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| 1 | Need of surveillance response systems to combat Ebola outbreaks and other emerging infectious diseases in African countries显示文摘There is growing concern in Sub-Saharan Africa about the spread of the Ebola virus disease(EVD),formerly known as Ebola haemorrhagic fever,and the public health burden that it ensues.Since 1976,there have been 885,343 suspected and laboratory confirmed cases of EVD and the disease has claimed 2,512 cases and 932 fatality in West Africa.There are certain requirements that must be met when responding to EVD outbreaks and this process could incur certain challenges.For the purposes of this paper,five have been identified:(i)the deficiency in the development and implementation of surveillance response systems against Ebola and others infectious disease outbreaks in Africa;(ii)the lack of education and knowledge resulting in an EVD outbreak triggering panic,anxiety,psychosocial trauma,isolation and dignity impounding,stigmatisation,community ostracism and resistance to associated socio-ecological and public health consequences;(iii)limited financial resources,human technical capacity and weak community and national health system operational plans for prevention and control responses,practices and management;(iv)inadequate leadership and coordination;and(v)the lack of development of new strategies,tools and approaches,such as improved diagnostics and novel therapies including vaccines which can assist in preventing,controlling and containing Ebola outbreaks as well as the spread of the disease.Hence,there is an urgent need to develop and implement an active early warning alert and surveillance response system for outbreak response and control of emerging infectious diseases.Understanding the unending risks of transmission dynamics and resurgence is essential in implementing rapid effective response interventions tailored to specific local settings and contexts.Therefore,the following actions are recommended:(i)national and regional inter-sectorial and trans-disciplinary surveillance response systems that include early warnings,as well as critical human resources development,must be quickly adopted by allied ministries and organisations in African countries in epidemic and pandemic responses;(ii)harnessing all stakeholders commitment and advocacy in sustained funding,collaboration,communication and networking including community participation to enhance a coordinated responses,as well as tracking and prompt case management to combat challenges;(iii)more research and development in new drug discovery and vaccines;and(iv)understanding the involvement of global health to promote the establishment of public health surveillance response systems with functions of early warning,as well as monitoring and evaluation in upholding research-action programmes and innovative interventions. | Ernest Tambo Emmanuel Chidiebere Ugwu Jeane Yonkeu Ngogang | 2014 | Infectious Diseases of Poverty2014，3，1： | 20 |
| 2 | Systematic review and meta-analysis of esophageal cancer in Africa:Epidemiology, risk factors, management and outcomes显示文摘BACKGROUND Esophageal cancer(EC)is associated with a poor prognosis,particularly so in Africa where an alarmingly high mortality to incidence ratio prevails for this disease.AIM To provide further understanding of EC in the context of the unique cultural and genetic diversity,and socio-economic challenges faced on the African continent.METHODS We performed a systematic review of studies from Africa to obtain data on epidemiology,risk factors,management and outcomes of EC.A non-systematic review was used to obtain incidence data from the International Agency for Research on Cancer,and the Cancer in Sub-Saharan reports.We searched EMBASE,PubMed,Web of Science,and Cochrane Central from inception to March 2019 and reviewed the list of articles retrieved.Random effects metaanalyses were used to assess heterogeneity between studies and to obtain odds ratio(OR)of the associations between EC and risk factors;and incidence rate ratios for EC between sexes with their respective 95%confidence intervals(CI).RESULTS The incidence of EC is higher in males than females,except in North Africa where it is similar for both sexes.The highest age-standardized rate is from Malawi(30.3 and 19.4 cases/year/100000 population for males and females,respectively)followed by Kenya(28.7 