Born in the Chinese city of Wuhan, the consequences of the coronavirus pandemic on global health and economies have been and continue to be devastating. In Africa, its countries grieve for ...unprecedented burdens of caseloads and mortality due to COVID-19, the virus responsible for the disease. This narrative review aims to establish the scale of the health and economic crisis wrought by the pandemic in Africa, including its impact on the informal economic sector, projections of the effect on national GDP, as well as its political dimensions.
Documentary evidence issued between January and 8 August 2020 was sought from the Google Scholar, PubMed, Scopus, and Web of Science databases. Searches of published and unpublished abstracts were also conducted from appropriate websites, government documents, organizational reports, newspaper commentaries, and reports issued by global, regional, and local centers of disease control and prevention.
The COVID-19 pandemic is responsible for a fourfold crisis in Africa: (1) a health crisis: the victimization of frontline healthcare workers and the looming caseload and death tolls with 1.039 million (12%) cases being confirmed and over 22,966 (2.4%) deaths as of 8 August 2020. The highest death toll was recorded in Southern Africa of 11,024 (48%) followed by North Africa with 6,989 (29.2%) deaths; (2) a social crisis: with the violation of human rights, the killing of citizens by security forces and increased crime. This, in turn, exacerbates social inequalities, the breakdown of households, instances of social unrest, and general impoverishment; (3) an economic crisis: manifested by a decline in GDP and mass unemployment; (4) a political crisis: implementation of measures that may not be appropriate for Africa, discrimination of refugees and immigrants, evacuation of citizens to their home countries, resulting in distrust of political leaders and postponement of national elections, and mounting cases of conflicts and unrest.
Lockdown during the COVID-19 outbreak is a prevention mechanism in affluent countries, in contrast to developing regions such as Africa, where it is a race against death and starvation. Policymakers must apply novel and locally relevant prevention and management strategies to cope with this growing disaster.
Background: There is a high prevalence of work productivity loss among patients with rheumatoid arthritis (RA), with a seeming link between loss of work productivity and RA disease activity. The ...increase in poor clinical outcomes associated with disease activity in this population has largely contributed to poor work performance, thereby creating a huge burden on patients with RA. Notwithstanding the reported more beneficial effects of eccentric exercise compared with conventional resistance training, there appears to be a death of information about the effects of this intervention on RA conditions. Aims of the study: This study aimed to investigate the effects of an eccentric exercise intervention on work-related performance and physical activity in RA patients. Method: Thirty-seven RA patients aged 30–65 (9 males; 28 females), who participated in the study were randomized into exercise and control groups. The Health and Work Performance Questionnaire and Health Assessment Questionnaire assessed RA patients’ work-related performance. Physical activity at work was assessed with the Global Physical Activity Questionnaire. Results: The study’s results confirmed that an eccentric exercise significantly improved work performance in the RA population (Absenteeism –1.5 P = 0.005, Presenteeism +8.33 P = 0.014). Further, our study found that an eccentric exercise intervention improved physical function in patients with RA (–0.263 P = 0.004). Interestingly, a significant increase in moderate-intensity physical activity was reported among RA patients who participated in the 12-week eccentric exercise intervention program (+106.66 P = 0.008). Conclusion: These findings, therefore, confirm that an eccentric exercise intervention could improve work-related performance and physical activity levels among RA patients.
University students globally are reportedly living unhealthy lifestyles, challenging universities to develop physical activity (PA) and health promotion (HP) intervention strategies. The current ...study aimed to review global universities’ physical activity and health promotion activities to inform the PA and HP guidelines for Eswatini university students in the Sub-Saharan region. An electronic search was performed for review articles published between 1996 and 2021, using Cochrane, Google Scholar, PubMed Central, Scopus, and Medline Web of Science databases. The documents reviewed showed that some global universities under investigation follow the health promoting university (HPU) concept influenced by the Ottawa charter (1986). The review articles further showed that implementing the healthy university concept differs due to cultural and contextual differences from one institution to another. The reviews showed the main item areas as smoking control/alcohol and drug abuse, mental health, sexual health, physical activities, healthy eating habits/diet categorized under health promotion. The main PA activities were pedometer activity tracking, measurement of PA using validated questionnaires, sports, games, among other intervention activities. The HPU concept is thus a good starting point that can be promoted and spread to all other universities globally with different charters’ guidance, including the Ottawa charter and the Okanagan charter.
