Sustainable development goals (SDGs) are a global agenda consisting of 17 goals which are to be achieved in 2030 by all member states. SDGs are more holistic goals i.e. these goals are closely interrelated and they affect the progress of one another. Sub-Saharan Africa countries are, once more lagging behind in the implementations of SDGs despite the efforts by governments, non-government organisations and international agencies. Rwanda, South Africa and Zambia where the three Sub-Saharan Africa countries on which the study focused. The three countries in this study were chosen on the basis that they cater to the general overview of African countries performance on SDGs. To conduct this study, a desk research method was adopted and secondary data was utilised. An in-depth analysis was done on the on three subs Saharan African countries i.e. Rwanda, South Africa, Zambia. Those goals where serious attention is needed are goals 1-9, 16 and 17. Most Sub-Saharan African countries performed better on goals 11, 12 and 15. It was concluded that the achievement of Sustainable development goals remains a mere dream for Sub Saharan Africa unless serious interventions are made.

Pharmacogenomics may improve patient care by guiding drug selection and dosing, however this requires prior knowledge of the pharmacogenomics of drugs commonly used in a specific setting. The aim of this study was to identify a preliminary set of pharmacogenetic variants important in Southern Africa. We describe co-morbidities in 3997 patients from Malawi, South Africa, and Zimbabwe. These patient cohorts were included in pharmacogenomic studies of anticoagulation, dyslipidemia, hypertension, HIV, and breast cancer. The 20 topmost prescribed drugs in this population were identified. Using literature, a list of pharmacogenes vital in disposition of the top 20 drugs was constructed leading to drug-gene pairs potentially informative in translation of pharmacogenomics. The most reported morbidity was hypertension (58.4%), making antihypertensives the most prescribed drugs, particularly amlodipine. Dyslipidemia occurred in 31.5% of the participants and statins were frequently prescribed cholesterol lowering drugs. HIV was reported in 20.3% of the study participants with lamivudine/stavudine/efavirenz being the most prescribed antiretroviral combination. Based on these data, pharmacogenes of immediate interest in Southern African populations include ABCB1, CYP2B6, CYP2C9, CYP2C19, CYP2D6, CYP3A4, CYP3A5, SLC22A1, SLCO1B1 and UGT1A1. Variants in these genes are a good starting point for pharmacogenomic translation programs in Southern Africa.

Is human capital heterogeneity a decisive factor for Chinese enterprises to invest in Africa? Based on the Outward Foreign Direct Investment (OFDI） data of Chinese enterprises in 37 African countries from 2007 to 2017, this paper using the FGLS model, is the empirical analysis of the mechanism and effect of the human capital heterogeneity of host countries on OFDI location selection. The human capital heterogeneity can be divided into four dimensions: scale, quality, cost and structure, which can be measured by health level, education level, wage level, child dependency ratio and old-age dependency ratio. The results show that: (1) the host country's human capital scale and child dependency ratio structure have a significant positive impact on decision-making for OFDI; (2) the cost of human capital and the structure of old-age dependency ratio are negatively correlated with the inflow of OFDI; (3) different from the existing conclusions, the quality of human capital will inhibit the inflow of OFDI in the sample period; (4) the extended test shows that the quality of human capital has a significant positive impact on OFDI decision-making. The results of robustness test are reliable. Finally, according to the conclusion of this paper, policy recommendations are put forward.

Background. Predisposition to HIV+ is influenced by a wide range of correlated economic, environmental, demographic, social, and behavioral factors. While evidence among a candidate handful have strong evidence, there is lack of a consensus among the vast array of variables measured in large surveys. Methods. We performed a comprehensive data-driven search for correlates of HIV positivity in >600,000 participants of the Demographic and Health Survey (DHS) across 29 sub-Saharan African countries from 2003 to 2017. We associated a total of 7,251 and of 6,288 unique variables with HIV+ in females and males respectively in each of the 50 surveys. We performed a meta-analysis within countries to attain 29 country-specific associations. Results. We identified 344 (5.4% out possible) and 373 (5.1%) associations with HIV+ in males and females, respectively, with robust statistical support. The identified associations are consistent in directionality across countries and sexes. The association sizes among individual correlates and their predictive capability was low to modest, but comparable to established factors. Among the identified associations, variables identifying being head of household among females was identified in 17 countries with a mean odds ratio (OR) of 2.5 (OR range: 1.1-3.5, R² = 0.01). Other common associations were identified with marital status, education, age, and ownership of land or livestock. Conclusions. Our continent-wide search for variables has identified under-recognized variables associated with HIV+ that are consistent across the continent and sex. Many of the association sizes are as high as established risk factors for HIV+, including male circumcision.

Arboviruses represents a real public health problem globally and in the Central African subregion in particular that represents a high risk zone for the emergence and re-emergence of arboviruses outbreaks. Furthermore, an updated review on the current arboviruses burden and associated mosquito vectors is lacking for this region. To contribute in filling this knowledge gap, the current study was designed with following objectives: (i) to systematically review data on the occurrence and distribution of arboviruses and mosquito fauna and (ii) to identify potential spillover mosquito species in Central African region in the last 30 years. Web search enabled the documentation of 2454 articles from different online databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and The Quality of Reporting of Meta-analyses (QUORUM) steps for a systematic review enabled the selection of 164 articles that fulfilled our selection criteria. Of the six arboviruses (Dengue Virus (DENV), Chikungunya Virus (CHIKV), Yellow Fever Virus (YFV), Zika Virus (ZIKV), Rift Valley Fever Virus (RVFV), and West Nile Virus (WNV)) of public health concern studied, the most frequently reported were Chikungunya and Dengue. The entomological records showed >248 species of mosquitoes and regrouped under 15 genera with Anopheles (n= 100 species), Culex (n= 56 species) and Aedes (n=52 species) having high species diversity. Three genera were rarely represented with only one species and included: Orthopodomyia, Lutzia, and Verrallina, but individuals of the genera Toxorhinchites and Finlayas were not identified upto the species level. We found that two Aedes species (Ae. aegypti and Ae. albopictus) colonised the same microhabitat and were involved in major epidemics of the six medically important arboviruses and other less frequently identified mosquito-genera consisted of competent species and were associated with outbreaks of medical and zoonotic arboviruses. The present study reveals high species richness of competent mosquito-vectors that could lead to the spillover of medically important arboviruses in the region. Although epidemiological studies were found, they were not regularly documented and this also applies to vector competence and transmission studies. Future studies will consider unpublished information in dissertations, technical reports from different countries to enable it more consistent. A regional project entitled: Ecology of Arboviruses (EcoVir) is underway in three countries (Gabon, Benin and Cote d’Ivoire) to generate a more comprehensive epidemiological and entomological data on this topic.

South Africa is a water stressed country experiencing mass urbanisation especially towards coastal cities. The country is already enduring the impacts of global warming and climate change with risk of water scarcity in many areas. The risk was evident with Cape Town near encounter with ‘Day Zero’ i.e., the day when water supplies would have been switched off and residents required to queue for daily water rations. The drought exposed the inadequa-cies of the existing water supply system. Paradoxically, in the same drought period, vast amounts of unutilized stormwater that could have augmented water supply run unabated into the ocean through rivers around the city. The study determined that the problem was not necessarily water shortage but lack of adequate water storage. This study investigated the suitability of coastal reservoirs for stormwater harvesting on the over 3000 km South African coastline. The objective was to identify suitable locations for coastal reservoirs. The study un-dertook a systematic process of selecting several candidate locations and eliminating unsuita-ble sites based on international best practice i.e., coastal topography, climate, hydrology, fluvi-al environment, catchment size and river water quality. Nine candidate sites were identified and ranked based on suitability and associated benefits. The identified locations in order of ranking include Knysna River, Berg River, Buffalo River, Kowie River, Thukela River, Orange River, Port of Richards Bay, Port of Durban, and Lourens River. The Knysna site, with a mean annual precipitation of 600 - 800 mm/annum and mean annual runoff of 100 - 500 Mm3/annum, was determined to be the most optimal location.

Most schoolchildren carry schoolbags, of which a substantial proportion carry loads that exceed 15% of their body mass. Although the effects of loading have been investigated to varying degrees, the status of schoolbag loading and the acute affects thereof on gait and posture have not been thoroughly investigated within the South African context. A total of 60 participants in the 10-13-year age range volunteered for the present study. Significant differences were evident for relative load carriage (χ2(3) = 14.54, p < .001), forefoot and heel forces (Mdiff = 17.05-34.86 N, p < .001), force-ratios (Mdiff = 0.02, p = .029), and gait speed (Mdiff = -0.18 km/hr, p = .016).), but not for any postural angles (Mdiff = -3.37-6.08 deg, all p > .052). Those who exceeded 15% BM were ~9 times more likely to report pain than those below 15% BM. The children in the current carried significantly heavier realtive loads (p < .001) compared to similarly aged children from other countries. Loading leads to acute changes in posture and gait that are likely not meaningful. However, excessive loading (>15% BM) leads to significantly higher perceptions and reporting of pain in 10-13 year-old children.

In tropical Africa, forests and savannas are the two most widespread biomes and potentially represent alternative stable states with divergent species composition. A classic, but untested, hypothesis posited by White (1983) suggests that the transition zones between forests and savannas contain a floristically impoverished assemblage with few representatives from each biome. Further, the evolutionary dimension of diversity has received limited attention, despite its importance for understanding the biogeographic history of biomes. Here, we quantify species richness and several measures of evolutionary diversity in 1° grid cells, using c. 300K occurrence records of trees and shrubs combined with biome affiliation data for 3,125 species. We find that assemblages in transition zones hold fewer woody species than assemblages in forest and savanna zones, as posited by White. However, transition zones hold more phylogenetic diversity than expected given their species richness, whether one considers forest and savanna assemblages separately or together. We also show that the Congo basin forest has low levels of phylogenetic diversity given the number of species and highlight south-eastern African savannas as a centre of savanna woody species richness and phylogenetic diversity. Regions with high phylogenetic diversity given the number of both forest and savanna species were centred around the Dahomey Gap and Cameroon, mainly in transition zones. Overall, our study shows that even if floristically impoverished, transition zones lead to unexpectedly high evolutionary diversity, suggesting they are important centres of evolutionary innovation and diversification.

Emerging information on the interactions between the COVID-19 pandemic and global food systems has highlighted how the pandemic is accentuating food crises across Africa. Less clear, however, are how the impacts differ between farming systems. Drawing on 50 key informant interviews with farmers, village leaders and extension officers, in South Africa and Tanzania, we identify the effects of COVID-19 and associated measures to curb the spread of the disease on farming production systems, the coping mechanisms adopted by farmers, and explore their longer-term plans for adaptation. We focus on a diverse range of production systems, from small-scale mixed farming systems in Tanzania, to large-scale corporate farms in South Africa. Our findings highlight how COVID-19 restrictions have interrupted the supply chains of agricultural inputs and commodities, increasing the storage time for produce, decreasing income and purchasing power, and reducing labour availability. Farmers’ responses were heterogeneous, with highly diverse small-scale farming systems and those less engaged with international markets least affected by the associated COVID-19 measures. Large-scale farmers were most able to access capital to buffer short-term impacts, whereas smaller-scale farms shared labour, diversified to subsistence produce and sold assets. However, compounded shocks, such as recent extreme climate events, limited the available coping options, particularly for smaller-scale and emerging farmers. The study highlights the need to understand the characteristics of farm systems to better equip and support farmers, particularly in contexts of uncertainty. We propose that policy actions should focus on (i) providing temporary relief and social support and protection to financially vulnerable stakeholders, (ii) job assurance for farmworkers, and engaging an alternative workforce in farming, (iii) investing in farming infrastructure, such as storage facilities, digital communication tools, and extension services, and iv) supporting diversified agroecological farming systems.

Objective In this study, we aim to synthesize some evidence on the impacts that COVID-19 is having on the epidemiology of Antimicrobial Resistance (AMR) in Africa since it was declared global pandemic by WHO in March 2020. Methodology A scoping review was undertaken by collecting and curating relevant resources from peer-reviewed articles and also from the gray literature. Mixed approaches of extracting data (qualitative and quantitative) were employed in synthesizing evidence, as suggested by Health Evidence Network (HEN). Findings A model constructed based on the synthesis of early evidences available on the effects of factors linked to COVID-19 in impacting the evolution of AMR in Africa predicted that, in cumulative terms, those factors favoring the evolution of AMR outpace those disfavoring it by no less than three folds. Conclusion COVID-19 is fueling the evolution of AMR almost unhindered in Africa. Due recognition of this crisis, concerted efforts for resource mobilization and global cooperation are needed to tackle it.

Energy demand has been overgrowing in developing countries. Moreover, the fluctuation of fuel prices is a primary concern faced by many countries that highly rely on conventional power generation to meet the load demand. Hence, the need to use alternative resources such as renewable energy is crucial to mitigate fossil fuel dependency alongside the reduction of Carbon Dioxide emission. Algeria’s being the largest county in Africa has rapid growth in energy demand since the past decade due to the significant increase of residential, commercial, and industry sectors. Currently, the hydrocarbon-rich nation highly dependent on fossil fuels for electricity generation, where renewable energy only has a small contribution to the country’s energy mix. However, the country has massive potential for renewable energy generations such as solar, wind, biomass, geothermal, and hydropower. Therefore, the government aims to diversify away from fossil fuel and promoting renewable energy generations through policies and renewable energy-related programs. The country’s Renewable Energy and Energy Efficiency Development Plan focuses on large scale solar, wind generation as well as geothermal and biomass technologies. This paper provides an update on the current energy position and renewable energy status in Algeria. Moreover, this paper discusses RE policies and programs that aim to increase the country’s renewable energy generation and its implementation status.

