Examples of possible distributors for contraceptive commodities.
\\n\\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\\n"}]',published:!0,mainMedia:{caption:"Highly Cited",originalUrl:"/media/original/117"}},components:[{type:"htmlEditorComponent",content:'IntechOpen is proud to announce that 191 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\nThroughout the years, the list has named a total of 261 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\nReleased this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
Note: Edited in March 2021
\n'}],latestNews:[{slug:"webinar-introduction-to-open-science-wednesday-18-may-1-pm-cest-20220518",title:"Webinar: Introduction to Open Science | Wednesday 18 May, 1 PM CEST"},{slug:"step-in-the-right-direction-intechopen-launches-a-portfolio-of-open-science-journals-20220414",title:"Step in the Right Direction: IntechOpen Launches a Portfolio of Open Science Journals"},{slug:"let-s-meet-at-london-book-fair-5-7-april-2022-olympia-london-20220321",title:"Let’s meet at London Book Fair, 5-7 April 2022, Olympia London"},{slug:"50-books-published-as-part-of-intechopen-and-knowledge-unlatched-ku-collaboration-20220316",title:"50 Books published as part of IntechOpen and Knowledge Unlatched (KU) Collaboration"},{slug:"intechopen-joins-the-united-nations-sustainable-development-goals-publishers-compact-20221702",title:"IntechOpen joins the United Nations Sustainable Development Goals Publishers Compact"},{slug:"intechopen-signs-exclusive-representation-agreement-with-lsr-libros-servicios-y-representaciones-s-a-de-c-v-20211123",title:"IntechOpen Signs Exclusive Representation Agreement with LSR Libros Servicios y Representaciones S.A. de C.V"},{slug:"intechopen-expands-partnership-with-research4life-20211110",title:"IntechOpen Expands Partnership with Research4Life"},{slug:"introducing-intechopen-book-series-a-new-publishing-format-for-oa-books-20210915",title:"Introducing IntechOpen Book Series - A New Publishing Format for OA Books"}]},book:{item:{type:"book",id:"464",leadTitle:null,fullTitle:"Autism Spectrum Disorders: The Role of Genetics in Diagnosis and Treatment",title:"Autism Spectrum Disorders",subtitle:"The Role of Genetics in Diagnosis and Treatment",reviewType:"peer-reviewed",abstract:"Estimated prevalence rates of autism spectrum disorders (ASDs) have increased at an alarming rate over the past decade; current estimates stand as high as 1 in 110 persons in the population with a higher ratio of affected males to females. In addition to their emotional impact on the affected persons and their family members (in fact, the latter are often unrecognized unaffected “patients†themselves), the economic and social impacts of ASDs on society are staggering. Persons with ASDs will need interdisciplinary approaches to complex treatment and life planning, including, but not limited to, special education, speech and language therapy, vocational skills training and rehabilitation, social skills training and cognitive remediation, in addition to pharmacotherapy. The current book highlights some of the recent research on nosology, etiology, and pathophysiology. Additionally, the book touches on the implications of new research for treatment and genetic counseling. Importantly, because the field is advancing rapidly, no book can be considered the final word or finished product; thus, the availability of open access rapid publication is a mechanism that will help to assure that readers remain current and up-to-date.",isbn:null,printIsbn:"978-953-307-495-5",pdfIsbn:"978-953-51-6443-2",doi:"10.5772/976",price:119,priceEur:129,priceUsd:155,slug:"autism-spectrum-disorders-the-role-of-genetics-in-diagnosis-and-treatment",numberOfPages:212,isOpenForSubmission:!1,isInWos:1,isInBkci:!1,hash:null,bookSignature:"Stephen Deutsch",publishedDate:"August 1st 2011",coverURL:"https://cdn.intechopen.com/books/images_new/464.jpg",numberOfDownloads:25794,numberOfWosCitations:11,numberOfCrossrefCitations:5,numberOfCrossrefCitationsByBook:0,numberOfDimensionsCitations:18,numberOfDimensionsCitationsByBook:0,hasAltmetrics:1,numberOfTotalCitations:34,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"October 20th 2010",dateEndSecondStepPublish:"November 17th 2010",dateEndThirdStepPublish:"March 24th 2011",dateEndFourthStepPublish:"April 23rd 2011",dateEndFifthStepPublish:"June 22nd 2011",currentStepOfPublishingProcess:5,indexedIn:"1,2,3,4,5,6",editedByType:"Edited by",kuFlag:!1,featuredMarkup:null,editors:[{id:"32007",title:"Prof.",name:"Stephen",middleName:"I.",surname:"Deutsch",slug:"stephen-deutsch",fullName:"Stephen Deutsch",profilePictureURL:"https://mts.intechopen.com/storage/users/32007/images/3613_n.jpg",biography:"Dr. Deutsch received his medical and graduate degrees in biochemical pharmacology from the New York University School of Medicine. He conducted his graduate research in the laboratory of Dr. Rody P. Cox, working on the molecular mechanisms of nonketotic hyperglycemia, which provided early insights into glycine’s neurotransmitter and metabolic roles in the CNS, and effects of sodium butyrate on changes in morphology, rates of cell division and gene expression in HeLa cells. The latter studies have assumed increased importance in view of butyrate’s role as the prototypic inhibitor of histone deacetylase activity and the important epigenetic regulatory role of the acetylation status of histones on gene expression. Dr. Deutsch completed training in Psychiatry at the NYU-Bellevue Psychiatric Hospital, where he worked with Drs. Samuel Gershon and Magda Campbell on clinical trials and development of rational pharmacotherapies for major psychiatric disorders. Specifically, with Dr. Campbell as a mentor, Dr. Deutsch conducted neuroendocrine studies showing that regulation of growth hormone release was abnormal in severely affected autistic children, participated in the seminal trials of haloperidol, and developed a rational for exploring the therapeutic value of opiate antagonists in these children. Subsequently, Dr. Deutsch completed a Pharmacology Research fellowship at the NIMH, working in the laboratory of Dr. Steven M. Paul on the in vivo characterization of the central benzodiazepine binding site. Currently, Dr. Deutsch is the Ann Robinson Endowed Chair and Professor and Chair of Psychiatry at Eastern Virginia Medical School in Norfolk, Virginia. He and his colleagues have shown that the Balb/c mouse is a genetic mouse model of autism spectrum disorders (ASDs) and they have shown that targeted NMDA receptor agonists can improve the impaired sociability of this mouse model. Collaboratively with Dr. Maria Urbano, Drs. Deutsch, Urbano and their colleagues are translating these preclinical and other genetic findings into clinical trials of new therapeutic strategies for ASDs. Dr. Deutsch has published over 240 original articles, reviews and book chapters. 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Municipal solid waste, which has traditionally been studied the most, is a stream that, by weight, is at relatively low percentages compared to the total amounts of solid wastes generated worldwide. Emphasis is lately given on special solid waste streams that may, or may not, have hazardous properties. The aspect of sustainability has been particularly introduced into solid waste management during the past two decades. For example, “sustainable landfilling” was a term introduced during the nineties to suggest the use of stabilization techniques before landfilling to reduce landfill emissions.
\r\n\r\n\tThis book, therefore, intends to provide the reader with a comprehensive overview of the current trends of research that aims to focus on this diverse nature of sustainable solid waste management: from valorization techniques to legal, economic, and behavioral aspects and from LCA to quality assessment methods.
",isbn:"978-1-80356-327-5",printIsbn:"978-1-80356-326-8",pdfIsbn:"978-1-80356-328-2",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,hash:"e3e2cbc06fea6858df1f375d49431b66",bookSignature:"Prof. Suhaiza Zailani",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11530.jpg",keywords:"Solid Waste Management, Sustainable, Supply Chain, UN Sustainable Development Goals, Venture, Solid Waste Management, Circular Economy, Sustainable Solid Waste, Behavioral Insights, Behavioral Aspects, Solid Waste Management, Business Sustainability",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"February 16th 2022",dateEndSecondStepPublish:"March 16th 2022",dateEndThirdStepPublish:"May 15th 2022",dateEndFourthStepPublish:"August 3rd 2022",dateEndFifthStepPublish:"October 2nd 2022",remainingDaysToSecondStep:"2 months",secondStepPassed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"Dr. Zailani was awarded the UM Distinguished Researcher in 2016, Emerald Literati Network Awards for Excellence in 2016, and last year, and was listed as one of the recipients for the Top 80 UM Researchers amongst the World’s Top 2% of scientists by Sandford University.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"172845",title:"Prof.",name:"Suhaiza",middleName:null,surname:"Zailani",slug:"suhaiza-zailani",fullName:"Suhaiza Zailani",profilePictureURL:"https://mts.intechopen.com/storage/users/172845/images/system/172845.png",biography:"Suhaiza Zailani is a Professor of Supply Chain with the Faculty of Business and Accountancy, University Malaya. 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Venkateswarlu",coverURL:"https://cdn.intechopen.com/books/images_new/371.jpg",editedByType:"Edited by",editors:[{id:"58592",title:"Dr.",name:"Arun",surname:"Shanker",slug:"arun-shanker",fullName:"Arun Shanker"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"72",title:"Ionic Liquids",subtitle:"Theory, Properties, New Approaches",isOpenForSubmission:!1,hash:"d94ffa3cfa10505e3b1d676d46fcd3f5",slug:"ionic-liquids-theory-properties-new-approaches",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/72.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"314",title:"Regenerative Medicine and Tissue Engineering",subtitle:"Cells and Biomaterials",isOpenForSubmission:!1,hash:"bb67e80e480c86bb8315458012d65686",slug:"regenerative-medicine-and-tissue-engineering-cells-and-biomaterials",bookSignature:"Daniel Eberli",coverURL:"https://cdn.intechopen.com/books/images_new/314.jpg",editedByType:"Edited by",editors:[{id:"6495",title:"Dr.",name:"Daniel",surname:"Eberli",slug:"daniel-eberli",fullName:"Daniel Eberli"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"57",title:"Physics and Applications of Graphene",subtitle:"Experiments",isOpenForSubmission:!1,hash:"0e6622a71cf4f02f45bfdd5691e1189a",slug:"physics-and-applications-of-graphene-experiments",bookSignature:"Sergey Mikhailov",coverURL:"https://cdn.intechopen.com/books/images_new/57.jpg",editedByType:"Edited by",editors:[{id:"16042",title:"Dr.",name:"Sergey",surname:"Mikhailov",slug:"sergey-mikhailov",fullName:"Sergey Mikhailov"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"1373",title:"Ionic Liquids",subtitle:"Applications and Perspectives",isOpenForSubmission:!1,hash:"5e9ae5ae9167cde4b344e499a792c41c",slug:"ionic-liquids-applications-and-perspectives",bookSignature:"Alexander Kokorin",coverURL:"https://cdn.intechopen.com/books/images_new/1373.jpg",editedByType:"Edited by",editors:[{id:"19816",title:"Prof.",name:"Alexander",surname:"Kokorin",slug:"alexander-kokorin",fullName:"Alexander Kokorin"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"2270",title:"Fourier Transform",subtitle:"Materials Analysis",isOpenForSubmission:!1,hash:"5e094b066da527193e878e160b4772af",slug:"fourier-transform-materials-analysis",bookSignature:"Salih Mohammed Salih",coverURL:"https://cdn.intechopen.com/books/images_new/2270.jpg",editedByType:"Edited by",editors:[{id:"111691",title:"Dr.Ing.",name:"Salih",surname:"Salih",slug:"salih-salih",fullName:"Salih Salih"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"58297",title:"Family Planning Services in Africa: The Successes and Challenges",doi:"10.5772/intechopen.72224",slug:"family-planning-services-in-africa-the-successes-and-challenges",body:'The world population reached 7.4 billion in 2016 at an annual growth rate of 2.55% with Africa accounting for 1203 million. It is estimated that between 2015 and 2030 the population in Africa will reach 1.3 billion [1]. Sub-Saharan Africa (SSA) (excluding North Africa) has seen remarkable population growth in the past three to four decades. SSA population in 1990 was 510 million, 688 million in 2002 and by 2016 has reached 974 million [2]. By 2050, three countries (Nigeria, 4th, Democratic Republic of the Congo, 8th and Egypt, 10th) with a combined population of 779 million will be the most populous nations in Africa [1]. Sub-Saharan Africa (SSA) has 11% of the world population but accounts for a pitiable 2% of global trade [3]. The population growth is largely driven by high fertility rate and rising cohort of women of reproductive age group (WRAG) (15–49 years).
Demographically, there is population momentum across most of the countries, as more than half of the population are under the age of 15 years. What this means is that even if replacement-level fertility is achieved, the population growth will continue for at least two decades because of the momentum built up in the age structure due to the past high fertility levels that has given rise to the greater number of couples who are having children. Social forces and pronatalist factors sustaining high fertility and which also impedes family planning (FP) programmes are well known [4, 5]. Added to this is the fact that in SSA husbands tend to want large families than their wives [6, 7]. Sub-Saharan African countries are still undergoing both demographic and epidemiologic traditions. Even though birth rate is declining, it is still in excess of death rates. Thus, the region has the highest rates of fertility globally with total fertility rates (TFR) that ranged from 4.8 children per woman in Kenya, 5.2 in Nigeria, 5.7 in South Sudan, and 7.6 in the Republic of Niger [1, 4, 8, 9]. It also has a high annual growth rate of more than 2.5% per year.
Again, the same continent is vulnerable to the “destructive forces” caused by nature as recent events have shown. The harsh adverse effects of global warming in the Sahel region, draught/famine in the horn of Africa, deforestation, overgrazing with declines in soil fertility and incessant floods in West Africa has contributed in sustaining the vicious cycle of poverty and disease. As the number increases, the pressure on the environment (both built and natural) including natural resources and available fertile land for agriculture increases. Consequently, the net effect is increased in greenhouse gases (GHGs) with its attendant effects on public health.
Before 1970, majority of Africa countries had not viewed population growth as a major factor in their national development strategies because of their small population (34 of the 48 countries had a total population of less than 5 million) [8]. By the mid-1970s, the trend started to change with the rising number of national governments that reported having population policies aimed at reducing the rapid growth of their respective populations: 25% in 1976, 39% in 1986, 60% in 1996 and 64% in 2009 [9]. Previously, pronatalist governments that wanted to maintain or even increase population growth have gradually modified their stance and accepted provision of FP services as integral part of maternal and child health (MCH) which is a key component of primary health-care (PHC) system. Also, government policies regarding access to and availability of modern contraceptives have been an important determinant of reproductive behavior as well as maternal and child health. Many governments have given direct support providing FP services through state-owned health facilities. The provision of FP services is a key component of Safe Motherhood Initiative launched in 1987 in Nairobi, Kenya, to reduce maternal mortality in developing countries, where 99% of all maternal deaths occur [10]. In African region women have 1 in 42 lifetime risk (compared to 1 in 2900 in Europe) of dying prematurely in childbirth [11]. Provision of universal access to high-quality family planning and maternal health services and skilled attendance at delivery are key action strategies under the safe motherhood initiative [12]. Contraceptive use averts about 230 million births every year globally, and family planning (FP) is a primary strategy for prevention of unwanted pregnancy [13].
