27 research outputs found
Youth empowerment against poverty in Yobe State, Northern Nigeria
Global efforts to end poverty and unfair development should focus on the empowered youth as the cornerstone. In Nigeria, the youth form 60 percent of the population. The majority of them are unemployed and ultimately poor. Poverty reduction requires empowerment to overcome the barriers to a better life. This study examined the nature of youth empowerment and its impact on the well-being of the youth in Yobe State, Nigeria. It used a quantitative method and administered questionnaires to 393 randomly selected respondents. Data was collected on youth's attitudes, views and experiences on various aspects of their lives and well-being and the nature of empowerment programmes in Yobe State. The study findings show that many empowerment programmes have been implemented but have had low impact on the youth. Poverty and unemployment remain high, mainly among the youth. In addition, youth attitudes and experiences show a lack of satisfaction with the nature of youth empowerment. Disempowered youth lack the confidence and belief that they have the opportunities to develop themselves or escape poverty and such disempowerment compromises their citizenry roles as the youth. Therefore, there is a need to improve the infrastructure and strengthen empowerment programmes to improve the well-being of the youth
Ethnic Party Bans in East Africa from a Comparative Perspective
Since 1990 the banning of ethnic and other identity-based parties has become the norm in sub-Saharan Africa. This article focuses on Kenya, Tanzania and Uganda as three East African countries that have opted for different ways of dealing with such parties. Using case studies, it traces the origins of the party bans in Tanzania and Uganda and explores the reasons for the absence of a ban in Kenya. The analysis shows that the laws on particularistic parties have actually been implemented by the appropriate institutions. However, these laws have only marginally influenced the character of the political parties in the three countries: A comparison of regional voting patterns suggests that bans on particularistic parties have not ensured the emergence of aggregative parties with a national following in Tanzania and Uganda. In Kenya on the other hand, where such a ban was nonexistent until 2008, parties have not proven to be more regional.Das Verbot ethnischer und anderer identitätsbasierter politischer Parteien ist seit Beginn der 1990er Jahre im subsaharischen Afrika zur Norm geworden. Der vorliegende Aufsatz analysiert drei ostafrikanische Länder, die verschiedene Wege im Umgang mit partikularistischen Parteien eingeschlagen haben und untersucht, warum Tansania und Uganda ein Parteienverbot eingeführt haben, Kenia jedoch nicht. Die Untersuchung macht zudem deutlich, dass die zuständigen Institutionen die Gesetze zwar anwenden, dies jedoch nicht zu nationalen Parteien führt: Eine Analyse der Wahlergebnisse auf subnationaler Ebene zeigt, dass insbesondere Oppositionsparteien oft regionale Hochburgen aber keine landesweite Unterstützung haben. Politische Parteien in Kenia sind dabei trotz divergierender Parteiregulierung nicht deutlich weniger national als Parteien in Tansania und Uganda
COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study
Background:
The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms.
Methods:
International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms.
Results:
‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country.
Interpretation:
This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men
The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance
INTRODUCTION
Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic.
RATIONALE
We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs).
RESULTS
Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants.
CONCLUSION
Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century
Global Health on the Move -- Dissecting Health Interventions Through a Social Medicine Immersion Course
Applying a set of innovative pedagogical approaches to the study of social medicine, the course Beyond the Biologic Basis of Disease: The Social and Economic Causation of Illness aims to train medical students to critically understand the linkages between social and clinical medicine. Through class discussion, field visits, and films, the students and course faculty work to analyze a variety of global health interventions with an analytical framework that classifies interventions into models of charity, development, or social justice. Through description of course pedagogy and content, presentation of the framework used to analyze interventions, and incorporation of student reflection, this paper provides an example of rigorous social medicine education employing theory, discussion, and hands-on activities to train future practitioners. We argue that incorporating such training for global health practitioners is indispensable in the quest to maximize partnership and the promotion of equity in global health interventions.
Resumen: Por medio de la aplicación de una serie de enfoques pedagógicos innovadores al estudio de la medicina social, el curso “Más allá de la base biológica de la enfermedad: las causas sociales y económicas de la enfermedad” (Beyond the Biologic Basis of Disease: The Social and Economic Causation of Illness) está destinado a formar a estudiantes de medicina en la comprensión crítica de los vínculos entre la medicina social y la clínica.
