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

Education on native tree species using indigenous knowledge systems is crucial in elementary school environmental education because it sensitizes learners on the significant roles played by the native trees and their interconnections with their culture and existence. Unfortunately in Ghana, there is no pedagogical model that would aid elementary school teachers in carrying out such education.This study was aimed at developing, implementing and evaluating an indigenous knowledge inspired pedagogical model for native tree education among elementary school learners in Ghana. The convergent parallel mixed methods design that aimed at collecting quantitative and qualitative datasets on the development and evaluation of the developed pedagogical model. The results show that the pedagogical model was deemed very satisfactory in all its aspects for native tree education among elementary school learners in Ghana. The model was able to assist in developing the sustainability consciousness and competence of elementary school learners toward caring for native trees through tree planting, making of nurseries and gardens, and engaging in native tree conservation campaigns. The study recommends that the Ministry of Education should adopt, improve and widely disseminate the pedagogical model and help in its broader implementation in various elementary schools across the country.

Malaria is a serious infection affecting millions of people in Africa. Our study investigated the personal preferences and applications of antimalarial medicines in Ghana. Based on over 1000 questionnaires distributed in Ghana from January to May 2019, we noticed that although Western medications to fight this disease are widely available, most patients in Ghana prefer treatment with locally produced herbal remedies. This preference appears to be due to a combination of traditional venues for obtaining medicines “on the street” rather than in licensed pharmacies, trust in local and “green” products, extensive advertisement of such local products, and an inherent distrust of imported and synthetic or unnatural medicines. Going local and natural is a trend also observed in other countries across the globe, and adds to the acceptance or rejection of drugs regardless of their activity or toxicity. In fact, adverse side effects associated with herbal remedies, such as general weakness and swollen, sore mouth, do not seem to deter the respondents of this study in Ghana. We propose a combination of (a) increasing public awareness of the benefits of modern medicine and (b) an improvement and control of the quality of herbal remedies to raise the standard of malaria treatment in countries such as Ghana.

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.

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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Management of urinary tract infection is challenged by increasing antimicrobial re-sistance (AMR) worldwide. In this study we describe the trends in antimicrobial re-sistance of uropathogens isolated from the largest private sector laboratory in Ghana over a five-year period. We reviewed positive urine cultures at the MDS Lancet Laboratories from 2017 to 2021. Proportions of uropathogens with antimicrobial resistance to oral and parenteral antimicrobials recommended by the Ghana standard treatment guidelines were determined. The proportion of multi-drug resistant isolates, ESBL and car-bapenemase-producing phenotypes were determined. Of 94,134 urine specimens submitted for culture, 20,010 (22.1%) were culture positive. Enterobacterales were the commonest group of organisms, E. coli (70.6) being the commonest isolate and Enterococcus spp. the commonest gram positive (1.3%) organisms. Among oral antimicrobials the highest resistance was observed to ciprofloxacin (62.3%) and cefuroxime (60.2) %) and the least resistance to Fosfomycin (1.9%). The least resistance among parenteral antimicrobials was to meropenem ( 0.3%). Highest multi-drug resistance levels were observed among Klebsiella spp. (68.6%) and E. coli (64.0%). ESBL positivity was highest in Klebsiella spp. (58.6%) and E. coli (50.0%). There may be a need to review the Ghana standard treatment guidelines to reflect increased resistance among uropathogens to recom-mended antimicrobials

Background: Monitoring of antibiotic prescription practices in hospitals is essential to assess and facilitate appropriate use. This is relevant to halt the progression of antimicrobial resistance. Methods: Assessment of antibiotic prescribing patterns and completeness of antibiotic prescriptions among out-patients in 2021 was conducted at the University Hospital of Kwame Nkrumah University of Science and Technology in the Ashanti region of Ghana. We reviewed electronic medical records (EMR) of 49,660 patients who had 110,280 encounters in the year. Results: The patient encounters yielded 350,149 prescriptions. Every month, 33-36% of patient encounters resulted in antibiotic prescription, higher than the World Health Organization’s (WHO) recommended optimum of 27%. Almost half of the antibiotics prescribed belonged to WHO’s Watch group. Amoxicillin-clavulanic acid (50%), azithromycin (29%), ciprofloxacin (28%), metronidazole (21%), and cefuroxime (20%) were the most prescribed antibiotics. Antibiotic prescribing parameters (indication, name of drug, duration, dose, route and frequency) were documented in almost all prescriptions. Conclusions: Extending antimicrobial stewardship to the out-patient settings by developing standard treatment guidelines, an out-patient specific drug formulary and antibiograms can promote rational antibiotic use at the hospital. The EMR system of the hospital is a valuable tool for monitoring prescriptions that can be leveraged for future audits.

