Health services strengthening in Africa - research is a key component

Funding patterns for biomedical research and infectious diseases burden in Gabon

Background

Biomedical research plays an important role in improving health. There seems to exist a negative correlation between the amount of biomedical research funding and disease burden from all Sub-Saharan African countries. In this study, we describe funding patterns for biomedical research, explore the correlation between funding and burden of diseases, and quantify inequalities in funds distribution across diseases in Gabon over the period 2005–2015.

Methods

Data on medical research funds from 2005 to 2015 were retrieved through a structured questionnaire distributed to Gabonese biomedical research institutions and by consulting online databases. Data on the burden of diseases were gathered from the World Health Organization and the Institute for Health Metrics and Evaluation. We used Kendall rank correlation coefficient to explore the correlation between cumulative funds over time and the burden of disease. The inequality distribution of funding across diseases was assessed through Gini coefficient and Lorenz curve.

Results

Biomedical research funding was characterized by a remarkable growth from 2005 to 2010 and a decline from 2010 to 2014. Funds were mostly from external sources and from partnerships. There was inequality in research funds allocation across diseases and malaria was far the most funded disease. There was a significant negative correlation between cumulative funding and the burden of HIV, tuberculosis, and of Helminthiasis (from 2006 to 2010) suggesting that research may be contributing to the management of such diseases. A positive, although not significant, correlation was found between cumulative funds and malaria burden.

Conclusions

The negative correlation between HIV and tuberculosis cumulative funding and burden suggests that research may be contributing to the management of such diseases but further research is needed to assess the causal direction of such as relationship. As the burden of non-communicable diseases is increasing, more research funds should be focused on those. While research partnerships have been and will remain fundamental, Gabon should increase the amount of national funds to overcome periods of reduced research funding flows from abroad.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12201-w.

High asthma prevalence and associated factors in urban malagasy schoolchildren

INTRODUCTION

Studies about bronchial asthma in Africa are impeded by the dearth of reliable data for the vast majority of countries on the continent. This study was conducted to establish the first epidemiological data concerning bronchial asthma in urban Malagasy schoolchildren.

METHODS

From three public and five private schools 1236 students aged 7-14 years were recruited and examined using a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. In a subgroup of 111 schoolchildren from two schools, lung function tests were conducted together with bronchodilator response (BDR) to establish reversible obstruction (change in FEV1 ≥ 12%).

RESULTS

The overall prevalence of wheezing in schoolchildren was 25.2%, with strikingly more wheezing in children attending private schools than public schools (p = .0012). The risk was diminished in students with older siblings (p < .03), but was not affected by other variables like smoking habits at home, body mass index, or cooking fuel. In the schools where BDR was performed, we found a point prevalence for reversible bronchial obstruction of 9% through lung function tests.

CONCLUSION

Bronchial asthma is of great relevance for schoolchildren living in urban Madagascar. Socioeconomic factors and air pollution seem to have a major impact in addition to the number of older siblings.

Operational research and HIV policy and guidelines: lessons from a study of patients lost to follow-up from a public antiretroviral treatment program in Cameroon

Can operations and implementation research guide today's unprecedented efforts to scale-up HIV/AIDS prevention, treatment, care, and support in resource-limited settings? Our study of patients with HIV/AIDS who were first seen at the Central Hospital (Yaoundé, Cameroon) to begin antiretroviral therapy demonstrates the value of using operations research to explore programs, policies, and guidelines used in health care. We studied one group of patients, those lost to follow-up. Our findings confirmed the value of early treatment, systems to follow individuals, free treatment, and resources that enable operations research. We encourage health-care workers and program managers to perform operational research in their own context, and we emphasize the importance of allocating adequate human, financial, and logistic resources for this activity. Finally, we stress that the health-care workers, program managers, and researchers must work together to better inform policy and guidelines.

The HIV/AIDS epidemic in sub-Saharan Africa: thinking ahead on programmatic tasks and related operational research

Until now, we have all been desperately trying to run behind the HIV/AIDS epidemic and catch up with it, but despite all our efforts, the epidemic remains well ahead of us. In 2010, the antiretroviral treatment (ART) gap was about 60%, AIDS-related deaths were almost two million a year, and on top of these figures, for every one person started on ART, there were two new HIV infections. What is needed to change this situation is to think ahead of the epidemic in terms of the programmatic tasks we will be faced with and try to act boldly in trying to implement those tasks. From a programmatic perspective, we: a) highlight what needs to fundamentally change in our thinking and overall approach to the epidemic; and b) outline a number of key task areas for implementation and related operational research.