5 research outputs found
Trend of HIV-seropositivity among children in a tertiary health institution in the Niger Delta Region of Nigeria
The objective of the study was to investigate the recent trends and magnitude of pediatric HIV-infection in the Niger Delta of Nigeria. It is a descriptive study of 1,559 consecutively recruited children (0-16 years), in whom laboratory requests for HIV screening were made, and seen in the Pediatrics Department of the University of Port Harcourt Teaching Hospital between January 1999 to December 2004 were evaluated for HIV –infection. The overall prevalence obtained was 25.8%. HIV-1 constituted the predominant viral serotype (97.6%) compared to HIV-2 (2.4%). The peak HIV seropositivity occurred in pediatrics 6-8 years. There was no statistically significant difference in prevalence rate based on gender (OR = 1, p = 0.98). Children with clinical diagnosis of bronchopneumonia, neonatal sepsis, septicemia and pulmonary tuberculosis had higher prevalence of HIV seropositivity. There is a trend of increasing HIV prevalence from 1999 to 2004 (χ2 for trend= 6.23, p = 0.39). History of previous blood transfusion was not significantly associated with HIV positivity (OR = 0.94, p = 0.94). This study shows that, in spite of the anti HIV campaign, there is a high prevalence of HIV among children attending tertiary health institution in the Niger Delta of Nigeria and the trend is increasing over the last 5 years. This calls for a re-intensified effort on health education and risk control programme, provision of antiretroviral regimen to prevent mother-to-child transmission of HIV, provision of supportive environment for voluntary counseling and confidential testing of pregnant women coupled with the provision of pediatric antiretroviral therapy to reduce HIV-related mortality and morbidity of HIV-infected Nigerian children. African Journal of Health Sciences Vol. 13 (1-2) 2008: pp. 80-8
Estimating the burden of selected non-communicable diseases in Africa: a systematic review of the evidence
Background
The burden of non-communicable diseases (NCDs) is rapidly increasing globally, and
particularly in Africa, where the health focus, until recently, has been on infectious diseases. The
response to this growing burden of NCDs in Africa has been affected owing to a poor
understanding of the burden of NCDs, and the relative lack of data and low level of research on
NCDs in the continent. Recent estimates on the burden of NCDs in Africa have been mostly
derived from modelling based on data from other countries imputed into African countries, and
not usually based on data originating from Africa itself. In instances where few data were
available, estimates have been characterized by extrapolation and over-modelling of the scarce
data. It is therefore believed that underestimation of NCDs burden in many parts of Africa cannot
be unexpected. With a gradual increase in average life expectancy across Africa, the region now
experiencing the fastest rate of urbanization globally, and an increase adoption of unhealthy
lifestyles, the burden of NCDs is expected to rise. This thesis will, therefore, be focussing on
understanding the prevalence, and/or where there are available data, the incidence, of four major
NCDs in Africa, which have contributed highly to the burden of NCDs, not only in Africa, but
also globally.
Methods
I conducted a systematic search of the literature on three main databases (Medline, EMBASE and
Global Health) for epidemiological studies on NCDs conducted in Africa. I retained and
extracted data from original population-based (cohort or cross sectional), and/or health service
records (hospital or registry-based studies) on prevalence and/or incidence rates of four major
NCDs in Africa. These include: cardiovascular diseases (hypertension and stroke), diabetes,
major cancer types (cervical, breast, prostate, ovary, oesophagus, bladder, Kaposi, liver, stomach,
colorectal, lung and non-Hodgkin lymphoma), and chronic respiratory diseases (chronic
obstructive pulmonary disease (COPD) and asthma). From extracted crude prevalence and
incidence rates, a random effect meta-analysis was conducted and reported for each NCD. An
epidemiological model was applied on all extracted data points. The fitted curve explaining the
largest proportion of variance (best fit) from the model was further applied. The equation
generated from the fitted curve was used to determine the prevalence and cases of the specific
NCD in Africa at midpoints of the United Nations (UN) population 5-year age-group population
estimates for Africa.
Results
From the literature search, studies on hypertension had the highest publication output at 7680, 92
of which were selected, spreading across 31 African countries. Cancer had 9762 publications and
39 were selected across 20 countries; diabetes had 3701 publications and 48 were selected across
28 countries; stroke had 1227 publications and 19 were selected across 10 countries; asthma had
790 publications and 45 were selected across 24 countries; and COPD had the lowest output with
243 publications and 13 were selected across 8 countries. From studies reporting prevalence
rates, hypertension, with a total sample size of 197734, accounted for 130.2 million cases and a
prevalence of 25.9% (23.5, 34.0) in Africa in 2010. This is followed by asthma, with a sample
size of 187904, accounting for 58.2 million cases and a prevalence of 6.6% (2.4, 7.9); COPD,
with a sample size of 24747, accounting for 26.3 million cases and a prevalence of 13.4% (9.4,
22.1); diabetes, with a sample size of 102517, accounting for 24.5 million cases and a prevalence
of 4.0% (2.7, 6.4); and stroke, with a sample size of about 6.3 million, accounting for 1.94
million cases and a prevalence of 317.3 per 100000 population (314.0, 748.2). From studies
reporting incidence rates, stroke accounted for 496 thousand new cases in Africa in 2010, with a
prevalence of 81.3 per 100000 person years (13.2, 94.9). For the 12 cancer types reviewed, a total
of 775 thousand new cases were estimated in Africa in 2010 from registry-based data covering a
total population of about 33 million. Among women, cervical cancer and breast cancer had 129
thousand and 81 thousand new cases, with incidence rates of 28.2 (22.1, 34.3) and 17.7 (13.0,
22.4) per 100000 person years, respectively. Among men, prostate cancer and Kaposi sarcoma
closely follows with 75 thousand and 74 thousand new cases, with incidence rates of 14.5 (10.9,
18.0) and 14.3 (11.9, 16.7) per 100000 person years, respectively.
Conclusion
This study suggests the prevalence rates of the four major NCDs reviewed (cardiovascular
diseases (hypertension and stroke), diabetes, major cancer types, and chronic respiratory diseases
(COPD and asthma) in Africa are high relative to global estimates. Due to the lack of data on
many NCDs across the continent, there are still doubts on the true prevalence of these diseases
relative to the current African population. There is need for improvement in health information
system and overall data management, especially at country level in Africa. Governments of
African nations, international organizations, experts and other stakeholders need to invest more
on NCDs research, particularly mortality, risk factors, and health determinants to have
evidenced-based facts on the drivers of this epidemic in the continent, and prompt better,
effective and overall public health response to NCDs in Africa