Contraception refers to the prevention of pregnancy as a consequence of sexual intercourse using either traditional or modern methods. The 1994 International Conference on Population and Development (ICPD) in Cairo was a paradigm shift and was seen as a turning point with respect to the role of FP. The earlier population conferences, Bucharest 1974 and Mexico City in 1984 mainly focused on demographic-economic issues. However, the Cairo Conference highlighted the important role FP plays in the context of social and economic development and goals regarding sexual and reproductive health and right including FP with a focus on women’s empowerment [14, 15]. The universal access to FP that links the 1994 Cairo Conference to Millennium Development Goal 5b (MDG 5b) of universal access to reproductive health is very much connected to the successful achievement of sustainable development goal (SDG) themes of people, planet, prosperity, peace and partnership [16]. Voluntary FP brings transformational benefits to women, families, communities and nations. Without universal access to FP and reproductive health, the impact and effectiveness of offering interventions will be less, will cost more and will take longer to achieve [16].
The demand for FP will never cease as long as life continues to exist on earth, and humans want to satisfy their physiological desires and need for procreation (generational species sustainability). At any point in time, there will always be a cohort of young adult couples who not only want to fulfill their sexual desires but also want to delay or postpone pregnancy, and so the demand for contraception will continue.
In SSA, health-care systems are weak and dysfunctional; despite this, there have been some remarkable gains in immunization services with resultant decline in death rates among under-fives. Yet, fertility has remained high. Added to this dimension is the unprecedented rapid urbanization that is sweeping across the continent. There is still a long way to go to achieve small or desired family size. In the whole region, only 17% of married women are using contraceptives, very much lower than the 50% reported from North Africa. Only in five countries (South Africa, Botswana, Zimbabwe, Kenya and Malawi) have FP programmes been a success to increase contraceptive use to higher levels [3]. This chapter is based on FP services in Africa. Published peer-reviewed journals, abstracts, Gray literature (government documents, technical reports, other reports, etc.), Internet articles and Demographic and Health Surveys (DHS) reports were used as resource materials. Manual search of reference list of selected articles was checked for further relevant studies.
The period 1970–1990 marked the golden era of family planning during which reproductive revolution occurred worldwide except in SSA. However, by the early 1990s, changes had begun to occur leading some experts to suggest that population and FP programmes started in the late 1960s in developing countries constituted one of the most important public health success stories of the twentieth century [14]. Benefits of FP were known ever since Beard in 1897 observed that ovarian follicles do not develop during pregnancy and that corpus luteum was responsible [17]. There are a variety of health benefits that are associated with the use of individual FP commodities; for instance, pills, injectable and implants have been associated with protection against uterine and ovarian cancers, benign cysts of the breast or ovaries and pelvic inflammatory diseases (PIDs). Pills can also reduce menstrual flow and dysmenorrhea and decreased prevalence of iron deficiency anaemia.
Family planning is a cost-effective public health and development intervention. Generally, planned pregnancies which are safer for the mother produce healthier children than unplanned pregnancy. FP allows individuals and couples to at least plan one aspect of their lives (reproductive life). The cost of averting unwanted birth is quite insignificant compared to the costs to the family and country of unwanted births [9]. Further, fewer public health interventions are as effective as FP programmes in reducing morbidity and mortality of mothers and infants and result in such a huge positive impacts [9, 18, 19].
The health and socio-economic benefits of healthy motherhood including the use of contraception are known. Contraceptive use promotes small family size, improves child survival and reduces sibling competition for scarce family and maternal resources [20, 21]. When used correctly and consistently, contraceptive use in developing countries have been shown to decrease the number of maternal deaths and also prevent more than half of all maternal deaths if full demand of birth control is met [12, 22]. Spacing children can reduce mortality among under-fives by 10% and among pregnant mothers by 32% [23, 24, 25, 26].
At macro-level, national population growth is slower which reduces strains on the environment, natural resources, education and health-care systems. FP reduces the risk of maternal mortality per birth (i.e. number of maternal deaths in 100,000 live births per year) [27] as a result of pregnancies too early, too many, too close and too late (4Ts of maternal mortality) [28, 29, 30] all of which are prevalent in SSA. The effective use of contraception can help couples achieve the desired number of children they want, prevent the number of unwanted pregnancies and reduce the risks of sexually transmitted infections (STIs) and thus overall improvement in maternal and child health and the nation.
Contraceptive use allows couples to realize their full potentials, and the woman can better fulfill her roles as a wife, mother, wage earner and community member. The man can better expand his roles as husband, father and family caregiver [30]. All these go a long way in curtailing population explosion, reduce dependency ratio (youth), better the health indices for the country and improve socio-economic conditions. This will also assist Africa to make progress in achieving all the sustainable development goals (SDGs).
The decision to limit one’s family size is wholly personal intimate decision between husband and wife. The practice to limit family size by whatever means has been known since man developed social conscience. In SSA, national family planning programmes were introduced, respectively, in the late 1960s in Kenya and Nigeria [31], in the early 1970s in Ghana and in the mid-1970s in South Africa [32]. Programmes to promote FP in developing countries began in the 1960s in response to improvements in child survival that led to increase in population growth. The number of developing countries with official policies to support FP rose from only 2 in 1960 to 74 by 1975 and 115 by 1996 [30]. Before the 1960s, African countries had no population policies in whatever form; by the mid-1970s, only 25% had; and this rose to 64% in 2009 [9]. Family planning programmes throughout SSA have made use of three approaches to service delivery:
Health-care facilities
Commercial outlets
Community-based systems
Family planning services and contraceptive commodity supply were started through assistance by the US Agency for International Development (USAID) and other international donors to national governments across Africa. Later on, non-governmental organizations (NGOs) came in to supply and/or donate FP commodities. Initially, the services were provided at health-care facilities in state, district and provincial capitals. During these “infantile” periods, access to family planning methods was under strict control of medical practitioner even in health facilities. During the period clients have to pay a token to access service which also was a huge barrier to many potential users. Firstly, the woman has to meet the eligibility criteria [33], they must be married and husband must give verbal (seen by the doctor) or written consent and be seen by the doctor as soon as she starts her menses. This was a good starting point for FP services delivery, but the burden and disadvantages of this “solo” practice became obviously inconvenient to the clients, long waiting time and other logistics. There was an urgent need to overhaul the system in order to improve access and service utilization. The World Health Organization (WHO) has published international guidelines on medical eligibility criteria that have proven to be invaluable [34].
Studies have shown that if given an adequate training, paramedical staff (nurses and midwives) could insert intrauterine devices (IUDs) and provide injectable contraceptives to high clinical standards and even lay staff, after a short training, could also dispense pills, and over-the-counter sale of pills without prescription was justifiable [9, 35, 36, 37]. Facility-based service provision is highly restrictive in terms of geographic access; this means that alternative approaches are in dire need in order to make the commodities easily accessible. However, studies have shown that the use of FP methods falls only modestly with increasing distance or travel time to the nearest source of contraception [38]. But in SSA where poverty index is high, physical accessibility becomes predictable and risky especially during raining season, and transport is available only once or twice (during market days) in a week; these are the real challenges to contraceptive use.
The provision of services through government facilities follows the PHC approach: all the three tiers (primary, secondary and tertiary) of health-care systems. The incorporation of contraceptive services into PHC facilities is an approach to boost contraceptive prevalence rates especially in SSA [39] where this has remained persistently low. In order to improve service availability and increase coverage, private health facilities later got involved. This involvement varies widely across the continent, being 40% in Kenya and more than 50% in Uganda but low (<20%) in areas where national government programmes are strong such as Namibia and South Africa. However, majority of these private facilities are Urban-based and thus serve the needs of urban elites.
Commercial outlets such as pharmacies, drug retail shops and patent medicine or street vendors and bazaars also constitute major significant outlets in which contraceptives (e.g. pills, condoms) can be obtained. Social marketing schemes run by NGOs or international organization are popular where advertising, logistics and product prices are highly subsidized in order to promote utilization. It is most effective when pills, condoms or both are fairly common methods; demand for contraception is well established coupled with a well-developed infrastructure (radio and television) and no restriction on promotion of FP methods [9]. In a world that is becoming globalized with rapid urbanization developing across Africa and intense exposure to mass media both formal and informal (WhatsApp, Facebook etc) the role of social marketing of contraceptives will likely rise with time.
Community-based distribution (CBD) of contraceptives can be used to supplement other government and private family planning services to meet the challenges of making the commodity widely available and accessible to those in urban slums, rural areas and hard-to-reach communities. CBD can be an important addendum or alternative to clinic-based services. Usually, it is cheap, easier for many people to reach and available in a wide range of settings. It is a complex concept involving varied operational design to suit local contexts. It is a programme involving non-clinical family planning service approaches that uses community organization, structure and institutions to promote the use of safe and simple contraceptive technologies [40]. It expands acceptability and convenience of contraceptives and resolves the cost of service, thereby extending its use among clientele who seek contraceptives but will not use services that are confined to clinical settings [40, 41].
CBD is thus a good example of the WHO’s commitment of PHC by making essential health care available to individuals and families in the community in an acceptable and affordable way with their full participation [42]. CBD is also compatible with the trend in many countries towards the decentralization of health services and the involvement of community in the provision and support of its own health services.
The following factors are used to identify populations in need of CBD programme, all of which are applicable to SSA:
Low prevalence of contraceptive use
Lack of awareness of family planning
Low usage of existing family planning services
Are far away from family planning clinics
Cultural barriers that impede attendance at clinics [42]
For a successful implementation, the agency (government, NGOs or international donors) usually worked with its own staff and the communities to identity local leaders and influential community members (gatekeepers). Regular meetings are held in the community centers, and assistance is sought to identify local volunteers (women and men) who will act as distributors of contraceptive methods.
CBD programmes originated in Asia in the 1960s and spread throughout Asia and Latin America in the 1970s and 1980s. It was introduced into sub-Saharan Africa in the late 1980s and 1990s; by 1996 more than half of the population of SSA lived in countries with some kind of CBD programme [41, 43]. At inception CBD programmes were integrated into existing health-care services with health-care providers involved in delivering FP services. But with time, community needs exceeded the abilities of national governments’ health programmes [44]. So, lay health workers became a good asset to drive CBD programmes, and selected community members were trained to provide FP services [45, 46]. CBD programmes are implemented through various approaches. These include home visits, group education meetings, fixed and mobile CBD posts, etc., while a variety of services are offered—contraceptive commodity distribution, health education and referrals for clinic-based services.
According to the WHO [42], different kinds of people can be recruited to work as distributors in CBD programmes across the world (Table 1).
|
Examples of possible distributors for contraceptive commodities.
Advantages of CBD programmes:
Easy access to contraceptives by rural folk
Receiving services in one’s own environment
Convenience for clients (in terms of time spent traveling and consultation)
Minimal transport costs
In sub-Saharan Africa, Zimbabwe was the first country to initiate CBD programme. On the other hand, Kenya has the greatest diversity in CBD programmes and activities globally. In the 1980s, CBD initiatives proliferated with the encouragement and support of the National Council for Population and Development and financial assistance from Kenyan USAID. Kenya in a sense thus represents a laboratory of CBD diversity in that nearly every type of CBD approach that has been tried elsewhere is present in some way in Kenyan setting [41, 47, 48]. The CBD programme in Tanzania started in 1988, when the International Planned Parenthood Federation (IPPF) launched a programme. By 1996, CBD programmes were fully functionally in 22 of the 104 districts in Tanzania and Zanzibar [43]. In Ghana, CBD programmes started with two experiments: the Danfa Project and Navrongo Community Health and Family Planning Project. The Navrongo Project started in the 1990s to address community explanations for failure of family planning outreach schemes [48]. The Navrongo Health Research Centre (NHRC) is part of a district-wide National Demographic Surveillance System. Mali had its most CBD project in 1986 in the rural district of Katibougou, and by the early 1990s, the second project was funded by USAID to expand FP service delivery in nine rural districts in two regions using village-level family planning promoters [45, 49].
Nigeria has had some form of CBD programmes since the 1990s; but in 2007, the country reviewed the results of pilot programme in the use of Community Health Extension Workers (CHEWS). CHEWS are the lowest cadre of trained medical personnel, who had at least 2–3 years of training in basic curative and preventive health services. The country also undertook a study tour to Uganda in 2008 to assess its community-based distribution of injectable contraceptives. By 2012, the National Council on Health approved the recommendation that allows CHEWS to provide injectable contraceptives across the country.
Thus, it can be said that CBD programmes has expanded in SSA over the past 20 years. A review of 93 developing countries in 1984 revealed that CBD programmes were functioning in 34 countries across the world with 7 programmes operating in SSA [40]. Between the 1980s and 1990s, the programme has expanded considerably. Countries with coverage <21% were designed as weak effort, while those with ≥21% coverage in all areas are strong [40]. Even though coverage within countries is variable and actual rates of exposure to CBD activities are unknown, more than half of populations of SSA lived in countries where CBD activity is operating by 1996 (Figure 1). So, it can be said that CBD programmes are well grounded in Africa, and considerable experience has accommodated over the years despite initial challenges. Family planning service has also been well integrated into other reproductive health services. It is important to note that contraceptive use relies on the principle of demand and supply. Generating demand is critical in the uptake of contraceptives, but this will not happen if supply system cannot guaranty consistent availability of acceptable and affordable commodities.
Sub-Saharan countries with CBD programmes, pilot projects or research (1994–1998) [
Pregnancies too early, too frequent, too many and too late are always associated with adverse outcomes [27, 29]. The health of mothers and that of her baby are inextricably bound, and the survival and wellbeing of even the older children are also compromised by their mother’s death. To avoid these adverse outcomes, medical guidelines recommend the uptake of family planning method by 6 weeks postpartum [50]. Contraceptive methods are by definition, preventive methods to assist women avoid unwanted pregnancies. The last few decades have witnessed a contraceptive revolution, and advances in medical science have shown us how to interfere with physiology of reproduction-ovulation cycle.
The methods can be categorized into:
Natural
Modern (temporary and permanent)
The production of an “ideal contraceptive” has continued to be elusive (contraceptive that is safe, inexpensive, acceptable, effective, reversible and long-lasting enough to obviate frequent administration which requires little or no medical attention) [51]. It is also difficult to assume that “one jacket” fits all, as a method that may be suitable to an individual may be unsuitable to another for a number of reasons—medical eligibility [34], religious beliefs and socio-economic situations. The current approach in family planning programmes is to provide a “cafeteria choice” where couples or individuals are offered all the available methods for which a choice can be made based on the need. Each method is unique in its mode of action, effectiveness, advantages and disadvantages.
