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Space weather science has been a growing field in Africa since 2007. This growth in infrastructure and human capital development has been accompanied by the deployment of ground-based observing infrastructure, most of which was donated by foreign institutions or installed and operated by foreign establishments. However, some of this equipment is no longer operational due to several factors, which are examined in this paper. It was observed that there are considerable gaps in ground-based space-weather-observing infrastructure in many African countries, a situation that hampers the data acquisition necessary for space weather research, hence limiting possible development of space weather products and services that could help address socio-economic challenges. This paper presents the current status of space weather science in Africa from the point of view of some key leaders in this field, focusing on infrastructure, situation, human capital development, and the research landscape. [ABSTRACT FROM AUTHOR]

No less than three international meetings on publishing in Africa have taken place recently, which have been followed with detailed action plawns. Among many other recommendations, calls for action to find solutions to perennial problems, as well as discussions focusing on sectorial innovation and revitalization of the African book industries, pwarticipants in all three meetings were strongly urged to start collecting and disseminating book industry data. It is true that reliable figures of book publishing output for the continent of Africa do not exist at the present time, with the exception of a very small number of countries, notably South Africa and Morocco. Meantime the state of African national bibliographies, which can form the groundwork of book industry data, presents a picture of neglect for the most part, with many national bibliographies seriously in arrears, currently dormant, or having ceased publication altogether. Only a small number are accessible in digital formats. Book publishing data and book production statistics are important elements in measuring the growth and vitality of indigenous publishing in any part of the world. In the absence of such data for most of the African continent, there is a need for research, analysis, documentation, and systematic gathering of current, reliable data and statistics on the whole book sector in Africa. However, there are huge challenges and complexities in the goal of collecting data for book industry surveys, which must not be underestimated. Many questions will need to be asked: for example, how is data going to be collected and analysed; what will be the parameters; and what are going to be the sources and the methods? Who should be responsible for undertaking the research and the compilation of such book industry data; and, crucially, who is going to fund the research and the data gathering process on a systematic and ongoing basis? Collecting book industry data is closely interrelated with the publication of national bibliographies and, in addition to examining the issues and challenges relating to the creation of book industry statistics, this paper also provides an analysis of the current state of national bibliographies in Africa, as well as linked matters such as legal deposit legislation, and compliance of legal deposit. Most national libraries and bibliographic agencies in Africa continue to operate under severe constraints, and have been chronically underfunded by their governments for the past four decades or more. An analysis of the current status of African national bibliographies sadly presents a dismal picture. It is unlikely that reliable data for the African book industries can be collected and published without the input and full cooperation of national libraries or bibliographic agencies. There is equally an urgent need for much more active collaboration and interaction between the agencies producing national bibliographies with publishers and book trade associations in each African country. Any attempts to revive the fortunes of African national libraries, and the resumption of publication of high quality and timely national bibliographies, will amount to a formidable task. This paper offers a range of suggestions and recommendations how the situation might be addressed and improved, but also points out that regular compilation of a national bibliography, and effective maintenance of legal deposit, necessitates adequate staff in terms of both numbers and expertise, which is not the case at this time. [ABSTRACT FROM AUTHOR]

Recall and social desirability bias undermine self-report of paper-and-pencil questionnaires. Mobile phone questionnaires may overcome these challenges. We assessed and compared sexual risk behavior reporting via in-clinic paper-and-pencil and mobile phone questionnaires. HVTN 915 was a prospective cohort study of 50 adult women in Soweto, who completed daily mobile phone, and eight interviewer-administered in-clinic questionnaires over 12 weeks to assess sexual risk. Daily mobile phone response rates were 82% (n = 3486/4500); 45% (n = 1565/3486) reported vaginal sex (median sex acts 2 (IQR: 1-3)) within 24 h and 40% (n = 618/1565) consistent condom. Vaginal sex reporting was significantly higher via mobile phone across all visits (p < 0.0001). There was no significant difference in condom use reporting by mobile phone and in-clinic paper-based questionnaires across all visits (p = 0.5134). The results show high adherence and reporting of sex on the mobile phone questionnaire. We demonstrate feasibility in collecting mobile phone sexual risk data. [ABSTRACT FROM AUTHOR]

High-quality, efficient, and off-grid appropriate appliances play an essential role in developing the distributed clean energy market—but little data or market intelligence exists to help market actors make informed decisions. To fill this significant knowledge gap, CLASP, in support of the Efficiency for Access Coalition, has developed the Off-Grid Appliance Data Platform: an off-grid appliance performance database. Based on analysis of the test data from the Platform, the paper provides a glimpse into the current status, efficiency and cost trends, and remaining challenges gleaned from the off-grid television, fan, and refrigeration market—top three appliances with significant potential to scale. The analyses show a wide variation in the efficiency of products across the market. Efficiency improvements are observed, albeit slowly. Analysis shows that prices are decreasing, but have not yet reached a level of affordability for off-grid consumers in Africa and South Asia. Through the appliance performance testing results and market trends, the authors of this paper hope to enhance the global knowledge about off-grid appliances performance. Further research and data collection around sales trends will enhance the comprehensiveness and robustness of future analyses of off-grid appliances. [ABSTRACT FROM AUTHOR]

This article is a product of the reflexive experience of data collection and analysis in a development organisation in Uganda. Several studies provide helpful debates about managing people in Africa. However, existent literature seldom covers pertinent issues related to collecting and analysing ethnographic data reflexively in African-based organisations. And yet, critical self-scrutiny and reflexivity to account for the researcher's identity in the research processes is vital for the quality of the findings. The key research questions for this paper are: how does the identity of an African researcher who was trained in 'Western' management theories, worked in an organisation in Africa, and then educated within a 'Western' setting affect the character of data generated? And does such as researcher fully become 'one of them', or effectively remain an independent researcher? This paper discusses the process and results of the reflexive process through which answers to these questions were explored. [ABSTRACT FROM AUTHOR]

The epistemological positioning that frequently validates the application of cultural probes in eliciting detailed exploration of phenomenon has not been sufficiently interrogated. Yet the epistemological assumptions behind the value of cultural probes continue to be drummed up and foisted on Africa's emerging ethnographic researchers who actually need to be a bit more critical in its adoption and application. This conceptual paper explores the extant literature on data collection based essentially on cultural probes as espoused in habitus. It is proposed that profound amounts of decolonization of the spirit, content, and process of data gathering is urgent and critical at this stage. Until this is done objectively, African ethnographic researchers should "look at the gift horse in the mouth" before they can properly configure what is right or wrong for the people of Africa who should be in the hot pursuit of the ownership, production and utilization of relevant and sacrosanct knowledge aimed at rapid socio-economic and political development of the continent. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to understand the nomological network of associations between collective mindfulness and big data analytics in fostering resilient humanitarian relief supply chains. Design/methodology/approach: The authors conceptualize a research model grounded in literature and test the hypotheses using survey data collected from informants at humanitarian aid organizations in Africa and Europe. Findings: The findings demonstrate that organizational mindfulness is key to enabling resilient humanitarian relief supply chains, as opposed to just big data analytics. Originality/value: This is the first study to examine organizational mindfulness and big data analytics in the context of humanitarian relief supply chains. [ABSTRACT FROM AUTHOR]