This study employed 15 CMIP6 GCMs and evaluated their ability to simulate rainfall over Uganda during 1981-2019. The models and the ensemble mean were assessed based on the ability to reproduce the annual climatologyseasonal rainfall distribution, trend, and statistical metrics, including mean bias error, root mean square error, and pattern correlation coefficient. The Taylor diagram and Taylor skill score (TSS) were used in ranking the models. The models performance varies greatly from one season to the other. The models reproduced the observed bimodal rainfall pattern of March to May (MAM) and September to November (SON) rains occurring over the region. Some models slightly overestimated, while some slightly underestimated, the MAM rainfall. However, there was a high rainfall overestimation during SON by most models. The models showed a positive spatial correlation with observed dataset, whereas a low correlation was shown interannually. Some models could not capture the rainfall patterns around local-scale features, for example, around the Lake Victoria basin and mountainous areas. The best performing models identified in the study include GFDL-ESM4, BCC-CMC-MR, IPSL-CM6A-LR, CanESM5, GDFL-CM4-gr1, and GFDL-CM4-gr2. The models CNRM-CM6-1 and CNRM-ESM2 underestimated rainfall throughout the annual cycle and mean climatology. However, these two models better reproduced the spatial trends of rainfall during both MAM and SON. The model spread in CMIP6 over the study area calls for further investigation on the attributions and possible implementation of robust approaches of Machine learning to minimize the biases.

South Africa is afflicted with the worst epidemic of HIV in the world a legacy of the system of oscillating migrant labour in the region and the consequent social disruption that was the legacy of Apartheid. The initial response from the national government was slow and ineffective but once the magnitude of the epidemic became apparent the government began to respond. The investment in HIV- and TB-related activities in 2013 was R22 Bn or (US$2.5; 2013 exchange rate) of which the South Africa government contributed 80% and the Presidents Emergency Plan for AIDS Relief (PEPFAR) 17%. South Africa now has the more people on anti-retroviral therapy than any other country and treatment is being started much sooner after infection. Much of the best biomedical, virological, immunological, mathematical and social science around the treatment and prevention of HIV and AIDS and the associated epidemic of TB has been done by South African’s and their international collaborators. If the efforts to control the epidemic are maintained South Africa is on track to meet the UNAIDS 90-90-90target by 2020 and to End AIDS by 2030 in spite of the magnitude of the problem. While individual, patient level data are increasingly available, especially in the Western Cape, much greater efforts need to be made to ensure that the information collected in this way is used to give feedback and support to clinic staff, to ensure that health clinics are providing the best possible service, and to individual patients and people living with HIV to ensure that they are receiving the best possible care and support. South Africa needs to make better use of the rich and detailed data that are being collected from individual clinics and their patients to identify problems or difficulties at the clinic level and to ensure that individual patients are retained on treatment, are virally suppressed and receive the best possible care and support.

Human genetic studies have long been vastly Eurocentric, raising a key question about the generalizability of these study findings to other populations. Because humans originated in Africa, these populations retain more genetic diversity, and yet individuals of African descent have been tremendously underrepresented in genetic studies. The diversity in Africa affords ample opportunities to improve fine-mapping resolution for associated loci, discover novel genetic associations with phenotypes, build more generalizable genetic risk prediction models, and better understand the genetic architecture of complex traits and diseases subject to varying environmental pressures. Thus, it is both ethically and scientifically imperative that geneticists globally surmount challenges that have limited progress in African genetic studies to date while meaningfully including African investigators, as greater inclusivity and enhanced research capacity affords enormous opportunities to accelerate genomic discoveries that translate more effectively to all populations. We review the advantages and challenges of studying the genetic architecture of complex traits and diseases in Africa. For example, with greater genetic diversity comes greater ancestral heterogeneity; this higher level of understudied diversity can yield novel genetic findings, but some methods that assume homogeneous population structure and work well in European populations may work less well in the presence of greater diversity and heterogeneity in African populations. Consequently, we advocate for methodological development that will accelerate studies important for all populations, especially those currently underrepresented in genetics.

Breast cancer remains one of the most deadly non-communicable diseases in the world. The incidence of breast cancer in South Africa is increasing, with rural African women presenting with advanced stages of the disease. In this study, we aim to explore sociocultural factors influencing breast cancer screening practices among rural African women. A qualitative exploratory study was conducted using semi-structured interviews with 22 rural African women selected by purposive sampling. Thematic analysis was used to analyze the data. In this study, four sociocultural factors were identified as influencing breast cancer screening practices among rural African women. These factors included psychological factors, habits, beliefs, and healthcare perception. Women in rural African communities have deep-rooted traditional beliefs and practices regarding breast cancer. Consequently, this influences women's preventative health behaviours regarding breast cancer screening. To increase the number of women participating in breast cancer screenings, it is vital to develop culturally sensitive health education programs. Engaging community healers will also help to increase the number of women participating in breast cancer screening.

Groundwater modeling is a useful tool for assessing sustainability in water resources planning. However, groundwater models are difficult to construct in regions with limited data availability. We illustrated how remote sensing data can be used leverage limited in situ data to build and calibrate a regional groundwater model in the Goulbi Maradi alluvial aquifer in Southern Niger in Western Africa. We used data from the NASA Gravity Recovery and Climate Experiment (GRACE) satellite mission to estimate recharge rates, the primary source of water to the aquifer. Additionally, we incorporated groundwater storage changes obtained from GRACE data from 2009 to 2021 to establish an overall water budget from which we could back-calculate groundwater withdrawals from pumping in the region. This approach allowed us to calibrate the model and then convert it to a predictive tool to analyze the impact of various assumptions about future recharge and groundwater extraction patterns associated with the development of groundwater infrastruction in the region. The results indicate that the Goulbi Maradi alluvial aquifer is sustainable, even an increase of groundwater extraction up to 28%.

Viral hepatitis remains one of the largest public health concerns worldwide. Especially in Central Africa, information on hepatitis virus infections has been limited, although the prevalence in this region has been reported to be higher than the global average. To reveal the current status of hepatitis B and C viruses (HBV and HCV) infections and the genetic diversity of the viruses, we conducted longitudinal surveillance in Gabon. We detected 22 HBV and 9 HCV infections in 2,047 patients with febrile illness. Genetic analyses of HBV identified subgenotype A1 for the first time in Gabon and an insertion generating a frameshift to create an X-preC/C fusion protein. We also revealed that most of the detected HCVs belonged to the “Gabon-specific” HCV subtype 4e (HCV-4e), and the entire nucleotide sequence of the HCV-4e polyprotein was determined to establish the first reference sequence. HCV-4e strains possessed resistance-associated substitutions similar to those of other HCV-4 strains, indicating that the use of direct-acting antiviral therapy may be complex. These results provide a better understanding of the current situation of hepatitis B and C virus infections in Central Africa, and will help public health organizations develop effective countermeasures to eliminate chronic viral hepatitis in this region.

Many educational institutions are using technology-enhanced learning. However, studies have shown that increased access to technological tools/gadgets is a precursor to incidents of cyberbullying. Using Bronfenbrenner’s Ecological Theory, we explored educators’ knowledge and intervention strategies regarding cyberbullying in schools. The design used in this study was qualitative and descriptive in nature. Purposive sampling technique was used to recruit a sample of eight educators working at secondary school in Johannesburg, South Africa. Data were collected using one-on-one interviews. Thematic analysis method was used to analyse the data. The findings revealed educators had sufficient knowledge of cyberbullying and how it affects learners in schools. However, interventions the teachers had put in place to prevent and manage incidences of cyberbullying were found to be ineffective due to parental disengagement and learners not reporting cases of cyberbullying. Recommendations for enhancing management of cyberbullying cases are provided.

Inherited retinal dystrophies (IRDs) are a global problem that is largely unaddressed, especially in Africa. Black indigenous Africans are rarely represented in research that develop genetic tests and genetic therapies for IRDs yet their genomes are more diverse. The aim of this literature review is to synthesize information on the IRD genetic research conducted among indigenous black Africans to identify challenges and opportunities for progress. PubMed was searched to identify empirical publications reporting the genetic analysis of IRDs among indigenous Africans. A total of 10 articles were selected for the review. Based on the information in the articles, the main genetic testing methods in use include next-generation, whole exome, and Sanger sequencing. The main IRDs characterized by the genetic tests include retinitis pigmentosa, Leber Congenital Amaurosis, Stagardt disease, and cone dystrophy. Examples of implicated genes include MERTK, GUCY2D, ABCA4, and KCNV2 for the four IRDs respectively. Research activities on the genetics of IRDs are generally scanty in Africa. Even in South Africa and North Africa where some research activities were noted, only a few indigenous black Africans were in the study cohorts. There is an urgent need for genetic research on IRDs, especially in East, Central, and West Africa.

Smart primary healthcare building facility services capture a new level of process and operational data through advanced monitoring, enabling experts to use the building facilities to produce significant and efficient healthcare service delivery within the individual spheres of influence. This study assessed the impact of IoT services on achieving smart primary healthcare building facilities in the rural area of South Africa to enhance primary healthcare delivery. The study identified three (3) basic constructs of IoT services that comprised the application of IoT location recognition and tracking services, the application of the IoT high-speed communication network-based services, and the application of IoT-based services. The study is quantitative, and a questionnaire was used to collect data from the project managers and healthcare practitioners working with the primary healthcare agency in South Africa. The study found a variable degree of impact between the three (3) IoT constructs and the achievement of primary healthcare building facility services in South Africa. The study recommends adopting IoT essential services for achieving smart primary healthcare building facility services in the rural areas of South Africa and other developing countries facing similar primary healthcare delivery challenges.

This paper presents an analysis of precipitation extremes over the East African region. The study employs six extreme precipitation indices defined by the Expert Team on Climate Change Detection and Indices (ETCCDI) to evaluate possible climate change. Observed datasets and CMIP6 simulations and projections are employed to assess the changes during the two main rainfall seasons of March to May (MAM) and October to December (OND). The study evaluated the capability of CMIP6 simulations in reproducing the observed extreme events during the period 1995 – 2014. Our results show that the multi-model ensemble (herein referred to as MME) of CMIP6 models can depict the observed spatial distribution of precipitation extremes for both seasons, albeit with some noticeable exceptions in some indices. Overall, MME's assessment yields considerable confidence in CMIP6 to be employed for the projection of extreme events over the study area. Analysis of extreme estimations shows an increase (decrease) in CDD (CWD) during 2081 – 2100 relative to the baseline period in both seasons. Moreover, SDII, R95p, R20mm, and PRCPTOT demonstrate significant OND estimates compared to the MAM season. The spatial variation for extreme incidences shows likely intensification over Uganda and most parts of Kenya, while reduction is observed over the Tanzania region. The increase in projected extremes during two main rainfall seasons poses a significant threat to the sustainability of societal infrastructure and ecosystem wellbeing. The results from these analyses present an opportunity to understand the emergence of extreme events and the capability of model outputs from CMIP6 in estimating the projected changes. More studies are encouraged to examine the underlying physical features modulating the occurrence of extremes incidences projected for relevant policies.

Psychological distress (PD) may be common among adolescents. The study aimed to estimate population-based rates of PD among adolescents in South Africa. National cross-sectional data were analysed from 2,240 adolescents (17 years median age) that participated in a community-based population survey, the “2012 South African National Health and Nutrition Examination Survey (SANHANES-1).” Results indicated that 16.0% of the adolescents had PD, 13.1% among boys and 18.5% among girls. In adjusted logistic regression analysis, increasing age, girls, belonging to the Black African population group, having experienced two or more traumatic life events, poor self-rated health status, having activity limitations, perceived body overweight, fast food and snack consumption were associated with PD. Almost one in six adolescents in South Africa reported PD and several associated factors were identified.

Presentation of case: A 20 year old men from Simanjiro district in northern Tanzania presented with a 3 year history of splenomegaly, fatigue, cachexia, skin maculae and recent onset of watery diarrhea at Kilimanjaro Christian Medical Centre (KCMC) in Northern Tanzania. Due to laboratory findings of pancytopenia, diagnostic workup included bone marrow aspiration cytology and biopsy. Although the rapid test (IT LEISH, rK39 RDT) was negative, blood smear showed amastigote forms of Leishmaniasis in macrophages. Repeat bone marrow aspiration and PCR eventually confirmed VL. The patient denied travel to known endemic areas of visceral leishmaniasis (VL). Treatment was initiated with Amphotericin B, but the patient died on the fourth day of treatment from respiratory insufficiency. An autopsy revealed massive organ manifestations of VL. Case discussion: This is the first reported autochthonous case of VL in Tanzania. Clark et al. detected the vector Phlebotomous martini in Northern Tanzania in 2013, in a region boardering the district of our patient. The negative rapid test draws attention to the fact that sensitivity and specificity was found to be low in East African VL patients as displayed earlier by a Kenyan study. Therefore, tissue samples (spleen or bone marrow) remain necessary for diagnosis. The variety of symptoms in this presented case was remarkable, including the occurrence of Post Kala Azar Dermal Leishmaniasis (PKDL) and VL at the same time. This has been described in East African VL cases before as well as the occurrence of chronic diarrhea. An elongated undiagnosed period likely led to a mixed clinical picture that included: hepato-splenomegaly, PKDL, cachexia, and diarrhea.

Coronavirus disease 2019 (COVID-19) since its declaration as a pandemic by world health organization (WHO) has spread across the various continent with little known about the most effective public health response for containing and mitigating the transmission of the epidemic. It is important to state that some authors have published on the lessons learned from transmission and management of COVID-19 infection but only a few considered it from the Africa perspective. Despite the late arrival of the pandemic in Africa and the notion that the virus may not thrive because of the high temperature in the continent; today the narrative has changed with the number of infected patients increasing daily. Herein, the authors have shared their perspectives and opinions on the dynamics and response to COVID-19 from Africa context to create more awareness and approach in mitigating the spread of the virus should the continent becomes the epicenter of COVID-19.

