BACKGROUND: Tracheal, bronchus, and lung cancer (TBL) is a major cause of mortality and top contributor to productivity loss in large emerging economies such as the BRICS (Brazil, Russia, India, China, and South Africa). We examined the time trends of TBL mortality across the BRICS to better understand the disease burden in these countries and inform public health and healthcare resource allocation. METHODS: TBL mortality-related data between 1990 and 2019 were obtained from the Global Burden of Disease Study 2019 and analyzed using age-period-cohort models. Net drift (local drift) was used to describe the expected age-adjusted TBL mortality rate over time overall (each age group); the longitudinal age curve was used to reflect the age effect; the period rate ratios (RRs) were used to reflect the period effect; and the cohort RR was used to reflect the cohort effect. RESULTS: In 2019, there were 958.3 thousand TBL deaths across the BRICS, representing 46.9% of the global TBL deaths. From 1990 to 2019, the age-standardized mortality rate (ASMR) of TBL decreased in Russia, Brazil, and South Africa while increased in China and India, with the largest reduction reported in Russia (-29.6%) and the largest increase in China (+22.4%). India showed an overall increase (+15.7%) in TBL mortality but the mortality risk decreased among individuals born after 1990 (men) and 1995 (women). Although South Africa and Brazil experienced an overall decline in TBL mortality, their recent birth cohorts, such as Brazilian individuals born after 1985 (men) and 1980 (women), and South African men born after 1995, had an increasing TBL mortality risk. China has experienced an overall increase in TBL mortality, with the mortality risk rising among individuals born after 1995 for both men and women. Russia, which had the highest TBL mortality among the BRICS countries in 1990, has demonstrated significant improvement over the past three decades. CONCLUSIONS Over the past 30 years, the BRICS accounted for an increasing proportion of global TBL mortality. TBL mortality increased in older women in all the BRICS countries except Russia. Among the recent birth cohort, the risk of TBL mortality increased in Brazil, China, and South Africa. More effective efforts are needed in the BRICS to reduce the burden of TBL and help achieve the United Nation's Sustainable Development Goals.
Humans ; Lung Neoplasms/mortality* ; Male ; Female ; China/epidemiology* ; Middle Aged ; Global Burden of Disease ; Aged ; India/epidemiology* ; Adult ; South Africa/epidemiology* ; Cohort Studies ; Russia/epidemiology* ; Brazil/epidemiology* ; Tracheal Neoplasms/mortality* ; Bronchial Neoplasms/mortality* ; Adolescent ; Young Adult ; Aged, 80 and over ; Child

A low prevalence of Parkinson's disease (PD) has been reported in the Sub-Saharan Africa (SSA) region. The genetic causes and clinical features of PD in this region have been poorly described. Very few reports have examined the availability and access to evidence-based quality care for people living with PD in this region. We reviewed all publications focusing on idiopathic PD from SSA published up to May 2016 and observed a prevalence of PD ranging from 7/100,000 in Ethiopia to 67/100,000 in Nigeria. The most recent community-based study reported a mean age at onset of 69.4 years. The infrequent occurrence of mutations in established PD genes was also observed in the region. Treatments were non-existent or at best irregular. Additionally, there is a lack of well-trained medical personnel and multidisciplinary teams in most countries in this region. Drugs for treating PD are either not available or unaffordable. Large-scale genetic and epidemiological studies are therefore needed in SSA to provide further insights into the roles of genetics and other etiological factors in the pathogenesis of PD. The quality of care also requires urgent improvement to meet the basic level of care required by PD patients.
Africa South of the Sahara ; Age of Onset ; Epidemiologic Studies ; Epidemiology ; Ethiopia ; Genetics ; Humans ; Nigeria ; Parkinson Disease ; Prevalence

Network scale-up is an indirect size estimation method, in which participants are questioned on sensitive behaviors of their social network members. Therefore, the visibility of the behavior affects the replies and estimates. Many attempts to estimate visibility have been made. The aims of this study were to review the main methods used to address visibility and to provide a summary of reported visibility factors (VFs) across populations. We systematically searched relevant databases and Google. In total, 15 studies and reports that calculated VFs were found. VF calculation studies have been applied in 9 countries, mostly in East Asia and Eastern Europe. The methods applied were expert opinion, comparison of NSU with another method, the game of contacts, social respect, and the coming-out rate. The VF has been calculated for heavy drug users, people who inject drugs (PWID), female sex workers (FSWs) and their clients, male who have sex with male (MSM), alcohol and methamphetamine users, and those who have experienced extra-/pre-marital sex and abortion. The VF varied from 1.4% in Japan to 52.0% in China for MSM; from 34.0% in Ukraine to 111.0% in China for FSWs; and from 12.0% among Iranian students to 57.0% in Ukraine for PWID. Our review revealed that VF estimates were heterogeneous, and were not available for most settings, in particular the Middle East and North Africa region, except Iran. More concrete methodologies to estimate the VF are required.
Africa, Northern ; Bias (Epidemiology) ; China ; Drug Users ; Europe, Eastern ; Expert Testimony ; Far East ; Female ; Humans ; Iran ; Japan ; Male ; Methamphetamine ; Methods ; Middle East ; Sex Workers ; Ukraine