Background: High sodium intake increases the risk of hypertension and cardiovascular diseases. For this reason the World Health Organization recommends a maximum intake of 2 g per day and a 30% reduction in population sodium intake by 2025. However, in global reviews, data on sodium intake in sub-Saharan Africa have been limited. Methods: A systematic review was conducted to identify studies reporting sodium intake in sub-Saharan African populations. Meta-regression analyses were used to test the effect of year of data collection and method of data collection (urinary/dietary), as well as any association between sex, urban/rural status or a country's economic development, and population sodium intake. Results: We identified 42 papers reporting 67 estimates of adult population sodium intakes and 12 estimates of child population sodium intakes since 1967. Of the 67 adult populations, 54 (81%) consumed more than 2 g sodium/day, as did four of the 12 (33 %) child populations. Sixty-five adult estimates were included in the meta-regression, which found that urban populations consumed higher amounts of salt than rural populations and that urine collection gave lower estimates of sodium intake than dietary data. Conclusions: Sodium intake in much of sub-Saharan Africa is above the World Health Organization's recommended maximum intake and may be set to increase as the continent undergoes considerable urbanization. Few identified studies used stringent measurement criteria or representative population samples. High quality studies will be required to identify where and with whom to intervene, in order to meet the World Health Organization's target of a 30% reduction in population sodium intake and to demonstrate progress towards this target. [ABSTRACT FROM AUTHOR]

Data plays a big role in educating the population on various issues that contribute to development. One of the major activities conducted after data collection is, dissemination of the data to different stakeholders. Uganda Bureau of Statistics disseminates data to its users through a number of channels. This paper discusses each method in detail and how it's used during this process. The major channel of sharing data with users is through dissemination workshops and the website. Other channels used for dissemination include the library and resource centre, social media and physical delivery to stakeholders in district public libraries. Having the above-mentioned channels of data dissemination in place, has helped UBOS remain the centre of excellence in dissemination of data to users, countrywide and in Africa. [ABSTRACT FROM AUTHOR]

Study Question: How many twins are born in human populations and how has this changed over recent decades?Summary Answer: Since the 1980s, the global twinning rate has increased by a third, from 9.1 to 12.0 twin deliveries per 1000 deliveries, to about 1.6 million twin pairs each year.What Is Known Already: It was already known that in the 1980s natural twinning rates were low in (East) Asia and South America, at an intermediate level in Europe and North America, and high in many African countries. It was also known that in recent decades, twinning rates have been increasing in the wealthier parts of our world as a result of the rise in medically assisted reproduction (MAR) and delayed childbearing.Study Design, Size, Duration: We have brought together all information on national twinning rates available from statistical offices, demographic research institutes, individual survey data and the medical literature for the 1980-1985 and the 2010-2015 periods.Participants/materials, Setting, Methods: For 165 countries, covering over 99% of the global population, we were able to collect or estimate twinning rates for the 2010-2015 period. For 112 countries, we were also able to obtain twinning rates for 1980-1985.Main Results and the Role Of Chance: Substantial increases in twinning rates were observed in many countries in Europe, North America and Asia. For 74 out of 112 countries the increase was more than 10%. Africa is still the continent with highest twinning rates, but Europe, North America and Oceania are catching up rapidly. Asia and Africa are currently home to 80% of all twin deliveries in the world.Limitations, Reasons For Caution: For some countries, data were derived from reports and papers based on hospital registrations which are less representative for the country as a whole than data based on public administrations and national surveys.Wider Implications Of the Findings: The absolute and relative number of twins for the world as a whole is peaking at an unprecedented level. An important reason for this is the tremendous increase in medically assisted reproduction in recent decades. This is highly relevant, as twin deliveries are associated with higher infant and child mortality rates and increased complications for mother and child during pregnancy and during and after delivery.Study Funding/competing Interest(s): The contribution of CM was partially supported by the European Research Council (ERC) under the European Union's Horizon 2020 Research and Innovation Programme (grant No 681546, FAMSIZEMATTERS), Nuffield College, and the Leverhulme Trust. The contribution of GP was partially supported by the French Agence Nationale de la Recherche (grant No ANR-18-CE36-0007-07). The authors declare no conflict of interest.Trial Registration Number: N/A. [ABSTRACT FROM AUTHOR]

Background: A community’s cultural beliefs, attitudes and discourse can affect their responses in surveys. Knowledge of these cultural factors and how to comply with them or adjust for them during data collection can improve data quality. Objective: This study describes implications of features of Gambian culture related to women’s reproductive health, and mortality, when collecting data in surveys. Methods: 13 in-depth interviews of female interviewers and a focus group discussion among male interviewers were conducted in two rural health and demographic surveillance systems as well as three key informant interviews in three regions in The Gambia. Results: From the fieldworker’s viewpoint, questions relating to reproduction were best asked by women as culturally pregnancies should be concealed, and menstruation is considered a sensitive topic. Gambians were reluctant to speak about decedents and the Fula did not like to be counted, potentially affecting estimation of mortality. Asking about siblings proved problematic among the Fula and Serahule communities. Proposals made to overcome these challenges were that culturally-appropriate metaphors and symbols should be used to discuss sensitive matters and to enumerating births/deaths singly instead of collecting summary totals, which had threatening connotations. This was as opposed to training interviewers to ask standardised and precise verbatim questions. Contribution: This paper presents indigenous Gambian solutions by fieldworkers to culturally sensitive topics when collecting pregnancy outcomes and mortality data in demographic and health surveys. For researchers collecting maternal mortality data, it highlights the potential shortcomings of the sibling history methodology. [ABSTRACT FROM AUTHOR]

