Fragile X syndrome (FXS) is a genetic disorder caused by a mutation in the fragile X messenger ribonucleoprotein 1 (FMR1) gene and known to be a leading cause of inherited intellectual disability globally. It results in a range of intellectual, developmental, and behavioral problems. Fragile X premutation associated conditions (FXPAC), also caused by a smaller CGG expansion (55 to 200 CGG repeats) in the FMR1 gene, is linked to other conditions that increase morbidity and mortality for affected persons. Limited research has been conducted on the burden, characteristics, diagnosis, and management of these conditions in Africa. This comprehensive review provides an overview of the current literature on FXS and FXPAC in Africa, epidemiology, clinical features and challenges faced, such as discrimination against affected persons, limited awareness and research, poor access to resources and genetic services and treatment. It further provides an in-depth analysis of the existing worldwide data for the diagnosis and treatment of these disorders. This review will improve understanding of FXS and FXPAC in Africa by incorporating existing knowledge, identifying research gaps, and potential topics for future research to enhance the well-being of individuals and families affected by FXS and FXPAC in the region.

(1)Background: Fascioliasis is considered a neglected tropical disease affecting an estimated 17 million people in more than 70 countries worldwide. The highest prevalence of human fascioliasis is found in regions where livestock farming and consumption of raw or undercooked freshwater plants are common, such as parts of Africa, Asia, Europe, and Latin America. It is responsible for over 90,000 disability-adjusted years of life due to associated abdominal complications. We conducted a study to investigate the prevalence of human fascioliasis through a systematic review and meta-analysis of all available literature in Sun-Saharan Africa.(2). Methods: We screened a total of 126 publications using pubmed online search engine databases; Web of Science and CAB for articles published within a 20-year period between 2000 and 2022. We used a comprehensive search method using a combination of terms, parasite and disease names. The initial search resulted in a screening of articles by title, abstracts and full texts. The relevant information on the prevalence of human fascioliasis in Africa was extracted. Of the 126 publications, 33 articles were selected for meta-analysis. The essential information required was extracted from these documents and determined through statistical analysis in Microsoft Excel for calculating the prevalence of human fascioliasis in sub-Saharan Africa. The variance of each study was assessed using a bimodal distribution and heterogeneity assessment using a I2 index. Analysis was performed using random effects models.(3)Results: A total of 271 articles were searched through the database search and 33 articles were eligible studies that provided qualitative information on the prevalence of human fascioliasis in Africa. These make up 12.17% (n=33). The pooled prevalence estimates for human fascioliasis are 0.032% (IVhet PPE: 0.032% (95%CI 1.4-6.53). The highest prevalence rate was observed in Egypt with a prevalence of 100%. The prevalence of human fascioliasis is very high in some sub-Saharan countries, partly due to neglect of diagnostics, demonstrating the bias of available information for decision-making in human fascioliasis across Africa, given the spatial presence, scarcity and incompleteness are region.(4)Conclusions: The prevalence of Human fascioliasis is very high in some Sub-Saharan Countries partly due to neglect in diagnostics. This presents how highly focal with spatial occurrences, scarcity and patchy the available information for decision making is on Human fascioliasis across the Sub-Saharan African region.

Two decades after the antiretroviral therapy (ART) introduction, several challenges still prevail in maintaining people living with HIV (PLHIV), even with "Test and Treat" and/or "Rapid Start of ART" initiatives, as well as the scale-up of ART worldwide to promote access and adherence to treatment. This review examined articles on ART adherence in Africa between 2016 and 2023, published in English and indexed in PubMed. A total of 16 articles out of 2415 were eligible and included for analyses. Overall, ART adherence rates in SSA regions ranged from 43% to 84%. Rates in the centre of the SSA region ranged from 58% to 80%, in the north from 50% to 83%, in the south from 77% to 84%, in the west from 43% to 60% and in the east from 69% to 73%. Most African countries use the self-report to assess treatment adherence, although unreliable. The main factors with negative influence on ART adherence were comorbidities, lack of motivation, socioeconomic difficulties or side effects. Conclusion: Adherence to ART is a good indicator for controlling the spread of HIV. It is important to overcome the barriers that make it difficult to comply with ART and reinforce the factors that facilitate the accession of medication.

This manuscript reviews two decades of projects funded by the Kirkhouse Trust (KT), a charity registered in the UK. KT was established to improve the productivity of legume crops important in African countries and in India. KT’s requirements for support are: 1) the research must be done by national scientists in their home institution, either a publicly funded agricultural research institute or a university; 2) the projects need to include a molecular biology component, which to date has mostly comprised the use of molecular markers for the selection of one or more target traits in a crop improvement programme; 3) the projects funded are included in consortia, to foster the creation of scientific communities and the sharing of knowledge and breeding resources. This account relates to the key achievements and challenges, reflects on the lessons learned and outlines future research priorities.

Abstract: The study used whole-genome sequencing (WGS) and bioinformatics analysis for the genomic characterization of 60 isolates of Listeria monocytogenes isolated from cattle farms, cattle abattoirs, and retail outlets in Gauteng province, South Africa. The isolates' sequence types (STs), clonal complexes (CCs), and lineages were determined using in silico multilocus sequence typing (MLST). We used BLAST-based analyses to identify virulence and antimicrobial genes, plasmids, proviruses, and the CRISPR-Cas system. The study investigated any association of the detected genes to the origin in the beef production chain of the L. monocytogenes isolates. Overall, in 60 isolates of Listeria monocytogenes, there were 7 STs, 6 CCs, 44 putative virulence factors, 2 resistance genes, 1 plasmid with AMR genes and 3 with conjugative genes, 1 CRISPR gene, and all 60 isolates were positive for proviruses. Among the 7 STs detected, ST204 (46.7%) and ST2 (21.7%) were the most prominent, with ST frequency varying significantly (p<0.001). The predominant CC detected were CC2 (21.7%) and CC204 (46.7%) in lineages I and II, respectively. Of the 44 virulence factors detected, 26 (across Listeria Pathogenicity Islands, LIPIs) were present in all the isolates. The difference in the detection frequency varied significantly (P<0.001). The two AMR genes (fosX and vga(G)) detected were present in all 60 (100%) isolates of L. monocytogenes. The only plasmid, NF033156, was present in 3 (5%) isolates. A CRISPR-Cas system was detected in 6 (10%), and all the isolates carried proviruses. Significant differences were detected in the frequencies of STs and virulence factors regarding the source and sample type of the L. monocytogenes isolates. The presence of both fosX and vga(G) genes in all the isolates from the three industries (cattle farms, abattoirs, and retail outlets) can potentially cause therapeutic implications. Our study, which characterized L. monocytogenes recovered from the three levels in the beef production chain in the country, provides the first evidence of the distribution of the pathogen with potential food safety and therapeutic implications.

This study examines the complex relation among environmental taxes, productive capacities, urbanization, and their collective effects on environmental quality in Africa, drawing on two decades of data from twenty African countries. It situates the study within the broader discourse on sustainable development and economic growth, emphasizing the Environmental Kuznets Curve (EKC) framework to examine the relationship between economic development, characterized by urban expansion and increased productive capacities, and the adoption of environmental taxes amidst the continent’s diverse economic and environmental environments. Using advanced econometric techniques, including the Cross-Section Augmented Autoregressive Distributed Lag (CS-ARDL) model and the Dynamic Common Correlated Effects Mean Group (DCCEMG) estimator, the study addresses data challenges such as cross-sectional dependence and slope heterogeneity. The results provide important insights into the dynamics of environmental quality in relation to economic and urban growth and the role of environmental taxation. The study proposes tailored policy strategies aimed at strengthening sustainable development initiatives in line with international agreements such as the Paris Agreement and the Sustainable Development Goals. These strategies advocate for a nuanced application of environmental taxes and the promotion of productive capacities to enhance environmental sustainability across the African continent.

Maize is an important staple food crop in sub-Saharan Africa (SSA). However, the average grain yield on farmers’ fields falls considerably short of the demand of the region’s population. In addition, the normal endosperm maize widely consumed in SSA is deficient in vitamin A. Drought, a consequence of climate change, is a major constraint to maize production, resulting in seasonal low grain yield in farmers’ fields. The objectives of this study were to assess the performance of newly developed extra-early maturing provitamin A hybrids under managed drought and well-watered conditions, compare the outcomes of multiple trait base-index and multi-trait genotype-ideotype distance index selection procedures, and identify drought-tolerant hybrids with stable performance across contrasting environments for commercialization in SSA. One hundred and ninety provitamin A hybrids and six checks were evaluated under managed drought and well-watered conditions at Ikenne for two seasons between 2021 and 2023. A 14*14-lattice design was used for the field evaluations under both research conditions. Drought stress was achieved by the complete withdrawal of irrigation water 25 days after planting. Results revealed significant differences among the hybrids under drought and well-watered conditions. Grain yield, ears per plant, and plant aspect under managed drought were correlated to the same traits under well-watered conditions suggesting that the expression of these traits is governed by common genetic factors. Twenty-nine hybrids were identified as top-performing drought-tolerant hybrids by the multiple trait base index and multiple-trait genotype–ideotype distance index. Of the selected outstanding 29 hybrids, 34% were derived from crosses involving the tester TZEEIOR 197, demonstrating the outstanding genetic potential of this inbred line. Further analysis of the 29 selected hybrids revealed TZEEIOR 509 × TZEEIOR 197 as the hybrid that combined the most drought-tolerant adaptive traits. However, the hybrids TZEEIOR 526 × TZEEIOR 97, TZEEIOR 384 × TZEEIOR 30, TZEEIOR 515 × TZEEIOR 249, TZEEIOR 510 × TZEEIOR 197, TZEEIOR 479 × TZEEIOR 197, and TZEEIOR 458 × TZEEIOR 197 were identified as the most stable hybrids across drought and well-watered conditions. These hybrids should be extensively tested in multi-location trials for deployment and commercialization in SSA.

Background: Several studies recently confirmed the emergence of resistance to antimalarial drugs in sub-Saharan Africa. Multiple first-line treatment (MFT) is one of the measures envisaged to respond to the emergence and spread of this resistance. The aim of this study was to identify perceived advantages and disadvantages of several MFT deployment strategies and to better understand potential implementation drivers and barriers. Methods: A qualitative survey was conducted in seven sub-Saharan countries amongst key opinion-leaders, national decision-makers, and end users. A total of 200 individual interviews were conducted and findings were analyzed following a thematic inductive approach. Results: From a policy perspective, the new MFT intervention would require endorsement at the global, national, and regional levels to ensure its inclusion in guidelines. Funding of the MFT intervention could be a bottleneck due to costs associated with additional training of healthcare workers, adaptation of drug delivery mechanisms, and higher costs of drugs. Concerning the MFT deployment strategies, a slight preference for the segmentation strategy was expressed over the rotation and geographic approaches, due to the perception that a segmentation approach is already in place at country level. Conclusions: The findings highlighted the need for a collective approach to MFT deployment through the engagement of stakeholders at all levels of malaria management.