cases/year/100000 population for both sexes).The incidence of EC rises sharply after the age of 40 years and reaches a peak at 75 years old.Meta-analysis shows a strong association with tobacco(OR 3.15,95%CI:2.83-3.50).There was significant heterogeneity between studies on alcohol consumption(OR 2.28,95%CI:1.94-2.65)and on low socioeconomic status(OR 139,95%CI:1.25-1.54)as risk factors,but these could also contribute to increasing the incidence of EC.The best treatment outcomes were with esophagectomy with survival rates of 76.6%at 3 years,and chemo-radiotherapy with an overall combined survival time of 267.50 d.CONCLUSION Africa has high incidence and mortality rates of EC,with preventable and nonmodifiable risk factors.Men in this setting are at increased risk due to their higher prevalence of tobacco and alcohol consumption.Management requires a multidisciplinary approach,and survival is significantly improved in the setting of esophagectomy and chemoradiation therapy. | Akwi W Asombang Nathaniel Chishinga Alick Nkhoma Jackson Chipaila Bright Nsokolo Martha Manda-Mapalo Joao Filipe G Montiero Lewis Banda Kulwinder S Dua | 2019 | World Journal of Gastroenterology2019，25，31： | 9 |
| 3 | Infections with Helicobacter pylori and challenges encountered in Africa显示文摘Helicobacter pylori(H.pylori)is the causative agent of gastritis,peptic ulcer disease,mucosa associated lymphoid tissue lymphoma and gastric cancer(GC).While this bacterium infects 50%of the world’s population,in Africa its prevalence reach as high as 80%as the infection is acquired during childhood.Risk factors for H.pylori acquisition have been reported to be mainly due to overcrowding,to have infected siblings or parent and to unsafe water sources.Despite this high H.pylori prevalence there still does not exist an African guideline,equivalent to the Maastricht V/Florence Consensus Report of the European Helicobacter and Microbiota Study Group for the management of this infection.In this continent,although there is a paucity of epidemiologic data,a contrast between the high prevalence of H.pylori infection and the low incidence of GC has been reported.This phenomenon is the so-called“African Enigma”and it has been hypothesized that it could be explained by environmental,dietary and genetic factors.A heterogeneity of data both on diagnosis and on therapy have been published.In this context,it is evident that in several African countries the increasing rate of bacterial resistance,mainly to metronidazole and clarithromycin,requires continental guidelines to recommend the appropriate management of H.pylori.The aim of this manuscript is to review current literature on H.pylori infection in Africa,in terms of prevalence,risk factors,impact on human health,treatment and challenges encountered so as to proffer possible solutions to reduce H.pylori transmission in this continent. | Stella Smith Muinah Fowora Rinaldo Pellicano | 2019 | World Journal of Gastroenterology2019，25，25： | 8 |
| 4 | Near-infrared reflectance spectroscopy reveals wide variation in major components of sesame seeds from Africa and Asia显示文摘Sesame is an important oilseed crop in Africa and Asia, owing to its high nutritional quality seed and market value. Variation in sesame seed components including oil, oleic acid,linoleic acid, and protein was investigated by near-infrared reflectance spectrometry in 139 samples collected from different countries. Oil and protein contents were between 40.8%and 60.3%(mean 53.0%) and 15.5% to 25.5%(mean 20.4%), respectively. Linoleic acid,ranging from 31.8% to 52.4%(mean 46%) was more abundant than oleic acid(31.8%–50.6%,mean 38.1%). Light-seeded samples displayed higher nutritional quality, as they were richer in oil, protein, and linoleic acid than dark seeds. Samples from Africa had higher oil and linoleic acid contents, while Asian samples had higher oleic content. The analysis revealed West African sesame cultivars containing especially high levels of seed components, which may command high market values. Two clusters of sesame samples grouped by seed composition were obtained, including one cluster with high oil and oleic acid content and the other with high protein and linoleic acid content. This study revealed that sesame samples from Africa and Asia harbor high variation for major seed components and also provided background information for breeding high-nutrition varieties according to the demands of sesame seed markets. | Komivi Dossa Xin Wei Marème Niang Pan Liu Yanxin Zhang Linhai Wang Boshou Liao Ndiaga Cissé Xiurong Zhang Diaga Diouf | 2018 | The Crop Journal2018，6，2： | 7 |
