Uncontrolled hypertension among patients with comorbidities in sub-Saharan Africa : protocol for a systematic review and meta-analysis

Background Uncontrolled hypertension is the most important risk factor and leading cause of cardiovascular diseases. It is predicted that the number of people with hypertension will increase, and a large proportion of this increase will occur in developing countries. The highest prevalence of uncontrolled hypertension is reported in sub-Saharan Africa, and treatment for hypertension is unacceptably low. Hypertension commonly co-exists with comorbidities and this is associated with poorer health outcomes for patients. This review aims to estimate the prevalence of uncontrolled hypertension among patients with comorbidities in sub-Saharan Africa. Methods and analysis All published and unpublished studies on the prevalence of uncontrolled hypertension among patients with comorbidities in sub-Saharan Africa will be included. MEDLINE via OVID, Embase, and Web of Science will be searched to identify all relevant articles published from January 2000 to June 2019. Experts in the field will be contacted for unpublished literature, and Open SIGLE will be reviewed for relevant information. No language restriction will be imposed. Two reviewers will select, screen, extract data, and assess the risk of bias while a third reviewer will arbitrate the disagreements. A meta-analysis will be performed on variables that are similar across the included studies. Proportions will be stabilized before estimates are pooled using a random effects model. The presence of publication bias will be assessed using Egger’s test and visual inspection of the funnel plots. This systematic and meta-analysis review protocol will be reported in accordance with the PRISMA-P protocol guidelines. Results will be stratified by country, comorbidity, and geographic region

Effects of salinity stress (NaCl) on growth attributes and some nutrient accumulation in cowpea (Vigna unguiculata)

This study investigates the impact of salinity (NaCl) on growth and ions accumulation in the leaves of three cowpea genotypes: OU100 and KEB-CP118 from Cameroon and ICV12 from Kenya. Four levels of salinity were used (0mM, 50mM, 100mM and 150mM) and the experiment was carried out in the greenhouse. Growth parameters were measured on 8 weeks old plants. Leaf ions concentrations (Na+, K+, K+/Na+) were determined.  It was observed that increasing salinity induced significant increase in Na+ and substantial reduction in the accumulation of K+ in the leave of all genotypes. Pearson’s correlation analysis revealed significant association among most of the growth parameters. Water content in shoots was not affected by salinity for all genotypes; however salinity induced a reduction of water content in the root for ICV12 and OU100 genotypes. Generally, results highlighted that high salt concentrations significantly delayed the growth process. The delay was more pronounced for OU100 genotype. Therefore, genotype effect toward salinity tolerance was noticed. KEB-CP118 was the most tolerant genotype as salinity did not affect negatively growth parameters. Its remarkable behavior under salinity indicates it should be explored in selection programs, used in development of tolerant varieties and promoted for cultivation in tropical zones affected by salinity

The causes, treatment, and outcome of acute heart failure in 1006 Africans From 9 countries

Background: Acute heart failure (AHF) in sub-Saharan Africa has not been well characterized. Therefore,wesought to describe the characteristics, treatment, and outcomes of patients admitted with AHF in sub-Saharan Africa. Methods: The Sub-Saharan Africa Survey of Heart Failure (THESUS–HF) was a prospective, multicenter, observational survey of patients with AHF admitted to 12 university hospitals in 9 countries. Among patients presenting with AHF, we determined the causes, treatment, and outcomes during 6 months of follow-up. Results: From July 1, 2007, to June 30, 2010, we enrolled 1006 patients presenting with AHF. Mean (SD) age was 52.3 (18.3) years, 511 (50.8%) were women, and the predominant race was black African (984 of 999 [98.5%]). Mean (SD) left ventricular ejection fraction was 39.5% (16.5%)... Conclusions: In African patients, AHF has a predominantly nonischemic cause, most commonly hypertension. The condition occurs in middle-aged adults, equally in men and women, and is associated with high mortality. The outcome is similar to that observed in non- African AHF registries, suggesting that AHF has a dire prognosis globally, regardless of the cause

La place du traitement peu ou non invasif dans la prise en charge de la grossesse extra-utérine à l’hôpital gynéco-obstétrique et pédiatrique de Yaoundé: une analyse rétrospective sur cinq ans