Background: Schistosomiasis is the third most important Neglected Tropical Disease, with more than 4 million South Africans being infected. Cases of re-infection with schistosomiasis after being treated using modern medication has opened ways to seeking alternative treatment modalities using medicinal plants. This study aims to explore and understand the way traditional healers diagnose schistosomiasis, the types of traditional medicines they use to treat it in communities with a high prevalence of infection, and to establish whether the unavailability of prescribed anti-schistosomal medicines leads to the use of traditional medicine. Methods: A qualitative exploratory study was conducted using a questionnaire from December 2022 to March 2023 in the iLembe District, KwaZulu-Natal Province, South Africa. In-depth individual interviews were carried out among traditional health practitioners (THPs) involved in managing female urogenital schistosomiasis (FUS). Recorded narrative data was transcribed verbatim, read through thoroughly and coded, and analysed using thematic or content analysis Results: Traditional Health Practitioners provide services to many women who did not want to be treated in the mainstream health care system for their FUS. The disease was perceived and understood the same way by most of the respondents, that being caused by use of fresh water. Various plants species, either alone or in combination, were used to manage bilharzia in women. Senecio serratuloides (Asteraceae) and Hypoxis hemerocallidea (Hypoxidaceae) were prominently used by THPs in FUS management. Conclusion: Traditional Health Practitioners are playing a key role in managing bilharzia in women in rural areas of the iLembe District, this study reported that THPs can diagnose schistosomiasis symptoms based on their knowledge and experience. Respondents indicated that modern conventional treatment was readily available and free in public sector healthcare facilities; however, they consulted patients suffering from FUS. Various traditional herbal medicines are reportedly used by THPs to manage bilharzia in women. Further studies are needed to investigate the views and experiences of clients regarding the success of the treatments used and why they seek care from THPs.

Hepatitis C virus (HCV) is a major public health threat associated with serious clinical consequences worldwide. The WHO reports an estimated 58 million people globally living with chronic hepatitis C virus (HCV) infection, with 1.5 million new cases and over 350,000 deaths annually due to HCV-related diseases. Despite the existence of multiple diagnostic methods, the accessibility of diagnosis and treatment is often hindered across the continent by limited resources, insufficient healthcare infrastructure, and low public awareness of Hepatitis C virus Hepatitis C virus infection is a major public health concern in African countries, which have the highest prevalence rates of HCV in the world (1–26%). Egypt, African country which had the highest prevalence of Hepatitis C virus infection in the world. Its national hepatitis C elimination initiative emerges as an exemplary case of success an having screened over 60 million individuals, and treated more than 4 million, thereby markedly diminishing both the prevalence and incidence of the disease. The strategies employed by Egypt offer critical insights and adaptable frameworks for other African Countries facing analogous challenges. The Aim of this Review is to highlight the triumphs and hurdles of Egypt's approach, while also providing strategic guidance for African Countries to accelerate the journey towards the eradication of hepatitis C.

This paper provides a study on the development of solar energy, its prospects, and its impacts in Africa. Although the main focus is on technologies adopted for different uses (solar farms, mini-grids, off-grid, solar houses, irrigation, lighting, etc.), we also consider some aspects that increase the adoption of solar energy, such as legislation and business models. Finally, we will examine current and future solar projects managed by NGOs and international companies and how they benefit to leveraging social and economic standards, quality of life as well as capacity building in Africa. This study shows the plethoric interest of institutions outside Africa in the market of solar energy in the continent and that there is no African strategy to increase its independency toward a sustainable development particularly through energy transition.

(1) Background: We aimed to determine the prevalence of hepatitis B virus (HBV) resistance-associated mutations (RAMs) in people with HBV and human immunodeficiency virus (HBV/HIV) in Botswana. (2) Methods: We sequenced HBV from participants with HBV/HIV from the Botswana Combination Prevention Project study (2013-2018) using the Oxford Nanopore GridION platform. Consensus sequences were analyzed for genotypic and mutational profiles. (3) Results: Overall, 98 HBV sequences had evaluable reverse transcriptase region coverage. The median participant age was 43 years (IQR: 37, 49) and 66/98 (67.4%) were female. Most participants, 85/97 (87.6%) had suppressed HIV viral load (VL). HBV RAMs were identified in 61/98 (62.2%) participants. Most RAMs were in positions 204 (60.3%), 180 (50.5%) and 173 (33.3%), mostly associated with lamivudine resistance. The triple mutations, rtM204V/L180M/V173L and was the most predominant (17/61 [27.9%]). Most participants (96.7%) with RAMs were on antiretroviral therapy for a median duration of 7.5 years (IQR: 4.8, 10.5). Approximately 27.9% (17/61) of participants with RAMs had undetectable HBV VL, 50.8% (31/61) had VL <2000IU/mL and 13/61 (21.3%) had VL ≥2000 IU/mL. (4) Conclusions: The high prevalence of lamivudine RAMs discourages the use of ART regimens with 3TC as the only HBV-active drug in people with HIV/HBV.

Adherence is vital for medicine to have an effect, yet adherence is considered to be low. However, research into adherence tends to focus on quantitative analysis of performance, something which fails to perceive how people are adherent in their many different environments. As a contribution to gaining a deeper understanding, interviews were held with 30 individuals in UK, Egypt, Kazakhstan and 6 countries in sub-Saharan Africa to understand their perceptions on adherence for a range of drugs, and these were compared with an existing well-regarded list. New reasons for non-adherence were discovered, and a new viewpoint on adherence derived which considers adherence to be a single act and therefore as an individual opportunity to be adherent, permitting greater focus on the enablers and inhibitors of adherence at a point in time.

Introduction Livestock abortigenic agents, which are microorganisms that lead to premature foetal death and expulsion before completion of the gestation period, are common in Africa and Asia. Abortion events cause economic losses by lowering reproduction (and hence herd/flock sizes) and effects on milk production. Despite the importance of livestock production for food security and livelihoods of millions of the world’s poorest communities, very little is known about the scale, magnitude or causes of livestock abortion in Africa. The aim of this review was to determine the current status of the burden of livestock abortion and surveillance measures adopted for livestock abortigenic pathogens in Africa and Asia, and to explore feasible surveillance technologies. Methodology A systematic literature search was conducted using Preferred Reporting of Systematic Reviews and Meta-analyses (PRISMA) guidelines in four databases for studies published between 1 Jan 1990 and 31 July 2021 that reported epidemiological surveys of livestock abortigenic pathogens in cattle, goats and sheep in Africa and Asia including; Brucella spp., Neospora caninum, Toxoplasma gondii, Rift valley fever virus, Coxiella burnetii, Chlamydia, Leptospira and Bovine viral Diarrhoea Virus. A meta-analysis was used to estimate the species-specific prevalence of the abortigenic diseases and the region where they were detected. Results In the systematic literature search, 48 full papers were included which in total included 50 species-specific surveillance reports from Africa and 19 from Asia. Adjusted median seroprevalence calculations estimated Brucella at 6.85% (range 1.2-11.6) of 9071 sheep, 3.35% (range 0.90-5.40) of 17,007 goats, 8.95% (range 0.50-63.60) of 171,733 cattle, Neospora at 6.80% (range 6.80 -6.80) of 555 sheep, 10.80 (range 10.80-10.80) of 185 goats, 12.65% (range 3.40- 25.60) of 3775 cattle, Toxoplasma at 27.50% (range 1.40 – 75.90) of 2284 sheep, 32.0% (range 20.00- 64.80) of 1226 goats, 7.50% (range 7.50 - 7.50) of 174 cattle, Coxiella at 9.20 (range 9.20 – 9.20) of 184 sheep, 24.20% (range 24.20-24.20) of 91 goats, 13.80% (range 13.80-13.80) of 217 cattle, Rift valley fever virus at 7.70 (2.40-40.00) of 874 sheep, 20.95 (range 2.50-40.00) of 547 goats, 7.45% (range 3.60-11.30) of 309 cattle, Bovine viral diarrhea virus at 78.90 (range 78.90 – 78.90) of 398 cattle, Leptospira at 70.50 (range 70.50 – 70.50) of 373 cattle and Chlamydia at 6.60 (6.60-6.60) of 803 sheep. We found that most studies, 45 (89%) used serological surveys, 1 (2%) used molecular and 1 (2%) reported to have used Mobile-phone based surveillance approach. Three studies (6.25%) of the 48 included were embedded in the national surveillance programs of the respective countries they were conducted, majority 89% were stand-alone cross-sectional studies. Conclusion In conclusion, livestock abortigenic pathogens are still a burden in many African and Asian countries.

Background: This qualitative systematic review protocol aims to explore the experiences of African customers in white-owned restaurants and hotels in post-apartheid South Africa, focusing on the dynamics of service interactions and their implications for racial relations within the hospitality industry. Despite the end of apartheid in 1994, the echoes of historical racial disparities and power imbalances persist, potentially influencing customer experiences in this sector, particularly in establishments owned by individuals of European descent. In view of above, the research question for this study is “How do African customers in white-owned restaurants and hotels in post-apartheid South Africa perceive and experience service interactions, and what are the underlying factors influencing these perceptions, considering historical power imbalances, societal perceptions, lingering effects of apartheid, inclusive practices, and the varied experiences across different hospitality establishments? Study Objectives: Objectives include examining the dynamics of service interactions, identifying factors influencing perceptions and experiences, evaluating alignment with inclusive practices and post-apartheid ideals, and describing African customers' experiences regarding service. Methods: The study will employ the SPIDER Framework to craft a nuanced research question that seeks to understand how African customers perceive and experience service interactions in these settings, considering historical power imbalances, societal perceptions, the lingering effects of apartheid, inclusive practices, and varied experiences across different types of hospitality establishments. This approach aims to dissect the intricate interplay of historical, societal, and economic factors that shape these experiences, providing insights into the complexities of achieving a truly inclusive and equitable hospitality landscape in post-apartheid South Africa. Expected Contribution to knowledge and practice: This review will contribute to a deeper understanding of the challenges and opportunities facing the hospitality industry in fostering environments that reflect the nation's diversity and commitment to reconciliation and social cohesion. By highlighting the lived experiences of African customers and examining the extent to which white-owned establishments embody post-apartheid ideals, this study aims to offer valuable recommendations for industry practitioners and policymakers to promote cultural sensitivity, equity, and inclusivity, thus enhancing the role of the hospitality industry in South Africa's broader societal transformation.

Cameroon introduced the malaria vaccine in its routine immunization programme on 22 January 2024, in the 42 districts out of 200, among the most at risk of malaria. A cross-sectional analysis of data on vaccine key events in the introduction roadmap and vaccine uptake during the first 30 days was conducted. In addition to available gray literature related to the introduction of the malaria vaccine, data on malaria vaccine uptake by vaccination session, collected through a digital platform, were analyzed. A total of 1,893 reports were received from 22 January 2024 to 21 February 2024 from 766 health facilities (85% of overall completeness). Two regions out of 10 recorded less than 80% of completeness. As of 21 February 2024, 13,811 children have received the first dose of the malaria vaccine, including 7,124 girls (51.6%) and 6,687 boys (48.4%). Thirty six percent of children were vaccinated through outreach sessions versus 61.5% through sessions in fixed posts. The overall monthly immunization coverage with the first dose was 37%. Early results have shown positive attitudes towards and acceptance of malaria vaccines. Suboptimal completeness of data reporting and low coverage highlight persistent gaps and challenges in vaccine rollout.

The availability of current land cover and land use (LCLU) information for monitoring the status of land resources has considerable value in ensuring sustainable land use planning. Similarly, the need to provide updated information on the extent of LCLU change in West Africa has become apparent, given the increasing demand for land resources driven by the rapid population growth in the sub-region. SERVIR West Africa, a regional consortium jointly supported by USAID and NASA to foster the use of geospatial and earth observation data and science for decision-making on critical environmental and food security challenges, in collaboration with the Food and Agriculture Organization of the United Nations (FAO), is building technical capacity in the sub-region to develop and implement harmonized regional land cover classification system for LULC change monitoring in West Africa, based on the Land Cover Meta Language (LCML-ISO 19144-2). This article focuses on the process, potential opportunities, outputs of this collaboration, exemplary use cases, and recommendations for the next steps.

