Background: Unsafe abortion (USA) is defined as the termination of a non-desired pregnancy, performed by an unqualified person or in an environment without minimum medical standards, or both. It can impact negatively ...Background: Unsafe abortion (USA) is defined as the termination of a non-desired pregnancy, performed by an unqualified person or in an environment without minimum medical standards, or both. It can impact negatively the fertility in the future by tubo-peritoneal lesions. The current study aimed to highlight the infertility factors associated with USA. Material and Methods: From January 1st 2000 to December 31st 2021, a total of 3876 patients that sought care for infertility in the University Clinic of Kinshasa and the Edith Medical Center were enrolled. The socio-demographic, clinical and paraclinical variables were recorded and analyzed in relation to USA history. Results: The patients’ average age was 33.4 ± 5.7 years. Half of them were housewives;about sixty percent of the patients were nulliparous (59.31%). Seventy percent had a secondary infertility with 43.33% having a history of unsafe abortion. The main diagnosis was genital infections and uterus myoma. The chronic endometritis, bilateral tubal occlusion and Uterine synechiae were more associated with USA group. The spermogram anomalies and other partners’ lesions seemed of infectious origin. Conclusion: The USA remains a more frequent phenomenon in our setting. The chronic endometritis, bilateral tubal occlusion, uterine synechiae and indirectly uterus myoma were the infertility factors related to USA. The genital infection of any origin seems to be the main denominator underlying the female and the male infertility in our setting.展开更多
Objectives This study aimed to determine the current prevalence of nurse retention in Sub-Saharan Africa(SSA),evaluate the strategies and interventions in SSA countries used to retain their nurses,and identify the key...Objectives This study aimed to determine the current prevalence of nurse retention in Sub-Saharan Africa(SSA),evaluate the strategies and interventions in SSA countries used to retain their nurses,and identify the key challenges impeding nurse retention.Methods A systematic review and meta-analysis were conducted.An electronic search was performed in August 2024 across multiple databases,including PubMed,Ovid Medline,Embase,CINAHL,Scopus,and grey literature sources.The studies were screened using Covidence,and quality assessments were conducted using the Mixed Methods Appraisal Tool.Results A total of 31 articles were included in the review.Meta-analysis revealed that the pooled nurses’retention rate in SSA was 53%(95%CI:38%–67%;I2=97%),while the pooled intention to stay(ITS)rate at work was 57%(95%CI:43%–71%;I2=99%).Subgroup analysis by region showed that the ITS rate was highest in East Africa(65%),followed by West Africa(63%),and lowest in Southern Africa(35%).Effective retention strategies included financial and non-financial incentives,increased production and training of nurses,steering students to shortage specialties,adequate rural housing,facility level improvements,availability of career and professional progression opportunities,nurses’recognition and involvement,employment terms,transparency and predictable management of human resources,supportive work environments,leadership,religious factors,and stakeholders’collaborations.Key challenges to nurses’retention include inadequate healthcare funding,governance issues,poor remuneration and working conditions,political interference,high unemployment rates,ineffective mobility management,unregulated international migration,and active recruitment by wealthier nations.Conclusions Nurse retention in SSA remains critically low.Interventions should be formulated for the above-mentioned effective improvement strategies to address these systemic challenges in order to retain nurses in SSA.展开更多
Since 1960,there have been more than thirty UN peacekeeping missions across Africa,the most of any region in the context of the conflicts that have plagued the region for decades.It has become increasingly evident tha...Since 1960,there have been more than thirty UN peacekeeping missions across Africa,the most of any region in the context of the conflicts that have plagued the region for decades.It has become increasingly evident that official diplomacy is not enough to resolve these crises.Experience shows that given the people’s reliance on religion,religion has continued to act as a force of conflict prevention and resolution in the region.The role played by faith-based diplomats has gained the trust of the conflict parties such that it would be unwise for national and international actors to neglect their role in policy making and conflict prevention and resolution.展开更多
