not be associated with visceral involvement. Other times de...Behçet’s disease (BD) is a multi-systemic vasculitis characterized by a triad made up of oral aphthosis, genital aphthosis and uveitis which may or may not be associated with visceral involvement. Other times described in the ancient silk road, BD is increasingly found in countries south of the Sahara with the mixing of populations. Our objective was to describe the epidemiology and clinical characteristics of BD in an African country. Methodology: This was a five-year retrospective study in the internal medicine department of Donka National Hospital. We used international criteria finding BD. Urinary dipstick was use for finding kidney disease. Result: During the period, five cases of Behçet’s disease were collected. The average age was 35 years old. The male sex was more represented with 3 out of 5 cases. The most common clinical manifestation was oral aphthosis in all patients (100%), followed by genital aphthosis in 4 cases (80%). The other clinical manifestations observed were uveitis in 3 cases (60%), joint manifestations such as arthralgia in 3 cases (60%) and neurological manifestations such as chronic headache in one case (20%). HLA-B51 was found in two cases. The pattergic test done in two patients came back positive (100%). The patients received colchicine and oral corticosteroid therapy. Two patients were lost to sight. We deplored a death probably in a neuro-Behçet table before the rebellious headaches. Conclusion: Behçet’s disease is a multi-systemic vasculitis that must be evoked and managed quickly in a tropical environment, especially since the prognosis, vital and functional prognosis can be engaged.展开更多
This study aims to investigate the main sectors of economic development before and the current situation of COVID-19 for Sub-Saharan African countries by demonstrating country experiences,the role of vaccines,and the ...This study aims to investigate the main sectors of economic development before and the current situation of COVID-19 for Sub-Saharan African countries by demonstrating country experiences,the role of vaccines,and the SSA economy forecast.The study has four main sections,including an introduction,an overview of socioeconomic indicators before the pandemic,methods,results findings,and discussion.The study used mixed methods,including an approach based on secondary data.The quantitative results were analysed using both empirical methods and the researcher’s prior expertise.The analysis of the effects of the COVID-19 pandemic on SSA countries was based on long-term data collected by several international financial institutions.The research findings demonstrated conclusively that COVID-19 is causing the collapse of the SSA economy,the first economic recession in 25 years,$37-79 billion in lost GDP by 2020,and an export decrease of 10.6%.In education,for example,64%of primary and 50%of secondary students lack ICT training,89%(216 million)do not have access to a home computer,and 82%(199 million)do not have an Internet connection missed classes during the COVID-19 period.The agricultural sector in SSA is also impacted by over 239 million hungry people.COVID-19 mass vaccinations and public debt amount to over$154 billion in obligations to get the SSA economy back on its feet with zero tolerance for embezzlement of public funds.These results can be used to make the economies of SSA countries resilient to the current crises and to address some thematic issues,such as the implementation of the African Continental Free Trade Area(AfCFTA)in all SSA countries,which will save time and money by getting rid of border taxes.Therefore,policymakers can use the findings to begin formulating plans to address issues like economic development,education,and food insecurity.展开更多
Soybean(Glycine max(L.) Merr.) is a non-native and non-staple crop in sub-Saharan Africa(SSA) with potential to be a commercial crop owing to its wide range of uses as food, feed,and industrial raw material. Soybean w...Soybean(Glycine max(L.) Merr.) is a non-native and non-staple crop in sub-Saharan Africa(SSA) with potential to be a commercial crop owing to its wide range of uses as food, feed,and industrial raw material. Soybean was first introduced to SSA by Chinese traders in the19 th century and was cultivated as an economic crop as early as 1903 in South Africa. In the past four decades, soybean cultivation area and production in SSA has increased exponentially, from about 20,000 ha and 13,000 t in the early 1970 s to 1,500,000 ha and2,300,000 t in 2016. Soybean yield has been stagnant in SSA for decades at about 1.1 t ha^(-1),much lower than the world average, representing one of the most challenging issues in the soybean industry in SSA. The low soybean yield in SSA can be attributed to the use of poorperforming varieties and to the limited application of fertilizers and rhizobial inoculants in soils with no history of soybean production. South Africa, Nigeria, Zambia, and Uganda are the leading soybean producers in SSA. Soybean research in SSA is conducted by international and national research institutions, including IITA, national soybean improvement programs, universities, and the private sector. Between 1970 and 2011, 195 soybean varieties were released by IITA, private breeders, and national soybean improvement programs in SSA. This paper reviews the history and current state of soybean production and of the utilization and adoption of tropical varieties in SSA, addresses the major soybean yield-limiting factors across the region, and discusses the potential of the soybean industry in SSA. It also highlights soybean improvement efforts and lessons learned from previous soybean improvement efforts and the current progress of some national soybean improvement programs in SSA. Opportunities for scaling up tropical soybean as a major crop across SSA countries are promising.展开更多
Background: Hypertensive patients with insulin resistance (IR) are at greater risk of cardiovascular disease and may represent a particular subset of hypertension (HTN) requiring special medical attention. Quantitativ...Background: Hypertensive patients with insulin resistance (IR) are at greater risk of cardiovascular disease and may represent a particular subset of hypertension (HTN) requiring special medical attention. Quantitative measurements of the IR are not suitable for routine clinical practice. Met-abolic syndrome (MetS) or simply abdominal obesity (AO) is surrogate of IR. The performance of the recently proposed Sub-Saharan Africa cut-off point of abdominal obesity for identifying IR in hypertensive patients has never been evaluated. Aims: The main objective was to compare the performance of the newly proposed Sub-Saharan Africa specific threshold of abdominal obesity (AO-SSA) to that of IDF (AO-IDF) in identifying IR in Congolese Black Hypertensive Patients. Methods: A cross-sectional study was conducted at the Heart of Africa Cardiovascular Center, Lomo Medical Clinic, Kinshasa Limete, DR Congo, between January 2007 and January 2010. Homeostatic model assessment (HOMA) index was calculated to determine IR. Multivariate logistic regression analysis was used to assess the independent determinants of IR. The intrinsic (sensitivity and specificity) and extrinsic (positive predictive value and negative predictive value) characteristics of the AO-SSA, AO-IDF, AO-ATP III, MetS-SSA, MetS-IDF, and MetS-ATP III were calculated. The kappa statistic was determined for agreement between the ATPIII, IDF and SSA defined AO and MetS with HOMA-IR. Results: Men represented the majority of the enrolled patients: 105 (64.4%) and the mean age of all participants were 