In low-and middle-income countries (LMICs), the burden of non-communicable diseases is increasing... more In low-and middle-income countries (LMICs), the burden of non-communicable diseases is increasing due to the combination of population aging and lifestyle changes. While interest in multimorbidity has been rising to study more precisely the complex morbid processes that adults experience, health data in LMICs are scarce and rarely allow such investigations. Focusing on multimorbidity leading to death, we aim to develop an approach to estimate multiple causes of death using available data. In settings where certification of death by physicians is not available, verbal autopsies (VAs) have been developed to diagnose likely causes of death from information collected via a structured interview with final caregivers about the signs and symptoms leading up to death. With an increasing use of probabilistic models to interpret VAs, we investigate their potential for identifying multiple causes using a database of 72,330 adult deaths (15 and older) from 22 Health and Demographic Surveillance System (HDSS) sites located in Asia and Africa, and detailed VA data from the Ouagadougou HDSS in Burkina Faso (1,700 deaths). The Bayesian model InterVA-4 attributes multiple likely causes to 11% of deaths. However, some combinations result more from uncertain diagnosis than from multimorbidity. Elaborating an index of similarity between causes based on the InterVA's probability matrix, we aim to differentiate competing causes (uncertainty) from co-occurring causes (multimorbidity). Selecting the most dissimilar associations of causes, we highlight the importance of associations between infectious and non-communicable diseases, as well as the burden of diabetes and cardiovascular diseases among the identified multimorbidity.
La santé et les droits reproductifs, loin d’être des coûts, représentent à la fois des investisse... more La santé et les droits reproductifs, loin d’être des coûts, représentent à la fois des investissements économiques profitables et des avancées anthropologiques essentielles. Les déterminants de genre sont au cœur de l’offre et de la demande éducatives en Afrique. Quelques pistes pour lever les obstacles institutionnels, économiques et sociaux à la réalisation d’un « écosystème du genre » sont évoquées.
Les questions de genre, de sante et droits sexuels et reproductifs et de developpement ont depuis... more Les questions de genre, de sante et droits sexuels et reproductifs et de developpement ont depuis plus de deux decennies pris une place grandissante a la fois chez les theoriciens et les praticiens du developpement, chercheurs, institutions nationales et internationales, organisations non gouvernementales et experts des agences de developpement. La Suede a joue un role determinant dans l'evolution de cet agenda global. Parmi les plus grands contributeurs d'Aide Publique au Developpement, la Suede est le pays qui a le plus integre les perspectives de genre et de droits au coeur de son dispositif d'aide internationale. Le cycle des grandes conferences onusiennes des annees 1990, qui font de l'egalite femmes- hommes a la fois une condition et un moyen pour atteindre un developpement humain durable a ete l'occasion pour la Suede de s'affirmer comme une puissance d'influence de premier ordre. L'examen des facteurs determinants dans l'histoire suedoise ...
While until recently the small and isolated Zika outbreaks in Eastern Asia and Pacific islands ha... more While until recently the small and isolated Zika outbreaks in Eastern Asia and Pacific islands had been overlooked, the large-scale outbreak that started in Brazil in 2015 and the increase of microcephaly cases in the same place and time made media headlines. Considered as harmless until recently, Zika has given rise to an important global crisis that poses not only health challenges but also environmental, economical, social, and ethical challenges for states and people around the world. The main objective of this paper is to review the recent Zika outbreak by covering a broad range of disciplines and their interactions. This paper synthetises experts' interviews and reactions conducted during a Massive Open Online Course (MOOC) entitled "In the footsteps of Zika…approaching the unknown." It reviews knowledge and uncertainties around epidemiology, geographical dispersion of the virus and its vectors through globalization and climate change, and also its modes of transmission, diagnosis, symptoms, and treatment of the disease. The resulting societal and ethical issues in pregnancy and women of reproductive age were also addressed as well as the global outbreak alert and response network in international organizations and social media. This paper attempted to combine each piece of the jigsaw puzzle of the Zika phenomenon to complete the best realistic picture, while keeping in mind the balance between the interdisciplinary nature and international context of Zika and its unique characteristics.