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.

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.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The rapid growth of the elderly population is a major global demographic and social issue. Unfortunately, there is a shortage of pension plans and social se-curity programmes for this population in developing countries which has severe consequences for their quality of life and planetary health (PH) wellbeing. In this article, we aimed to better understand the pension systems in Ghana, Pakistan, and Myanmar, by reviewing the official government materials (such as pension reports) and published literature. We observed several policy implementation gaps and inequity in pension schemes for older people, specifically for informal and private sector workers. Considering the size of formal versus informal economies and the level of development index of each country, we suggest a wide variety of options in pension policies, financing, designing cash benefits and pension payments to cover all older citizens. This article addresses an unmet need of the elderly people, their wider environmental and economic sustainability to ensure social justice and resource utilization. The governments of developing countries should embrace and establish unique, inclusive, and friendly policies encompassing the informal sector to warrant older adults’ functional and planetary wellbeing with dignity and honor.

(1) Background: Rational use of medicines (RUM) and their assessment is important to ensure optimal use of resources and patient care in hospitals. These assessments are essential to identifying practice gaps for quality improvement. (2) Methods: Assessment of adherence to WHO/ International Network for Rational Use of Drugs core prescribing indicators among out-patients in 2021 was conducted at the University Hospital of the Kwame Nkrumah University of Science and Technology in the Ashanti region of Ghana. We reviewed electronic medical records (EMR) of 110,280 patient encounters in the year which resulted in 336,087 medicines prescribed. (3) Results: The average number of medicines prescribed per encounter was 3 with generics being prescribed in 76% of prescriptions. Injections were prescribed in 7% of encounters while 90% of medicines were from Ghana’s Essential Medicines List 2017. (4) Conclusions: With the exception of patient encounters with injections, all prescribing indicators assessed in this study did not meet WHO optimum levels providing targets for quality improvement in RUM. Implementing prescribing guides and policies, regular audits and feedback as well as continuous professional development training may help to improve prescribing practices in the hospital.

This service improvement project was carried out at LEKMA Hospital, Ghana. Ghana has high levels of antimicrobial resistance (AMR). There is an urgent need to introduce models of care that optimize antibiotic prescribing. Methods Delayed / back-up prescribing is a strategy that could reduce antibiotic use in suspected upper respiratory tract infections. Four different models of delayed / back-up prescribing [no prescription; post-dated prescription (given to patient); post-dated prescription (forwarded to pharmacy); and follow-up appointment for reassessment after 3 days] were implemented in discussion between clinician and patient. Patients were contacted 10 days after their appointment to record compliance, check on their wellbeing, and rate their experience. Results Over a 3-month period (12/2019-02/2020), 142 patients were eligible for delayed / back-up prescribing. The most common clinical diagnoses were sore throat (102/140, 73%), common cold (22/140, 16%) and sinusitis (10/140, 7%). In total, 12 (9%) patients remained symptomatic at day 10, and only one individual in the entire cohort took antibiotics. Most patients (95%) rated their experience as good or very good. Conclusions Delayed / back-up prescribing models can lead to substantial reduction in antibiotic consumption amongst outpatient department patients with suspected upper respiratory tract infections. Delayed / back-up prescribing can be implemented safely in low and middle-income countries.

(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 &lt;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.

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.

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.

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.

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.

This paper investigates how agroecology in Africa is researched for two purposes. First, we present evidence of links between agroecology and food and nutrition security in sub-Saharan Africa. Second, we investigate which pathways of influence are dominant in the existing research and which pathways are under-represented. To achieve these objectives we anchor our analysis within feminist economics, thereby making use of the concepts of social reproduction and agency in our analysis of the literature. By employing a systematic literature review of empirical studies from African countries, starting from 1996 to 2020, we consolidate evidence that agroecology has contributed to food and nutrition security by acting toward sustainability at the farm level. However, our review shows in a second step that social and household dimensions of agroecology at the level of households and territories are not well documented in research linking agroecology to food security and nutrition in sub-Saharan Africa. Given that sustainable production practices such as agroecological practices are not mutually exclusive from the social activities of farmers and cultural contexts in which farmers are embedded, it is important to consider social and ecological processes concomitantly when assessing the value of Agroecology programs.