| 5 | China in action: national strategies to combat against emerging infectious diseases显示文摘During the 2013–2016 Ebola epidemic in West Africa,there was a special team as part of an international effort working in field.This was the Chinese aid team deployed to West Africa as a multidisciplinary group composed of experienced virologists,epidemiologists and physicians.As part of an international effort,they participated in the control of Ebola virus disease from the very beginning until the end of | Min Han Jinhui Gu George F.Gao William J.Liu | 2017 | Science China(Life Sciences)2017，60，12： | 6 |
| 6 | NEURAL NETWORK ASSESSMENT OF ROCKBURST RISKS FOR DEEP GOLD MINES IN SOUTH AFRICA显示文摘NEURALNETWORKASSESSMENTOFROCKBURSTRISKSFORDEEPGOLDMINESINSOUTHAFRICA①FengXiatingColegeofResourcesandCivilEnginering,Northeast... | Feng XiatingCollege of Resources and Civil Engineering,Northeastern University, Shenyang 110006, P. R. ChinaS. WebberCSIR Mining Technology, Johannesburg, South AfricaM. U. OzbayDepartment of Mining Engineering,University of the Witwatersr | 1998 | 中国有色金属学会会刊:英文版1998，8，2： | 6 |
| 7 | From 30 million to zero malaria cases in China: lessons learned for China-Africa collaboration in malaria elimination显示文摘Malaria was once one of the most serious public health problems in China,with more than 30 million malaria cases annually before 1949.However,the disease burden has sharply declined and the epidemic areas has shrunken after the implementation of an integrated malaria control and elimination strategy,especially since 2000.Till now,China has successfully scaled up its efforts to become malaria-free and is currently being evaluated for malaria-free certification by the WHO.In the battle against malaria,China's efforts have spanned generations,reducing from an incidence high of 122.9/10000(6.97 million cases)in 1954 to 0.06/10000(7855 cases)in 2010.In 2017,for the first time,China reached zero indigenous case of malaria,putting the country on track to record three consecutive years of zero transmission by 2020,accoding to the National Malaria Elimination Action Plan(2010-2020).China's efforts to eliminate malaria is impressive,and the country is dedicated to sharing its lessons learned in malaria elimination-including,but not limited to,the application of novel genetics-based approaches-with other nations through new initiatives.China will promote international relationships and establish collaborative platforms on a wide range of topics in roughly 65 countries,including 20 African nations.China's experience in applying innovative genetics-based approaches and tools to characterize malaria parasite populations,including surveillance of markers related to drug resistance,categorization of cases as indigenous or imported,and objective identification of the likely sources of infections to inform efforts towards malaria control and elimination in Africa could offer game-changing results when applied to settings with ongoing transmission. | Jun-Hu Chen Jun Fen Xiao-Nong Zhou | 2021 | Infectious Diseases of Poverty2021，10，2： | 5 |
| 8 | Burden of diabetic foot ulcer in Nigeria: Current evidence from the multicenter evaluation of diabetic foot ulcer in Nigeria显示文摘BACKGROUND Nigeria bears the greatest burden of diabetes prevalence in Sub-Saharan Africa. Diabetic foot ulcer (DFU) is a serious and potentially life-threatening complication of diabetes. Significant improvements in diabetic foot incidence and outcomes have been recorded in many Western countries in the past decade. However, the current burden of DFU in Nigeria is largely unknown. AIM To evaluate the patients’ profile, ulcer characteristics, associated co-morbidities and outcome of patients with DFU in Nigeria. METHODS Multicenter evaluation of diabetic foot ulcer in Nigeria was a one year multicenter observational study of patients hospitalized for DFU in six tertiary health institutions in Nigeria from March 2016 to March 2017. Demographic and diabetes information, ulcer characteristics and associated co-morbidities were assessed. Relevant laboratory and imaging studies were performed. All patients received appropriate multi-disciplinary care and were followed up until discharge or death. Outcome variables of