African countries have been experiencing an upsurge in public health problems as a result of the increased availability and use of psychoactive substances trafficked into the continent and also produced locally. However, mounting effective policy and programme interventions have been impeded by a lack of reliable data on various aspects of drug use and the harms associated with drugs. To address this challenge, the African Union started an ambitious programme aimed at improving the capacity of African Union member states to respond effectively to drug demand reduction challenges through strengthening research and data collection capabilities. The programme entails the establishment and operationalisation of a continent-wide drug surveillance sentinel with a public health orientation for the systematic collection and dissemination of comparable data on drug use and related problems in Africa. A key finding of the surveillance system, which draws data from national networks, has been the increase in the number of young drug users in the context of inadequate comprehensive treatment and care services, which threatens harnessing the continent's demographic dividend. Sprouting evidence on drug use patterns and trends has aided shifts in policies and programmes towards addressing drug addictions and related health challenges at the national level. [ABSTRACT FROM AUTHOR]

This paper investigates the impact of the COVID-19 pandemic on CSO's in Africa and the ways in which they responded to it. In gathering data, a desk review methodology was adopted focusing on literature from across Africa with specific emphasis on the impact of COVID-19 on CSO's. This data was accessed from a combination of reports published by CSO organizations based in Africa, global humanitarian organizations, academic journals, and trusted news sources. [ABSTRACT FROM AUTHOR]

Context: Population-based cohort studies have been pivotal in establishing a number of nutrition-health interactions, especially in high-income settings. Less research is available from low- and middle-income countries due to the lack of detailed longitudinal data. Objective: To describe the use of prospectively collected longitudinal data from the rural West Kiang region of The Gambia to explore nutrition-health interactions in a rural sub-Saharan African context. Methods: Demographic records initiated in 1947, coupled with data on maternal and child health, have been used to explore nutrition-health relationships. Results: An analysis of the longitudinal demographic data demonstrated a highly significant association between season of birth and infection-related adult mortality in this context. Additionally, using routine data on childhood anthropometry, it has been shown that, despite a significant decline in child undernutrition, rates remain unacceptably high, likely reflecting the very high socio-economic threshold required to eliminate undernutrition. Conclusion: The foresight to establish demographic data collection over seventy years ago has supported a wealth of novel research within a traditional African context. The availability of detailed clinical records on maternal and child health is helping to unravel the factors driving child undernutrition in rural Africa, and to identify targets for interventions to improve health in this context. [ABSTRACT FROM AUTHOR]

Over the last few decades, primate sanctuaries have become more numerous, particularly in Africa. Sanctuaries play an obvious and vital role in the battle against the illegal trade in wildlife and provide opportunities for local people to learn about the importance of protecting habitat and laws governing wildlife trade. Given the multi-disciplinary role of sanctuaries, the Pan African Sanctuary Alliance provides mechanisms to exchange best practices and establishes links to other conservation partners. In April 2011, the managers of the 22 Pan African Sanctuary Alliance members were surveyed in order to collect detailed information on the conservation activities of each sanctuary. The majority of the 22 sanctuaries conducted both on- and off-site education activities, engaging more than 429,000 people in education activities per year. Sanctuaries reported that they provided employment for over 550 local community members across Africa, as well as resources for community education and infrastructure, with an economic impact over $3 million per year. Sanctuaries were also involved in activities that promote law enforcement and believed that the activities they supported have led to better protection of primate habitats. The results of the survey demonstrate that sanctuaries have moved towards supporting and implementing community development activities aimed at poverty reduction, while conducting conservation activities. While Pan African Sanctuary Alliance sanctuaries were initially established to provide care and housing for orphaned, confiscated and displaced primates, this paper demonstrates how sanctuaries have combined ex-situ with in-situ initiatives to support social, economic, and environmental progress in primate range countries in Africa. [ABSTRACT FROM AUTHOR]

The presence of quality data and data management is important for the future of food in Africa. Data management can impact agriculture sector performance and food security because it facilitates the identification of agriculture sector problems and planning. However, existing systems, data collection practices, record keeping and handling are all challenged by a myriad of factors that undermine quantity and quality of data output. This paper discusses how countries can improve and implement data capture, record keeping and investment in data management. Using past literature and data management, we assess the current status of data management systems and challenges faced at the farmer, local/NGO, national and international levels. Drawing on best practices currently at work in the private sector and amongst NGO-supported projects, we identify potential investment opportunities and incentives that could promote a culture of record keeping, documentation, data management. Over time, investing in projects that have built-in incentives that solve farmer needs can facilitate record keeping at the farmer level. Putting in place mechanisms such as central registries and platforms for sharing information and coordinating local initiatives can promote the culture of documentation and data management at the local/NGO level. Improvements at the national level may stem from investing more in human and financial resources, capitalizing on public-private partnerships to develop and deploy innovative digital tools for data collection and management, as well as building stronger linkages and tapping into international capacities of agricultural data collection. [ABSTRACT FROM AUTHOR]

Copyright of African Population Studies is the property of Union for African Population Studies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper is a contribution to interweaving two lines of research that have progressed in separate ways: network analysis of international trade and the literature on African trade and development. Gathering empirical data on African countries has important limitations and so does the space occupied by African countries in the analysis of trade networks. Here, these limitations are dealt with by the definition of two independent bipartite networks: a destination share network and a commodity share network. These networks–together with their corresponding minimal spanning trees–allow to uncover some ordering emerging from African exports in the broader context of international trade. The emerging patterns help to understand important characteristics of African exports and its binding relations to other economic, geographic and organizational concerns as the recent literature on African trade, development and growth has shown. [ABSTRACT FROM AUTHOR]

We argue that the lack of a strong and consistent correlation between egotropic assessments and vote choice in observational data from poor countries may be a statistical artifact resulting from respondents' attempts to evade taxation. Using data from two rounds of the Afrobarometer, we show that respondents report significantly worse economic conditions when they think they are reporting to the government; the likelihood of misreporting increases with actual or perceived effective tax rate. Misreporting causes a conflation in the data between those who are actually experiencing worsening conditions and those who are merely claiming to, attenuating the apparent effect of pocketbook concerns on the vote. When we control for this bias in the African data, we find that egotropic evaluations are significantly and positively correlated with vote choice. [ABSTRACT FROM AUTHOR]

This study presents a pattern overlooked in previous research on measuring sensitive political outcomes: over the course of data collection, responses tend to shift in the direction of support for the local incumbent power. We suggest that, whereas earlier responses are largely devoid of this social desirability bias, word of the research spreads across enumeration areas, and individuals interviewed later in the process alter their responses out of fear of retribution for inappropriate answers. We document the pattern using original data from two surveys on support for violent extremism conducted in three different countries in the Sahel region of Africa. We rule out a host of alternative explanations and further confirm that the pattern can arise not just with overt survey measures but even with covert, experimental ones. We then demonstrate the same pattern using out-of-sample data from a separate well-known study. The findings offer a cautionary note to both conventional and experimental approaches to measuring sensitive attitudes. [ABSTRACT FROM AUTHOR]