Over the past few decades, there have been major advances in crop productivity across the world, which has been made possible through a combination of productivity enhancing technological innovations. Beyond this achievement however, most parts of Africa are still battling with low crop productivity resulting in food shortages and food insecurity. The yields of many staple crops are still far below their agronomic potentials with output increases being attributed largely to area expansion. This paper examines the implications of the current trends of crop/plant productivity for food security and rural livelihood development in Africa using Ghana as a case study. The paper argues that crop production in Africa is becoming a less viable and unattractive livelihood activity with farmers diversifying out of agriculture into non-agricultural activities such as illegal small-scale mining, which have negative consequences on the ability of African countries to attain the Sustainable Development Goals (SDGs).

Chan and colleagues in their paper titled “Human origins in a southern African palaeo-wetland and first migrations” (https://www.nature.com/articles/s41586-019-1714-1) report 198 novel whole mitochondrial DNA (mtDNA) sequences and infer that ‘anatomically modern humans’ originated in the Makgadikgadi–Okavango palaeo-wetland of southern Africa around 200 thousand years ago. This claim relies on weakly informative data. In addition to flawed logic and questionable assumptions, the authors surprisingly disregard recent evidence and debate on human origins in Africa. As a result, the emphatic and high profile conclusions of the paper are unjustified.

Nowadays one of the issues interesting for researchers of political, social, and economic sciences is to investigate immigration from different angles. Accordingly, they use a diverse range of instruments, different types of graphs, descriptive indices and complex mathematical models. Immigration has always been one of the paths helping humans in their own efforts for getting compatible with the environment and coping with difficulties. Nevertheless, if this issue has been considered as an instrument regulating resources and species automatically, in the present era, its negative aspects have been evident and socioeconomic consequences of immigration in the framework of development economy and security has attracted scholars’ attentions. One of the countries attracting for immigrants particularly in the continent of Africa is South Africa. Statistics indicates that this country is the most attractive one for refugees. Somalis are one of the most important and largest groups seeking refuge in South Africa because they are usually merchants who earn money in the poor places. However, business in the poor places endangers their lives and properties because of high rate of crimes and xenophobia. As a result, the target countries face a lot of socioeconomic and security problems. The present study tries to investigate the issue of Somali immigration using network models.

Despite numerous interventions to promote gender equality, sub-Saharan Africa has one of the highest prevalence rates of non-partner sexual assault in the world, thus constituting a major social and public health issue in the region. As social workers frequently provide services to this population, an exploratory cross-sectional study was conducted to explore rape myth acceptance among undergraduate social work students studying in Namibia. Findings revealed the positive influence of social work education in reducing rape myth acceptance as well as highlighted the influence of age, gender, country of origin, self-identification as a feminist, and religiosity on rape myth acceptance among this population.

In sub-Saharan Africa (SSA), cervical cancer is a critical public health issue; it is the second leading cause of cancer among women and the leading cause of female cancer deaths. Incidence and mortality rates are substantially higher than in high-income countries with population-based screening programs, yet implementing screening programs in SSA has so far proven to be challenging due to financial, logistical and sociocultural factors. Human Papillomavirus (HPV) vaccination is an effective approach for primary prevention of cervical cancer and presents an opportunity to reduce the burden from cervical cancer in SSA. With a number of SSA countries now eligible for GAVI support for vaccine introduction, it is timely to consider the factors that impede and facilitate implementation of vaccine programs in SSA. This article reviews the epidemiological and clinical features of cervical cancer in SSA and describes the current status of HPV vaccine implementation in SSA countries. The review considers the challenges that will need to be addressed, and effective approaches to the design and implementation of HPV vaccination programs, using Rwanda as a case study. The review aims to provide suggestions and guidance to those involved in the development and implementation of HPV vaccination programs in SSA.

(1) Background: Respiratory infections are a major public health problem worldwide, with potentially serious consequences. Indeed, these infections remain one of the main causes of morbidity and mortality in children under 5 years old in developing countries. Etiological information on respiratory infections is crucial for prevention and case management strategies. This systematic review aims to describe the etiology of respiratory infections reported in studies carried out in sub-Saharan African countries; (2) Methods: Using PubMed, HINARI and Google scholar search engines, a systematic search was carried out to identify published articles on the etiology of viral and/or bacterial respiratory infections in sub-Saharan Africa in patients of all ages. We have only considered data from sub-Saharan Africa. Papers published from 2010 to 2021, in English or French have been included in this review; (3) Results: After reviewing 115 articles reporting studies carried out in the African continent, only 32 articles were selected of which, studies were conducted in 15 sub-Saharan African countries, including 6/32 (18.75%) in Cameroon. Twenty (62.5%) were cross-sectional studies, and twenty-four (75%) were hospital-based investigations. In these studies, RT-PCR and culture methods were respectively used for viruses and bacteria investigations. Respiratory syncytial virus was the most frequently identified, with prevalence ranging from 0.6% to 59%, followed by rhinovirus (9.3% -73%), influenza virus (flu) A/B (0.9%-69.1%), and human adenovirus (0.9% - 30.8%). Streptococcus pneumoniae (14.2% - 96%), followed by Haemophilus influenzae type b (2.5% - 54%), and Klebsiella pneumoniae (1.4% - 49.9%) were the most frequently detected bacteria; (4) Conclusions: This review has reported that many pathogens, mainly viruses, are associated with acute respiratory infections in sub-Saharan Africa in both children and adults. Unfortunately, the limited geographical distribution of data across sub-Saharan Africa does not allow most of countries to develop an effective strategy for the prevention and treatment of respiratory infections.

For women giving birth, every moment of delay in receiving skilled care significantly increases the risks of stillbirth, neonatal and maternal death. More than half of all births in developing countries including South Africa, take place outside a health facility and without skilled birth attendants. This has therefore, made it difficult to achieve the Sustainable Development Goals of global reduction in maternal mortality, which is a key health challenge globally, especially in developing countries and sub-Saharan Africa in particular. The aim of this study was to explore and describe the views of pregnant women regarding facility-based delivery. Focus group discussions were used to gather information from the pregnant women. Information was collected from six groups of pregnant women who had delivered babies at the antenatal care facilities in the past years. Results showed several factors associated with the failure to use institutional delivery service, such as long distance from the health care facility, lack of transport, lack of transport fare, shortages of skilled staff, failure to disclose pregnancy, cultural and religious beliefs, and staff attitudes.

Cryptococcosis is a leading cause of death among people with HIV in sub-Saharan Africa. Limited diagnostic and therapeutic options significantly impair treatment options in Africa. We investigated the burden of cryptococcosis and related mortality among people with HIV and suspected sepsis in Ethiopia. We conducted a prospective cohort at 1) Adama Hospital Medical College and 2) Asella Referral and Teaching Hospital from September 2019 to November 2020. We enrolled adult HIV-infected patients presenting with suspected sepsis and assessed 28-day survival. We performed blood cultures and cryptococcal antigen (CrAg) testing. In total, 82 participants were enrolled with a median age of 35 years and 61% being female. Overall, 11(13%) had positive CrAg tests, of which 5 had Cryptococcus detected in blood cultures. Despite high-dose fluconazole (1200mg/d) monotherapy in patients with positive CrAg tests, the 28-day mortality was 64%(7/11), being significantly higher than in CrAg-negative patients (9%(6/71); p<0.001). Cryptococcosis is the leading cause of mortality among HIV-infected sepsis patients. CrAg screening in HIV-infected patients attending emergency department can minimize the cryptococcosis missing case irrespective of CD4 count and viral load. These findings warrant the need of a bundle approach for diagnosis of HIV-infected persons presenting with sepsis in low- and middle-income countries.

Though there has been a decline in the number of new cases of viral hepatitis-induced acute liver failure in Europe and the United States of America, viral hepatitis still remains the leading cause of acute liver failure in Asia-Pacific and South America. However, the epidemiology of viral-hepatitis-induced acute liver failure in sub-Saharan Africa-the world epicenter of viral hepatitis-is unclear. The aim of this review was to collate data on the incidence, prevalence, specific etiologic agents, features/diagnosis, treatment and prognosis of viral-induced acute liver failure in sub-Saharan Africa. One hundred and forty-seven cases of viral-induced acute liver failure were recorded in 11 studies conducted in six countries between 1981-2020. Etiological agents were: Hepatitis viruses A, B, C, and E, as well as Adenovirus, Enterovirus, Parvovirus, Herpes Simplex Virus (HSV) and EBV. HAV was the most frequent in paediatric subjects: (11/16) 69% and (19/30) 63%. HBV was the only etiological agent in the study that only included adults. HEV (genotype 2 in one study) contracted amidst hepatitis E outbreaks was the most commonly reported cause of ALF in pregnant women. Treatment was mainly supportive, and liver transplantation reported only in South Africa. Where reported, case fatality rates were high. In conclusion, viral-hepatitis induced acute liver failure is largely understudied in sub-Saharan Africa. The few available data are consistent with literature from the other parts of the world regarding aetiologic agents. Liver transplantation is not available in most sub-Saharan African countries, and short-term case fatality rates of individuals with acute liver failure could outstrip current rates from the other world regions.

Digital transformation of agriculture can support economic growth and food and nutri-tion security in Africa. This study provides an overview of the status of digital agriculture in five west African countries, analyzing their efforts in developing the enabling environment and inno-vations while formulating recommendations based on the identified gaps for the effective trans-formation of the sector. Information was retrieved through a literature search from various sources, including web pages and databases of national agricultural and digital transformation institutions and start-ups of the five target countries (Benin, Burkina Faso, Côte d'Ivoire, Ghana, Nigeria) and regional/international institutions. There have been increasing agri-digital initia-tives in the five countries, which were grouped into seven categories based on their objectives. Steady progress was also observed in mobile internet adoption, despite the differences in deploy-ing crucial infrastructure to promote digital agriculture. The mobile connectivity index (MCI) in all five countries is below 60. Nonetheless, Ghana and Cote d'Ivoire demonstrated more efforts in internet and electricity access, especially in rural areas. Benin and Nigeria have developed sep-arate documents depicting the roadmap for Digital Agriculture, while the other countries are working to create one or have it embedded in their national development plans. Similarities and specificities exist among countries for laws and processes protecting Agri-digital innovators. To be competitive and self-reliant in the global e-economy, these countries must reposition them-selves to accelerate changes in digital agriculture through effective governance and synergy of actions in different sectors and across nations.

The tumor microenvironment (TME) plays a critical role in cancer progression and treatment outcomes. Despite advances in cancer research, many therapeutic strategies have failed to provide the desired clinical outcomes. In this integrated review, aimed to explore the role of TME in cancer biology and develop novel therapeutic strategies that target not only cancer cells but also the surrounding microenvironment. Study conducted a comprehensive literature search using PubMed, Embase, and Web of Science databases for articles published between 2016 and 2022. Inclusion of articles that discussed the impact of TME on cancer development and progression, as well as articles that proposed novel therapeutic strategies targeting the TME. The analysis of the literature revealed that the TME plays a crucial role in cancer development and progression by promoting cancer cell survival, angiogenesis, invasion, and metastasis, and by interfering with the efficacy of cancer therapies. The TME is composed of a complex network of non-cancerous cells, extracellular matrix components, and signaling molecules that interact with cancer cells. Several novel therapeutic strategies have been proposed based on the modulation of TME components. One of the most promising approaches is the use of immunotherapy, which aims to enhance the immune system's ability to recognize and attack cancer cells. Immunotherapy drugs such as checkpoint inhibitors, chimeric antigen receptor (CAR) T cells, and immune-stimulatory monoclonal antibodies have been approved for the treatment of different cancer types. These approaches have shown promising results in preclinical studies and clinical trials. The TME plays a critical role in cancer development and progression, and targeting its components represents a promising avenue for cancer therapy. Novel therapeutic strategies such as immunotherapy, extracellular matrix-targeting drugs, and nanoparticle-based therapies have shown promising results in preclinical studies and clinical trials. However, further research is needed to identify the most effective strategies and to overcome the challenges associated with TME targeting.

While vaccines are a well-established method of controlling the spread of infectious diseases, vaccine hesitancy jeopardizes curbing the spread of COVID-19. Through the Vaccine Information Network (VIN), this study explored barriers and motivators to COVID-19 vaccine uptake. We conducted 18 focus group discussions with male and female community members, stratified by country, age group, and—for Zimbabwe only—by HIV status. Participants’ median age across both countries was 40 years (interquartile range of 22–40) and most (65.9%) were female. We conceptualized the key themes within the World Health Organization’s Strategic Advisory Group of Experts on Immunization (SAGE) 3Cs (convenience, confidence, complacency) vaccine hesitancy model. Barriers to vaccine uptake—lack of convenience, low confidence, and high complacency—included inaccessibility of vaccines and vaccination sites, vaccine safety and development concerns, and disbelief in COVID-19’s existence. Motivators to vaccine uptake—convenience, confidence and low complacency—included accessibility of vaccination sites, user-friendly registration processes, trust in governments and vaccines, fear of dying from COVID-19 and knowing someone who had died or become infected with COVID-19. Overall, vaccine hesitancy in South Africa and Zimbabwe was influenced by inconvenience, a lack of confidence, and high complacency around COVID-19 vaccines.

