Africa South Of The Sahara

撒哈拉以南非洲
  • 文章类型: Journal Article
    背景:最近在撒哈拉以南非洲爆发的埃博拉病毒病(EVD)和马尔堡病毒病(MVD)表明需要更好地了解动物水库,疾病负担,和人类传播丝状病毒。该方案概述了系统的文献综述,以评估撒哈拉以南非洲地区感染人类的丝状病毒的患病率。次要目的是定性地描述和评估用于评估患病率的测定。
    方法:本系统评价的数据源包括PubMed,Embase,和WebofScience。标题,摘要,全文将由一名主要审稿人审核,然后由一组次要审稿人审核,和数据将使用预先指定和试点的数据提取表单进行提取。审查将包括人体横断面研究,队列研究,以及直到2024年3月13日在撒哈拉以南非洲进行的随机对照试验,这些试验已经发表在同行评审的科学期刊上,没有语言限制。患病率将按病原体分层,人口,分析,和抽样方法,并在森林地块中呈现,估计患病率和95%置信区间。如果一个阶层中有足够的研究,将计算I2统计数据(使用R统计软件),如果异质性较低,数据将被汇集。此外,用于检测感染的分析将被评估。纳入审查的所有研究将使用JBI患病率关键评估工具评估质量和偏倚风险,并使用等级确定性评级评估确定性。
    结论:使用患病率准确测量撒哈拉以南非洲感染人类的丝状病毒的暴露率提供了对自然史的基本理解,传输,以及亚临床感染的作用。本系统综述将确定研究差距,并为寻求提高我们对丝状病毒感染的理解的未来研究提供方向。了解自然历史,传输,亚临床感染的作用对于预测干预对疾病负担的影响至关重要。
    背景:根据PRISMA-P方法中概述的指南,该协议于2023年4月7日在PROSPERO注册(ID:CRD42023415358).
    BACKGROUND: Recent outbreaks of Ebola virus disease (EVD) and Marburg virus disease (MVD) in sub-Saharan Africa illustrate the need to better understand animal reservoirs, burden of disease, and human transmission of filoviruses. This protocol outlines a systematic literature review to assess the prevalence of filoviruses that infect humans in sub-Saharan Africa. A secondary aim is to qualitatively describe and evaluate the assays used to assess prevalence.
    METHODS: The data sources for this systematic review include PubMed, Embase, and Web of Science. Titles, abstracts, and full texts will be reviewed for inclusion by a primary reviewer and then by a team of secondary reviewers, and data will be extracted using a pre-specified and piloted data extraction form. The review will include human cross-sectional studies, cohort studies, and randomized controlled trials conducted in sub-Saharan Africa up until March 13, 2024 that have been published in peer-reviewed scientific journals, with no language restrictions. Prevalence will be stratified by pathogen, population, assay, and sampling methodology and presented in forest plots with estimated prevalence and 95% confidence intervals. If there are enough studies within a stratum, I2 statistics will be calculated (using R statistical software), and data will be pooled if heterogeneity is low. In addition, assays used to detect infection will be evaluated. All studies included in the review will be assessed for quality and risk of bias using the JBI Prevalence Critical Appraisal Tool and for certainty using the GRADE certainty ratings.
    CONCLUSIONS: Accurately measuring the rate of exposure to filoviruses infecting humans in sub-Saharan Africa using prevalence provides an essential understanding of natural history, transmission, and the role of subclinical infection. This systematic review will identify research gaps and provide directions for future research seeking to improve our understanding of filovirus infections. Understanding the natural history, transmission, and the role of subclinical infection is critical for predicting the impact of an intervention on disease burden.
    BACKGROUND: In accordance with the guidelines outlined in the PRISMA-P methodology, this protocol was registered with PROSPERO on April 7, 2023 (ID: CRD42023415358).