interest were ulcer healing, lower extremity amputation (LEA), duration of hospitalization and mortality. RESULTS A total of 336 patients (55.1% male) with mean age of 55.9 ± 12.5 years were enrolled into this study. Majority (96.1%) had type 2 diabetes. Only 25.9% of the subjects had prior foot care knowledge. Most of the subjects presented late to the hospital and median (IQR) duration of ulcer at presentation was 39 (28-54) d. Ulcers were already advanced (Wagner grades ≥ 3) in 79.2% of the subjects while 76.8% of the ulcers were infected at the time of admission. The commonest comorbidities were systemic hypertension, anemia and hyperglycemic emergencies. One hundred and nineteen subjects (35.4%) suffered LEA while 10.4% left against medical advice. The median (IQR) duration of hospitalization was 52.0 (29-66) d with case fatality rate of 20.5%. CONCLUSION The burden of DFU in Nigeria is very high. The major gaps include low level of foot care knowledge among diabetic patients, overdependence on self-medication and unorthodox medicine following development of foot ulceration, late hospital presentation, and high amputation and mortality rates. Extensive foot care education within the framework of a multi-disciplinary foot care team is highly desirable. | Ejiofor Ugwu Olufunmilayo Adeleye Ibrahim Gezawa Innocent Okpe Marcelina Enamino Ignatius Ezeani | 2019 | World Journal of Diabetes2019，10，3： | 5 |
| 9 | A Case of New Variant COVID-19 First Emerging in South Africa Detected in Airplane Pilot—Guangdong Province,China,January 6,2021显示文摘On January 6,2021,Guangdong CDC successfully isolated the 501Y.V2 variant of coronavirus disease 2019(COVID-19)virus from a throat swab of a patient.The 501Y.V2 variant was first detected in South Africa,and the patient is a 55-year-old male airline pilot of South African nationality.He entered Guangzhou City,the capital of Guangdong Province,from Singapore on the evening of December 8,2020 and was subject to a COVID-19 test. | Fengjuan Chen Bosheng Li Peter Hao Yang Song Wenbo Xu Nankun Liu Chunliang Lei Changwen Ke | 2021 | China CDC weekly2021，3，2： | 5 |
| 10 | Non-conventional humanitarian interventions on Ebola outbreak crisis in West Africa: health, ethics and legal implications显示文摘Due to the lack of Ebola outbreak early warning alert,preparedness,surveillance and response systems,the most deadly,complex and largest ever seen Ebola war has been devastating West African communities.The unparalleled Ebola tsunami has prompted interrogations into,and uncertainties about,the effectiveness and efficiency of national,regional and international community’s illed-responses using conventional humanitarian control and containment approaches and methods.The late humanitarian and local non-government organisations emergency responses and challenges to curb transmission dynamics and stop the ongoing spread in the Ebola outbreak in West Africa have led to an unprecedented toll of 14,413 reported Ebola cases in eight countries since the outbreak began,with 5,177 reported deaths including 571 health-care workers and 325 died as 14 November 2014.These indications the need of further evaluation of monitoring as substantial proportion of infections outside the context of Ebola epicentres,Ebola health centres treatment and care,infection prevention and control quality assurance checks in these countries.At the same time,exhaustive efforts should target ensuring an sufficient supply of optimal personal protective equipment(PPE)to all Ebola treatment facilities,along with the provision of training and relevant guidelines to limit to the minimum possible level of risk.The continent hosts a big proportion of the world’s wealth,yet its people live in abject poverty,with governments unable to feed and govern them effectively,and who are condemned to endure even darker moments with the Ebola outbreak in West Africa.Institutionalisation of practical and operational non-conventional emergency response models efficient health systems,and tailored programmes can clearly support to prevent,control and eventually stamp out Ebola geo-distribution in addition to population mental health services that are requisite to address the massive range of the health,socio-psychological and economic consequences during and post Ebola associated crises.There is a critical need for a more pragmatic and robust scientific approach to transform and re-orient the huge natural and human resource potentials towards achieving universal coverage,the 2015-2030 Millennium Developing Goals(MDGs),sustainable growth and development in Africa. | Ernest Tambo | 2014 | Infectious Diseases of Poverty2014，3，1： | 4 |
