Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “AFRICA”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources
PubMed1989

Cancer pain control in Africa (state of the art).

There may be quantitatively more cancer in the developing world, Africa included, than in the developed world. Unlike in the developed world, cancer patients in Africa present for treatment at a late stage and therefore most of them have pain. Yet, the most commonly used modality for treatment of the cancer pain is drugs. Based on the economics of most countries in Africa, their Health Budgets can afford mostly the non-opioid and strong opioid drugs in more or less adequate quantities. Chemotherapy for cancer is very expensive and remains restricted to treating curable cancers. Radiotherapy is new to Africa and available in only very few Centres. There is urgent need to improve on the facilities available in Africa if cancer pain is to be treated more adequately than at present.

Africa↗
PubMed1988

Health and health care in post-apartheid South Africa: a future vision.

This paper accepts the idea that patterns and distribution of health care and resources are determined by "realpolitik," and that South Africa is at present in the throes of a political revolution, the outcome of which is bound to reflect a considerable degree of "self-determination" of the majority black (African, Asian, and mixed-race) people. It is postulated that the health services-and other pre-determinants of the health of the black people-will be shaped by a mixed socialist-capitalist economy and a socialized or nationalized form of health care service. This is because all the leading players in the revolutionary stakes, especially the exiled African National Congress of South Africa (ANC) and the above-ground United Democratic Front (UDF) and its affiliate, the National Alternative Medical and Dental Association (NAMDA), who are the front-runners, advocate these kind of changes for the future of South Africa, as exemplified in the ANC's Freedom Charter of 1955.Powerful political forces, both inside South Africa and in the Western World, are resisting this outcome, despite it clearly being the democratic will of the people, as shown by all the polls. These reactionary strategies would leave the health of most blacks in South Africa and Namibia little improved over its present status.

Delivery of Health Care↗
PubMed1987

AIDS in subsaharan Africa.

AIDS has existed in subsaharan Africa at least since 1980. However, the genesis of this condition and its emergence as a health problem remain obscured by lack of data and by antibody data that are now questionable. In Africa, as elsewhere, AIDS is associated with an immunodeficiency associated with the LAV/HTLV-III retrovirus. The clinical manifestations vary somewhat because of the different range of opportunistic pathogens in that environment. Although the "classical," more indolent, endemic form of African Kaposi sarcoma is not associated with this virus or with immunodeficiency, a new, aggressive variety of Kaposi sarcoma in Africa appears to be. The origin of LAV/HTLV-III remains unclear, but the clinical syndrome of AIDS has emerged in Africa only in the past decade. A pattern of geographic spread can be recognized, in which AIDS was seen earliest in Kinshasa, Zaïre, and then emerged in Zambia, Rwanda, and Uganda. Recently, reports indicate spread into Tanzania and Kenya. Transmission appears to be primarily heterosexual, but the factors enhancing heterosexual spread in Africa to a greater extent than in the U.S. and Europe need to be further studied.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Lessons learned from applied field research activities in Africa during the malaria eradication era.

The Malaria Conference in Equatorial Africa, convened by the World Health Organization in 1950 in Kampala, Uganda, was a milestone in the history of modern malaria control activities on the continent of Africa. It presented and assessed the available international information on epidemiological aspects of this disease and attempted to coordinate the various methods of research and control of malaria. Its two main recommendations were that malaria should be controlled by all available methods, irrespective of the degree of endemicity of the disease, and that the benefits that malaria control might bring to the indigenous population should be evaluated.The first period of field research and pilot control projects in Africa was between 1950 and 1964. A large number of studies in several African countries showed that the use of residual insecticides such as DDT and HCH might decrease, at times considerably, the amount of malaria transmission, but interruption of transmission could not be achieved, except in two relatively small projects in the forest areas of Cameroon and Liberia. During the second period, from 1965 to 1974, the difficulties of malaria eradication and control in Africa became more evident because of the development of resistance of Anopheles gambiae to DDT, HCH, and dieldrin; moreover administrative, logistic, and financial problems had emerged. It became clear that the prospects for malaria control (let alone those for eradication) were related to the availability of a network of basic health services. A number of "pre-eradication" programmes were set up in order to develop better methods of malaria control and to improve the rural health infrastructures. Much field research on the chemotherapy of malaria was carried out and the value of collective or selective administration of antimalarial drugs was fully recognized, although it became obvious that this could not play an important part in the decrease of transmission of malaria in Africa.The role of research as one of the ways of solving the technical problems of malaria control in tropical Africa was stressed from the early days of the global malaria eradication programme; the past ten years have seen an immense expansion of this activity.