Burkitt’s lymphoma(BL)is among the most common pediatric cancers in Sub-Saharan African children,accounting for 30-50%of malignancies in Sub-Saharan African children,with a strong etiological link with Epstein-Barr v...Burkitt’s lymphoma(BL)is among the most common pediatric cancers in Sub-Saharan African children,accounting for 30-50%of malignancies in Sub-Saharan African children,with a strong etiological link with Epstein-Barr virus(EBV)infection.The disease is especially aggressive in nature,with more than 70%mortality when diagnosed at advanced stages which is frequent and resulting from poor healthcare infrastructure and limited access to diagnostic facilities.Liquid biopsy approaches,which detect tumor-derived components in bodily fluids,offer promising potential for early,minimally invasive detection of EBV-positive BL.Emerging evidence suggests liquid biopsy methods can reduce diagnostic delays from weeks to≤48 h without compromising>85%concordance with tissue biopsy,demonstrated in Malawi and Kenyan pilot trials(2021-2023).According to the WHO-AFRO report(2023),due to administrative and cost burdens,only 15%of regional clinics are offering liquid biopsy testing as liquid biopsy test costs approximately 120/test as compared to histopathology,which costs$35.This review critically evaluates the technical and implementation challenges associated with developing liquid biopsy assays specifically tailored for BL detection in resource-limited settings across Sub-Saharan Africa.We discuss recent technological advances in circulating tumor DNA(ctDNA)analysis,EBV biomarker detection as technical validations of ctDNA and EBV marker assays have 90-95%sensitivity in early studies,and point-of-care diagnostics,alongside the logistical,economic,and sociocultural barriers to their effective implementation.Additionally,we propose strategic frameworks for overcoming these challenges through collaborative international partnerships,capacity building initiatives,and context-appropriate technology adaptation.Through all these cross-sector partnerships and approaches could transform BL outcomes by enabling stage-shift to 80%early-stage diagnoses,reducing mortality rates by 50%,potentially doubling survival rates in high-burden regions.展开更多
There has been an increase in mental health problems in Sub-Saharan Africa.Considering this,it is critical to track the region’s level of mental health literacy(MHL)to identify key mental health priorities and to dir...There has been an increase in mental health problems in Sub-Saharan Africa.Considering this,it is critical to track the region’s level of mental health literacy(MHL)to identify key mental health priorities and to direct the most effective interventions.The purpose of this study was to review the existing literature on MHL in sub-Saharan Africa.EBSCOhost(inclusive of Academic Search Ultimate,MEDLINE,APA PsycINFO,APA Psych Articles,and Global Health),CINAHL with full text,Wiley Online Library,Taylor and Francis Online Journals and Google Scholar databases were searched to retrieve relevant articles.The study only considered original full-text,peer-reviewed,English-written research on MHL carried out in sub-Saharan Africa and published between 2015 and 2023.Scoping review steps by Arksey and O’Malley(2005)were followed.Grey literature,review studies,and review protocols were excluded.The data was analysed using reflexive thematic analysis(RTA).The results showed that MHL varies within the region,making it difficult to determine the exact state.Furthermore,the study uncovered factors that contribute to both poor and better MHL in the region.Poor MHL was linked to residing in the township and being male.Better MHL was associated with higher education levels,being female,urban residence,and having a history of mental illness,among other factors.The studyfindings provide evidence-based recommendations for regional,policy,or legislative-led interventions and prioritisations of mental health education programs and public mental health campaigns to increase awareness of mental health.展开更多
Climate change poses substantial challenges to agricultural productivity and sustainability,particularly in Mediterranean and Sub-Saharan Africa regions.Local smallholder farmers’adaptation strategies to climate chan...Climate change poses substantial challenges to agricultural productivity and sustainability,particularly in Mediterranean and Sub-Saharan Africa regions.Local smallholder farmers’adaptation strategies to climate change are crucial for mitigating these impacts.Therefore,this study investigated the socioeconomic factors influencing smallholder farmers’perceptions and adaptation strategies to climate change in four countries(Morocco,Egypt,Italy,and Senegal)of Mediterranean and Sub-Saharan Africa regions using a binary logistic regression(BLR)model.The results indicated that educational level,farming experience,agricultural income,farm size,participation in agricultural workshops,and training in Good Agricultural Practices(GAPs)significantly impacted smallholder farmers’perceptions and adaptation strategies to climate change(such as smallholder farmers adopting drought-tolerant crops).Higher educational level was linked