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PubMed1995

Morbidity pattern among refugees in Eastern Ethiopia.

The population of refugees in eastern Africa and the health problems affecting them are enormous. This study was conducted to document the morbidity pattern among refugees in eastern Ethiopia. The study was conducted to document the morbidity pattern among refugees in eastern Ethiopia. The study utilized a descriptive cross sectional design. Data were collected using a uniform format from all refugee camps in the eastern Ethiopia. Respiratory tract infection and diarrhoeal diseases were identified to be the major causes of morbidity, accounting for 31.8% and 27.3% respectively in children under five years, and for 34.9% and 8.5% respectively in the other age groups. The findings were consistent with other studies done in refugee populations elsewhere. Universality of the problems was noted and a coordinated multidisciplinary approach is recommended to alleviate the health problems of refugees.

Adolescent↗
PubMed2006

The known distribution and ecological preferences of the tick subgenus Boophilus (Acari: Ixodidae) in Africa and Latin America.

A compilation of the known distribution of Boophilus ticks in Africa and Latin America is presented, together with details on climate preferences. B. annulatus is recorded mainly in the western part of a strip from the equator to parallel 20 degrees N. It associates with woodlands and forests (lowland rain forest and secondary grassland). This species is also present in the Mediterranean region, associated to woodland and open areas. B. decoloratus extends southern to parallel 20 degrees N, in woodland with montane vegetation and Zambezian miombo; some records have been collected in the highveld grassland. B. geigyi is mainly collected in the western range of a stripe extending between parallels 5 degrees N and 18 degrees N, associated with Sudanian woodland, lowland rain forest with secondary grassland and woodland. Confirmed records of microplus in Africa are restricted to Malagasy region and south and eastern Africa, being predominant in the Zambezian miombo, deciduous forest with secondary grassland, and woodland. In Latin America, microplus is abundant in the Mesoamerican corridor to Venezuela and Colombia, and southern in Brazil and Argentina. The tick is mainly associated to the biomes of Chaco and Pampas in Argentina, the North-central moist Andes, the Atlantic forest (southern range) and the moist Meso-American vegetation (northern range). Most collections of B. annulatus and B. geigyi came from areas where winter minimum temperature is above 15 degrees C, maximum temperatures remain between 33 and 36 degrees C and maximum rainfall is recorded between June and September. B. decoloratus and African B. microplus are recorded in sites with low temperatures in May-September. Minimum temperature requirements are similar for both B. decoloratus and African B. microplus, and both are around 4 degrees C less than the value recorded for collections of Latin-American B. microplus. The rainfall pattern observed for decoloratus shows a minimum in May and June. The requirements of total rainfall are highest for B. microplus in Latin America, while records of African B. microplus are concentrated in areas of low rainfall between May and October, and high rainfall between November and March (low rainfall in the same period for B. decoloratus). Statistical analysis revealed the existence of populations (demes) with ecologically different requirements within each tick species. Both B. annulatus and B. decoloratus showed many different demes clearly associated to defined areas. The collections of Latin American B. microplus are very homogeneous according climate preferences and well separated from the African counterpart.

Africa↗
PubMed2000

Re-emergence of Chikungunya and O'nyong-nyong viruses: evidence for distinct geographical lineages and distant evolutionary relationships.