| 11 | 西非地区埃博拉疫情显示文摘2014年12月7日开始,几内亚和利比里亚的埃博拉疫情开始持续消退。然而,由于传统的丧葬习俗和患者亲友对感染的隐瞒等原因,塞拉利昂的疫情仍在加重。截止2014年11月26日,塞拉利昂、几内亚和利比亚感染超过3周的新增确诊病例为374、319和1 339人。直至2014年12月8日的累计疑似和确诊病例17 800人,共造成6 331人死亡。 | 李云飞 张菁 | 2015 | 中国感染与化疗杂志2015，15，4： | 4 |
| 12 | Gastric cancer in Africa:Current management and outcomes显示文摘Gastric cancer is the fourth most common cancer and second most common cause of cancer death worldwide.Globally,gastric cancer poses a significant public health burden-both economically and socially.In 2008,the economic burden from premature cancer deaths and disability was$895 billion and gastric cancer was the second highest cancer responsible for healthy life lost.With the expected increase in cancer deaths and non-communicable diseases,these costs are expected to rise and impact patient care.World Health Organization,estimates a 15%increase in non-communicable disease worldwide,with more than 20%increase occurring in Africa between 2010 and 2020.Mali,West Africa,is ranked 15th highest incidence of gastric cancer worldwide at a rate of 20.3/100000,yet very scarce published data evaluating etiology,prevention or management exist.It is understood that risk factors of gastric cancer are multifactorial and include infectious agents(Helicobacter pylori,Epstein-Barr virus),genetic,dietary,and environmental factors(alcohol,smoking).Interestingly,African patients with gastric cancer are younger,in their 3rd-4th decade,and present at a late stage of the disease.There is sparse data regarding gastric cancer in Africa due to lack of data collection and under-reporting,which impacts incidence and mortality rates.Currently,GLOBOCAN,an International Agency for Research on Cancer resource,is the most comprehensive available resource allowing comparison between nations.In resource limited settings,with already restricted healthcare funding,data is needed to establish programs in Africa that increase gastric cancer awareness,curtail the economic burden,and improve patient management and survival outcomes. | Akwi W Asombang Rubayat Rahman Jamal A Ibdah | 2014 | World Journal of Gastroenterology2014，20，14： | 4 |
| 13 | Yersinia pestis, a problem of the past and a re-emerging threat显示文摘Yersinia pestis is the bacteria that causes plague,one of the deadliest diseases in human history.Three major plague pandemics(the Justinian Plague,the Black Death and the Modern Plague)have been recorded.Each caused massive fatalities and has become defining events in the time periods in places that were affected.The presence of natural plague foci in rodents across the world is one of the risk factors for human plague.While plague is a relatively rare problem for most countries,more than 90%of plague cases in the world still occur in Africa.This article discusses the threat of Yersinia pestis in the modern world by considering its prevalence and severity of illness it causes,transmission,antibiotic resistance,and its potential as a bioweapon. | Jae-Llane Ditchburn Ryan Hodgkins | 2019 | Biosafety and Health2019，1，2： | 4 |
| 14 | Prevalence and virological profiles of hepatitis B infection in human immunodeficiency virus patients显示文摘AIM: To determine the prevalence of hepatitis B virus (HBV) in adult human immunodeficiency virus (HIV) patients with CD4+ T-cell count less than 500/mm 3 and without antiretroviral therapy; to describe different HBV-HIV coinfection virological profiles; and to search for factors associated with HBs antigen (HBsAg) presence in these HIV positive patients.METHODS: During four months (June through September 2006), 491 patients were received in four HIV positive monitoring clinical centers in Abidjan. Inclusion criteria: HIV-1 or HIV-1 and 2 positive patients, age ≥ 18 years, CD4+ T-cell count < 500/mL and formal and signed consent of the patient. Realized blood tests included HIV serology, CD4+ T-cell count, quantitative HIV RNA load and HBV serological markers, such as HBsAg and HBc antibody (anti-HBcAb). We performed HBeAg, anti-HBe antibody (anti-HBeAb), anti-HBc IgM and quantitative HBV DNA load in HBsAg positive patients. Anti-HBsAb had been tested in HIV patients with HBsAg negative and anti-HBcAb-positive. HBV DNA was also