The aim of the study is to assess whether a blue-enriched light intervention improves nocturnal alertness and daytime sleep of night workers.
Thirteen miners performing 12-hour night shifts for 12 ...consecutive nights were exposed to a baseline and a blue-enriched light condition. All subjects wore an actigraph and completed a Psychomotor Vigilance Task at the beginning and at the end of each shift. Data were analyzed with linear mixed models.
In the blue-enriched light condition, the daily increase in median reaction time (RT), mean RT, slowest 10% of RT, and fastest 10% of RT was lower than that observed in the baseline condition between day 1 and 12 ( P ≤ 0.05).
The addition of blue-enriched light during a long period of extended night shifts counteracts most of the daily decline in nocturnal alertness observed in the standard lighting condition, irrespectively of sleep duration and sleep efficiency.
Sickle cell disease and β-thalassemia affect the production of the adult β-hemoglobin chain. The clinical severity is lessened by mutations that cause fetal γ-globin expression in adult life (i.e., ...the hereditary persistence of fetal hemoglobin). Mutations clustering ~200 nucleotides upstream of the HBG transcriptional start sites either reduce binding of the LRF repressor or recruit the KLF1 activator. Here, we use base editing to generate a variety of mutations in the -200 region of the HBG promoters, including potent combinations of four to eight γ-globin-inducing mutations. Editing of patient hematopoietic stem/progenitor cells is safe, leads to fetal hemoglobin reactivation and rescues the pathological phenotype. Creation of a KLF1 activator binding site is the most potent strategy - even in long-term repopulating hematopoietic stem/progenitor cells. Compared with a Cas9-nuclease approach, base editing avoids the generation of insertions, deletions and large genomic rearrangements and results in higher γ-globin levels. Our results demonstrate that base editing of HBG promoters is a safe, universal strategy for treating β-hemoglobinopathies.
To synthesize the existing evidence on NCD policy equity, policy practices, and policy implementation gaps to prevent NCDs in African countries.
Following the PRISMA-Extension for equity-focused ...review guidelines, the authors systematically searched documentary evidence from seven databases (BMC, CINHAL Plus, Cochrane, Google Scholar, PubMed, Web of Science, and Scopus) to identify studies conducted and published on African countries between April 2013 and December 31, 2020.
From identified 213 records, 21 studies were included in the final synthesis. Major results showed inadequate studies on NCD policy, unsatisfactory NCD-related policy development, poor policy implementation, lack of policy equity to combat NCDs, and lack of data recorded on NCDs' prevalence, morbidity, and mortality.
The rigorous WHO-endorsed NCD policies and prevention strategies on the African continent might debar African policymakers and leaders from developing and implementing indigenous NCD-combating strategies. Continent-wide innovative and indigenous NCD-prevention policies and policy equity to effectively prevent, control, and manage NCDs must be developed by African scientists and policymakers.
Background: Three-quarters of non-communicable disease (NCD) mortality occurs in low- and middle-income countries. However, in most developing countries, quality and reliable data on morbidity, ...mortality and risk factors for NCD to predict its burden and prevalence are less well understood and availability of these data is limited. To better inform policymakers and improve healthcare systems in developing countries, it is also important that these factors be understood within the context of the particular country in question. Objective: The aim of this study is to further inform practitioners in Ethiopia about the availability and status of NCD information within the Ethiopian healthcare system.
Method: A mixed method research design was used with data collected from 13 public referral hospitals in Ethiopia. In phase 1 quantitative data were collected from 312 health professionals (99 physicians; 213 nurses) using a cross-sectional survey. In phase 2, qualitative data were collected using: interviews (n 1/4 13 physician hospital managers); and one focus group (n 1/4 6 national health bureau officers).
