Paper long abstract:

The African Science Partnership for Intervention Research Excellence (ASPIRE), is a pan-African research consortium for capacity building in "One Health". Collaborating with 21 institutions from 14 African and European countries, its research focuses on ecosystem and population health by broadening disciplinary, sectoral, linguistic, cultural and geographic boundaries. With nearly 65 Postdocs, PhD and Master students, ASPIRE conducts interdisciplinary and transdisciplinary research on diseases at the human-animal-environment interface (zoonoses). This includes surveillance-responses of endemic diseases as well as research of emerging, communicable and foodborne diseases.

Afrique One-ASPIRE is one of eleven beneficiaries of the DELTAS Africa initiative, an independent funding mechanism of the Alliance for Accelerating Excellence in Science in Africa(AESA) of the African Academy of Sciences (AAS), supported by the New Partnership for Africa's Development, Development Planning and Coordination Agency (NEPAD) with financial support from the Wellcome Trust and the British Department for International Development (DFID).

In our presentation we will share the experience of this excellence initiative in Africa.

Paper long abstract:

Background:

The current pandemic outbreak of Covid-19, which started in Wuhan a China region in December 2019, is caused by the SARS-Cov-2 virus. So far, there have been approximately 47 000 000 cases with more than a million of deaths. The current characterization of the disease indicated more severe cases and deaths in Asia, Europe and America comparing to Africa. More importantly, the Sub-Saharan region of Africa shows a different pattern of transmission, clinical features of SARS-CoV2. Therefore, this project is conducted in order to better understand the SARS-Cov-2 clinical epidemiology patterns in Sub-Saharan Africa.

Method:

A multicenter prospective and observational clinical epidemiology of Covid-19 which will be conducted in Gabon, Senegal and Ethiopia. The aim of this project is to determine infectivity, transmissibility and clinical outcomes of symptomatic index cases and their counterpart household contacts. Clinical parameters, including temperature, blood pressure, pulse rate, also inflammation markers, kidney and liver function tests will be collected, as well as nasal and oropharyngeal swabs samples in order to assess the viral load and the recovery time(negative to PCR) to be negative. Nasal scarpes and nasosorption for the evaluation of cytokines that are involved in nasopharyngeal intoxication. In addition, there will be a biobank sampling of urine, blood, stool, cells, and nasal mucosa samples for further analysis.

Expected outcomes:

At the end of the project, we expect to have a better understanding of COVID-19 clinical course, the transmission characteristics of SARS-CoV2 and its immune responses across Africa, with its specific sociocultural, environmental, economic, and population characteristics.

Key words: SARS-Cov2, Clinical-epidemiology, COVID-19, Biobank.

Funding: EDCTP: RIA2020EF-2961

Paper long abstract:

Background: Studies show that sexual and gender minorities have unique health care needs and encounter complicated problems to access health services. This paper examines factors that mediate health care seeking behaviour and utilization of health care services among Lesbian Gay and Bisexual (LGB) in Ethiopia, and coping mechanisms they use to navigate these challenges.

Methods: Concurrent mixed method design was used. Participants were selected using purposive and snowball sampling. Ninety-three LGB (64.5% Gays, 17.2% Lesbians, and 18.3% Bisexuals) with an average age of 27 (ranging between the 18 and 42 years) took part in the quantitative wing of the research. In-depth interviews and an FGD were held with 10 and 8 participants, each respectively. The quantitative data was analyzed using descriptive statistics. Qualitative data was analyzed thematically.

Results: The study found sexual health and mental health problems to be main concerns of LGB. LGB live under acute anxiety and fear of being exposed, or bringing shame and humiliation to themselves or their families. Disclosure, wilful or not, was often met with stigma, discrimination, rejection, isolation, verbal and physical abuse. Informants emphasized link between mental health and risky sexual practices. Risk perception to HIV was high among LGB, with two-thirds reporting high risk. Only 37.5% (33/88) stated being always motivated to seek care when sick and the rest cited the following barriers that stifled their health seeking behaviour and utilization of health care services: Stigma and discrimination 84.6% (77/91), shame and embarrassment 84.6% (77/91), fear of being discovered/confidentiality concerns (80.2%, 73/91), lack of LGB friendly services 47.2 (42/89), affordability (18.9%, 17/90), distance (17.8%, 16/90), permission to see doctor 8.8%, 8/91), health care professional refusal (10.6%, 9/85).