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  • 文章类型: Journal Article
    范围审查的目的是了解和描述撒哈拉以南非洲和南非骨科手术人群中与手术部位感染(SSI)相关的危险因素。本文介绍了将用于范围审查的协议。
    将使用MEDLINE(PubMed)进行全面的文献检索,CINAHL(EBSCO),Embase和Cochrane图书馆确定符合纳入标准的文章,包括出版文献和灰色文献,为了广泛概述已报告的与接受骨科手术并在手术后90天内发生SSI的患者相关的危险因素。其他研究将通过探索纳入的合格研究的参考列表来获得。通过使用人口的组合,曝光,成果框架,与每个类别相关的术语和同义词,在不同的变化中,以及布尔运算符(AND,OR,不是)在搜索策略中,为范围审查确定了全面和相关的文献。
    预计结果将提供风险因素的基线,为临床使用的风险评估工具的开发提供信息。
    该协议将为制定范围审查提供信息,以描述撒哈拉以南非洲和南非骨科手术后与SSIs相关的因素。
    UNASSIGNED: The objective of the scoping review will be to understand and describe risk factors associated with surgical site infection (SSI) in an orthopaedic surgery population in Sub-Saharan Africa and South Africa. This paper describes the protocol that will be used for the scoping review.
    UNASSIGNED: A comprehensive literature search will be conducted using MEDLINE (PubMed), CINAHL (EBSCO), Embase and Cochrane Libraries to identify articles meeting the inclusion criteria, including both published and grey literature, in order to provide a broad overview of the reported risk factors associated with patients who have undergone an orthopaedic surgery with an outcome of SSI within 90 days of a procedure. Additional studies will be sourced by exploring the reference list of included eligible studies. By using a combination of the Population, Exposure, Outcome framework, terms and synonyms related to each category, in different variations, along with Boolean operators (AND, OR, NOT) in the search strategy, identified comprehensive and relevant literature for the scoping review.
    UNASSIGNED: It is anticipated the results will provide a baseline of risk factors that will inform the development of a risk assessment tool for clinical use.
    UNASSIGNED: This protocol will inform the development of a scoping review to describe factors associated with SSIs following orthopaedic surgery in Sub-Saharan Africa and South Africa.
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  • 文章类型: Journal Article
    背景:人类免疫缺陷病毒(HIV)是全球健康问题,造成三千五百多万人死亡,97%发生在发展中国家,特别影响撒哈拉以南非洲。虽然艾滋病毒检测对于早期治疗和预防至关重要,现有的研究往往集中在特定的群体,忽视一般成人检测率。这项研究旨在确定撒哈拉以南非洲成年人接受艾滋病毒检测的预测因素。
    方法:数据来自官方人口与健康调查项目数据库,采用多级整群抽样技术收集调查数据。在这项研究中,纳入来自13个撒哈拉以南非洲国家的283,936名成年人的加权样本.采用多水平多变量逻辑回归分析来确定HIV检测吸收的预测因素。Akaike的信息标准指导模型选择。调整后的比值比和相应的95%置信区间确定了显著的预测变量。
    结果:在撒哈拉以南非洲国家的成年人中,艾滋病毒检测的患病率为65.01%[95%CI(64.84%,65.17%)]。影响因素包括男性[AOR:0.51,95%CI(0.49,0.53)],不同年龄段的赔率比不同(20-24[AOR:3.3,95%CI(3.21,3.46)],25-29[AOR:4.4,95%CI(4.23,4.65)],30-34[AOR:4.6,95CI(4.40,4.87)],35-39[AOR:4.0,95CI(3.82,4.24)],40-44[AOR:3.7,95CI(3.50,3.91)],45-49[AOR:2.7,95CI(2.55,2.87)],50+[AOR:2.7,95CI(2.50,2.92)]),婚姻状况(已婚[AOR:3.3,95CI(3.16,3.46)],同居[AOR:3.1,95%CI(2.91,3.28)],丧偶/分居/离婚[AOR:3.4,95CI(3.22,3.63)]),女性家庭负责人(AOR:1.28,95CI(1.24,1.33)),教育水平(小学[AOR:3.9,95CI(3.72,4.07)],次要[AOR:5.4,95CI(5.16,5.74)],更高的[AOR:8.0,95CI(7.27,8.71)]),媒体曝光(AOR:1.4,95CI(1.32,1.43)),财富指数(中间[AOR:1.20,95CI(1.17,1.27)],更丰富的[AOR:1.50,95CI(1.45,1.62)]),对PLWHIV有歧视态度[AOR:0.4;95%CI(0.33,0.37)],有多个性伴侣[AOR:1.2;95%CI(1.11,1.28)],对艾滋病毒有全面的了解[AOR:1.6;95%CI(1.55,1.67)],农村住宅(AOR:1.4,95CI(1.28,1.45)),和较低的社区文盲率(AOR:1.4,95CI(1.31,1.50))显着影响了该地区的HIV检测吸收。