This article provides evidence to show that the contributions of African researchers to the informetrics literature are minimal. The three main challenges identified as limiting the contributions of African scholars to the informetrics literature are lack of appropriate skills, inadequate data collection sources, and unaffordable analytical tools. To overcome these challenges, it is suggested that regular pre-conference workshops on informetrics should be organized, an African Citation Index should be developed, and the use of free analytical tools should be encouraged. [ABSTRACT FROM AUTHOR]

Abstract: Research on caregiving children tends to be limited to children''s caregiving experiences of parents with a specific disease or disability. This has led to a common perception that children''s caregiving is a single, uniform and often long-term experience. Whilst this is most certainly the case for many children in economically more advanced countries, this may not hold true in rural Africa, where poverty and AIDS can have significant knock-on effects on entire families and communities. This paper seeks to develop a more complex understanding of children''s caring experiences by asking children whom they have cared for over time and explore the different pathways that lead to their caregiving at different stages of their lives. The study reports on qualitative data collected from 48 caregiving children and 10 adults in the Bondo district of western Kenya in 2007. A multi-method approach was adapted, with historical profiles, Photovoice and draw-and-write essays complementing 34 individual interviews and 2 group discussions. A thematic network analysis revealed that children''s caregiving was not confined to a single experience. Children were observed to provide care for a number of different family and community members for varying periods of time and intensities. Although their living arrangements and life circumstances often gave them little choice but to care, a social recognition of children''s capacity to provide care for fragile adults, helped the children construct an identity, which both children and adults drew on to rationalise children''s continued and multiple caring experiences. The study concludes that agencies and community members looking to support caregiving children need to consider their care trajectories — including whom they care for as well as the order, intensity, location and duration of their past and likely future caring responsibilities. [Copyright &y& Elsevier]

The Fishery Performance Indicators is a data collection tool that allows collection of comparable fisheries data in the environmental, economic and community pillars even under data poor circumstances. In this paper, data collected for 35 fisheries in 14 African countries are analyzed and compared to global averages. Similar to a previous global analysis, the different pillars of sustainability were positively correlated. The results are even more pronounced for Africa than globally. The only exception is the relationship between environment and community pillars in Africa, which is statistically insignificant, and this is also the case for open access fisheries globally. The average scores in Africa are lower than global average scores in all dimensions, which is not unexpected given the high number of open access fisheries. However, factors that are not fisheries specific may be more important for this result, suggesting that a country's governance, economic conditions, and development status are important for fisheries performance. • Most African fisheries operate under governance systems with open access incentives. • African fisheries are scoring lower than the global averages in the three sustainability pillars. • The largest performance gaps between African fisheries and the rest of world are in the post-harvest sector. [ABSTRACT FROM AUTHOR]

Data science is a concept to unify statistics, data analysis, machine learning and their related methods in order to analyze actual phenomena with data to provide better understanding. This article focused its investigation on acquisition of data science skills in building partnership for efficient school curriculum delivery in Africa, especially in the area of teaching statistics courses at the beginners' level in tertiary institutions. Illustrations were made using Big data of selected 18 African countries sourced from United Nations Educational, Scientific and Cultural Organization (UNESCO) with special focus on some macro-economic variables that drives economic policy. Data description techniques were adopted in the analysis of the sourced open data with the aid of R analytics software for data science, as improvement on the traditional methods of data description for learning and thus open a new charter of education curriculum delivery in African schools. Though, the collaboration is not without its own challenges, its prospects in creating self-driven learning culture among students of tertiary institutions has greatly enhanced the quality of teaching, advancing students skills in machine learning, improved understanding of the role of data in global perspective and being able to critique claims based on data. [ABSTRACT FROM AUTHOR]

Background and context: Routine collection of quality oncology data remains underprioritized in resource limited settings. For breast cancer (BC) care at Princess Marina Hospital (PMH) in Botswana, this hampers its use for oncology program evaluation and clinical research. The Peo Data Acquisition Core (DAC), part of a consortium for planning of a noncommunicable diseases center for research excellence in Southern Africa, engaged relevant stakeholders and departments at PMH to establish health care worker driven processes that support sustained improvements in the quality of routinely collected breast cancer data. Aim: Assess PMH BC care needs to support the improvement of routinely collected data. Strategy/Tactics: Conventional routine data quality assessments guide iterative identification of data quality gaps for improvement, but tend to consume additional human resources to implement and prioritize data quality over existing provider concerns. We undertook a holistic approach to identifying needs challenging the improvement of data routinely collected about PMH BC patients. Program/Policy process: A need assessment began with mapping of patient care process, capturing process steps, including subprocesses, actors, and an inventory of related data capture systems. The assessment also gathered care providers' perceptions of challenges to providing care as well as perceptions of the up-time of an existing electronic health record (EHR). Outcomes: BC patient management involves multiple care providers who attend to patients in different locations within the hospital. Except for EHR captured laboratory data, nearly all other documentation of patient care occurred through paper-based registers, diaries and general clinical forms. Providers indicated the overbooking of patient appointments and use of different formats to manage patient data as key challenges for them. EHR appointment scheduling components appear underutilized by providers, and a brief monitoring of provider perceptions of the EHR's speed and reliability suggests it is poorest in the mornings - at a time when providers are the busiest attending to patients. What was learned: Needs assessment findings suggest several opportunities to respond to provider recognized challenges through greater adoption of EHR usage. Establishment of a Quality Improvement (QI) group that champions improvements in routine BC data quality should integrate standardization of patient data formats and EHR centralized appointment booking. QI group composition should include both care providers and an EHR IT technician. [ABSTRACT FROM AUTHOR]

Objective: We sought to classify causes of stillbirth for six low-middle-income countries using a prospectively defined algorithm.Design: Prospective, observational study.Setting: Communities in India, Pakistan, Guatemala, Democratic Republic of Congo, Zambia and Kenya.Population: Pregnant women residing in defined study regions.Methods: Basic data regarding conditions present during pregnancy and delivery were collected. Using these data, a computer-based hierarchal algorithm assigned cause of stillbirth. Causes included birth trauma, congenital anomaly, infection, asphyxia, and preterm birth, based on existing cause of death classifications and included contributing maternal conditions.Main Outcome Measures: Primary cause of stillbirth.Results: Of 109 911 women who were enrolled and delivered (99% of those screened in pregnancy), 2847 had a stillbirth (a rate of 27.2 per 1000 births). Asphyxia was the cause of 46.6% of the stillbirths, followed by infection (20.8%), congenital anomalies (8.4%) and prematurity (6.6%). Among those caused by asphyxia, 38% had prolonged or obstructed labour, 19% antepartum haemorrhage and 18% pre-eclampsia/eclampsia. About two-thirds (67.4%) of the stillbirths did not have signs of maceration.Conclusions: Our algorithm determined cause of stillbirth from basic data obtained from lay-health providers. The major cause of stillbirth was fetal asphyxia associated with prolonged or obstructed labour, pre-eclampsia and antepartum haemorrhage. In the African sites, infection also was an important contributor to stillbirth. Using this algorithm, we documented cause of stillbirth and its trends to inform public health programs, using consistency, transparency, and comparability across time or regions with minimal burden on the healthcare system.Tweetable Abstract: Major causes of stillbirth are asphyxia, pre-eclampsia and haemorrhage. Infections are important in Africa. [ABSTRACT FROM AUTHOR]