Abstract: Diabetes mellitus (DM) is associated with severe COVID-19 infection and complications. This study assessed COVID-19 vaccine acceptance and hesitancy in diabetes and explored reasons for nonvaccinating. This was a web-based cross-sectional survey using a mixed-method approach conducted between March-May 2021 corresponding to most SSA countries' early vaccine rollout period. Participants were those aged ≥18 years with self-reported DM in 11 Sub-Saharan African (SSA) countries. Responses to comments on reasons for vaccine hesitancy and facilitators for vaccine uptake were analyzed. Of the 73 participants with DM, 65.8% were males older than 35 years (86.3%), had post-secondary education (90%), and a significant proportion was from South Africa (39.7%), Nigeria (28.8%) and Ghana (13.7%). 64.4% had COVID-19 symptoms, 46.6% were tested for COVID-19, of which 19.2% tested positive. Few participants (6.8%) had taken the COVID-19 vaccination, 65.8% were willing to take the vaccine, while 26.0% either refused or hesitated to take the vaccine. The main reasons identified for not taking the vaccine were: advice from religious leaders, concerns about the vaccine safety, its effects, and efficacy, mistrust of the pharmaceutical companies, the conspiracy theories around the vaccines, the process of production, and the personal belief of the participants. However, participants stated they would take the vaccine if given more education about it, receive positive feedback from those vaccinated, are rewarded for taking the vaccine or if vaccination becomes a condition for travel and employment. The findings of this study showed that uptake of the COVID-19 vaccine was very low in this high-risk group. It is imperative that efforts to increase the uptake of vaccines, such as the provision of education and relevant information, are made.

The study evaluated the association between nutrient patterns and body fat and regional adiposity in middle-aged black South African (SA) men and women and determined if this differed by sex. Body fat and regional adiposity (dual-energy x-ray absorptiometry), and dietary intake (7-day quantified food frequency questionnaire) were measured in black SA men (n=414) and women (n=346). Using principal component analysis, nutrient patterns were computed from 25 nutrients in the combined sample. Four nutrient patterns were extracted, explaining 67% of the variance in nutrient intake. Animal and fat, as well as the vitamin C, sugar and potassium driven patterns, were positively associated with total adiposity. In contrast, the retinol and vitamin B12 pattern was associated with the centralisation of fat. Notably, the strength of the association between the animal-driven nutrient pattern and BMI was greater in men (1.14 kg/m2, 95%CI (0.63-1.66)) than women (0.81 kg/m2, 95%CI (0.25-1.36)) (Pint=0.017). In contrast, the plant driven pattern was associated with higher abdominal subcutaneous adipose tissue (SAT) in women (44 cm2, 95%CI (22-67)) but not men (Pint =1.54 x 10-4). These interactions suggest that although men and women have similar nutrient patterns, the associations with the whole body and regional body fat are different.

Satellite-based broad-scale (i.e., global and continental) human settlement data offer foundational information for diverse applications spanning climate hazard mitigation, sustainable development monitoring, spatial epidemiology, and demographic modeling. While many human settlement products report exceptional detection accuracies above 85%, there is a substantial blind spot in that product validation is typically centered on large urban areas rather than rural, small-scale settlements that are home to 3.4 billion people. In this study, we make use of a data-rich collection of 30 refugee settlements in Uganda to produce a targeted assessment of small-scale settlement detection by four broad-scale human settlement products: Global Human Settlements Built-Up Sentinel-2 (GHS-BUILT-S2), World Settlement Footprint (WSF), High Resolution Settlement Layer (HRSL), and Geo-Referenced Infrastructure and Demographic Data for Development (GRID3). We measured each product’s areal coverage within refugee settlements, assessed product detection accuracies in comparison to an independent dataset of 317,416 refugee settlement building footprints, and examined agreement between products. For refugee settlements established before 2016, the human settlement products had a low median F1-Score (F1) of 0.24, a high median false alarm rate of 0.59, and tended to only agree at locations of highest building density. Individually, WSF entirely overlooked 8 of the 30 study refugee settlements (median F1=0.17); GHS-BUILT-S2 underestimated the building footprint area by a median 50% (F1=0.15); GRID3 overestimated the building footprint area by a median 280% (F1=0.38); and HRSL underestimated the median area by 7% (F1=0.34). All products suffer from low detection accuracy and high false alarm rates, but GRID3 and HRSL, based on 0.5 meter resolution imagery, offer better detection accuracy than GHS-BUILT S2 and WSF, which are based on 10-30 meter resolution imagery. These results show that human settlement products have far to go in providing an accurate depiction of small-scale refugee settlements and would benefit from incorporating refugee settlements in training and validation of broad-scale human settlement detection.