The African continent has the highest prevalence of hypertension globally, with South Africa reporting the highest prevalence in Southern Africa. While the influence of genetic variability in the pathogenesis of hypertension is well described internationally, limited reports are available for African populations. This study aimed to assess the association of genetic variants and essential hypertension in a cohort of two ethnic South African population groups. Two hundred and seventy-seven hypertensive and one hundred and seventy-six normotensive individuals were genotyped for 79 variants. Genotyping was performed using the Illumina GoldenGate Assay and allele-specific polymerase chain reaction. The association of variants was assessed using the Fisher Exact test under the additive and allelic genetic models, while multivariate logistic regression was used to predict the development of hypertension. Five variants (CYP11B2 rs179998, AGT rs5051 and rs699, AGTR1 rs5186 and ACE rs4646994) were significantly associated with essential hypertension in the cohort under study. Furthermore, AGTR1 rs5186 and AGT rs699 were identified as risk factors for the development of hypertension in both ethnic groups. In two ethnic South African populations an association was observed between Renin-Angiotensin-Aldosterone System (RAAS) related genes and the development of hypertension.

Antimicrobial resistance (AMR) is a worldwide healthcare problem. Multidrug resistant organisms (MDRO) have the ability to spread quickly owing to their resistance mechanisms. Although colonized individuals are crucial MDRO dispensers, colonizing microbes have the potential to turn pathogenic under certain conditions, leading to symptomatic infections in carriers. Carbapenemase producing Enterobacterales (CPE) are among the most important MDRO involved in infections and colonizations, associating with multiple resistance mechanisms and virulence factors, causing infections with severe outcomes. All research papers identified in the most comprehensive online databases which contained information related to the topic of this article were analyzed, and relevant data was extracted and included. The first information on CPE could be traced back to the mid-2000s, but pertinent data for many African countries was established in the past 5-8 years. Information is presented chronologically for each country. Although no clear conclusions could be drawn for some countries, it was observed that CPE colonizations are present in most African countries and carbapenem-resistance levels are rising. The most common CPE involved are Klebsiella pneumoniae and Escherichia coli, and the most prevalent carbapenemases are NDM-type and OXA-48-type enzymes. Prophylactic measures, such as screening, are required to combat this phenomenon.

Health communication has been highlighted as a cost-effective preventive intervention in Africa where prevalence of tobacco use is still relatively low compared to other World Health Organization (WHO) regions. This scoping review aims to examine tobacco control health communication interventions in Africa. The review was guided by the PRISMA-ScR checklist. Data was extracted from twenty peer-reviewed papers, WHO Global Health Observatory on Anti-tobacco mass media campaigns for 54 African countries, and six WHO Framework Convention on Tobacco Control reports on Article 12. Data extraction informed by JBI data extraction questions was used for peer review studies while a pre-determined template was used for the other sources. Narrative data synthesis informed by the JBI manual for evidence synthesis was employed. Lack of research that comprehensively address all areas of health communication and Inconsistent use of health communication campaigns was identified. Only an average of 6 countries had ever implemented effective mass media campaigns in a decade while an average of 33 countries consistently failed to conduct campaigns that lasted more than 3 weeks. Although the involvement of key populations was clearly vital to ensure content relevance and message clarity; a lack of health communication informed by young people was observed as they rarely participated in key decision-making despite reportedly being targets of interventions. Clear health communication for tobacco use prevention informed by young people is lacking in African countries. Active participation of young people in developing targeted campaigns is needed to facilitate content relevance and comprehension to ultimately contribute to tobacco use prevention.

Globally, the need for sustainable urban development has never been more urgent than now. This is because estimates indicate that more than half of the global population will be living in urban areas by 2050, with South Africa estimated at 80%. This paper focuses on socio-economic nuances that impede sustainable urban development, as well as the strategies that can accelerate sustainable urban development in South Africa. Through a literature review methodology, the analysis identified the following issues as impediments to sustainable urban development in South Africa, informal settlements and businesses, lack of consultations with urban citizens, unresolved apartheid legacies, violence, crime and insecurity, and migration and immigration intricacies in South Africa. The paper also established the strategies to accelerate sustainable urban development as working with informality and against it, promoting inclusivity and access to resources, formulating, and accelerating policy reforms, investing in rural areas and towns, and finally investing in superior technology and innovation. These findings imply that there is a need to seek alternative development models and approaches, to address social challenges such as poverty, unemployment, and poor housing, aspects that impact negatively on urban development planning and sustainable development. This is because the major challenges to sustainable urban development are human-related challenges, that need social and economic solutions. There is also a need to reduce rural-urban migration by developing rural towns to ease pressure in major towns which are already spilling over.

Seafood, especially from the ocean, is now seen as a greener and more sustainable source of protein causing an increase in its demand. This has also led to people making choices towards seafood as a replacement of carbon intensive protein sources. As a result, the demand for seafood is growing, and the Aquaculture industry is required to increase their produce while keeping the produce safe and sustainable. There are many challenges faced by the aquaculture industry in meeting these increased demands. One such challenge is the presence of harmful algal blooms (HAB) in the ocean which can have a major impact on aquatic life. In this paper we look at the impact of this challenge on aquaculture and the mitigating strategies. We will focus on Abagold Limited, a land-based marine aquaculture business that specializes in large scale production of abalone (Haliotis midae) based in Hermanus, South Africa. HABs are considered a threat to commercial scale abalone farming along the South-African coastline and requires continuous monitoring. The most recent HAB was in February-April 2019, the area experienced a severe red-tide event with blooms of predominantly Lingulodinium polyedrum. We present some of the mitigation strategies employing digital technologies for future proofing the industry.

Africa is a home to growing number of biosafety organisations that work to enhance public health in their nations by bringing attention to the significance of biosafety and biosecurity. Since many African countries are low-resource countries, they frequently confront a number of obstacles that seriously limit their ability to create or grow a sustainable capacity for managing biosafety and biosecurity. The goals of biosecurity and biosafety protocols are to reduce both intentional and unintentional biological risks that could have disastrous effects on a nation's health system, agriculture, security, political and economic stability. Regrettably, on a national, regional, and international level, biosecurity and biosafety are frequently given insufficient priority.Eventhough, Africa are home to a growing number of biosafety organisations that work to enhance public health in their nations by bringing attention to the significance of biosafety and biosecurity, Standard Biosafety and Biosecurity Measures to contain hazardous infections are missing across the African continent. In this paper the current state, challenges, and future prospects of biosafety and biosecurity status of African nations discussed.

Background Although COVID-19 outcomes vary between and within countries, there is little published data on how aspects of social determinants of health (SDoH) affect COVID-19 outcomes in the African context. Objective The current study set to examine COVID-19 case and death rates and their correlates among African countries using data from different sources. Methods An ecological cross-sectional study comprising 28 African countries with a recent Demographic and Health Survey, DHS (2010-2018). Response variables were COVID-19 case and death rates (as of August 15, 2020). Covariates comprised three healthcare systems measures; rates of hospital beds (2005-2017), ventilators (2020) and doctors (2010-2018) per 10,000 population, and 9 broad topics common to multiple SDoH frameworks aggregated to the country level; geography (urban residence), wealth index, education, employment, crowding, and access to information. Rates per 10,000 population were calculated for healthcare measures and mapped for visualization. A Negative Binomial regression was used to assess whether aspects of SDoH are correlated with COVID-19. Results Our analysis indicated that 1 in 4 (25.1%) households in study countries are without clean water and handwashing access. Country-level health system capacity (hospital beds, ventilators, and medical doctors) varied considerably between the countries. Negative Binomial regression showed that the odds of COVID-19 morbidity and death was higher in countries with a high proportion of households without access to quality water and doctors per 10,000 people. Having a high proportional of educated women (1.003: 95% CI, 1.001 – 1.005), hospital beds per population and less people per room (0.959: 95% CI, 0.920 – 1.000) was negatively correlated with COVID-19 deaths while being insured and owning a mobile phone was correlated with illness. Conclusion Both aspects of SDoH and healthcare system contribute either negatively or positively to COVID-19 outcomes. Addressing healthcare system capacity and economic and environmental SDoH will be critical for mitigating the spread of COVID-19 and re-emerging diseases on the African continent.

Keywords: Demographics, Diversity, Gender, Race, Age, Professionals, Built Environment, Construction Industry, South Africa

The prevalent use of synthetic chemical rodenticides (both 1st or 2nd generation anticoagulants and acute rodenticides) is the primary method for managing rodents in sub-Saharan Africa. However, this practice poses substantial health and environmental risks and often fails to yield significant, sustainable reductions in rodent pest populations. In this paper, the second one of a two-part series, we advocate for a more responsible and sustainable approach to rodent management in urban and agricultural settings in sub-Saharan Africa. We propose a shift towards environmentally friendly rodent management strategies, specifically emphasizing the adoption of Ecologically-Based Rodent Management (EBRM) as a viable alternative to synthetic chemical rodenticides. EBRM relies on a comprehensive understanding of pest rodent biology, ecology, and behavior, along with the implementation of a range of community-based interventions. These actions are designed to ensure the consistent reduction of rodent pest populations to economically and hygienically acceptable levels. By embracing EBRM, we not only anticipate a reduction in the social impacts of pest rodents in a cost-effective manner but also a significant decrease in the risks posed by rodents and synthetic chemical rodenticides to human health and the environment. This paradigm shift towards EBRM promises a more sustainable and responsible approach to rodent management in sub-Saharan Africa.

Natural radioactivity of 238U, 232Th and 40K for liquid and solid samples collected from Sidi Salem dam (Tunisia) and Aïn Dalia dam (Algeria) were measured using TERRA detector of rays (gam-ma, beta, and alpha), Atomic adsorption and Gamma-ray spectrometry were used to analyze the levels of radionuclides and toxic heavy metals, respectively. Toxic heavy metals (Fe, Bb, Zn, Ni, Cu, Cr and Cd) and associated health risks in surface water and sediment of dams have been in-vestigated in this present study. The radioactivity mean rates in the water samples were 1.72±0.01, 0.068±0.01 and 94.6±1.04 Bql-1 for 238U, 232Th and 40K respectively (Tunisia dam) and were 1.9± 0.24, 0.09±0.01 and 131.43±1.03 Bql-1 for 238U, 232Th and 40K respectively (Algeria dam). The 238U, 232Th and 40K radioactivity mean concentration measured in the sediment samples were 2.67±0.01, 0.18±0.012 and 197.87±2.01 Bqkg-1 respectively (Tunisian dam) and were 4.34±0.05, 0.27±0.05 and 287.61±3.34 Bqkg-1 respectively (Algeria dam). The activity concentration of 40K was higher than that of 238U and 232Th for the water and sediment samples. The mean activity concen-trations follow the order 40K > 238U > 232Th. The cumulative impact can be a serious immediate radiological health burden on the ecosystem, environment and people's health in this study area and can be transposable to any other similar region. The good knowledge of monitoring quality and quantity for the transboundary water resources and the international collaborations are es-sential to safeguard human health (women’s breasts cancer, thyroid cancer, neurological im-pact…), and avoid the conflicts, especially during these climatic upheavals of drought.