Chikungunya (CHIK) virus is a member of the genus Alphavirus in the family TOGAVIRIDAE: Serologically, it is most closely related to o'nyong-nyong (ONN) virus and is a member of the Semliki Forest antigenic complex. CHIK virus is believed to be enzootic throughout much of Africa and historical evidence indicates that it spread to other parts of the world from this origin. Strains from Africa and Asia are reported to differ biologically, indicating that distinct lineages may exist. To examine the relatedness of CHIK and ONN viruses using genetic data, we conducted phylogenetic studies on isolates obtained throughout Africa and Southeast Asia. Analyses revealed that ONN virus is indeed distinct from CHIK viruses, and these viruses probably diverged thousands of years ago. Two distinct CHIK virus lineages were delineated, one containing all isolates from western Africa and the second comprising all southern and East African strains, as well as isolates from Asia. Phylogenetic trees corroborated historical evidence that CHIK virus originated in Africa and subsequently was introduced into Asia. Within the eastern Africa and southern Africa/Asia lineage, Asian strains grouped together in a genotype distinct from the African groups. These different geographical genotypes exhibit differences in their transmission cycles: in Asia, the virus appears to be maintained in an urban cycle with Aedes aegypti mosquito vectors, while CHIK virus transmission in Africa involves a sylvatic cycle, primarily with AE: furcifer and AE: africanus mosquitoes.

Aedes↗
PubMed1996

Biodemography and genetics of the Berba of Benin.

Genetic structure of the Berba of Benin was studied on the basis of biodemographic data and ABO, RH, MNS, KEL, JK, FY, ACP1, ADA, AK1, CA2, ESD, GLO1, G6PD, PGD, PGM1 (subtypes and thermostability), PGM2, PGP, SODA, HB alpha, HB beta, HB delta, BF, C3, and HP gene frequencies. Comparisons were carried out with other populations of Benin and of sub-Saharan Africa. Correspondence analysis revealed genetic differentiation among the three main groups of populations who inhabit sub-Saharan Africa: Bushmen-Hottentots, Pygmies, and Negroes. The genetic differentiation of the Negroes in relation to their linguistic affiliation and geographic localization was evident. The first group included the populations belonging to the Bantoid subfamily of the Nigritic linguistic stock living in southern Africa; in the second subcluster the populations of central-eastern Africa were localized, and the third subcluster included the populations living in the West.

ABO Blood-Group System↗
PubMed2000

False teeth and real suffering: the social course of 'germectomy' in eastern Uganda.

The removal of the incipient canine teeth ('germectomy') in small babies is a practice carried out in many parts of eastern Africa. This article describes how 'germectomy' among the Jop'Adhola in Eastern Uganda is an important idiom of distress, referred to as false teeth by English speaking people, and lakijo marach (bad teeth) or gira kwanya (that which is removed) in the local language Dhop'Adhola. Through an analysis of how the notion of false teeth is shaped by macro social forces of war and poverty as well as by negotiations within the local social world, the discussion is taken beyond the question of cultural belief. False teeth as a practice seems to have spread through vast geographical areas within a few decades, but as the example of the Jop'Adhola shows, it has taken a particular social course in eastern Uganda--as it is most likely to also have done everywhere else it has gained a footing. By analyzing its social course we may gain insight into important mediating social processes which may have as much to do with actual health outcome in a particular area as health care per se.

Anthropology, Cultural↗
PubMed2004

Ecologic and geographic distribution of filovirus disease.

We used ecologic niche modeling of outbreaks and sporadic cases of filovirus-associated hemorrhagic fever (HF) to provide a large-scale perspective on the geographic and ecologic distributions of Ebola and Marburg viruses. We predicted that filovirus would occur across the Afrotropics: Ebola HF in the humid rain forests of central and western Africa, and Marburg HF in the drier and more open areas of central and eastern Africa. Most of the predicted geographic extent of Ebola HF appear to have been observed; Marburg HF has the potential to occur farther south and east. Ecologic conditions appropriate for Ebola HF are also present in Southeast Asia and the Philippines, where Ebola Reston is hypothesized to be distributed. This first large-scale ecologic analysis provides a framework for a more informed search for taxa that could constitute the natural reservoir for this virus family.

Africa↗
PubMed1995

Epidemiology and semiology of rheumatoid arthritis in Third World countries.