57 ± 11 years. Insulin resistance was found in 79.1% of the study population with 88.7, 79.3, 84.6, 71.4, 75.5, 91.1, 60.3 and 44.8 respectively among patient with MetS-ATP, MetS-IDF, MetS-SSA, AO-ATP III, AO-IDF, AO-SSA, diabetics and non-obese non-diabetic hypertensive patients. In multivariate analysis, the risk of IR was associated independently and significantly (p < 0.05) with cigarette smoking, low-HDL-C, hyperuricemia, and diastolic HTN, as shown in the following equation: Y = ﹣1.404 + 1.054 Cigarette Smoking + 0.872 low HDL-C + 0.983 hyperuricemia + 0.852 diastolic hypertension. The AO-SSA, with 87.7% sensitivity and 67.6% specificity, was the only surrogate who showed an acceptable agreement with the HOMA-IR index. Abdominal obesity defined according to other thresholds and the metabolic syndrome whatever the used diagnostic criteria have a slight agreement with the HOMA-IR index. Conclusion: IR was found to be prevalent in our study population. Cigarette smoking, low-HDL-C, hyperuricemia, and isolated diastolic HTN magnify IR. The AO-SSA is an easy and cost efficient method to diagnose IR in Congolese Black Hypertensive Patients. Further study in wider group is indicated to validate our findings.展开更多
There is a growing body of evidence showing a close correlation between left ventricular mass with cardiovascular morbidity and overall mortality. Therefore, identifying the determinants of left ventricular hypertroph...There is a growing body of evidence showing a close correlation between left ventricular mass with cardiovascular morbidity and overall mortality. Therefore, identifying the determinants of left ventricular hypertrophy can be of great importance for cardiovascular prevention, for prognosis and therapeutic intervention. Objective: To assess the prevalence and identify the independent determinants of echocardiographic left ventricular hypertrophy in The MA-Ghreb and Sub-Saharan Africa Left-Ventricul ArGEometry Study (MAG-SALVAGES) participants. Methods: The MAG-SALVAGES is a community based study in which 100 asymptomatic Black Sub-Saharan African (BSSA) and 189 white skin Maghreb within the age of 18 to 55 years underwent a resting echocardiography. Multivariate logistic regression analysis was utilized to identify the independent determinants of LVH left ventricular hypertrophy. Results: Men represented the majority of the enrolled participants: 173 (59.9%). Echocardiographic left ventricular hypertrophy was seen in 10 (3.5%) participants. Age ≥40 years, female gender, overall obesity, abdominal obesity, hypertension status and less fruit consumption were significantly associated with echocardiography left ventricular hypertrophy. After adjusting for confounding factors, age ≥40 years, female gender, abdominal obesity and less fruit consumption were independently and significantly associated with echocardiographic left ventricular hypertrophy, as illustrated in the following equation: Y = 0.36 + 0.162 age >40 years + 2.69 female gender + 2.52 abdominal obesity + 1.31 less fruit consumption. Conclusion: Lifestyle changes for the prevention of abdominal obesity and encouraging fruit consumption may be beneficial in preventing left ventricular hypertrophy.展开更多
Climate change adaptation strategies provide a cushion for smallholder farmers,especially in subSaharan Africa against the risks posed by climate hazards such as droughts and floods.However,the decision-making process...Climate change adaptation strategies provide a cushion for smallholder farmers,especially in subSaharan Africa against the risks posed by climate hazards such as droughts and floods.However,the decision-making process in climate adaptation is complex.To better understand the dynamics of the process,we strive to answer this question:what are the potential trade-offs and synergies related to decision-making and implementation of climate adaptation strategies among smallholder farmers in sub-Saharan Africa region?A systematic literature review methodology was used through the Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA)statement with the four-stage inclusion/exclusion criteria to identify the literature from selected databases(Scopus and Google Scholar).The climate adaptation strategies are organized into five broad categories(crop management,risk management,soil/land management,water management,and livestock management strategies).Evidence suggests that potential trade-offs may arise concerning added costs,additional labor requirements,and competition among objectives or available resources.The synergies,on the other hand,arise from implementing two or more adaptation strategies concurrently in respect of increased productivity,resilience,yield stability,sustainability,and environmental protection.Trade-offs and synergies may also differ among the various adaptation strategies with minimum/zero tillage,comparatively,presenting more tradeoffs.The development and promotion of low-cost adaptation strategies and complementary climate adaptation options that minimize the trade-offs and maximize the synergies are suggested.Skills and knowledge on proper implementation of climate change adaptation strategies are encouraged,especially at the local farm level.展开更多
Sub-Saharan Africa(SSA)has the highest maternal and under-five mortality rates in the world.The advent of the coronavirus disease 2019 exacerbated the region's problems by overwhelming the health systems and affec...Sub-Saharan Africa(SSA)has the highest maternal and under-five mortality rates in the world.The advent of the coronavirus disease 2019 exacerbated the region's problems by overwhelming the health systems and affecting access to healthcare through travel restrictions and rechanelling of resources towards the containment of the pandemic.The region failed to achieve the Millenium Development Goals on maternal and child mortalities,and is poised to fail to achieve the same goals in the Sustainable Development Goals.To improve on the maternal and child health outcomes,many SSA countries introduced digital technologies for educating pregnant and nurs-ing women,making doctors'appointments and sending reminders to mothers and expectant mothers,as well as capturing information about patients and their illnesses.However,the collected epidemiological data are not being utilised to inform patient care and improve on the quality,efficiency and access to maternal,neonatal and child health(MNCH)care.To the researchers'best knowledge,no review paper has been published that focuses on digital health for MNCH care in SSA and proposes data-driven approaches to the same.Therefore,this study sought to:(1)identify digital systems for MNCH in SSA;(2)identify the applicability and weaknesses of the dig-ital MNCH systems in SSA;and(3)propose a data-driven model for diverging emerging technologies into MNCH services in SSA to make better use of data to improve MNCH care coverage,efficiency and quality.The PRISMA methodology was used in this study.The study revealed that there are no data-driven models for monitoring pregnant women and under-five children in Sub-Saharan Africa,with the available digital health technologies mainly based on SMS and websites.Thus,the current digital health systems in SSA do not support real-time,ubiquitous,pervasive and data-driven healthcare.Their main applicability is in non-real-time pregnancy moni-toring,education and information dissemination.Unless new and more effective approaches are implemented,SSA might remain with the highest and unacceptable maternal and under-five mortality rates globally.The study proposes feasible emerging technologies that can be used to provide data-driven healthcare for MNCH in SSA,and the recommendations on how to make the transition successful as well as the lessons learn from other regions.展开更多