In every human society, there are traditions that are passed down from generation to generation through the teaching of certain beliefs, cultural norms, attitudes, customs and habits. These traditional beliefs and practices cover all aspects of life including reproduction. Throughout human history, traditional family planning practices to space children have been rich and varied [52]. Traditional methods of contraception are those methods which do not involve the use of orthodox medicine. Some of these methods have existed dating back to prehistoric times. Today, traditional family planning is practiced worldwide for a number of reasons: being natural does not involve a third party (health-care provider) and does not fall under any religious ban [53].
Natural family planning (fertility awareness) is a method of family planning and preventing or spacing pregnancy by observing naturally (physiological) occurring signs and symptoms of the menstrual cycle. The couples avoid intercourse in the days (fertile period) during the menstrual cycle when the woman is most likely to become pregnant. Fertility awareness is based on a scientific knowledge of the female and male reproductive systems and on the understanding of the signs and symptoms that occur physiologically in women’s menstrual cycle to indicate when she is fertile or infertile. This is often referred to as safe period.
Natural family planning provides women with alternatives for those who do not wish to use modern (artificial) methods. In low-income countries, women tend to adopt postpartum family planning methods only after resumption of sexual intercourse or menses [54, 55, 56]. In sub-Saharan Africa, both events can be delayed as typically women practice prolonged breastfeeding (up to 2 years) which lengthens their period of amenorrhea, and in Middle and West Africa, women abstain from sexual intercourse for extended periods of time after a birth [57]. Indeed, many African cultures discourage sex during breast-feeding because of misconception that semen pollutes the breast milk. However, recent report has shown that the mean duration of postpartum insusceptibility to pregnancy (combined period of amenorrhea and abstinence) is between 15 and 20 months in most SSA countries [58, 59]. The safety of these methods despite their use cannot be guaranteed. For instance, withdrawal method (coitus interruptus), one of the oldest methods of fertility control, the slightest mistake in timing of withdrawal may result in deposition of some amount of semen. Thus, the failure rate may be as high as 25% [51]. Many women erroneously believed that they were protected completely when amenorrhoeic. At the population level, amenorrhoea is related to low risk of pregnancy; the absence of menses does not guarantee protection from pregnancy for individual women (except during the time frame of lactational amenorrhoea). Despite these problems, till date they continue to be used alongside modern contraceptives as evidenced by Demographic and Health Surveys (DHS) conducted across Africa.
Table 2 shows the percentage of women who use modern and traditional methods of contraception in 1992 and most recent DHS reports of some selected countries in SSA.
Country | 1 | 2 | ||||
---|---|---|---|---|---|---|
Any method | Traditional method | Modern method | Any method | Traditional method | Modern method | |
Burkina Faso | 10 | 6 | 4 | 15 | 1.0 | 15 |
Ghana | 20 | 10 | 10 | 23 | 5.0 | 22 |
Kenya | 33 | 6 | 27 | 58 | 4.8 | 53.2 |
Malawi | 13 | 6 | 7 | 59 | 1 | 58 |
Niger | 4 | 2 | 2 | 14 | 2 | 12 |
Nigeria | 6 | 3 | 4 | 15.1 | 5.4 | 9.8 |
Senegal | 7 | 3 | 5 | 25.1 | 2.1 | 23.1 |
Tanzania | 18 | 5 | 13 | 38 | 6 | 32 |
Uganda | 15 | 4 | 9 | 39 | 4 | 35 |
Zambia | 26 | 12 | 14 | 49 | 4.3 | 44.8 |
Zimbabwe | 48 | 6 | 42 | 67 | 1 | 66 |
Since the 1960s when oral contraceptives (OCs) were first marketed, they have symbolized modern contraception and have remained the most widely used hormonal method globally. OCs provide millions of women with effective, convenient and safe protection from pregnancy. Currently, more than 100 million women use OCs. Data on both ever use and current use of contraceptive revealed the continuing popularity of OCs [63]. Hormonal contraceptives can be classified into:
Oral pills
Combined oral contraceptives (COCs)
Progestogen-only pill (POP)
Emergency contraception
Slow-release (depot) formulations
Injectable
Subcutaneous implants
Vaginal rings
Worldwide, an estimated 8% of all married women currently use the pill and rank third among all family planning methods currently used by married women. The use of pills accounts for about one-quarter of all contraceptive use among both married and unmarried women in sub-Saharan Africa [62]. Overall, about 15% of married women use family planning, and less than 4% use the pill.
In some countries in Africa, OC usage is among the highest in the world: 33% of married women in Zimbabwe, 21% in Mauritius, 1.8% in Nigeria, 18% each in Botswana and Cape Verde respectively [62]. The use of COCs has been associated with health benefits. It reduces menstrual blood flow and dysmenorrhoea and lowers the prevalence of iron deficiency anaemia [63, 64, 65]. Generally, when taken correctly, OCs offer highly effective contraceptive. Among perfect users (women who do not miss pills and follow the instructions correctly), only 1 in every 1000 women becomes pregnant in the first year [62]. Among typical users, about 60–80 women in every 1000 will become pregnant during the first year [66]. Appropriate health education and counseling of clients are the key ingredients to the successful use of OCs.
When oral contraceptives were introduced in family planning programmes, they were hailed as a major breakthrough. However, overtime, it became obvious that not many women are good in remembering to take their pills on a daily basis and follow the schedule of administration. The use of injectable contraceptives provides many advantages: no user error, privacy and less dependence on the women’s compliance. The most commonly used is depot medroxyprogesterone acetate (DMPA). Irregular spotting, bleeding and amenorrhoea are well-known problems associated with the use of DMPA.
The story of a small pebble placed in the uterus of a camel to prevent pregnancy during long caravan journeys by Arabs in Middle East is regarded as the beginning of intrauterine contraceptive devices [67]. The IUDs is one of the most effective reversible contraceptive methods with an average pregnancy rate after 1 year of use of 3–5 per 100 typical users. Because IUDs have longer continuation rates than the OCs or injectable contraceptives, the overall effectiveness of IUDs and oral contraceptives are about the same in family planning programmes [68]. A major concern of IUDs is expulsion and pregnancy rates as shown in Table 3.
Device | Pregnancy rate | Expulsion rate |
---|---|---|
Lippes Loop | ||
C | 3.0 | 19.1 |
D | 2.7 | 12.7 |
Progestasert | 1.8 | 3.1 |
Copper-7 | 1.9 | 5.6 |
Cu-T-200 | 3.0 | 7.8 |
Cu-T-200c | 0.9 | 8.0 |
Nova T | 0.7 | 5.8 |
Multiload 250 | 0.5 | 2.2 |
Multiload 375 | 0.1 | 2.1 |
Rates of pregnancy and expulsion per 100 women after 12 months of use [69].
As the use of contraceptives increase in Africa, IUDs are becoming more acceptable. However, its popularity varies widely throughout the continent and even within the countries as evidenced by recent DHS reports. For instance, its use in Nigeria between 1990 and 2013 was 0.8–1.1%, [70], while in Mali and Uganda, very few women use IUD [71].
The training of doctors and paramedical staff to deliver family planning services is the cornerstone to the success of family planning programmes. In Africa, the primary goal is to train doctors, nurses, midwives and other field workers to manage family planning clinics as a team. The family planning nurse is essential to the success of the family planning programme.
Condoms are the most widely known and used as barrier device by male partners around the world. Condoms are easy, effective and safe method of preventing pregnancy and sexually transmitted infections (STIs) including HIV. Although rates of condom use have been low in many areas of sub-Saharan Africa, many people now use condoms because of HIV education and prevention programmes [72, 73].
Globally, millions of couples of childbearing age in developing countries used voluntary surgical contraceptive (VSC), making it a popular method of family planning in the world [74]. But data for sub-Saharan African countries are scarce; however, based on world fertility survey results for Kenya, Lesotho and Sudan, female and male sterilization appears to be rare [75]. In another report, the use of vasectomy was under 1% [52]. This method of family planning is not too popular in SSA for a number of reasons. The method requires skilled personnel that are not available at the primary healthcare (PHC) level used by majority, and services are only available in urban areas. On the conservative side, in situations where the marriage has failed or death of partner occurred, the woman by cultural and religious norm is encouraged to remarry, and in order to “secure” her marriage, position and respect in the family and the society, she will be desirous to have at least a child to the new husband.
The dividends accrued from improvements in reproductive health are cumulative and key to achieving sustainable development goals (SDGs) by improving maternal health, reducing child mortality and eradicating extreme poverty. Family planning brings transformational benefits to the women, families, communities and nations [16]. In the twenty-first century, the maternal mortality in the continent is still unacceptably high. The lifetime risk of maternal mortality of women in SSA is 1 in 39 live births, the highest when compared to other regions.
Despite recent increases in contraceptive use, sub-Saharan Africa is still characterized by high levels of fertility with TFR of 5 (number of births per woman) and a considerable unmet need for contraception [76]. Sub-Saharan Africa is still undergoing demographic transition (i.e. a shift to low death rate and birth rates). This is largely due to high birth rates with low contraceptive use. It is estimated that 90% of abortion-related and 20% of pregnancy-related morbidity and mortality together with 32% maternal deaths could be prevented by the use of effective contraceptive [9, 77]. In SSA, about 14 million unintended pregnancies occur each year, with about half occurring among women aged 15–24 years [78, 79]. The low level of utilization of contraceptives is due to several factors, the health systems and the framework within which family planning (FP) services are delivered, and suboptimal service factors [79]. Others are barriers at the individual level: risk perception, lack of or insufficient knowledge needed to make desired decision or choices, male partner disapproval and economic and geographic access to service facility. Knowledge of FP is crucial to make informed choice. Also noted are barriers to utilization of FP: commodity stock-out, limited provider skills and limited number of methods [80]. Even though contraceptive methods and services are frequently geared towards women, men are the primary decision-makers on family size and their partners’ use of family planning methods [8, 81, 82].
Men’s fertility preferences and attitudes towards family planning seem to influence their wives’ attitudes towards the use of modern contraceptives [83]. This translates to the fact that the importance of male involvement in any family planning programme cannot be overemphasized. Information and knowledge on contraceptive methods are necessary tools to informed choices and utilization. Better informed and knowledgeable women are able to seek for desired information and also know where to access appropriate services. On the other hand, lack of knowledge together with cultural, social and religious factors is a major impediment to service utilization [81, 84, 85].
At the community level, since individuals leave in communities, it definitely can influence personal health-seeking behavior, as there are intersections between personal beliefs and attitudes and community norms. Previous studies revealed that women may choose to accept family planning or indeed choose a particular method because of the methods adopted by those in the community [86]. Again, recently, several studies have explored the role of contextual factors in contraceptive use in African countries [87, 88, 89, 90]. Beyond individual and family factors, the context in which women live does influence their contraceptive decisions. The growing body of literature has identified a number of contextual factors that influence the use of contraceptive: presence and quality of reproductive health services, macroeconomic factors, community fertility norms, female autonomy and availability of physical infrastructure [91]. Previous studies [26, 76, 92] and reports of Demographic and Health Surveys [61] in SSA reported a near universal knowledge on family planning among women of reproductive age group. Unfortunately, this has not translated into increased utilization of contraceptive methods as evidenced by low contraceptive prevalence rates (CPRs). This can well be demonstrated by contraceptive prevalence in the world and by region of Africa (Figure 2) [93] with West Africa having the lowest prevalence rate among married or in-union women (15–49 years old) in 2015.
Contraceptive prevalence and unmet need for FP (percent) in the world and African region.
The low usage and CPRs could be attributed to negative attitude directed at the methods and other factors discussed earlier. Thus, the promotion of modern contraceptive use will require multifaceted interventions across all the levels of society. Specifically, addressing some or all of these barriers to the use of modern FP will importantly contribute to family, community and national socio-economic development. Particularly, contraceptive use needs to be promoted in West Africa on both health and economic grounds.
The decline in fertility in SSA has been slow than expected and has stalled in some countries [94, 95]. The total fertility rate varies from 4.8 children per woman in Kenya to 7.6 in the Republic of Niger [8, 9] and the lowest contraceptive prevalence of 22% among married women [96] and globally the highest level of unmet need for FP of about 25% [96]. Worldwide, over 222 million women have unmet need for contraceptive [97], and about 34 million women in Africa had unmet need for FP in 2009 [98]. The demand for contraceptives, with improved access and uptake, is the key public health intervention to improve maternal health outcomes, thereby reducing maternal mortality. Increasing contraceptive use has many demographic dividends, and unmet need denies women these benefits and violates their reproductive health rights. Studies have shown that several obstacles have hindered women access to FP services: unavailability of services, cultural and religious barriers, lack of knowledge and rural residence [99, 100]. Additionally, weaknesses in the existing FP programmes coupled with the fact that in SSA FP programmes tended to offer select methods (as a matter of convenience) or as a means of promoting the most effective and long-lasting methods [78]. Reasons for not using contraceptive are quite unfounded as contraception is a safe medical intervention. It is estimated that mortality risk of unplanned and unwanted pregnancy is 20 times the risk of any modern contraceptive method and 10 times the risk of a “properly” performed abortion [101].
The concept of unmet needs for contraceptive dates back to the 1960s, the “KAP-Gap” era, and was used as a rationale for investment in family planning programmes [102]. It is the proportion of currently married, fecund women who do not want any more children but are not using any form of family planning (unmet need for limiting) or currently married women who want to postpone their next birth for 2 years but are not using any form of family planning (unmet need for spacing) [103]. Unmet need is essentially a conflict between what a woman wants and what she does about it. She might want fewer fertility but fails to take action needed to prevent pregnancy. The total demand for family planning is the proportion of married women with unmet need and married women with met need for family planning. In other words, it is the sum of contraceptive prevalence plus unmet need for family planning. Currently, the total demand for FP (sum of unmet need and current contraceptive use) is around 44% in SSA [104]. Also, unique to the continent is the fact that predominantly the unmet need is for spacing rather than for limiting births. Thus, it shows the importance attached to child spacing in Africa and a reluctance to commit to a final cessation of childbearing [9]. It also shows that demand for contraception (to space) exists within this population that can be explored. In countries where growing numbers of women want to avoid a pregnancy but contraceptive use is low, unmet need is higher. Rwanda, Senegal, Togo and Uganda all have unmet need of about 30% or higher [104]. The main objective for the study of unmet need is to estimate the potential demand for FP [102].
Basically, its purpose is to identify women who are currently exposed to the risk of unintended pregnancy but who are not using any method of contraceptive. In theory, these women either do not want any more births (limiting) or want to postpone the next birth for at least 2 more years (spacing). The computation of unmet need is complex and can vary depending on which categories of women are included in the definition [104]. When this is summed up with current contraceptive use, it provides a picture of total potential demand for FP in a country (Figure 3).
Potential demand for family planning.
Experts have also raised the following concerns on its measurement:
The term does not necessarily reflect actual or potential interest in method use.
Women’s personal opposition to family planning.
It does not reflect how women perceive themselves to be at risk of pregnancy.
Failure to differentiate between married women who are sexually active and those who are not and thus not at risk of pregnancy [105].