Studies conducted over the last three decades in Third World countries have confirmed that rheumatoid arthritis occurs throughout the world. When interpreting the results of these studies, however, the potential biases resulting from the socioeconomic, demographic and health care conditions in these countries should be kept in mind. These studies, of which most did not include representative samples, identified geographic variations in the semiology and genetic profile of the disease. In India, the prevalence of rheumatoid arthritis (0.75%) is similar to that in the West. In China, Indonesia, and the Philippines, in contrast, rheumatoid arthritis appears rare (prevalence below 0.4%), in both urban and rural settings. The rarity of rheumatoid arthritis in rural Africa contrasts with the high prevalence of the disease in Jamaica, where over 2% of the adult population are affected. In a study in Latin America, rheumatoid arthritis was the reason for seeking medical advice in 22% of rheumatology clinic patients. These differences probably reflect variations in the interactions between genetic and environmental factors. Rheumatoid arthritis may be less severe in Asia and West Africa than in western countries. No such difference has been found for Jamaica or southern and eastern Africa. In China and India, the genetic profile associated with rheumatoid arthritis is not uniform. Thus, associations with antigens other than HLA DR4 have been demonstrated. This genetic variability may reflect the heterogeneity of the Chinese and Indian populations. It may also support the theory of a shared epitope. In southern Africa, most rheumatoid arthritis patients carry the HLA DR4 antigen.(ABSTRACT TRUNCATED AT 250 WORDS)

Africa↗
PubMed2003

Phylogeography of Biomphalaria glabrata and B. pfeifferi, important intermediate hosts of Schistosoma mansoni in the New and Old World tropics.

The historical phylogeography of the two most important intermediate host species of the human blood fluke Schistosoma mansoni, B. glabrata in the New World, and B. pfeifferi in the Old World, was investigated using partial 16S and ND1 sequences from the mitochondrial genome. Nuclear sequences of an actin intron and internal transcribed spacer (ITS)-1 were also obtained, but they were uninformative for the relationships among populations. Phylogenetic analyses based on mtDNA revealed six well-differentiated clades within B. glabrata: the Greater Antilles, Venezuela and the Lesser Antilles, and four geographically overlapping Brazilian clades. Application of a Biomphalaria-specific mutation rate gives an estimate of the early Pleistocene for their divergence. The Brazilian clades were inferred to be the result of fragmentation, due possibly to climate oscillations, with subsequent range expansion producing the overlapping ranges. Within the Venezuela and Lesser Antilles clade, lineages from each of these areas were estimated to have separated approximately 740 000 years ago. Compared to B. glabrata, mitochondrial sequences of B. pfeifferi are about 4x lower in diversity, reflecting a much younger age for the species, with the most recent common ancestor of all haplotypes estimated to have existed 880 000 years ago. The oldest B. pfeifferi haplotypes occurred in southern Africa, suggesting it may have been a refugium during dry periods. A recent range expansion was inferred for eastern Africa less than 100 000 years ago. Several putative species and subspecies, B. arabica, B. gaudi, B. rhodesiensis and B. stanleyi, are shown to be undifferentiated from other B. pfeifferi populations.

Africa↗
PubMed2005

Socioeconomic status as a risk factor for HIV infection in women in East, Central and Southern Africa: a systematic review.