Globally, there are 1.35 million road fatalities every year, which are estimated to cost governments approximately US$ 518 billion, making road fatalities the 8th leading cause of death across all age groups and the leading cause of death of children and young adults. In South Africa, despite tremendous governmental efforts to curb the soaring trajectory of road accidents, the annual number of road fatalities has increased by 26% in recent years. By fitting a structural equation model (SEM) and a GARCH Model (Generalized Auto-Regressive Conditional Heteroskedastic-ity) to analyze and predict future trend of road accidents (number of road accidents, number of casualties, number of fatal crashes and number of persons killed) in South Africa, we propose and test a complex metamodel that integrates multiple causality relationships. We show an increasing trend of road accidents over time, a trend that is predictable by number of vehicles in the country, the population of the country and the total distance travelled by vehicles. We further show that death rate linked to road accidents is on average 23.14 deaths per 100,000 persons and is pre-dictable following the equation: y = -0.0114x2+1.2378x-2.2627 (R2=0.76) with y = death rate and x = year. Finally, in the next decade, the number of road accidents is predicted to be roughly constant at 617,253 accidents but can reach 1 896 667 accidents in the worst-case scenario. The number of casualties was also predicted to be roughly constant at 93 531 over time, although this number may reach 661 531 in the worst-case scenario. However, although the number of fatal crashes may decrease in the next decade, it is forecasted to reach 11 241 within the next 10 years with the worse scenario estimated at 19 034 within the same period. At the same time, the number of persons killed in fatal crashes is also predicted to be roughly constant at 14 739 but may also reach 172 784 in the worse scenario. Overall, the present study reveals perhaps the positive effects of government initiatives to curb road accidents and their consequences; we call for more stronger actions for a drastic reduction in road accident events in South Africa.

This research assesses the changes in the total water storage (TWS) during the twentieth century and their future projections in the Nile River Basin (NRB) via TWSA (TWS anomalies) records from GRACE (Gravity Recovery and Climate Experiment), GRACE-FO (Follow-On), data-driven-reanalysis TWSA and land surface model (LSM), in association with precipitation, temperature records, and standard drought indicators. The analytical approach incorporates the development of 100+ yearlong TWSA records using a probabilistic conditional distribution fitting approach by the GAMLSS (Generalized Additive Model for Location, Scale, and Shape) model. The drought and flooding severity, duration, magnitude, frequencies, and recurrence were assessed during the studied period. The results showed, 1- The NRB between 2002 to 2020 has transited to substantial wetter conditions. 2- The TWSA reanalysis records between 1901 to 2002 revealed that the NRB had experienced a positive increase in TWS during the wet and dry seasons. 3- The projected TWSA between 2021 to 2050 indicated slight positive changes in TWSA during the rainy seasons. The analysis of drought and flooding frequencies between 1901 to 2050 indicated the NRB has ~64 dry-years compared to ~86 wet-years. The 100+ yearlong TWSA records assured that the NRB transited to wetter conditions relative to few dry spells. These TWSA trajectories call for further water resources planning in the region especially during flood seasons. This research contributes to the ongoing efforts to improve the TWSA assessment and its associated dynamics for transboundary river basins. It also demonstrates how an extended TWSA record provides unique insights for water resources management in the NRB and similar regions.

The most widely distributed bla_CTX-M gene on a global scale is bla_CTX-M-15. The dissemination has been associated with clonal spread and different types of mobile genetic elements. This study aimed to review and describe the genetic environments of bla_CTX-M-15 gene detected from Enterobacteriaceae in published literature from Africa. A literature search for relevant articles was done through PubMed, and Google Scholars electronic databases, 43 articles from 17 African countries were included in the review based on the eligibility criteria. Insertion sequences were reported as part of the genetic environment of bla_CTX-M-15 gene in 32 studies, integrons in 13 studies, and plasmids in 23 studies. In this review, five insertion sequences including ISEcp1, IS26, orf447, IS903, and IS3 have been detected associated with the genetic environment of bla_CTX-M-15 in Africa. Seven different genetic patterns were seen in bla_CTX-M-15 genetic environment. Insertion sequence ISEcp1 was commonly located upstream of the end of the bla_CTX-M-15 gene while insertion sequence orf477 was located downstream. In some studies, ISEcp1 was truncated upstream of bla_CTX-M-15 by insertion sequences IS26 and IS3. Class 1 integron (Intl1) was most reported to be associated with bla_CTX-M-15 (13 studies), with Intl1/dfrA17–aadA5 being the most common gene cassette array. IncFIA-FIB-FII multi-replicons and IncHI2 replicon types were the most common plasmid replicon types that horizontally transfer bla_CTX-M-15 gene. Aminoglycoside modifying enzymes, and plasmid-mediated quinolone resistance genes were commonly collocated with bla_CTX-M-15 gene on plasmids. This review revealed the predominant role of ISEcp1, Intl1and IncF plasmid in the mobilization and continental dissemination of the bla_CTX-M-15 gene in Africa.