Given that challenges on the issue of socioeconomic development faced by countries in sub-Saharan Africa(SSA)have been identified as critical to strengthening the inherent link between governance and socioeconomic con...Given that challenges on the issue of socioeconomic development faced by countries in sub-Saharan Africa(SSA)have been identified as critical to strengthening the inherent link between governance and socioeconomic conditions,this study examines the interconnections between governance and socioeconomic conditions in SSA.With a focus on 25 countries in SSA between 2005 and 2019,we conduct the analysis based on the Panel-Corrected Standard Error and System Generalized Method of Moments estimations and panel causality tests.The results show that SSA does not seem to have the means of effective governance to spur improved socioeconomic conditions.Moreover,the pervasiveness of institutional problems in many countries of SSA has been responsible for the poor socioeconomic conditions in the region.Likewise,governance quality and socioeconomic conditions are found to influence each other.An improvement in socioeconomic conditions could result in better governance quality.On the other hand,governance quality is viewed as a vital ingredient in achieving needed socioeconomic development outcomes.Thus,it is suggested that there is a need for countries in SSA to streamline governing systems toward engendering improved well-being.The introduction and implementation of transformative policies through effective governance are also necessary for ensuring critical structural changes and increasing social service provision.Overall,there should be a proactive identification of ineffective policies and procedures by policymakers to enhance meaningful impacts in the region.展开更多
Rural electrification remains a great challenge for Sub-Saharan Africa (SSA) as access to electricity is a prerequisite to accelerate its development. The present paper reviews the measures adopted to promote access t...Rural electrification remains a great challenge for Sub-Saharan Africa (SSA) as access to electricity is a prerequisite to accelerate its development. The present paper reviews the measures adopted to promote access to electricity in rural and remote areas of SSA. The main barriers to rural electrification in these developing countries are presented before showing technologies used for the aforementioned purpose. Then, adopted methods for enhancing the use of renewable energy in SSA are shown. Moreover, the policy adopted by decision makers and project planners are also highlighted. In addition, the optimal solutions proposed by researchers are given such as the cost-effective off-grid system type that might be a viable alternative to diesel power generation.展开更多
Introduction: Carotid web (CW), a rare and probably unknown arterial cause of ischemic stroke (IS), is commonly reported in young black patients, although most of the published cases resided in a non-African country. ...Introduction: Carotid web (CW), a rare and probably unknown arterial cause of ischemic stroke (IS), is commonly reported in young black patients, although most of the published cases resided in a non-African country. We describe the features of the first six Senegalese cases diagnosed at the Neurology Department of the Fann Teaching Hospital in Dakar. Patients and Method: It was a preliminary retrospective and prospective study conducted at the Neurology department of Fann teaching hospital (Dakar-Senegal). The symptomatic CW diagnosis was based on angioCT-scan of the neck arteries. The National Institute of Health Stroke Scale (NIHSS) and the modified-Rankin Scale (mRS) were used to assess the severity of the IS and the functional disability after the event, respectively. Results: CW was causing a left sylvian infarction in 4 patients. The mean age of the patients at the IS diagnosis was 41 ± 6 years with a sex ratio of 1. The mean time to diagnosis of CW was 13 months. Smoking (1/6), hypertension (1/6), and obesity (1/6) were the main vascular risk factors. The mean LDL cholesterol level was 1.52 g/L ± 0.49. The mean initial NIHSS was 15 ± 6 (8-22). Half of the patients had a severe infarction (NIHSS ≥ 15). For secondary prevention, half of the patients were treated with aspirin and the other half with acenocoumarol. After 18 months ± 17 of follow-up, the mean mRS score was 2 ± 1 (1-3). Conclusion: CW is an unknown cause of IS in young black patients. An early and appropriate multidisciplinary management could help to reduce the risk of recurrences.展开更多
Intra-partum foetal death has been variously defined.However, a definition adopted at a technical consultation in 2006 is employed in this review. The quality of intrapartum care is a crucial factor for pregnancy outc...Intra-partum foetal death has been variously defined.However, a definition adopted at a technical consultation in 2006 is employed in this review. The quality of intrapartum care is a crucial factor for pregnancy outcome for both mothers and new-borns. Intra-partum stillbirth is defined as late foetal death during labour, which clinically presents as fresh stillbirth. The largest proportion of the world's stillbirths occurs in the late preterm, term and intra-partum periods. The Western Pacific region has the greatest reduction in stillbirth with a 3.8% annual decline between 1995 and 2009; however, the annual decline in the African region is less than 1%. Caesarean delivery is still uncommon, especially in rural areas: 1% of births in rural Sub-Saharan Africa and 5% in rural South Asia are by caesarean delivery; 62% of stillbirths occurred during the intra-partum period; 61.4% of stillbirths are attributable to obstetrical complications. Preventive measures aimed at reducing the incidence of intra-partum foetal death entail all measures aimed at improving quality antenatal care and preventing intrapartum asphyxia. This review discusses intra-partum foetal deaths from a Sub-Saharan African perspective. It explores the contribution of research within the region to identifying its impact on new-born health and potential cost-effective policy interventions.展开更多
Background: This review identified papers that described periodontitis and rheumatoid arthritis in sub-Saharan Africa. Only English language publications from January 2010 to December 2017 describing original research...Background: This review identified papers that described periodontitis and rheumatoid arthritis in sub-Saharan Africa. Only English language publications from January 2010 to December 2017 describing original research in sub-Saharan Africa on the association between periodontitis and rheumatoid arthritis were considered for this study. Methods: Published databases: Pub-Med, Science direct and Google scholar, were searched using terms “periodontitis”, “rheumatoid arthritis” and “Sub-Saharan Africa” to generate a set of putative studies. Articles with data on both rheumatoid arthritis and periodontitis compared to controls were selected. Studies on the association of periodontitis with cardiovascular disease, arthritis or rheumatoid arthritis alone were excluded. Data were extracted, critically appraised, and analyzed using a random-effect Mantel-Haenszel meta-analysis on plaque index, gingival index, pocket depth and clinical attachment loss. Results: Three publications were selected for the systematic review and 2 for the meta-analysis. Two studies were from Sudan, and one was from Burina Faso. There was a significant increase in pocket depth (mean difference: 0.31;95% CI: 0.21, 0.41;N = 274;(p ≤ 0.001)) and clinical attachment loss (mean difference: 0.47;95% CI: 0.22, 0.75;N = 274;(p ≤ 0.001)) in participants with rheumatoid arthritis compared to normal controls. Conclusion: Findings from these combined studies show a significant relationship between periodontal disease and rheumatoid arthritis with increased periodontal pocket depth and clinical attachment loss. They also highlight the need for additional work especially in the area of associating rheumatoid arthritis with P. gingivalis, the oral microbiome and treating periodontal diseases to help in the management of rheumatoid arthritis.展开更多
