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African Setting (african + setting)

Distribution by Scientific Domains

Medical Sciences	63%
Humanities and Social Sciences	18%

Selected Abstracts

The Relationship Between Helicobacter pylori Infection, the Virulence Genotypes of the Infecting Strain and Gastric Cancer in the African Setting

HELICOBACTER, Issue 4 2001
J. A. Louw
Abstract Background. The relationship between Helicobacter pylori infection and gastric carcinoma remains controversial, especially in the African setting where infection is common, while gastric cancer is perceived to be uncommon, the basis of the so called ,African enigma'. This discrepancy between infection and the development of disease is commonly attributed to differences in host, environment and bacterial factors. Interest in the bacterial factors has focused on heterogeneity in the so-called ,virulence genes'. Aim. The aim of this prospective, case-controlled study was to establish whether H. pylori infection is significantly associated with gastric cancer and to investigate whether gastric cancer is associated with genotypically distinct (as it relates to the candidate virulence genes) organisms in this population. Methods. Patients with histologically confirmed gastric cancer were matched with nonulcer dyspeptic controls for age (within 5 years), gender and ethnicity. Helicobacter pylori status was determined by RUT, histology, culture and serology (locally validated and used as default determinant of H. pylori status). Tumors were classified according to the Lauren classification. The ,virulence genotype' of 17 paired culture samples was determined by previously described and validated molecular techniques (cagA presence, vacA alleles, structure of the cag pathogenicity island and analysis of the iceA alleles). Categorical variables were analysed by the ,2 test. Results. Forty-eight patients (median age 59 years) could be adequately matched to controls. 39/48 (81%) cases and 43/48 (90%) controls were H. pylori positive (NS). Significant differences in the virulence genotypes of infecting strains were noted: vacAs2-controls 24%, cases 0%, p < .00001; vacAs1 present , cases 100%, controls 76%, p < .05; cagA -3,-length > 650 bp , cases 47%, controls 0%, p < .002; cag pathogenicity island intact , cases 82%, controls 43%, p < .04; iceA1 , cases 53%, controls 6%, p < .005. cagA was found in all subjects. Conclusion. This study indicates that, in this African population at least, there is no difference in the prevalence of H. pylori infection when comparing gastric cancer cases with matched controls. However, the findings suggest that gastric cancer may be associated with infection by organisms that are genotypically different from those not associated with disease. [source]

MANDATORY HIV TESTING IN PREGNANCY: IS THERE EVER A TIME?

DEVELOPING WORLD BIOETHICS, Issue 1 2008
RUSSELL ARMSTRONG
ABSTRACT Despite recent advances in ways to prevent transmission of HIV from a mother to her child during pregnancy, infants continue to be born and become infected with HIV, particularly in southern Africa where HIV prevalence is the highest in the world. In this region, emphasis has shifted from voluntary HIV counselling and testing to routine testing of women during pregnancy. There have also been proposals for mandatory testing. Could mandatory testing ever be an option, even in high-prevalence settings? Many previous examinations of mandatory testing have dealt with it in the context of low HIV prevalence and a well-resourced health care system. In this discussion, different assumptions are made. Within this context, where mandatory testing may be a strategy of last resort, the objections to it are reviewed. Special attention is paid in the discussion to the entrenched vulnerability of women in much of southern Africa and how this contributes to both HIV prevalence and ongoing challenges for preventing HIV transmission during pregnancy. While mandatory testing is ethically plausible, particularly when coupled with guaranteed access to treatment and care, the discussion argues that the moment to employ this strategy has not yet come. Many barriers remain for pregnant women in terms of access to testing, treatment and care, most acutely in the southern African setting, despite the presence of national and international human rights instruments aimed at empowering women and removing such barriers. While this situation persists, mandatory HIV testing during pregnancy cannot be justified. [source]

Use of endoscopy in diagnosis and management of patients with dysphagia in an African setting