tested in 188 anti-HBcAb positive patients with HBsAg negative status and without anti-HBsAb. Univariate analysis (Pearsonχ 2 test or Fischer exact test) and multivariate analysis (backward step-wise selection logistic regression) were performed as statistical analysis. RESULTS: Mean age of 491 patients was 36 ± 8.68 years and 73.3% were female. Type-1 HIV was found in 97% and dual-type HIV (type 1 plus type 2) in 3%. World Health Organization (WHO) clinical stage was 1, 2, 3 and 4 respectively in 61 (12.4%), 233 (47.5%), 172 (35%) and 25 patients (5.1%). Median CD4+ T-cell count was 341/mm 3 (interquartile range: 221-470). One hundred and twelve patients had less than 200 CD4+ T-cell/mm 3 . Plasma HIV-1 RNA load was elevated (≥ 5 log 10 copies/mL) in 221 patients (45%). HBsAg and anti-HBcAb prevalence was respectively 13.4% and 72.9%. Of the 66 HBsAg positive patients, 22 were inactive HBV carriers (33.3%), 21 had HBeAg positive hepatitis (31.8%) and 20 had HBeAg negative hepatitis (30.3%). HBeAg and anti-HBeAb were indeterminate in 3 of them. Occult B infection prevalence (HBsAg negative, anti-HBcAb positive, anti-HBsAb negative and detectable HBV DNA) was 21.3%. Three parameters were significantly associated with the presence of HBsAg: male [odds ratio (OR): 2.2;P = 0.005; 95% confidence interval (CI): 1.3-3.8]; WHO stage 4 (OR: 3.2;P = 0.01;95% CI: 1.3-7.9); and aspartate aminotransferase (AST) level higher than the standard (OR: 1.9;P = 0.04; 95% CI: 1.02-3.8). CONCLUSION: HBV infection prevalence is high in HIV-positive patients. HBeAg positive chronic hepatitis and occult HBV infection are more frequent in HIVpositive patients than in HIV negative ones. Parameters associated with HBsAg positivity were male gender, AIDS status and increased AST level. | Koffi Alain Attia Serge Eholié Eugène Messou Christine Danel Sandrine Polneau Henri Chenal Thomas Toni Myreille Mbamy Catherine Seyler Naomi Wakasugi Thérèse N'dri-Yoman Xavier Anglaret | 2012 | World Journal of Hepatology2012，4，7： | 4 |
| 15 | Is China ready for monkeypox?显示文摘Monkeypox is a rare viral infection caused by the monkeypox virus,which is similar to human smallpox.It is also a zoonosis which is found mainly in tropical rain forests of central and western Africa.The monkeypox virus was first detected in grivet at a laboratory in Copenhagen,Denmark,in 1958,and was later found in many African rodents,such as murine and squirrels.Therefore,it is believed that the primary way of infection is through direct human contact with these infected animals.In May 2003,human monkeypox appeared in the Western Hemisphere in the United States and spreaded rapidly,which immediately attracted the attention of all countries. | Qiang Wei | 2022 | Animal Models and Experimental Medicine2022，5，4： | 4 |
| 16 | Retinopathy in non diabetics, diabetic retinopathy and oxidative stress: a new phenotype in Central Africa?显示文摘AIM:To evaluate the rates of retinopathy without diabetes and diabetic retinopathy(DR),associated with some markers of oxidative stress,antioxidants and cardiometabolic risk factors.METHODS:We determined the prevalence of DR in 150type 2 diabetes mellitus(T2DM)patients,that of retinopathy in 50 non diabetics,the levels of body mass index(BMI),waist circumference(WC),blood pressure,lipids,8-isoprostane,8-hydroxydeoxyguanosine(8-oHdG),gamma-glutamyl transferase(GGT),oxidized low density lipoprotein(LDL)(OxLDL),thiobarbituric acid reacting substances(TBARS),reduced glutathione(GSH),superoxide dismutase(SOD),uric acid,creatinine,albumin,total antioxidant status(TAOS),zinc,selenium,magnesium,vitamin C,vitamin D,vitamin E,glucose,apolipoprotein B(ApoB).RESULTS:The prevalences of DR at 53y and Rtp at62y were 44%(n=66)and 10%(n=5),respectively.Thehighest levels of 8-isoprostane,8-OHdG,TBARS,SOD,and OxLDL were in DR.The lowest levels of vitamin D,vitamin C,TAOS,and vitamin E were in DR.In the casecontrol study discriminant analysis,the levels of vitamin C,vitamin D,ApoB,8-OHdG,creatinine,Zn,vitamin E,and WC distinguished significantly non-diabetics without DR(controls),T2DM patients without DR and T2DM patients with DR.CONCLUSION:Anticipation of DR onset is significantly associated with the exageration of oxidative stress biomarkers or decrease of antioxidants in African type 2diabetics.Prevention of oxidative stress and abdominal obesity is needed.Supplementation in vitamin C,D,and E should be recommended as complement therapies of T2DM. | Benjamin Longo-Mbenza Moise Mvitu Muaka Wayiza Masamba Lucien Muizila Kini Igor Longo Phemba Dalida Kibokela Ndembe Doris Tulomba Mona | 2014 | International Journal of Ophthalmology(English edition)2014，7，2： | 4 |