Goats are one of the oldest domesticated animal species widely distributed in the world playing an important role in the food production system in Sub-Saharan African Region (SSAR). Due to their multiple uses (milk pr...Goats are one of the oldest domesticated animal species widely distributed in the world playing an important role in the food production system in Sub-Saharan African Region (SSAR). Due to their multiple uses (milk production, meat, fiber and hides) and adaptation aptitudes to ecological conditions, goats produce and contribute positively to farmers’ socio-economy status in various production systems. This review aimed at giving a summary overview on the goat’s production systems characteristics, the genetic diversity and the candidate genes affecting reproductive and milk production performances in goat breeds in SSAR. It has been observed that traditional livestock production system with communal grazing system is the most used in goat keeping in SSAR. The geographical locations play an important role in the relationships between goat’s distributions in the region. At the same time, goats might have been differentiated and isolated one to others due to the wide geographic range, the diversify climate and the topography in the region. Among the six worldwide known haplogroups of goat (A, B, C, D, G and F), haplogroup A is the most representative in SSAR. However, haplogroup G and B can be found in some goat populations in some countries in east (Kenya and Ethiopia) and south parts of Africa. This review reveals that little is known on the candidate genes associated with prolificacy and milk production traits in indigenous goat breeds in the region. That observation suggests the importance of assessing candidate genes associated with economic traits in the populations of goat in SSAR.展开更多
文摘The aim of this study is to examine the qualities that auditors engaged in detecting potential fraud within multinational corporations in Sub-Saharan Africa should possess.To achieve this goal,a quantitative approach was used to develop and test a research model based on three theories:agency theory,attribution theory,and cognitive dissonance theory.Responses from a panel of two hundred and nine(209)auditors who conducted a legal audit mission in a Sub-Saharan multinational were analyzed using SmartPLS 3.3.3 software.The results emphasize the crucial importance of auditors’competence and continuous training in fraud detection.However,professional skepticism and time pressure were found to be non-significant in this context.This conclusion provides essential insights for auditors,highlighting the key qualities needed to effectively address fraud detection within multinational corporations in Sub-Saharan Africa.
基金PTQ receives funding from the Canada First Research Excellence Fund(Grant No.499077)and the Canada Research Chairs Program.
文摘This research paper assesses the reality of Climate-Smart Agriculture(CSA)practices’potential to promote the outcomes of sustainable food systems(SFS)within Ghana’s smallholding agriculture context.The study demon-strates that rural farmers generally perceive CSA’s contribution to‘food and nutrition security’and‘economic performance’as more important than CSA’s contribution to‘social equity’and‘environmental stewardship’.From a narrow perspective,the study demonstrates that farmers perceive CSA’s potential to‘prevent pest and disease outbreaks’and‘increase human capital information’as the most important contribution of CSA to SFS outcomes.In contrast,CSA’s potential to promote environmental stewardship is perceived as the least important among Ghana’s rural farmers.This enormity of displacement of smallholders’perceptions at large is motivated by de-mographic,socioeconomic and ecological factors.Moreso,the CSA for SFS outcomes narratives is driven by farmers’self-apprise,social networks and other local information dissemination agents.Furthermore,research findings suggest farmers’awareness of CSA practices and interventions is deficient owing to unmet training and information needs for approximately 82%of the CSA practices and interventions.This situation elucidates the dichotomy of CSA practices’narratives as tools for attaining food,nutrition security and economic performance to the detriment of critical issues such as increasing awareness and building farmers’capacity to engage with CSA practices while also managing socio-ecological trade-offs that emerge over time due to engagement with CSA.Critical(re)orientation is needed across the scale to drive CSA practices and interventions that confine cli-mate adaptation and food production practices within safe planetary boundaries without undermining social,economic,food and nutrition security needs.
文摘Context: Endometriosis is a pathology that directly affects the daily lives of women with frequent impairment of their quality of life. In our environment, medical, socio-cultural, financial factors and factors related to the organization of the health care system greatly delay its diagnosis. The objectives of the present study were to determine the diagnosis delay and to assess the quality of life before surgery of women with endometriosis using the specific Endometriosis Health Profile 5 (EHP-5) questionnaire. Methods: We carried out a descriptive, observational, retrospective study in 8 medical centers in the City of Kinshasa, from January 2019 to October 2022. A total of 80 women with endometriosis confirmed by laparoscopy (16 diagnostic and 64 operative laparoscopies) and histopathology were interviewed. We used the revised American Society for Reproductive Medicine (rASMR) classification, the Endometriosis Fertility Index (EFI) score was calculated for infertile women and the EHP-5 questionnaire to assess quality of life. Our data was entered and analyzed using Statistical Analysis Software 16.1 (STATA 16.1). Results: Diagnosis delay of endometriosis was on average 12 ± 4.3 years. The overall mean EHP-5 score of all patients showed a severe deterioration in quality of life (604 ± 235). A negative relationship was observed between the age of the patient, the diagnostic delay, and the alteration of the quality of life in patients over 36 years old and those with about 11 years of diagnostic delay presenting the slight alteration. Patients with a high social level had very severe quality impairment. Women on hormonal treatment, those with a history of pregnancy, childbirth, miscarriage and abortion had a slight and significant deterioration in quality of life (p 0.05). Conclusion: Despite some limitations, our preliminary study highlights that in sub-Saharan Africa, the diagnosis of endometriosis is delayed and associated with a severe alteration in quality of life. Moreover, diagnosis of endometriosis seems to be restricted to women with high social levels. Therefore, further efforts are required to develop a health policy to decrease delay for diagnosis with potential benefits on symptoms, quality of life, fertility while limiting stigma and psychological effects of this debilitating pathology.
