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Browsing SBS Scholarly Articles by Subject "Africa"
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- ItemChloramphenicol Pharmacokinetics in African children with severe malaria(Journal of tropical pediatrics, ) Kokwaro, G.; Muchohi, Simon N.; Ogutu, Benhards R.; Newton, Charles RJC
- ItemPopulation pharmacokinetics of a single daily intramuscular dose of gentamicin in children with severe malnutrition(Journal of Antimicrobial Chemotherapy, ) Kokwaro, G.; Seaton, Claire; Ignas, James; Muchohi, Simon N.; Maitland, Kathryn; Thomson, AlisonObjectives: The World Health Organization recommends that all children admitted with severe malnutrition should routinely receive parenteral ampicillin and gentamicin; despite this, mortality remains high. Since this population group is at risk of altered volume of distribution, we aimed to study the population pharmacokinetics of once daily gentamicin (7.5 mg/kg) in children with severe malnutrition and to evaluate clinical factors affecting pharmacokinetic parameters. Methods: Thirty-four children aged 0.5–10 years were studied. One hundred and thirty-two gentamicin concentrations (median of four per patient), drawn 0.4–24.6 h after administration of the intramuscular dose, were analysed. The data were fitted by a two-compartment model using the population package NONMEMw. Results: Gentamicin was rapidly absorbed and all concentrations measured within the first 2 h after administration were >8 mg/L (indicating that satisfactory peak concentrations were achieved). Ninetyeight percent of samples measured more than 20 h after the dose were <1 mg/L. The best model included weight, and it was found that high base deficit, high creatinine concentration and low temperature (all markers of hypovolaemic shock) reduced clearance (CL/F). Weight influenced volume of the central (V1/F) and peripheral (V2/F) compartments, and high base deficit reduced V2/F and intercompartmental CL (Q/F). Interindividual variability in CL was 26%, in V1/F 33% and in V2/F and Q/F was 52%. Individual estimates of CL/F ranged from 0.02 to 0.16 (median 0.10) L/h/kg and those of Vss/F from 0.26 to 1.31 (median 0.67) L/kg. Initial half-lives had a median of 1.4 h and elimination half-lives and a median of 14.9 h. Excessive concentrations were observed in one patient who had signs of renal impairment and shock. Conclusions: Although a daily dose of 7.5 mg/kg achieves satisfactory gentamicin concentrations in the majority of patients, patients with renal impairment and shock may be at risk of accumulation with 24 hourly dosing. Further studies of gentamicin pharmacokinetics in this group are now needed to inform future international guideline recommendations.
- ItemStrategic options of economic integration and global trade for Africa in the 21st centuryMudida, RobertDespite huge strides in economic development made in many parts of the world over the last few decades, many people in Africa still remain in dire poverty. According to the 2007/2008 United Nations Human Development Report, the twenty countries with the lowest human development are all located in Sub-Saharan Africa. Trade has often been identified as a vital engine of economic growth and development to facilitate an African renaissance in the 21st Century. However, economic integration schemes in Africa continue to suffer from many limitations and Africa’s participation in the global economy remains miniscule. Regional integration arrangements in Africa, for example, continue to be characterized by overlapping membership and weak institutions. At the turn of the new century Africa’s share of world trade plummeted to levels below those in the 1960s when it had accounted for 2 percent of world trade. The erosion of Africa’s world trade share represents a staggering income loss of billions of dollars annually. The acceleration of globalization seems to have placed Africa at the threshold of further marginalization. With the formation of the African Union in 2002 and associated institutions such as the New Partnership for Africa’s Development (NEPAD), it appeared that there was a renewed impetus for development on the continent. A new and better calibre of African leaders emerged in some countries in the 21st century, although with some notable exceptions. This paper will explore what needs to be achieved for economic integration to be more effective in Africa and for Africa to participate more effectively in global trade. The relationship between different economic integration initiatives in Africa to global trade liberalization in the framework of the WTO will be explored. It will be argued that in order for African states to become more fully integrated in the global economy they will need to adopt a more pro-active rather than reactive approach. Such an approach will center on building more effective institutions at the national and regional levels so as to give Africa a greater voice in the 21st century. Africa’s development challenges are essentially about a crisis of institutions at the political, economic and social levels. Weak regional institutions reflect internal weaknesses of member states. The paper will explore competing conceptual constructs of regional integration in Africa with a view to arriving at a set of strategic options for enhanced effectiveness.For example, open regionalism based on neo-classical assumptions will be contrasted with the concept of “regionalism from below” which emphasizes the importance of civil society and informal organizations in regionalism. Concerns of African states arising from the existing multilateral framework and current trade round of the WTO will also be examined as will be strategic options for integrating Africa more fully into the global economy.
- ItemStrengthening capacity for health research in Africa(The Lancet, ) Gilbert Kokwaro; Whitworth, James AG; Kinyanjui, Samson; A, Valerie Snewin; Tanner, Marcel; Walport, Mark; Sewankambo, NelsonHealth research has a key role in the development of low-income and middle-income countries. There are several current initiatives that have greatly contributed to capacity strengthening of health research in sub-Saharan Africa, including those supported by WHO and Tropical Disease Research (TDR), the Swedish International Development Agency (SIDA) and Department for Research Cooperation (SAREC), the European Union, the Bill & Melinda Gates Foundation, the International Clinical Epidemiology Network (INCLEN), the Fogarty International Centre, the National Institutes of Health (NIH), and the Wellcome Trust. However, enormous challenges remain for sub-Saharan Africa to establish a common framework for sustainable research capacity strengthening. The Global Ministerial Forum on Research for Health in Bamako will give emphasis to the challenges of research for development and health, the need for more health-system research, and a greater intersectoral approach to science, technology, and health. That health research is indispensable for improving health, equity, and development is now widely accepted,1 yet how sub-Saharan African countries can develop their fragile health systems and their own capacity to do health research is rarely discussed.2 A recent African-led initiative—the Initiative to Strengthen Health Research Capacity in Africa (ISHReCA)—has identified nine key requirements to strengthening health-research capacity in Africa (panel 1). We focus on these requirements and suggest practical strategies for sustainable capacity strengthening in African institutions.
- ItemWhat determines gender inequality in household food security in Kenya? application of exogenous switching treatment regression(ScienceDirect, 2014-04) Menale, Kassie; Ndiritu, Simon W.; Stage, JesperThis paper explores the link between the gender of a household head and food security in rural Kenya. The results show that the food security gap between male-headed households (MHHs) and female-headed households (FHHs) is explained by their differences in observable and unobservable characteristics. FHHs’ food security status would have been higher than it is now if the returns (coefficients) on their observed characteristics had been the same as the returns on the MHHs’ characteristics. Even if that had been the case, however, results indicate that FHHs would still have been less food-secure than the MHHs due to unobservable characteristics.