    结论:本研究强调需要有针对性的干预措施,以解决撒哈拉以南非洲成年人在艾滋病毒检测方面的差异,并在2030年前实现95-95-95目标方面取得进展。因此,针对关键因素的量身定制的干预措施对于增强测试的可及性和强调提高认识运动至关重要,方便的服务访问,有针对性的教育工作,以改善早期诊断,治疗,以及该地区的艾滋病毒预防。
    BACKGROUND: Human Immunodeficiency Virus (HIV) is a global health concern, causing over 35 million deaths, with 97% occurring in developing nations, particularly impacting Sub-Saharan Africa. While HIV testing is crucial for early treatment and prevention, existing research often focuses on specific groups, neglecting general adult testing rates. This study aims to identify predictors of HIV testing uptake among adults in Sub-Saharan Africa.
    METHODS: Data were obtained from the official Demographic and Health Survey program database, which used a multistage cluster sampling technique to collect the survey data. In this study, a weighted sample of 283,936 adults was included from thirteen Sub-Saharan African countries. Multilevel multivariable logistic regression analysis was employed to identify predictors of HIV testing uptake. Akaike\'s information criteria guided model selection. Adjusted odds ratios and corresponding 95% confidence intervals determined significant predictor variables.
    RESULTS: Among adults in Sub-Saharan African countries, the prevalence of HIV testing uptake was 65.01% [95% CI (64.84%, 65.17%)]. Influential factors included male sex [AOR: 0.51, 95% CI (0.49,0.53)], varying odds ratios across age groups (20-24 [AOR: 3.3, 95% CI (3.21, 3.46) ], 25-29 [AOR: 4.4, 95% CI (4.23, 4.65)], 30-34 [AOR: 4.6, 95%CI (4.40, 4.87)], 35-39 [AOR: 4.0, 95%CI (3.82, 4.24)], 40-44 [AOR: 3.7, 95%CI (3.50, 3.91)], 45-49 [AOR: 2.7, 95%CI (2.55, 2.87)], 50+ [AOR: 2.7, 95%CI (2.50, 2.92)]), marital status (married [AOR: 3.3, 95%CI (3.16, 3.46)], cohabiting [AOR: 3.1, 95% CI (2.91, 3.28)], widowed/separated/divorced [AOR: 3.4, 95%CI (3.22, 3.63)]), female household headship (AOR: 1.28, 95%CI (1.24, 1.33)), education levels (primary [AOR: 3.9, 95%CI (3.72, 4.07)], secondary [AOR: 5.4, 95%CI (5.16, 5.74)], higher [AOR: 8.0, 95%CI (7.27, 8.71)]), media exposure (AOR: 1.4, 95%CI (1.32, 1.43)), wealth index (middle [AOR: 1.20, 95%CI (1.17, 1.27)], richer [AOR: 1.50, 95%CI (1.45, 1.62)]), Having discriminatory attitudes towards PLWHIV [AOR: 0.4; 95% CI (0.33, 0.37)], had multiple sexual partners [AOR: 1.2; 95% CI (1.11, 1.28)], had comprehensive knowledge about HIV [AOR: 1.6; 95% CI (1.55, 1.67)], rural residence (AOR: 1.4, 95%CI (1.28, 1.45)), and lower community illiteracy (AOR: 1.4, 95%CI (1.31, 1.50)) significantly influenced HIV testing uptake in the region.