基金This work is supported by National Natural Science Foundation of China(Grants No.72104246,71874203).
文摘Impoverished sub-Saharan Africa(SSA)is under increasing environmental pressure from global environmental changes.It is now generally accepted in academic circles that economic development in SSA countries can cause environmental pressure in other countries.However,there is research gap on the impact of economic assistance on environmental pressure in SSA countries and whether economic assistance causes spatial spillovers of environ-mental pressure between SSA countries.To better understand the impact of economic assistance on environmental pressures in SSA,a dynamic spatial Dubin panel model was developed.It helped us explore the spatial spillover effects of economic assistance on environmental pressures in recipient countries based on the panel data from 34 SSA countries.The results show that economic assistance had a positive stimulating effect on environmen-tal pressures of recipient countries,which means that the degree of human disturbance to the environment has deepened.Due to the regional correlation effect,neighboring countries were saddled with environmental pres-sures from the target country.Moreover,environmental pressures have time inertia,which can easily produce a snowball effect.The decomposition of effects shows that the impact of economic assistance on environmental pressures is relatively minor.Environmental pressures have spillover effects,so to deal with diffuse risks,joint regional prevention and control policies should be developed.
文摘The relationship between environmental degradation and poverty has increasingly become the focus of national strategic decision-making in recent years.However,despite several theoretical explorations on the nexus,a dearth of empirical literature on the poverty-environmental degradation nexus,specifically on Sub-Saharan Africa(SSA),still exists.In this study,we investigated the poverty-environmental degradation nexus in SSA.We hypothesized that poverty is both a cause and effect of environmental degradation,and this relationship is explained as a vicious cycle.Unlike previous studies,we employed several alternative indicators of environmental degradation to examine the poverty-environmental degradation nexus in this study.We used data from 41 countries of SSA between 1996 and 2019 and employed the generalized method of moments(GMM)approach.The findings suggest a cyclical relationship between poverty and environmental degradation in SSA,which confirms that an increase in poverty leads to an increase in environmental degradation,especially in deforestation and PM2.5 emissions.Similarly,the increase in environmental degradation positively affects poverty in SSA.We also confirmed that exogenous conditioning factors such as population growth rate,education,industrialization,and income inequality,institutional quality indicators such as governance effectiveness,control of corruption,freedom ad civil liberty,and democracy,and endogenous factors including fossil fuel energy use,fuelwood energy use,household health expenditure,infant mortality rate,and agriculture productivity influence the nexus between poverty and environmental degradation.The findings on the relationship between poverty and environmental degradation in SSA are a testimonial evidence that both poverty and environmental degradation are significant issues in SSA.Hence,poverty alleviation policies in SSA should not lead to PM2.5 emissions and deforestation,which may as well force people into a poverty-environmental degradation trap.Instead,poverty reduction policies should simultaneously achieve environmental conservation.
文摘Background: Heart failure is a major public health challenge in sub-Saharan Africa. In patients with chronic Heart Failure and cardiac desynchrony, studies have suggested that cardiac resynchronization, can improve cardiac function and the quality of life of patients. However, in Sub-Saharan Africa, very few studies have been done on cardiac resynchronization which is in its infancy. The aim of this study is to report the local data from our hospital. Method: It was a transversal, descriptive and analytical study conducted from November 2019 to September 2022 at the Cardiology Department of the Principal Hospital of Dakar. Results: Twelve patients were implanted for Cardiac Resynchronization Therapy (CRT). The sex ratio was 8 males/4 females. The average age was 67 ± 11 years. Ten patients had non-ischemic heart disease and the two others had ischemic one. All of them had NYHA III or IV scores before CRT. The Quality of Life (QOL) was judged as poor by all of the patients. The average duration of QRS was 156 ± 9 ms. 27.9% ± 5% was the mean Left Ventricular ejection fraction (LVEF). Complications occur in 3/12 patients (25%). It was one CS vein dissection, one micro LV lead dislodgement and one phrenic nerve stimulation. Nine patients, who were considered as responders, had an improvement of QOL and NYHA, the LVEF increased and the end-diastolic dimension, and the duration of the QRS interval all decreased. Two patients do not respond and one (1) who had permanent atrial fibrillation, was a secondary responder after an atrioventricular junction ablation. Conclusion: Cardiac resynchronization is a therapy that improves the QOL of patients, the LVEF and reduces the duration of the QRS interval. However, this procedure is not without risk of complications. In sub-Saharan Africa, the major challenge is to improve the financial accessibility of this therapy for the population.
文摘Behçet’s disease (BD) is a multi-systemic vasculitis characterized by a triad made up of oral aphthosis, genital aphthosis and uveitis which may or may not be associated with visceral involvement. Other times described in the ancient silk road, BD is increasingly found in countries south of the Sahara with the mixing of populations. Our objective was to describe the epidemiology and clinical characteristics of BD in an African country. Methodology: This was a five-year retrospective study in the internal medicine department of Donka National Hospital. We used international criteria finding BD. Urinary dipstick was use for finding kidney disease. Result: During the period, five cases of Behçet’s disease were collected. The average age was 35 years old. The male sex was more represented with 3 out of 5 cases. The most common clinical manifestation was oral aphthosis in all patients (100%), followed by genital aphthosis in 4 cases (80%). The other clinical manifestations observed were uveitis in 3 cases (60%), joint manifestations such as arthralgia in 3 cases (60%) and neurological manifestations such as chronic headache in one case (20%). HLA-B51 was found in two cases. The pattergic test done in two patients came back positive (100%). The patients received colchicine and oral corticosteroid therapy. Two patients were lost to sight. We deplored a death probably in a neuro-Behçet table before the rebellious headaches. Conclusion: Behçet’s disease is a multi-systemic vasculitis that must be evoked and managed quickly in a tropical environment, especially since the prognosis, vital and functional prognosis can be engaged.