Underreporting of natural methods [106] in large-scale surveys which is a long standing methodological issue.
Today, the major source of data for measuring unmet need globally is the Demographic and Health Surveys (DHS) and for which data is available in most countries in SSA. Many countries have had two or four rounds of such surveys between 1990 and 2014. The DHS questions administered to women asked whether they are doing anything to avoid a pregnancy. If the woman reports the use of a natural method and does not simultaneously use a more effective method, she is counted as a user of natural methods. Currently, in the DHS questionnaire, there is no follow-up questions specific to natural methods resulting in possibility of under reporting in some developing countries [106]. Despite these drawbacks, measurement of unmet need has endured as a good analytical tool till date. Its importance cannot be overemphasized: the estimate is useful as it helps to reveal the size and characteristics of the potential market for contraceptives, allows for projection of how much fertility could decline if additional needs for FP were met. Reducing unmet need for FP is key to helping couples achieve their reproductive rights and achieving demographic goals.
The lessons here are to understand the variations in unmet need across the continent. Respective national governments will need to understand uniqueness of unmet needs in order to strengthen family planning programmes to reduce unmet need. Studies have revealed that strong programmatic interventions not only reduce unmet need and increase contraceptive use but also increase the proportion of women using modern contraceptives [107].
The challenges to family planning programmes are many, varied and require attention at the highest policy level in order to realize the huge demographic, socio-economic and development dividends of low fertility levels. This will also make SDGs achievable. Continued political will and support are prerequisite for sustainability and acceptability of FP programme:
Data collection and analysis are still problems coupled with weakened and dysfunctional health-care systems in virtually all countries across Africa. This makes monitoring and evaluation of programmes a challenging task.
Persuading national governments to adjust their budgetary priorities to meet health requirements is one of the biggest challenges. Indeed, in 2001, African leaders made Abuja (Nigeria) declaration with a commitment to allocate 15% of public expenditure to health by 2015 [108]. Till date, there is still huge funding gaps as the health sector is heavily underfunded.
There is a need for broader attention to ever-increasing reproductive health needs including FP of women especially the cohort of women coming into motherhood or childbearing age.
Studies in SSA and around the world reveal a near universal knowledge on contraceptive methods, yet the practice has shown the contrary. So, addressing all or some of these barriers responsible will significantly influence service uptake.
Expanding FP services in a variety of “right mix” of contraceptive commodity availability to the rural folk and hard-to-reach areas has still persisted and needs to be addressed.
There is a need to link population pressure on both the built and natural environments to reproductive health interventions as a national policy to FP service utilization.
More research is needed on family planning: most studies are based on cross-sectional designs that cannot establish temporal sequence of cause and effect. Researches based on longitudinal data analysis methods or experiment or randomized control trial designs are needed to generate quality evidence that underscore important causal linkages between factors of interest and adolescent, maternal, child, family and population outcomes [109].
Over the past five decades, the use of FP methods has steadily increased in SSA with percentage of married women using modern contraceptives ranging between <20% and 69%. Unmet need for FP is unacceptably high. Despite near universal knowledge on contraceptives, practice remains low. Thus, there is a need for publicity campaigns through information, education and communication (IEC) to address social and cultural barriers to FP including misconceptions, misinformation and myths about modern FP methods.
Since decision-making power still resides with men, creating an environment in which both sexes can seek services and encouraging men to discuss FP with their wives will go a long way in promoting service utilization. Contraceptives for spacing are the predominant forms of FP preferred in SSA and show that even within this population demand for contraceptives exists. So, campaigns and provision of services that frame contraception as a method to space births and improve maternal and child health may be more culturally acceptable to promote use. Contraception should be vigorously promoted in SSA not only for its demographic dividends but also on socio-economic and health grounds and the attainment of SDGs.
Important shift in political commitment and priorities together with good governance, adequate funding is needed to sustain FP programmes. Efforts need to be intensified to encourage partner communication and engagement in order to improve FP practice. Further, research is needed to address unmet needs for FP.
I declare that l have no conflict of interest in writing this chapter.
The history of dyes began over 4000 years ago, and for many years, dyes were extracted from natural sources, such as flowers, vegetables, wood, insects, and roots, among others [1]. The synthetic dye industry began with the synthesis of mauveine, by researcher William Henry Perkin, in 1865. This dye, which until then was extracted from coal tar, was synthesized by Perkin while the researcher was looking for a new synthetic route for quinine, a drug used to treat malaria [2]. Perkin’s discovery marked the creation of a new generation of dyes [3].
Synthetic dyes are organic compounds that are produced from raw materials of petrochemical origin. Such compounds may or may not be soluble in water, are generally easily absorbed, and quickly impart color to substrates [1]. Structurally, dyes contain three essential groups: the chromophore, which is the active site of dyes where atoms interacting with visible electromagnetic radiation are located [2]; auxochrome, which has functional groups that introduce the chromophore, increase the fiber’s affinity to color, and decrease its solubility in water [4] and conjugated aromatic structures, such as benzene, anthracene and perylene rings [2]. Dyes are classified according to their chemical structure and application mode. Thus, according to the chemical structure of the dye, this is classified into azo, anthraquinone, sulfur, phthalocyanine, and triarylmethane [2]. Depending on its method of application, the dye is classified as reactive, direct, dispersed, basic, and by vat dyeing [5].
The chemical composition of the dye reflects in its pigmentation (formation of its color), being also responsible for the lighter or darker tone of each dye. The coloring is due to the absorption of light of a certain wavelength in the visible range of the electromagnetic spectrum, that is, the dye is a molecule capable of absorbing certain light radiations and then reflecting the complementary colors [6]. Table 1 brings together the main classes of dyes used in the textile industry, the types of fiber or substrates to which the dyes of each class are applied, the types of interaction between dye and fiber or substrate, and the methods of application or dyeing.
Classes | Fiber type | Interaction between dye and fiber | Method of application |
---|---|---|---|
Acid dye | nylon, wool, silk | Electrostatics; hydrogen bond | Neutral to acid dye baths. |
Basic dye | modified nylon, polyester | Electrostatics | Acid baths. |
Direct dye | cotton, rayon, leather, nylon | Intermolecular forces. | Neutral or slightly alkaline baths containing additional electrolytes. |
Dispersed dye | polyester, polyamide, acetate, plastic, acrylic | Hydrophobic - solid-state mechanism | High or low-temperature pressure transport methods. |
Reactive dye | cotton, nylon, silk, wool | Covalent bond | Under the influence of heat and pH of the medium, which must be alkaline, the dye reacts with the fiber functional group, with which it covalently bonds. |
Sulfur dye | cotton, rayon | Covalent bond | Aromatic substrate covered with sodium sulfide and reoxidized to sulfur-containing products, insoluble in fiber. |
Vat dye | cotton, rayon | Impregnation and oxidation | Water-insoluble dyes are solubilized by reduction with sodium hydrosulfite and then exhausted into the fiber and reoxidized. |
Main classes of dyes used in the textile industry, types of fiber to which the dyes of each class are applied, types of interaction between dye and fiber, and methods of application or dyeing [7].
Dyes are materials of great importance in different industrial sectors, such as fabric production, papermaking, plastics, cosmetics, as well as in medicine and biology [8]. Currently, the world production of dyes is about 800 tons a year and most of the dyes produced, about 70 million tons a year, are used in the textile industry [1].
With high world production, the textile industry occupies the second place among the industrial sectors that most pollute since during the dyeing stage a large amount of dyes is released into the environment due to the nonadhesion of the dye to the substrate to be dyed [2]. Therefore, the search for economically viable and ecologically sustainable alternatives for the treatment of effluents containing textile dyes is of extreme importance and interest, whereupon bioremediation is a process that can help to solve this industrial problem.
This chapter brings together the main and most recent information reported in the scientific literature on the enzymatic bioremediation of dyes from textile industry effluents. In this context, the negative impacts of dyes used in this industrial segment on human and animal health are discussed, as well as methods conventionally used for the treatment of industrial effluents containing dyes, the principles of enzymatic bioremediation, the enzymes used in this process, and their by-products.
Textile industry effluents are considered the most polluting compounds both by the volume generated and discarded and by their toxicity [9]. Wastewater from the textile industry is estimated to contain between 10 and 200 mg L−1 of dyes, as well as other organic chemicals, inorganic compounds, and additives. Even after the treatment of such effluents, about 90% of the dyes are still dumped in water bodies without undergoing chemical changes [1]. The biodegradation of such dyes is hampered by their xenobiotic nature, aromatic structure, high thermal resistance, and photostability [4].
In recent studies, Gita et al. [9] have observed that the toxicity of dyes is generally low for mammals and aquatic organisms, however, secondary products formed by biodegradation, especially aromatic amines from anaerobic dye reduction, can be harmful. In addition, these authors found that the concomitant presence of dyes and other pollutants in textile wastewater, such as heavy metals, can have a synergistic effect, causing considerable damage to the aquatic environment.
The main concern about the discharge of dyes is the presence of genotoxic, mutagenic, teratogenic, and carcinogenic effects, observed in animal studies [9]. Carcinogenicity is related to the formation of ions that bind to DNA and RNA, causing mutations and leading to the formation of tumors. In this sense, benzidine and 2-naphthylamine dyes are associated with a high incidence of bladder cancer [10]. Azure-B dye is capable of interspersing in the helical structure of the DNA and may have cytotoxic effects since it is an inhibitor of monoamine oxidase A (MAO-A), an enzyme that acts on the central nervous system and is important to human behavior [10]. Sudan 1 dye, widely used in the textile industry, although illegal in many European countries and the US, is also used in foods, such as paprika. Such dye, when present in the body of humans and animals, is transformed by the action of enzymes in carcinogenic aromatic amines [10]. Furthermore, human exposure to dyes can still generate skin and lung irritations, headaches, congenital malformation, and nausea [11].
Triphenylmethane dyes are phytotoxic to agricultural plantations, cytotoxic to mammals, and generate tumors in several fish species [10]. The violet crystal dye is also a powerful carcinogen, capable of inducing tumors in fish, such as hepatocellular carcinoma and reticular cell sarcoma in several organs [10].
Some of the main environmental problems related to the disposal of synthetic dyes are—
In the literature, a correlation is described between the increase in the concentration of dyes and the decrease in the growth of microalgae, reaching the total suppression of their growth [9]. In that study, different concentrations of three dyes were used to evaluate the specific growth rate of green algae
Aquatic macrophytes are used as natural ecological markers to quantify the phytotoxicity of textile dyes when exposed to effluents that contain those since there is a change in all their parameters [4]. In the presence of two textile dyes,
Among thousands of dyes studied, found in effluents, more than 100 have the potential to form carcinogenic amines. However, these potentially toxic dyes are still marketed and used, especially in small textile factories. In several places around the world, the demands of export and cheap labor sustain the existence of factories with a small-scale activity that clandestinely releases toxic dyes into water bodies [10].
Textile industry effluents contain large quantities of biodegradable organic compounds and nonbiodegradable compounds [14]. According to the literature, there are more than 8000 substances, such as acids, surfactants, salts, metals, oxidizing agents, reducing agents, as well as dyes and their auxiliaries [15]. Wastewater from the textile industry contains characteristic color, resulting from the mixture of dyes, in addition to the presence of metals, organic carbon, ammonium salts, nitrate, and orthophosphate [5].
Due to the environmental impact of this type of effluent, pretreatment is necessary before such compounds are released into natural water bodies, and the textile industry shows interest in controlling this problem [14]. However, even after treatment, effluents are still discarded in rivers with up to 90% of dyes that have not undergone chemical changes [1]. Table 2 shows information related to the studied treatment processes for the removal of textile dyes from industrial effluents and the main results obtained, as reported in the literature.
Name of dyes | Treatment Method | Main Results | Reference |
---|---|---|---|
Reactive Yellow 138, Reactive Red 231, and Navy HEXL® Procion | Electrolysis, carried out in a filter-press cell, under galvanostatic conditions. | Complete discoloration (99%) was observed in all cases. | [14] |
Reactive Red 120 | Biodegradation and dye biosorption by | The immobilized VITSAJ5 bacterium exhibited maximum adsorption of 87%. There was only 37% of removal without immobilization of the microorganism. | [15] |
Malachite Green, Reactive Red 198, and Direct Yellow 31 | Chitosan adsorption. | The amount of dye adsorbed depends on the mass of the adsorbent and decreased with its increase. | [16] |
Basic Blue 9 (MB), Basic Green 4 (MG), and Acid Orange 52 (MO) | Adsorption using synthesized materials | Fast adsorption of MB, MG, and MO in the initial 60 min. After 240 min, adsorption equilibrium is reached. | [17] |
Basic Blue 26 (BB26), Basic Green 1 (BG1), Basic Yellow 2 (BY2), and Basic Red 1 (BR1) | Adsorption on carbonaceous materials (acai seeds and Brazil nut shells), activated in the following ways: chemical activation with H3PO4, heat treatment, and oxidation with HNO3. | The adsorbents activated by heat treatment showed good performance for the removal of BB26 (87 and 85%) and BG1 (100 and 99%) but were not efficient for the removal of BY2 and BR1. Chemical activation was the most efficient for all dyes tested. Oxidation with HNO3 showed the worst results. | [18] |
Diamine Green B (DG-B), Acid Black 24 (AB-24), and Congo Red (CR) | Cellulose adsorption on cationized rice husk (CRHC). | Maximum adsorption capacities of DG-B, AB-24, and CR: 207.15, 268.88, and 580.09 mg g−1 at pH = 8, respectively, following the order CR > DG-B > AB-24. | [19] |
Methylene Blue (MB) | Photocatalytic degradation of organic dyes with nanocomposites | Synthesized nanocompounds showed high catalytic activity for the reduction of methylene blue under solar irradiation, efficiency of up to 90.1%, simple and low-cost method. | [20] |
Basic Yellow 28 (BY28), Acid Brown 75 (AB75) | Adsorption of cationic and anionic dyes by natural clays rich in smectite. | BY28: removal efficiency increased (97%) with increasing pH. AB75 anionic dye: adsorption was high in acidic medium (86%). | [21] |
Reactive Violet 5 (RV5) | Decolorization of azo-reactive dyes using sequential chemical treatment and activated sludge. | Almost complete decolorization was obtained for dye concentrations up to 300 mg L−1. Fenton’s reagent was unable to decolorize at concentration ≥ 500 mg L−1 (87.4% dechlorination). | [22] |
Procion Red HE-3B (RR120) | Photoelectrocatalysis | Treatment proved to be efficient, with up to 100% of decolorization in 30 min, concentration 10 mg L−1 of the dye RR120. The efficiency is only effective at low concentrations, with increasing concentration the decolorization occurs to a certain extent, then stabilizes. | [23] |
Reactive Red 120 | Simultaneous adsorption, filtration, and photoelectrocatalytic oxidation processes | The simultaneous performance of the treatments demonstrated that the dye was completely removed in solution. No pretreatment of intermediate by-products was necessary. | [24] |
Acid Blue 25 | Adsorption | The absorbent material was shown to reach an equilibrium constant in 270 min, as was observed to reduce absorption with alkaline solutions. The mortality rate of | [25] |
Acid Blue 25 | Adsorption Chitosan beads (CB) and chitosan beads with immobilized | The adsorbent with immobilized The adsorption capacity increased in both treatments with acidification, and also varied with temperature. There was a significant decrease in toxicity with the CBY treatment. | [26] |
Examples of treatment processes used to remove textile dyes.