Drowning is a serious public health concern. Low middle income countries are mostly affected, as they carry 90% of the global drowning burden. The purpose of this epidemiological study is to provide a comprehensive overview of fatal drownings in South Africa between 2016 and 2021. The data used for the study was obtained from the South African Police Service. Descriptive statistics were used to summarise data. Statistical analysis included a t-test and chi-square test. The results indicate that the average fatal drownings per annum is 1477 in South Africa, with a drowning rate of 2.54 per 100 000 population from 2016 - 2021. The KwaZulu-Natal province had the highest incidence of drowning. The 0 – 4-year category has a high prevalence of drowning amongst all the age categories. More males drowned in South Africa compared to females. The study highlights key areas of concern these include age, sex, race, province, type of water body and time of day. This information is crucial to inform drowning prevention initiatives in South Africa.

Targeting genes involved in sexual determinism for vector or pest control purpose, requires a better understanding of their polymorphism in natural populations in order to ensure a rapid spread of the construct. By using genomic data from An. gambiae s.l., we analyzed the genetic variation and the conservation score of the fru gene in 18 natural populations across Africa. A total of 34339 SNPs were identified including 3.11% non-synonymous segregating sites. Overall, the nucleotide diversity was low and the Tajima's D neutrality test was negative indicating an excess of low frequency SNPs in the fru gene. The allelic frequencies of the non-synonymous SNPs were low (freq < 0.26) except two SNPs identified at high frequencies (freq > 0.8) in the Zinc-finger A and B protein domains. The conservation score was variable throughout the fru gene with maximum values in the exonic compared to the intronic regions. These results showed a low genetic variation in overall the exonic regions especially the male sex-specific exon and the BTB-exon 1 of the fru gene. These findings are crucial for the development of a gene drive construct targeting the fru gene that can rapidly spread without encountering resistance in wild populations.

Countries in West Africa are adversely affected by climate change (erratic rainfall and rising temperature) resulting in floods, desertification, drought and sea level rise. These events are anticipated to have negative impacts on agricultural development on the continent, ultimately, contributing to food insecurity and environmental degradation. This implies that the production capacity of agrarian communities is unable to meet the food demand of the growing urban population. Can sustainable and innovative urban farming technology such as aquaponics achieve food security as well as sustainable development in countries vulnerable to climate change? This study uses inferential statistic to examine the plant growth performance in micro-scale aquaponics and specific growth rate per day (SGR) for the fish growth performance vis-à-vis conventional urban farming production. A quantitative analysis use to examine the barriers to adoption based on survey of (five) urban aquaculture practitioners in Lagos, Nigeria. Literature review was use to assess the economic feasibility of a small-scale aquaponics system in developing countries based on Net-Discounted Benefit-Cost Rate (DBCR). The results suggest that aquaponics can improve food security through fish and vegetable production and it is likely that urban farming practitioners will adopt the technology if support mechanism are in place. Aquaponics systems present a novel opportunity to promote environmental conservation as well as sustainable food production and consumption in urban areas in Western Africa if adequate financial credit and knowledge transfer is provided.

This study examines the improvement in coupled intercomparison project phase six (CMIP6) models against the predecessor CMIP5 in simulating mean and extreme precipitation over the East Africa region. The study compares the climatology of the precipitation indices simulated by the CMIP models with the CHIRPS dataset using robust statistical techniques for 1981 – 2005. The results display the varying performance of the general circulation models (GCMs) in the simulation of annual and seasonal precipitation climatology over the study domain. CMIP6-MME shows improved performance in the local annual mean cycle simulation with a better representation of two peaks, especially the MAM rainfall relative to its predecessor. Moreover, simulation of extreme indices is well captured in CMIP6 models relative to its predecessor. The CMIP6-MME performed better than the CMIP5-MME with lesser biases in simulating SDII, CDD, and R20mm over East Africa. Remarkably, most CMIP6 models are unable to simulate extremely wet days (R95p). A few CMIP6 models (e.g., NorESM2-MM and CNRM-CM6-1) depicts robust performance in reproducing the observed indices across all analyses. Conversely, OND season shows the overestimation of some indices (i.e., R95p, PRCPTOT), except for SDII, CDD, and R20mm. Consistent with other studies, the mean ensemble performance for both CMIP5/6 shows better performance due to the cancellation of some systematic errors in the individual models. Generally, the CMIP6 depicts improved performance in the simulation of MAM season akin CMIP5 models. However, the new model generation is still marred with uncertainty, thereby depicting substandard performance over the East Africa domain. This calls for further investigation of attribution studies into the sources of persistent systematic biases and a prerequisite for identifying individual models with robust features that can accurately simulate observed patterns for future usage.

This study evaluates the historical mean surface temperature (hereafter T2m) and examines how T2m changes over East Africa (EA) in the 21^st century using CMIP6 models. An evaluation was conducted based on mean state, trends, and statistical metrics (Bias, Correlation Coefficient, Root Mean Square Difference, and Taylor skill score). For future projections over EA, five best performing CMIP6 models (based on their performance ranking in historical mean temperature simulations) under the shared socioeconomic pathways SSP2-4.5 and SSP5-8.5 scenarios were employed. The historical simulations reveal an overestimation of the mean annual T2m cycle over the study region with fewer models depicting underestimations. Further, CMIP6 models reproduce the spatial and temporal trends within the observed range proximity. Overall, the best performing models are as follows: FGOALS-g3, HadGEM-GC31-LL, MPI-ESM2-LR, CNRM-CM6-1, and IPSL-CM6A-LR. During the three-time slice under consideration, the Multi Model Ensemble (MME) project many changes during the late period (2080 – 2100) with expected mean changes at 2.4 °C for SSP2-4.5 and 4.4 °C for the SSP5-8.5 scenario. The magnitude of change based on Sen’s slope estimator and Mann-Kendall test reveal significant increasing tendencies with projections of 0.24°C decade-1 (0.65°C decade-1) under SSP2-4.5 (SSP5-8.5) scenarios. The findings from this study illustrate higher warming in the latest model outputs of CMIP6 relative to its predecessor, despite identical instantaneous radiative forcing.

To bring to the fore the aim of this research, effects of fluctuating temperature, was measured against food and nutrition security in the region using food production index, and undernourished population growth rate as proxies; controlled over share of arable land, irrigation, population and labour share for agriculture. Dynamic panel of generalized method of moments (GMM) was adopted, the period 2000 to 2016 were considered and 29 countries in sub-Sahara Africa were selected within the empirical framework of global water balance as mentioned by Rai and Singh (2012). Findings from the study reveals that the short run effect of temperature increase in degrees pose at least -3.1% negative and significant impact effects on the food production while the long run elasticity hits -7.5% and the controlled effect on arable land revealed a positive impact on the food production to the tune of 3.9%. Contrarily, arable land expansion reduces the under nourished population by -8.55%. Population increase on the other hand increases undernourished population in the region to the tune of 11.95%. The study therefore recommended expansion in the arable land and encourages population control policy in order to negate the undesired effects of temperature on food and nutritional security.

There is growing adoption of corporate sustainability practice in both for-profit and not-for-profit organizations. This proliferation is largely due to the increasing concerns for social, environmental and economic factors in which we assume shared responsibility. Despite the growing attention of researchers and practitioners, several corporations failed to meet their sustainability responsibilities. Several reasons could be associated to this phenomenon such as lack of regulatory mechanism, accountability, etc. This review, however, seeks to examine how nongovernmental organizations (henceforth, NGOs) influence corporate sustainability adoption (i.e. sustainability reporting). In the review of prior research, we leveraged the institutional-legitimacy and corporate governance theories. The findings suggest that NGOs have greater potential in sustainability discourse through two salient actions, namely (1) collaborative partnership, and (2) confrontational tactics. While the former promotes stakeholder involvement in corporate decision making through dialogue, joint-projects on CSR, sustainability reporting, the latter, however, is the last resort – involving “naming and shaming” corporations for poor social and environmental performance through public and social media. The objective of such action is to cause reputational damage to businesses. Finally, it is also observed that crucial to NGO power and influence is the collaboration with government and civil society organizations in the fight for environmental sustainability and accountability.

The novel COVID-19 pandemic prompted an unprecedented Institutional reaction to aggregate existing capacity from silos of research laboratories to establish a multidisciplinary research laboratory for COVID19 testing. In less than two weeks, resources were mobilized from the community to strengthen public health response and epidemic control. Such strengthening of institutional research capacity to support public health response contributes to a natural knowledge transfer, facilitates collaboration, and generates new frontiers for knowledge production that should ultimately lead to professional development and retention of skilled human resources. This report describes the pre-established mechanisms and involvement of the authors that made it possible to set-up a multidisciplinary laboratory in a remarkably short period of time. We also discuss the opportunities and sustainability of multidisciplinary laboratory research post-COVID19. Existing institutional capacity can be repurposed to establish multidisciplinary research laboratories to support the strengthening of basic and clinical translational research capacity in resource limited settings and impact on public health and scientific knowledge for socioeconomic development.

The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2, has been declared by the World Health Organization (WHO) as a pandemic. Unfortunately, finding a vaccine or developing drugs from the scratch is a time-consuming luxury given the widespread and high fatality rates of the virus. In the short term, repurposing of drugs already in use seem to be the most rational step to quickly and effectively curb the virus. Several antiviral agents had been proposed as possible remedies, but the 4-aminoquinolines, Chloroquine (CHQ) and hydroxychloroquine (HCHQ) appear to be generating more interest. They are generic, cheaply available and have proven efficacy against malaria parasites in Africa. The human immunodeficiency virus (HIV), on the other hand, targets the immune system thereby reducing the patient’s ability to fight infections. Sadly, 68% of the global HIV burden occur in Africa. It is therefore anticipated that incidence of severe forms of COVID-19 could occur in Africa because of associated endemic conditions that compromise the immune system. With CHQ and HCHQ being considered for clinical use against COVID-19, there is a need to highlight their potential merits and confounding variables in the subgroup of patients with or without HIV.

The study sought to gauge the impact of COVID-19 pandemic in unleashing digital transformation in the education sector in South Africa. In order to gauge the impact, the study tracked the rate at which the 4IR tools were used by various institutions during the COVID-19 lockdown. Data were obtained from secondary sources, mainly newspaper articles, magazines and peer-reviewed journals. The findings are that, in South Africa, during the lockdown, a variety of 4IR tools were unleashed from primary education to higher and tertiary education where educational activities switched to remote learning (online learning). These observations point to the fact that South Africa generally has, some pockets of excellence to drive the education sector into the 4IR, which has the potential to increase access. Access to education, particularly at a higher education level, has always been a challenge due to a limited number of spaces available. Much as this pandemic has brought with it massive human suffering across the globe, there is an opportunity to assess successes and failures of deployed technologies, costs associated with them, and scaling these technologies to improve access.

South Africa possesses the largest anti-retroviral therapy (ART) program in the world but the path to this record was dramatic. There is scarce literature employing a comprehensive framework to explain this ART policy change and inform current policy making processes. This paper applies the Advocacy Coalition Framework (ACF) to analyse the interactions among diverse actors, institutions and networks that were associated with the ART policy change in South Africa. Post-apartheid, HIV/AIDS and AIDS-related mortality were serious public health problems. At the time, the discernible coalitions in the AIDS policy subsystem were the prescience coalition and AIDS dissidents. In view of the availability of compelling scientific evidence on the pathogenesis of HIV/AIDS, the clinical usefulness of ART, the availability of funding for national ART roll-out, strong global advocacy to reduce the cost of ART, all of these in an era when access to adequate HIV care was increasingly considered a human right, the environment to establish an appropriate ART policy for the country was conducive. However, AIDS dissidents dominated the policy agenda via their control over key institutions, the use of various dimensions of power, biasing evidence to inform policy, and promoting the activities of strong interest groups that were not in support of ART. National ART roll-out ultimately emerged as a political priority as a result of external shocks (on the ART policy subsystem) which disfavoured the dominant coalition. Failure to supplement this application of the ACF with key pubic policy concepts such as power dimensions, evidence use in policy, governance and emergence of global health networks would have led to suboptimal appraisal of the ART policy change and misinformation of current policy making processes.

The prevalence of congenital hearing impairment (HI) is highest in Africa. Estimates evaluated genetic causes to account for 31% of HI cases in Africa, but the identification of associated causative genes mutations have been challenging. In this study, we reviewed the potential roles, in humans, of 38 novel genes identified in a murine study. We gathered information from various genomic annotation databases and performed functional enrichment analysis using online resources i.e. genemania and g.proflier. Results revealed that 27/38 genes are express mostly in the brain, suggesting additional cognitive roles. Indeed, HERC1- R3250X had been associated with intellectual disability in a Moroccan family. A homozygous 216-bp deletion in KLC2 was found in two siblings of Egyptian descent with spastic paraplegia. Up to 27/38 murine genes have link to at least a disease, and the commonest mode of inheritance is autosomal recessive (n=8). Network analysis indicates that 20 other genes have intermediate and biological links to the novel genes, suggesting their possible roles in HI. This study will contribute to advance our knowledge in unravelling the biological roles of novel murine HI genes in humans and could enhance the understanding of the genetic causes of HI in Africans.