文摘This study aims to investigate the main sectors of economic development before and the current situation of COVID-19 for Sub-Saharan African countries by demonstrating country experiences,the role of vaccines,and the SSA economy forecast.The study has four main sections,including an introduction,an overview of socioeconomic indicators before the pandemic,methods,results findings,and discussion.The study used mixed methods,including an approach based on secondary data.The quantitative results were analysed using both empirical methods and the researcher’s prior expertise.The analysis of the effects of the COVID-19 pandemic on SSA countries was based on long-term data collected by several international financial institutions.The research findings demonstrated conclusively that COVID-19 is causing the collapse of the SSA economy,the first economic recession in 25 years,$37-79 billion in lost GDP by 2020,and an export decrease of 10.6%.In education,for example,64%of primary and 50%of secondary students lack ICT training,89%(216 million)do not have access to a home computer,and 82%(199 million)do not have an Internet connection missed classes during the COVID-19 period.The agricultural sector in SSA is also impacted by over 239 million hungry people.COVID-19 mass vaccinations and public debt amount to over$154 billion in obligations to get the SSA economy back on its feet with zero tolerance for embezzlement of public funds.These results can be used to make the economies of SSA countries resilient to the current crises and to address some thematic issues,such as the implementation of the African Continental Free Trade Area(AfCFTA)in all SSA countries,which will save time and money by getting rid of border taxes.Therefore,policymakers can use the findings to begin formulating plans to address issues like economic development,education,and food insecurity.
基金supported by the International Cooperation Program of MST of China(2009DFB20580)the Major Basic Research Project of MST of China(Grant No: 2006CB806400)+1 种基金Special Basic Research Project(Grant No:2007FY110200)of MST of Chinathe IVPP Project(Grant No:KA209508)
文摘关于现代的人的起源的当前、主导的理论是 out-of-Africa 假设，它断言人现代人的左非洲的人口 100,000 年以前并且在欧亚大陆的人的代替的土生土长的人口。许多学者与 paleoenvironmental 变化等同人的 out-of-Africa 疏开。直到现在，然而，很少对动物区系的数据给予了特殊注意并且动物区系的模式是否支持流行理论。中国动物志的最近的比较学习证明在非洲和东亚之间的动物志的通讯能发生在晚第三纪期间，但是它在更新世期间是很有限的。在中国第四级的动物志，仅仅 16% 类也是在 sub-Saharan 非洲人动物志的现在。也在能与非洲的动物志有关的中国第四级的动物志的主导的 taxa 之中没有元素。为存在没有可靠证明河马和 Giraffa，以及 Panthera 狮子座，在期间在中国第四级。二争论 taxa 是 Acinonyx 和 Crocuta，仍然关于有关他们在欧亚大陆的种类鉴定有争论。两个在非洲和欧亚大陆类有 co 特定的 taxa，是可能的。尽管二个类被限制到今天的非洲，他们确实在中国有长进化的历史。为为人的 Out of 非洲假设现代人，在中国和非洲之间的有限动物区系的交换的含意还不是完全清楚的。
基金supported by the Agricultural Science and Technology Innovation Program of CAAS and China Agriculture Research System (CARS-04) awarded to T.Han of CAAS and S.E.Ibrahim of Agricultural Research Corporation(ARC)Soybean Research Program,Wad Medani,Sudan
文摘Soybean(Glycine max(L.) Merr.) is a non-native and non-staple crop in sub-Saharan Africa(SSA) with potential to be a commercial crop owing to its wide range of uses as food, feed,and industrial raw material. Soybean was first introduced to SSA by Chinese traders in the19 th century and was cultivated as an economic crop as early as 1903 in South Africa. In the past four decades, soybean cultivation area and production in SSA has increased exponentially, from about 20,000 ha and 13,000 t in the early 1970 s to 1,500,000 ha and2,300,000 t in 2016. Soybean yield has been stagnant in SSA for decades at about 1.1 t ha^(-1),much lower than the world average, representing one of the most challenging issues in the soybean industry in SSA. The low soybean yield in SSA can be attributed to the use of poorperforming varieties and to the limited application of fertilizers and rhizobial inoculants in soils with no history of soybean production. South Africa, Nigeria, Zambia, and Uganda are the leading soybean producers in SSA. Soybean research in SSA is conducted by international and national research institutions, including IITA, national soybean improvement programs, universities, and the private sector. Between 1970 and 2011, 195 soybean varieties were released by IITA, private breeders, and national soybean improvement programs in SSA. This paper reviews the history and current state of soybean production and of the utilization and adoption of tropical varieties in SSA, addresses the major soybean yield-limiting factors across the region, and discusses the potential of the soybean industry in SSA. It also highlights soybean improvement efforts and lessons learned from previous soybean improvement efforts and the current progress of some national soybean improvement programs in SSA. Opportunities for scaling up tropical soybean as a major crop across SSA countries are promising.
文摘Background: Hypertensive patients with insulin resistance (IR) are at greater risk of cardiovascular disease and may represent a particular subset of hypertension (HTN) requiring special medical attention. Quantitative measurements of the IR are not suitable for routine clinical practice. Met-abolic syndrome (MetS) or simply abdominal obesity (AO) is surrogate of IR. The performance of the recently proposed Sub-Saharan Africa cut-off point of abdominal obesity for identifying IR in hypertensive patients has never been evaluated. Aims: The main objective was to compare the performance of the newly proposed Sub-Saharan Africa specific threshold of abdominal obesity (AO-SSA) to that of IDF (AO-IDF) in identifying IR in Congolese Black Hypertensive Patients. Methods: A cross-sectional study was conducted at the Heart of Africa Cardiovascular Center, Lomo Medical Clinic, Kinshasa Limete, DR Congo, between January 2007 and January 2010. Homeostatic model assessment (HOMA) index was calculated to determine IR. Multivariate logistic regression analysis was used to assess the independent determinants of IR. The intrinsic (sensitivity and specificity) and extrinsic (positive predictive value and negative predictive value) characteristics of the AO-SSA, AO-IDF, AO-ATP III, MetS-SSA, MetS-IDF, and MetS-ATP III were calculated. The kappa statistic was determined for agreement between the ATPIII, IDF and SSA defined AO and MetS with HOMA-IR. Results: Men represented the majority of the enrolled patients: 105 (64.4%) and the mean age of all participants were 57 ± 11 years. Insulin resistance was found in 79.1% of the study population with 88.7, 79.3, 84.6, 71.4, 75.5, 91.1, 60.3 and 44.8 respectively among patient with MetS-ATP, MetS-IDF, MetS-SSA, AO-ATP III, AO-IDF, AO-SSA, diabetics and non-obese non-diabetic hypertensive patients. In multivariate analysis, the risk of IR was associated independently and significantly (p < 0.05) with cigarette smoking, low-HDL-C, hyperuricemia, and diastolic HTN, as shown in the following equation: Y = ﹣1.404 + 1.054 Cigarette Smoking + 0.872 low HDL-C + 0.983 hyperuricemia + 0.852 diastolic hypertension. The AO-SSA, with 87.7% sensitivity and 67.6% specificity, was the only surrogate who showed an acceptable agreement with the HOMA-IR index. Abdominal obesity defined according to other thresholds and the metabolic syndrome whatever the used diagnostic criteria have a slight agreement with the HOMA-IR index. Conclusion: IR was found to be prevalent in our study population. Cigarette smoking, low-HDL-C, hyperuricemia, and isolated diastolic HTN magnify IR. The AO-SSA is an easy and cost efficient method to diagnose IR in Congolese Black Hypertensive Patients. Further study in wider group is indicated to validate our findings.
