Chronic non-communicable disease as a new epidemic in Africa: focus on The Gambia

Introduction: Recent epidemiological data suggest increasing burden of NCDs in many African countries but these diseases have not been given adequate attention due to the overwhelming burden of infectious diseases. There are no recent reports or studies on NCDs or related issues in The Gambia, consequently, this report intends to stimulate further epidemiological studies and also policy initiatives to forestall an epidemic. Methods: Routine data on morbidity (in and out-patients), hospitalisation and mortality due to NCDs from health facilities in The Gambia between 2008 and 2011 were used. Other relevant data from multiple sources were also used. Results: There is an increasing trend in the morbidity, hospitalisation and mortality due to NCDs in the Gambia between 2008 and 2011; 19.8%, 9.9% and 23.4% increments respectively. There is evidence of gender differences in these variables; more males suffer higher mortality from NCDs than females (p<0.001) while females suffer significantly higher morbidity and hospitalisation (p <0.001). Furthermore, there is dearth of highly skilled health workforce as well as poor health infrastructures in The Gambia. Conclusion: NCDs are becoming a public health challenge and the capacity to respond to NCDs in most African countries, particularly, The Gambia is very weak. There is need for a population-based study to accurately quantify the burden and their risk factors as a first step towards policy formulation and effective implementation. Furthermore, there is dire need for increased investments on health workforce as well as medical products and technologies towards addressing the consequences of this emerging epidemic.Pan African Medical Journal 2013; 14: 8

Contemporary issues and challenges of health sector in Nigeria

This paper examined the contemporary issues and challenges of the Nigerian health sector. It also attempted to identify the effect of the issues and challenges on the Nigerian citizens' health condition. The paper utilised primary data by interacting with randomly selected medical doctors, pharmacists, image scientists and nurses to elicit facts and information on issues, challenges and problems they experience in their hospitals. The findings of their experiences revealed that constellation of social, economic and environmental challenges are being experienced from hospitals, ranging from brain drain, poor remuneration, obsolete infrastructure, inadequate medical facilities and underfunding of the hospitals. The paper concluded that the Nigerian health system is defective when compared with developed countries and even with few African countries.Keywords: Health sector, Hospital management, Health policy, Health care deliver

Tackling the Global Environmental Problem of Climate Change through COVID-19 Economic Recovery Stimulus Packages: Some Suggested Legal Strategies

The effects of the COVID-19 are both immediate and dreadful. But another profound emergency is the planet's unfolding environmental crisis of climate change. Climate change disruption is getting to the point of no return. We must act decisively to protect our planet from both the COVID-19 and the existential problem of climate interruption. We need to turn the COVID-19 economic recovery process into a real opportunity to do things right for the future. The economic and social devastation caused by climate disruption will be many times greater than the current COVID-19 pandemic. COVID-19 pandemic-which is resulting in significant economic and political shifts worldwide, should be the international community's unique window of opportunity in which recovery plans can be instrumental in creating a more sustainable and resilient future through ambitious climate mitigation, adaptation, and financing aimed at building back better. This article, which adopted the doctrinal research methodology, examines how the global environmental problem of climate change can be tackled through COVID-19 economic recovery stimulus packages. The paper finds that focusing COVID-19 economic recovery stimulus packages on greener economy, renewable energies, circular economy, and reforestation can help tackle the global environmental problem of climate change. Further, the paper finds that there is a need for legal frameworks that guarantee investments in the suggested strategic areas taking insights from the European Commission Green Deal policy framework. This paper recommends that national governments and international financial lending institutions should focus their COVID-19 economic recovery stimulus packages on investments that tackle the global environmental problem of climate change. Keywords: Global environmental problem, climate change, COVID-19, economic recovery, stimulus packages, legal strategies, European Commission Green Deal DOI: 10.7176/JLPG/123-06 Publication date:August 31st 2022