Improvements that can be attained in seasonal climate predictions in various parts of Africa using the multimodel supersensemble scheme are presented in this study. The synthetic superensemble (SSE) used follows the approach originally developed at Florida State University (FSU). The technique takes more advantage of the skill in the climate forecast data sets from atmosphere-ocean general circulation models running at many centres worldwide including the WMO global producing centers (GPCs). The module used in this work drew data sets from the Four versions of FSU coupled model system, seven models from the DEMETER project which is the forerun to the current European Ensembles Forecast System, the NCAR Model, and the Predictive Ocean Atmosphere Model for Australia (POAMA), all making a set of 13 individual models. An archive consisting of monthly simulations of precipitation was available over all the 5 regions of Africa, namely Eastern, Central, Northern, Southern, and Western Africa. The results showed that the SSE forecast for precipitation carries a higher skill compared to each of the member models and the ensemble mean. Relative to the ensemble mean (EM), the SSE provides an improvement of 18% in simulation of season cycle of precipitation climatology. In Eastern Africa, during December-February season, a north-south gradient of precipitation prevails between Tropical East Africa and the sector of the region towards Southern Africa. This regional scale climate pattern is a direct influence of the Intertropical Convergence Zone (ITZC) across the African continent during this time of the year. The SSE emerges with superior skill scores such as lowest root mean square error above the EM and the member models, for example in the prediction of spatial location and precipitation magnitudes that characterize the see-saw precipitation pattern in Eastern Africa. In all parts of Africa, and especially Eastern Africa where seasonal precipitation variability is a frequent cause huge human suffering in due to droughts and famine, the multimodel superensemble and its subsequent improvements will always provide a forecast that out weighs the best Atmosphere-Ocean Climate Model.

This paper contributes to the understating of tornadoes in South Africa using case study analysis. In South Africa tornadoes are the recurring phenomenon (the climatology) but so far they have received less attention. Damages from storms itself (tornadoes inclusive) are significant in South Africa relative to other weather-related disasters for example floods, heat waves, and droughts. For their understanding, a case study approach was adopted in the current study. Data were in courtesy of the following, National Oceanic and Atmospheric Administration (NOAA), National Centers for Environmental Predictions (NCEP), Eumetsat Germany, and South African Weather Service (SAWS). The aim of the study was to provide an overview of the occurrence of tornadoes in South Africa using a Klerksdorp tornado, which occurred on March 4, 2007, Northwest Province in South Africa. From the case study analysis, the tornado was associated with the cold front and cut-off low (both are extratropical circulation) which were the dominant weather systems of the day. Therefore we conclude that, a case study approach may be the best way to study events of these nature for a more informed decision, for example, issuing an early warning system. In future, case studies, for example, involving interaction between extratropical and tropical circulation will also be an interesting study.

This paper deals with the analysis of the temperatures in a group of 36 African countries. By looking at the maximum, minimum and the range (the difference between the maximum and the minimum) and using a long memory model based on fractional integration and cointegration, we first show that all series display a long memory pattern, with a significant positive time trend in 29 countries for the maximum temperatures and in 33 for the minimum ones. Looking at the range, the estimated value for the order of integration is smaller than the one based on maximum or minimum temperatures in 17 countries. Performing fractional cointegration tests between the maximum and minimum temperatures, our results indicate that the two series cointegrate in the classical sense (i.e., with a short memory equilibrium relationship) in a group of 11 countries, and there is another group of eight countries displaying cointegration in a fractional sense. The remaining 17 countries with no evidence of cointegration are therefore at the very high risk of climate change due to the absence of long-term comovement in their maximum and minimum temperatures. Findings in this paper are of tremendous interpretations and relevance for the analysis and climate projections in Africa.

The increasing cancer burden is a major health concern in Arab countries with variations in cancer profiles. Given the limited oncology research output and scarce data on cancer trial participation in the Arab region, this study explored the therapeutic cancer trial landscape in Arab countries over the past 20 years. A bibliometric analysis of the PubMed database was conducted on primary publications of therapeutic trials with a participating Arab center. Arab countries participated in 320 published cancer-related therapeutic trials (2000‒2021). There was a consistent increase in the number of trials, sample size, multiregional site participation, and number of randomized trials. However, most trials were small, did not receive external funding, and included a single Arab site. Compared with Arab-only trials, trials with joint non-Arab sites were larger (p = .003) and more likely to be externally funded (p < .001). Citation numbers and journal impact factors were higher in trial publications with joint non-Arab authorship than those without (p < .001, for both). Despite improving conduct and publication records of oncology trials with Arab centers, cancer trial participation remains limited in Arab countries. Concerted efforts are required to encourage sponsorship and international collaboration in this region.

To date, 41 species of Gyrodactylus have been described from Africa. However, none of these have been reported in Morocco. After identifying and examining 738 cyprinid host specimens, 26 specimens belonging to Gyrodactylus were found to parasitize the gills of nine species of Luciobarbus, Carasobarbus, and Pterocapoeta. The current study describes in detail 12 specimens of Gyrodactylus isolated from the gills of Luciobarbus pallaryi (Pellegrin, 1919) and Luciobarbus ksibi (Boulenger, 1905). Based on morphoanatomical observations, the characterization of the specimens collected suggests a species of Gyrodactylus new to science, described here as Gyrodactylus nyingiae n. sp. The new species is different from previously described gyrodactylids infecting African cyprinid hosts because it has a longer hamulus total length, a longer hamulus root, a downward projecting toe, a trapezium shaped ventral bar membrane with slightly striated median portion and small rounded anterolateral processes. This study brings the total number of Gyrodactylus spp. found in African cyprinids to four.

Background: United Nations Sustainable Development Goals state that by 2030, the Global maternal mortality rate (MMR) should be lower than 70 per 100,000 live births. MMR is still one of Africa's leading causes of death among women. This research aims to study regional trends in maternal mortality in Africa. Methods: We extracted data for Maternal mortality rates per 100,000 births from the UNICE data bank from 2000 to 2017, being 2017 the last date available. Joinpoint regression was used to study the trends and estimate the annual percent change (APC). Results: Maternal mortality has decreased in Africa over the study period by an average APC of -3.0% (95% CI -2.9;-3,2%). All regions showed significant downward trends, with the sharpest decreases in the South. Only the North African region is close to the United Nations' sustainable development goals for Maternal mortality. The remaining sub-Saharan African regions are still far from achieving the goals. Conclusions: maternal mortality has decreased in Africa, especially in the South Africa region. The only region closed to the United Nations target is North Africa. The remaining sub-Saharan African regions are still far from achieving the goals. These results could be used for the development of Regional Policies.

Background: United Nations Sustainable Development Goals state that by 2030, the Global maternal mortality rate (MMR) should be lower than 70 per 100,000 live births. MMR is still one of Africa's leading causes of death among women. This research aims to study regional trends in maternal mortality in Africa. Methods: We extracted data for Maternal mortality rates per 100,000 births from the World Bank database from 1990-2015. Joinpoint regression was used to study the trends and estimate the annual percent change (APC). Results: Maternal mortality has decreased in Africa over the study period by an average APC of -2.6%. All regions showed significant downward trends, with the sharpest decreases in East Africa. Only the North African region is close to the United Nations' sustainable development goals for Maternal mortality. The remaining sub-Saharan African regions are still far from achieving the goals. Conclusions: maternal mortality has decreased in Africa, especially in East Africa. The only region closed to the United Nations target is North Africa. The remaining sub-Saharan African regions are still far from achieving the goals. These results could be used for the development of Regional Policies.

The high costs of cancer treatment and lack of investment in health care are significant obstacles to public health on the African continent. The objective of this study was to estimate the financial cost of treating children suffering from cancer in Africa. We conducted a systematic review and meta-analysis of expert opinions between March 2000 and March 2020. The key search terms included ‘cost’, ‘cancer’ and ‘child’; we selected articles that specifically addressed the financial costs of childhood cancer in African countries. Of the 103 articles found, 18 met the inclusion criteria. Cancer care was a heavy financial burden in most of the countries studied, although costs varied from country to country; the average expenditure on healthcare was US$1017.39 ± US$319.1 per year. In countries without a health insurance system, the highest proportion of cancer care costs, 46.6%, was indirect, whereas in countries with a cancer financing system, the direct cost of treatment was low, 53.4%. The cost of treating childhood cancer is high in Africa in relation to the standard of living of individuals residing in this region.

Vaccination attitudes among healthcare workers (HCWs) is a vital factor for measuring their level of vaccination uptake and intention to recommend vaccinations to their patients. To our knowledge, no study has been conducted in South Africa to assess hesitancy to influenza vaccines among HCWs. We used questionnaire adapted from Betsch and colleagues to conduct an online and face-to-face cross-sectional study among HCWs at the start of COVID-19 vaccine roll-out prior to the flu season. Main outcome was influenza vaccine hesitancy. We used multivariate logistic regression to assess predictors of influenza vaccine hesitancy. Of 401 participants, 64.5% were women, 49.2% nurses, and 12.5% physicians. A total of 54.9% were willing to accept vaccination, 20.4% were undecided, and 24.7% intended to refuse. Older participants above 17-25 years and physicians were likely to receive the vaccine. Key predictors of vaccine acceptance were confidence in the effectiveness, consideration of benefits and risks, and willingness to be vaccinated to protect others. Influenza vaccine hesitancy was highest in those who did not trust that influenza vaccines are safe. For future flu seasons, tailored education programs targeting younger HCWs and more information about the composition of flu vaccines would be vital to improve vaccine uptake.

: Urinary schistosomiasis caused by the parasite Schistosoma haematobium is the most common form of schistosomiasis. This parasite has a high potential for genetic exchange within parasite populations giving rise to the genetic diversity that is important for its survival. Genetic differ-ences may lead to some parasite strains being more immunogenic which may have a negative impact on management and control of schistosomiasis. Therefore, understanding these genetic differences in the parasite may lead to better management of the disease. A literature search was done on PubMed, African Journals online and Google scholar using predefined search terms such as urinary schistosomiasis, S. haematobium, genetic diversity in sub-Saharan Africa in com-bination with Boolean operators (AND, OR). The search included studies published from 2000-2020 that emphasised on genetic diversity of Schistosoma haematobium in sub-Saharan Africa. Sixteen studies from 18 sub-Saharan African countries that met the inclusion criteria were se-lected. Most studies conducted in these countries showed a high genetic diversity of Schistosoma haematobium studies with microsatellite markers being the most commonly used method for ge-netic diversity determination. Fisher’s exact test showed that the distribution of genetic diversity in sub-Saharan African regions was not statistically significant (p=0.768). The highest number of studies on genetic diversity of Schistosoma haematobium were conducted in West Africa with Ni-geria and Zimbabwe in Southern Africa conducting the most studies, 4/36 (11%) each. Results obtained show the need for continued monitoring of genetic variations in Schistosoma haemato-bium in sub- Saharan Africa. This will aid in understanding the epidemiology of disease, ad-vancing novel treatment and vaccine strategies.

The problem of antimicrobial resistance has created a new need for alternative/ complementary treatments. To this end, bacteriophages offer an exciting prospect, as they can infect and kill specific bacteria without harming the host. This survey aimed to evaluate the state of applied phage research in Africa, among the members of the Africa phage Forum (APF). This was a cross-sectional survey whereby a google form was created for the members of the Africa Phage forum to fill so as to access the stage of phage research in Africa. Data was collected between June and July 2021 using a structured questionnaire form. A total of 65 out of a total of 101 forum members completed the questionnaire. The survey indicated that a majority 68% of phage researchers in Africa were at the training stages of their career. Some available participants were limited (8%). Most of the members identified funding, lack of skill set, near absence of adequate laboratory infrastructure as major hurdles for phage research. Despite these challenges, 73.3% of APF members work with the ESKAPE group with the majority of its members carrying out research in Phage in Biocontrol (80%), whereas others perform research related to human phage therapy (60%). However, it appeared this research has not yet reached the stage of commercialization. Overall, Phage research is in its infancy in Africa. Key challenges included poor laboratory infrastructure, lack of capacity building in the phage field, and lack of local awareness on the significance of phages for policymakers and governments. APF could, therefore, play a role in creating phage awareness in Africa; mobilizing resources; enhancing networks and collaborations amongst APF members and beyond, especially with more experienced phage mentors in the Western countries, to greatly reduce the gap in knowledge and enhance phage research in Africa.

According to this study, approximately half of Africa's forests are utilized primarily or partially for the production of wood and non-wood commodities. Aims to evaluate Africa's forestry and forest products, namely Wood Forest Products (WFPs) and Non-wood Forest Products (NWFPs) in the sixteen (16) West African countries. While adhering to the following guidelines: wood extraction and preparation, analyzing wood primarily used as an energy source in Africa, identifying non-wood forest products in Africa, the state of export, trade, and customs procedures in West Africa, and examining the role of forests and forest stakeholders in Africa's low-carbon economy transition. An exploratory literature review of selected wood forest products and non-wood forest products (plants and animals) in West Africa identifying the country, the natural land area with the natural habitat issues of the forest, the species most harvested and traded in the West African sub-region. The study reemphasized some government legislation, policies, and market trade failures and limitations while also stating that trees may help in the low-carbon revolution through interventions aimed at maintaining, improving, and restoring natural capital have demonstrated that high environmental requirements of sustainable forest management (SFM) may be met in both natural and planted forests. The study identified a systematic assessment of the most common forest products (wood and non-wood forest products) considering the available data on the national forest reserves of the selected countries in West Africa. The study also revealed the need for biodiversity conservation of the available forest reserves to help mitigate the impact of global warming targeting the United Nation’s Sustainable Development Goal 13- Climate Action. Which is focused on integrating climate change mitigation, adaptation, impact reduction, and early warning signs into the national policies, improving forest planning and management education, awareness-raising, and institutional capacity within the sub-region.

Human activities mostly impact the trend and direction of surface water, groundwater, and other river basin resources in the watershed in Africa. Human activities influence river flows and the water quality at both highlands and lowlands. A watershed is indeed a conserved area of land that collects rain and snow and empties or penetrates into ground water sources. The act of managing the activities around the watershed is the Integrated Watershed Management while considering the social, economic, and environmental issues, as well as community interests to manage water resources sustainably. These watersheds, river basins, and groundwater resources provide important services for communities and biodiversity. This paper reveals that the best way to protect groundwater resources is on a watershed basis using IWM. This technique enables us to handle a variety of concerns and objectives while also allowing us to plan in a complicated and uncertain environment. IWM involves cooperation and participation from a wide range of community interests and water users, including municipalities, companies, people, agencies, and landowners, for stakeholders' input to be successful. All of the strategies and plans are produced concerning one another, as well as the overall conditions of the watershed, local land uses, and specific issues.

