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

The number of people living with HIV/AIDS continues to grow, estimated to be 39.5 million as of the end of 2006, while 4.3 million people were newly infected in 2006. The proportions of women has continued to grow, currently approaching 50%. Sub-Saharan Africa continues to bear the brunt of global epidemic, comprising 63% of all infections worldwide. The most striking increases have occurred in East Asia, Eastern Europe, and Central Asia. High-risk behaviors (intravenous drug use and unprotected sex between men or with paid sex workers) are the predominant route of transmission. The number of people with HIV/AIDS continues to increase since the first report of HIV in Korea, now approaching 4,580 as of the end of 2006. The real magnitude of HIV epidemic is believed to be much larger than the recent estimates by UNAIDS shows (13,000 people with HIV infection). The prevalence among the general population is still low (less than 0.1%; probably 0.003~0.01%). The HIV epidemic in Korea shows several peculiar features: 1) a male predominance suggesting that the epidemic may still be largely confined to male homosexual community, while the transmission through heterosexual contact remains less prominent, 2) a conspicuous absence of contribution of intravenous drug use to current epidemic, and 3) a very small number of vertical transmission due to the relatively limited number of infected women. The HIV epidemic is expected to continue to grow in the foreseeable future in Korea as well as globally unless drastic efforts are made to cope with the epidemic.
Africa South of the Sahara ; Asia ; Epidemiology* ; Europe, Eastern ; Far East ; Female ; Heterosexuality ; HIV ; Homosexuality ; Humans ; Korea ; Male ; Prevalence ; Seroepidemiologic Studies ; Strikes, Employee ; Unsafe Sex

BACKGROUND: Endemic malaria has become increasingly rare since the late 1970s, but since the reemergence of indigenous vivax malaria in 1993, the number of cases of malaria have recently increased. We analyzed the cases of malaria who were treated in Kangnam St. Mary's Hospital with regards to epidemiology, clinical manifestations, and treatment outcome, and made a comparison between indigenous and imported cases. METHODS: We retrospectively analyzed data of 40 confirmed cases of malaria treated in the same hospital. RESULTS: Twenty-one cases were indigenous and 19 were imported malaria. Peripheral blood smear revealed Plasmodium vivax in all indigenous malaria, whereas in imported cases 13 were P. falciparum and 6 were P. vivax. Yeonchon-gun(7 cases) was the most prevalent area in the indigenous cases; Africa and Southeast Asia(7 cases, respectively) were the most prevalent areas in the imported cases. Anemia(hemoglobin <10g/dL) was found more frequently in the imported cases, but the difference was not statistically significant. One patient, who was infected in South America showed initially resistant to primaquine, but was cured after extended treatment with increased dosage of primaquine. CONCLUSION: As cases of indigenous malaria in Korea are increasing, early diagnosis, treament, and prevention of malaria are important. To prevent imported malaria, anyone who travels to endemic areas should receive proper education and chemoprophylaxis, considering the pattern of drug resistance.
Africa ; Chemoprevention ; Drug Resistance ; Early Diagnosis ; Education ; Epidemiology ; Humans ; Korea ; Malaria* ; Malaria, Vivax ; Plasmodium vivax ; Primaquine ; Retrospective Studies ; South America ; Treatment Outcome