DISEASES OF THE ESOPHAGUS, Issue 3 2010
H. M. Y. Mudawi
SUMMARY The objectives of this study were to define the utility of esophagogastroduodenoscopy in the diagnosis and management of patients presenting with dysphagia and to determine the relative incidence of the various causes of dysphagia in Sudan. This is a prospective, cross-sectional, descriptive, hospital-based study carried out at the endoscopy unit of Soba University Hospital, Khartoum, Sudan. All patients complaining of dysphagia underwent upper gastrointestinal endoscopy with therapeutic intervention when necessary. A total of 114 patients were enrolled in the study, with a mean age of 47 years SD ± 19 and a male to female ratio of 1 : 1.04. A benign condition was diagnosed in 56% of the cases; this included esophageal strictures in 21% of the cases and achalasia in 14%. Malignant causes were mainly due to esophageal cancer (40.4%) and cancer of the stomach cardia (3.5%). Therapeutic intervention was attempted in 83% of the cases. Risk factors predictive of a malignant etiology were age over 40 years (P < 0.000), dysphagia lasting between 1 month and 1 year (P < 0.000), and weight loss (P < 0.000). A barium study was performed in 35 cases (31%) prior to endoscopic examination and proved to be inaccurate in three cases (8.6%). Upper gastrointestinal endoscopy in our African setting is an accurate and useful investigation in the diagnosis and management of patients presenting with dysphagia. Patients over the age of 40 years presenting with dysphagia and weight loss are more likely to have a neoplastic disease and should be referred for urgent endoscopy. [source]

The Relationship Between Helicobacter pylori Infection, the Virulence Genotypes of the Infecting Strain and Gastric Cancer in the African Setting

Young age a predictor of weak reactivity in a rapid antibody test in infants infected with HIV

JOURNAL OF MEDICAL VIROLOGY, Issue 8 2010
Leana Maree
Abstract In a resource-constrained African setting, children suspected of being infected with HIV are often screened with rapid antibody tests prior to definitive diagnosis with viral genome detection. It has previously been shown that a rapid antibody assay such as the CapillusÔ HIV-1/HIV-2 test may have a high false-negative rate in infants. In this study CD count and percentage, HIV-1 viral load, antigen-specific reactivity, and age was explored as predictors of negative or low antibody reactivity by this assay. Young age was found to be the only factor associated significantly with low antibody reactivity. This phenomenon appeared to be specific to HIV since no such age association was found for antibody reactivity to tetanus toxoid. Rapid assays only validated in adults should therefore be used with utmost caution in young infants since this may lead to high rates of false-negative results. J. Med. Virol. 82:1314,1317, 2010. © 2010 Wiley-Liss, Inc. [source]

Gender in the boss,subordinate relationship: a Nigerian study

JOURNAL OF ORGANIZATIONAL BEHAVIOR, Issue 4 2004
D. O. Adebayo
The present study examines the interaction effect of gender of both subordinates and supervisors on subordinates' perception of differentiation of boss,subordinate relationship in an African setting. Data was collected from a total of 60 boss,subordinate dyads in four-sex combinations obtained through a survey of a large five-star hotel in Abuja, Nigeria. Results revealed that subordinates in opposite-sex dyads perceived better quality of exchange than those in same-sex dyads. The strongest quality of exchange was perceived in male boss,female subordinate dyad, while the weakest was perceived in female boss,female subordinate dyad. This emphasizes the importance of gender in the differentiation of boss,subordinate relationships in an African setting. Copyright © 2004 John Wiley & Sons, Ltd. [source]

Management of HIV and AIDS in the African context

ORAL DISEASES, Issue 2002
R Wood
The initial response to the African HIV epidemic was to concentrate on the prevention of new infections. There is now an urgent need to address the health care requirements of large numbers of already infected individuals. The spectrum of disease in the African setting is dominated by tuberculosis, bacterial and protozoan infections. In much of Africa, health services are overwhelmed by the care of terminally ill AIDS patients. In the absence of specific HIV therapy, health care resources are being increasingly utilised, but with little survival benefit for the individual. Resources available for treating patients vary considerably between the richer and poorer countries of the continent. Primary prevention of opportunistic infections and maternal child transmission are at present affordable and cost-effective interventions. Whilst antiretroviral therapies may presently be unaffordable in much of Africa, they represent a modality that can have a major effect on HIV survival. The challenge is to improve the health and longevity of HIV-infected individuals with the rational use of the limited health resources available in Africa today. [source]