Background: Up to one half of the population in Africa, Asia and Latin America has little access to high-quality biomedical services and relies on traditional health systems. Medical pluralism is thus in many developing countries the rule rather than the exception, which is why the World Health Organization is calling for intercultural partnerships to improve health care in these regions. They are, however, challenging due to disparate knowledge systems and lack of trust that hamper understanding and collaboration. We developed a collaborative, patient-centered boundary mechanism to overcome these challenges and to foster intercultural partnerships in health care. To assess its impact on the quality of intercultural patient care in a medically pluralistic developing country, we conducted and evaluated a case study. Methods: The case study took place in Guatemala, since previous efforts to initiate intercultural medical partnerships in this country were hampered by intense historical and societal conflicts. It was designed by a team from ETH Zurich's Transdisciplinarity Lab, the National Cancer Institute of Guatemala, two traditional Councils of Elders and 25 Mayan healers from the Kaqchikel and Q'eqchi' linguistic groups. It was implemented from January 2014 to July 2015. Scientists and traditional political authorities collaborated to facilitate workshops, comparative diagnoses and patient referrals, which were conducted jointly by biomedical and traditional practitioners. The traditional medical practices were thoroughly documented, as were the health-seeking pathways of patients, and the overall impact was evaluated. Results: The boundary mechanism was successful in discerning barriers of access for indigenous patients in the biomedical health system, and in building trust between doctors and healers. Learning outcomes included a reduction of stereotypical attitudes towards traditional healers, improved biomedical procedures due to enhanced self-reflection of doctors, and improved traditional health care due to refined diagnoses and adapted treatment strategies. In individual cases, the beneficial effects of traditional treatments were remarkable, and the doctors continued to collaborate with healers after the study was completed. Comparison of the two linguistic groups illustrated that the outcomes are highly context-dependent. Conclusions: If well adapted to local context, patient-centered boundary mechanisms can enable intercultural partnerships by creating access, building trust and fostering mutual learning, even in circumstances as complex as those in Guatemala. Creating multilateral patient-centered boundary mechanisms is thus a promising approach to improve health care in medically pluralistic developing countries. [ABSTRACT FROM AUTHOR]

Summary: In the Middle East and North Africa (MENA), a vitamin D dose ≥2000 IU/day may be needed to allow to the majority of the population to reach the target 25-hydroxyvitamin D (25(OH)D) level ≥20 ng/ml. Data in the region on the effect of vitamin D supplementation on various skeletal and extra-skeletal effects are scarce. Introduction: Hypovitaminosis D is prevalent worldwide, more so in the Middle East and North Africa (MENA). This study aims to determine the effects of vitamin D replacement on the mean difference in 25-hydroxyvitamin D [25(OH)D] level reached and other outcomes, in the MENA. Methods: This is a meta-analysis of randomized trials from the MENA, administering vitamin D supplementation for at least 3 months, without language or time restriction. We conducted a comprehensive search in seven databases until July 2015. We abstracted data from published reports, independently and in duplicate. We calculated the mean difference (MD) and 95 % CI of 25(OH)D level reached for eligible comparisons, and pooled data using RevMan version 5.3. Results: We identified 2 studies in elderly and 17 in adults; for the latter, 11 were included in the meta-analysis. Comparing a high vitamin D dose (>2000 IU/day) to placebo (nine studies), the MD in 25(OH)D level achieved was 18.3 (CI 14.1; 22.5) ng/ml; p value < 0.001; I = 92 %. Comparing an intermediate dose (800-2000 IU/day) to placebo (two studies), the MD in 25(OH)D level achieved was 14.7 (CI 4.6; 24.9) ng/ml; p value 0.004; I = 91 %. Accordingly, 89 and 71 % of participants, in the high and intermediate dose groups, respectively, reached the desirable level of 20 ng/ml. The risk of bias in the included studies was unclear to high, except for three studies. Conclusion: In the MENA region, vitamin D doses ≥2000 IU/day may be needed to reach the target 25(OH)D level ≥20 ng/ml. The long-term safety and the efficacy of such doses on various outcomes are unknown. [ABSTRACT FROM AUTHOR]

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Whereas the sample composition biases of web surveys have been discussed extensively for developed countries, studies for developing countries are scarce. This article helps to fill that gap by comparing similar non-probability-based web surveys (WEB) and probability-based face-to-face (F2F) surveys both to each other and to the labor force. An analysis of WageIndicator data on work and wages derived from surveys held in 2009–2013 in 10 developing countries (WEB-sampleN = 9135; F2F-sampleN = 14,659), shows that F2F samples resemble the labor force to a larger extent than web samples do. In both cases, individuals in their 20s and early 30s are overrepresented, and younger and older respondents are underrepresented. This trend is more pronounced in WEB than in F2F samples. However, the differences converge in countries with higher Internet usage. A comparison of the WEB and F2F samples shows that compositions differ greatly, with web respondents being younger, more often male, more often living alone, and higher educated, although these differences are smaller in countries with higher Internet usage. Given the cost differences between the two survey modes, one should nevertheless consider the potential of web surveys as an instrument to gain explorative insights, specifically when searching for individuals with particular characteristics. [ABSTRACT FROM AUTHOR]