    CONCLUSIONS: This study highlights the need for tailored interventions to address disparities in HIV testing uptake among adults in Sub-Saharan Africa and progress towards the achievement of 95-95-95 targets by 2030. Thus, tailored interventions addressing key factors are crucial for enhancing testing accessibility and emphasizing awareness campaigns, easy service access, and targeted education efforts to improve early diagnosis, treatment, and HIV prevention in the region.
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  • 文章类型: Journal Article
    自2011年启动以来,已有59个国家的政府使用世界银行的“促进更好教育成果的系统方法”(SABER)政策工具来设计其基于学校的国家健康和营养计划。该工具指导各国政府对照国际基准自我评估其教育系统政策,并确定可采取行动的优先事项,以加强国家计划。撒哈拉以南非洲49个国家中有32个(65%)进行了SABER审查,在全球范围内,68%的低收入国家和54%的中低收入国家采用了这种方法。对51项可比的SABER学校供餐调查的分析表明,建立国家学校供餐框架更长的国家在其他政策领域也往往更先进。反之亦然。SABER的评论一致确定,也许可以预见,最薄弱的政策领域与方案设计有关,实施和财政空间。此分析还发现,该工具在跟踪几个时间点实施的政策演变方面具有附加价值,并表明随着国家计划的成熟,政策领域变得更加先进。该工具的这些好处与2021年共同创建全球学校膳食联盟的98个国家特别相关。联盟成员国的具体目标是扩大覆盖面,并支持受COVID-19大流行期间学校关闭影响的学童和青少年的福祉。SABER工具具有证明的潜力,加快和跟踪学校膳食政策的变化,因为它以前曾被撒哈拉以南非洲74%(31/42)的低收入和中低收入国家使用,是这些国家政治经济中已经被接受的要素,因此有可能迅速部署。
    Since its launch in 2011, 59 governments have used the World Bank\'s Systems Approach for Better Education Results (SABER) policy tool to design their national school-based health and nutrition programs. This tool guides governments to self-evaluate their education system policies against international benchmarks and identify actionable priorities to strengthen national programs. Thirty-two of the 49 countries in sub-Saharan Africa (65%) have undertaken a SABER review, and globally the approach has been adopted by 68% of the world\'s low-income countries and 54% of lower-middle-income countries. Analysis of 51 comparable SABER School Feeding surveys suggests that countries with longer established national school meals frameworks tend also to be more advanced in other policy areas, and vice versa. The SABER reviews consistently identify, perhaps predictably, that the weakest policy areas relate to program design, implementation and fiscal space. This analysis also found that the tool had an additional value in tracking the evolution of policies when implemented over several time points, and showed that policy areas become more advanced as national programs mature. These benefits of the tool are particularly relevant to the 98 countries that co-created the global School Meals Coalition in 2021. The Coalition member countries have the specific goal of enhancing coverage and support for the well-being of schoolchildren and adolescents affected by the school closures during the COVID-19 pandemic. The SABER tool has the demonstrated potential to implement, accelerate and track changes in school meals policy and, since it has been previously used by 74% (31/42) of low- and lower-middle-income countries in sub-Saharan Africa, is an already accepted element of the political economies of those countries and so has the potential to be deployed rapidly.
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  • 文章类型: Journal Article
    背景:卒中是全球成年人和老年人死亡和残疾的主要原因。尽管已经进行了几项主要研究来确定撒哈拉以南非洲地区卒中幸存者中卒中后认知障碍的患病率,这些研究的结果不一致.因此,本研究旨在确定撒哈拉以南非洲地区卒中幸存者中卒中后认知障碍的合并患病率,并确定其相关因素.