BACKGROUND: Allergic rhinitis (AR) is a global health problem and is characterised by one or more symptoms, including sneezing, itching, nasal congestion and rhinorrhea. OBJECTIVE: We investigated the features of AR and the physician's approach to the management of AR patients in four geographical regions. METHODS: In this cross-sectional study, a questionnaire survey concerning AR was completed by Honorary and Corresponding Members of the Italian Society of Rhinology from different countries among 4 world geographical regions—Asia, Europe, the Americas, and Africa. RESULTS: The prevalence of AR was reported to be 15%–25%. Children and adolescents, as well as young adults, were the age groups more affected by AR with comorbidities of asthma, sinusitis, conjunctivitis, and nasal polyposis. Nasal symptoms of AR were more intense in the spring (51.92%) and autumn (28.85%). The most common aero-allergens were pollen and mites (67.31%), animal dander and pollutants (23.08%), and fungal allergens (21.15%). Allergen-specific immunotherapy was prescribed for both perennial and seasonal allergens (32.69%) via sublingual swallow (46.15%) and subcutaneous (32.69%) routes. For the AR patients, the most prescribed drugs were intranasal corticosteroids (86.54%) and oral H₁-antihistamines (82.69%). CONCLUSION: A network of experts can improve our knowledge concerning AR epidemiology, and together with guidelines, could assist practitioners and otolaryngologists in standardising the diagnosis and treatment of AR.
Adolescent ; Adrenal Cortex Hormones ; Africa ; Allergens ; Americas ; Animals ; Asthma ; Child ; Comorbidity ; Conjunctivitis ; Cross-Sectional Studies ; Dander ; Diagnosis ; Epidemiology ; Estrogens, Conjugated (USP) ; Europe ; Global Health ; Humans ; Immunotherapy ; Mites ; Pollen ; Prevalence ; Pruritus ; Rhinitis, Allergic ; Seasons ; Sinusitis ; Sneezing ; Sublingual Immunotherapy ; Young Adult

Network scale-up is an indirect size estimation method, in which participants are questioned on sensitive behaviors of their social network members. Therefore, the visibility of the behavior affects the replies and estimates. Many attempts to estimate visibility have been made. The aims of this study were to review the main methods used to address visibility and to provide a summary of reported visibility factors (VFs) across populations. We systematically searched relevant databases and Google. In total, 15 studies and reports that calculated VFs were found. VF calculation studies have been applied in 9 countries, mostly in East Asia and Eastern Europe. The methods applied were expert opinion, comparison of NSU with another method, the game of contacts, social respect, and the coming-out rate. The VF has been calculated for heavy drug users, people who inject drugs (PWID), female sex workers (FSWs) and their clients, male who have sex with male (MSM), alcohol and methamphetamine users, and those who have experienced extra-/pre-marital sex and abortion. The VF varied from 1.4% in Japan to 52.0% in China for MSM; from 34.0% in Ukraine to 111.0% in China for FSWs; and from 12.0% among Iranian students to 57.0% in Ukraine for PWID. Our review revealed that VF estimates were heterogeneous, and were not available for most settings, in particular the Middle East and North Africa region, except Iran. More concrete methodologies to estimate the VF are required.
Africa, Northern ; Bias (Epidemiology)* ; China ; Drug Users ; Europe, Eastern ; Expert Testimony ; Far East ; Female ; Humans ; Iran ; Japan ; Male ; Methamphetamine ; Methods* ; Middle East ; Sex Workers ; Ukraine

Enterotoxigenic Escherichia coli (ETEC) causes neonatal and post-weaning diarrhea in pigs. In order to determine the risk factors, rectal/fecal swabs and visceral organs obtained from pig farms in two regions of South Africa were analyzed microbiologically against risk variables. Seventy-two percent of young pigs were found to be positive for ETEC toxin genes; estB (38.9%), estB/STAP (25%), and estB/LT (13.9%) were dominant. Risk factors for ETEC-diarrhea in pigs include: leaving sick piglets in a pen with healthy piglets [odds ratio (OR) = 33.52; P < 0.0001]; water spillage in pen (OR = 42.87; P < 0.0001); hypothermic piglets (OR = 7.29; P < 0.0001); runt piglets in pen with healthy littermates (OR = 3.65; P < 0.0001); and prolonged use of antibiotics (OR = 3.05; P = 0.05).
Animals ; Animals, Newborn ; Diarrhea ; epidemiology ; microbiology ; Escherichia coli ; genetics ; isolation & purification ; Escherichia coli Infections ; epidemiology ; microbiology ; veterinary ; Genes, Bacterial ; Prevalence ; Rectum ; microbiology ; Risk Factors ; South Africa ; Swine ; Swine Diseases ; epidemiology ; microbiology ; Weaning