Antiretroviral therapy (ART)-naïve patients are vulnerable to becoming lost-to-care (LTC) because they are not monitored as often as patients on treatment. We examined data from 19,461 HIV positive adults at 10 HIV clinics in Democratic Republic of Congo (DRC), Cameroon, and Burundi participating in the Phase 1 International epidemiologic Databases to Evaluate AIDS Central Africa (IeDEA-CA) study. Patients were LTC if they were ART-naïve and did not return within 7 months of the end of data collection. Logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs) for risk factors associated with LTC. Of 5353 ART-naïve patients, 4420 (83%) were LTC and 933 (17%) were in-care. The odds of being LTC were greatest among patients from DRC (OR = 2.16, CI: 1.64–2.84,p< .0001), males (OR = 1.39, CI: 1.15–1.69,p= .0009), and ages 18–49 (OR = 1.45, CI: 1.16–1.82,p= .001). The odds of being LTC were least among patients with a WHO Clinical Stage of 1 or 2 (OR = 0.65, CI: 0.55–0.77,p< .0001) and in a perceived concordant relationship (OR = 0.61, CI: 0.43–0.87,p< .0001). LTC patients were more likely to have characteristics associated with higher risk for HIV transmission and progression. Many entered care at advanced stages and were less likely to know their partner’s serostatus. Greater efforts to retain ART-naïve patients may increase earlier initiation of ART. [ABSTRACT FROM AUTHOR]

Background: The prevalence of HIV in Malawi is one of the highest in sub-Saharan Africa, and misconceptions about its mode of transmission are considered a major contributor to the continued spread of the virus. Methods: Using the 2010 Malawi Demographic and Health Survey, the current study explored factors associated with misconceptions about HIV transmission among males and females. Results: We found that higher levels of ABC prevention knowledge were associated with lower likelihood of endorsing misconceptions among females and males (OR = 0.85, p < 0.001; OR = 0.85, p < 0.001, respectively). Compared to those in the Northern region, both females and males in the Central (OR = 0.54, p < 0.001; OR = 0.53, p <0.001, respectively) and Southern regions (OR = 0.49, p < 0.001; OR = 0.43, p < 0.001, respectively) were less likely to endorse misconceptions about HIV transmission. Moreover, marital status and ethnicity were significant predictors of HIV transmission misconceptions among females but not among males. Also, household wealth quintiles, education, religion, and urban--rural residence were significantly associated with endorsing misconceptions about HIV transmission. Conclusion: Based on our findings, we recommend that education on HIV transmission in Malawi should integrate cultural and ethnic considerations of HIV/AIDS. [ABSTRACT FROM AUTHOR]

Avian influenza virus (H5N1) is a rapidly disseminating infection that affects poultry and, potentially, humans. Because the avian virus has already adapted to several mammalian species, decreasing the rate of avian-mammalian contacts is critical to diminish the chances of a total adaptation of H5N1 to humans. To prevent the pandemic such adaptation could facilitate, a biology-specific disease surveillance model is needed, which should also consider geographical and socio-cultural factors. Here, we conceptualized a surveillance model meant to capture H5N1-related biological and cultural aspects, which included food processing, trade and cooking-related practices, as well as incentives (or disincentives) for desirable behaviours. This proof of concept was tested with data collected from 378 Egyptian and Nigerian sites (local [backyard] producers/live bird markets/village abattoirs/commercial abattoirs and veterinary agencies). Findings revealed numerous opportunities for pathogens to disseminate, as well as lack of incentives to adopt preventive measures, and factors that promoted epidemic dissemination. Supporting such observations, the estimated risk for H5N1-related human mortality was higher than previously reported. The need for multidimensional disease surveillance models, which may detect risks at higher levels than models that only measure one factor or outcome, was supported. To develop efficient surveillance systems, interactions should be captured, which include but exceed biological factors. This low-cost and easily implementable model, if conducted over time, may identify focal instances where tailored policies may diminish both endemicity and the total adaptation of H5N1 to the human species. [ABSTRACT FROM AUTHOR]

Background: Overweight and obesity are risk factors for many chronic diseases globally. However, the extent of the problem in low-income countries like Sub-Saharan Africa is unclear. We assessed the magnitude and disparity of both phenomena by place of residence, level of education and wealth quintile using cross-sectional data from 32 countries.Methods: Demographic and Health Survey (DHS) data collected in 32 Sub-Saharan African countries between January 2005 and December 2013 were used. A total of 250651 women (aged 15-49 years) were analyzed. Trained personnel using a standardized procedure measured body weight and height. Body mass index (BMI) was calculated by dividing body weight by height squared. Prevalence of overweight (25.0-29.9 kg/m(2)) and obesity (≥ 30.0 kg/m(2)) were estimated for each country. Analysis of the relationships of overweight and obesity with place of residence, education and wealth index were carried out using logistic regression.Results: The pooled prevalence of overweight for the region was 15.9% (95% CI, 15.7-16.0) with the lowest in Madagascar 5.6% (95% CI, 5.1-6.1) and the highest in Swaziland 27.7% (95% CI, 26.4-29.0). Similarly, the prevalence of obesity was also lowest in Madagascar 1.1% (95% CI, 0.9-1.4) and highest in Swaziland 23.0 (95% CI, 21.8-24.2). The women in urban residence and those who were classified as rich, with respect to the quintile of the wealth index, had higher likelihood of overweight and obesity. In the pooled results, high education was significantly associated with overweight and obesity.Conclusions: The prevalence of overweight and obesity varied highly between the countries and wealth index (rich vs. poor) was found to be the strongest predictor in most of the countries. Interventions that will address the socio-cultural barriers to maintaining healthy body size can contribute to curbing the overweight and obesity epidemic in Africa. [ABSTRACT FROM AUTHOR]

Background. While near-infrared spectroscopy (NIRS) has recognized relevance for developing countries, biomedical applications are rare. This reflects the cost and complexity of NIRS and the convention of comprehensive training for accurate data collection. In an international initiative using transcutaneous NIRS to screen for bladder disease in Africa, we evaluated if interactive training enabled clinic staff to collect data accurately. Methods. Workshop training in a Ugandanmedical clinic on NIRS monitoring theory; bladder physiology and chromophore changes occurring with disease; device orientation; device positioning over the bladder, monitoring subjects during voiding; and saving/uploading data. Participation in patient screening followed with observation, assistance, and then data collection. Evaluation comprised conduct of serial independent screenings with analysis if saved files were of diagnostic quality. Results. 10 individuals attended 1-hour workshops and then 0.5-3.0 hours of screening. Five then felt able to conduct screening independently and all collected data were of diagnostic quality (>5 consecutive patients); all had participated in screening for >1.5 hours (6+ subjects); less participation allowed competent assistance but not consistent adherence to the monitoring protocol. Conclusion. A simplified NIRS system, small-group theory/orientation workshops, and >I.5 hours of 1 : 1 training during screening enabled clinic staff in Africa to collect accurate NIRS data. [ABSTRACT FROM AUTHOR]