    方法:这些研究来自谷歌学者,Scopus,PubMed,和WebofScience数据库。对所包括的研究的参考列表进行手动搜索。使用随机效应DerSimonian-Laird模型计算撒哈拉以南非洲卒中幸存者卒中后认知障碍的合并患病率。
    结果:共有10项主要研究纳入最终的meta分析,样本量为1,709名卒中幸存者。PSCI的合并患病率来自9项纳入研究,样本量为1,566。相比之下,有关相关因素的数据来自所有10项纳入研究,样本量为1,709项.卒中幸存者中卒中后认知障碍的合并患病率为59.61%(95%CI:46.87,72.35);I2=96.47%;P<0.001)。年龄增加(≥45岁)[AOR=1.23,95%CI:1.09,1.40],较低的教育水平[AOR=4.35,95%CI:2.87,6.61],功能恢复不良[AOR=1.75,95%CI:1.42,2.15],左半球卒中[AOR=4.88,95%CI:2.98,7.99]与卒中后认知障碍显著相关。
    结论:在撒哈拉以南非洲的卒中幸存者中,卒中后认知障碍的合并患病率相当高。年龄增加,教育水平较低,功能恢复不良,和左半球卒中是撒哈拉以南非洲地区卒中后认知障碍的综合独立预测因子.利益相关者应专注于赋权教育和生活方式的改变,保持他们的思想,保持与社会活动的联系,并为具有这些确定因素的卒中幸存者提供康复服务,以降低卒中后认知障碍的风险。
    BACKGROUND: Stroke is the leading cause of death and disability among adults and elderly individuals worldwide. Although several primary studies have been conducted to determine the prevalence of poststroke cognitive impairment among stroke survivors in sub-Saharan Africa, these studies have presented inconsistent findings. Therefore, this study aimed to determine the pooled prevalence of poststroke cognitive impairment and identify its associated factors among stroke survivors in sub-Saharan Africa.
    METHODS: The studies were retrieved from the Google Scholar, Scopus, PubMed, and Web of Science databases. A manual search of the reference lists of the included studies was performed. A random-effects DerSimonian-Laird model was used to compute the pooled prevalence of poststroke cognitive impairment among stroke survivors in sub-Saharan Africa.
    RESULTS: A total of 10 primary studies with a sample size of 1,709 stroke survivors were included in the final meta-analysis. The pooled prevalence of PSCI was obtained from the 9 included studies with a sample size of 1,566. In contrast, the data regarding the associated factors were obtained from all the 10 included studies with a sample size of 1,709. The pooled prevalence of poststroke cognitive impairment among stroke survivors was 59.61% (95% CI: 46.87, 72.35); I2 = 96.47%; P < 0.001). Increased age (≥ 45 years) [AOR = 1.23, 95% CI: 1.09, 1.40], lower educational level [AOR = 4.35, 95% CI: 2.87, 6.61], poor functional recovery [AOR = 1.75, 95% CI: 1.42, 2.15], and left hemisphere stroke [AOR = 4.88, 95% CI: 2.98, 7.99] were significantly associated with poststroke cognitive impairment.
    CONCLUSIONS: The pooled prevalence of poststroke cognitive impairment was considerably high among stroke survivors in sub-Saharan Africa. Increased age, lower educational level, poor functional recovery, and left hemisphere stroke were the pooled independent predictors of poststroke cognitive impairment in sub-Saharan Africa. Stakeholders should focus on empowering education and lifestyle modifications, keeping their minds engaged, staying connected with social activities and introducing rehabilitative services for stroke survivors with these identified factors to reduce the risk of developing poststroke cognitive impairment.