Lead exposure is associated with poor cognitive development in children. Very few studies in sub-Saharan Africa (SSA) have studied blood lead levels (BLLs) and non-gasoline sources of exposure in children. Data from a birth cohort in Benin (2011-2013) suggested that 58% of one-year-old children had BLLs > 50 ug/L. We aimed to investigate the prevalence of elevated BLLs (>50 µg/L and >100 µg /L) among 425 of these children at six-years-of-age in 2016-18 and to compare BLLs between age one-year and six-years and study sources of lead at six years. BLLs were analyzed by inductively coupled plasma mass spectrometry. Multiple linear regression and quantile regressions were used to study potential sources of lead. The prevalence of BLLs >50 µg/L in children was 59.5% [Geometric Mean (GM) 56.4 µg/L, 95% CI: 54.1 - 58.7] at six years of age compared to 54.8% [GM 56.5 µg/L, 95% CI: 53.4-59.6] at one year of age. The prevalence of children with BLLs >100 µg/L decreased from 14.4% at one year of age to 8.2% at six years of age. After adjustment for all other covariates, consumption of peanut more than once per month was significantly associated with a 22.0% (95% CI: 4.6, 42.5) increment in BLLs at six years compared with no consumption. Consumption of bushmeat killed by lead bullets at six years was associated with an increase in the higher percentiles of BLLs (P75) compared with the absence of this source. Other potential sources of lead associated with BLLs with marginal significance were consumption of rice, paternal occupational exposure, and the presence of activity with the potential use of lead. This prospective cohort confirms the persistently high prevalence of elevated BLLs in children residing in a rural region in the south of Benin as well as the presence of multiple and continuous sources of lead. These results highlight the need for prevention programs to reduce and eliminate lead exposure in children.

Nigeria is the most populous country in the African continent. The aim of this study was to analyze risk factors for COVID-19 prevalence and deaths in all 6 geopolitical regions and 37 states in Nigeria. We analyzed the data retrieved from various sources, including Nigeria CDC, Nigeria National Bureau of Statistics, Unicef-Nigeria multiple indicator cluster survey and the Institute of Health Metrics and Evaluation, University of Washington. We examined 4 clinical risk factors (prevalence of TB, HIV, smoking and BCG vaccination coverage) and 5 sociodemographic factors (age ≥65, population density, literacy rate, unemployment and GDP per capita). Multivariate modeling was conducted using generalized linear model. Our analysis showed that the incidence of confirmed COVID-19 cases differed widely across the 37 states, from 0.09 per 100,000 in Kogi to 83.7 in Lagos. However, more than 70% of confirmed cases were concentrated in just 7 states: Lagos, Abuja, Oyo, Kano, Edo, Rivers and Delta. Case mortality rate (CMR) per million population also varied considerably, with Lagos, Abuja and Edo having CMR above 9. On bivariate analysis, higher CMR correlated positively with GDP and to a lesser extent with TB and population density. On multivariate analysis, which is more definitive, states with higher HIV prevalence and BCG coverage had lower CMR, while high GDP states had a greater CMR. This study indicates that COVID-19 has disproportionately affected certain states in Nigeria. Population susceptibility factors include higher economic development but not literacy or unemployment. Death rates were mildly lower in states with higher HIV prevalence and BCG vaccination coverage.

The COVID-19 pandemic has created extraordinary challenges and prompted remarkable social changes around the world. The implications of the novel coronavirus and the public health control measures that have been implemented to mitigate its impact are likely to be accompanied by a unique set of consequences for specific populations living in low income-countries that have fragile health systems and pervasive social-structural vulnerabilities. This paper discusses the implications of COVID-19 and related public health interventions for children and young people living in Eastern and Southern Africa. Actionable prevention, care, and health promotion initiatives are proposed to attenuate the negative effects of the pandemic and government-enforced movement restrictions on children and young people.

Background: There are major air pollution monitoring gaps in sub-Saharan Africa. Developing capacity in the region to conduct air monitoring in the region can help estimate exposure to air pollution for epidemiology research. The purpose of our study is to develop a land use regression (LUR) model using low-cost air quality sensors developed by a research group in Uganda (AirQo). Methods: Using these low-cost sensors, we collected continuous measurements of fine particulate matter (PM2.5) between May 1, 2019 and February 29, 2020 at 22 monitoring sites across urban municipalities of Uganda. We compared average monthly PM2.5 concentrations from the AirQo sensors with measurements from a BAM-1020 reference monitor operated at the US Embassy in Kampala. Monthly PM2.5 concentrations were used for LUR modeling. We used eight Machine Learning (ML) algorithms and ensemble modeling; using 10-fold cross validation and root mean squared error (RMSE) to evaluate model performance. Results: Monthly PM2.5 concentration was 60.2 µg/m³ (IQR: 45.4-73.0 µg/m³; median= 57.5 µg/m³). For the ML LUR models, RMSE values ranged between 5.43 µg/m³ - 15.43 µg/m³ and explained between 28% and 92% of monthly PM2.5 variability. Generalized additive models explained the largest amount of PM2.5 variability (R²=0.92) and produced the lowest RMSE (5.43 µg/m³) in the held-out test set. The most important predictors of monthly PM2.5 concentrations included monthly precipitation, major roadway density, population density, latitude, greenness, and percentage of households using solid fuels. Conclusion: To our knowledge, ours is the first study to model the spatial distribution of urban air pollution in sub-Saharan Africa using air monitors developed from the region itself. Non-parametric ML for LUR modeling performed with high accuracy for prediction of monthly PM2.5 levels. Our analysis suggests that locally produced low-cost air quality sensors can help build capacity to conduct air pollution epidemiology research in the region.