Cholera is an acute secretory form of diarrhea caused by a potent enterotoxin (cholera toxin) after ingestion of toxigenic Vibrio cholerae of the O1 or O139 serogroups. Although cholera is very common in Africa and Asia as a whole, the incidence of cholera has been very low in recent years in Korea. Dehydration and electrolyte abnormalities due to massive watery diarrhea can lead to death, and the mortality rates in untreated patients with severe cholera can exceed 70%. Effective rehydration therapy is the cornerstone of the management of patients with cholera and can reduce the mortality rate to less than 0.2%. Antibiotics reduce the volume and duration of diarrhea, but are recommended for patients with severe disease because of the rapid emergence and spread of multidrug-resistant V. cholerae across the globe. Two oral cholera vaccines are available, and the World Health Organization recommends that these oral vaccines be considered in integrated prevention programs in endemic countries at risk for outbreaks.
Africa ; Anti-Bacterial Agents ; Asia ; Cholera Toxin ; Cholera Vaccines ; Cholera* ; Dehydration ; Diarrhea ; Disease Outbreaks ; Eating ; Enterotoxins ; Epidemiology* ; Fluid Therapy ; Humans ; Incidence ; Korea ; Mortality ; Serogroup ; Vaccines ; Vibrio cholerae ; World Health Organization

Novel subtypes of Asian-origin (Goose/Guangdong lineage) H5 highly pathogenic avian influenza (HPAI) viruses belonging to clade 2.3.4, such as H5N2, H5N5, H5N6, and H5N8, have been identified in China since 2008 and have since evolved into four genetically distinct clade 2.3.4.4 groups (A–D). Since 2014, HPAI clade 2.3.4.4 viruses have spread rapidly via migratory wild aquatic birds and have evolved through reassortment with prevailing local low pathogenicity avian influenza viruses. Group A H5N8 viruses and its reassortant viruses caused outbreaks in wide geographic regions (Asia, Europe, and North America) during 2014–2015. Novel reassortant Group B H5N8 viruses caused outbreaks in Asia, Europe, and Africa during 2016–2017. Novel reassortant Group C H5N6 viruses caused outbreaks in Korea and Japan during the 2016–2017 winter season. Group D H5N6 viruses caused outbreaks in China and Vietnam. A wide range of avian species, including wild and domestic waterfowl, domestic poultry, and even zoo birds, seem to be permissive for infection by and/or transmission of clade 2.3.4.4 HPAI viruses. Further, compared to previous H5N1 HPAI viruses, these reassortant viruses show altered pathogenicity in birds. In this review, we discuss the evolution, global spread, and pathogenicity of H5 clade 2.3.4.4 HPAI viruses.
Africa ; Animals ; Asia ; Birds ; China ; Disease Outbreaks ; Epidemiology ; Europe ; Influenza in Birds* ; Japan ; Korea ; Poultry ; Reassortant Viruses ; Seasons ; Vietnam ; Virulence*

Rheumatoid arthritis (RA) is expected to increase in Africa and South Africa. Due to the low numbers of rheumatologists in South Africa, specialist physicians also have to care for patients with RA. Furthermore several new developments have taken place in recent years which improved the management and outcome of RA. Classification criteria were updated, assessment follow-up tools were refined and above all, several new biological disease-modifying anti-rheumatic drugs were developed. Therefore it is imperative for specialist physicians to update themselves with the newest developments in the management of RA. This article provides an overview of the newest developments in the management of RA in the South African context. This approach may well apply to countries with similar specialist to patient ratios and disease profiles.
Antirheumatic Agents/adverse effects/*therapeutic use ; Arthritis, Rheumatoid/diagnosis/*drug therapy/epidemiology ; Diffusion of Innovation ; Humans ; Practice Guidelines as Topic ; Practice Patterns, Physicians' ; Prevalence ; *Rheumatologists/standards ; Risk Factors ; Severity of Illness Index ; South Africa/epidemiology ; *Specialization ; Treatment Outcome

Africa ; epidemiology ; Asia, Southeastern ; epidemiology ; Carcinoma ; Epstein-Barr Virus Infections ; complications ; epidemiology ; virology ; Herpesvirus 4, Human ; pathogenicity ; Humans ; Middle East ; epidemiology ; Nasopharyngeal Neoplasms ; epidemiology ; etiology ; virology