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  • 文章类型: Journal Article
    疟原虫是撒哈拉以南非洲地区最常见的非恶性疟原虫。尽管如此,关于其遗传多样性的数据很少。因此,我们旨在建立一种基于大小多态性区域的malariae基因分型方法,该方法可以很容易地应用于分子流行病学研究。
    四种潜在的基因分型标记,Pm02,Pm09,疟原虫血小板反应蛋白相关匿名蛋白(pmtrap),和疟原虫裂殖子表面蛋白片段2(pmmsp1F2)通过巢式PCR扩增,并使用自动毛细管凝胶电泳进行分析。
    我们观察到pmtrap(MOI=1.61)和pmmsp1F2(He=0.81)的等位基因多样性最高。进一步将两种标记pmtrap和pmmsp1F2应用于21个疟疾阳性个体的不同样品组,随访一周,我们看到他们的表现有很高的一致性。结果表明,在无症状的加蓬研究人群中,疟原虫感染具有很大的复杂性和高度的动态性。
    我们成功地实施了一个新的针对疟原虫的基因分型小组,该小组仅由两个标记组成:pmtrap和pmmsp1F2。它可以很容易地应用于其他环境,以调查疟原虫种群的基因型多样性,提供有关该寄生虫物种的分子流行病学的进一步重要数据。
    UNASSIGNED: Plasmodium malariae is the most common non-falciparum species in sub-Saharan Africa. Despite this, data on its genetic diversity is scarce. Therefore, we aimed to establish a P. malariae genotyping approach based on size polymorphic regions that can be easily applied in molecular epidemiological studies.
    UNASSIGNED: Four potential genotyping markers, Pm02, Pm09, P. malariae thrombospondin-related anonymous protein (pmtrap), and P. malariae merozoite surface protein fragment 2 (pmmsp1 F2) were amplified via nested PCR and analysed using automated capillary gel electrophoresis.
    UNASSIGNED: We observed the highest allelic diversity for pmtrap (MOI = 1.61) and pmmsp1 F2 (He = 0.81). Further applying the two markers pmtrap and pmmsp1 F2 on a different sample set of 21 P. malariae positive individuals followed up over one week, we saw a high consistency in their performance. The results show a large complexity and high dynamics of P. malariae infections in the asymptomatic Gabonese study population.
    UNASSIGNED: We successfully implemented a new genotyping panel for P. malariae consisting of only two markers: pmtrap and pmmsp1 F2. It can be easily applied in other settings to investigate the genotype diversity of P. malariae populations, providing further important data on the molecular epidemiology of this parasite species.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    背景:人类福祉的一个重要方面是积极的性健康结果。然而,不良性健康结果的问题仍然是一个主要的公共卫生问题,特别是撒哈拉以南非洲(SSA)的残疾妇女。因此,当前的范围审查从以下五个方面绘制了过去二十九年来对残疾妇女性健康的研究:性活动,使用避孕药,性自主权,性暴力和危险的性行为,同时寻求确定当前的知识状态并解决SSA中的研究差距。
    方法:当前的范围审查是由Arksey和O\'Malley提出的方法学框架提供的。在PubMed中进行了探索性搜索,WebofScience,非洲在线期刊,等。,为了确定在SSA中进行的侧重于性活动的研究,使用避孕药,性自主权,自1994年国际人口与发展会议成立至2024年3月30日以来,SSA残疾妇女中的性暴力和危险的性行为。这一过程导致纳入了十七(17)项研究。
    结果:在通过各种数据库确定的1362个中,34项研究纳入全文检索和筛选;只有17项研究符合纳入标准。符合条件的研究在SSA的六个国家进行,并在2008年至2023年之间发表。八项研究采用定量研究类型,六个利用定性方法,三种采用混合方法分析。两项关于性活动的研究,十项是关于避孕药具的使用,四次是关于性暴力的,一项关于危险性行为的研究,虽然没有关于性自主性的研究符合纳入标准。
    结论:这篇综述表明,关于性活动的研究很少或很少,使用避孕药,性自主权,在SSA,甚至在大量研究(避孕药具使用)的残疾妇女中,性暴力和危险的性行为,大多数研究是在一个国家进行的。未来的研究应该考虑检查性健康的维度,比如性自主权,在文献中没有或很少的残疾妇女的性活动和危险的性行为。
    性健康对人们的整体福祉非常重要,它包括我们在社交方面的感受,精神上,情感上,和身体。在撒哈拉以南非洲,特别是残疾妇女,性健康是一个大问题。所以,本综述回顾了过去29年中有关撒哈拉以南非洲地区残疾妇女性健康的研究.它集中在五个方面:性活动,使用避孕药,性自主权,性暴力,和危险的性行为。在数据库中搜索相关研究,发现17项符合设定标准。这些研究来自撒哈拉以南非洲的六个国家,发表于2008年至2023年之间。大多数研究都是关于避孕药具的使用,很少关注性活动,性暴力,和危险的行为。没有任何关于性自主性的合格研究。审查的结论是,没有足够的研究这些性健康方面的残疾妇女在撒哈拉以南非洲,特别是关于性自主权,未来的研究应该对此进行进一步的探讨。
    BACKGROUND: An essential aspect of human well-being is positive sexual health outcomes. However, the issue of adverse sexual health outcomes continues to be a major public health concern, particularly for women with disabilities in sub-Saharan Africa (SSA). Therefore, this current scoping review mapped studies conducted in the last twenty-nine years on the sexual health of women with disabilities from these five dimensions: sexual activity, contraceptive use, sexual autonomy, sexual violence and risky sexual behaviour, whilst seeking to identify the current state of knowledge and address the study gaps in SSA.