Africa↗
PubMed1983

Absence of 'true' minimal change nephrotic syndrome in African children in South Africa.

Minimal change nephrotic syndrome (MCNS) which is a well defined clinical, histopathological and therapeutic entity accounts for the majority of childhood nephrosis throughout the world except Africa. We describe 15 (13%) of 115 biopsy-confirmed African children with nephrotic syndrome who had minimal change on light microscopy. These are compared to 42 biopsied Indian children with typical MCNS. The critical differences between African children and children with classical MCNS were the lack of a predictable response in eight of the former to steroids and cyclophosphamide and in a later peak age of presentation (7-8 years). These patients differed in most respects from minimal change seen in the malarial zones of North Africa except for clinical presentation. Minimal change in West and East Africa more closely approximates typical MCNS. Two of the African patients with minimal change had endemic syphilis and responded clinically to penicillin therapy. The clinical presentation in all the African children, the favourable short-term outcome in 12 of these patients, immunofluorescent (13 patients) and electron microscopic (three patients) findings, and selectivity of proteinuria (eight patients) paralleled that of classical MCNS. The implications of this study are that African children in South Africa with MCNS should not be treated with steroids or cyclophosphamide. There is no clear benefit in the use of these drugs in nephrotic children with obvious glomerular lesions and therefore it follows that such therapy should be avoided in all African children in South Africa with this disease.

Black or African American↗
PubMed1993

Rabies in southern Africa.

The first confirmed outbreak of rabies in Africa, believed to have followed the importation of an infected dog from England in 1892, occurred in the eastern Cape Province of South Africa, and was brought under control in 1894. An unconfirmed epidemic of rabies in dogs occurred in western Zambia in 1901. By the following year the disease had apparently spread along a major trade route, to cause an outbreak in Zimbabwe which engulfed most of the country before being eradicated in 1913. The existence of endemic rabies of viverrids (mongooses and genets) was confirmed in South Africa in 1928, and since then the viverrid disease has continued to occur widely on the interior plateau of the country with spill-over of infection to cattle and a variety of other animals. From about 1947 onwards, an invasive form of dog rabies spread from southern Zambia and/or Angola into Namibia, across northern and eastern Botswana into Zimbabwe and the northern Transvaal by 1950, entered Mozambique in 1952, and spread from there to Swaziland in 1954. Dog rabies extended from southern Mozambique into Natal in 1961 to cause a major epidemic which was brought under control in 1968. The disease re-entered northern Natal from Mozambique in 1976 and since then dog rabies has proved difficult to control in the peri-urban settlements of Natal-KwaZulu. The disease spread from Natal to Lesotho in 1982, and into the Transkei region of the eastern Cape Province in 1987, to reach the Ciskei by 1990. The spread of the disease in dogs was followed by the emergence of rabies of jackals and cattle in central Namibia, northern Botswana, Zimbabwe and the northern Transvaal. A unique outbreak of rabies in kudu antelope occurred in central Namibia from 1977 to 1985, apparently involving oral spread of infection between individuals. A few cases of rabies in the bat-eared fox were recognized each year in Namibia from 1967 onwards, and from the 1970s the occurrence of the disease in the fox has emerged as a distinct problem in the northern Cape Province and spread to the west coast. The rabies-related viruses, Lagos bat, Mokola and Duvenhage, associated with bats, shrews and rodents in Africa, are known to have caused isolated cases of disease in South Africa, and on one occasion a small outbreak involving six cats and a dog in Bulawayo, Zimbabwe.(ABSTRACT TRUNCATED AT 400 WORDS)

Africa, Southern↗
PubMed1993

Optometric education and optometry in Africa.

BACKGROUND: For the vast majority of people in Africa, eye care services are not available. Optometrists have long been practicing in parts of Africa, but optometric teaching institutes have only recently appeared in several African nations. METHODS: Utilizing interviews, site visits, and a literature review this article presents a survey of the current status of optometric education, the profession of optometry, and eye care needs in Africa. RESULTS AND CONCLUSIONS: Four countries in Africa have optometric teaching institutes: South Africa, Nigeria, Tanzania, and Ghana. Most of these programs are struggling in difficult economic and/or political environments. The difficulties facing these programs are likely to remain, but the recent dramatic developments in communication and cooperation between these four countries will be a positive force towards seriously addressing the need for more optometric practitioners throughout the African continent.