Abstract: Droughts are complex and gradually evolving conditions of extreme water deficits which can compromise livelihoods and ecological integrity, especially in fragile arid and semi-arid regions that depend on rainfed farming, such as Kitui West in south-eastern Kenya. Against the background of low ground-station density, 10 gridded rainfall products and four gridded temperature products were used to generate an ensemble of 40 calculations of the Standardized Precipitation Evapotranspiration Index (SPEI) to assess uncertainties in the onset, duration and magnitude of past droughts. These uncertainties were driven more by variations between the rainfall products than variations between the temperature products. Remaining ambiguities in drought occurrence could be resolved by complementing the quantitative analysis with ground-based information from key informants engaged in disaster relief, effectively formulating an ensemble approach to SPEI-based drought identification to aid decision making. The reported trend towards drier conditions in Eastern Africa was confirmed for Kitui West by the majority of data products, whereas the rainfall effect on the increasingly dry conditions was more subtle than annual and seasonal declines and greater annual variation, which warrants further investigation. Nevertheless, the effects of increasing droughts are already felt on the ground and warrant decisive action.

In late/early 2019/2020, unprecedented high-water-levels were observed in Lake Victoria causing massive flooding in the low-lying lake-adjacent areas and disrupting human and natural systems in the Lake Victoria Basin (LVB). The high lake water-level coincided with unusually heavy and prolonged 2019 June to December precipitation in the LVB. The current study estimates future precipitation patterns over the LVB using HighResMIP and ScenarioMIP general circulation model (GCM) simulations from the 6^th phase of the Coupled Model Intercomparison Project (CMIP6). Results show that HighResMIP and ScenarioMIP simulations can adequately reproduce LVB’s precipitation patterns – albeit with location-specific biases. Generally, the GCM simulations tend to over-estimate precipitation patterns over Lake Victoria while under-estimating precipitation patterns over the lake-adjacent areas. Projections show significant future precipitation changes over the LVB relative to the 1970-1999 baseline, with more pronounced changes over the lake than in lake-adjacent areas. Overall, mean annual precipitation is projected to increase by about 18% and 31% by the end of the century, under SSP2-4.5 and SSP5-8.5 scenarios, respectively. Additionally, mean daily precipitation intensity (SDII) is projected to increase by up-to 14% while the maximum 5-day precipitation values (RX5Day) increase by up-to 71% under the SSP5-8.5 scenario. Heavy precipitation events, represented by the width of the right tail distribution of precipitation (99p-90p), are projected to increase by 50% and 94% under SSP2-4.5 and SSP5-8.5, respectively. Given that direct precipitation accounts for about 80% of Lake Victoria’s water budget, the lake’s future water-level fluctuations are likely to be more rampant and unpredictable under the changing climate. Hence, enhanced production and use of climate services is recommended to minimize the risk posed by potentially high water-level fluctuations in Lake Victoria and, ultimately, enhance the socio-economic safety of communities in the LVB.

Mobile health devices are emerging applications that could help deliver point-of-care (POC) diagnosis, particularly in settings with limited laboratory infrastructure, such as sub-Saharan Africa (SSA). The advent of coronavirus has resulted in an increased deployment and use of mHealth-linked POC diagnostics in SSA. We performed a systematic review and meta-analysis to evaluate the accuracy of mobile-linked point-of-care diagnostics in SSA. Our systematic review and meta-analysis were guided by the Preferred Reporting Items requirements for Systematic Reviews and Meta-Analysis (PRISMA). We exhaustively searched PubMed, Science Direct, Google Scholar, MEDLINE, and CINAHL with full-text via EBSCOhost databases from mHealth inception to March 2021. The statistical analyses were conducted using OpenMeta-Analyst software. All 11 included studies were considered for the meta-analysis. The included studies focused on malaria infections, Schistosoma haematobium, Schistosoma mansoni, soil-transmitted helminths, and trichuris trichiura. The pooled summary of sensitivity and specificity estimates were moderate compared to the gold reference standard. The overall pooled estimates of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of mobile-linked POC diagnostic devices were as follows: 0.499 (95% CI: 0.458-0.541); 0.535 (95% CI: 0.401-0.663); 0.952 (95% CI: 0.60-1.324); 1.381 (95% CI: 0.391-4.879); and 0.944 (95% CI: 0.579-1.538), respectively. Evidence shows that mobile-linked POC diagnostics' diagnostic accuracy is presently moderate in detecting infections in sub-Saharan Africa. Future research is recommended to evaluate mHealth devices' diagnostics with excellent sensitivities and specificities in diagnosing diseases in this setting.

The widely used logistic model for epidemic case reporting data may be either restrictive or unrealistic in presence of containment measures when implemented after an epidemic outbreak. For flexibility in epidemic case reporting data modelling, we combined an exponential growth curve for the early epidemic phase with a flexible growth curve to account for the potential change in growth pattern after implementation of containment measures. We also fitted logistic regression models to recoveries and deaths from the confirmed positive cases. In addition, the growth curves were integrated into a SIQR (Susceptible, Infective, Quarantined, Recovered) model framework to provide an overview on the modelled epidemic wave. We focused on the estimation of: (1) the delay between the appearance of the first infectious case in the population and the outbreak (“epidemic latency period"); (2) the duration of the exponential growth phase; (3) the basic and the time-varying reproduction numbers; and (4) the peaks (time and size) in confirmed positive cases, active cases and new infections. The application of this approach to COVID-19 data from West Africa allowed to discuss the effectiveness of some containment measures implemented across the region.

Electric mobility begins to enter East-African markets. This paper aims to investigate what policy level solutions and stakeholder constellations are established in the context of e-mobility in Dar es Salaam, Kigali, Kisumu and Nairobi and in which ways they attempt to tackle implementation of electric mobility solutions. The study employs two key methods including content analysis of policy and programmatic documents as well as interviews based on purposive sampling ap-proach with stakeholders involved in mobility transitions. The study findings point out that transport operators and their representative associations are less recognized as major players in the transition, far behind new e-mobility players (start-ups) and public authorities. The study further indicates that a set of financial and technical barriers persist such as high upfront invest-ment costs in vehicles and infrastructure, or anxieties regarding competitiveness with fossil fuel vehicles, that constrain the uptake of such private e-mobility initiatives. This study concludes by identifying current gaps that need to be tackled by policy makers and stakeholders in order to implement inclusive electric mobility in East-African cities, considering modalities that include transport providers and address their financial constraints.

Recent studies indicated that Plasmodium vivax can infect Duffy-negative individuals, but the varied diagnostic and methodological approaches have limited our ability to characterize P. vivax across Africa. Here, we utilized a standardized approach to compare epidemiological and genetic attributes of P. vivax from Botswana, Ethiopia, and Sudan, where Duffy-positive and Duffy-negative individuals coexist. Among 1,215 febrile patients, the proportions of Duffy negativity range from 20-36% in East Africa to 84% in Southern Africa. Considerable differences were observed in P. vivax prevalence among Duffy-negative populations ranging from averaged 9.2% in Sudan to 86% in Botswana. P. vivax parasite density in Duffy-negative infections is significantly lower than in Duffy-positive infections. Phylogenetic analyses of 229 PvDBP sequences indicated that Duffy-negative P. vivax were not monophyletic but occurred in multiple well-supported clades, suggesting independent origins. Duffy-negative Africans are clearly not resistant to P. vivax and the public health significance should no longer be neglected.

Budget deficits, economic crisis and competing demands for lean state resources are clear reasons why governments, especially in sub-Saharan Africa are now inclined towards the public-private partnership model of infrastructure finance. This paper comparatively examines the regulation of public-private partnership in Nigeria and South Africa. The aim is to highlight areas where both countries can learn from their experiences. The paper finds that beyond the problem of overlapping laws, weak institutional mechanisms and the need to check the arbitrariness of public officials as some of the problems that need to be addressed to build strong public-private partnership regimes in sub-Saharan Africa. The paper recommends among others, holistic strategies for strengthening the framework and practice in both countries and the need to make the public-private partnership process less cumbersome.

The eruption of the COVID-19 pandemic has affected every sphere of life and may forever change how we have always lived and conducted our businesses, and no one can resist the wind of change that is blowing. Of all the sectors of governance, the educational sector, particularly at the tertiary level, appears to have been most greatly affected and therefore requires a more pragmatic approach to resolution. As of 29th June, Sub-Sahara Africa has reported 382,190 cases of COVID-19. In rejoinder to the virus epidemic, several Sub Sahara African governments implement the resolution to slam learning institutions to enclose the infection. Consequently, advanced schooling institutions obliged to reorganize their loom, becoming more digitally become forward, and changing to online platforms.

Governments all over the world are currently grappling with the COVID-19 pandemic. While some countries were very hard hit, others were only mildly hit but all are still taking measures to mitigate the consequences. The virus emerged in December 2019 in Wuhan, China and spread to most continents by the beginning of March 2020, which led to the World Health Organization declaring it as a pandemic on the 11^th of March 2020. Since it was a novel disease, there was limited information on the virus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) belongs to the same family as the Severe Acute Respiratory Syndrome Coronavirus 1 (SARS-CoV-1) and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Researchers all over the world started working simultaneously to understand the virus to provide the necessary treatment regime or vaccine in order to reduce the impact of the virus on its victims. Africa and other developing countries with limited resources and poor planning and management are expected to be among the worst hit in the long run. The implications of the COVID-19 on food, water, hygiene, sanitation, and the environment in Africa have been reviewed in this paper, as well as possible implications they may pose to the population, based on the existing common practices and their immediate impacts. This information can assist policymakers in Africa to adequately plan the management of the COVID-19 in order to lessen its impact on the population.

Abstract: Many countries around the world suffer from the lack of a sea port directly linked to the rest of the world. Such countries are called "landlocked countries". This leads to Weak competitiveness of their products in the global market, as well as to the high cost of the imports. Africa has the largest share of these countries, with 16 of the 43 landlocked countries around the world. The aim of this paper is to propose a general framework for criteria that can be used to choose between ports in transit countries that can be used for import or export. These criteria are related to the assessment of the sea ports in terms of infrastructure and tariffs. It is also related to transport infrastructure from the transit country to the landlocked country and the level of safety. The study identified nine criteria that could be used to compare between ports in transit countries. Using Full Consistency Method (FUCOM) to evaluate those criteria showed that the number of navigation lines is the most important criteria followed by the port service level.

Pig genetic resources in Africa originate from different regions. Genetic analysis has shown a strong phylogeographic pattern with the pigs on the eastern parts showing a high frequency of alleles from the Far East while the ones on the western parts show a strong European influence. This highlights the influence of trade routes on the genetic legacy of African pigs. They have, however, since adapted to the local environments to produce unique populations with unique attributes. Most of the pigs are now reared in resource-constrained smallholdings under free-range conditions. They are largely owned by women who spread ownership of the resource through kinship networks. Very little work has been done to characterize, conserve and sustainably utilize pig genetic resources in Southern Africa. The risk status of the breeds together with population numbers, distribution and other attributes are largely unknown. This paper proposes several strategies for the sustainable utilization of the pig genetic resources: a market-driven in situ conservation program and two complementary ex situ strategies. In addition, the possibility of community-based breed improvement programs is discussed.

Background. Perinatal depression is one of the leading causes of disability in perinatal women and is highly prevalent in disadvantaged communities in LMICs. However, care capacity remains low in most LMICs. As such, we decided to find and assess a screening program that addresses perinatal mental health problems in a resource-efficient manner. This leads us to a critically appraisal of the Perinatal Mental Health Project (PMHP), a screening program based in peri-urban Western Cape Town that stresses task sharing and stepped care intervention. Method. PubMed, Ovid Medline (1946 to 2018), and Google Scholar were searched for publications until March 2018, with data or evaluation of the PMHP. PMHP website publications were used for data and interpretation. The program’s viability was evaluated based on criteria published by UK National Screening Council. The program’s impact was analyzed using published patient outcome data. Access to care was evaluated at three barriers to accessing care proposed by Gjerdingen et al. (2007). The financial model was evaluated using the “four-pillars” of sustainable organization financial management proposed by León (2001). Findings. The PMHP’s screening program viability satisfies most criteria of the UK National Screening Council, and the program’s benefits outweigh its harms. Patient self-reports indicate successful impact with several highlights in accessibility. The program also demonstrates financial sustainability and potential for scaling-up. Interpretations. The operation model of the PMHP shows satisfactory viability and sustainability. With modifications fitting local context and government cooperation, this model offers promising potential in bringing public health and economic benefits.

In this paper, the validity of the Wagner’s law is investigated in tenth selected Sub- Saharan African countries, namely Botswana, Equatorial Guinea, Mauritania, Nigeria, South Africa, Sierra Leone, Tanzania, Ethiopia, Madagascar, and DR Congo. Five variants of the Wagner’s law were tested for the period 2005-2014, using panel econometric approaches encompassing cointegration and causality. The study found a long run relationship between the public expenditure and the various explanatory variables used as proxies of income. The long-run causality tests indicate that there is bidirectional causality between expenditure and income in all models with the exemption of the Gupta model. It is concluded that for Sub-Saharan Africa, both the Wagner’s law the Keynesian hypothesis tend to be valid under the period of investigation. The explanation is that there has been the tendency for public expenditure to grow relative to national income (Wagner’s law) and that public expenditure is a policy instrument (an exogenous factor) for improving national income (Keynesian hypothesis) during the 10-year period.