Agricultural productivity is expected to decrease under changing climate conditions that correspond to the stability of West African food systems. Although numerous studies evaluated food production gaps or impacts of climate variability on crop yields, many uncertainties are associated with climate extremes, but also rapid population growth and the corresponding dietary lifestyle determine farming activities. Here, we present a food supply and demand analysis based on the relationship between climate change, crop production, as well as population growth in three experimental sites from southwestern Burkina Faso to southwestern Ghana. The method consists of a tiered approach that encompassed a statistical analysis of historical climate as well as agricultural time series using boxplots and a trend test by Mann-Kendall. Food balance sheets were calculated by estimating the demand using a population growth model linked to food supply with local consumption patterns. Results of the boxplot analysis revealed for the majority of climate time series light to strong right-skewed distributions with either a few heavy rainfall or hot temperature events. We found almost insignificant rainfall and temperature trends for both sites in the Sudano-Guinean savannah. The rainfall regime of southwestern Ghana indicated an insignificant upward or downward trend while the temperature significantly increased over time. Crop yield boxplots demonstrated mainly right-skewed distributions for cereals, legumes and tubers as well as cash crops such as cotton. Backed by the Mann-Kendall test, maize and sorghum significantly enhanced in both study areas of the Sudano-Guinean savannah. Southwestern Ghana depicted a different crop pattern where cassava and plantain showed a strong upward trend at a confidence level of 1%. The grouped food balances sheets across the regions illustrated a surplus for the Sudano-Guinean savannah ranging from 221.2 megatons (Mt) to 4,846.77 Mt while southwestern Ghana exhibited a deficit between -193.33 Mt and -16,188.82 Mt. Despite a growing yield of various crops, food demand outpaces the regional production. Hence, it is recommended to focus on a larger array of commodities, imports and marketing of farm products.

On February 28, 2023, the Facebook page of the United Nations Children's Fund (UNICEF) South Africa, announced the beginning of the HPV vaccination campaign for 2023. The aim of this study was to examine the attitudes of Facebook users, who commented on the UNICEF South Africa post, towards HPV vaccination to inform the development and implementation of interventions that can increase HPV vaccine acceptance and uptake. Several comments were questions regarding the eligible criteria for vaccination, side effects, consent form, and vaccination strategies. Many Facebook users were hesitant towards HPV vaccination due to various reasons including concerns around side effects, religious beliefs, vaccine stock outs, and their distrust in the institutions or systems involved in vaccination programmes. Few users accepted HPV vaccination because they believed that it was very important thing to do, beneficial for the children’s health, and they have vaccinated they children before. Our findings of the current study contribute to the promotion of acceptance and uptake of HPV vaccination by developing and implementing interventions tailored to address identified barriers that are associated with hesitant to HPV vaccination.

Food and nutrition insecurity, affecting 30% of the global population in 2020, poses a significant challenge to achieving Sustainable Development Goal (SDG) 2 - Zero Hunger. Urbanization, particularly in sub-Saharan African cities e.g. Lagos, Nigeria, exacerbates these issues, impacting resources and contributing to informal settlements. There is emphasis on innovative solutions in urban farming, with Recirculating Aquaculture Systems (RAS) emerging as one of the promising approach due to its efficiency in space and capital utilization. However, maintaining optimal conditions in RAS, crucial for SDG 2 and 11, requires robust water quality monitoring. This study explores the availability of digital tools for water quality monitoring in small-scale urban RAS, evaluating handheld devices and IoT sensors' reliability through t-test statistical method. The results aim to guide practitioners in selecting effective monitoring tools, contributing valuable insights for sustainable aquaculture in urban areas, particularly in sub-Saharan Africa, where access to affordable digital solutions is pivotal for success and can attract youth to agri-food technologies.

In livestock, brucellosis is mainly an asymptomatic disease except for abortion, therefore two serological tests are used for diagnosis as no single test is suitable. Abattoir samples enable a combination of culture, molecular and serological tests to detect brucellosis. This study assessed Brucella specific PCR (ITS-PCR) to detect brucellosis and to conduct molecular characterization of Brucella spp. isolated from PCR-positive livestock (n=565) slaughtered at abattoirs and the appropriate sample tissue(s). ITS-PCR detected Brucella DNA in 33.6% cattle, 14.5% sheep and 4.7% pig tissues. Impure Brucella cultures from PCR-positive tissues were 43.6% (44/94) cattle, 51.7% (15/29) sheep, and 50% (2/4) pigs with predominantly B. abortus identification with AMOS-PCR and low isolation of mixed B. abortus and B. melitensis in all species. In cattle 33% of isolates were from lymph nodes while in sheep 38.0% were from liver and kidney and only from tonsils in pigs (2/4). Brucella infections identified with AMOS-PCR were present in seropositive and mainly seronegative (75.6-100%) livestock with the potential to cause brucellosis during pregnancy or breeding. This study demonstrated the value of the polyphasic approach, especially with chronic infections and the potential risk of these asymptomatic animals.

This paper examines patterns and drivers of energy choices for cooking and lighting in South Africa using the Statistics South African (StatSA, 2022) Census data at district municipality (districts) levels. Employing spatial and regression analysis, the findings show that electricity is the main source of energy for cooking across South Africa. However, there is a large swathe of the country covering districts, such as Vhembe and Mopani in Limpopo, eastern Mpumalanga, KwaZulu-Natal, and northern Eastern Cape provinces, where wood is the predominantly used energy type for cooking. There is almost uniform use of gas for cooking across the country. Electricity is the main energy source for lighting in South Africa. It is followed by candles, likely explained by loadshedding, and surprisingly solar energy a distant third. In terms of drivers, dwelling types play statistically significant role in what energy type to use for cooking and lighting, albeit differently. In terms of lighting, formal dwelling is positively related to the choice of electricity and informal dwelling is related to the choice of electricity (negatively) and candles (positively) for lighting. The level of higher education, household size, and the dependency ratio have varied statistically significant roles in the choice of either energy type for cooking or lighting by formal, informal, and traditional dwellers. Relevant policy prescriptions that are needed to engender the country towards sustainable energy use, diversification of energy types from electricity to other renewable energy sources, such as solar, and reduction in over-dependency on the biomass energy sources, such as paraffin and wood, especially in rural and poor districts, are proposed.

Inland capture fisheries play a critical role in supporting food security and livelihoods in West Africa. Therefore, it is important to evaluate genetic health of exploited fish populations. The African bonytongue, Heterotis niloticus, supports important commercial and subsistence fisheries in West Africa. Sharp declines of stocks have been reported, however. Herein, we estimate contemporary effective population sizes (Ne) of four Heterotis populations in Nigeria, three in Benin, and five in Cameroon using the Linkage Disequilibrium method with correction for age structure. Ne estimates were used to assess genetic short-term (i.e., inbreeding depression) and long-term (i.e., loss of evolutionary potential) risks. Analyses failed to obtain Ne point estimates for two populations. For the remaining ten populations, corrected Ne point estimates fell well below 500, the minimum recommended for populations to retain evolutionary potential; with eight populations below 100 (range 2.8–83.5), the minimum recommended to avoid inbreeding depression, one borderline (100–125), and one above this threshold (312–392). The lower 95% confidence interval bound of Ne for eleven populations was very small (0.7–14.6), and for the remaining population it was 44.2. Accordingly, all populations examined can be considered potentially at risk of inbreeding depression.

This article describes the challenges, pharmacological strategies, and recommendations for managing multidrug-resistant breast cancer in Sub-Saharan Africa (SSA). By examining the current breast cancer treatment landscape, region-specific challenges, and promising pharmacological interventions, the objective is to bring to light the insufficient research on breast cancer and its multidrug resistance in this part of the world and guide healthcare professionals, policymakers, and researchers in developing evidence-based strategies for improved breast cancer care in SSA. Breast cancer is the leading cause of cancer morbidity in SSA, necessitating continuous advancements in its management. This overview explores the evolution of breast cancer treatment, including surgery, targeted therapy, immunotherapy, radiotherapy, and chemotherapy. Despite these advancements, multidrug resistance poses a significant challenge, impacting treatment efficacy and patient outcomes.The article provides insights into various breast cancer treatment modalities, emphasizing surgery, targeted therapy, immunotherapy, radiotherapy, and chemotherapy. Each approach is discussed in detail, highlighting its significance in managing breast cancer. The effectiveness of these treatments is contingent on timely diagnosis and intervention. Multidrug resistance is examined as a critical obstacle in breast cancer treatment, elucidating its impact on treatment failure and patient outcomes. Mechanisms such as the efflux system, enhanced DNA repair, apoptosis inhibition, alterations in drug targets, and the tumor microenvironment contribute to multidrug resistance, emphasizing the need for a multifaceted understanding.The unique challenges faced in SSA regarding multidrug-resistant breast cancer are delineated. These include the lack of comprehensive data, late presentation and diagnosis, poor genomic studies, limited access to specialized care, financial constraints, inadequate infrastructure, and psychosocial support issues. Addressing these challenges is crucial for devising effective strategies. In response to multidrug resistance, the article discusses contemporary treatment strategies such as P-glycoprotein inhibitors, combined chemotherapy, and immunotherapy. Notable advancements, including the use of Tariquidar and synergistic effects of combined chemotherapy, are highlighted, presenting promising avenues for overcoming resistance.The article proposes recommendations to enhance breast cancer management in SSA, encompassing strengthening primary healthcare services, creating specialized oncology facilities and long-term monitoring and data collection. Breast cancer management in SSA is multifaceted, marked by challenges and evolving solutions. Multidrug resistance remains a significant hurdle, demanding a holistic approach. Promising advancements in pharmacological interventions offer hope, while comprehensive recommendations serve as a roadmap for progress. By implementing these strategies, SSA can substantially improve multidrug-resistant breast cancer care and overall patient well-being.

Influenza virus strain A/South Africa/3626/2013 (H1N1)pdm09 (SA-WT) is a non-mouse-adapted model strain, which has naturally high pathogenic properties for mice. It has been suggested that the high pathogenicity of this strain for mice could be due to the three strain-specific substitutions in the polymerase complex (Q687R in PB1, N102T in PB2, and E358E/K heterogeneity also in PB2). To evaluate the role of these replacements, SA-WT was passaged five times in mouse lungs, and the genome of the mouse-adapted version of the SA-WT strain (SA-M5) was sequenced. SA-M5 lost E358E/K heterogeneity and retained E358, which is the prevalent amino acid at this position among H1N1pdm09 strains. Besides, in the hemagglutinin of SA-M5, two heterogeneous substitutions (G155G/E and S190S/R) were identified. Both viruses, SA-M5 and SA-WT, were compared for their toxicity, ability to replicate, pathogenicity, and immunogenicity for mice. In mice infected with SA-M5 or SA-WT strains, toxicity, virus titer in pulmonary homogenates, and mouse survival did not differ significantly. Contrarily, an increase in the immunogenicity of SA-M5 compared to SA-WT was observed. This increase could be due to the substitutions G155G/E and S190S/R in the HA of SA-M5. The prospects for using SA-M5 in studying the immunogenicity mechanisms were also discussed.