Africa↗
PubMed1993

[Comparison between nursing in child psychiatry in South Africa and in San Francisco].

The provision of services to children with psychiatric disorders in the Republic of South Africa--especially black and underprivileged children--is limited and inadequate. The practice of the nurse in the field of child psychiatry is vague and undeveloped and there are few nurses in South Africa with the knowledge and skills to set guidelines for this area of practice. A qualitative field study was undertaken in South Africa and San Francisco to analyze, describe and compare the situation in regard to contemporary nursing practice in child psychiatry. The result showed that nurses in San Francisco were academically better qualified than their colleagues in South Africa, while many similarities regarding therapeutic skills were found. Problems in South Africa included rigid systems, insufficient recognition, poor job descriptions and inadequate supervision. Large numbers of nurses who are specialized in child psychiatry have left the health services as a result of frustration and problems encountered in practice. These problems must be addressed in order to retain nurses recruited to this field of practice.

Child↗
PubMed1996

[Hydatidosis in Africa in 1996: epidemiological aspects].

Hydatidosis is hyperendemic in most north African countries and in several areas of East Africa. The cycle of infestation involves dogs, ruminants and man. While sheep and goats appear to be the most common domestic intermediate, camels appear to act as the intermediate in some parts of North and East Africa. Hydatidosis is considered to be essentially rural but urban cycles have been reported in North Africa. During the last decade, echotomographic, and serologic screening for human hydatidosis were carried out in Tunisia and in nomadic populations from East Africa. These surveys have provided reliable accurate prevalence data showing that hydatidosis is a major public health problem in these areas. The highest worldwide incidence in man is in the Turkana district of Kenya. This high incidence is related to promiscuity between humans and dogs in Turkana. A pilot program to control hydatid disease was started in Turkana over 10 years ago. For unknown reasons human infestation is rare in West and Southern Africa despite the presence of hydatidosis in cattle.

Africa↗
PubMed1996

Lyme disease in South Africa.

OBJECTIVE: This article presents an overview of Lyme disease (LD) as it applies to neuropsychiatry and summarises research results on the epidemiology of LD in South Africa. METHOD: The study is based on a review of research papers from various medical disciplines that focused on the epidemiology of LD in South Africa. RESULTS: Assessment of the incidence of LD in South Africa is based on a few anecdotal studies. The results of the studies are dominated by experimental weeknesses. CONCLUSIONS: The sporadic nature of LD Incidence in South Africa may either reflect a restriction of research efforts or be a true indication of the epidemiology of the disease. This review lends support to the former hypothesis. The low reported incidence of LD in South Africa is probably due to a lack of awareness and research effort.

Humans↗
PubMed1997

Current status of food-borne parasitic zoonoses in South Africa and Namibia.

Epidemiological data on food-borne parasitic zoonoses in countries of southern Africa are sporadic. In a study of toxoplasmosis in South Africa, there was an overall prevalence of 21% (2, 147/10,228). Prevalences vary between the different cultural groups and from one geographical region to another. The prevalence rate for the San (Bushmen) people of Namibia and Botswana was 9% (65/725) compared to the 30% (190/635) found in the Indian and Black communities of Kwazulu-Natal province, South Africa. These variations are probably linked to the dietary habits of the different cultural communities. Cysticercosis appears to be most prevalent in the Eastern Cape Province (former Transkei), where pigs roam freely and sanitation facilities are inadequate or non-existent. Segments of tapeworms often feature as an ingredient of concoctions prepared by traditional healers and are suspected sources of many of the cases of cysticercosis in South Africa. Trichinella nelsoni has been identified in wild game in South Africa: so far no cases of infection in humans have been recorded. Cases of Sarcocystis have been identified in some instances but infection is probably underdiagnosed in the country.

Animals↗
PubMed1971

Cancer of the oesophagus in Africa. A summary and evaluation of the evidence for the frequency of occurrence, and a preliminary indication of the possible association with the consumption of alcoholic drinks made from maize.

The oesophagus is the most common site of tumour development in men in parts of eastern and southern Africa. In West Africa cancer of the oesophagus is practically unknown. In the areas where it is common, the frequency is not uniformly high but shows sharp gradients within short distances. Most of the present high frequencies seem to have developed from a negligible incidence 30 or forty years ago. In all areas the disease is more common in men than women but the sex ratio varies from less than 2: 1 to 12: 1. Alcohol has been shown to be implicated in the development of cancer of the oesophagus elsewhere in the world. Home-made beer and spirit are common in many parts of Africa but there is no geographical association between frequency of consumption and the occurrence of oesophageal cancer. Evidence exists which suggests that both the geographical and temporal distributions in Africa could reflect the use of maize as a major ingredient of alcoholic drinks.