    METHODS: This current scoping review was informed by the methodological framework proposed by Arksey and O\'Malley. Exploratory searches were conducted in PubMed, Web of Science, African Journals Online, etc., to identify studies conducted in SSA that focus on sexual activity, contraceptive use, sexual autonomy, sexual violence and risky sexual behaviour among women with disabilities in SSA since the inception of the International Conference on Population and Development in 1994 to 30th of March 2024. This process resulted in the inclusion of seventeen (17) studies.
    RESULTS: Of the 1362 identified through various databases, 34 studies were included for the full-text retrieval and screening; only 17 studies met the inclusion criteria. The eligible studies were conducted across six countries in SSA and published between 2008 and 2023. Eight studies used quantitative study type, six utilised qualitative approach, and three employed mixed-methods analysis. Two studies were conducted on sexual activity, ten were conducted on contraceptive use, four were conducted on sexual violence, and one study was conducted on risky sexual behaviour, whilst no study on sexual autonomy met the inclusion criteria.
    CONCLUSIONS: This review showed that there were few or scarce studies on sexual activity, contraceptive use, sexual autonomy, sexual violence and risky sexual behaviour among women with disabilities in SSA and even where the studies were substantial (contraceptive use), the majority of the studies were conducted in a country. Future studies should consider examining dimensions of sexual health, such as sexual autonomy, sexual activity and risky sexual behaviour of women with disabilities that were not available or were scarce in the literature.
    Sexual health is really important for people\'s overall well-being, and it includes aspects like how we feel socially, mentally, emotionally, and physically. In sub-Saharan Africa, especially for women with disabilities, sexual health is a big concern. So, this review looked at studies done over the last 29 years about the sexual health of women with disabilities in sub-Saharan Africa. It focused on five areas: sexual activity, contraceptive use, sexual autonomy, sexual violence, and risky sexual behaviour. Databases were searched for relevant studies and found 17 that fit the set criteria. These studies were from six countries in sub-Saharan Africa and were published between 2008 and 2023. Most of the studies were about contraceptive use, with fewer focusing on sexual activity, sexual violence, and risky behaviour. There weren\'t any eligible studies on sexual autonomy. The review concluded that there\'s not enough research on these sexual health dimensions among women with disabilities in sub-Saharan Africa, especially on sexual autonomy, and future studies should explore this further.