In the context of climate change in West Africa characterized by a reduction of precipitation, this study was conducted to evaluate the impact of climate change on water resources from now to the end of the 21st century in the transboundary watershed of the Sassandra River shared by Guinea and Côte d’Ivoire. Historical and future climate (Representative Concentration Pathways or RCPs 4.5 and 8.5 scenarios) data were projected with the model. The Abdus Salam ICTP RegCM4 was used. The hydrological modeling of the river basin was carried out with the conceptual hydrological model, GR2M. This model is a monthly time steps model that allows the assessment of the discharge of the Sassandra River for each climate scenario according to the 2030 (2021–2040), 2050 (2041–2060), 2070 (2061–2080), and 2090 (2081–2100) horizons. The results showed a reduction of the annual discharge when compared to the baseline (1961–1980). For the RCP 4.5, the observed values went from –1.2% in 2030 to –2.3% in 2070 and rose to –2.1% in 2090. Concerning the RCP 8.5, we saw a variation from –4.2% to –7.9% in the 2030 and 2090 horizons, respectively. With the general decrease of rainfall in West Africa, it is appropriate to assess the impact on water resources on the largest rivers (Niger, Gambia, and Senegal) that irrigate the Sahelo-Saharian zone.

An important aspect of the new sustainable development goals (SDGs) is a greater emphasis on reducing the health impacts of urban ambient air pollution (AAP) in developing countries. Meanwhile, the burden of disease attributable to AAP in sub-Saharan Africa (SSA) is growing, yet estimates of its impact in the region are likely underestimated due to a lack of air quality monitoring, the paucity of epidemiological studies, and important population vulnerabilities in the region. The lack of studies in the SSA region also represents an important global health disparity and environmental justice issue because thousands of air pollution health effects studies have been conducted in Europe and North America rather than in some of the most polluted regions of the world, such as SSA. In this review, we synthesize all of the ambient air pollution epidemiological studies that have been conducted in SSA to date. We highlight the gaps in AAP epidemiological studies conducted in different sub-regions of SSA and provide methodological recommendations for future environmental epidemiology studies addressing AAP in the SSA region.

Urban agriculture is an early practice, especially for cities in the Global South that are expanding at an unprecedented rate, and in African cities, it can be a way to attend to essential social and health needs. However, it is unclear whether architects and urban planners have expressed interest or already incorporated urban farming within their designs of African cities. This literature review was conducted to understand to what extent architects and urban planners have researched urban agriculture and health. Comprehensive searches based on urban agriculture, health, and Africa were conducted in Scopus, PubMed, and Web of Science from 2000 to December 2020. Zotero, Mozilla Firefox search engine, and Google Chrome were used to collect paper metadata. The duplicate articles were excluded, and all the n = 240 publications remaining were included in the analysis. Food security and the immediate health impact of urban agriculture on health were the most addressed topics. These studies reported the harmful effects of urban agriculture on malaria and the wastewater irrigation of plants. The evidence on urban agriculture is increasing from public health researchers, but not in the field of urban planning or architecture. Future research on urban agriculture's impacts on urban health should be increasingly done by architects and planners to help shape urban planning practices and regulations that could help create urban agriculture that benefits urban health.

This study analyzes the potential response of the seasonal cycle of heatwave (HWDI), dry (CDD) and wet (CWD) spells indices over West Africa for the near (2031-2060) and the far (2071-2100) future periods, under RCP4.5 and RCP8.5 scenarios using CORDEX simulations. Although some relative biases during the historical period (1976-2005), the CORDEX simulations and their ensemble mean outperform the seasonal variability of the above indices over three defined sub-regions of West Africa (i.e., Guinea gulf, west and east Sahel). They have shown significant correlation coefficients and less RMSE. They project an increase in heatwave days for both near and far future periods over whole west Africa region under both RCP scenarios. In addition, the Sahel regions will face to a decrease in wet spells days from March to November, whereas, the Gulf of Guinea will face to a decrease during all the year, except CCCLM simulation which indicates an increase during the retreat phase of the monsoon (October to December). The results also have shown an increase in dry spells over Sahel regions, more pronounced during March-November period, whereas, over Guinea gulf, the increase is observed over the entire year. On the other hand, the months of increasing dry spells and decreasing wet spells coincide, suggesting that countries in these regions could be exposed simultaneously to dry season associated with a high risk of drought and heatwave under future climate conditions.

(1) Background: With the United Nations Sustainable Development Goals (SDG) (2015-2030) fo-cusing on reducing maternal mortality, monitoring and forecasting Maternal Mortality Rates (MMR) in regions like Africa become crucial for health strategy planning by policymakers, in-ternational organizations, and NGOs. (2) Methods: We collected maternal mortality rates per 100,000 births from the World Bank database between 1990 and 2015. Join Point regression was applied to assess trends, and the autoregressive integrated moving average (ARIMA) model was used on 1990-2015 data to forecast the MMR for the next 15 years. (3) Results: The study found a decline in MMR in Africa with an average annual percentage change (APC) of -2.6% (95% CI -2.7; -2.5). North Africa reported the lowest MMR, while East Africa experienced the sharpest decline. The region-specific ARIMA models predict that the maternal mortality rate (MMR) in 2030 will vary across regions, ranging from 65 deaths per 100,000 births in North Africa to 249 deaths per 100,000 births in Central Africa., averaging 197 per 100,000 births for the continent. (4) Conclusions: Despite the observed decreasing trend in maternal mortality rate (MMR), the MMR in Africa remains relatively high. The results indicate that MMR in Africa will continue to decrease by 2030. However, only North and South Africa will likely reach the SDG target.

Drought is one natural disaster with the greatest impact worldwide. Southern Africa (SA) is susceptible and vulnerable to drought due to its type of climate. In the last four decades, droughts have occurred more frequently, with increasing intensity and impacts on ecosystems, agriculture and health. The work consisted of a systematic literature review on the drought regime’s characteristics in the SA, under current and future climatic conditions, conducted on the Web of Science and Scopus platforms, using the PRISMA2020 methodology, with usual and appropriate inclusion and exclusion criteria to minimize/eliminate the risk of bias, which lead to 41 documents published after the year 2000. The number of publications on the drought regime in SA is still very small. The country with the most drought situations studied is South Africa and the fewer studies are Angola and Namibia. The analysis revealed that the main driver of drought in SA is the ocean-atmosphere interactions including the El Niño Southern Oscillation. The documents used drought indices, evaluating drought descriptors for some regions, but it was not possible to identify one publication that reports the complete study of the drought regime, including the spatial and temporal distribution of all drought descriptors in SA.

Following the unprecedented and global health crisis of COVID-19, without a doubt, there has been a tremendous impact on international tourism for two reasons: the imposed travel restrictions discourage people from traveling, while travelers watch increased anxiety when responding to the new travel landscape. We address the problem of travelers’ changing travel risk perceptions in the COVID-19 pandemic aftermath. Our main goal is to identify and weigh critical emerging travel risks and create a risk evaluation index in which one can measure the destinations and strategic interventions’ performance for South African travelers. We found that tourist perceived risks are multidimensional, including categories like additional expenses, exchange rates, and refund-related factors. These three criteria are the most important to overall travel risk perception. We applied the developed risk evaluation index to five tourist destinations to evaluate their performance regarding the identified risks, being the UK the country with the best performance.

Machine learning has seen enormous growth in the last decade, with healthcare being a prime application for advanced diagnostics and improved patient care. The application of machine learning for healthcare is particularly pertinent in Africa, where many countries are resource-scarce. However, it is unclear how much research on this topic is arising from African institutes themselves, which is a crucial aspect for applications of machine learning to unique contexts and challenges on the continent. Here, we conduct a bibliometric study of African contributions to research publications related to machine learning for healthcare, as indexed in Scopus, between 1993 and 2022. We identified 3,772 research outputs, with most of these published since 2020. North African countries currently lead the way with 64.5% of publications for the reported period, yet Sub-Saharan Africa is rapidly increasing its output. We found that international support in the form of funding and collaborations is correlated with research output generally for the continent, with local support garnering less attention. Understanding African research contributions to machine learning for healthcare is a crucial first step in surveying the broader academic landscape, forming stronger research communities, and providing advanced and contextually aware biomedical access to Africa.

The purpose of the study is to empirically analyze the effect of quality of governance on tax revenue in South Africa. This is done by analyzing a time series dataset covering 1996 to 2020. The study used voice and accountability, regulatory quality, government effectiveness, control of corruption, political stability and rule of law as proxies of quality of governance. Multiple regression analysis was performed to test hypotheses. Based on the regression results, all quality of governance variables in South Africa have a negative effect on tax revenue except corruption control. The findings of this study also include policy recommendations. The government of South Africa must design and implement effective ways to combat poor governance, which results in a tax revenue shortfall.

Unprecedented in scale, immense COVID-19 immunization programmes have been rolled out globally. This article explores aspects of hypothetical vaccine acceptability in Soweto, South Africa, shortly before such vaccines became available. Whereas hypothetical acceptance was normative, this has not translated into uptake today, which remains concerningly low in South Africa, especially in Soweto. For that reason, we mobilise anthropological concepts to analyse acceptance, hesitancy, and denial, respectively, to gauge and understand public proclivity to inoculate. We find that COVID-19’s haphazard mediatization generated a ‘field of suspicion’ towards authorities and vaccination, which, amplified by dis- and misinformation, fostered othering, hesitancy, and denial considerably. It remains paramount during vaccination rollouts to unveil and address aspects detrimental to vaccine confidence and selectivity, especially in lower-income groups for underlying, context-specific cultural, spiritual, historical, and socioeconomic reasons. Appropriate mediazation alongside a debunking of counterfactual claims is crucial in driving forward immunization.

To contain and mitigate the coronavirus (COVID-19) pandemic, African governments have implemented non-pharmacological interventions (NPIs), such as imposing travel bans, confining people to their homes and closing schools, shops and workplaces. These NPIs are likely to be less effective in circumstances where people need to leave their homes to work, collect food, water and cooking fuel or where people cannot maintain distancing due to overcrowded living environments. Using data from the nationally representative South African General Household Survey 2019, we examined individuals’ vulnerability to the risk of COVID-19 infection due to their health, socioeconomic and living circumstances. We explored socioeconomic-related inequalities in COVID-19 using concentration curve and concentration index methods. Our results showed that vulnerability to COVID-19 was disproportionately concentrated among those with low socioeconomic status. Using the Recentered Influence Function decomposition approach, we found that higher income and education had a significant and positive impact on reducing socioeconomic-related COVID-19 vulnerability. Conversely, people with lower socioeconomic status were more likely to live in circumstances that made compliance with NPI requirements almost impossible, and they were also more likely to have pre-existing health conditions that made them more vulnerable to COVID-19.

Turkey is located in the heart of complex transition geography between Eurasia and the Middle East. In the grand scheme, the so-called Eastern Mediterranean Basin is almost amidst the dusty belt and a hot spot of climate change. The downstream location of dust carrying winds from the closer desert sources reveals Turkey as an open plane to particulate matter exposure throughout the year. In order to clarify this phenomenon, it is aimed to find out the desert dust climatology of Turkey via CALIPSO onboard Lidar. This prominent instrument enables us to understand clouds, aerosols and their types and relatedly climatic systems with its valuable products. In this study, 9-year CALIPSO derived pure dust product is formed to explain horizontal and vertical distributions, transport heights and case incidences. Results indicated mass and conditional abundancy are higher with the location shifts from west to east. In the same direction, dominant spring months change to summer and autumn. Mountain range systems surrounding Anatolia are the main obstacles against lofted and buoyant dust particles travelling to northern latitudes. Even if high ridges accumulate mass load on the southern slopes, it also enables elevated particles to reach the ground level of the inner cities.

Human papillomavirus (HPV) self-sampling (Self-HPV) is a promising strategy to improve cervical cancer screening coverage in low-income countries. However, issues associated with women who prefer conventional HPV clinical-sampling over HPV self-sampling may affect screening participation. To address this issue, our study assessed factors associated with women’s preferences related to Self-HPV. This study was embedded in a large clinical trial recruiting women aged 30–49 years in a primary HPV-based study termed “3T-Approach” (for Test-Triage-Treatment), launched in 2018 at Dschang District Hospital, West Cameroon. Participants were invited to perform a Self-HPV. After the sampling and before receiving the results, participants completed a questionnaire about cervical cancer screening and their preferences and perceptions around Self-HPV. The median age of the 2201 participants was 40.6 (IQR 35–45) years. Most (1693 (76.9%)) preferred HPV self-sampling or had no preference for either method and 508 (23.1%) preferred clinician-sampling. Factors associated with an increased likelihood of reporting a clinician-sampling preference were tertiary educational level (14.4% CI: 12.8–16.1 vs 29.5% CI: 25.6–33.6) and being an employee with higher grade professional or managerial occupations (5.5% CI: 3.8–7.9 vs 2.6% CI: 2.3–2.8). The main reported reason for women preferring clinician-sampling was a lack of “self-expertise”. Most women (&gt;99%) would agree to repeat HPV self-sampling and would recommend it to their relatives. HPV self-sampling in the cultural context of central Africa was well accepted by participants, but some participants would prefer to undergo clinician sampling. Health systems should support well-educated women to increase self-confidence in using HPV self-sampling.

This paper discusses the use of a participatory approach to assess the level of understanding of the Water-Energy-Climate Change nexus in South Africa. The aim is to facilitate the development of well-coordinated, systematic, and holistic strategies for efficient management of the nexus and its implications in the country. The assessment was guided by the broader Integrated Water Resource Management framework, which promotes a participatory approach in the administration of water resources. The paper argues that despite the reasonable level of understanding of WECC, there is still a lack of integrated policy development and planning among key stakeholders. This is exacerbated by limited coordination and consultation among these stakeholders, particularly policymakers. This necessitates the urgent adoption of holistic and systems thinking approaches, and the promotion of collaboration among different stakeholders mandated to manage WECC sectors. Until such approaches are adopted, the WECC nexus will continue to impede the country’s socio-economic development and environmental wellbeing.

