Coinfections and comorbidities in African health systems: At the interface of infectious and noninfectious diseases

Osakunor, Derick Nii Mensah; Sengeh, David Moinina; Mutapi, Francisca

doi:10.1371/journal.pntd.0006711

Cited by 27 publications

(18 citation statements)

References 98 publications

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“…The old age of the study cohort implies a longer convalescence period as well as a more pronounced need for access to rehabilitation services. In an area where healthcare provision is already strained by the growing burden of infectious and non-infectious diseases, the procurement of additional resources required to deliver rehabilitation services may not be given a priority [22][23][24].…”

Section: Discussionmentioning

confidence: 99%

Chronic subdural hematomas: a case series from the medical ward of a north Tanzanian referral hospital

et al. 2019

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Background: Chronic subdural hematomas (CSDH) initially present as focal neurological deficits with or without signs of increased intracranial pressure, for which admission to the general medical ward may occur if they present with poorly understood neurological deficits and no evident history of trauma. The symptoms may be long standing and mimic stroke upon presentation. Their distribution and specific clinical features in sub-Saharan Africa are largely unknown. Methods: We describe a series of subdural hematoma (SDH) inpatients from the medical ward of a tertiary referral center in Northern Tanzania, describing clinical and radiological characteristics and providing clinical outcome where possible. Results: Our study population numbered 30, with a male majority (n = 19, 63.3%) and a mean age of 66.8 ± 14.5 years. Mean duration from symptom onset to admission in the medical ward was 20.0 ± 30.8 days. History of head injury was reported in only 43.3% of patients. Improvement in the neurological examination was noted in 68.1% of the 22 patients who underwent surgery. The mortality rate was 20.0%. Conclusion: A majority of the patients were elderly males and presented late to the hospital. Delayed presentation and diagnosis due to, amongst other reasons, postponed imaging resulted in a prolonged time to definitive treatment and a high mortality rate compared to other regions of the world.

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Section: Discussionmentioning

confidence: 99%

Chronic subdural hematomas: a case series from the medical ward of a north Tanzanian referral hospital

et al. 2019

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“…Health systems in lower-income countries are often unprepared to address the dual disease burden of infectious and chronic diseases in their populations. 79-81 Access to healthcare staff, resources, and medications, which may already be scarce, can become increasingly inadequate. 82-84 Focusing on epidemic containment during outbreaks can detract from the capacity to address underlying NCDs, draining resources for overall care.…”

Section: Convergence Of Infectious Diseases and Ncds—the Haddon Matrixmentioning

confidence: 99%

The Role of Noncommunicable Diseases in the Pursuit of Global Health Security

et al. 2021

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Noncommunicable diseases and their risk factors are important for all aspects of outbreak preparedness and response, affecting a range of factors including host susceptibility, pathogen virulence, and health system capacity. This conceptual analysis has 2 objectives. First, we use the Haddon matrix paradigm to formulate a framework for assessing the relevance of noncommunicable diseases to health security efforts throughout all phases of the disaster life cycle: before, during, and after an event. Second, we build upon this framework to identify 6 technical action areas in global health security programs that are opportune integration points for global health security and noncommunicable disease objectives: surveillance, workforce development, laboratory systems, immunization, risk communication, and sustainable financing. We discuss approaches to integration with the goal of maximizing the reach of global health security where infectious disease threats and chronic disease burdens overlap.

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“…Unfortunately, most health care systems, including those in LMICs, are structured to provide care in a vertical, disease-speci c and curative nature [35,36], rather than to provide organized care for chronic conditions. This kind of curative approach is often inadequate, ine cient, and ineffective when a multiplex of chronic conditions coexist [37] and unfortunately a high level of unmet treatment needs persists among people with multimorbidity [38].…”

Section: Implications For Patients and The Health System In Low-and Mmentioning

confidence: 99%

Multimorbidity Patterns and Function Among Adults in Low- and Middle-income Countries: a Scoping Review Protocol

Berner

Tawa

Louw

2021

Preprint

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BackgroundA fifth of adults in low-income and middle-income countries (LMICs) have multimorbid conditions, which are linked to socio-economic deprivation and aging. Multimorbidity is associated with high rates of functional problems and disability, increased healthcare utilization and lower quality of life. Literature on multimorbidity and associations with function is mostly from high-income countries (HICs) and focused among adults. Data regarding patterns and their impact on person-centered outcomes are limited. There is need for research into understanding common patterns of multimorbidity, and their association with functional impairment, particularly in LMICs. Therefore, the need for evidence-based, and context-relevant strategic policy, planning and delivery models for health and rehabilitation services is imperative in attaining Universal Health Coverage (UHC). The planned scoping review aims to provide an overview of the scope and nature of existing literature on multimorbidity patterns and function among adults in LMICs. MethodsA scoping review will be conducted according to a five-step framework guidance. The PRISMA-ScR guidelines will be followed in reporting. A comprehensive electronic search of PubMed, Scopus, EBSCOhost (including MEDLINE and the Cumulative Index to Nursing and Allied Health Literature [CINAHL]), Scielo, Cochrane and Google Scholar will be conducted from January 1976 onwards. Studies will be included if they are primary or secondary, qualitative or quantitative research reported in English, published (between January 1976 and the search date) in a peer-reviewed journal, and describe multimorbidity patterns and associations with physical functional impairments, activity limitations or participation restrictions among adults in LMICs. Search results will be independently screened by two reviewers and data extraction will cover; study characteristics, participants’ characteristics, multimorbidity measures, patterns analysis and functional measures. Descriptive statistics and narrative synthesis will be used to synthesize and summarize the findings.DiscussionPatients with multimorbidity have unique and cross-cutting needs, hence the need for an integrated and person-centered approaches to policy, planning and delivery of medical and rehabilitation services. Considering the shift towards primary healthcare-led management of chronic diseases and UHC, the proposed scoping review is timely and the findings will provide insights into the current extent and scope of multimorbidity research, and guide future inquiry in the field. Protocol registrationOpen Science Framework (OSF), osf.io/gcy7z

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Coinfections and comorbidities in African health systems: At the interface of infectious and noninfectious diseases

Cited by 27 publications

References 98 publications

Chronic subdural hematomas: a case series from the medical ward of a north Tanzanian referral hospital

Chronic subdural hematomas: a case series from the medical ward of a north Tanzanian referral hospital

The Role of Noncommunicable Diseases in the Pursuit of Global Health Security

Multimorbidity Patterns and Function Among Adults in Low- and Middle-income Countries: a Scoping Review Protocol

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