The composition, as well as the standards allowed for each substance present in the composition of effluents from textile factories, aiming at its release in surface water bodies, vary according to the standards of each country. In China, the chemical oxygen demand (COD) and chrominance of wastewater from dyeing and finishing processes cannot exceed 80 mg L−1 and 60, respectively, so that such effluents can be released into the environment. In the United States, according to the Environmental Protection Agency (EPA), the limit value for COD is 163 kg per ton of fabric, however, in practice, cod effluents are up to 15 times higher than the legal standard [27]. Therefore, it is essential to apply efficient treatment strategies that ensure the complete removal of pollutants or that ensure the sustainability of the environment for future generations through physical, chemical, and biological technologies or a combination of them [10].
Physical methods, such as membrane filtration (nanofiltration, reverse osmosis, electrodialysis), sorption techniques, or chemical methods, such as coagulation or flocculation combined with flotation and filtration, flocculation by precipitation, electroflotation, and electrokinetic coagulation, considered for the removal of various dyes, do not degrade them. Such methods simply promote the reduction of the concentration of dyes, converting them from one chemical way to another, thus creating secondary pollution [6]. Among the several processes used for the removal of wastewater dyes, such as chemical oxidation, biodegradation, electrochemical treatment, adsorption, and photocatalytic degradation, the use of photocatalyst provides good results with high efficiency, low cost, speed, and better performance in environmental conditions when sunlight is used in the process [28].
Several natural materials, such as chitosan, are used in physical dye adsorption processes. Chitosan is a modified natural biopolymer, derived from the deacetylation of chitin, which is the most abundant polymer on the planet, derived from important biomass produced by inferior plants and animals, such as arthropods, shells of crustaceans, lobsters, shrimps, crabs, and squid [16]. Adsorption is one of the most efficient methods for removing dyes, however, there is a need for further treatment of the residue resulting from the process.
In addition to the physical and chemical processes aimed at the removal of dyes from wastewater, biological processes also play an important role. Among the biological methods that can be used to remove dyes from industrial wastewater, phytoremediation is a process that has advantages compared to chemical and physical methods of removal. The removal of textile dyes by plants occurs by adsorption, accumulation, and subsequent degradation, mediated by enzymes [29].
In situations where the application of chemical products must be continuous, the use of microorganisms may be considered a simpler and low-cost process, since microorganisms can be added only once in the effluent to be treated, as they have the potential to multiply [30]. Within this context, the activated sludge is commonly used in bioreactors for effluent treatment, which is one of the most used processes by the textile industry [10]. Another possible biological method for the treatment of effluents is the use of bacterial cultures. The isolation of pure cultures from textile wastewater is usually not performed, as it can be a slow and laborious process. Thus, mixed bacterial cultures are commonly used, which, due to cooperation to achieve a potentiated effect, provide better results in discoloration and mineralization of toxic aromatic amines [1].
Bioremediation techniques have been gaining increasing prominence worldwide due to high public acceptance, low cost compared to conventional remediation methods, high availability of enzymes, and minimal impact on the environment [31]. The exploration of enzymes for bioremediation has been of great interest due to their ability to function in wider ranges of pH and temperature, in the presence of contaminants and saline concentrations [32]. Enzymatic bioremediation is an ecological, economical, promising, and innovative technique. The process consists of exploring the typical characteristics of microorganisms or genetically modified organisms capable of producing specific enzymes to catalyze or metabolize the pollutant, transforming the toxic form into a nontoxic form and sometimes into new products [33].
Among the enzymes involved in bioremediation processes are laccases, dehalogenases, and hydrolases. Laccases are enzymes capable of catalyzing the oxidation of phenolic compounds, aromatic amines, and their compounds. Dehalogenases degrade a wide range of halogenated compounds by cleaving C – X bonds (X = halogen atom, such as Cl). Hydrolases break chemical bonds using water and convert larger molecules into smaller molecules, decreasing their toxicity. These enzymes facilitate the cleavage of C – C, C – O, C – N, S – S, S – N, S – P, C – P bonds [33].
Enzymes can be used in free or immobilized form, the latter having the following advantages—long-term operational stability, easy recovery, and reuse in industrial applications, which improve process performance and lower overall cost [34]. Immobilization consists of coupling the enzyme with an insoluble support matrix to maintain an adequate geometry, which guarantees greater stability to the enzyme [32]. The bioremediation process using microbial enzymes can be slow and so far, only a few bacterial species have been able to produce enzymes with potent biodegradation capacity. Thus, the use of genetically modified organisms is more common due to their ability to produce large amounts of enzymes under optimized conditions [33].
Enzymes from aerobic bacteria, such as
In the treatment of effluents from the textile industry, enzymes act on the dyes, generating precipitates that can be easily removed or chemically transformed into easy-to-treat compounds [35]. The rate of dye degradation by enzymes will depend on the chemical structure of the dye, salt content, the concentration of metal ions, pH, and temperature of the wastewater [36]. The enzymatic degradation of pollutants in textile effluents has several advantages, such as specificity and selectivity to the substrate, in addition to being an accessible, efficient method that meets the principles of green chemistry [37]. The requirement of large amounts of enzyme, high cost, thermal instability, inhibition of enzymatic activity, attack of certain enzymes by proteases, and the formation of undesirable by-products are the main difficulties or challenges related to the use of enzymatic degradation for wastewater treatment [30].
Some of the problems listed can be solved, at least partially, by immobilizing effective enzymes in low-cost matrices, leading to their separation and reuse, in addition to application in continuous bioreactors [30]. To control the reactions in the biodegradation process, the use of enzymes is often more advantageous than the use of cells [37]. As for the high cost of the enzymes themselves due to the fact of trying to obtain an enzymatic solution as pure as possible, the tendency is that it will decrease as technologies and techniques advance and the exploration of cheaper growth substrates for the reproduction of microorganisms increases.
Enzyme-mediated bioremediation has gained notoriety due to its versatility and efficiency in the degradation of persistent organic pollutants, thus being applied in industrial, biotechnological, and environmental processes [38]. These enzymes can be obtained from the extraction of intracellular and extracellular metabolites from cultures of certain species of bacteria, fungi, algae, and plants [39].
Table 3 shows some studies related to the degradation of dyes by enzymes produced by microorganisms. As it is shown, many of the tested can decolorize the dyes, as well as provide a decrease in their toxicity, as in the case, for example, of horseradish peroxidase, which promotes the decrease in the toxicity of the methyl orange dye.
Study objective(s) | Results and by-products of degradation | Reference |
---|---|---|
Use of ionic liquids (ILs) with surfactant characteristics in the degradation of Indigo Carmine (IC) dye by laccase. | Rapid and significantly higher discoloration of the IC dye in 0.5 h. Color removal percentage: 82% (against 6% obtained without ionic liquids). By-products from IC oxidation induced by laccase: indole-2,3-dione, which is decomposed into aminobenzoic acid. Both are less toxic than the IC. | [38] |
Use of the isolate of | The Accumulation of various intermediates during degradation as naphthalene derivatives, for example. These products are less toxic than CR. | [40] |
Validation of a novel bioinformatics amalgamation and bacterial remediation approach using non-native strains for decolorization and degradation of azo dyes: Drimaren Red CL-5B (Reactive Red 195). | The gas chromatography–mass spectrometry (GC–MS) analysis of the degradation products indicated the formation of low molecular weight metabolites, confirming the dye degradation. Need to carry out microbial toxicity, cytotoxicity, and phytotoxicity tests before large-scale bioremediation. | [41] |
Development of an airlift bioreactor for the use of copper alginate laccase in the degradation of dyes: Indigo Carmine (IC), Remazol Brilliant Blue R (RBBR), Bromophenol Blue (BB), Crystal Violet (CV), Malachite Green (MG), Congo Red (CR), Direct Blue 15 (DB) and Direct Red 23 (DR). | 100% decolorization of IC and RBBR, quickly. Discoloration percentages of MG, BB, and CV: 82; 64.4, and 48.5%; respectively. Percentages of discoloration of azo dyes CR, BD, and DR: 64, 54, and 22%, respectively. Isatin sulfonic acid was confirmed as the main degradation product. | [36] |
Development of a hydrogel blended with an agarose-chitosan polymer for plant-based horseradish peroxidase (HRP) immobilization and its use in the degradation of synthetic textile dye RB-19. | During the degradation process, the chromophore was fragmented into respective smaller fractions, leading to discoloration. The RB-19 has degraded into its possible daughter compounds. There is no result of toxicity studies of these compounds. | [42] |
Use of a packed bed reactor equipped with polyacrylamide gel-immobilized horseradish peroxidase (PAG-HRP) for the purpose of sequentially degrading the Methyl Orange (MO) dye. | PAG-HRP biocatalytic system: efficient in biologically based degradation. The MO degradation efficiency was 93.5% at pH 6. Significant reduction in the toxicity of azo textile dyes according to the results of acute toxicity bioassays together with phytotoxicity. | [43] |
Study the potential of | High CR removal (85%). 97% of discoloration results from the combination of two processes: adsorption and enzymatic biodegradation. Detoxification by According to phytotoxicity and microtoxicity analysis results, the metabolites generated after the CR biodegradation are less toxic than the crude dye. | [44] |
Evaluate the performance of a new | Maximum decolorization efficiency: ranged between 55.81 (blend III) and 80.56% (blend VI) in 24 h of treatment with MG-Y-SH at 18°C and static conditions. Maximum decolorization efficiency by MG-Y-SH reached 100% for 100 mg L−1 of RR120 in 3 h. Phytotoxicity results indicate the ability of MG-Y-SH to convert the toxic azo dye RR120 into non-toxic metabolites. | [45] |
Test a new consortium of oleaginous yeasts that produce lipase and xylanase in the removal of Sigma-Aldrich, Reactive Black 5 (RBB), Reactive Green 19 (G19R), Reactive Red 120 (HE3B), Reactive Blue 19 (B19R), Reactive Violet 5 (V5R) and Reactive Orange 16 (O3R) textile dyes. | Discoloration rate obtained by the Phytotoxicity assay results: metabolites generated after biodegradation of RBB are less toxic when compared to the original dye. | [46] |
Examine Methylene Blue (MB) dye removal performance by an immobilized enzyme. | The immobilized enzyme showed the highest removal efficiency (99%) compared to the pure nanocarrier and the free enzyme (81 and 36% removal, respectively). No result of toxicity analysis of by-products was presented. | [47] |
Evaluation of a new strain of white-rot fungus, | The discoloration occurred by the absorption of mycelia and by degradation by manganese peroxidase (MnP) and laccase enzymes. By-products or intermediates identified: naphthylamine and benzidine (very toxic to an organism). At 48 h the by-products were more toxic than the original dye, demonstrating the dye can take a long time to become harmless. | [48] |
Immobilization of lignin peroxidase (LiP) on Ca-alginate granules, its application in the degradation of dyes, and its potential for reducing the cytotoxicity of Reactive Red 195a (VR), Reactive Blue 21 (AR21), Reactive Blue 19 (AR19); Reactive Yellow 154a (AR154); Sandal-Fix Black CKF. | Discoloration efficiencies: 66, 59, 52, 40, and 48% were observed for VR, AR21, AR19, sandal-fix black CKF, and AR154, respectively with free LiP, which increased to 93, 83, 89, 70, and 80% with immobilized LiP. It was an efficient catalyst for the decolorization and detoxification of synthetic dye solutions. Results of the hemolytic and brine shrimp lethality tests—they showed that Ca-alginate beads entrapped LiP may be an effective biocatalyst for bioremediation of dye-based textile industry effluents. | [49] |
Biochemical characterization of stable azoreductase enzyme from | The lower value of the Michaelis–Menten constant (KM) indicates a very high affinity of the three dyes with the azoreductase enzyme. Azo dye metabolites resulted from the action of enzyme: they had reduced toxicity on fibroblast cell lines (L929) as compared to raw and intact dye. | [50] |
Main results of studies on dye bioremediation by enzymes and degradation by-products.
As reported in the literature, dye-decolorizing microorganisms produce a variety of enzymes, including azoreductase, riboflavin reductase, laccase, peroxidases, NADH-DCIP reductase, tyrosinase, reductase, and aminopyrine N-demethylase, lignin peroxidase, and veratryl alcohol oxidase [39]. Among those enzymes, the main ones responsible for the discoloration of azo dyes are azoreductases, laccases, and peroxidases [35].
Azoreductases are considered the main degradation enzymes produced by bacteria [30]. Such enzymes can be of two types—
Peroxidases also play a role in the degradation of the azo dye and are oxidoreductases, which contain heme. Peroxidases are present in plants, microorganisms, and animals. The mechanism of action of such enzymes is similar to that of laccases, providing the degradation of the dye without the production of toxic by-products [30]. Peroxidases act especially on synthetic dyes, degrading their respective constituents through the oxidative polymerization of phenolic compounds to form insoluble polymers [52]. An association between oxide-reducing enzymes can significantly reduce the toxicity of dyes [39].
Enzymes are proteins easily affected by changes in pH, and small variations in the medium’s pH can result in changes in the ionization phase of the active site and the distribution of charge in the protein structure, possibly affecting its affinity for the substrate [52]. Thus, one of the main challenges of enzymatic treatment is the deactivation of the biocatalyst caused, mainly, by the denaturation of the enzyme, due to the pH of the medium or extreme temperatures, which can alter the conformation of the enzyme’s active site [53]. Despite the many advances in enzymatic engineering, enzymes are still expensive and/or labile and, as a result, the industrial application of enzymes often requires their immobilization in a matrix (support) [54].
It is essential to evaluate the toxicity of effluents containing dyes after they have undergone enzymatic biodegradation, as some degradation products are mutagenic and carcinogenic, which represents a threat to human and animal health [30]. Thus, phytotoxicity tests are widely used and, according to the literature, among the bioindicators considered suitable for the detection of environmental toxicity,
Ali et al. [55] performed phytotoxicity studies, whose results indicate that MG-Y-SH can convert the toxic azo dye RR120 into nontoxic metabolites. However, many studies reported in the literature lack further tests to evaluate the by-products of enzymatic dye degradation, as well as the effects of these by-products on the environment.
Much of the textile dyes are still discharged into rivers without undergoing chemical changes, even with conventional effluent treatments. Pollution generated by dyes from textile industry effluents is harmful to human and animal health, presenting carcinogenic, genotoxic, mutagenic effects, in addition to having direct effects on the survival of aquatic species, as such dyes can accumulate in the food chain, conferring toxicity to water and soil and interfere with the development of crops of agricultural interest.