Diagnostic accuracy of verbal autopsies in ascertaining the causes of stillbirths and neonatal deaths in rural Ghana

PAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 5 2008
Karen M. Edmond
Summary This study evaluated the diagnostic accuracy of a verbal autopsy (VA) tool in ascertaining the causes of stillbirths and neonatal deaths in rural Ghana and was nested within a community-based maternal vitamin A supplementation trial (ObaapaVitA trial). All stillbirths and neonatal deaths between 1 January 2003 and 30 June 2004 were prospectively included. Community VAs were carried out within 6 months of death and were classified with a primary cause of death by three experienced paediatricans. The reference standard diagnosis was obtained by the study paediatrician in 4 district hospitals in the study area. There were 20 317 deliveries, 661 stillbirths and 590 neonatal deaths with a VA diagnosis in the study population. A total of 311 stillbirths and 191 neonatal deaths had both a VA and a hospital reference standard diagnosis. The VA performed poorly for stillbirth diagnoses such as congenital abnormalities and maternal haemorrhage. Accuracy was higher for intrapartum obstetric complications and antepartum maternal disease. For neonatal deaths, sensitivity was >60% for all major causes; specificity was 76% for birth asphyxia but >85% for prematurity and infection. Overall, VA diagnostic accuracy was higher than expected in this rural African setting. Our classification system was based on the expected public health importance of the individual causes of death, differing implications for intervention and the ability to distinguish between the individual causes in low-resource settings. We believe this system was easier to use than traditional approaches and resulted in high precision and accuracy. However, further simplifications are needed to allow use of the World Health Organisation VA in routine child health programmes. The diagnostic accuracy of the VA tool should also be assessed in other regions and in multicentre studies. [source]

Witchcraft and the limits of mass mediation in Malawi

THE JOURNAL OF THE ROYAL ANTHROPOLOGICAL INSTITUTE, Issue 2 2007
Harri Englund
This article explores what the study of witchcraft in an African setting can contribute to current efforts to theorize mass mediation and the imagination it fosters. Recent ethnographies of witchcraft discourses in Africa have continued to associate them with the formation of small-scale groups, but evidence from Malawi shows how they enable subjects to imagine sociality on an indeterminate scale. The article deploys the concept of mediation to theorize how in this imagination witches mediate sociality as the unrecognized third parties who give rise to recognized social relationships of varying scale. The ethnography of witchcraft discourses in radio broadcasting and an impoverished peri-urban area demonstrates not only their relevance to apparently disparate contexts but also their potential to exceed the impact of the mass media. The case of a violent conflict involving Pentecostal Christians, South Asian entrepreneurs, Muslims, and members of a secret society provides an example of how arguments about witchcraft had a greater impact on the popular imagination than a mass-mediated report of the same conflict. The article concludes by arguing that witchcraft discourses should be accorded weight equal to the mass media in theorizing the imagination. [source]

Developmental monitoring using caregiver reports in a resource-limited setting: the case of Kilifi, Kenya

ACTA PAEDIATRICA, Issue 2 2010
A Abubakar
Abstract Aim:, The main aim of the current study was to evaluate the reliability, validity and acceptability of developmental monitoring using caregiver reports among mothers in a rural African setting. Methods:, A structured interview for parents of children aged 24 months and less was developed through both participant consultation and a review of literature. The reliability and validity of the schedule was evaluated through a 10-month monitoring programme of 95 children, aged 2,10 months. The acceptability of the process was evaluated by studying retention rates and by organizing focus group discussions with participating mothers. Results:, The structured interview ,Developmental Milestones Checklist' consisted of 66 items covering three broad domains of child functioning: motor, language and personal,social development. The interview yielded scores of developmental achievements that showed high internal consistency and excellent test,retest reliability. The results were sensitive to maturational changes and nutritional deficiencies. In addition, acceptable retention rates of approximately 80% were found. Participating mothers reported that they found the procedures both acceptable and beneficial. Conclusion:, Developmental monitoring using caregiver report is a viable method to identify and monitor at-risk children in Sub-Saharan Africa. [source]