文摘There is a growing body of evidence showing a close correlation between left ventricular mass with cardiovascular morbidity and overall mortality. Therefore, identifying the determinants of left ventricular hypertrophy can be of great importance for cardiovascular prevention, for prognosis and therapeutic intervention. Objective: To assess the prevalence and identify the independent determinants of echocardiographic left ventricular hypertrophy in The MA-Ghreb and Sub-Saharan Africa Left-Ventricul ArGEometry Study (MAG-SALVAGES) participants. Methods: The MAG-SALVAGES is a community based study in which 100 asymptomatic Black Sub-Saharan African (BSSA) and 189 white skin Maghreb within the age of 18 to 55 years underwent a resting echocardiography. Multivariate logistic regression analysis was utilized to identify the independent determinants of LVH left ventricular hypertrophy. Results: Men represented the majority of the enrolled participants: 173 (59.9%). Echocardiographic left ventricular hypertrophy was seen in 10 (3.5%) participants. Age ≥40 years, female gender, overall obesity, abdominal obesity, hypertension status and less fruit consumption were significantly associated with echocardiography left ventricular hypertrophy. After adjusting for confounding factors, age ≥40 years, female gender, abdominal obesity and less fruit consumption were independently and significantly associated with echocardiographic left ventricular hypertrophy, as illustrated in the following equation: Y = 0.36 + 0.162 age >40 years + 2.69 female gender + 2.52 abdominal obesity + 1.31 less fruit consumption. Conclusion: Lifestyle changes for the prevention of abdominal obesity and encouraging fruit consumption may be beneficial in preventing left ventricular hypertrophy.
文摘Climate change adaptation strategies provide a cushion for smallholder farmers,especially in subSaharan Africa against the risks posed by climate hazards such as droughts and floods.However,the decision-making process in climate adaptation is complex.To better understand the dynamics of the process,we strive to answer this question:what are the potential trade-offs and synergies related to decision-making and implementation of climate adaptation strategies among smallholder farmers in sub-Saharan Africa region?A systematic literature review methodology was used through the Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA)statement with the four-stage inclusion/exclusion criteria to identify the literature from selected databases(Scopus and Google Scholar).The climate adaptation strategies are organized into five broad categories(crop management,risk management,soil/land management,water management,and livestock management strategies).Evidence suggests that potential trade-offs may arise concerning added costs,additional labor requirements,and competition among objectives or available resources.The synergies,on the other hand,arise from implementing two or more adaptation strategies concurrently in respect of increased productivity,resilience,yield stability,sustainability,and environmental protection.Trade-offs and synergies may also differ among the various adaptation strategies with minimum/zero tillage,comparatively,presenting more tradeoffs.The development and promotion of low-cost adaptation strategies and complementary climate adaptation options that minimize the trade-offs and maximize the synergies are suggested.Skills and knowledge on proper implementation of climate change adaptation strategies are encouraged,especially at the local farm level.
文摘Sub-Saharan Africa(SSA)has the highest maternal and under-five mortality rates in the world.The advent of the coronavirus disease 2019 exacerbated the region's problems by overwhelming the health systems and affecting access to healthcare through travel restrictions and rechanelling of resources towards the containment of the pandemic.The region failed to achieve the Millenium Development Goals on maternal and child mortalities,and is poised to fail to achieve the same goals in the Sustainable Development Goals.To improve on the maternal and child health outcomes,many SSA countries introduced digital technologies for educating pregnant and nurs-ing women,making doctors'appointments and sending reminders to mothers and expectant mothers,as well as capturing information about patients and their illnesses.However,the collected epidemiological data are not being utilised to inform patient care and improve on the quality,efficiency and access to maternal,neonatal and child health(MNCH)care.To the researchers'best knowledge,no review paper has been published that focuses on digital health for MNCH care in SSA and proposes data-driven approaches to the same.Therefore,this study sought to:(1)identify digital systems for MNCH in SSA;(2)identify the applicability and weaknesses of the dig-ital MNCH systems in SSA;and(3)propose a data-driven model for diverging emerging technologies into MNCH services in SSA to make better use of data to improve MNCH care coverage,efficiency and quality.The PRISMA methodology was used in this study.The study revealed that there are no data-driven models for monitoring pregnant women and under-five children in Sub-Saharan Africa,with the available digital health technologies mainly based on SMS and websites.Thus,the current digital health systems in SSA do not support real-time,ubiquitous,pervasive and data-driven healthcare.Their main applicability is in non-real-time pregnancy moni-toring,education and information dissemination.Unless new and more effective approaches are implemented,SSA might remain with the highest and unacceptable maternal and under-five mortality rates globally.The study proposes feasible emerging technologies that can be used to provide data-driven healthcare for MNCH in SSA,and the recommendations on how to make the transition successful as well as the lessons learn from other regions.
文摘Given that challenges on the issue of socioeconomic development faced by countries in sub-Saharan Africa(SSA)have been identified as critical to strengthening the inherent link between governance and socioeconomic conditions,this study examines the interconnections between governance and socioeconomic conditions in SSA.With a focus on 25 countries in SSA between 2005 and 2019,we conduct the analysis based on the Panel-Corrected Standard Error and System Generalized Method of Moments estimations and panel causality tests.The results show that SSA does not seem to have the means of effective governance to spur improved socioeconomic conditions.Moreover,the pervasiveness of institutional problems in many countries of SSA has been responsible for the poor socioeconomic conditions in the region.Likewise,governance quality and socioeconomic conditions are found to influence each other.An improvement in socioeconomic conditions could result in better governance quality.On the other hand,governance quality is viewed as a vital ingredient in achieving needed socioeconomic development outcomes.Thus,it is suggested that there is a need for countries in SSA to streamline governing systems toward engendering improved well-being.The introduction and implementation of transformative policies through effective governance are also necessary for ensuring critical structural changes and increasing social service provision.Overall,there should be a proactive identification of ineffective policies and procedures by policymakers to enhance meaningful impacts in the region.
