104 research outputs found
Ambient air pollution and health in Sub-Saharan Africa : current evidence, perspectives and a call to action
No full textCITATION: Katoto, P. D. M. C., et al. 2019. Ambient air pollution and health in Sub-Saharan Africa : current evidence, perspectives and a call to action. Environmental Research, 173:174-188, doi:10.1016/j.envres.2019.03.029.The original publication is available at https://www.sciencedirect.com/Background: People from low- and middle-income countries are disproportionately affected by the global burden
of adverse health effects caused by ambient air pollution (AAP). However, data from Sub-Saharan Africa (SSA)
are still scarce. We systematically reviewed the literature to describe the existing knowledge on AAP and health
outcomes in SSA.
Methods: We searched PubMed, Medline-OVID, EMBASE and Scopus databases to identify studies of AAP and
health outcomes published up to November 15, 2017. We used a systematic review approach to critically analyze
and summarize levels of outdoor air pollutants, and data on health effects associated with AAP. We excluded
occupational and indoor exposure studies.
Results: We identified 60 articles, with 37 only describing levels of AAP and 23 assessing the association between
air pollution and health outcomes. Most studies (75%) addressing the relation between AAP and disease were
cross-sectional. In general, exposure data were only obtained for selected cities in the framework of temporary
international collaborative research initiatives without structural long-term continuation. Measurements of AAP
revealed 10–20 fold higher levels than WHO standards. Of the 23 studies reporting health effects, 14 originated
from South Africa, and most countries within SSA contributed no data at all. No studies, except from South
Africa, were based on reliable morbidity or mortality statistics at regional or country level. The majority of
studies investigated self-reported respiratory symptoms. Children and the elderly were found to be more susceptible
to AAP.
Conclusion: AAP and its negative health effects have been understudied in SSA compared with other continents.
The limited direct measurements of air pollutants indicate that AAP in SAA cities is high compared with international
standards. Efforts are needed to monitor AAP in African cities, to identify its main sources, and to
reduce adverse health effects by enforcing legislation.https://www.sciencedirect.com/science/article/pii/S0013935119301574?via%3DihubPublisher's versio
Telomere length and outcome of treatment for pulmonary tuberculosis in a gold mining community
No full textTelomere length (TL) is a marker of ageing and mitochondrial DNA (mtDNA) is an early marker of inflammation caused by oxidative stress. We determined TL and mtDNA content among active pulmonary tuberculosis (PTB) patients to assess if these cellular biomarkers differed between artisanal miners and non-miners, and to assess if they were predictive of treatment outcome. We conducted a prospective cohort study from August 2018 to May 2019 involving newly diagnosed PTB patients at three outpatient TB clinics in a rural Democratic Republic of Congo. We measured relative TL and mtDNA content in peripheral blood leukocytes (at inclusion) via qPCR and assessed their association with PTB treatment outcome. We included 129 patients (85 miners and 44 non-miners) with PTB (median age 40 years; range 5–71 years, 22% HIV-coinfected). For each increase in year and HIV-coinfection, TL shortened by − 0.85% (− 0.19 to − 0.52) (p ≤ 0.0001) and − 14% (− 28.22 to − 1.79) (p = 0.02) respectively. Independent of these covariates, patients with longer TL were more likely to have successful TB treatment [adjusted hazard ratio; 95% CI 1.27 for a doubling of leucocyte telomere length at baseline; 1.05–1.44] than patients with a shorter TL. Blood mtDNA content was not predictive for PTB outcome. For a given chronological age, PTB patients with longer telomeres at time of diagnosis were more likely to have successful PTB treatment outcome.sponsorship: P.D.M.C. K was fellow of the Fonds Marc Vervenne of the KU Leuven (Belgium) and he is supported by the US National Institutes of Health (NIH)-Fogarty Postdoctoral Fellowship: Grant no. 1D43TW010937-01A1. D.S.M is a FWO postdoc, with funding