The importance of ICTs for dissemination of information to farmers has been verified by extension practitioners, information and communication scholars, policy makers and development agencies. Information related to new seed varieties, production technologies, livestock breeds, vaccines, including weed and pest control, as well as relevant market information is constantly required by smallholder farmers. The identification of specific attributes among smallholder farmers which contributes to their adoption of a proposed ICT-based information source provides an important tool for developing interventions which address the information needs of farmers. Using a literature survey methodology, pertinent studies related to adoption of ICTs, farmers’ information source usage and relevant frameworks were identified, including applicable theories and models in technology adoption and information behaviour. In the proposed framework, the socio-economic characteristics of smallholder farmers were posited as key variables influencing smallholder farmers, within a farming system, to adopt ICT-based information sources. The framework contributes to discern the prospects of adopting ICT-based information sources by individual farmers within a farming system, and may also envisage other related welfare outcomes and market participation pathways among smallholder farmers. The review also addresses the paucity of conceptual discourse, while contributing to a growing pool of research on ICT in African agriculture.

This study analyses uncertainties associated with the main features of the annual cycle of West African rainfall (amplitude, timing, duration) in 15 CMIP5 simulations over the Sahelian and Guinean regions with satellite daily precipitation estimates. The annual cycle of indices based on daily rainfall such as the frequency and the intensity of wet days, the consecutive dry (CDD) and wet days (CWD), the 95th percentile of daily rainfall (R95) have been assessed. Over both regions, satellite datasets provide more consistent results on the annual cycle of monthly precipitation than on higher-frequency rainfall indices, especially over the Guinean region. CMIP5 simulations display much higher uncertainties in both the mean precipitation climatology and higher-frequency indices. Over both regions, most of them overestimate the frequency of wet days. Over the Guinean region, the difficulty of models to represent the bimodality of the annual cycle of precipitation involves systematic biases the frequency of wet days. Likewise, we found strong uncertainties in the simulation of the CWD and the CDD over both areas. Finally, models generally provide too early (late) onset dates over the Sahel (the Guinean region) and overestimate rainfall during the early and late monsoon phases. These errors are strongly coupled errors in the latitudinal position of the ITCZ and do not compensate at the annual scale nor when considering West Africa as a whole. wet days. We found strong uncertainties in the simulation of the CWD and he CDD over both areas. Conversely for R95p and R95PTOT, the ncertainties in CMIP5 models appear somewhat weaker, but the magnitude f R95 is largely underestimated in most models.

This study analyses uncertainties associated with the annual cycle of West African rainfall characteristics in 15 simulations of the Coupled Model Intercomparison Project phase 5 (CMIP5) over the Sahel and Guinean regions. Indices based on daily rainfall such as the frequency and the ntensity of wet days, the consecutive dry days (CDD) and wet days (CWD), the 95th percentile of daily rainfall (R95) and its contribution to the umulative monsoon rainfall (R95PTOT) have been assessed. Over both regions, TRMM, GPCP and CHIRPS observational datasets provide very consistent results on the annual cycle of precipitation but less so on the frequency of wet days. Conversely, higher uncertainties are noted on the intensity of wet days over both study areas, particularly over the Guinean region. Overall, CMIP5 simulations present much higher uncertainties in the representation of the mean precipitation climatology, often provide too early (late) onset dates over the Sahel (the Guinean region) and overestimate rainfall during the early and late monsoon phases. These errors do not compensate at the annual scale nor when considering West Africa as a hole. Results also reveal that over the Guinean region, the difficulty of models to represent the annual structure of the mean precipitation strongly involves biases in the representation of the annual cycle of the frequency of wet days. We found strong uncertainties in the simulation of the CWD and he CDD over both areas. Conversely for R95 and R95PTOT, the ncertainties in CMIP5 models appear somewhat weaker, but the magnitude of R95 is largely underestimated in most models.