In low-and middle-income countries (LMICs), the burden of non-communicable diseases is increasing... more In low-and middle-income countries (LMICs), the burden of non-communicable diseases is increasing due to the combination of population aging and lifestyle changes. While interest in multimorbidity has been rising to study more precisely the complex morbid processes that adults experience, health data in LMICs are scarce and rarely allow such investigations. Focusing on multimorbidity leading to death, we aim to develop an approach to estimate multiple causes of death using available data. In settings where certification of death by physicians is not available, verbal autopsies (VAs) have been developed to diagnose likely causes of death from information collected via a structured interview with final caregivers about the signs and symptoms leading up to death. With an increasing use of probabilistic models to interpret VAs, we investigate their potential for identifying multiple causes using a database of 72,330 adult deaths (15 and older) from 22 Health and Demographic Surveillance System (HDSS) sites located in Asia and Africa, and detailed VA data from the Ouagadougou HDSS in Burkina Faso (1,700 deaths). The Bayesian model InterVA-4 attributes multiple likely causes to 11% of deaths. However, some combinations result more from uncertain diagnosis than from multimorbidity. Elaborating an index of similarity between causes based on the InterVA's probability matrix, we aim to differentiate competing causes (uncertainty) from co-occurring causes (multimorbidity). Selecting the most dissimilar associations of causes, we highlight the importance of associations between infectious and non-communicable diseases, as well as the burden of diabetes and cardiovascular diseases among the identified multimorbidity.
La santé et les droits reproductifs, loin d’être des coûts, représentent à la fois des investisse... more La santé et les droits reproductifs, loin d’être des coûts, représentent à la fois des investissements économiques profitables et des avancées anthropologiques essentielles. Les déterminants de genre sont au cœur de l’offre et de la demande éducatives en Afrique. Quelques pistes pour lever les obstacles institutionnels, économiques et sociaux à la réalisation d’un « écosystème du genre » sont évoquées.
Les questions de genre, de sante et droits sexuels et reproductifs et de developpement ont depuis... more Les questions de genre, de sante et droits sexuels et reproductifs et de developpement ont depuis plus de deux decennies pris une place grandissante a la fois chez les theoriciens et les praticiens du developpement, chercheurs, institutions nationales et internationales, organisations non gouvernementales et experts des agences de developpement. La Suede a joue un role determinant dans l'evolution de cet agenda global. Parmi les plus grands contributeurs d'Aide Publique au Developpement, la Suede est le pays qui a le plus integre les perspectives de genre et de droits au coeur de son dispositif d'aide internationale. Le cycle des grandes conferences onusiennes des annees 1990, qui font de l'egalite femmes- hommes a la fois une condition et un moyen pour atteindre un developpement humain durable a ete l'occasion pour la Suede de s'affirmer comme une puissance d'influence de premier ordre. L'examen des facteurs determinants dans l'histoire suedoise ...
While until recently the small and isolated Zika outbreaks in Eastern Asia and Pacific islands ha... more While until recently the small and isolated Zika outbreaks in Eastern Asia and Pacific islands had been overlooked, the large-scale outbreak that started in Brazil in 2015 and the increase of microcephaly cases in the same place and time made media headlines. Considered as harmless until recently, Zika has given rise to an important global crisis that poses not only health challenges but also environmental, economical, social, and ethical challenges for states and people around the world. The main objective of this paper is to review the recent Zika outbreak by covering a broad range of disciplines and their interactions. This paper synthetises experts' interviews and reactions conducted during a Massive Open Online Course (MOOC) entitled "In the footsteps of Zika…approaching the unknown." It reviews knowledge and uncertainties around epidemiology, geographical dispersion of the virus and its vectors through globalization and climate change, and also its modes of transmission, diagnosis, symptoms, and treatment of the disease. The resulting societal and ethical issues in pregnancy and women of reproductive age were also addressed as well as the global outbreak alert and response network in international organizations and social media. This paper attempted to combine each piece of the jigsaw puzzle of the Zika phenomenon to complete the best realistic picture, while keeping in mind the balance between the interdisciplinary nature and international context of Zika and its unique characteristics.
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