| 17 | Gastro-duodenal disease in Africa: Literature review and clinical data from Accra, Ghana显示文摘Gastroduodenal disease(GDD)was initially thought to be uncommon in Africa.Amongst others,lack of access to optimal health infrastructure and suspicion of conventional medicine resulted in the reported prevalence of GDD being significantly lower than that in other areas of the world.Following the increasing availability of flexible upper gastro-intestinal endoscopy,it has now become apparent that GDD,especially peptic ulcer disease(PUD),is prevalent across the continent of Africa.Recognised risk factors for gastric cancer(GCA)include Helicobater pylori(H.pylori),diet,Epstein-Barr virus infection and industrial chemical exposure,while those for PUD are H.pylori,non-steroidal antiinflammatory drug(NSAID)-use,smoking and alcohol consumption.Of these,H.pylori is generally accepted to be causally related to the development of atrophic gastritis(AG),intestinal metaplasia(IM),PUD and distal GCA.Here,we perform a systematic review of the patterns of GDD across Africa obtained with endoscopy,and complement the analysis with new data obtained on premalignant gastric his-topathological lesions in Accra,Ghana which was compared with previous data from Maputo,Mozambique.As there is a general lack of structured cohort studies in Africa,we also considered endoscopy-based hospital or tertiary centre studies of symptomatic individuals.In Africa,there is considerable heterogeneity in the prevalence of PUD with no clear geographical patterns.Furthermore,there are differences in PUD within-country despite universally endemic H.pylori infection.PUD is not uncommon in Africa.Most of the African tertiary-centre studies had higher prevalence of PUD when compared with similar studies in western countries.An additional intriguing observation is a recent,ongoing decline in PUD in some African countries where H.pylori infection is still high.One possible reason for the high,sustained prevalence of PUD may be the significant use of NSAIDs in local or over-the-counter preparations.The prevalence of AG and IM,were similar or modestly higher over rates in western countries but lower than those seen in Asia..In our new data,sampling of 136 patients in Accra detected evidence of pre-malignant lesions(AG and/or IM)in 20 individuals(14.7%).Likewise,the prevalence of pre-malignant lesions,in a sample of 109 patients from Maputo,were 8.3%AG and 8.3%IM.While H.pylori is endemic in Africa,the observed prevalence for GCA is rather low.However,cancer data is drawn from country cancer registries that are not comprehensive due to considerable variation in the availability of efficient local cancer reporting systems,diagnostic health facilities and expertise.Validation of cases and their source as well as specificity of outcome definitions are not explicit in most studies further contributing to uncertainty about the precise incidence rates of GCA on the continent.We conclude that evidence is still lacking to support(or not)the African enigma theory due to inconsistencies in the data that indicate a particularly low incidence of GDD in African countries. | Timothy N Archampong Richard H Asmah Cathy J Richards Vicki J Martin Christopher D Bayliss Edília Botao Leonor David Sandra Beleza Carla Carrilho | 2019 | World Journal of Gastroenterology2019，25，26： | 3 |
| 18 | Diabetic nephropathy in Africa:A systematic review显示文摘AIM:To determine the prevalence and incidence of diabetic nephropathy in Africa.METHODS:We performed a systematic narrative review of published literature following the MOOSE Guidelines for Meta-Analysis and Systematic Reviewsof Observational Studies.We searched Pub MedMEDLINE for all articles published in English and French languages between January 1994 and July 2014 using a predefined strategy based on the combination of relevant terms and the names of each of the 54 African countries and African sub-regions to capture the largest number of studies,and hand-searched the reference lists of retrieved articles.Included studies reported on the prevalence,incidence or determinants of chronic kidney disease(CKD) in people with diabetes within