Africa, Eastern↗
PubMed2000

Inequality of child mortality among ethnic groups in sub-Saharan Africa.

Accounts by journalists of wars in several countries of sub-Saharan Africa in the 1990s have raised concern that ethnic cleavages and overlapping religious and racial affiliations may widen the inequalities in health and survival among ethnic groups throughout the region, particularly among children. Paradoxically, there has been no systematic examination of ethnic inequality in child survival chances across countries in the region. This paper uses survey data collected in the 1990s in 11 countries (Central African Republic, Côte d'Ivoire, Ghana, Kenya, Mali, Namibia, Niger, Rwanda, Senegal, Uganda, and Zambia) to examine whether ethnic inequality in child mortality has been present and spreading in sub-Saharan Africa since the 1980s. The focus was on one or two groups in each country which may have experienced distinct child health and survival chances, compared to the rest of the national population, as a result of their geographical location. The factors examined to explain potential child survival inequalities among ethnic groups included residence in the largest city, household economic conditions, educational attainment and nutritional status of the mothers, use of modern maternal and child health services including immunization, and patterns of fertility and migration. The results show remarkable consistency. In all 11 countries there were significant differentials between ethnic groups in the odds of dying during infancy or before the age of 5 years. Multivariate analysis shows that ethnic child mortality differences are closely linked with economic inequality in many countries, and perhaps with differential use of child health services in countries of the Sahel region. Strong and consistent results in this study support placing the notion of ethnicity at the forefront of theories and analyses of child mortality in Africa which incorporate social, and not purely epidemiological, considerations. Moreover, the typical advantage of relatively small, clearly defined ethnic groups, as compared to the majority in the national population, according to fundamental indicators of wellbeing--child survival, education, housing, and so forth--suggests that many countries in sub-Saharan Africa, despite their widespread poverty, are as marked by social inequality as are countries in other regions in the world.

Africa South of the Sahara↗
PubMed1998

Fertility levels, trends, and differentials in sub-Saharan Africa in the 1980s and 1990s.

This study presents an assessment of fertility trends in 23 countries of sub-Saharan Africa. It examines trends and differentials in proximate determinants and fertility preferences. Findings from the Demographic and Health Surveys for these countries over a period of 15 years show that desired family size has decreased significantly. Two-thirds of the countries examined show evidence of fertility decline, a particularly rapid decline in the cases of Kenya and Zimbabwe. Areas with higher education for women and lower child mortality experienced larger reductions in fertility and desired family size. Contraceptive use far exceeds other proximate determinants in explaining these changes. The striking regularity in fertility reduction across all ages indicates that contraception is practiced mostly for birth spacing and that contraceptive methods have gained wide acceptance among younger cohorts. Good prospects are seen for further intensification of fertility declines in East Africa and urban West Africa. However, low levels of education and high child mortality make rapid changes unlikely in rural West Africa.

Adolescent↗
PubMed1998

Impact of the HIV epidemic on mortality in sub-Saharan Africa: evidence from national surveys and censuses.

OBJECTIVE: To measure recent trends in all-cause child and adult mortality in national populations in sub-Saharan Africa. DESIGN: Secondary analysis of data collected in national household surveys and censuses. METHODS: The index of infant and child mortality is the probability of dying before age 5 years (under-five mortality). For adult mortality, it is the probability of dying between ages 15 and 60 years. Mortality trends are assessed in three ways: (i) by comparison of data collected in the 1990s with those from the 1980s; (ii) using the retrospective reports of the survival of women's children and siblings collected by Demographic and Health Survey inquiries; and (iii) by comparing the latter estimates with estimates from data on orphanhood. RESULTS: Under-five mortality is stagnant or rising in several African countries. In some countries, however, adverse trends developed too early in the 1980s to be attributable to HIV. In most countries, the three approaches to monitoring adult mortality yield consistent results. Adult death rates doubled or tripled between the 1980s and mid-1990s in Uganda, Zambia, and Zimbabwe. Mortality also rose substantially elsewhere in East and Central Africa but not in West Africa. Increases in mortality are concentrated among young adults. In general, men are worst affected, but in Uganda the rise in women's mortality is greater. CONCLUSIONS: Data can be collected in national household surveys and censuses to monitor the mortality impact of HIV in Africa. Such data have begun to document the differential impact of the epidemic. In those countries with data in which HIV became prevalent by the late 1980s, massive rises in adult mortality occurred by the mid-1990s.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Molecular epidemiology of the RNA satellite of Rice yellow mottle virus in Africa.