Results: Results highlighted the lack of NCD morbidity, mortality and risk factor data, periodic evaluation of NCD data and standardised protocols for NCD data collection in hospitals. The study also identified similar discrepancies in the availability of NCD data and standardised protocols for NCD data collection among the regions of Ethiopia.
Conclusion: This study highlighted important deficiencies in NCD data and standardised protocols for data collection in the Ethiopian healthcare system. These deficiencies were also observed among regions of Ethiopia, indicating the need to strengthen both the healthcare system and health information systems to improve evidence-based decision-making.
Implications: Identifying the status of NCD data in the Ethiopian healthcare system could assist policymakers, healthcare organisations, healthcare providers and health beneficiaries to reform and strengthen the existing healthcare system.
Considering present concerns about healthcare costs and the lack of evidence and published articles on breast reconstruction costs in Switzerland, we retrospectively investigated charges to the Swiss ...healthcare system for different breast reconstruction procedures at the Centre Hospitalier Universitaire Vaudois.
We selected all hospitalized patients at the University Hospital who underwent a "total" delayed breast reconstruction from January 2012 to December 2015. Analysis included 72 women who underwent autologous or implant-based reconstructions. Three main breast reconstruction techniques were included: Deep Inferior Epigastric Perforator (n = 46) autologous flap reconstruction, Tissue Expander followed by Implant (n = 12) and pedicled Latissimus Dorsi (n = 12) flap with or without tissue expander and implant (n = 7). For all different groups, the global costs of reconstruction and total number of required operations were statistically compared.
Global costs for Deep Inferior Epigastric Perforator reconstruction were 29,728 ± 1892 CHF (avg ± Std. Error of Mean), while Tissue Expander reconstruction showed a significantly higher global cost, reaching an average of 44,313 ± 5553 CHF (avg ± Std. Error of Mean). LD showed a similar cost, compared to the Deep Inferior Epigastric Perforator reconstruction (29,813 ± 3637 CHF), increasing when including an implant (37,688 ± 4840 CHF). No significant differences in the number of interventions were detected.
These data show that autologous breast reconstruction (DIEP) delivers the best cost ratio, with lower overall costs. Implant-based reconstructions showed a greater likelihood of complications and re-intervention, globally creating superior costs when compared to autologous reconstructions.
Despite the popularity and health benefits of running, a popular sporting activity performed by many individuals worldwide, runners are at risk of being injured. Of concern is the lack of ...evidence-based data and information on Ethiopian 10, 000-meter long-distance runners. The purpose of this study was to establish the incidence and the risk factors associated with lower-extremity running-related injuries amongst 10, 000-meter long distance runners in Ethiopia. A prospective study was used over a period of ten months in eleven running clubs and twelve Youth Athletics Training Programs in Amhara Regional State and Addis Ababa. Participants completed a self-reported questionnaire on 1) demographic characteristics; 2) risk factors associates with running-related injuries and, 3) their injury status. Logistic regression analysis and odds ratio (OR) and its 95% confidence interval (CI) was estimated for the predictor variables. The incidence of running-related injury was 62.4%, corresponding to 0.35 injuries per 100 running hours or 3.54 injuries per 1000 running hours. The most commonly injured anatomical site was the knee (33.6%), with a strain the most common type of injury (36.4%). Participants previously injured had an 8.20 higher OR (2.14-31.40). Runners who train respectively 40km-50km (OR = 0.003, 95% CI, 0.000-0.073) and 50km-60km (OR = 0.053, 95% CI, 0.004-0.728) per week and runners that wore running shoes eight to eleven months (OR = 0.033, 95% CI, 0.003-0.392) was significantly associated with a protective benefit against running-related injuries. Runners, coaches, and medical professionals must acknowledge the specific risk factors associated with running-related injuries. The results underscore urgent interventions to ensure that 10 000-meter Ethiopian long distance runners become injury free.
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