Background: Most assessments of the burden of obesity in nutrition transition contexts rely on body mass index (BMI) only, even though abdominal adiposity might be specifically predictive of adverse health outcomes. In Tunisia, a typical country of the Middle East and North Africa (MENA) region, where the burden of obesity is especially high among women, we compared female abdominal vs. overall obesity and its geographic and socio-economic cofactors, both at population and within-subject levels. Methods: The cross-sectional study used a stratified, three-level, clustered sample of 35- to 70-year-old women (n = 2,964). Overall obesity was BMI = weight/height2 ≥ 30 kg/m2 and abdominal obesity waist circumference ≥ 88 cm. We quantified the burden of obesity for overall and abdominal obesity separately and their association with place of residence (urban/rural, the seven regions that compose Tunisia), plus physiological and socio-economic cofactors by logistic regression. We studied the within-subject concordance of the two obesities and estimated the prevalence of subject-level “abdominal-only” obesity (AO) and “overall-only” obesity (OO) and assessed relationships with the cofactors by multinomial logistic regression. Results: Abdominal obesity was much more prevalent (60.4% [57.7-63.0]) than overall obesity (37.0% [34.5-39.6]), due to a high proportion of AO status (25.0% [22.8-27.1]), while the proportion of OO was small (1.6% [1.1-2.2]). We found mostly similar associations between abdominal and overall obesity and all the cofactors except that the regional variability of abdominal obesity was much larger than that of overall obesity. There were no adjusted associations of AO status with urban/rural area of residence (P = 0.21), education (P = 0.97) or household welfare level (P = 0.94) and only non-menopausal women (P = 0.093), lower parity women (P = 0.061) or worker/employees (P = 0.038) were somewhat less likely to be AO. However, there was a large residual adjusted regional variability of AO status (from 16.6% to 34.1%, adjusted P < 0.0001), possibly of genetic, epigenetic, or developmental origins. Conclusion: Measures of abdominal adiposity need to be included in population-level appraisals of the burden of obesity, especially among women in the MENA region. The causes of the highly prevalent abdominal-only obesity status among women require further investigation. [ABSTRACT FROM AUTHOR]

Background: Outbreaks of vector-borne diseases (VBDs) impose a heavy burden on vulnerable populations. Despite recent progress in eradication and control, malaria remains the most prevalent VBD. Integrative approaches that take into account environmental, socioeconomic, demographic, biological, cultural, and political factors contributing to malaria risk and vulnerability are needed to effectively reduce malaria burden. Although the focus on malaria risk has increasingly gained ground, little emphasis has been given to develop quantitative methods for assessing malaria risk including malaria vulnerability in a spatial explicit manner. Methods: Building on a conceptual risk and vulnerability framework, we propose a spatial explicit approach for modeling relative levels of malaria risk - as a function of hazard, exposure, and vulnerability - in the United Republic of Tanzania. A logistic regression model was employed to identify a final set of risk factors and their contribution to malaria endemicity based on multidisciplinary geospatial information. We utilized a Geographic Information System for the construction and visualization of a malaria vulnerability index and its integration into a spatially explicit malaria risk map. Results: The spatial pattern of malaria risk was very heterogeneous across the country. Malaria risk was higher in Mainland areas than in Zanzibar, which is a result of differences in both malaria entomological inoculation rate and prevailing vulnerabilities. Areas of high malaria risk were identified in the southeastern part of the country, as well as in two distinct "hotspots" in the northwestern part of the country bordering Lake Victoria, while concentrations of high malaria vulnerability seem to occur in the northwestern, western, and southeastern parts of the mainland. Results were visualized using both 10x10 km2 grids and subnational administrative units. Conclusions: The presented approach makes an important contribution toward a decision support tool. By decomposing malaria risk into its components, the approach offers evidence on which factors could be targeted for reducing malaria risk and vulnerability to the disease. Ultimately, results offer relevant information for place-based intervention planning and more effective spatial allocation of resources. [ABSTRACT FROM AUTHOR]

Diabet. Med. 30, 399-412 (2013) Abstract Aim To summarize findings from studies reporting the prevalence and incidence of diabetic retinopathy and diabetic maculopathy in African countries in light of the rising prevalence of diabetes mellitus. Methods Using a predefined search strategy, we systematically searched MEDLINE, EMBASE, Science Citation index and Conference Proceedings Citation index, African Index Medicus and the grey literature database 'OpenSIGLE' for studies published between January 1990 and February 2011. Included studies reported prevalence or incidence of diabetic retinopathy or diabetic maculopathy of subjects with diabetes resident in African countries. Results Sixty-two studies from 21 countries were included: three population-based surveys; two cohort studies; five case-control studies; 32 diabetes clinic-based, nine eye clinic-based and 11 other hospital-based surveys. Included studies varied considerably in terms of patient selection, method of assessing the eye and retinopathy classification. In population-based studies, the reported prevalence range in patients with diabetes for diabetic retinopathy was 30.2 to 31.6%, proliferative diabetic retinopathy 0.9 to 1.3%, and any maculopathy 1.2 to 4.5%. In diabetes clinic-based surveys, the reported prevalence range for diabetic retinopathy was 7.0 to 62.4%, proliferative diabetic retinopathy 0 to 6.9%, and any maculopathy 1.2 to 31.1%. No obvious association between prevalence and income level of the country was detected. Conclusions Large, community-based cross-sectional and cohort studies are needed to investigate rates and determinants of prevalence of diabetic retinopathy, incidence and progression in Africa. Consensus is needed on the most appropriate methods of identification and classification of retinopathy for research and clinical practice. Estimates of prevalence of diabetic retinopathy, proliferative diabetic retinopathy and maculopathy are comparable with recent European and American studies. [ABSTRACT FROM AUTHOR]

Aims To develop risk scores for diabetes and diabetes or impaired glycaemia for individuals living in the Middle East and North Africa region. In addition, to derive national risk scores for Algeria, Saudi Arabia and the United Arab Emirates and to compare the performance of the regional risk scores with the national risk scores. Methods An opportunistic sample of 6588 individuals aged 30-75 years was screened. Screening consisted of a questionnaire and a clinical examination including measurement of HbA1c. Two regional risk scores and national risk scores for each of the three countries were derived separately by stepwise backwards multiple logistic regression with diabetes [HbA1c ≥ 48 mmol/mol (≥ 6.5%)] and diabetes or impaired glycaemia [HbA1c ≥ 42 mmol/mol (≥ 6.0%)] as outcome. The performance of the regional and national risk scores was compared in data from each country by receiver operating characteristic analysis. Results The eight risk scores all included age and BMI, while additional variables differed between the scores. The areas under the receiver operating characteristic curves were between 0.67 and 0.70, and for sensitivities approximately 75%; specificities varied between 50% and 57%. The regional and the national risk scores performed equally well in the three national samples. Conclusions Two regional risk scores for diabetes and diabetes or impaired glycaemia applicable to the Middle East and North Africa region were identified. The regional risk scores performed as well as the national risk scores derived in the same manner. [ABSTRACT FROM AUTHOR]