A SURVEY OF THE BARRIERS OF WOMEN ENTREPRENEURS IN AKURE CITY OF ONDO STATE NIGERIA

The paper surveyed the barriers faced by women entrepreneurs in Akure City of Ondo State, Nigeria. This was necessitated by need to ensure that women play an important role in the generation of employment and wealth creation in Akure City of Ondo State, Nigeria. Both primary and secondary sources of data were utilized for the study. The primary sources of data were collected using structured questionnaires. The sample consisted of 120 women entrepreneurs in Akure City of Ondo State, Nigeria. Respondents were selected from women entrepreneurs in agriculture, vocational training, manufacturing, trading and services. The questionnaires were administered using descriptive and inferential statistics to achieve the objectives of the study. The findings revealed that there are many barriers affecting Akure based women entrepreneurs which aptly explain why they cannot contribute meaningfully to entrepreneurship development of Ondo State. The study concluded that the barriers facing Akure based women entrepreneurs should be addressed in order for them to contribute significantly to the economic growth of Ondo State and Nigeria as a whole

Beyond SARS-CoV-2: Lessons That African Governments Can Apply in Preparation for Possible Future Epidemics.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has placed unprecedented pressure on healthcare systems, even in advanced economies. While the number of cases of SARS-CoV-2 in Africa compared to other continents has so far been low, there are concerns about under-reporting, inadequate diagnostic tools, and insufficient treatment facilities. Moreover, proactiveness on the part of African governments has been under scrutiny. For instance, issues have emerged regarding the responsiveness of African countries in closing international borders to limit trans-continental transmission of the virus. Overdependence on imported products and outsourced services could have contributed to African governments' hesitation to shut down international air and seaports. In this era of emerging and re-emerging pathogens, we recommend that African nations should consider self-sufficiency in the health sector as an urgent priority, as this will not be the last outbreak to occur. In addition to the Regional Disease Surveillance Systems Enhancement fund (US$600 million) provided by the World Bank for strengthening health systems and disease surveillance, each country should further establish an epidemic emergency fund for epidemic preparedness and response. We also recommend that epidemic surveillance units should create a secure database of previous and ongoing pandemics in terms of aetiology, spread, and treatment, as well as financial management records. Strategic collection and analysis of data should also be a central focus of these units to facilitate studies of disease trends and to estimate the scale of requirements in preparation and response to any future pandemic or epidemic

Knowledge, attitude and practice towards tuberculosis in Gambia: a nation-wide cross-sectional survey.

BACKGROUND: Early diagnosis and treatment of tuberculosis (TB) are the mainstay of global and national TB control efforts. However, the gap between expected and reported cases persists for various reasons attributable to the TB services and care-seeking sides of the TB care cascade. Understanding individual and collective perspectives of knowledge, attitudes, beliefs and other social circumstances around TB can inform an evidence-based approach in engaging communities and enhance their participation in TB case detection and treatment. METHODS: The study was conducted during the Gambian survey of TB prevalence. This was a nationwide cross-sectional multistage cluster survey with 43,100 participants aged ≥15 years in 80 clusters. The study sample, a random selection of 10% of the survey population within each cluster responded to a semi-structured questionnaire administered by trained fieldworkers to assess the knowledge, attitudes and practice of the participants towards TB. Overall knowledge, attitude and practice scores were dichotomised using the computed mean scores and analysed using descriptive, univariable and multivariable logistic regression. RESULTS: All targeted participants (4309) were interviewed. Majority were females 2553 (59.2%), married 2614 (60.7%), had some form of education 2457 (57%), and were unemployed 2368 (55%). Although 3617 (83.9%) of the participants had heard about TB, only 2883 (66.9%) were considered to have good knowledge of TB. Overall 3320 (77%) had unfavourable attitudes towards TB, including 1896 (44%) who indicated a preference for staying away from persons with TB rather than helping them. However, 3607(83.7%) appeared to have the appropriate health-seeking behaviours with regard to TB as 4157 (96.5%) of them were willing to go to the health facility if they had symptoms suggestive of TB. CONCLUSIONS: About 3 in 10 Gambians had poor knowledge on TB, and significant stigma towards TB and persons with TB persists. Interventions to improve TB knowledge and address stigma are required as part of efforts to reduce the burden of undiagnosed TB in the country

Translation of genomic epidemiology of infectious pathogens: Enhancing African genomics hubs for outbreaks.