to the greater possibility of smallholder farmers adopting drought-tolerant crops in Italy and Egypt,while gaps in rural education limited the possibility of smallholder farmers adopting drought-tolerant crops in Morocco and Senegal.Farming experience and agricultural income also enhanced the possibility of smallholder farmers adopting drought-tolerant crops,with notable variations across countries due to systemic barriers such as limited infrastructure in Senegal.Larger farm size and participation in agricultural workshops further improved the possibility of smallholder farmers adopting drought-tolerant crops,particularly in Morocco and Egypt.The findings highlighted the importance of tailored interventions and policy measures to support smallholder farmers in effectively responding to the challenges of climate change under diverse agricultural contexts.By understanding the specific needs and circumstances of smallholder farmers in these countries,policymakers can develop more effective adaptation strategies to enhance agricultural resilience and sustainability under the context of climate change.展开更多
Francophone countries in sub-Saharan Africa had been more resistant to induced abortion.Their cultural heritage from France had been influential in strengthening their pronatalist position regarding contraception and ...Francophone countries in sub-Saharan Africa had been more resistant to induced abortion.Their cultural heritage from France had been influential in strengthening their pronatalist position regarding contraception and abortion.Most of them inherited the judicial system and cultural value from France,which have been transmitted to Francophone countries.However,cultural and behavioral changes in reproductive health have begun in Francophone sub-Saharan Africa since the mid-1990s after the paradigm shift on population policy with the International Conference on Population and Development(ICPD)in 1994.Some women have started to use contraception for birth limitation.Induced abortion to prevent unintended pregnancy has been increasingly liberalized in some settings.In this study,the changing contexts for induced abortion in Francophone countries will be reviewed.Recent step undertaken by Benin to legalize abortion in most circumstances shows that Francophone countries may be overcoming their cultural barriers and adapting universal human rights based reproductive behaviors.展开更多
Low levels of environmental education,energy consumption,and other anthropogenic factors strongly contribute to the rising temperature in the world's atmosphere.As such,this study reveals how energy consumption an...Low levels of environmental education,energy consumption,and other anthropogenic factors strongly contribute to the rising temperature in the world's atmosphere.As such,this study reveals how energy consumption and education affect the ecological footprint(EF)and also determines the education thresholds for EF sustainability in sub-Saharan Africa(SSA).The estimation methods in this study are strictly second-generation econometric techniques because of the problems of slope heterogeneity and cross-sectional dependence discovered in the preliminary analysis.The results confirm cointegration,warranting the need for long-run parameter estimators.The Augment Mean Group estimator suggests that natural resources,non-renewable energy consumption(NRE),and economic growth increase the EF.Although renewable energy consumption(REN)and globalization reduce the EF,these indicators are insignificant.The results of the Method of Moment Quantile Regression(MMQR)reveal that REN exacts an indirect effect on the EF via education.Furthermore,the education thresholds required for ecological sustainability have been established.In line with these outcomes,it is proposed that the region redesign its energy policy to encourage eco-friendly consumption by leaning more on pro-environmental strategies and tightening environmental regulations.展开更多
Research background: Breast cancer remains a major public health problem, with a high number of new cases and deaths each year. However, despite advances in research to improve this disease, there is a high rate of la...Research background: Breast cancer remains a major public health problem, with a high number of new cases and deaths each year. However, despite advances in research to improve this disease, there is a high rate of late detection, leading to diagnosis at an advanced stage and a reduced chance of survival. Objective: The aim of this study is to identify the factors associated with late detection of breast cancer in women in Sub-Saharan Africa from 2014 to 2020.Setting: This systematic review focuses on sub-Saharan Africa. Methods: We searched for articles in four databases (PubMed, Embase, Global-Health and CINAHL) between 2014 and 2020 and performed a narrative synthesis to organize and group the different factors associated with late breast cancer detection. Result: After reviewing 583 publications, 6 studies were selected, highlighting factors such as lack of awareness, knowledge gaps, difficulties in accessing health services and financial constraints associated with late breast cancer screening. The participants, who ranged in number from 20 to 1776, were mainly aged between 18 and 25, with a mean age of 25 years and 6 months. Conclusion: The analysis enabled us to identify various factors associated with late breast cancer screening. Collaboration between health professionals, community organizations and policy-makers is essential to foster an environment conducive to the prevention and early detection of breast cancer.展开更多