Advances in remote sensing have led to use of satellite-derived rainfall products to complement the sparse rain gauge data. Although globally derived and some regional bias corrected, these products often show large discrepancies with ground measurements attributed to local and external factors that require systematic consideration. Decreasing rain gauge network however inhibits continuous validation of these products. We propose to deal with this problem by the use of Bayesian approach to merge the existing historical rain gauge information to create a consistent satellite rainfall data that can be used for climate studies. Monthly Bayesian bias correction is applied to the Climate Hazards Group Infrared Precipitation with Stations (CHIRPS v2) data to reduce systematic errors using a corresponding gridded (0.05°) rain gauge data over East Africa for a period of 33 (1981–2013) years of which 22 years are utilized to derive error fields which are then applied to an independent CHIRPS data for 11 years for validation. The bias correction is spatially and temporally assessed during the rainfall wet months of March-May (MAM), June-August (JJA) and October–December (OND) in East Africa. Results show significant reduction of systematic errors at both monthly and yearly scales and harmonization of their cumulative distributions. Monthly statistics showed a reduction of RMSD (29–56)% and MAE (28–60)% and an increase of correlations (2–32) %, while yearly ones showed reductions of RMSD (9-23)%, and MAE (7–27)% and increase of correlations (4–77)% for MAM months, reduction of RMSD (15–35)% and MAE (16–41)% and increase in correlations (5–16)% for JJA months, and reduction of RMSD (3–35)% and MAE (9–32)% and increase of correlations (3–65)% for OND months. Systematic errors of corrected data were influenced by local processes especially over Lake Victoria and high elevated areas. Large-scale circulations induced errors were mainly during JJA and OND rainfall seasons and were reduced by the separation of anomalous years during training. The proposed approach is recommended for generating long-term data for climate studies where consistencies of errors can be assumed.

It is well recognised that the mining industry in South Africa is highly rated for its substantial contribution to the country’s economic growth, including employment and infrastructural development. It is also known that mining and ore processing activities potentially pose a severe threat to public health and environmental well-being, in the way operations are carried out, mine wastes are disposed of (in dumps), local communities are relocated, mine management and the mining community in general, perceive established environmental standards and etiquette. This paper examines ethical practices and norms in the South African mining industry, with particular reference to the management of tailings dams. We analyse the modes of articulation of the country’s regulatory instruments for tailings management, and review the corporate social responsibility (CSR) approach of leading mining companies. Despite decades of research and resulting recommendations on tailings management, it is concluded that current legislations are largely ineffective, level of adherence by mine management and the mining community, low, and mechanisms for compliance monitoring, weak. New perspectives on legislative issues for unsolved problems in tailings handling are put forward, and directions for future research, indicated.

Savannas and adjacent vegetation types like gallery forests are highly valuable ecosystems contributing to several ecosystem services including carbon budgeting. Financial mechanisms such as REDD+ have provided an opportunity for developing countries to alleviate poverty through conservation of its forestry resources. For availing this opportunity carbon stock assessments are essential. Therefore, a research study at two protected areas i.e. Nazinga Game Ranch and Bontioli Nature Reserve, in Burkina Faso was conducted with the objective of assessing carbon Mg C ha-1 in aboveground biomass (AGB)dry of trees in different formations of the south-sudanian savanna in Burkina Faso, West Africa. Similarly analysis of various vegetation parameters was also conducted to understand the overall vegetation structure of these two protected areas. For estimating AGBdry, existing allometric equation for dry tropical woody vegetation types was used. The Importance Value Index (IVI) and Family Importance Value (FIV) were estimated through standard procedures. Various linear and non-linear regression analyses were conducted to test the relationships between carbon and other parameters such as DBH, height and basal area (BA). The results showed that both sites collectively contain mean carbon of 3.41 ± 4.98 Mg C ha-1. Amongst different vegetation types, gallery forests recorded the highest mean carbon of 9.38 ± 6.90 Mg C ha-1. The highest IVI of 115.56 at Nazinga Game Ranch was recorded for Anogeissus leiocarpa. Similarly, highest IVI of 98.59 was recorded for Mitragyna inermis at Bontioli Nature Reserve. The highest FIV was recorded for Combretaceae for both of the sites. To our knowledge, this was the first study conducted to assess the carbon stocks at the two protected areas in southern Burkina Faso. The study therefore was an attempt for addressing the knowledge gap particularly on carbon stocks of protected savannas. It could serve as a baseline for carbon stocks for future initiatives such as payment for environmental services and REDD+ at these areas.