A more rigorous inspection of the release of dyes is important given its potential toxicity, as well as the factories that may be clandestinely dumping effluents containing toxic dyes in water bodies, without any treatment. Studies must be carried out to optimize effluent treatment methods, which must be ecological and efficient, making use of new technologies provided by modern science.
Among the methods currently used, photocatalytic degradation presents good results, is cheap, and uses sunlight, a clean source of energy. In addition to this method, there is phytoremediation, considered an ecologically correct process, and enzymatic remediation. The enzymes used in the enzymatic bioremediation of textile industry effluents are mainly azoreductases, laccases, and peroxidases.
Enzymatic bioremediation or even conventional treatment can generate by-products that are equally toxic to the starting compounds. But in some cases, less toxic intermediate compounds are generated, such as those presented in this chapter. Therefore, due importance must be given to these secondary products or by-products, identifying them, quantifying them, and subjecting them to proper handling and treatment.
The key point for the treatment of dyes is to have greater investment by companies to put the results of scientific research into practice. An alternative would be to carry out tests in simulation stations, as if on an industrial scale. In addition, genetic engineering has significantly revolutionized the field of bioremediation, with the possibility of modifying organisms or their metabolites so that they are more efficient in degrading pollutants.
This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brazil (CAPES) – Finance Code 001. We are grateful to this research funding agency and the Agricultural and Livestock Graduation Program, São Paulo State University (UNESP), School of Agricultural and Veterinarian Sciences (FCAV).
The authors declare no conflict of interest.
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This chapter focuses on the methods involved in algal-synthesized nanoparticles and its applications.",book:{id:"5128",slug:"algae-organisms-for-imminent-biotechnology",title:"Algae",fullTitle:"Algae - Organisms for Imminent Biotechnology"},signatures:"Felix LewisOscar, Sasikumar Vismaya, Manivel Arunkumar,\nNooruddin Thajuddin, Dharumadurai Dhanasekaran and Chari\nNithya",authors:[{id:"183668",title:"Dr.",name:"Nithya",middleName:null,surname:"Chari",slug:"nithya-chari",fullName:"Nithya Chari"}]},{id:"51074",doi:"10.5772/62916",title:"Algae as an Indicator of Water Quality",slug:"algae-as-an-indicator-of-water-quality",totalDownloads:5034,totalCrossrefCites:11,totalDimensionsCites:23,abstract:"The formation of plankton/algae under natural conditions is related to tolerance class (ecological optimum) due to abiotic limiting factors of ecosystem, as well as the biotic interactions among algae. In the ecological niche, the appearance of organisms is affected by anthropogenic and non-anthropogenic environmental factors. Algae composition and temporal variation in abundances are important in determining the trophic level of lakes. Algal communities are sensitive to changes in their habitat, and thus, total biomass of algae and many algae species are used as indicators of water quality. Algae communities give more knowledge on variations in water quality than nutrient or chlorophyll-a values. Water quality is a canonical group of physical, chemical, and biological properties of the given water. Consequently, eutrophication of freshwater is regarded as a water quality which results in the degeneration of the aquatic ecosystem and affects water utilisation. Cyanobacteria has been accepted as a major indicator of eutrophication in freshwater as their blooms are common in waters affected by nutrient concentration. The purpose of this chapter is to assess physical and chemical variables and the role of algal abundance to determine the water quality in the freshwater ecosystems.",book:{id:"5128",slug:"algae-organisms-for-imminent-biotechnology",title:"Algae",fullTitle:"Algae - Organisms for Imminent Biotechnology"},signatures:"Didem Gökçe",authors:[{id:"178260",title:"Associate Prof.",name:"Didem",middleName:null,surname:"Gokce",slug:"didem-gokce",fullName:"Didem Gokce"}]},{id:"50534",doi:"10.5772/63069",title:"Considerations for Photobioreactor Design and Operation for Mass Cultivation of Microalgae",slug:"considerations-for-photobioreactor-design-and-operation-for-mass-cultivation-of-microalgae",totalDownloads:5994,totalCrossrefCites:8,totalDimensionsCites:17,abstract:"Microalgae have great biotechnological potential for production of substances through photosynthesis. Light capture process and electron transportation imply energy losses due to reflection, fluorescence emission, and energy dissipation as heat, giving a maximum theoretical value of 8‐9% for microalgae energy capture efficiency and conversion to biomass. For development of full potential of microalgae the knowledge of the light capture process is required. High yields can only be obtained linking photobioreactor design with biological process taking place inside. In massive microalgae cultures, light gradients are generated and this depends on the biomass concentration, cellular types, cells sizes, and pigment content, and also on geometry, hydrodynamic, and light conditions inside the photobioreactor. In the present chapter we explain the relationship between light energy capture process and photobioreactor design and operation conditions, like turbulence, gas exchange, and nutrient requirements. Finally, the productivity and costs are discussed, and the parameters that determine the economic viability of any microalgae culture.",book:{id:"5128",slug:"algae-organisms-for-imminent-biotechnology",title:"Algae",fullTitle:"Algae - Organisms for Imminent Biotechnology"},signatures:"Juan Cristóbal García Cañedo and Gema Lorena López Lizárraga",authors:[{id:"185868",title:"Dr.",name:"Gema Lorena",middleName:null,surname:"López-Lizárraga",slug:"gema-lorena-lopez-lizarraga",fullName:"Gema Lorena López-Lizárraga"},{id:"293413",title:"Dr.",name:"Juan Cristóbal",middleName:null,surname:"García Cañedo",slug:"juan-cristobal-garcia-canedo",fullName:"Juan Cristóbal García Cañedo"}]},{id:"69201",doi:"10.5772/intechopen.89324",title:"Drying and Quality of Microalgal Powders for Human Alimentation",slug:"drying-and-quality-of-microalgal-powders-for-human-alimentation",totalDownloads:1263,totalCrossrefCites:5,totalDimensionsCites:15,abstract:"The demand for natural foods with high protein content and functional properties is constantly growing in the last years. In this context, microalgae as Spirulina (Arthrospira spp.), Chlorella spp., Haematococcus pluvialis, Dunaliella salina, and others, assume a key role to diversify the offer of nutritious and functional ingredients and supplements. Microalgae are commercialized, mostly, as dried powders to facilitate their use as food ingredients and to allow easy transportation and long-term stability. Microalgal powder quality and storage stability depend mainly on drying method, packaging, and storage conditions. Most of the studies that approach the subject of microalgal drying evaluate the efficiency of the process and suitability for this raw material. However, studies that assess the effect of traditional and innovative drying methods on quality of microalgal powder for human consumption are rare in literature. In this chapter, the state of the art of drying processing technology for microalgae was reviewed, discussing the effect of dehydration on quality and stability of microalgal powders with potential use in human alimentation.",book:{id:"9354",slug:"microalgae-from-physiology-to-application",title:"Microalgae",fullTitle:"Microalgae - From Physiology to Application"},signatures:"Fábio de Farias Neves, Mariana Demarco and Giustino Tribuzi",authors:null},{id:"50671",doi:"10.5772/63272",title:"Challenges and Opportunities in the Present Era of Marine Algal Applications",slug:"challenges-and-opportunities-in-the-present-era-of-marine-algal-applications",totalDownloads:2747,totalCrossrefCites:3,totalDimensionsCites:12,abstract:"Marine algae are of high importance in their natural habitats and even more now in the world of green technology. The sprouting interest of the scientific community and industries in these organisms is driven by the fast-growing world of modern biotechnology. Genomics, transcriptomics, proteomics, metabolomics and their integration collectively termed here as ‘marine algal-omics’ have broadened the research horizon in view of enhancing human’s life by addressing environmental problems and encouraging novelty in the field of pharmaceuticals among so many more. Their use in the human society dates back to 500 B. C. in China and later across the globe; they are still being used for similar purposes and more today. There is a hiking interest in marine algae and their derivatives—from phycoremediation, food supplements, pharmaceuticals to dyes. Marine algae are currently considered as an emerging panacea for the society. They are being studied in a multitude of arenas. The multi-use of marine algae is enticing and promises to be a boon for industrial applications. Yet, most marine algae face challenges that might variably constrain their commercialisation. This chapter gives an overview of marine algae including all the ‘omics’ technologies involved in studying marine algae and it explores their multitude applications. It also draws the various successful industries budded around them and presents some of the challenges and opportunities along with future directions.",book:{id:"5128",slug:"algae-organisms-for-imminent-biotechnology",title:"Algae",fullTitle:"Algae - Organisms for Imminent Biotechnology"},signatures:"Keshini Beetul, Arvind Gopeechund, Deepeeka Kaullysing, Sushma\nMattan-Moorgawa, Daneshwar Puchooa and Ranjeet Bhagooli",authors:[{id:"178209",title:"Ms.",name:"Keshini",middleName:null,surname:"Beetul",slug:"keshini-beetul",fullName:"Keshini Beetul"},{id:"184390",title:"Mr.",name:"Arvind",middleName:null,surname:"Gopeechund",slug:"arvind-gopeechund",fullName:"Arvind Gopeechund"},{id:"184391",title:"Ms.",name:"Deepeeka",middleName:null,surname:"Kaullysing",slug:"deepeeka-kaullysing",fullName:"Deepeeka Kaullysing"},{id:"184392",title:"Mrs.",name:"Sushma",middleName:null,surname:"Mattan-Moorgawa",slug:"sushma-mattan-moorgawa",fullName:"Sushma Mattan-Moorgawa"},{id:"184393",title:"Prof.",name:"Daneshwar",middleName:null,surname:"Puchooa",slug:"daneshwar-puchooa",fullName:"Daneshwar Puchooa"},{id:"184394",title:"Dr.",name:"Ranjeet",middleName:null,surname:"Bhagooli",slug:"ranjeet-bhagooli",fullName:"Ranjeet Bhagooli"}]}],mostDownloadedChaptersLast30Days:[{id:"64156",title:"Cyanobacteria Growth Kinetics",slug:"cyanobacteria-growth-kinetics",totalDownloads:1799,totalCrossrefCites:2,totalDimensionsCites:5,abstract:"Harmful cyanobacterial blooms are a global problem for freshwater ecosystems used for drinking water supply and recreational purposes. Cyanobacteria also produce a wide variety of toxic secondary metabolites, called cyanotoxins. High water temperatures have been known to lead to cyanobacterial bloom development in temperate and semiarid regions. Increased temperatures as a result of climate change could therefore favor the growth of cyanobacteria, thus augmenting the risks associated with the blooms. Though temperature is the main factor affecting the growth kinetics of bacteria, the availability of nutrients such as nitrogen and phosphorus also plays a significant role. This chapter studies the growth kinetics of toxin-producing Microcystis aeruginosa and evaluates potential risks to the population in scenarios of climate change and the presence of nutrients. The most suitable control methods for mitigation are also evaluated.",book:{id:"6889",slug:"algae",title:"Algae",fullTitle:"Algae"},signatures:"Leda Giannuzzi",authors:[{id:"252117",title:"Dr.",name:"Leda",middleName:null,surname:"Giannuzzi",slug:"leda-giannuzzi",fullName:"Leda Giannuzzi"}]},{id:"65952",title:"CO2 Capture for Industries by Algae",slug:"co-sub-2-sub-capture-for-industries-by-algae",totalDownloads:2102,totalCrossrefCites:5,totalDimensionsCites:11,abstract:"The increased usage of fossil fuels has led to increase in the concentration of CO2, which is a greenhouse gas responsible for global warming. Algae-based CO2 conversion is a cost-effective option for reducing carbon footprint. In addition, algae-based CO2 mitigation strategy has the potential to obtain valuable products at the end of the process. In the present study, freshwater algal species were isolated and identified for CO2 capture, such as Hydrodictyon, Spirogyra, Oscillatoria, Oedogonium, and Chlorella. The algal strains were screened based on different parameters like fast growth rate, high rate of photosynthesis, strong tolerance to the trace constituents of other gases (gaseous hydrocarbons, NOx, SOx, etc.), high temperature tolerance, and possibility to produce high value products, etc. The study involves integrated methods for utilizing 90–99% CO2 from a natural gas processing industry (GAIL India, Ltd.) as well as 13–15% of CO2 from flue gas of thermal power plants (Chandrapura and Santaldih Thermal Power Station) as carbon nutrient source along with the additional nutritional supplements. A 400-ml and 25-l flat panel photo-bioreactor (PSI Photo-bioreactors) was used for CO2 capture. After CO2 capture, the algal biomass was used to extract value-added products such as amino acid rich feed, algal oil, algal pellets, etc.",book:{id:"6889",slug:"algae",title:"Algae",fullTitle:"Algae"},signatures:"Vetrivel Anguselvi, Reginald Ebhin Masto, Ashis Mukherjee and Pradeep Kumar Singh",authors:[{id:"255851",title:"Dr.",name:"Vetrivel",middleName:null,surname:"Anguselvi",slug:"vetrivel-anguselvi",fullName:"Vetrivel Anguselvi"},{id:"269996",title:"Dr.",name:"R E",middleName:null,surname:"Masto",slug:"r-e-masto",fullName:"R E Masto"},{id:"269997",title:"Dr.",name:"Ashis",middleName:null,surname:"Mukherjee",slug:"ashis-mukherjee",fullName:"Ashis Mukherjee"},{id:"270059",title:"Dr.",name:"P K",middleName:null,surname:"Singh",slug:"p-k-singh",fullName:"P K Singh"}]},{id:"51074",title:"Algae as an Indicator of Water Quality",slug:"algae-as-an-indicator-of-water-quality",totalDownloads:5034,totalCrossrefCites:11,totalDimensionsCites:23,abstract:"The formation of plankton/algae under natural conditions is related to tolerance class (ecological optimum) due to abiotic limiting factors of ecosystem, as well as the biotic interactions among algae. In the ecological niche, the appearance of organisms is affected by anthropogenic and non-anthropogenic environmental factors. Algae composition and temporal variation in abundances are important in determining the trophic level of lakes. Algal communities are sensitive to changes in their habitat, and thus, total biomass of algae and many algae species are used as indicators of water quality. Algae communities give more knowledge on variations in water quality than nutrient or chlorophyll-a values. Water quality is a canonical group of physical, chemical, and biological properties of the given water. Consequently, eutrophication of freshwater is regarded as a water quality which results in the degeneration of the aquatic ecosystem and affects water utilisation. Cyanobacteria has been accepted as a major indicator of eutrophication in freshwater as their blooms are common in waters affected by nutrient concentration. The purpose of this chapter is to assess physical and chemical variables and the role of algal abundance to determine the water quality in the freshwater ecosystems.",book:{id:"5128",slug:"algae-organisms-for-imminent-biotechnology",title:"Algae",fullTitle:"Algae - Organisms for Imminent Biotechnology"},signatures:"Didem Gökçe",authors:[{id:"178260",title:"Associate Prof.",name:"Didem",middleName:null,surname:"Gokce",slug:"didem-gokce",fullName:"Didem Gokce"}]},{id:"64455",title:"Cyanobacteria for PHB Bioplastics Production: A Review",slug:"cyanobacteria-for-phb-bioplastics-production-a-review",totalDownloads:2186,totalCrossrefCites:4,totalDimensionsCites:11,abstract:"Cyanobacteria, or blue-green algae, can be used as host to produce polyhydroxyalkanoates (PHA), which are promising bioplastic raw materials. The most important material thereof is polyhydroxybutyrate (PHB), which can replace the commodity polymer polypropylene (PP) in many applications, yielding a bio-based, biodegradable alternative solution. The advantage from using cyanobacteria to make PHB over the standard fermentation processes, with sugar or other organic (waste) materials as feedstock, is that the sustainability is better (compare first-generation biofuels with the feed vs. fuel debate), with CO2 being the only carbon source and sunlight being the sole energy source. In this review article, the state of the art of cyanobacterial PHB production and its outlook is discussed. Thirty-seven percent of dry cell weight of PHB could be obtained in 2018, which is getting close to up to 78% of PHB dry cell weight in heterotrophic microorganisms in fermentation reactors. A good potential for cyanobacterial PHB is seen throughout the literature.",book:{id:"6889",slug:"algae",title:"Algae",fullTitle:"Algae"},signatures:"Erich Markl, Hannes Grünbichler and Maximilian Lackner",authors:[{id:"251081",title:"Dr.",name:"Maximilian",middleName:null,surname:"Lackner",slug:"maximilian-lackner",fullName:"Maximilian Lackner"},{id:"255232",title:"Prof.",name:"Erich",middleName:null,surname:"Markl",slug:"erich-markl",fullName:"Erich Markl"},{id:"277237",title:"Dr.",name:"Hannes",middleName:null,surname:"Grünbichler",slug:"hannes-grunbichler",fullName:"Hannes Grünbichler"}]},{id:"50544",title:"Algal Nanoparticles: Synthesis and Biotechnological Potentials",slug:"algal-nanoparticles-synthesis-and-biotechnological-potentials",totalDownloads:5784,totalCrossrefCites:17,totalDimensionsCites:67,abstract:"A nanoparticle can be defined as a small object that behaves as a whole unit in terms of its transport and properties. Nanoparticles are sized between 1 and 100 nm in diameter. Nanoparticles can act against the microbes in multiple ways, and the microbes are less likely to develop resistance against nanoparticles because it requires multiple gene mutations. The large surface-to-volume ratio of nanoparticles, their ability to easily interact with other particles, and several other features make them attractive tools in various fields. Nanoparticles are widely used various fields such as electronics, cosmetics, biomedical, and biotechnology. Nanoparticles can be synthesized by physical methods such as attrition, pyrolysis, and using some wet chemical methods. The physical and chemical methods have various drawbacks such as high cost of production, require high energy input and generation of toxic by-products. To overcome this, several biological methods are employed in the synthesis of nanoparticles. The biological methods are generally cost effective, nontoxic, and ecofriendly. This chapter focuses on the methods involved in algal-synthesized nanoparticles and its applications.",book:{id:"5128",slug:"algae-organisms-for-imminent-biotechnology",title:"Algae",fullTitle:"Algae - Organisms for Imminent Biotechnology"},signatures:"Felix LewisOscar, Sasikumar Vismaya, Manivel Arunkumar,\nNooruddin Thajuddin, Dharumadurai Dhanasekaran and Chari\nNithya",authors:[{id:"183668",title:"Dr.",name:"Nithya",middleName:null,surname:"Chari",slug:"nithya-chari",fullName:"Nithya Chari"}]}],onlineFirstChaptersFilter:{topicId:"424",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:87,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:98,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:27,numberOfPublishedChapters:287,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:9,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:11,numberOfPublishedChapters:139,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:8,numberOfPublishedChapters:129,numberOfOpenTopics:0,numberOfUpcomingTopics:2,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!1},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:107,numberOfOpenTopics:3,numberOfUpcomingTopics:1,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:10,numberOfPublishedChapters:103,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:12,numberOfOpenTopics:2,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:0,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!1},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:0,numberOfPublishedChapters:10,numberOfOpenTopics:4,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. The whole process of submitting an article and editing of the submitted article goes extremely smooth and fast, the number of reads and downloads of chapters is high, and the contributions are also frequently cited.",author:{id:"55578",name:"Antonio",surname:"Jurado-Navas",institutionString:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRisIQAS/Profile_Picture_1626166543950",slug:"antonio-jurado-navas",institution:{id:"720",name:"University of Malaga",country:{id:null,name:"Spain"}}}},{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}}]},series:{item:{id:"6",title:"Infectious Diseases",doi:"10.5772/intechopen.71852",issn:"2631-6188",scope:"This series will provide a comprehensive overview of recent research trends in various Infectious Diseases (as per the most recent Baltimore classification). Topics will include general overviews of infections, immunopathology, diagnosis, treatment, epidemiology, etiology, and current clinical recommendations for managing infectious diseases. Ongoing issues, recent advances, and future diagnostic approaches and therapeutic strategies will also be discussed. This book series will focus on various aspects and properties of infectious diseases whose deep understanding is essential for safeguarding the human race from losing resources and economies due to pathogens.",coverUrl:"https://cdn.intechopen.com/series/covers/6.jpg",latestPublicationDate:"May 19th, 2022",hasOnlineFirst:!0,numberOfPublishedBooks:13,editor:{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},editorTwo:null,editorThree:null},subseries:{paginationCount:4,paginationItems:[{id:"3",title:"Bacterial Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/3.jpg",isOpenForSubmission:!1,editor:null,editorTwo:null,editorThree:null},{id:"4",title:"Fungal Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/4.jpg",isOpenForSubmission:!0,editor:{id:"174134",title:"Dr.",name:"Yuping",middleName:null,surname:"Ran",slug:"yuping-ran",fullName:"Yuping Ran",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bS9d6QAC/Profile_Picture_1630330675373",biography:"Dr. Yuping Ran, Professor, Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China. Completed the Course Medical Mycology, the Centraalbureau voor Schimmelcultures (CBS), Fungal Biodiversity Centre, Netherlands (2006). International Union of Microbiological Societies (IUMS) Fellow, and International Emerging Infectious Diseases (IEID) Fellow, Centers for Diseases Control and Prevention (CDC), Atlanta, USA. Diploma of Dermatological Scientist, Japanese Society for Investigative Dermatology. Ph.D. of Juntendo University, Japan. Bachelor’s and Master’s degree, Medicine, West China University of Medical Sciences. Chair of Sichuan Medical Association Dermatology Committee. General Secretary of The 19th Annual Meeting of Chinese Society of Dermatology and the Asia Pacific Society for Medical Mycology (2013). In charge of the Annual Medical Mycology Course over 20-years authorized by National Continue Medical Education Committee of China. Member of the board of directors of the Asia-Pacific Society for Medical Mycology (APSMM). Associate editor of Mycopathologia. Vice-chief of the editorial board of Chinses Journal of Mycology, China. Board Member and Chair of Mycology Group of Chinese Society of Dermatology.",institutionString:null,institution:{name:"Sichuan University",institutionURL:null,country:{name:"China"}}},editorTwo:null,editorThree:null},{id:"5",title:"Parasitic Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/5.jpg",isOpenForSubmission:!0,editor:{id:"67907",title:"Dr.",name:"Amidou",middleName:null,surname:"Samie",slug:"amidou-samie",fullName:"Amidou Samie",profilePictureURL:"https://mts.intechopen.com/storage/users/67907/images/system/67907.jpg",biography:"Dr. Amidou Samie is an Associate Professor of Microbiology at the University of Venda, in South Africa, where he graduated for his PhD in May 2008. He joined the Department of Microbiology the same year and has been giving lectures on topics covering parasitology, immunology, molecular biology and industrial microbiology. He is currently a rated researcher by the National Research Foundation of South Africa at category C2. He has published widely in the field of infectious diseases and has overseen several MSc’s and PhDs. His research activities mostly cover topics on infectious diseases from epidemiology to control. His particular interest lies in the study of intestinal protozoan parasites and opportunistic infections among HIV patients as well as the potential impact of childhood diarrhoea on growth and child development. He also conducts research on water-borne diseases and water quality and is involved in the evaluation of point-of-use water treatment technologies using silver and copper nanoparticles in collaboration with the University of Virginia, USA. He also studies the use of medicinal plants for the control of infectious diseases as well as antimicrobial drug resistance.",institutionString:null,institution:{name:"University of Venda",institutionURL:null,country:{name:"South Africa"}}},editorTwo:null,editorThree:null},{id:"6",title:"Viral Infectious Diseases",coverUrl:"https://cdn.intechopen.com/series_topics/covers/6.jpg",isOpenForSubmission:!0,editor:{id:"158026",title:"Prof.",name:"Shailendra K.",middleName:null,surname:"Saxena",slug:"shailendra-k.-saxena",fullName:"Shailendra K. Saxena",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRET3QAO/Profile_Picture_2022-05-10T10:10:26.jpeg",biography:"Professor Dr. Shailendra K. Saxena is a vice dean and professor at King George's Medical University, Lucknow, India. His research interests involve understanding the molecular mechanisms of host defense during human viral infections and developing new predictive, preventive, and therapeutic strategies for them using Japanese encephalitis virus (JEV), HIV, and emerging viruses as a model via stem cell and cell culture technologies. His research work has been published in various high-impact factor journals (Science, PNAS, Nature Medicine) with a high number of citations. He has received many awards and honors in India and abroad including various Young Scientist Awards, BBSRC India Partnering Award, and Dr. JC Bose National Award of Department of Biotechnology, Min. of Science and Technology, Govt. of India. 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Biosensors, Biomaterials and Tissue Engineering",value:9,count:1},{group:"subseries",caption:"Bioinspired Technology and Biomechanics",value:8,count:2},{group:"subseries",caption:"Bioinformatics and Medical Informatics",value:7,count:9}],publicationYearFilters:[{group:"publicationYear",caption:"2021",value:2021,count:4},{group:"publicationYear",caption:"2019",value:2019,count:5},{group:"publicationYear",caption:"2018",value:2018,count:3}],authors:{paginationCount:302,paginationItems:[{id:"198499",title:"Dr.",name:"Daniel",middleName:null,surname:"Glossman-Mitnik",slug:"daniel-glossman-mitnik",fullName:"Daniel Glossman-Mitnik",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/198499/images/system/198499.jpeg",biography:"Dr. Daniel Glossman-Mitnik is currently a Titular Researcher at the Centro de Investigación en Materiales Avanzados (CIMAV), Chihuahua, Mexico, as well as a National Researcher of Level III at the Consejo Nacional de Ciencia y Tecnología, Mexico. His research interest focuses on computational chemistry and molecular modeling of diverse systems of pharmacological, food, and alternative energy interests by resorting to DFT and Conceptual DFT. He has authored a coauthored more than 255 peer-reviewed papers, 32 book chapters, and 2 edited books. He has delivered speeches at many international and domestic conferences. He serves as a reviewer for more than eighty international journals, books, and research proposals as well as an editor for special issues of renowned scientific journals.",institutionString:"Centro de Investigación en Materiales Avanzados",institution:{name:"Centro de Investigación en Materiales Avanzados",country:{name:"Mexico"}}},{id:"76477",title:"Prof.",name:"Mirza",middleName:null,surname:"Hasanuzzaman",slug:"mirza-hasanuzzaman",fullName:"Mirza Hasanuzzaman",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/76477/images/system/76477.png",biography:"Dr. Mirza Hasanuzzaman is a Professor of Agronomy at Sher-e-Bangla Agricultural University, Bangladesh. He received his Ph.D. in Plant Stress Physiology and Antioxidant Metabolism from Ehime University, Japan, with a scholarship from the Japanese Government (MEXT). Later, he completed his postdoctoral research at the Center of Molecular Biosciences, University of the Ryukyus, Japan, as a recipient of the Japan Society for the Promotion of Science (JSPS) postdoctoral fellowship. He was also the recipient of the Australian Government Endeavour Research Fellowship for postdoctoral research as an adjunct senior researcher at the University of Tasmania, Australia. Dr. Hasanuzzaman’s current work is focused on the physiological and molecular mechanisms of environmental stress tolerance. Dr. Hasanuzzaman has published more than 150 articles in peer-reviewed journals. He has edited ten books and written more than forty book chapters on important aspects of plant physiology, plant stress tolerance, and crop production. According to Scopus, Dr. Hasanuzzaman’s publications have received more than 10,500 citations with an h-index of 53. He has been named a Highly Cited Researcher by Clarivate. He is an editor and reviewer for more than fifty peer-reviewed international journals and was a recipient of the “Publons Peer Review Award” in 2017, 2018, and 2019. He has been honored by different authorities for his outstanding performance in various fields like research and education, and he has received the World Academy of Science Young Scientist Award (2014) and the University Grants Commission (UGC) Award 2018. He is a fellow of the Bangladesh Academy of Sciences (BAS) and the Royal Society of Biology.",institutionString:"Sher-e-Bangla Agricultural University",institution:{name:"Sher-e-Bangla Agricultural University",country:{name:"Bangladesh"}}},{id:"187859",title:"Prof.",name:"Kusal",middleName:"K.",surname:"Das",slug:"kusal-das",fullName:"Kusal Das",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSBDeQAO/Profile_Picture_1623411145568",biography:"Kusal K. Das is a Distinguished Chair Professor of Physiology, Shri B. M. Patil Medical College and Director, Centre for Advanced Medical Research (CAMR), BLDE (Deemed to be University), Vijayapur, Karnataka, India. Dr. Das did his M.S. and Ph.D. in Human Physiology from the University of Calcutta, Kolkata. His area of research is focused on understanding of molecular mechanisms of heavy metal activated low oxygen sensing pathways in vascular pathophysiology. He has invented a new method of estimation of serum vitamin E. His expertise in critical experimental protocols on vascular functions in experimental animals was well documented by his quality of publications. He was a Visiting Professor of Medicine at University of Leeds, United Kingdom (2014-2016) and Tulane University, New Orleans, USA (2017). For his immense contribution in medical research Ministry of Science and Technology, Government of India conferred him 'G.P. Chatterjee Memorial Research Prize-2019” and he is also the recipient of 'Dr.Raja Ramanna State Scientist Award 2015” by Government of Karnataka. He is a Fellow of the Royal Society of Biology (FRSB), London and Honorary Fellow of Karnataka Science and Technology Academy, Department of Science and Technology, Government of Karnataka.",institutionString:"BLDE (Deemed to be University), India",institution:null},{id:"243660",title:"Dr.",name:"Mallanagouda Shivanagouda",middleName:null,surname:"Biradar",slug:"mallanagouda-shivanagouda-biradar",fullName:"Mallanagouda Shivanagouda Biradar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/243660/images/system/243660.jpeg",biography:"M. S. Biradar is Vice Chancellor and Professor of Medicine of\nBLDE (Deemed to be University), Vijayapura, Karnataka, India.