Introduction: Hepatitis B is an infectious disease that remains a real public health problem in Africa. Students represent a group at risk for this disease. The objective of this study was to estimate the hepatitis B ...Introduction: Hepatitis B is an infectious disease that remains a real public health problem in Africa. Students represent a group at risk for this disease. The objective of this study was to estimate the hepatitis B vaccination coverage rate among students in sub-Saharan Africa. Methods: A systematic search of databases (PubMed, AJOL) and a manual search of Google Scholar was conducted to retrieve all published studies reporting hepatitis B vaccination coverage among students in sub-Saharan Africa. The pooled coverage rate was estimated with a 95% confidence interval (CI) in a random-effects meta-analysis. Results: A total of 35 studies were included and included 20,520 students. The mean age was 22.1 ± 5.1 years with a predominance of female sex (sex ratio F/M = 1.05). The vaccination coverage rate was 28.8% [95% CI: 22.9% - 34.7%]. Disaggregation allowed to estimate coverage rates of 29.8% [95% CI: 22.9% - 36.7%], 23.4% [95% CI: 9.4% - 37.4%] and 17.0% [95% CI: 14.4% - 19.5%] respectively in West Africa, East Africa and Central Africa. Conclusion: Less than a third of students in sub-Saharan Africa are protected against hepatitis B. However, the majority of this target group is at risk of infection. It would be relevant to screen and, if necessary, vaccinate all new students.展开更多
The aim of this study is to examine the qualities that auditors engaged in detecting potential fraud within multinational corporations in Sub-Saharan Africa should possess.To achieve this goal,a quantitative approach ...The aim of this study is to examine the qualities that auditors engaged in detecting potential fraud within multinational corporations in Sub-Saharan Africa should possess.To achieve this goal,a quantitative approach was used to develop and test a research model based on three theories:agency theory,attribution theory,and cognitive dissonance theory.Responses from a panel of two hundred and nine(209)auditors who conducted a legal audit mission in a Sub-Saharan multinational were analyzed using SmartPLS 3.3.3 software.The results emphasize the crucial importance of auditors’competence and continuous training in fraud detection.However,professional skepticism and time pressure were found to be non-significant in this context.This conclusion provides essential insights for auditors,highlighting the key qualities needed to effectively address fraud detection within multinational corporations in Sub-Saharan Africa.展开更多
Background: Evidence-based practice (EBP) is vital for high-quality patient care, yet its implementation among physiotherapists in sub-Saharan Africa (SSA) faces significant challenges. This scoping review explores th...Background: Evidence-based practice (EBP) is vital for high-quality patient care, yet its implementation among physiotherapists in sub-Saharan Africa (SSA) faces significant challenges. This scoping review explores the barriers and facilitators of EBP in this region. Objectives: To identify barriers and facilitators of EBP at individual, organisational, and extra organisational levels among physiotherapists in SSA. Methods: A comprehensive literature search was conducted across PubMed, Sabinet, BioMed Central, and Google Scholar. Seven studies from Ghana, Nigeria, Cameroon, Benin, Kenya, Zimbabwe and South Africa met the inclusion criteria. Results: Key barriers at the practitioner level included lack of time, insufficient knowledge of EBP, limited access to information resources, and inadequate research skills. Facilitators comprised positive attitudes toward EBP and a desire for further knowledge. At the organisational level, resource unavailability emerged as a major barrier. Notably, no studies addressed extra organisational factors. Conclusion: This review highlights critical barriers and facilitators of EBP among SSA physiotherapists and emphasises the need for further research on extra organisational influences. Addressing systemic challenges is essential for enhancing physiotherapist engagement in EBP, ultimately improving patient care and outcomes in sub-Saharan Africa.展开更多