number: FWO Grant 12X9620N. Fieldwork has been supported by the KU Leuven Alumni Association and the University of Antwerp-USOS via the CEGEMI of the Catholic University of Bukavu. The costs of measuring Telomere length and mtDNA were covered by a grant of the European Research Council (ENVIRONAGE). The funders had no role in the study design, data collection, analysis, interpretation, or writing of the report. The corresponding author had full access to all the study data and had final responsibility for the decision to submit for publication. (US National Institutes of Health (NIH)-Fogarty Postdoctoral Fellowship|1D43TW010937-01A1, FWO|12X9620N, European Research Council (ENVIRONAGE), John E. Fogarty International Center for Advanced Study in the Health Sciences|D43TW010937, John E. Fogarty International Center for Advanced Study in the Health Sciences|R25TW011217, National Center for Advancing Translational Sciences|UL1TR001863)status: Publishe
Acute and chronic exposure to air pollution in relation with incidence, prevalence, severity and mortality of COVID-19: a rapid systematic review
No full textBackground Air pollution is one of the world's leading mortality risk factors contributing to seven million deaths annually. COVID-19 pandemic has claimed about one million deaths in less than a year. However, it is unclear whether exposure to acute and chronic air pollution influences the COVID-19 epidemiologic curve. Methods We searched for relevant studies listed in six electronic databases between December 2019 and September 2020. We applied no language or publication status limits. Studies presented as original articles, studies that assessed risk, incidence, prevalence, or lethality of COVID-19 in relation with exposure to either short-term or long-term exposure to ambient air pollution were included. All patients regardless of age, sex and location diagnosed as having COVID-19 of any severity were taken into consideration. We synthesised results using harvest plots based on effect direction. Results Included studies were cross-sectional (n = 10), retrospective cohorts (n = 9), ecological (n = 6 of which two were time-series) and hypothesis (n = 1). Of these studies, 52 and 48% assessed the effect of short-term and long-term pollutant exposure, respectively and one evaluated both. Pollutants mostly studied were PM2.5 (64%), NO2 (50%), PM10 (43%) and O-3 (29%) for acute effects and PM2.5 (85%), NO2 (39%) and O-3 (23%) then PM10 (15%) for chronic effects. Most assessed COVID-19 outcomes were incidence and mortality rate. Acutely, pollutants independently associated with COVID-19 incidence and mortality were first PM2.5 then PM10, NO2 and O-3 (only for incident cases). Chronically, similar relationships were found for PM2.5 and NO2. High overall risk of bias judgments (86 and 39% in short-term and long-term exposure studies, respectively) was predominantly due to a failure to adjust aggregated data for important confounders, and to a lesser extent because of a lack of comparative analysis. Conclusion The body of evidence indicates that both acute and chronic exposure to air pollution can affect COVID-19 epidemiology. The evidence is unclear for acute exposure due to a higher level of bias in existing studies as compared to moderate evidence with chronic exposure. Public health interventions that help minimize anthropogenic pollutant source and socio-economic injustice/disparities may reduce the planetary threat posed by both COVID-19 and air pollution pandemics.We are grateful to Dr. Lilian Byamungu, MD. MSc (Clinincal Epidemiology) (University of KwaZulu-Natal, South Africa) for her critical appraisal of the manuscript and methodological approach. Our gratitude goes also to the memory of Mr. Hikmet BAKAN for supporting this work since the beginning but who passed way after a COVID-19 infection
Household Air Pollution Is Associated with Chronic Cough but Not Hemoptysis after Completion of Pulmonary Tuberculosis Treatment in Adults, Rural Eastern Democratic Republic of Congo