The virus SARS-CoV-2 has resulted in numerous modelling approaches arising rapidly to understand the spread of the disease COVID-19 and to plan for future interventions. Herein, we present an SEIR model with a spatial spread component as well as four infectious compartments to account for the variety of symptom levels and transmission rate. The model takes into account the pattern of spatial vulnerability in South Africa through a vulnerability index that is based on socioeconomic and health susceptibility characteristics. Another spatially relevant factor in this context is level of mobility throughout. The thesis of this study is that without the contextual spatial spread modelling, the heterogeneity in COVID-19 prevalence in the South African setting would not be captured. The model is illustrated on South African COVID-19 case counts and hospitalisations.

Plasmodium vivax malaria is a neglected tropical disease, despite being more geographically widespread than any other form of malaria. The documentation of P. vivax infections in different parts of Africa where Duffy-negative individuals are predominant suggested that there are alternative pathways for P. vivax to invade human erythrocytes. Duffy-negative individuals may be just as fit as Duffy-positive individuals and are no longer resistant to P. vivax malaria. In this review, we describe the complexity of P. vivax malaria, characterize pathogenesis and candidate invasion genes of P. vivax, and host immune responses to P. vivax infections. We provide a comprehensive review on parasite ligands in several Plasmodium species that further justify candidate genes in P. vivax. We also summarize previous genomic and transcriptomic studies related to the identification of ligand and receptor proteins in P. vivax erythrocyte invasion. Finally, we identify topics that remain unclear and propose future studies that will greatly contribute to our knowledge of P. vivax.

The study aimed to assess the prevalence and correlates of hazardous, harmful or dependent alcohol use (HHDA) and drug use among persons 15 years and older in South Africa. In a national cross-sectional 2017 survey, 39,210 persons 15 years and older (Median=34 years) responded to a questionnaire on substance and health variables. Logistic regression was used to assess the determinants of HHDA and any drug use. Results indicate that (10.3%) engaged HHDA, 16.5% among males and 4.6% among females, and past 3-month drug use was 8.6%, 13.3% among males and 4.1% among females. In adjusted logistic regression analysis, among men, middle age (25-34 year olds), higher education, urban residence, drug use, and psychological distress were positively and Indian or Asian and White population groups were negatively associated with HHDA. Among women, middle age (25-34 year olds), Coloureds, residing on rural farms and urban areas, drug use and psychological distress were positively and older age (55 years and older), and Indians or Asians were negatively associated with HHDA. In adjusted logistic regression analysis, among men, having Grade 8-11 education, Coloureds, being unemployed, and HHDA were positively and middle and older age (25 years and older) and being a student or learner were negatively associated with past 3-month any drug use. Among women, Coloureds, Indians or Asians, and HHDA were positively and older age (45 years and older) was negatively associated with past 3-month and drug use. About one in ten participants engaged HHDA and any drug use, and several sociodemographic and health indicators were identified associated with HHDA and any drug use.

1) Background: Intellectual disability is more common in low- and middle-income countries than in high-income countries. Stigma and discrimination have contributed to barriers to people with intellectual disability accessing healthcare. As part of a larger study on caregiving of children with intellectual disability in urban Cape Town, South Africa, we interviewed a sub-group of families who had never used the intellectual disability services available to them, or who had stopped using them; 2) Methods: We employed a qualitative research design and conducted semi-structured interviews to explore the views and perspectives of parents and caregivers of children with intellectual disability who are not using specialised hospital services. We developed an interview guide to help explore caregivers’ and parents’ views; 3) Results: Results revealed that caregivers and parents of children with intellectual disability did not use the service due to financial difficulties, fragile care networks and opportunity costs, community stigma and lack of safety, lack of faith in services and powerlessness at effecting changes, and self-stigmatisation; 4) Conclusion: Current findings highlight a need for increased intervention at community level and collaboration with community-based projects to facilitate access to services, and engagement with broader issues of social exclusion.

Abstract The COVID-19 pandemic has tremendously affected the African continent and the rest of the world. Most businesses have closed and a lot of people have lost their jobs. The aviation industry has been shaken to the core with airlines losing millions of dollars and flights being cancelled. The tourism industry has consequently been affected due to restricted travel of tourists, impacting wildlife conservation and livelihoods. Schools, colleges and universities have been closed. The virus has infected millions of people and hundreds of thousands of people have died globally putting strain on health systems especially those of hard hit countries. Various countries all over the world have put measures to control the spread of the virus through lockdowns and social distancing policies. The reduced economic activities and mobility of people has resulted in improved air quality, cleaner water and beaches in some countries. However there are also negative impacts such as challenges in waste management, increased pharmaceutical and household waste and discovery of the corona virus in wastewater, a potential threat to public health. A considerable amount of research has been done on the socio-economic impacts of COVID-19 in Africa but there is still limited research on its impact on the environment. This paper serves to highlight the observed and potential environmental impacts of COVID-19 in Africa.

Introduction: Differentiated service delivery (DSD) models for antiretroviral treatment (ART) for HIV are being scaled up in the expectation that they will improve the quality and efficiency of treatment delivery and reduce costs while maintaining at least equivalent clinical outcomes. Even this minimum requirement of equivalent clinical outcomes is poorly documented for most models and settings, however. We reviewed the recent literature on DSD models to describe what is known about clinical outcomes. Methods: We conducted a rapid systematic review of peer-reviewed publications in PubMed, Embase, and the Web of Science and major international conference abstracts that reported outcomes of DSD models for the provision of ART in sub-Saharan Africa from January 1, 2016 to September 12, 2019. Sources reporting standard clinical HIV treatment metrics, primarily retention in care and viral load suppression, were reviewed and categorized by DSD model and source quality assessed. Results and Discussion: Twenty-nine papers and abstracts describing 37 DSD models and reporting 52 discrete outcomes met search inclusion criteria. Of the 37 models, 7 (19%) were facility-based individual models, 12 (32%) out-of-facility based individual models, 5 (14%) client-led groups, and 13 (35%) healthcare worker-led groups. Retention was reported for 73% of the models and viral suppression for 57%. Where a comparison with conventional care was provided, retention in most DSD models was within 5% of that for conventional care; where no comparison was provided, retention generally exceeded 80%. For viral suppression, all those with a comparison to conventional care reported a small increase in suppression in the DSD model; reported suppression exceeded 90% in 11/21 models. Analysis was limited by the extensive heterogeneity of study designs, outcomes, models, and populations. Most sources did not provide comparisons with conventional care, and metrics for assessing outcomes varied widely and were in many cases poorly defined. Conclusion: Existing evidence on the clinical outcomes of DSD models for HIV treatment in sub-Saharan Africa is limited in both quantity and quality but suggests that retention in care and viral suppression are roughly equivalent to those in conventional models of care.

This paper examines the asymmetrical relationship between exchange rate and consumer prices in 40 Sub-Saharan African (SSA) countries from 1990q1 to 2017q4. The exchange rate pass-through (ERPT) to consumer prices is estimated for each country by using the nonlinear autoregressive distributed lags (NARDL) framework and dynamic panel estimators robust to cross-sectionally correlated errors. Firstly, our findings suggest an asymmetrical ERPT in the SSA region during the short-term, whereas there are mixed results across sub-regions in the long-term. Next, we find incomplete and significant ERPT to consumer prices in the entire SSA region which is higher during the depreciation of the local currency than after appreciations. Third, we find nonlinear ERPT with respect to the size of the exchange rate. The pass-through is higher during large exchange rate changes than after small changes. Finally, we find that the pass-through is greater in the countries with fixed exchange rate regime (CFA franc zone) having low inflationary environment than in the other SSA countries with flexible exchange rate regime and high inflation levels. As a result, policymakers should take into account these asymmetries and non-linearities to improve the credibility of monetary policy, strengthen trade liberalization and establish competitive market structures in the Sub-Saharan region.

The unsustainability of the services related to water, sanitation and hygiene in informal settlements in Sub-Saharan Africa services is deeply embedded in current societal and governance structures, cultures and practices; it is context-dependent and involves numerous actors with different interests. The field of sustainability transitions research addresses such persistent and large scale societal challenges, with transition management being one of its widely applied governance approach. By drawing on an analysis of the root causes of unsustainability and unreliability of WASH services in three case studies in Sub-Saharan Africa (Arusha-Tanzania, Dodowa-Ghana, Kampala-Uganda), we explore how a transition management approach can be designed to support a transition towards sustainable Water, Sanitation and Hygiene (WASH) in Sub-Saharan Africa. We distinguish the following contextual dimensions related to the unsustainability of WASH services: a) Multiplicity of WASH practices, structures and arrangements, b) Governance capacities for WASH services and maintenance, c) Landownership for sustainable access to WASH, d) Public participation in decision-making related to WASH, e) socio-economic structures governing access to WASH. These dimensions prompt the identification of conceptual and application challenges for transition management. Based on these challenges, recommendations were formulated for the design of a prescriptive transition management process that is not only functional but also emancipatory of character.

This paper analyses the design and implementation of REDD+ in the West African region, an important global biodiversity area. Drawing on in-depth interviews, analysis of policy documents and observation of everyday activities, we sought to understand how REDD+ has been designed and implemented in Nigeria and Ghana. We draw on tools from political ecology to examine how, and why REDD+ takes the form it does in these countries. We focus on three key dimensions that emerged as strong areas of common emphasis in our case studies -- capacity building, carbon visibility, and property rights. First, we show that, while REDD+ design generally foregrounds an ostensible inclusionary politics, its implementation is driven through various forms of exclusion. This contradictory inclusion-exclusion politics, which is partly emblematic of the neoliberal provenance of the REDD+ policy, is also a contingent reality and a strategy for navigating complexities and pursuing certain interests. Second, we show that though the emergent foci of REDD+ implementation in our case studies align with global REDD+ expectations, they yet manifest as historically and geographically contingent processes that reflect negotiated and contested relations among actors that constitute the specific national circumstance of each country. We conclude by reflecting on the wider implications of these findings for understanding REDD+ implementation more broadly.

Packaged water consumption has grown rapidly in urban areas of many low and middle income countries, but particularly in Ghana. However, the sources of water used by this growing packaged water industry and its implications for water resource management and transport-related environmental impacts have not been described. This study aimed to assess the spatial distribution of regulated packaged water production in Ghana, both in relation to demand and for natural mineral water, to hydrogeological characteristics. 764 addresses for premises licenced to produce packaged water from 2009-2015 were mapped and compared to regional sachet water consumption and beverage import/export data examined. We find evidence to suggest packaged water is transported shorter distances in Ghana than in developed countries. For natural mineral waters, producers should be able to address the most widespread water quality hazards (including high salinity, iron and nitrates) in aquifers used for production through reverse osmosis treatment. The study suggests there is scope to integrate beverage product and groundwater regulatory databases to support groundwater management.

Accurate and consistent rainfall observations are vital for climatological studies in support of better planning and decision making. However, estimation of accurate spatial rainfall is limited by sparse rain gauge distributions. Satellite rainfall products can thus potentially play a role in spatial rainfall estimation but their skill and uncertainties need to be under-stood across spatial-time scales. This study aimed at assessing the temporal and spatial performance of seven satellite products (TARCAT (Tropical Applications of Meteorology using SATellite and ground-based observations (TAMSAT) African Rainfall Climatology And Time series), Climate Hazards Group InfraRed Precipitation with Station data (CHIRPS), Tropical Rainfall Measuring Mission (TRMM-3B43), Climate Prediction Center (CPC) Morphing (CMORPH), the Precipitation Estimation from Remotely Sensed Information using Artificial Neural Networks- Climate Data Record (PERSIANN-CDR), CPC Merged Analysis of Precipitation (CMAP) and Global Precipitation Climatology Project (GPCP) using gridded (0.05o) rainfall data over East Africa for 15 years(1998-2012). The products’ error distributions were qualitatively compared with large scale horizontal winds (850 mb) and elevation patterns with respect to corresponding rain gauge data for each month during the ‘long’ (March-May) and ‘short’ (October-December) rainfall seasons. For validation only rainfall means extracted from 284 rain gauge stations were used, from which qualitative analysis using continuous statistics of Root Mean Squared Difference, Standard deviations, Correlations, coefficient of determinations (from scatter plots) were used to evaluate the products’ performance. Results revealed rainfall variability dependence on wind flows and modulated by topographic influences. The products’ errors showed seasonality and dependent on rainfall intensity and topography. Single sensor and coarse resolution products showed lowest performance on high ground areas. All the products showed low skills in retrieving rainfall during ‘short’ rainfall season when orographic processes were dominant. CHIRPS, CMORPH and TRMM performed well, with TRMM showing the best performance in both seasons. There is need to reduce products’ errors before applications.

Abstract: Rice is one of the most important food crops in sub-Saharan Africa. Climate change, variability, and economic globalization threaten to disrupt rice value chains across the subcontinent, undermining their important role in economic development, food security, and poverty reduction. This paper maps existing research on the vulnerability of rice value chains, synthesizes the evidence and the risks posed by climate change and economic globalization, and discusses agriculture and rural development policies and their relevance for the vulnerability of rice value chains in sub-Saharan Africa. Important avenues for future research are identified. These include the impacts of multiple, simultaneous pressures on rice value chains, the effects of climate change and variability on parts of the value chain other than production, and the forms and extent to which different development policies hinder or enhance the resilience of rice value chains in the face of climatic and other pressures.