This study assesses the role of mobile money innovations on income inequality and gender inclusion in 42 sub-Saharan African countries from 1980 to 2019 using interactive quantile regressions.It finds that,first,incom...This study assesses the role of mobile money innovations on income inequality and gender inclusion in 42 sub-Saharan African countries from 1980 to 2019 using interactive quantile regressions.It finds that,first,income inequality unconditionally reduces the involvement of women in business and politics.Second,mobile money innovations interact with income inequality to have a positive impact on women in business and politics.Third,the net effects of mobile money innovations on gender inclusion through income inequality are consistently negative.Fourth,as the positive conditional or interactive effects and negative net effects are consistent across the conditional distribution of gender inclusion,thresholds at which mobile money innovations can completely dampen the negative effect of income inequality on gender inclusion are provided.Therefore,policymakers should work toward improving conditions for mobile money innovations.They should also be aware that reducing both income inequality and enhancing mobile money innovations simultaneously leads to more inclusive outcomes in terms of gender inclusion.展开更多
Soybean(Glycine max(L.) Merr.) is a non-native and non-staple crop in sub-Saharan Africa(SSA) with potential to be a commercial crop owing to its wide range of uses as food, feed,and industrial raw material. Soybean w...Soybean(Glycine max(L.) Merr.) is a non-native and non-staple crop in sub-Saharan Africa(SSA) with potential to be a commercial crop owing to its wide range of uses as food, feed,and industrial raw material. Soybean was first introduced to SSA by Chinese traders in the19 th century and was cultivated as an economic crop as early as 1903 in South Africa. In the past four decades, soybean cultivation area and production in SSA has increased exponentially, from about 20,000 ha and 13,000 t in the early 1970 s to 1,500,000 ha and2,300,000 t in 2016. Soybean yield has been stagnant in SSA for decades at about 1.1 t ha^(-1),much lower than the world average, representing one of the most challenging issues in the soybean industry in SSA. The low soybean yield in SSA can be attributed to the use of poorperforming varieties and to the limited application of fertilizers and rhizobial inoculants in soils with no history of soybean production. South Africa, Nigeria, Zambia, and Uganda are the leading soybean producers in SSA. Soybean research in SSA is conducted by international and national research institutions, including IITA, national soybean improvement programs, universities, and the private sector. Between 1970 and 2011, 195 soybean varieties were released by IITA, private breeders, and national soybean improvement programs in SSA. This paper reviews the history and current state of soybean production and of the utilization and adoption of tropical varieties in SSA, addresses the major soybean yield-limiting factors across the region, and discusses the potential of the soybean industry in SSA. It also highlights soybean improvement efforts and lessons learned from previous soybean improvement efforts and the current progress of some national soybean improvement programs in SSA. Opportunities for scaling up tropical soybean as a major crop across SSA countries are promising.展开更多
Background: Hypertensive patients with insulin resistance (IR) are at greater risk of cardiovascular disease and may represent a particular subset of hypertension (HTN) requiring special medical attention. Quantitativ...Background: Hypertensive patients with insulin resistance (IR) are at greater risk of cardiovascular disease and may represent a particular subset of hypertension (HTN) requiring special medical attention. Quantitative measurements of the IR are not suitable for routine clinical practice. Met-abolic syndrome (MetS) or simply abdominal obesity (AO) is surrogate of IR. The performance of the recently proposed Sub-Saharan Africa cut-off point of abdominal obesity for identifying IR in hypertensive patients has never been evaluated. Aims: The main objective was to compare the performance of the newly proposed Sub-Saharan Africa specific threshold of abdominal obesity (AO-SSA) to that of IDF (AO-IDF) in identifying IR in Congolese Black Hypertensive Patients. Methods: A cross-sectional study was conducted at the Heart of Africa Cardiovascular Center, Lomo Medical Clinic, Kinshasa Limete, DR Congo, between January 2007 and January 2010. Homeostatic model assessment (HOMA) index was calculated to determine IR. Multivariate logistic regression analysis was used to assess the independent determinants of IR. The intrinsic (sensitivity and specificity) and extrinsic (positive predictive value and negative predictive value) characteristics of the AO-SSA, AO-IDF, AO-ATP III, MetS-SSA, MetS-IDF, and MetS-ATP III were calculated. The kappa statistic was determined for agreement between the ATPIII, IDF and SSA defined AO and MetS with