This is a critical, systematic review of the relationship between socioeconomic status (SES) and HIV infection in women in Southern, Central and Eastern Africa. In light of the interest in micro-credit programmes and other HIV prevention interventions structured to empower women through increasing women's access to funds and education, this review examines the epidemiological and public health literature, which ascertains the association between low SES using different measurements of SES and risk of HIV infection in women. Also, given the focus on structural violence and poverty as factors driving the HIV epidemic at a structural/ecological level, as advocated by Paul Farmer and others, this study examines the extent to which differences in SES between individuals in areas with generalized poverty affect risk for SES. Out of 71 studies retrieved, 36 studies met the inclusion criteria including 30 cross-sectional, one case-control and five prospective cohort or nested case-control studies. Thirty-five studies used at least one measurement of female's SES and fourteen also included a measurement of partner's SES. Studies used variables measuring educational level, household income and occupation or employment status at the individual and neighbourhood level to ascertain SES. Of the 36 studies, fifteen found no association between SES and HIV infection, twelve found an association between high SES and HIV infection, eight found an association between low SES and HIV infection and one was mixed. In interpreting these results, this review examines the role of potential confounders and effect modifiers such as history of STDs, number of partners, living in urban or rural areas and time and location of study in sub-Saharan Africa. It is argued that STDs and number of partners are on the causal pathway under investigation between HIV and SES and should not be adjusted as confounders in any analysis. In conclusion, it is argued that in low-income sub-Saharan Africans countries, where poverty is widespread, increasing access to resources for women may initially increase risk of HIV or have no effect on risk-taking behaviours. In some parts of Southern Africa where per capita income is higher and within-country inequalities in wealth are greater, studies suggest that increasing SES may decrease risk. This review concludes that increased SES may have differential effects on married and unmarried women and further studies should use multiple measures of SES. Lastly, it is suggested that the partner's SES (measured by education or income/employment) may be a stronger predictor of female HIV serostatus than measures of female SES.

Adult↗
PubMed1977

A yellow fever epizootic in Zika forest, Uganda, during 1972: Part 1: Virus isolation and sentinel monkeys.

The results of the yellow fever immunity survey of Central and East Africa reported by SAWYER & WHITMAN in 1936 prompted scientists to undertake well-planned epidemiological studies on yellow fever in eastern Africa. A Yellow Fever Research Institute (the present East African Virus Research Institute) was established at Entebbe in 1936 for this purpose. One of the areas where much work has been carried out is a strip of typical tropical forest, the Zika Forest, 12 kilometres from the Institute. Routine surveillance work, particularly on the biting activity of the yellow fever vector mosquitoes, has been going on since 1946. It was during one of these studies in 1972 that the first yellow fever virus strain was isolated from Aedes africanus collected from the Zika and Sisa forests and one strain was isolated from Coquillettidia fuscopennata, also from the Zika Forest. Three sentinel rhesus monkeys, nomimmune to YF, which were kept in the Zika Forest during the time of the epizootic died of YF disease. The present observations indicate that YF is still present in Africa, and as such it still remains a potential menace to the human population. The epidemiological implications are discussed.

Aedes↗
PubMed1995

Characterisation of African isolates of rinderpest virus.

Isolates of rinderpest virus (RPV) recovered from outbreaks of the disease in Kenya and Southern Sudan between 1986 and 1993 were compared to each other and to earlier isolates from East and West Africa. The recent isolates were mildly pathogenic for susceptible cattle and thus resembled other mild strains of RPV recovered from cattle and wildlife in East Africa more than 30 years ago. Monoclonal antibody analysis using a panel of 12 anti-RPV haemagglutinin protein-specific antibodies (mAbs) revealed that individual isolates were distinguishable. However, the panel of mAbs could not be used to relate the isolates on the basis of their pathogenicity or geographic origin. Immunoprecipitation of the virus-induced proteins from infected Vero cells, followed by SDS-polyacrylamide gel electrophoresis, showed that the recent mild RPV isolates from eastern Africa were closely related to each other and to their contemporary isolates from Nigeria and Egypt, but they were distinct from another mild isolate recovered from the region three decades ago. Two distinct lineages of African RPV isolates were identified by sequencing a region of the genome around the proteolytic enzyme cleavage site of the fusion protein from the old and new isolates. One lineage, which included virus isolates recovered from East and West Africa during the 1960s, showed a closer phylogenetic relationship to Asian and Middle Eastern RPV isolates. The other lineage consisted mainly of isolates recovered from East, West and North Africa between 1983 and 1993. The results showed that there was co-circulation of two different lineages of RPV in Nigeria during the epizootics of the 1980s.

Africa↗