\nHe obtained his MD with a gold medal in General Medicine and\nhas devoted himself to medical teaching, research, and administrations. He has also immensely contributed to medical research\non vascular medicine, which is reflected by his numerous publications including books and book chapters. Professor Biradar was\nalso Visiting Professor at Tulane University School of Medicine, New Orleans, USA.",institutionString:"BLDE (Deemed to be University)",institution:{name:"BLDE University",country:{name:"India"}}},{id:"289796",title:"Dr.",name:"Swastika",middleName:null,surname:"Das",slug:"swastika-das",fullName:"Swastika Das",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/289796/images/system/289796.jpeg",biography:"Swastika N. Das is Professor of Chemistry at the V. P. Dr. P. G.\nHalakatti College of Engineering and Technology, BLDE (Deemed\nto be University), Vijayapura, Karnataka, India. She obtained an\nMSc, MPhil, and PhD in Chemistry from Sambalpur University,\nOdisha, India. Her areas of research interest are medicinal chemistry, chemical kinetics, and free radical chemistry. She is a member\nof the investigators who invented a new modified method of estimation of serum vitamin E. She has authored numerous publications including book\nchapters and is a mentor of doctoral curriculum at her university.",institutionString:"BLDEA’s V.P.Dr.P.G.Halakatti College of Engineering & Technology",institution:{name:"BLDE University",country:{name:"India"}}},{id:"248459",title:"Dr.",name:"Akikazu",middleName:null,surname:"Takada",slug:"akikazu-takada",fullName:"Akikazu Takada",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/248459/images/system/248459.png",biography:"Akikazu Takada was born in Japan, 1935. After graduation from\nKeio University School of Medicine and finishing his post-graduate studies, he worked at Roswell Park Memorial Institute NY,\nUSA. He then took a professorship at Hamamatsu University\nSchool of Medicine. In thrombosis studies, he found the SK\npotentiator that enhances plasminogen activation by streptokinase. He is very much interested in simultaneous measurements\nof fatty acids, amino acids, and tryptophan degradation products. By using fatty\nacid analyses, he indicated that plasma levels of trans-fatty acids of old men were\nfar higher in the US than Japanese men. . He also showed that eicosapentaenoic acid\n(EPA) and docosahexaenoic acid (DHA) levels are higher, and arachidonic acid\nlevels are lower in Japanese than US people. By using simultaneous LC/MS analyses\nof plasma levels of tryptophan metabolites, he recently found that plasma levels of\nserotonin, kynurenine, or 5-HIAA were higher in patients of mono- and bipolar\ndepression, which are significantly different from observations reported before. In\nview of recent reports that plasma tryptophan metabolites are mainly produced by\nmicrobiota. He is now working on the relationships between microbiota and depression or autism.",institutionString:"Hamamatsu University School of Medicine",institution:{name:"Hamamatsu University School of Medicine",country:{name:"Japan"}}},{id:"137240",title:"Prof.",name:"Mohammed",middleName:null,surname:"Khalid",slug:"mohammed-khalid",fullName:"Mohammed Khalid",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/137240/images/system/137240.png",biography:"Mohammed Khalid received his B.S. degree in chemistry in 2000 and Ph.D. degree in physical chemistry in 2007 from the University of Khartoum, Sudan. He moved to School of Chemistry, Faculty of Science, University of Sydney, Australia in 2009 and joined Dr. Ron Clarke as a postdoctoral fellow where he worked on the interaction of ATP with the phosphoenzyme of the Na+/K+-ATPase and dual mechanisms of allosteric acceleration of the Na+/K+-ATPase by ATP; then he went back to Department of Chemistry, University of Khartoum as an assistant professor, and in 2014 he was promoted as an associate professor. In 2011, he joined the staff of Department of Chemistry at Taif University, Saudi Arabia, where he is currently an assistant professor. His research interests include the following: P-Type ATPase enzyme kinetics and mechanisms, kinetics and mechanisms of redox reactions, autocatalytic reactions, computational enzyme kinetics, allosteric acceleration of P-type ATPases by ATP, exploring of allosteric sites of ATPases, and interaction of ATP with ATPases located in cell membranes.",institutionString:"Taif University",institution:{name:"Taif University",country:{name:"Saudi Arabia"}}},{id:"63810",title:"Prof.",name:"Jorge",middleName:null,surname:"Morales-Montor",slug:"jorge-morales-montor",fullName:"Jorge Morales-Montor",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/63810/images/system/63810.png",biography:"Dr. Jorge Morales-Montor was recognized with the Lola and Igo Flisser PUIS Award for best graduate thesis at the national level in the field of parasitology. He received a fellowship from the Fogarty Foundation to perform postdoctoral research stay at the University of Georgia. He has 153 journal articles to his credit. He has also edited several books and published more than fifty-five book chapters. He is a member of the Mexican Academy of Sciences, Latin American Academy of Sciences, and the National Academy of Medicine. He has received more than thirty-five awards and has supervised numerous bachelor’s, master’s, and Ph.D. students. Dr. Morales-Montor is the past president of the Mexican Society of Parasitology.",institutionString:"National Autonomous University of Mexico",institution:{name:"National Autonomous University of Mexico",country:{name:"Mexico"}}},{id:"217215",title:"Dr.",name:"Palash",middleName:null,surname:"Mandal",slug:"palash-mandal",fullName:"Palash Mandal",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/217215/images/system/217215.jpeg",biography:null,institutionString:"Charusat University",institution:null},{id:"49739",title:"Dr.",name:"Leszek",middleName:null,surname:"Szablewski",slug:"leszek-szablewski",fullName:"Leszek Szablewski",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49739/images/system/49739.jpg",biography:"Leszek Szablewski is a professor of medical sciences. He received his M.S. in the Faculty of Biology from the University of Warsaw and his PhD degree from the Institute of Experimental Biology Polish Academy of Sciences. He habilitated in the Medical University of Warsaw, and he obtained his degree of Professor from the President of Poland. Professor Szablewski is the Head of Chair and Department of General Biology and Parasitology, Medical University of Warsaw. Professor Szablewski has published over 80 peer-reviewed papers in journals such as Journal of Alzheimer’s Disease, Biochim. Biophys. Acta Reviews of Cancer, Biol. Chem., J. Biomed. Sci., and Diabetes/Metabol. Res. Rev, Endocrine. He is the author of two books and four book chapters. He has edited four books, written 15 scripts for students, is the ad hoc reviewer of over 30 peer-reviewed journals, and editorial member of peer-reviewed journals. Prof. Szablewski’s research focuses on cell physiology, genetics, and pathophysiology. He works on the damage caused by lack of glucose homeostasis and changes in the expression and/or function of glucose transporters due to various diseases. He has given lectures, seminars, and exercises for students at the Medical University.",institutionString:"Medical University of Warsaw",institution:{name:"Medical University of Warsaw",country:{name:"Poland"}}},{id:"173123",title:"Dr.",name:"Maitham",middleName:null,surname:"Khajah",slug:"maitham-khajah",fullName:"Maitham Khajah",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/173123/images/system/173123.jpeg",biography:"Dr. Maitham A. Khajah received his degree in Pharmacy from Faculty of Pharmacy, Kuwait University, in 2003 and obtained his PhD degree in December 2009 from the University of Calgary, Canada (Gastrointestinal Science and Immunology). Since January 2010 he has been assistant professor in Kuwait University, Faculty of Pharmacy, Department of Pharmacology and Therapeutics. His research interest are molecular targets for the treatment of inflammatory bowel disease (IBD) and the mechanisms responsible for immune cell chemotaxis. He cosupervised many students for the MSc Molecular Biology Program, College of Graduate Studies, Kuwait University. Ever since joining Kuwait University in 2010, he got various grants as PI and Co-I. He was awarded the Best Young Researcher Award by Kuwait University, Research Sector, for the Year 2013–2014. He was a member in the organizing committee for three conferences organized by Kuwait University, Faculty of Pharmacy, as cochair and a member in the scientific committee (the 3rd, 4th, and 5th Kuwait International Pharmacy Conference).",institutionString:"Kuwait University",institution:{name:"Kuwait University",country:{name:"Kuwait"}}},{id:"195136",title:"Dr.",name:"Aya",middleName:null,surname:"Adel",slug:"aya-adel",fullName:"Aya Adel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/195136/images/system/195136.jpg",biography:"Dr. Adel works as an Assistant Lecturer in the unit of Phoniatrics, Department of Otolaryngology, Ain Shams University in Cairo, Egypt. Dr. Adel is especially interested in joint attention and its impairment in autism spectrum disorder",institutionString:"Ain Shams University",institution:{name:"Ain Shams University",country:{name:"Egypt"}}},{id:"94911",title:"Dr.",name:"Boulenouar",middleName:null,surname:"Mesraoua",slug:"boulenouar-mesraoua",fullName:"Boulenouar Mesraoua",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94911/images/system/94911.png",biography:"Dr Boulenouar Mesraoua is the Associate Professor of Clinical Neurology at Weill Cornell Medical College-Qatar and a Consultant Neurologist at Hamad Medical Corporation at the Neuroscience Department; He graduated as a Medical Doctor from the University of Oran, Algeria; he then moved to Belgium, the City of Liege, for a Residency in Internal Medicine and Neurology at Liege University; after getting the Belgian Board of Neurology (with high marks), he went to the National Hospital for Nervous Diseases, Queen Square, London, United Kingdom for a fellowship in Clinical Neurophysiology, under Pr Willison ; Dr Mesraoua had also further training in Epilepsy and Continuous EEG Monitoring for two years (from 2001-2003) in the Neurophysiology department of Zurich University, Switzerland, under late Pr Hans Gregor Wieser ,an internationally known epileptologist expert. \n\nDr B. Mesraoua is the Director of the Neurology Fellowship Program at the Neurology Section and an active member of the newly created Comprehensive Epilepsy Program at Hamad General Hospital, Doha, Qatar; he is also Assistant Director of the Residency Program at the Qatar Medical School. \nDr B. Mesraoua's main interests are Epilepsy, Multiple Sclerosis, and Clinical Neurology; He is the Chairman and the Organizer of the well known Qatar Epilepsy Symposium, he is running yearly for the past 14 years and which is considered a landmark in the Gulf region; He has also started last year , together with other epileptologists from Qatar, the region and elsewhere, a yearly International Epilepsy School Course, which was attended by many neurologists from the Area.\n\nInternationally, Dr Mesraoua is an active and elected member of the Commission on Eastern Mediterranean Region (EMR ) , a regional branch of the International League Against Epilepsy (ILAE), where he represents the Middle East and North Africa(MENA ) and where he holds the position of chief of the Epilepsy Epidemiology Section; Dr Mesraoua is a member of the American Academy of Neurology, the Europeen Academy of Neurology and the American Epilepsy Society.\n\nDr Mesraoua's main objectives are to encourage frequent gathering of the epileptologists/neurologists from the MENA region and the rest of the world, promote Epilepsy Teaching in the MENA Region, and encourage multicenter studies involving neurologists and epileptologists in the MENA region, particularly epilepsy epidemiological studies. \n\nDr. Mesraoua is the recipient of two research Grants, as the Lead Principal Investigator (750.000 USD and 250.000 USD) from the Qatar National Research Fund (QNRF) and the Hamad Hospital Internal Research Grant (IRGC), on the following topics : “Continuous EEG Monitoring in the ICU “ and on “Alpha-lactoalbumin , proof of concept in the treatment of epilepsy” .Dr Mesraoua is a reviewer for the journal \"seizures\" (Europeen Epilepsy Journal ) as well as dove journals ; Dr Mesraoua is the author and co-author of many peer reviewed publications and four book chapters in the field of Epilepsy and Clinical Neurology",institutionString:"Weill Cornell Medical College in Qatar",institution:{name:"Weill Cornell Medical College in Qatar",country:{name:"Qatar"}}},{id:"282429",title:"Prof.",name:"Covanis",middleName:null,surname:"Athanasios",slug:"covanis-athanasios",fullName:"Covanis Athanasios",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/282429/images/system/282429.jpg",biography:null,institutionString:"Neurology-Neurophysiology Department of the Children Hospital Agia Sophia",institution:null},{id:"190980",title:"Prof.",name:"Marwa",middleName:null,surname:"Mahmoud Saleh",slug:"marwa-mahmoud-saleh",fullName:"Marwa Mahmoud Saleh",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/190980/images/system/190980.jpg",biography:"Professor Marwa Mahmoud Saleh is a doctor of medicine and currently works in the unit of Phoniatrics, Department of Otolaryngology, Ain Shams University in Cairo, Egypt. She got her doctoral degree in 1991 and her doctoral thesis was accomplished in the University of Iowa, United States. Her publications covered a multitude of topics as videokymography, cochlear implants, stuttering, and dysphagia. She has lectured Egyptian phonology for many years. Her recent research interest is joint attention in autism.",institutionString:"Ain Shams University",institution:{name:"Ain Shams University",country:{name:"Egypt"}}},{id:"259190",title:"Dr.",name:"Syed Ali Raza",middleName:null,surname:"Naqvi",slug:"syed-ali-raza-naqvi",fullName:"Syed Ali Raza Naqvi",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259190/images/system/259190.png",biography:"Dr. Naqvi is a radioanalytical chemist and is working as an associate professor of analytical chemistry in the Department of Chemistry, Government College University, Faisalabad, Pakistan. Advance separation techniques, nuclear analytical techniques and radiopharmaceutical analysis are the main courses that he is teaching to graduate and post-graduate students. In the research area, he is focusing on the development of organic- and biomolecule-based radiopharmaceuticals for diagnosis and therapy of infectious and cancerous diseases. Under the supervision of Dr. Naqvi, three students have completed their Ph.D. degrees and 41 students have completed their MS degrees. He has completed three research projects and is currently working on 2 projects entitled “Radiolabeling of fluoroquinolone derivatives for the diagnosis of deep-seated bacterial infections” and “Radiolabeled minigastrin peptides for diagnosis and therapy of NETs”. He has published about 100 research articles in international reputed journals and 7 book chapters. Pakistan Institute of Nuclear Science & Technology (PINSTECH) Islamabad, Punjab Institute of Nuclear Medicine (PINM), Faisalabad and Institute of Nuclear Medicine and Radiology (INOR) Abbottabad are the main collaborating institutes.",institutionString:"Government College University",institution:{name:"Government College University, Faisalabad",country:{name:"Pakistan"}}},{id:"58390",title:"Dr.",name:"Gyula",middleName:null,surname:"Mozsik",slug:"gyula-mozsik",fullName:"Gyula Mozsik",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/58390/images/system/58390.png",biography:"Gyula Mózsik MD, Ph.D., ScD (med), is an emeritus professor of Medicine at the First Department of Medicine, Univesity of Pécs, Hungary. He was head of this department from 1993 to 2003. His specializations are medicine, gastroenterology, clinical pharmacology, clinical nutrition, and dietetics. 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