Background To date little has been published about epidemiology and public health capacity (training, research, funding, human resources) in WHO/AFRO to help guide future planning by various stakeholders.Methods A bibliometric analysis was performed to identify published epidemiological research. Information about epidemiology and public health training, current research and challenges was collected from key informants using a standardized questionnaire.Results From 1991 to 2010, epidemiology and public health research output in the WHO/AFRO region increased from 172 to 1086 peer-reviewed articles per annum [annual percentage change (APC) = 10.1%, P for trend < 0.001]. The most common topics were HIV/AIDS (11.3%), malaria (8.6%) and tuberculosis (7.1%). Similarly, numbers of first authors (APC = 7.3%, P for trend < 0.001), corresponding authors (APC = 8.4%, P for trend < 0.001) and last authors (APC = 8.5%, P for trend < 0.001) from Africa increased during the same period. However, an overwhelming majority of respondents (>90%) reported that this increase is only rarely linked to regional post-graduate training programmes in epidemiology. South Africa leads in publications (1978/8835, 22.4%), followed by Kenya (851/8835, 9.6%), Nigeria (758/8835, 8.6%), Tanzania (549/8835, 6.2%) and Uganda (428/8835, 4.8%) (P < 0.001, each vs South Africa). Independent predictors of relevant research productivity were ‘in-country numbers of epidemiology or public health programmes’ [incidence rate ratio (IRR) = 3.41; 95% confidence interval (CI) 1.90–6.11; P = 0.03] and ‘number of HIV/AIDS patients’ (IRR = 1.30; 95% CI 1.02–1.66; P < 0.001).Conclusions Since 1991, there has been increasing epidemiological research productivity in WHO/AFRO that is associated with the number of epidemiology programmes and burden of HIV/AIDS cases. More capacity building and training initiatives in epidemiology are required to promote research and address the public health challenges facing the continent. [ABSTRACT FROM PUBLISHER]

Purpose – The purpose of this research is to shed light on the main barriers faced by Mozambican micro and small enterprises (MSEs) and their implications in respect to the support policies available for these enterprises. Design/methodology/approach – A literature review was made on those barriers faced by the MSEs and on the policies and governmental instruments of assistance available for MSEs. Then, a two-step research was conducted. The first phase consisted of collecting data from 21 MSEs in Mozambique, mainly by means of interviews where the main barriers faced by those interviewed were identified and hence, this led to the second phase, which was interviewing governmental/support entities in order to know what they had done to minimize those barriers which had been identified by the entrepreneurs. Findings – The results show that financial and competitive barriers are the main barriers faced by the analyzed MSEs. These barriers vary according to the field of activity of the enterprises. Originality/value – This study serves to enrich the state of the art on the subject of smaller enterprises in Africa and will specially help to fill the lack of academic research available about Mozambique. [ABSTRACT FROM AUTHOR]

In this study, data on web links collected from 15 African countries, three with the highest Internet penetration in each of North, West, Central, East, and South regions were used to study the number and origins of links to Africa. The sample has a ratio of one Internet user per 12 persons. Altogether, all African countries generated a total of 124,047,702 Web pages and 30,546,967 inlinks to the pages, an average of about 0.25 links per page. But the sample constituted which 28% of all the countries in the region generated 98,629,700 pages and 21,272,500 inlinks, an average of about 0.21 inlinks per page. South Africa ranked highest in web pages and web links per population and also received the highest number of inlinks from other African countries and the G8. However, Kenya linked other African countries more than the others did. Population size does not relate to number of web pages, self-in links. and inlinks or penetration, but relates positively with number of Internet users. Among others, a major step in boasting use of Internet resources in Africa will be in developing policies that will encourage African countries to use information developed by other African countries. [ABSTRACT FROM AUTHOR]

The specific objectives were to identify the epidemiology of cutaneous sarcoidosis and describe the clinical and laboratory aspects of the disease. Materials and Methods. We performed a descriptive cross-sectional study involving 24 referred cases of cutaneous sarcoidosis in 25 years (1990–2014) collected at Venereology Dermatology Department of the University Hospital of Treichville (Abidjan) both in consultation and in hospitalization. Results. The hospital frequency was one case per year. The average age was 42 years, ranging from 9 to 64. The sex ratio was 1. The shortest time interval between the appearance of the skin lesion and consultation of Dermatology Department at CHU Treichville was 3 months. The elementary lesions were represented primarily by a papule (18 cases), placard (3 cases), and nodule (2 cases) and mainly sat on the face and neck in 8 cases (38%). Extra cutaneous lesions were dominated by ganglion and respiratory involvement with 5 cases each followed by musculoskeletal damage in 3 cases. Chest radiography showed abnormality in 13 cases (54%). The pulmonary function test performed in 13 patients found 7 cases (54%) having restrictive ventilatory syndrome and 6 cases (46%) being normal. A tuberculin anergy was found in 11 cases (61%). [ABSTRACT FROM AUTHOR]

Large prospective epidemiologic studies are vital in determining disease etiology and forming national health policy. Yet, such studies do not exist in sub-Saharan Africa (SSA) notwithstanding the growing burden of chronic diseases. We explored the feasibility of establishing a large-scale multicountry prospective study at five sites in four sub-Saharan countries. Based on country-specific considerations of feasibility, Nigeria enrolled health care professionals, South Africa and Tanzania enrolled teachers, and Uganda enrolled village residents at one rural and one periurban site each. All sites used a 6-month follow-up period but different approaches for data collection, namely standardized questionnaires filled out by participants or face-to-face interviews. We enrolled 1415 participants from five sites (range 200–489) with a median age of 41 years. Approximately half had access to clean-burning cooking fuel and 70% to piped drinking water, yet 92% had access to a mobile phone. The prevalence of chronic diseases was 49% among 45- to 54-year-olds and was dominated by hypertension (21.7% overall) – ranging from 4.5 to 31.2% across sites – and a serious injury in the past 12 months (12.4% overall). About 80% of participants indicated willingness to provide blood samples. At 6-month follow-up, 68% completed a questionnaire (45 to 96% across sites) with evidence that mobile phones were particularly useful. Our pilot study indicates that a large-scale prospective study in SSA is feasible, and the burden of chronic disease in SSA may already be substantial necessitating urgent etiologic research and primary prevention. [ABSTRACT FROM AUTHOR]