文摘Rural electrification remains a great challenge for Sub-Saharan Africa (SSA) as access to electricity is a prerequisite to accelerate its development. The present paper reviews the measures adopted to promote access to electricity in rural and remote areas of SSA. The main barriers to rural electrification in these developing countries are presented before showing technologies used for the aforementioned purpose. Then, adopted methods for enhancing the use of renewable energy in SSA are shown. Moreover, the policy adopted by decision makers and project planners are also highlighted. In addition, the optimal solutions proposed by researchers are given such as the cost-effective off-grid system type that might be a viable alternative to diesel power generation.
文摘Introduction: Carotid web (CW), a rare and probably unknown arterial cause of ischemic stroke (IS), is commonly reported in young black patients, although most of the published cases resided in a non-African country. We describe the features of the first six Senegalese cases diagnosed at the Neurology Department of the Fann Teaching Hospital in Dakar. Patients and Method: It was a preliminary retrospective and prospective study conducted at the Neurology department of Fann teaching hospital (Dakar-Senegal). The symptomatic CW diagnosis was based on angioCT-scan of the neck arteries. The National Institute of Health Stroke Scale (NIHSS) and the modified-Rankin Scale (mRS) were used to assess the severity of the IS and the functional disability after the event, respectively. Results: CW was causing a left sylvian infarction in 4 patients. The mean age of the patients at the IS diagnosis was 41 ± 6 years with a sex ratio of 1. The mean time to diagnosis of CW was 13 months. Smoking (1/6), hypertension (1/6), and obesity (1/6) were the main vascular risk factors. The mean LDL cholesterol level was 1.52 g/L ± 0.49. The mean initial NIHSS was 15 ± 6 (8-22). Half of the patients had a severe infarction (NIHSS ≥ 15). For secondary prevention, half of the patients were treated with aspirin and the other half with acenocoumarol. After 18 months ± 17 of follow-up, the mean mRS score was 2 ± 1 (1-3). Conclusion: CW is an unknown cause of IS in young black patients. An early and appropriate multidisciplinary management could help to reduce the risk of recurrences.
文摘Intra-partum foetal death has been variously defined.However, a definition adopted at a technical consultation in 2006 is employed in this review. The quality of intrapartum care is a crucial factor for pregnancy outcome for both mothers and new-borns. Intra-partum stillbirth is defined as late foetal death during labour, which clinically presents as fresh stillbirth. The largest proportion of the world's stillbirths occurs in the late preterm, term and intra-partum periods. The Western Pacific region has the greatest reduction in stillbirth with a 3.8% annual decline between 1995 and 2009; however, the annual decline in the African region is less than 1%. Caesarean delivery is still uncommon, especially in rural areas: 1% of births in rural Sub-Saharan Africa and 5% in rural South Asia are by caesarean delivery; 62% of stillbirths occurred during the intra-partum period; 61.4% of stillbirths are attributable to obstetrical complications. Preventive measures aimed at reducing the incidence of intra-partum foetal death entail all measures aimed at improving quality antenatal care and preventing intrapartum asphyxia. This review discusses intra-partum foetal deaths from a Sub-Saharan African perspective. It explores the contribution of research within the region to identifying its impact on new-born health and potential cost-effective policy interventions.
文摘Background: This review identified papers that described periodontitis and rheumatoid arthritis in sub-Saharan Africa. Only English language publications from January 2010 to December 2017 describing original research in sub-Saharan Africa on the association between periodontitis and rheumatoid arthritis were considered for this study. Methods: Published databases: Pub-Med, Science direct and Google scholar, were searched using terms “periodontitis”, “rheumatoid arthritis” and “Sub-Saharan Africa” to generate a set of putative studies. Articles with data on both rheumatoid arthritis and periodontitis compared to controls were selected. Studies on the association of periodontitis with cardiovascular disease, arthritis or rheumatoid arthritis alone were excluded. Data were extracted, critically appraised, and analyzed using a random-effect Mantel-Haenszel meta-analysis on plaque index, gingival index, pocket depth and clinical attachment loss. Results: Three publications were selected for the systematic review and 2 for the meta-analysis. Two studies were from Sudan, and one was from Burina Faso. There was a significant increase in pocket depth (mean difference: 0.31;95% CI: 0.21, 0.41;N = 274;(p ≤ 0.001)) and clinical attachment loss (mean difference: 0.47;95% CI: 0.22, 0.75;N = 274;(p ≤ 0.001)) in participants with rheumatoid arthritis compared to normal controls. Conclusion: Findings from these combined studies show a significant relationship between periodontal disease and rheumatoid arthritis with increased periodontal pocket depth and clinical attachment loss. They also highlight the need for additional work especially in the area of associating rheumatoid arthritis with P. gingivalis, the oral microbiome and treating periodontal diseases to help in the management of rheumatoid arthritis.
文摘Goats are one of the oldest domesticated animal species widely distributed in the world playing an important role in the food production system in Sub-Saharan African Region (SSAR). Due to their multiple uses (milk production, meat, fiber and hides) and adaptation aptitudes to ecological conditions, goats produce and contribute positively to farmers’ socio-economy status in various production systems. This review aimed at giving a summary overview on the goat’s production systems characteristics, the genetic diversity and the candidate genes affecting reproductive and milk production performances in goat breeds in SSAR. It has been observed that traditional livestock production system with communal grazing system is the most used in goat keeping in SSAR. The geographical locations play an important role in the relationships between goat’s distributions in the region. At the same time, goats might have been differentiated and isolated one to others due to the wide geographic range, the diversify climate and the topography in the region. Among the six worldwide known haplogroups of goat (A, B, C, D, G and F), haplogroup A is the most representative in SSAR. However, haplogroup G and B can be found in some goat populations in some countries in east (Kenya and Ethiopia) and south parts of Africa. This review reveals that little is known on the candidate genes associated with prolificacy and milk production traits in indigenous goat breeds in the region. That observation suggests the importance of assessing candidate genes associated with economic traits in the populations of goat in SSAR.