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

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

BACKGROUND: Human T-cell lymphotropic virus type I (HTLV-I) is a retrovirus that has been identified as a cause of adult T-cell leukemia/lymphoma and tropical spastic paraparesis. HTLV-I infection is highly endemic in the southwestern islands of Japan, Caribbean basin, South America, and Africa. In 1993, we showed that the seroprevalence of antibodies to HTLV-I was 0.13% among blood donors in Korea, but surprisingly, 0.80% in Cheju-Do adjacent to endemic areas of Japan. So this study was designed to reevaluate the seroprevalence of antibodies to HTLV-I among residents in Cheju-Do. METHODS: Total 2,372 residents in Cheju-Do were tested from December 1995 to March 1996. Anti-HTLV-I antibodies were detected by the microtiter particle agglutination test. RESULTS: Among total 2,372 residents, 19 were anti-HTLV-I positive. So the overall positive rate of anti-HTLV-I antibodies was 0.80%. The positive rate in females was higher than in males (0.82% vs 0.78%). The positive rate was 1.45% in the age group of 20-29 years, 1.41% in 40-49 years, 0.91% in 0-9 years, 0.70% in 30-39 years, and 0.54% in 50-59 years. The mean age of seropositive cases is 35.2 in males and 35.4 in females, with a mean of 35.3. Geographically, high positive rate was observed in Sogwipo-City (1.37%) and Namcheju-Gun (0.83%) compared to those of Pukcheju-Gun (0.64%) and Cheju-City (0.61%), which showed high seroprevalence in districts adjacent to endemic areas of Japan. Any specific risk factors or associated disorders of HTLV-I infection could not be found among the seropositive cases. CONCLUSION: The seroprevalence of antibodies to HTLV-I in Cheju-Do was noted to be very high by the microtiter particle agglutination test. So henceforth serosurvey by confirmative laboratory tests is needed, and if high seroprevalence is showed from it, screening of blood donors for HTLV-I in Cheju-Do should be considered to prevent transfusion-associated HTLV-I infection.
Adult ; Africa ; Agglutination Tests ; Antibodies ; Blood Donors ; Caribbean Region ; Epidemiology ; Female ; HTLV-I Infections ; Human T-lymphotropic virus 1 ; Humans* ; Islands ; Japan ; Jeju-do* ; Korea ; Male ; Mass Screening ; Paraparesis, Tropical Spastic ; Retroviridae ; Risk Factors ; Seroepidemiologic Studies* ; South America ; T-Lymphocytes*

In this review, we mainly focus on zoonotic encephalitides caused by arthropod-borne viruses (arboviruses) of the families Flaviviridae (genus Flavivirus) and Togaviridae (genus Alphavirus) that are important in both humans and domestic animals. Specifically, we will focus on alphaviruses (Eastern equine encephalitis virus, Western equine encephalitis virus, Venezuelan equine encephalitis virus) and flaviviruses (Japanese encephalitis virus and West Nile virus). Most of these viruses were originally found in tropical regions such as Africa and South America or in some regions in Asia. However, they have dispersed widely and currently cause diseases around the world. Global warming, increasing urbanization and population size in tropical regions, faster transportation and rapid spread of arthropod vectors contribute in continuous spreading of arboviruses into new geographic areas causing reemerging or resurging diseases. Most of the reemerging arboviruses also have emerged as zoonotic disease agents and created major public health issues and disease epidemics.
Africa ; Alphavirus* ; Animals, Domestic ; Arboviruses* ; Arthropod Vectors ; Asia ; Encephalitis ; Encephalitis Virus, Venezuelan Equine ; Encephalitis Virus, Western Equine ; Encephalitis Viruses ; Encephalomyelitis, Equine ; Epidemiology* ; Flaviviridae ; Flavivirus* ; Global Warming ; Humans ; Population Density ; Public Health ; South America ; Togaviridae ; Transportation ; Urbanization ; Zoonoses

Invasive cancer of the cervix is considered a preventable disease because it has a long preinvasive state, cervical cytology screening programs are currently available, and the treatment of pre-invasive lesions is effective. Cancer of the cervix is the second most common cancer among women worldwide, with an estimated 493,000 new cases and 274,000 deaths in 2002. The highest incidence rates are observed in sub-Saharan Africa, Melanesia, Latin America and the Caribbean, South-Central Asia, and South East Asia. In Korea, cervical cancer is the fifth most common cancer among women with over 3,000 new cases every year. Age-standardized incidence rate (ASR) is 15.5 per 100,000, which is lower than those in developing countries but higher than in western countries such as Europe and North America. The patients' mean parity is 2.59, and the range of age in peak incidence is 40~49 years (29.8%), followed by 50~59 years (21.9%). As the age goes on, more advanced stage cancer is frequent. Squamous cell carcinoma is the most common cell type, and adenocarcinoma is more frequent among those under 60 years old. Operation (56.0%) is the major treatment modality under stage IIa, and concurrent chemoradiation (31.6%) is the major treatment over stage IIb. The 5year survival rate is 73.9%. It is generally thought that human papillomavirus (HPV) test and HPV vaccine might play an important role in lowering the incidence of cervical cancer, and continuous epidemiologic studies will support its usefulness and efficacy.
Adenocarcinoma ; Africa South of the Sahara ; Asia ; Carcinoma, Squamous Cell ; Caribbean Region ; Developing Countries ; Epidemiologic Studies ; Epidemiology* ; Europe ; Far East ; Female ; Humans ; Incidence ; Korea ; Latin America ; Mass Screening ; Melanesia ; Middle Aged ; North America ; Parity ; Survival Rate ; Uterine Cervical Neoplasms*