Satellite RNA was sought in 51 isolates of Rice yellow mottle virus (RYMV) representative of the geographical, molecular and pathogenic variability of the virus in Africa. Three-quarters of the isolates from cultivated rice and wild gramineaceous hosts supported a satellite RNA. The prevalence of RYMV isolates that were associated with a satellite differed among regions, being c. 100% in West and Central Africa and c. 36% in East Africa. The RYMV satellite showed a low diversity as only seven of the 220 sequenced positions were variable. One insertion also occurred after serial host passages of the satellite. Two forms of the satellite differed by six substitutions forming three base pairs in one branch of the predicted RNA secondary structure. There was no evidence of intermediates between these two forms, but double-infection occurred. Each form had a specific geographical distribution: one occurred in Central Africa, the other elsewhere in Africa. There was no relation between the occurrence or the forms of the satellite and the phylogeny of the helper virus. The satellite was not involved in symptom modulation or ability to break host-plant resistances to the disease.

Nucleic Acid Conformation↗
PubMed1992

Public expenditures and health care in Africa.

Unfavorable economic conditions in most of Africa (in this paper Africa refers to Sub-Saharan Africa only) have meant public austerity and a deceleration in government health spending. Given the dominant role of government in providing health services in Africa there is a need to investigate the links between public spending and the provision of health care. Analyzing information from five Sub-Saharan African countries, namely Botswana, Burkina Faso, Cameroon, Ethiopia and Senegal, we investigate the impacts of shifting expenditure patterns and levels on the process of providing health services as well as on delivery of health care. The country analyses indicate that in addition to the level of public spending, the expenditure mix (i.e. salaries, drugs, supplies etc.), the composition of the health infrastructure (hospitals, clinics, health posts etc.), community efforts, and the availability of private health care all influence health care delivery. Consequently, per capita public expenditure (the most important indicator in a number of related studies) alone as a measure of the availability of health care and especially for cross-country comparisons is inadequate. Reductions in government resources for health care often result in less efficient mixing of resources and hence less health care delivery, in quality and quantity terms. With the recent trends in health care spending in Africa there should be greater effort to increase the efficient use of these increasingly scarce resources, yet the trend in resource mix has been in the opposite direction. Given the input to public health care of local communities, as well as the provision of private health care, it would seem that government spending on health care should be counter-cyclical, i.e. government health spending should accelerate during periods of economic down turns. Such counter-cyclical spending would tend to offset the difficulties facing local communities and the declining ability of individuals to pay for private health care. Recommending counter-cyclical health spending may seem wishful, but it points up the necessity of understanding what is likely to happen to health care in African countries in the face of economic difficulties, and particularly in the face of fiscal austerity.

Botswana↗
PubMed2001

A seroprevalence study of human herpesvirus type 8 (HHV8) in eastern and Central Africa and in the Mediterranean area.

Human herpes virus type 8 (HHV8) is the major determinant of Kaposi's sarcoma (KS), a neoplasm with wide geographic variations in incidence rates. To assess the prevalence of HHV8 infection among populations with differing rates of KS, we used sera from 1,402 persons (Central Africa: Cameroon, n = 293, age range: 5-40; eastern Africa: Uganda, n = 315, age range: 1-64: Mediterranean area: Egypt, n = 236, age range: 13-19: Italy, blood donors n = 134, age range: 20-67: Italy. HIV seroconverters n = 424, age range: 16-65). Serum samples were tested for antibodies to lytic and latent antigens of HHV8 using two immunofluorescence assays. HHV8 prevalence was evaluated according to geographic area, gender and age groups. Overall, the highest prevalence of HHV8 lytic antigens (47.5%) was recorded among children and adults in Africa. Approximately 40% of children and adolescents from Egypt and of Italian HIV-positive persons (39.9%) were HHV8 seropositive. In eastern and Central Africa and in Egypt, no differences emerged between males and females for both types of HHV8 antibodies. Conversely, Italian females were at lower HHV8 risk than their male counterparts. Moreover the prevalence of HHV8 infection tended to increase with age. This investigation partially confirms that HHV8 infection mirrors incidence rates of KS. The high prevalence of HHV8 infection in newborns, children and adolescents in Egypt, in eastern and in Central Africa strongly suggests the existence of transmission modes other than sexual.

Adolescent↗