A través de discusiones en clase, visitas de campo y de documentales los estudiantes y el profesorado trabajan para analizar una variedad de intervenciones en salud global dentro un marco analítico que clasifica a las intervenciones en modelos de beneficencia, de desarrollo o de justicia social. El presente artículo provee un ejemplo de educación rigurosa en medicina social que emplea teoría, discusión y actividades prácticas en la formación de futuros médicos. Además, presenta una descripción de la pedagogía y del contenido del curso, así como del marco utilizado en el análisis de las intervenciones y la incorporación de la reflección de los estudiantes. Sostenemos que este tipo de entrenamiento en la formación de trabajadores de la salud es indispensable en la búsqueda de la maximización de la colaboración y en la promoción de equidad en las intervenciones de salud global
Anti-Ebola therapy for patients with Ebola virus disease: a systematic review
Background:
Management of Ebola virus disease (EVD) has historically focused on infection prevention, case detection and supportive care. Several specific anti-Ebola therapies have been investigated, including during the 2014–2016 West African outbreak. Our objective was to conduct a systematic review of the effect of anti-Ebola virus therapies on clinical outcomes to guide their potential use and future evaluation.
Methods:
We searched PubMed, EMBASE, Global Health, Cochrane Library, African Index Medicus, WHOLIS (inception-9 April 2018), and trial registries for observational studies or clinical trials, in any language, that enrolled patients with confirmed EVD who received therapy targeting Ebola virus and reported on mortality, symptom duration, or adverse effects.
Results:
From 11,257 citations and registered trials, we reviewed 55 full-text citations, of which 35 met eligibility criteria (1 randomized clinical trial (RCT), 8 non-randomized comparative studies, 9 case series and 17 case reports) and collectively examined 21 anti-Ebola virus agents. The 31 studies performed during the West African outbreak reported on 4.8% (1377/28616) of all patients with Ebola. The only RCT enrolled 72 patients (0.25% of all patients with Ebola) and compared the monoclonal antibody ZMapp vs. standard care (mortality, 22% vs. 37%; 95% confidence interval for risk difference, − 36 to 7%). Studies of convalescent plasma, interferon-β-1a, favipiravir, brincidofovir, artesunate-amodiaquine and TKM-130803 were associated with at least moderate risk of bias.
Conclusions:
Research evaluating anti-Ebola virus agents has reached very few patients with EVD, and inferences are limited by non-randomized study designs. ZMapp has the most promising treatment signal.Medicine, Faculty ofNon UBCInfectious Diseases, Division ofMedicine, Department ofPediatrics, Department ofReviewedFacult
Establishing Healthcare Worker Performance and Safety in Providing Critical Care for Patients in a Simulated Ebola Treatment Unit: Non-Randomized Pilot Study
Improving the provision of supportive care for patients with Ebola is an important quality improvement initiative. We designed a simulated Ebola Treatment Unit (ETU) to assess performance and safety of healthcare workers (HCWs) performing tasks wearing personal protective equipment (PPE) in hot (35 °C, 60% relative humidity) or thermo-neutral (20 °C, 20% relative humidity) conditions. In this pilot phase to determine the feasibility of study procedures, HCWs in PPE were non-randomly allocated to hot or thermo-neutral conditions to perform peripheral intravenous (PIV) and midline catheter (MLC) insertion and endotracheal intubation (ETI) on mannequins. Eighteen HCWs (13 physicians, 4 nurses, 1 nurse practitioner; 2 with prior ETU experience; 10 in hot conditions) spent 69 (10) (mean (SD)) minutes in the simulated ETU. Mean (SD) task completion times were 16 (6) min for PIV insertion; 33 (5) min for MLC insertion; and 16 (8) min for ETI. Satisfactory task completion was numerically higher for physicians vs. nurses. Participants’ blood pressure was similar, but heart rate was higher (p = 0.0005) post-simulation vs. baseline. Participants had a median (range) of 2.0 (0.0–10.0) minor PPE breaches, 2.0 (0.0–6.0) near-miss incidents, and 2.0 (0.0–6.0) health symptoms and concerns. There were eight health-assessment triggers in five participants, of whom four were in hot conditions. We terminated the simulation of two participants in hot conditions due to thermal discomfort. In summary, study tasks were suitable for physician participants, but they require redesign to match nurses’ expertise for the subsequent randomized phase of the study. One-quarter of participants had a health-assessment trigger. This research model may be useful in future training and research regarding clinical care for patients with highly infectious pathogens in austere settings.Medicine, Faculty ofNon UBCInfectious Diseases, Division ofMedicine, Department ofPediatrics, Department ofReviewedFacultyResearcherOthe