BACKGROUND: Deadly emerging infectious pathogens pose an unprecedented challenge to health systems and economies, especially across Africa, where health care infrastructure is weak, and poverty rates remain high. Genomic technologies are vital for enhancing the understanding and development of intervention approaches against these pathogens, including Ebola and the novel coronavirus disease 2019 (COVID-19). DISCUSSION: Africa has contributed few genomes of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) to the global pool in growing open access repositories. To bridge this gap, the Africa Centre for Disease Control and Prevention (ACDC) is coordinating continent-wide initiatives to establish genomic hubs in selected well-resourced African centres of excellence. This will allow for standardisation and efficient and rapid data generation and curation. However, the strategy to ensure capacity for high-throughput genomics at selected hubs should not overshadow the deployment of portable, field-friendly and technically less demanding genomics technologies in all affected countries. This will enhance small-scale local genomic surveillance in outbreaks, leaving validation and large-scale approaches to be taken at central genomic hubs. CONCLUSION: The ACDC needs to scale-up its campaign for government support across African Union countries to ensure the sustainable financing of its strategy for increased pathogen genomic intelligence and other interventions in current and inevitable future epidemics in Africa

A tuberculosis nationwide prevalence survey in Gambia, 2012.

OBJECTIVE: To estimate the population prevalence of active pulmonary tuberculosis in Gambia. METHODS: Between December 2011 and January 2013, people aged ≥ 15 years participating in a nationwide, multistage cluster survey were screened for active pulmonary tuberculosis with chest radiography and for tuberculosis symptoms. For diagnostic confirmation, sputum samples were collected from those whose screening were positive and subjected to fluorescence microscopy and liquid tuberculosis cultures. Multiple imputation and inverse probability weighting were used to estimate tuberculosis prevalence. FINDINGS: Of 100 678 people enumerated, 55 832 were eligible to participate and 43 100 (77.2%) of those participated. A majority of participants (42 942; 99.6%) were successfully screened for symptoms and by chest X-ray. Only 5948 (13.8%) were eligible for sputum examination, yielding 43 bacteriologically confirmed, 28 definite smear-positive and six probable smear-positive tuberculosis cases. Chest X-ray identified more tuberculosis cases (58/69) than did symptoms alone (43/71). The estimated prevalence of smear-positive and bacteriologically confirmed pulmonary tuberculosis were 90 (95% confidence interval, CI: 53-127) and 212 (95% CI: 152-272) per 100 000 population, respectively. Tuberculosis prevalence was higher in males (333; 95% CI: 233-433) and in the 35-54 year age group (355; 95% CI: 219-490). CONCLUSION: The burden of tuberculosis remains high in Gambia but lower than earlier estimates of 490 per 100 000 population in 2010. Less than half of all cases would have been identified based on smear microscopy results alone. Successful control efforts will require interventions targeting men, increased access to radiography and more accurate, rapid diagnostic tests

Modelling the COVID-19 pandemic in context : An international participatory approach

Funding RA is funded by the Bill and Melinda Gates Foundation (OPP1193472). LW is funded by the Li Ka Shing Foundation. CF is funded by grant #2017/26770-8, São Paulo Research Foundation (FAPESP). The CoMo Consortium has support from the Oxford University COVID-19 Research Response Fund (ref: 0009280). Scientific writing assistance and editorial support was provided by Adam Bodley, according to Good Publication Practice guidelines.Peer reviewedPublisher PD