La grossesse extra-utérine (GEU) est la plus fréquente des urgences chirurgicales gynécologiques. Bien que l’abstention thérapeutique, le traitement médical et la coelioscopie soient de plus en plus pratiqués dans notre pays, la prise en charge chirurgicale par laparotomie reste la modalité thérapeutique la plus fréquemment utilisée. L’objectif de notre travail était de déterminer la place des traitements peu ou non invasifs dans la prise en charge de la grossesse extra-utérine à l’Hôpital Gynéco- Obstétrique et Pédiatrique de Yaoundé. Il s’agissait d’une étude rétrospective descriptive ayant eu lieu au Service de Gynécologie & Obstétrique de l’Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé. Toutes les patientes ayant été reçues avec un diagnostic de GEU du 1er Janvier 2004 au 31 Décembre 2008 ont été incluses. Au total 281 dossiers respectaient nos critères d’inclusion et ont pu être analysés. 59 patientes (21,0% des cas) ont bénéficié avec succès d’un traitement peu ou non invasif. Parmi elles, 37 patientes (62,71% des cas) ont bénéficié avec succès du traitement médical. La coelioscopie a été la voie d’abord utilisée chez 19 patientes opérées (32,20% des cas). L’abstention thérapeutique avec contrôle clinique, échographique et biologique a été adoptée avec succès chez 3 patientes (5,09% des cas). Le traitement chirurgical par laparotomie a concerné la plupart des cas diagnostiqués (79,00% des cas, soit 222 patientes). Le traitement peu ou non invasif de la GEU est une réalité dans notre environnement. Le traitement médical est la modalité non invasive la plus utilisée, suivie de la coelioscopie et enfin de l’abstention thérapeutique.MOTS CLES: Grossesse extra-utérine – Traitement conservateur – Traitement médical – Abstention thérapeutique – Coelioscopie

SIGMOISIDE E: A NEW ANTIBACTERIAL TRITERPENOID SAPONIN FROM ERYTHRINA SIGMOIDEA (HUA)

Chemical analysis of the stem bark of Erythrina sigmoidea (Leguminoseae) yielded two known isoflavones, 6,8-diprenylgenisteine (3) and warangalone (4) as well as a new triterpenoid saponin designated sigmoiside E (1). Its structure was established by chemical and spectroscopic means as 16-O-β-D-galactopyranosyl maniladiol (1). Sigmoiside E exhibited antibacterial activity against gram-negative bacteria. KEY WORDS: Erythrina sigmoidea, Stem bark, Triterpenoid, Saponin, Isoflavone, Leguminoseae Bull. Chem. Soc. Ethiop. 2007, 21(3), 373-378

How to assess and prepare health systems in low- and middle-income countries for integration of services: a systematic review

Despite growing support for integration of frontline services, a lack of information about the pre-conditions necessary to integrate such services hampers the ability of policy makers and implementers to assess how feasible or worthwhile integration may be, especially in low- and middle-income countries (LMICs). We adopted a modified systematic review with aspects of realist review, including quantitative and qualitative studies that incorporated assessment of health system preparedness for and capacity to implement integrated services. We searched Medline via Ovid, Web of Science and the Cochrane library using terms adapted from Dudley and Garner’s systematic review on integration in LMICs. From an initial list of 10 550 articles, 206 were selected for full-text review by two reviewers who independently reviewed articles and inductively extracted and synthesized themes related to health system preparedness. We identified five ‘context’ related categories and four health system ‘capability’ themes. The contextual enabling and constraining factors for frontline service integration were: (1) the organizational framework of frontline services, (2) health care worker preparedness, (3) community and client preparedness, (4) upstream logistics and (5) policy and governance issues. The intersecting health system capabilities identified were the need for: (1) sufficiently functional frontline health services, (2) sufficiently trained and motivated health care workers, (3) availability of technical tools and equipment suitable to facilitate integrated frontline services and (4) appropriately devolved authority and decision-making processes to enable frontline managers and staff to adapt integration to local circumstances. Moving beyond claims that integration is defined differently by different programs and thus unsuitable for comparison, this review demonstrates that synthesis is possible. It presents a common set of contextual factors and health system capabilities necessary for successful service integration which may be considered indicators of preparedness and could form the basis for an ‘integration preparedness tool’

Minimum mean-square-error expression of LMMSE channel estimation in SISO OFDM systems

International audienceAn expression of the minimum mean square error (MMSE) of the linear MMSE channel estimation is given in the case of a non-invertible channel covariance matrix, as in single-input single-output (SISO) OFDM system. A matrix expression, already proposed for a multi-input multi-output OFDM system in a previous article, is not valid in SISO. A new proof is then proposed, by deriving a scalar expression of the MMSE, which leads to solve an optimisation problem. Furthermore, we show that the proposed solution is the global minimum. Simulations validate the proposed development

The African Chrysops

African Chrysops are less studied than their European and American counterparts. The bionomics of only Chrysops silacea and Chrysops dimidiata is frequently reported. These two species feed on mammals in general but humans remain their main host. From the resting place in the canopy of the natural and secondary forest, they locate their hosts as they move but smoke of wood is a much better attractant than the movement. Other species live either in the rain forest or in the wooden savannah feeding on mammals and reptiles. Chrysops are biological and mechanical vectors of diseases in human and livestock. They also cause painful bites often resulting in open wounds, which can serve as open door for bacterial infections. In the past, control relied on the use of insecticides and clearing of vegetation around the habitations. Nowadays, recourse to repellents, trappings and destruction of the canopy around houses is recommended. The detailed geographical distribution of African Chrysops is still to be elucidated, as well as any genetic variability within and among species. The aims of the chapter are to provide the reader with the state-of-the-art knowledge on African Chrysops, and to present the gap in knowledge of this genus species