No full textLittle is known about the respiratory health damage related to household air pollution (HAP) in survivors of pulmonary tuberculosis (PTB). In a population-based cross-sectional study, we determined the prevalence and associated predictors of chronic cough and hemoptysis in 441 randomly selected PTB survivors living in 13 remote health zones with high TB burden in the South Kivu province of the Democratic Republic of Congo (DRC). Trained community and health-care workers administered a validated questionnaire. In a multivariate logistic regression, chronic cough was independently associated with HAP (adjusted odds ratios (aOR) 2.10, 95% CI: 1.10⁻4.00) and PTB treatment >6 months (aOR 3.80, 95% CI: 1.62⁻8.96). Among women, chronic cough was associated with cooking ≥3 h daily (aOR 2.74, 95% CI: 1.25⁻6.07) and with HAP (aOR 3.93, 95% CI: 1.15⁻13.43). Independent predictors of hemoptysis were PTB retreatment (aOR 3.04, 95% CI: 1.04⁻5.09) and ignorance of treatment outcome (aOR 2.24, 95% CI: 1.09⁻4.58) but not HAP (aOR 1.86, 95% CI: 0.61⁻5.62). Exposure to HAP proved a major risk factor for chronic cough in PTB survivors, especially in women. This factor is amenable to intervention.sponsorship: Patrick D.M.C. Katoto is Fellow of the Fonds Marc Vervenne of the KU Leuven, Belgium. This work was supported by the ATS foundation and the PATS MECOR writing awards. We thank Olivier Rusumba, coordinator of the "Ambassadeur de la lutte contre la tuberculose" for helping to make field work possible. The views expressed in this publication are those of the author(s) and not necessarily those of the founders. (ATS foundation, PATS MECOR writing awards, MRC|MR/L002515/1, MRC|MR/P022006/1)status: Publishe
Telomere length and outcome of treatment for pulmonary tuberculosis in a gold mining community
No full textCITATION: Katoto, P. D. M. C. et al. 2021. Telomere length and outcome of treatment for pulmonary tuberculosis in a gold mining community. Scientific Reports, 11:4031, doi:10.1038/s41598-021-83281-2.The original publication is available at https://www.nature.comTelomere length (TL) is a marker of ageing and mitochondrial DNA (mtDNA) is an early marker of inflammation caused by oxidative stress. We determined TL and mtDNA content among active pulmonary tuberculosis (PTB) patients to assess if these cellular biomarkers differed between artisanal miners and non-miners, and to assess if they were predictive of treatment outcome. We conducted a prospective cohort study from August 2018 to May 2019 involving newly diagnosed PTB patients at three outpatient TB clinics in a rural Democratic Republic of Congo. We measured relative TL and mtDNA content in peripheral blood leukocytes (at inclusion) via qPCR and assessed their association with PTB treatment outcome. We included 129 patients (85 miners and 44 non-miners) with PTB (median age 40 years; range 5–71 years, 22% HIV-coinfected). For each increase in year and HIV-coinfection, TL shortened by − 0.85% (− 0.19 to − 0.52) (p ≤ 0.0001) and − 14% (− 28.22 to − 1.79) (p = 0.02) respectively. Independent of these covariates, patients with longer TL were more likely to have successful TB treatment [adjusted hazard ratio; 95% CI 1.27 for a doubling of leucocyte telomere length at baseline; 1.05–1.44] than patients with a shorter TL. Blood mtDNA content was not predictive for PTB outcome. For a given chronological age, PTB patients with longer telomeres at time of diagnosis were more likely to have successful PTB treatment outcome.https://www.nature.com/articles/s41598-021-83281-2Publisher's versio
Nuclear and mitochondrial data reveal different evolutionary processes in the Lake Tanganyika cichlid genus -2
No full text<p><b>Copyright information:</b></p><p>Taken from "Nuclear and mitochondrial data reveal different evolutionary processes in the Lake Tanganyika cichlid genus "</p><p>http://www.biomedcentral.com/1471-2148/7/137</p><p>BMC Evolutionary Biology 2007;7():137-137.</p><p>Published online 14 Aug 2007</p><p>PMCID:PMC2000897.</p><p></p>the distributions of bootstrap support values obtained in 53 taxon-reduced bootstrap analyses for nodes, which experienced a significant increase in bootstrap support (marked by solid circles) upon removal of the following taxa: A, "red belly"; B, the yellow coloured morphs near the Lufubu River estuary (samples from Lufubu, Ilangi, Inangu and Kabeyeye); C, samples from Livua; D, samples from Chisanze; E, samples from Katoto. The nodes are identified in Fig. 3
Household air pollution and risk of pulmonary tuberculosis in HIV-Infected adults.