This study investigates the spatio-temporal variability of the onset, offset, and Length of the rainy season in Senegal over the 1981-2018 period. The onset, offset dates, and length of the rainy season are crucial parameters for agricultural planning in West Africa, which exhibits high interannual and spatial variability in rainfall. The objective is to detect and spatially classify these phenological parameters across Senegal using different approaches. Daily precipitation data from the Climate Hazards group InfraRed Precipitation with Stations (CHIRPS) dataset over the study period and ERA5 reanalysis were used. The method of was applied to detect the onset, offset dates, and length of the rainy season. The Kohonen algorithm was then used to spatially classify these parameters on topological maps. A hierarchical ascendant classification was also performed to reduce the number of classes obtained. Finally, a composite analysis of moisture transport before the onset and end of the 1984 and 2007 seasons was conducted with ERA5 data. The results show a meridional gradient of the start of the season, progressively later from southeast to northwest, while the end follows a north-south gradient. The duration of the rainy season ranges from 45 days in northern Senegal to 150 days in the south. The maximum number of dry days also decreases from north to south. The Kohonen self-organizing maps allow spatial prediction of the onset, end date, and duration of the rainy season across Senegal. The dynamics analysis reveals that early onset years are associated with stronger and earlier northward moisture transport over West Africa, underscoring the role of this parameter in triggering the rainy season. These promising results can provide an early warning to policymakers and farmers on the start and end dates of the season in each area of Senegal.

Abattoir workers are liable to zoonotic infections from animals and animal products, pri-marily to diseases with asymptomatic and chronic clinical manifestations in animals such as brucellosis. No published reports exist on the seroprevalence of brucellosis in abattoir workers in South Africa. Therefore, this cross-sectional study was conducted to estimate the occurrence and risk factors for Brucella exposure in abattoir workers in Gauteng Province. A total of 103 abattoir workers and managers from six abattoirs, where brucellosis-positive slaughtered cattle and sheep were previously detected, were interviewed, and tested with serological assays using the Rose Bengal test (RBT), BrucellaCapt, and IgG-ELISA. A pre-tested questionnaire was administered to consenting respondents to obtain infor-mation on risk factors for brucellosis. Of the 103 respondents tested, the distribution of fe-male and male workers was 16 (15.5%) and 87 (84.5%), respectively. The seroprevalence for exposure to brucellosis was 21/103 (20.4%, 95%CI: 13.1-29.5) using a combination of RBT, BrucellaCapt, or IgG-ELISA. For test-specific results, seroprevalences by RBT, BrucellaCapt, and IgG-ELISA were 13/103 (12.6%, 95%CI: 6.9-20.6), 9/103 (8.74%, 95%CI: 4.1-15.9) and 18/103 (17.5%, 95%CI: 10.7-26.2), respectively. Low-throughput abattoirs were identified as associated risk as 29.3% of workers were seropositive compared to 12.7% of workers in high-throughput abattoirs, which highlights that direct contact at abattoirs poses higher risk to workers than indirect and direct contact outside abattoirs. This study confirmed the occurrence of Brucella spp. antibodies among abattoir workers in South Africa, possibly due to occupational exposure to Brucella spp. and highlight the occupational hazard to workers. Furthermore, findings underscore that abattoir facilities can serve as points for active and passive surveillance for indicators of diseases of public health importance. We recommend periodic implementation of brucellosis testing of abattoir workers country-wide to establish baseline data for informing appropriate preventive practices and reduce the potential burden of infection rate among these high-risk workers.

The effective implementation of a sustainable supply chain leadership (SSCL) strategy at each organization’s level, positively impacts on corporation’s competitive advantage and sustainable development. While fears have been acknowledged in previous literature, the benefit of designing Sustainable supply chain models for operational excellence and sustainable development is a noteworthy exploration. The study collected statistical data using an online Survey- monkey questionnaire from 46 of the top 100 JSE-listed companies with the intention to elucidate the large firms’ transition from longstanding linear approaches to sustainable production and consumption to a more circular approach. A bivariate data analysis was used to generate the results in SPSS. The results indicate a positive contribution of SSCL strategy to operational excellence and sustainable development of large corporations if only the entire supply chain system is well-coordinated and implemented. This study makes a vital contribution by proposing a new SSCL model for fast-tracking corporate sustainability and enhancing corporate contributions to sustainable growth.

The global SARS-Cov-2 which caused the coronavirus disease 2019 (COVID-19) pandemic has had a significant impact over the last 3.5 years, especially among healthcare workers (HCWs) who were constantly in the forefront of the pandemic. Due to the nature of their work, HCWs faced a potential risk of exposure. Therefore, this study investigated the individual-level factors associated with perceived COVID-19 risk among South African HCWs. We used an analytical cross-sectional study design to analyse data from the South African Health Care workers’ response to the Coronavirus (COVID-19) pandemic online survey conducted by the Human Sciences Research Council across the nine provinces in South Africa, from 11th April to 7th May 2020. In this study, only data (n= 5 579) with non-missing values for COVID-19 risk and individual-level factors (age, gender, educational level, occupational category, and race) was analysed. Univariate and Multivariate binomial logistic regression analyses were conducted. The crude and adjusted odds ratio and p-value ≤ 0.05, were used to describe the association between the individual-level factors and perceived COVID-19 risk, from low-medium to high. The binomial logistic regression was used to assess the factors associated with high perceived risk. Perceived COVID-19 risk among HCWs in South Africa was significantly associated with age, race, educational level and occupational category. Being 60 years and older, being “White”, having a Master’s and Doctorate degrees and being a healthcare worker other than a nurse practitioner and medical practitioner, all had higher odds of having high perceived COVID-19 risk. The findings may be used to guide policies and programs aimed at mitigating the impacts of COVID-19 and other similar pandemics.

Morphological study of lakes defines the sensitivity of their watershed. Moreover, it plays important role in safeguarding the lake’s ecosystem services through proper planning and utilization of the lakes’ resources. In the last few decades, the morphology of lakes in Ethiopian and Kenyan Rift (EKR) valley are experiencing contradicting morphological changes. Being in the same system, some are shrinking and others are expanding beyond their natural boundaries. The objective of this review is to shed light on the trends in spatio-temporal water level fluctuation and their contributing factors for lakes to the academia and decision makers. Peer reviewed article journals, conference proceedings, thesis, and book chapters collected from online sources and supplied by authors on request formed a database of 346 documents where 226 are critically assessed. The review indicated that lakes in Ethiopian rift are shrinking and expanding, while Kenyan lakes are expanding. The en-dorheic lakes suffered the most fluctuations due to anthropogenic factors at the expense of loss of forest and woodlands in their watershed. While the lakes’ water quality related to the morphological changes are given less attention, the predicted 12 m drop of Lake Turkana due to projects in the Omo catchment did not materialize.

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.

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.

Emerging pollutants pose significant threats to Uganda's ecosystems and public health amidst rapid urbanization, industrial growth, and intensified agriculture. This systematic review comprehensively assessed these pollutants by analyzing existing Ugandan literature and research studies, revealing various types in different environmental compartments. These pollutants, including pharmaceuticals, personal care products, pesticides, industrial chemicals, heavy metals, radionuclides, biotoxins, disinfection byproducts, hydrocarbons, and microplastics, originate from urban, industrial, and agricultural regions. Wastewater and improper waste disposal are major contributors. From an initial search of 794 articles across multiple databases such as PubMed, African Journal Online (AJOL), Web of Science, Science Direct, and Google Scholar, 138 were found relevant. The review underscores potential ecological and health impacts, including antibiotic resistance, endocrine disruption, and carcinogenicity. Existing monitoring and regulation efforts are discussed, alongside the need for specific regulations, improved data collection, and public awareness campaigns. Recommendations include advanced wastewater treatment, sustainable agriculture, and source control measures. Emphasis is placed on further research to address knowledge gaps and develop effective policies and interventions. Uganda can mitigate these risks by implementing comprehensive monitoring, robust regulations, and sustainable practices, safeguarding the environment and public health.

The current paper provides a detailed review of the historical outbreaks of each of the four plague locust species found in South Africa, namely the brown locust, the African migratory locust, the red locust and the southern African desert locust. The history and dynamics of the plague infestations and the major local outbreaks are summarized. The typical patterns of the outbreaks of the different species are described and the threat of these locusts to agriculture in South Africa is defined. The brown locust produces regular outbreaks in the semi-arid Karoo, with large-scale eruptions of plague proportions occurring once or twice per decade. Patterns of outbreaks often repeat themselves, but the sheer size of the plague outbreaks are almost impossible to stop and the brown locust has the potential to threaten food security throughout southern Africa. The African migratory locust produces outbreaks in some of the main maize and wheat cropping areas where it is difficult to control. This locust has taken advantage of the man-made crop environment to produce an extra generation per year that was not previously possible in the original grasslands. The coastal area of KwaZulu Natal in South Africa was a prime reception and breeding area for plague invasions of the red locust in the past and the country therefore relies on the successful control of outbreaks in east and central Africa into prevent the recurrence of the plague invasions. The southern African desert locust occurs in the Kalahari Desert area and outbreaks requiring chemical control are rare.

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.

Sarocladium and Fusarium species are commonly identified as causal agents of rice sheath rot disease worldwide. However, limited knowledge exists about their genetic, pathogenic, and toxigenic diversity in sub-Saharan African (SSA) countries, where an increasing incidence of this disease has been observed. This study aimed at identifying, characterizing, as well as assessing the genetic, pathogenic, and toxigenic diversity of the pathogens associated with rice sheath rot disease in Mali, Nigeria, and Rwanda. In this study seventy fungal isolates were obtained from rice plants displaying disease symptoms on research and farmer’s fields in Mali, Nigeria, and Rwanda. Thus, an extensive comparative analysis was conducted to assess their genetic, pathogenic, and toxigenic diversity. The Fusarium spp. were characterized using the translation elongation factor (EF-1α) region, while a concatenation of Internal Transcribed Spacer (ITS) and Actin-encoding regions were used to resolve Sarocladium species. Phylogenetic analysis revealed four Fusarium species complexes. The dominant complex in Nigeria was the Fusarium incarnatum-equiseti species complex (FIESC), comprising F. hainanense, F. sulawesiense, F. pernambucatum, and F. tanahbumbuense, while F. incarnatum was found in Rwanda. The Fusarium fujikuroi species complex (FFSC) was predominant in Rwanda and Mali, with species such as F. andiyazi, F. madaense, and F. casha in Rwanda, and F. annulatum and F. nygamai in Mali. F. marum was found in Nigeria. Furthermore, Fusarium oxysporum species complex (FOSC) members, F. callistephi and F. triseptatum, were found in Rwanda and Mali, respectively. Two isolates of F. acasiae-mearnsii, belonging to the Fusarium sambucinum species complex (FSAMSC) were obtained in Rwanda. Isolates of Sarocladium which were previously classified in three phylogenetic groups were resolved into three species which are: attenuatum, oryzae and sparsum. S. attenuatum was dominant in Rwanda, while S. oryzae and S. sparsum were found in Nigeria. Also, the susceptibility of FARO44, a rice cultivar released by Africa Rice Centre (AfricaRice) was tested against isolates from the four Fusarium species complexes and the three Sarocladium species. All isolates evaluated could induce typical sheath rot symptoms albeit with varying disease development levels. In addition, liquid chromatography-tandem mass spectrometry (LC-MS/MS) was used to determine variation in the in vitro mycotoxins of the Fusarium species. Regional differences were observed in the in vitro mycotoxins profiling. Out of the forty-six isolates tested, nineteen were able to produce one to four mycotoxins. Notably, very high zearalenone (ZEN) production was specific to the two F. hainanense isolates from Ibadan-Nigeria, while Fusarium nygamai isolates from Mali produced high amounts of fumonisins. To the best of our knowledge, it seems this study is the first to elucidate genetic, pathogenic, and toxigenic diversity of Fusarium species associated with the rice sheath rot disease complex in selected countries in SSA.