Conclusion: This research suggests the need for recognizing the existence of LGB, their unique sexual and mental health needs, and availing appropriate services. Mental health issues in particular need to be given appropriate attention. The study shows that LGB peer networking, face-to-face and virtual, represent key strategies to coping with access barriers to sexual and mental health care services. One of the implications of the research is to strengthen and support the online LGB peer network groups to improve their capacity to provide advice on sexual and mental health issues, and information on where to access LGB friendly services, if and when available

Paper short abstract:

. The paper examines factors that influence household access to healthcare. The main objective of the study was to identify the factors that influence household access to healthcare. It is hoped that the results of the study will improve policy-makers understanding on access to healthcare services.

Paper long abstract:

Against a background of limited access to healthcare services, this paper examines the factors that influence household access to healthcare services in Eldoret municipality, Kenya. The main objective of the study was to identify the factors that influence household access to healthcare services in the municipality. The study was guided by the following specific objectives: to investigate the socio-economic factors that influence household access to healthcare services; to assess the influence of health insurance on household access to healthcare services; and to establish the influence of referral system on household access to healthcare services. It is hoped that the results of the study will improve policy-makers understanding on factors that influence access to healthcare services and to serve as an important tool for any possible intervention aimed at improving access to healthcare. Health Belief Model (HBM) is employed as the theoretical framework. Research design takes survey form. The unit of analysis constituted household heads in the municipality. Stratified, systematic, purposive and convenience sampling procedures were used to arrive at a sample size of two hundred and sixty household heads. Data was derived from both primary and secondary sources and analyzed using Statistical Package for the Social Sciences (SPSS) to ascertain statistical relationships between variables. Multiple regression analysis was employed on a number of demographic and socio-economic variables in the likelihood of access to healthcare. The findings indicate that: there are specific urban dimensions of access to healthcare; among the respondents there is substantial unmet healthcare need; and for many urban families using healthcare services is determined by much more than being able to reach them physically. It further answers the questions: Do socio-economic characteristics, health insurance and referral system; have any role in access to healthcare. Besides, the findings of the study raise new areas for further research in healthcare.

Key Words: Access Households Healthcare Health insurance Referral

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Paper long abstract:

In recent years there have been increasing bilateral relations between Nigeria and the Netherlands in different sectors of the economy; however, there seems to be little exchanges at the theoretical-normative levels. In this respect, health research ethics is a possible and plausible common ground of exchanging ideas and experiences while building cooperation and partnership. Diseases, infections and health pandemic ravaging the world are heightening the need for good science and medical research with integrity. In protecting research subjects in rural and urban areas from abuses and unwarranted risks, medical research ethics committees are statutorily established across states in the world to regulate the activities of clinical researchers, provide guidance on medical research integrity and facilitate qualitative healthcare delivery. While Nigeria and the Netherlands are not exceptions to the universal ideals of having medical research ethics committees, the histories, circumstances of emergence, configuration and structures, powers, roles and limitations of such committees in the two countries are diverse with some common interesting grounds, worthy of investigation. Currently, there is no study profiling the variations, the extent, the contents and overlaps of the mechanism for research ethics capacity-building in Nigeria and the Netherlands. Nor are there studies interrogating the areas of win-win partnership in research ethics capacity-building and policies between the two countries. Understanding the ambience, contents and mechanisms of capacity-building in research ethics in each of these countries is critical not only to improved bilateral relations and exchanges in medical research and healthcare but also in shaping future directions in the areas of value orientation, curriculum adaptation and health policy regulations. Thus, through philosophical methods of content analysis, critical review of literatures and comparative evaluation, this paper aims to investigate the areas of overlaps, gaps and the strategic lessons that can impact future partnership in ethical biomedical researches in Nigeria and the Netherlands. This paper argues that the efficiency of health research ethics committees is, among other things, a function of the capacity, skills, training, the goodwill of the stakeholders, and the principles underlying research ethics practices. In achieving the UN sustainable health development goals in Nigeria, leveraging on the medical research ethics models, functions, and institutionalization in the Netherlands deserves to be taken seriously. The Netherlands can gain comparative insights from the value placed on the role of culture in minimizing biomedical research misconduct in Nigeria. In both contexts, there are potential models of cooperation that can be calibrated.