No full textBACKGROUND: In low- and middle-income countries countries, millions of deaths occur annually from household air pollution (HAP), pulmonary tuberculosis (PTB), and HIV-infection. However, it is unknown whether HAP influences PTB risk among people living with HIV-infection. METHODS: We conducted a case-control study among 1,277 HIV-infected adults in Bukavu, eastern Democratic Republic of Congo (February 2018 - March 2019). Cases had current or recent (<5y) PTB (positive sputum smear or Xpert MTB/RIF), controls had no PTB. Daily and lifetime HAP exposure were assessed by questionnaire and, in a random sub-sample (n=270), by 24-hour measurements of personal carbon monoxide (CO) at home. We used multivariable logistic regression to examine the associations between HAP and PTB. RESULTS: We recruited 435 cases and 842 controls (median age 41 years, [IQR] 33-50; 76% female). Cases were more likely to be female than male (63% vs 37%). Participants reporting cooking for >3h/day and ≥2 times/day and ≥5 days/week were more likely to have PTB (aOR 1·36; 95%CI 1·06-1·75) than those spending less time in the kitchen. Time-weighted average 24h personal CO exposure was related dose-dependently with the likelihood of having PTB, with aOR 4·64 (95%CI 1·1-20·7) for the highest quintile [12·3-76·2 ppm] compared to the lowest quintile [0·1-1·9 ppm]. CONCLUSION: Time spent cooking and personal CO exposure were independently associated with increased risk of PTB among people living with HIV. Considering the high burden of TB-HIV coinfection in the region, effective interventions are required to decrease HAP exposure caused by cooking with biomass among people living with HIV, especially women
Mediastinal cystic teratoma misdiagnosed as pleural tuberculosis: A case report and review of 53 cases revealed by pleural effusion
No full textCommunity-based case studies of vaccine hesitancy and the COVID-19 response in South Africa: study protocol
No full textIn 2021 the South African government launched a large COVID-19 immunization campaign with the goal of reaching more than 40 million individuals. Nonetheless, certain international largely internet-based surveys at the time showed a significant proportion of vaccine hesitancy in South Africa. This study aims to determine and
co-create with local stakeholders a comprehensive understanding of vaccine hesitancy and opportunities to support the promotion of other COVID-19 health-promoting behaviours at community level. A mixed-methods multiple case-study design; informed by the socio-ecological model of behaviour change. Four socioeconomically diverse communities across South Africa will be selected and data collection will take place concurrently through three iterative phases. Phase 1 will provide insights into community experiences of COVID-19 (response) through desktop mapping exercises, observations, in-depth interviews, and focus group discussions (FGDs)
designed as expression sessions with local stakeholders. Phase 2 will explore the extent and drivers of community acceptance of COVID-19 vaccines. This phase will comprise a survey based on WHO���s Behavioural and Social Drivers of Vaccination tool as well as further FGDs with community members. Phase 3 will involve cross-case study syntheses and presentation of findings to national role-players. This study will provide ground up, locally responsive, and timeous evidence on the factors influencing COVID-19 health-seeking
behaviours to inform ongoing management and mitigation of COVID19 in South Africa. It will also provide insights into the applicability of a novel vaccine hesitancy model in Africa.
Behavioural and social drivers of human papillomavirus vaccination in eThekwini District of KwaZulu-Natal Province, South Africa.
No full textBackgroundCervical cancer is the second most common cancer in women in South Africa. Infection with high-risk types of human papillomavirus (HPV) is the cause of cervical cancer, which can be prevented by HPV vaccination. However, there is wide variation in HPV vaccination coverage among the urban districts of South Africa; with the lowest coverage being 40% in eThekwini, KwaZulu-Natal. There could be many factors which affect HPV vaccine uptake in eThekwini District. Thus, this research aims to investigate the behaviourial and social drivers of HPV vaccination in this district.MethodsThe study will consist of two phases. We will apply a convergent parallel mixed methods approach, including a quantitative survey (phase 1) and in-depth interviews (phase 2) among caregivers and frontline healthcare workers to determine the drivers of HPV vaccination uptake.DiscussionThe study will provide knowledge on the main barriers facing HPV vaccination and provide contextually-tailored solutions for how these barriers might be addressed. A policy brief will be formulated from this study aimed at government policymakers and other stakeholders who formulate or influence policy, respectively. In addition, we will disseminate the findings through peer-reviewed publications in scientific journals
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