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%.

Entrepreneurship education in South Africa holds significant promise in empowering the youth and fostering economic growth. This article explores the impact of entrepreneurship education on youth empowerment, focusing on case studies of successful young entrepreneurs, evaluation of entrepreneurial skills development, and analysis of employment and economic outcomes. While effective models of entrepreneurship education emphasize experiential learning and collaboration with local businesses, resource constraints and infrastructure gaps pose challenges. Moreover, socio-cultural perceptions and gender disparities influence youth's willingness to engage in entrepreneurship, hindering inclusivity. Evaluating the long-term impact remains challenging, requiring robust monitoring and evaluation mechanisms. The article concludes with recommendations to enhance the impact of entrepreneurship education, including increasing funding, challenging stereotypes, fostering collaboration, and developing evaluation mechanisms to support South Africa's youth in realizing their entrepreneurial potential.

The persistent burden of chronic hepatitis B among ≤5-year-old children in Africa suggests missed opportunities for controlling mother-to-child transmission (MTCT) of the hepatitis B virus (HBV). This scoping review maps the evidence base on the risk of HBV MTCT, the status of HBV MTCT mitigation strategies including hepatitis B birth-dose vaccination, and the role of systems complexity on the suboptimal adoption and performance of hepatitis B birth-dose vaccination programs in Africa. Overall, 88 peer-reviewed and grey literature sources published between 2000–2022 were included in this review. The evidence base consistently argues for a growing risk of HBV MTCT amidst the HIV co-epidemic in the region. Without universal HBV screening programs integrated within broader antenatal care services, current selective hepatitis B birth-dose vaccination is unlikely to effectively interrupt HBV MTCT. We underscore critical health systems-related barriers to universal adoption and optimal performance of hepatitis B birth-dose vaccination programs in the region. To better conceptualize the role of complexity and system-wide effects on the observed performance of the program, we propose an adapted systems-based logic model. Ultimately, exploring contextualized complex systems approaches to scaling-up universal hepatitis B birth-dose vaccination programs should form an integral part of the regional research agenda.

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.

(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.

The COVID-19 pandemic had a significant impact on the mental health of individuals globally, and primary healthcare (PHC) nurses play a critical role in providing mental healthcare services. However, limited research has explored the experiences of PHC nurses in providing mental healthcare services during the COVID-19 pandemic. This study explored the experiences of PHC nurses in providing mental healthcare services during the pandemic in Durban, South Africa. The aim was to identify the challenges faced by healthcare providers and the potential for innovative approaches to improve access to care. A qualitative, exploratory design guided the study, and data were collected through in-depth interviews with twelve PHC nurses purposively selected. Thematic analysis was used to analyse the data. Findings from interviews with primary healthcare nurses reveal that the pandemic exacerbated existing challenges, including medication adherence issues, fear and uncertainty among patients, vaccine hesitancy, decreased clinic visits, and the mental and emotional toll on both patients and healthcare workers. PHC nurses adapted their services by increasing outreach efforts, prioritising patient care, and utilising technology and non-governmental organisations’ (NGO) support. Challenges included reduced patient visits, complexities in healthcare provision, and lack of adequate support. Positive changes observed include increased mental health awareness among healthcare professionals and younger generations. Recommendations include implementing outreach and awareness campaigns, providing accurate information about COVID-19 and vaccinations, and promoting cultural sensitivity in mental healthcare provision.

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.

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.

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.

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.

Earth Observation (EO) techniques have significantly evolved over time, covering a wide range of applications in different domains. The scope of this study is to review the research conducted on EO in the Eastern Mediterranean, Middle East, and North Africa (EMMENA) region and to identify the main knowledge gaps. We searched through the Web of Science database for papers published between 2018 and 2022 for EO studies in the EMMENA. We categorized the papers in the following thematic areas: Atmosphere, Water, Agriculture, Land, Disaster Risk Reduction (DRR), Cultural Heritage, Energy, Marine Safety and Security (MSS) and Big Earth Data (BED); 6647 papers were found with the highest number of publications in the thematic areas of BED (27%) and Land (22%). Most of the EMMENA countries are surrounded by sea, yet there was a very small number of studies on MSS (0.9% of total number of papers). This study detected a gap in fundamental research in the BED thematic area. Other future needs identified by this study are the limited availability of very high resolution and near real time remote sensing data, the lack of harmonized methodologies and the need for further development of models, algorithms, early warning systems and services.

Whole-genome sequencing (WGS) was used for genomic characterization of 110 strains of Listeria innocua isolated from 23 cattle farms, 8 beef abattoirs, and 48 retail outlets in Gauteng province, South Africa. In silico multilocus sequence typing (MLST) was used to identify the isolates' sequence types (STs). BLAST-based analyses were used to identify antimicrobial and virulence genes. The study also linked the detection of the genes to the origin (sources and types of samples) of the L. innocua isolates. The study detected 12 STs, 13 resistance genes, and 23 virulence genes. Of the 12 STs de-tected, ST637 (26.4%), ST448 (20%), 537 (13.6%), and 1085 (12.7%) were predominant, and the frequency varied significantly (P<0.05). All 110 isolates of L. innocua were car-riers of one or more antimicrobial resistance genes, with resistance genes lin (100%), fosX (100%), and tet(M) (30%) being the most frequently detected (P<0.05). Of the 23 virulence genes recognized, 13 (clpC, clpE, clpP, hbp1.svpA, hbp2, iap/cwhA, lap, lpeA, lplA1, lspA, oatA, pdgA, and prsA2) were found in all 110 isolates of L. innocua. Overall, diversity and significant differences were detected in the frequencies of STs, resistance, and virulence genes according to the origins (source and sample type) of the L. innocua isolates. This, being the first genomic characterization of L. innocua recovered from the three levels (farm, abattoir, and retail outlets) of the beef production system in South Africa, provides data on the organism's distribution and potential food safety implications..

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.

(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.

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.

: (1) Background: Hepatitis B core antibodies (anti-HBc) are a marker of hepatitis B virus (HBV) exposure; hence a normal HBV serology profile is characterized by HBV surface antigen (HBsAg) and anti-HBc positivity. However atypical HBV serologies occur and we aimed to determine the prevalence of an atypical profile (HBsAg+/anti-HBc-) in a cohort of people with HIV-1 (PWH) in Botswana. (2) Methods: Plasma samples from an HIV-1 cohort in Botswana (2013-2018) were used. Samples were screened for HBsAg and anti-HBc. Next generation sequencing was done using the GridION platform. Wilcoxon rank-sum test and Chi-squared tests were used for comparison of continuous and categorical variables respectively. (3) Results: HBsAg+/anti-HBc- prevalence was 13.7% (95% CI 10.1 – 18.4) (36/263). HBsAg+/anti-HBc- participants were significantly younger (p&lt;0.001), female (p=0.02), ART naïve (p=0.04) and had detectable HIV viral load (p=0.02). There were no mutational differences in sequences isolated from participants with HBsAg+/anti-HBc- versus those with HBsAg+/anti-HBc+ serology. (4) Conclusions: We report a high HBsAg+/anti-HBc– atypical serology profile prevalence among PWH in Botswana. We caution against HBV testing algorithms that consider only anti-HBc+ samples for HBsAg testing as they are likely to underestimate HBV prevalence. Studies to elucidate the mechanisms and implications of this profile are warranted.

Diagnostics is believed to drive about 70% of medical interventions, but this may not be true for all demographics. With more than 30% of the African population living in extreme poverty ($1.9 per day - 2022); and healthcare costs competing unfavorably against unbridled access to antibiotics and herbal concoctions, especially in Sub-Saharan Africa, how do you convince such a people to choose diagnostics first? More importantly, how do you design a medical device targeted at meeting the diagnostic needs of this demographic? In developing diagnostic devices for such a market, what is worth sacrificing? How dire is the need for advanced technologies in devices developed for such a demographic? These are questions that remain unaddressed by the technological breakthroughs and current research in medical device development, especially for infectious disease diagnostics. The objective of this paper is to underscore critical concerns which must be considered in the bid to successfully design medical diagnostic devices for Africa and perhaps, other limited-resource settings. It is also written as a suggestive guidance document for researchers whose interest is in the development of infectious disease diagnostic platforms for rural Africa and similar limited-resource environments.

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.

Prostate cancer is driven by acquired genetic alterations, including those impacting the epigenetic machinery. With African ancestry a significant risk factor for aggressive disease, we hypothesize that dysregulation among the roughly 656 epigenetic genes may contribute to prostate cancer health disparities. Interrogating prostate tumor genomic data from 109 men of southern African and 56 men of European Australian ancestry, we found African-derived tumors to present with a longer tail of epigenetic driver gene candidates (72 versus 10). Biased towards African-specific drivers (63 versus 9 shared), many are novel to prostate cancer (18/63) including several putative therapeutic targets (CHD7, DPF3, POLR1B, SETD1B, UBTF and VPS72). Through clustering of all variant types and copy number alterations, we describe two epigenetic PCa taxonomies capable of differentiating patients by ancestry and predicted clinical outcomes. We identified top genes in African and European-derived tumors that represent a multifunctional “generic machinery”, alteration to which may be instrumental in epigenetic dysregulation and prostate tumorigenesis. In conclusion, numerous somatic alterations in the epigenetic machinery drive prostate carcinogenesis but African-derived tumors appear to achieve this with greater diversity amongst such alterations. The greater novelty observed in African-derived tumors illustrates the significant clinical benefit to be derived from a much needed African tailored approach to prostate cancer healthcare aimed at reducing prostate cancer health disparities.

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&lt;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.

Mobile payment has become increasingly popular due to the widespread use of smartphones and their applications. However, its adoption in African countries has been limited, despite its potential to simplify our lives. This study aims to enhance our understanding of the factors that affect the acceptance of mobile payment in Nigeria. To achieve this, the paper explores the impact of "network externalities" in addition to traditional technology acceptance factors. The study hypothesizes that the key drivers of mobile payment acceptance are performance expectancy, effort expectancy, social influence, trust, and network externality. The research findings suggest that while traditional drivers still play a role in customers' willingness to adopt mobile payment, network externalities have the strongest impact. Although the results did not support the influence of effort expectancy, the paper provides recommendations for future research.

A cross-sectional study was applied to investigate the influence of food systems and food environments on food choices and nutrition transition of households in Limpopo province, South Africa. A sample of 429 households were systematically selected using a paper selection draw from three districts. Food systems, food environments, food choices, and nutritional measurements of the households and informants were assessed, using a validated questionnaire. Most of the household informants responsible for food procurement were females (80.4%). There was a significant association (p < 0.001) between proximity to food stores and dietary diversity of the households. Staple foods were available in almost all surveyed households (95.6%). More than half of the households (59.8%) had home gardens in their yards. Almost half of the households (48.4%) had a low Dietary Diversity Score. The study revealed that 46.0% of households were food secure. Over a third (36.2%) of households’ informants were obese and 32.5% were diabetic. The mean total blood cholesterol was 3.69 ± 0.74 mmol/L. A high percentage of both females (89.6%) and males (91.5%) had normal haemoglobin levels. Most of the informants had normal systolic blood pressure levels (63%), with just over half who had high diastolic levels (57%). The 25 coping strategies were applied during food shortages periods. Even though the food environments provided both obesogenic and protective foods, the consumption of unhealthy foods was high.