The African society is one of the societies with rich culture and traditions. Apart from the indigenous religion of Africa, Christianity and Islam are worshiped as the major religions of the African society. Literature reflects a great amount of influence of religions on the existing societies, people and cultures. African literature often mirrors the clash of indigenous religion with Christianity. In the writings of African authors one can find the elements of Christian beliefs and practices. The present paper, however, is focused on the African woman novelist Buchi Emecheta’s selected four novels: Second-Class Citizen (1974), The Bride Price (1976), The Slave-Girl (1977) and The Joys of Motherhood (1979). The paper attempts to discuss the impact of Christianity on the social and cultural aspects of the African society with special focus on African women. The findings reveal the positive as well as negative impacts of the new religion on African people and on the position of African women through the characters present in the selected novels. With the medium of writing and through Christianity, Emecheta seek to educate her society and improve upon the position of the African women.

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.

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.

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.

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.

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

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.

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.

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.

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.

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.

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.

Unlike their marine counterparts, tropical freshwater clupeids receive little scientific attention. However, they sustain important fisheries that may be of (inter)national commercial interest. Africa harbours over 20 freshwater clupeid species within Pellonulini. Recent research suggests their most abundant parasites are gill-infecting monogenean flatworms within Kapentagyrus. After inspecting specimens of 12 freshwater clupeids from West and Central Africa, mainly sourced in biodiversity collections, we propose 11 new species of Kapentagyrus which we describe using their haptoral and genital morphology. Because of their high morphological similarity, species delineation relies mostly on morphometrics of anchors and hooks. Specifically, earlier, molecular taxonomic work indicated that the proportion between the length of the anchor roots, and between hook and anchor length, are diagnostic. On average, about one species of Kapentagyrus exists per pellonuline species, although Pellonula leonensis harbours four species and Microthrissa congica two, while Microthrissa moeruensis and Potamothrissa acutirostris share a gill monogenean species. This study more than quadruples the number of known species of Kapentagyrus, also almost quadrupling the number of pellonuline species of which monogeneans are known. Since members of Kapentagyrus are informative about their hosts’ ecology, evolutionary history, and introduction routes, this enables a parasitological perspective on several data-poor African fisheries.

Land use land cover (LULC) changes are highly pronounced in African countries, as they are characterized by an agriculture-based economy and a rapidly growing population. Understanding how land use/cover change (LULCC) influence watershed hydrology will enable local governments and policymakers to formulate and implement effective and appropriate response strategies to minimize the undesirable effects of future land use/cover change or modification and sustain the local socio-economic situation. The hydrological response of the Ethiopia Fincha’a watershed to LULCC happened during the last 30 years was investigated comparing the situation in three reference years: 1994, 2004 and 2018. The information was derived from Landsat sensors, respectively Landsat 5 TM, Landsat 7 ETM and Landsat 8 OLI/TIRS. The various LULC classes were derived via ArcGIS using a supervised classification system, and the accuracy assessment was done using confusion matrixes. For all the years investigated the overall accuracies and the kappa coefficients were higher than 80%, with 2018 as the more accurate year. The analysis of LULCC revealed that forest decreased by 19.99% between the years 1994-2004, and it decreased by 11.85% in the following period 2004-2018. Such decline in areas covered by forest is correlated to an expansion of cultivated land by 16.4% and 10.81%, respectively. After having evaluated the LULCC at the basin scale, the watershed was divided into 18 sub-watersheds, which contained 176 Hydrologic Response Units (HRUs), having a specific LULC. Accounting for such a detailed subdivision of the Fincha’a watershed, the SWAT model was firstly calibrated and validated on past data, and then applied to infer information on the hydrological response of each HRU on LULCC. The modelling results pointed out a general increase of average water flow, both during dry and wet periods, as a consequence of a shift of land coverage from forest and grass towards settlements and build-up areas. The present analysis pointed out the need of accounting for past and future LULCC in modelling the hydrological responses of rivers at the watershed scale.

Competition over environmental and natural resources characteristically lies at the heart of armed conflicts in Africa. It is also common knowledge that some companies dealing in products such as laptops, smart phones and jewellery; import minerals from conflict-affected areas, thereby indirectly fuelling conflicts in these areas or undermining human rights. For a continent endowed with natural resources including minerals, Africa has suffered the brunt of this predicament. This state of affairs has lent impetus to the adoption of several regulations geared towards curbing irresponsible business practices by companies relying on such minerals, the goal being, amongst others, to guarantee the protection of human rights. In May 2017, the European Union adopted Regulations intended to stop the importation of conflict minerals in Europe, debatably making giant strides in the direction of protection of human rights. These Regulations are to come into force in 2021. However, can these regulations advance the much-desired goal of protection of human rights in Africa on issues pertaining to conflict minerals? By analyzing the 2017 EU Regulations in light of previous regulations of a similar nature, the paper concludes that the said regulations constitute a weak normative framework and could in fact have unintended consequences on the fundamental rights of civilians in natural resource-rich conflict areas of Africa.