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  • 文章类型: Journal Article
    无论是否有机会将利润效率提高至少73%,在撒哈拉以南非洲运营的小额信贷机构的效率仅为27%,远低于平均值。结论是在使用随机前沿方法分析小额信贷机构的利润效率之后得出的,该方法应用于从34个撒哈拉以南非洲国家的128个小额信贷机构获得的数据。研究结果表明,小额信贷机构之间存在跨时间的统一利润效率经验。在低收入国家经营的小额信贷机构和信用合作社形式的小额信贷在经济上比同行更有效率。此外,小额信贷机构的利润效率受到总资产的显著影响,每笔贷款成本,每位员工的贷款,法律地位,和该县小额信贷的收入群体。值得注意的是,女性借款人和女性贷款官员的存在对小额信贷机构的利润效率产生了不利影响,这表明性别多样性在小额信贷机构的效率中起着作用。最后,我们建议小额信贷的管理机构更多地致力于提高劳动效率,赚取资产利用率,贷款收取效率,女性的参与和最热门的技术实施。
    Irrespective of the promising opportunity to improve profit efficiency by at least 73%, microfinance institutions operating in Sub-Saharan Africa are efficient only for 27%, far below the average value. The conclusion is drawn after analyzing the profit efficiency of the microfinance institutions using the stochastic frontier approach applied to data obtained from 128 microfinance institutions operating in 34 Sub-Saharan African countries. The study results suggest the presence of uniform profit efficiency experience across time among microfinance institutions. Microfinance institutions operating in low-income countries and credit union form microfinance are economically more efficient than their counterparts. Furthermore, the profit efficiency of microfinance institutions is significantly affected by total assets, cost per loan, loan per staff, legal status, and the county\'s income group of microfinance. Notably, the profit efficiency of microfinance institutions is adversely affected by the presence of female borrowers and female loan officers suggesting that gender diversity plays a role in the efficiency of microfinance institutions. Finally, we recommend that the managing body of microfinance work more on improving labor efficiency, earning asset utilization, loan collection efficiency, women\'s involvement and the hottest technology implementation.
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  • 文章类型: Journal Article
    背景:非洲的移民正在增加,并受到各种相互关联的社会经济,冲突和与气候有关的原因。PHC服务的初级医疗保健(PHC)迁移将处于应对相关健康问题的最前沿。
    目的:本研究旨在回顾有关移民对非洲PHC服务提供的影响以及移民在获得PHC方面面临的挑战的文献。
    方法:在非洲大学(2010年至2021年)的六个数据库和灰色文献中应用了系统方法(用于系统审查的首选报告项目和用于范围审查的荟萃分析扩展)。对数据进行了定量和定性分析。
    结果:共确认了3628项研究,纳入了50项。大多数研究是描述性或使用混合方法。出版物来自25个国家,52%的研究来自南非,乌干达和肯尼亚。大多数移民来自津巴布韦,刚果民主共和国和索马里。移民社区的人口健康管理具有挑战性。移民通过增加传染病影响PHC服务,精神健康障碍,生殖健康问题和营养不良。初级保健服务在处理灾难情况下的流离失所人口方面准备不足。获得PHC服务受到与移民有关的因素的影响,卫生服务和医护人员。
    结论:一些非洲国家需要更好地准备其PHC服务和提供者,以应对非洲范围内越来越多的移民。供稿:审查指出需要关注政策,减少获取障碍,提高初级保健提供者的技能,以处理多样性和复杂性。
    BACKGROUND:  Migration in Africa is increasing and driven by a variety of inter-related socio-economic, conflict and climate-related causes. Primary healthcare (PHC) migration on PHC service will be in the forefront of responding to the associated health issues.
    OBJECTIVE:  This study aimed to review the literature on the effect of migration on PHC service delivery in Africa and the challenges facing migrants in accessing PHC.
    METHODS:  A systematic approach (Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews) was applied across six databases and grey literature from African universities (2010 to 2021). Data were extracted and analysed quantitatively and qualitatively.
    RESULTS:  A total of 3628 studies were identified and 50 were included. Most studies were descriptive or used mixed methods. Publications came from 25 countries, with 52% of studies from South Africa, Uganda and Kenya. Most migrants originated from Zimbabwe, the Democratic Republic of Congo and Somalia. Population health management for migrant communities was challenging. Migration impacted PHC services through an increase in infectious diseases, mental health disorders, reproductive health issues and malnutrition. Primary healthcare services were poorly prepared for handling displaced populations in disaster situations. Access to PHC services was compromised by factors related to migrants, health services and healthcare workers.
    CONCLUSIONS:  Several countries in Africa need to better prepare their PHC services and providers to handle the increasing number of migrants in the African context.Contribution: The review points to the need for a focus on policy, reducing barriers to access and upskilling primary care providers to handle diversity and complexity.
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