This study assesses the durability of severe acute respiratory coronavirus-2 (SARS-CoV-2) anti-nucleocapsid (anti-N) immunoglobulin G (IgG) after infection, and examines its association with established risk factors among South African healthcare workers (HCWs). Blood samples were obtained from 390 HCWs with diagnosis of coronavirus disease 2019 (COVID-19) for assay of the SARS-CoV-2 anti-N IgG at two time points (Phase 1 &amp; 2) between November 2020 and February 2021. Out of 390 HCWs with COVID-19 diagnosis, 267 (68.5%) had detectable SARS-CoV-2 anti-N IgG antibodies at the end of phase I. These antibodies persisted for 4-5 and 6-7 months in 76.4% and 16.1%, respectively. In the multivariate logistic regression model analysis, black participants were more likely to sustain SARS-CoV-2 anti-N IgG for 4-5 months. However, participants who were HIV positive were less likely to sustain SARS-CoV-2 anti-N IgG antibodies for 4-5 months. In addition, individuals who were &lt;45 years of age were more likely to sustain SARS-CoV-2 anti-N IgG for 6-7 months. Of the 202 HCWs selected for phase 2, 116 participants (57.4%) had persistent SARS-CoV-2 anti-N IgG for an extended mean period of 223 days (7.5 months). Findings support the longevity of vaccine responses against SARS CoV-2 in black Africans.

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.

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.

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.

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.

Epidemics of arboviruses in general, and dengue fever, in particular, are an increasing threat in areas where Aedes (Ae.) aegypti is present. The effectiveness of chemical control of Ae. aegypti is threatened by the increasing frequency of insecticide resistance. The aim of this study was to determine the susceptibility status of Ae. aegypti to public health insecticides and assess the underlying mechanisms driving insecticide resistance. Ae. aegypti eggs were collected in two study sites in the vicinity of houses for two weeks using Gravid Aedes Traps (GATs). After rearing mosquitoes to adulthood, female Ae. aegypti were exposed to the diagnostic doses of permethrin, deltamethrin and bendiocarb, using Centers for Disease Control and Prevention (CDC) bottle bioassays. Unexposed, un-engorged female Ae. aegypti were tested individually for mixed-function oxidase (MFO), glutathione-S-transferase (GST) and esterase activity. Finally, allele-specific PCR (AS-PCR) was used to detect kdr mutations (F1534C, S989P and V1016G) in the voltage-gated sodium channel gene in insecticide-exposed Ae. aegypti. Most traps were oviposition positive; 93.2% and 97% of traps contained Ae. aegypti eggs in the 10ème arrondissement of Cotonou and in Godomey-Togoudo, respectively. Insecticide bioassays assays detected resistance to permethrin and deltamethrin in both study sites and complete susceptibility to bendiocarb. By comparison to the insecticide-susceptibility Rockefeller strain, field Ae. aegypti populations had significantly higher levels of GSTs and significantly lower levels of  and  esterases; there was no significant difference between levels of MFOs. AS-PCR genotyping revealed the presence of the three kdr mutations (F1534C, S989P and V1016G) at high frequencies; 80.9% (228/282) of Ae. aegypti tested had at least one mutation, while the simultaneous presence of all three kdr mutations was identified in 13 resistant individuals. Study findings demonstrated phenotypic pyrethroid resistance, the overexpression of key detoxification enzymes and the presence of several kdr mutations in Ae. aegypti populations, emphasizing the urgent need to implement vector control strategies, targeting arbovirus vector species in Benin.

: Background: Vaccine-related death is one of the leading causes of death among African Children. Vaccine coverage is a very important measure to decrease infant mortality. Covid-19 Pandemic has affected the healthcare system and may have disrupted vaccine coverage. Methods: DTP third doses (DTP3) Vaccine Coverage was extracted from UNICEF databases from 2012 to 2021( the last available date). Joinpoint regression was performed to detect the point where the trend changed. The annual percentage change (APC) with 95% confidence intervals (95% CI) was calculated for Africa and the regions. We compared DTP3 vaccination coverage in 2019 with 2021 in each country to verify compliance with WHO targets. Result: During the whole period, the vaccine coverage in Africa has increased with an Annual Percent change of 1.2% (IC 95% 0.9-1.5): We detected one Joint point in 2019. In 2019-2021, there was a decrease in DTP3 coverage with an APC of -3.5(95% -6.0;-0,9). (P< 0.001). Vaccination rates have decreased in many regions and countries during the last two years. Conclusions. COVID-19 has disrupted vaccine coverage, decreasing it all over Africa.

Agroecology is a holistic approach to farming that emphasizes the use of local resources and ecological processes to increase productivity, reduce environmental impact, and enhance resilience. Despite its potential benefits, the adoption of agroecological practices in Sub-Saharan Africa has been slow. This paper examines the opportunities for promoting agroecology in the region, including the growing demand for organic and sustainable food, the availability of local knowledge and resources, and the potential for agroecology to improve rural livelihoods and support climate change adaptation. The premise is that the promotion of agroecology faces several challenges. which include, inadequate policy and institutional support, lack of access to credit and markets, limited extension services, and weak land tenure systems. The paper draws on case studies from across Sub-Saharan Africa to illustrate the opportunities and challenges of promoting agroecology in the region. These case studies highlight the diversity of agroecological practices and the importance of context-specific approaches. Overall, the paper maintains that agroecology has the potential to transform agriculture in Sub-Saharan Africa, but that realizing this potential will require concerted efforts from governments, civil society, and the private sector.

Agriculture is the primary source of economic growth in many countries in West Africa. It provides food and livelihoods for the population. The purpose of this study is to review the digital agriculture status in five countries, namely Benin, Burkina Faso, Coˆte d’Ivoire, Ghana, and Nigeria. The study consisted of a bibliometric analysis using a database exported from the web of science through a well-defined search string. Additionally, the cases of digital technology deployment in the countries were assessed through a systematic review approach comparing the technologies used in the target countries. Representative articles from the bibliometric review published in the last five years were selected for the comparative analysis. The bibliometric analysis based on 3,249 publications revealed that the research interests have significantly increased since 2014. The top two countries in terms of authors’ nationality were Nigeria and Ghana, respectively. Climate change, Machine Learning (ML) and adoption were the hot topics of discussion. The digital agriculture survey showed that publications in Nigeria were focused on Internet of Things (IoT), Wireless Sensors Networks, blockchain, and Artificial Intelligence (IA) technologies. Ghana also has a strong interest in blockchain, AI, and big data, while Burkina Faso focused on IoT and AI. Cote d’Ivoire and Benin focused only on AI.

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.

Land Use /Land Cover (LULC) change is a major global concern and a topic of scientific debate. In West Africa, the key among the past changes is the loss of natural vegetation related to changes in different Land Use/Land Cover (LULC) categories, e.g., water bodies, wetland and bare soil. However, not all detected changes in these LULC categories are relevant for LULC change management intervention in a resource-constrained continent, as a massive change in the dominant LULC types may be due to errors in the LULC maps. Previous LULC change analysis detected large discrepancies in the existing LULC maps in the Africa continent. Here we applied an open and synergistic framework to update and improve the existing LULC maps at every five years intervals from 1990 to 2020 in West Africa at a finer spatial resolution of 30m. Next, we detected spatial temporal pattern in past and present LULC changes with the intensity analysis framework in the periods of 1990–2000, 2000–2010, and 2010–2020. A faster annual rate of overall transition was detected in 1990–2000 (first period) and 2010–2020 (recent period) than in 2000–2010 (middle). We observed consistent gains in rangeland (shrubland and grassland) in all the periods, which confirms the observed re-greening of rangeland in the West Africa continent. By contrast, forestland areas experienced consistent losses for the entire periods, which indicate deforestation and degradation. As regards cropland, a net loss was observed in the drought period and net gains in the subsequent periods. The settlement category also gained actively in all periods. Net losses of wetland and bare land categories were also observed in all the periods. We observed net gains in water bodies in 1990–2000 and net losses in the last period. We highlighted the active forestland losses as systematic and hence a clarion call for an intervention. The simultaneous active gross loss and gain intensity of cropland raises food security concern and must send an early warning signal to policy makers that the food security of marginal geographic locations is under threat despite the massive expansion of cropland observed in this study area. The intensity analysis framework was vital to identify the settlement category as relevant for LULC change management intervention across time and space in West Africa instead of focusing on dynamics of all the LULC categories that may be irrelevant and hence a cost effective LULC change management approach. Policies to control the expansion of settlements will indirectly regulate the expansion of cropland field because we observed that as settlement encroached on cropland, simultaneously cropland encroached on natural vegetation to meet the food security requirements of the inhabitants.

The purpose of this study is to characterize atmospheric pollution and its sources in two West African urban sites during the dry season (January 2009 in Bamako, Mali, and December 2009 in Dakar, Senegal). Particulate Matter (PM) source apportionment was performed using Principal Component Analysis (PCA) and Positive Matrix Factorization (PMF). Carbonaceous components, water-soluble inorganic compounds, and trace elements were analyzed from PM (TSP, PM10, and PM2.5) samples. The measured PM2.5 and PM10 concentrations were 5 to 10 times and 3 to 8 times higher than the 2005 WHO 24-hour standards, respectively. PCA and PMF analyses identify five sources in both cities. The sources contributing to aerosol concentrations (PM2.5 - PM10) in Bamako are motor vehicles (20-13%), solid fuel combustion (16-13%), crustal dust (24-30%), resuspended road dust (26-30%) and secondary aerosols (10-16%). During the sampling period in Bamako, dust was the most prevalent source, accounting for 63% of the total PM10 mass. In Dakar, the main identified sources were motor vehicles (28-19%), mineral dust (16-25%), industries and oil burn-ing (11-10%), sea salts (15-20%), and resuspended road particles (21-29%). The findings also indicate that anthropogenic emissions contribute significantly to the PM2.5 fraction, implying that populations are highly exposed to fine particles.

The state of BIM adoption and implementation in facility management in Africa has been regarded as a developmental discourse gradually gaining grounds. While several studies have focused on manual review of the intellectual progression of BIM research, this confined review however understates the evolution of BIM in facility management. This approach therefore is not always representative of the picture of BIM in facility management at its formative stage. This paper aims to present a scientometric review of BIM in facility management exploring the intellectual progress made so far by authors. The state of the art of BIM in facility management research and practice and the challenges debilitating against BIM in facility management research. The review revealed a considerable amount of research endeavours limited by inadequate collaboration acorss organizations and institutions. The study also revealed the low degree of awareness amongst researchers in the AEC sector. While North America and China were leading countries due to the activity of few universities, Africa wasn’t as visible in research endeavours. The study recommended an increase in awareness drive across countries and increased government effort, joint funding for research to include gaps in practice issues.