African countries.RESULTS:Overall,we included 32 studies from 16 countries;two being population-based studies and the remaining being clinic-based surveys.Most of the studies(90.6%) were conducted in urban settings.Methods for assessing and classifying CKD varied widely.Measurement of urine protein was the most common method of assessing kidney damage(62.5% of studies).The overall prevalence of CKD varied from 11% to 83.7%.Incident event rates were 94.9% for proteinuria at 10 years of follow-up,34.7% for endstage renal disease at 5 years of follow-up and 18.4% for mortality from nephropathy at 20 years of followup.Duration of diabetes,blood pressure,advancing age,obesity and glucose control were the common determinants of kidney disease.CONCLUSION:The burden of CKD is important among people with diabetes in Africa.High quality data from large population-based studies with validated measures of kidney function are still needed to better capture the magnitude and characteristics of diabetic nephropathy in Africa. | Jean Jacques N Noubiap Jashira Naidoo Andre P Kengne | 2015 | World Journal of Diabetes2015，6，5： | 3 |
| 19 | A retrospective cohort study of body mass index and survival in HIV infected patients with and without TB co-infection显示文摘Background:High early morbidity and mortality following antiretroviral therapy(ART)initiation has been a distinguishing feature of ART programmes in resource limited settings(RLS)compared to high-income countries.This study assessed how well body mass index(BMI:kg/m^(2))correlated with survival among HIV infected patients with and without TB co-infection.Methods:We retrospectively evaluated clinical data from 1000 HIV infected patients,among whom 389 were also co-infected with TB,between January 2008 and December 2010,in KwaZulu-Natal,South Africa.Results:Among 948 patients eligible for analysis,15.7%(149/948)were underweight(<18.50),55.9%(530/948)had normal BMI(≥18.50-24.90),18.7%(177/948)were overweight(25.00-29.00)and 9.7%(92/948)were obese(≥30.00).Irrespective of TB status,underweight patients,had significantly higher risk of death compared to those with normal BMI at baseline(aHR=2.9;95%CI:1.5-5.7;P=0.002).Conclusions:Irrespective of TB co-infection,low BMI correlated with mortality in HIV infected patients.Trial registration:UKZN Biomedical Research Ethics Committee Reference number E 248/05,23 September 2005. | Kogieleum Naidoo Nonhlanhla Yende-Zuma Stanton Augustine | 2018 | Infectious Diseases of Poverty2018，7，1： | 3 |
| 20 | Decomposition and decoupling analysis of carbon dioxide emissions in African countries during 1984–2014显示文摘The potential for mitigating climate change is growing worldwide,with an increasing emphasis on reducing CO_(2)emissions and minimising the impact on the environment.African continent is faced with the unique challenge of climate change whilst coping with extreme poverty,explosive population growth and economic difficulties.CO_(2)emission patterns in Africa are analysed in this study to understand primary CO_(2)sources and underlying driving forces further.Data are examined using gravity model,logarithmic mean divisia index and Tapio's decoupling indicator of CO_(2)emissions from economic development in 20 selected African countries during 1984-2014.Results reveal that CO_(2)emissions increased by 2.11%(453.73 million ton)over the research period.Gravity centre for African CO_(2)emissions had shifted towards the northeast direction.Population and economic growth were primary driving forces of CO_(2)emissions.Industrial structure and emission efficiency effects partially offset the growth of CO_(2)emissions.The economic growth effect was an offset factor in central African countries and Zimbabwe due to political instability and economic mismanagement.Industrial structure and emission efficiency were insufficient to decouple economic development from CO_(2)emissions and relieve the pressure of population explosion on CO_(2)emissions in Africa.Thus,future efforts in reducing CO_(2)emissions should focus on scaleup energy-efficient technologies,renewable energy update,emission pricing and long-term green development towards sustainable development goals by 2030. | Claudien Habimana Simbi Jianyi Lin Dewei Yang Jean Claude Ndayishimiye Yang Liu Huimei Li Lingxing Xu Weijing Ma | 2021 | Journal of Environmental Sciences2021，33，4： | 3 |
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