In Africa, vector-borne diseases (VBDs) are still a major public health issue especially in cities that gather an increasing human population. Market gardening practices, for example, can favor the transmission of urban malaria, while insufficient water supply and waste management favor the circulation of arboviroses related to Aedes mosquitoes. Urban planning is a major challenge to mitigate vector risks. As a planning strategy, greening is a concept that is increasingly considered as a major element impacting the well-being of inhabitants, but also for the restoration of biodiversity in cities. Nevertheless, the impact of urban green spaces on vector risk remains poorly investigated, as they may serve as refuge for vectors. This is why the diversity of mosquitoes in terms of species and larval habitat, through larval prospections in environmental water collections and human landing catches, is studied here at an intra-urban interface area between a forest and an urban ecosystem in order to assess the vector risk generated by preserving a forest patch in the heart of Libreville, capital of Gabon, central Africa. Out of 104 water containers explored, 94 (90.4%) were artificial, mainly comprising gutters, used tires, and plastic bottles, while 10 (9.6%) were natural, comprising a puddle, streams, and tree holes. The majority of the water collections recovered (73.1%) were found outside of the forested area, natural and artificial ones considered together. A total of 770 mosquitoes belonging to 14 species were collected from water collections. The mosquito community was largely dominated by anthropophilic species like Aedes albopictus (33.5%), Culex quinquefasciatus (30.4%), and Lutzia tigripes (16.5%). The Shannon index of diversity showed that mosquitoes were almost twice less diversified inside the forest (0.7) than outside (1.3). However, both communities were quite similar in terms of common species and relative abundance (Morisita-Horn index = 0.7). Regarding Human landing catches, Aedes albopictus (86.1%) was the most aggressive species, putting people at risk of Aedes-borne viruses. This study uncovered the importance of considering urban forested ecosystems as potential drivers of disease emergence and spread in urban areas, as they might locally boost urban mosquito densities due to poor environmental practices, mainly maintained by humans through poor environmental practices. In Gabon, this study should contribute to guide targeted vector control strategies, especially regarding the implementation of policies for a better environmental management and vector surveillance in urbanized areas.

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.

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.

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.

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.

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.

Abstract: Tuberculosis (TB) and human immunodeficiency virus (HIV) epidemics in South Africa have been closely related and persistent, posing a significant burden for healthcare provision. We explored the patients perspectives on challenges and barriers of scaling up TB and HIV integrated services. A descriptive cross-sectional study applying a qualitive research approach was used. Through focus group discusssions (FGDs), we interviewed 29 patients accessing TB and HIV services at the study sites which were selected at primary health care (PHC) clinics in the O.R Tambo district in Eastern Cape, South Africa. Anonymised data was analysed using both content and thematic analysis technique. Challenges and barriers identified included a lack of health education about TB and HIV; an inadequate counselling for antiretroviral drugs (ARVs) and HIV; a lack of awareness of the National TB control program; and poor quality of services provided by the health care facilities. These findings suggest that the O.R. Tambo district needs to strengthen its TB-HIV integration immediately. Keywords: TB-HIV integration; Challenges and barriers; Patients; O.R Tambo District; Eastern Cape; South Africa

The persistence of diseases that affect construction workforce as a result of activities on construction sites poses a danger to the sustainable development of the industry. This resulted to a huge loss of skilled labour and economic development of the industry and the entire country. The arrival of the fourth industrial revolution (4IR) technologies urges an urgent need to assess the effect of the technology’s biological driver on the construction occupation related diseases. Therefore, this study is aimed at assessing the effect of 4IR on the construction occupation related diseases in Gauteng, South Africa. The study is quantitative in design and questionnaire survey were administered to project and Health and Safety (H&S) managers in Gauteng, South African construction sector using a proportionate simple random sampling technique. For data analysis, the Warp PLS-SEM 8.0 software algorithm was used for the analysis of the collated data. The study found that the effects of the 4IR’s biological driver variables ranges between moderate to high effects for genome sequencing (GENSE) and Neurotechnology (NEURO) respectively. The combined predictive relevance of the two (2) variables predicts 64% of the construction occupation related diseases. This implies that the adoption of the driver would help reduce the causes of construction-related diseases. Hence, implies that continuous deployment of 4IR technologies would ensure that construction occupation related diseases are easily identified and put on alert.

Drinking water quality is a major concern, especially in African countries. This manuscript aims to analyze the chemical composition of Lioua’s groundwater in order to determine the geological processes influencing the chemical elements' composition and origin. Therefore, chemometrics techniques such as multivariate statistical analysis (MSA) and time series methods (TSM) are used. Indeed, MSA includes a component analysis (PCA) and a cluster analysis (CA), while au-tocorrelation analysis (AA) supplemented by simple spectral density analysis (SDA) is used for TMS. PCA displays three main factors explaining a total variance (TV) of 85.01 %. Factors 1, 2, and 3 are 68.72%, 11.96%, and 8.89 % of TV, respectively. In the CA, three groups were controlled by TDS and EC. G1 reveals a close association between SO42−, K+, Ca2+, and TDS; G2 reveals a close association between Na+, Cl−, Mg2+, and EC; G3 shows the dissociation of bicarbonates HCO3− and NO3− from other chemical elements. AA shows a linear interrelationship of EC, Mg2+, Na+, K+, Cl−, and SO42−. However, NO3− and HCO3− indicate uncorrelated characteristics with other parameters. For SDA, the correlograms of Mg2+, Na+, K+, Cl−, and SO42− have a similar trend with EC. None-theless, pH, Ca2+, HCO3− and NO3− exhibit multiple peaks related to the presence of several dis-tinct cyclic mechanisms. The methods enabled the authors to conclude that the geochemical processes influencing the chemical composition are: (i) dissolution of evaporated mineral depos-its, (ii) water-rock interaction, and (iii) evaporation process. In addition, Groundwater exhibits two bipolar characteristics, one recorded with negative and positive charges on pH and Ca+ and another recorded only with negative charges on HCO3− and NO3−. On the other hand, SO42-, K+, Ca2+, and TDS are the major predominant elements in the groundwater’s chemical composition. The major participation of salts and chlorides is in the electrical conductivity of water. The dominance of the lithological factor in the overall mineralization of the Plio-Quaternary surface aquifer waters. The origins of HCO3− and NO3− are different. Indeed, carbonated for HCO3- has a carbonate origin, whereas NO3– has an anthropogenic origin. The salinity was affected by Mg2+, SO42-, Cl-, Na+, K+, and EC. Ca2+, HCO3− and NO3− are resulted from human activity fertilizers, the carbonate facies outcrops, and domestic sewage.

Background: After its initial detection in Wuhan, China, in December 2019, SARS-CoV-2 has spread rapidly, causing successive epidemic waves worldwide. This study aims to provide a genomic epidemiology of SARS-CoV-2 in Burkina Faso. Methods: Three hundred and seventy-seven SARS-CoV-2 genomes obtained from PCR-positive nasopharyngeal samples (PCR cycle threshold score <35) collected between May 5, 2020, and January 31, 2022 were analysed. Genomic sequences were assigned to phylogenetic clades using NextClade and to Pango lineages using pangolin. Phylogenetic and phylogeographic analyses were performed to determine the geographical sources and time of virus introduction in Burkina Faso. Results: The analyzed SARS-CoV-2 genomes could be assigned to 10 phylogenetic clades and 27 Pango lineages already described worldwide. Our analyses revealed the important role of cross-border human mobility in the successive SARS-CoV-2 introductions in Burkina Faso from neighboring countries. Conclusion: This study provides additional insights into the genomic epidemiology of SARS-CoV-2 in West Africa. It highlights the importance of land travel in the spread of the virus and the need to rapidly implement preventive policies. Regional cross-border collaborations and the adherence of the general population to government policies are key to prevent new epidemic waves.

: The ichthyofauna of Lake Tanganyika consists of 12 families of fish of which five belong to Siluriformes (catfishes). Studies on siluriforms and their parasites in this lake are very fragmentary. The present study was carried out to help fill the knowledge gap on the monogeneans parasitizing the siluriform fishes of Lake Tanganyika in general and more particularly Clarias gariepinus. The gills of a specimen of Clarias gariepinus (Clariidae) were examined for ectoparasites. We identified the monogenean Gyrodactylus transvaalensis (Gyrodactylidae). This is the first time this parasite was found infecting gills. We are the first to observe a large spine in the male copulatory organ of this species, and to provide measurements of its genital spines; this completes the description of the male copulatory organ which is important in standard monogenean identification. This is the first monogenean species reported on C. gariepinus at Lake Tanganyika and the third known species on a representative of Siluriformes of this lake. It brings the total number of species of Gyrodactylus recorded in Lake Tanganyika to four. Knowing that other locations where this species has been reported are geographically remote from Lake Tanganyika, we propose a “failure to diverge” phenomenon for G. transvaalensis.

In the context of global warming and reduction in fresh water availability is presented a study of the evolution of dew, rain and evapotranspiration in the NW of Africa. The time periods are concerned with the years 2005-2020, using existing data, and years 2020-2100, using the low and high emissions representative concentration pathway scenarios RCP 2.6/8.5 from the Cordex database. A continuous decrease in rain precipitation is observed, on order of -14 mm/decade for the more credible scenario RCP 8.5. The amplitude is maximum on the coast and on the foothills of Atlas. A clear decrease in dew yields is also observed along a NW/SE axis, strongly correlated with a corresponding decrease in relative humidity (up to 7%). Chemical dew and rain data in the representative site of Mirleft correspond to the major cations Na+ > Ca2+ > Mg2+ > K+, similar to a local spring water. Concentrations in rain are about two times less than in dew water. Ionic concentrations are compatible with WHO standards. The seasonal variations of the ionic concentrations in dew and rain follow a volume dilution dependence. The expected diminution in dew and rain volumes according to the RCPs 2.6 and 8.5 should increase the dew and rain ionic concentrations in the future.

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.

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.

The urban population in developing countries, especially sub-Saharan Africa, is rapidly increas-ing. As towns and cities grow, so does the demand for fish protein. While flow-through aqua-culture can provide fresh, healthy and nutritious fish protein, it is plagued by extensive land re-quirement as well as effluent discharge, thus, unsuitable for city regions. Alternatively, small-scale Recirculating Aquaculture System (RAS) could improve food and nutritional security (FNS), livelihoods as well as reduce environmental degradation in urban areas despite land and water constraints. The question however remains - what are the key technical, business and managerial issues, surrounding small-scale RAS in urban farming? This study reviews the RAS prototype of the Sustainable Aquaponics for Nutritional and Food Security in Urban Sub-Saharan Africa (SANFU) II project based on mass balance and stock density, relevant for fish survival and/or availability as well as net cash-flow analyses. The results suggest that small-scale RAS are technically and financially viable only with family labor having proper aquaculture monitoring and management skills. Furthermore, access to adequate equipment and inputs as well as electricity for the recirculating system are crucial. Urban innovation actors will adopt RAS if operations are profitable given that family labor is employed.

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.

In many developing countries, plastic waste management is left to citizens. This usually results in hazardous landfilling or open-air burning, leading to emissions that are harmful to human health and the environment. An easy, profitable, and clean method of processing and transforming the waste into value is required. In this context, this study provides an open-source methodology to transform low-density polyethylene drinking water sachets, into pavement blocks by using a streamlined do-it-yourself approach that requires only modest capital. Two different materials, sand, and ashes are evaluated as additives in plastic composites and the mechanical strength of the resulting blocks are tested for different proportion mix of plastic, sand, and ash. The best composite had an elastic modulus of 169MPa, a compressive strength of 29MPa, and a water absorptivity of 2.2%. The composite pavers can be sold at 100% profit while employing workers at 1.5X the minimum wage. In the West African region, this technology has the potential to produce 19 million pavement tiles from 28,000 tons of plastic water sachets annually in Ghana, Nigeria, and Liberia. This can contribute to waste management in the region while generating a gross revenue of 2.85 billion XOF (4.33 million USD).