HOMA-IR. Results: Men represented the majority of the enrolled patients: 105 (64.4%) and the mean age of all participants were 57 ± 11 years. Insulin resistance was found in 79.1% of the study population with 88.7, 79.3, 84.6, 71.4, 75.5, 91.1, 60.3 and 44.8 respectively among patient with MetS-ATP, MetS-IDF, MetS-SSA, AO-ATP III, AO-IDF, AO-SSA, diabetics and non-obese non-diabetic hypertensive patients. In multivariate analysis, the risk of IR was associated independently and significantly (p < 0.05) with cigarette smoking, low-HDL-C, hyperuricemia, and diastolic HTN, as shown in the following equation: Y = ﹣1.404 + 1.054 Cigarette Smoking + 0.872 low HDL-C + 0.983 hyperuricemia + 0.852 diastolic hypertension. The AO-SSA, with 87.7% sensitivity and 67.6% specificity, was the only surrogate who showed an acceptable agreement with the HOMA-IR index. Abdominal obesity defined according to other thresholds and the metabolic syndrome whatever the used diagnostic criteria have a slight agreement with the HOMA-IR index. Conclusion: IR was found to be prevalent in our study population. Cigarette smoking, low-HDL-C, hyperuricemia, and isolated diastolic HTN magnify IR. The AO-SSA is an easy and cost efficient method to diagnose IR in Congolese Black Hypertensive Patients. Further study in wider group is indicated to validate our findings.展开更多
Faidherbia albida is an ideal agroforestry tree commonly intercropped with annual crops like millet and groundnuts in the dry and densely populated areas of Africa. With its peculiar reverse phenology, it makes growth...Faidherbia albida is an ideal agroforestry tree commonly intercropped with annual crops like millet and groundnuts in the dry and densely populated areas of Africa. With its peculiar reverse phenology, it makes growth demands at a different time from that of crops. In addition, it deposits great amount of organic fertilizer on food crops. Leaves entering soils are comparable to fertilization of almost 50 t·ha^-1year^-1 of manure in dense stands of 50 large trees per ha. These nutrients help maximize agricultural production and reduce the need for a fallow period on poorer soils. Research has shown that millet grown under F. albida yielded 2.5 and 3.4 fold increases in grain and protein, respectively. Animals eat pods which contain mean amounts of crude protein of 20.63% and carbohydrate of 40.1% in seeds. Moreover, the continued existence ofF. albida in agroforestry parklands as in Ethiopia and Mali signifies the success of traditional conservation measures. Modem scientists have also developed much interest in the role of agroforestry in maintaining long-term biological balance between agriculture and livestock production systems. To ensure food security, which still remains a major challenge in sub-Saharan Africa, and concurrently minimize environmental degradation, promotion of agroforestry that specifically involves indigenous trees is crucial. We discuss the prospective role ofF. albida in alleviating poverty while simultaneously protecting the environment from factors associated with, for example, deforestation and loss of biodiversity. The overall aim is to promote wide-scale adoption ofF. albida as a valuable tree crop in farming systems, particularly in those areas where it remains unexploited.展开更多
Sub-Saharan Africa(SSA)has the highest maternal and under-five mortality rates in the world.The advent of the coronavirus disease 2019 exacerbated the region's problems by overwhelming the health systems and affec...Sub-Saharan Africa(SSA)has the highest maternal and under-five mortality rates in the world.The advent of the coronavirus disease 2019 exacerbated the region's problems by overwhelming the health systems and affecting access to healthcare through travel restrictions and rechanelling of resources towards the containment of the pandemic.The region failed to achieve the Millenium Development Goals on maternal and child mortalities,and is poised to fail to achieve the same goals in the Sustainable Development Goals.To improve on the maternal and child health outcomes,many SSA countries introduced digital technologies for educating pregnant and nurs-ing women,making doctors'appointments and sending reminders to mothers and expectant mothers,as well as capturing information about patients and their illnesses.However,the collected epidemiological data are not being utilised to inform patient care and improve on the quality,efficiency and access to maternal,neonatal and child health(MNCH)care.To the researchers'best knowledge,no review paper has been published that focuses on digital health for MNCH care in SSA and proposes data-driven approaches to the same.Therefore,this study sought to:(1)identify digital systems for MNCH in SSA;(2)identify the applicability and weaknesses of the dig-ital MNCH systems in SSA;and(3)propose a data-driven model for diverging emerging technologies into MNCH services in SSA to make better use of data to improve MNCH care coverage,efficiency and quality.The PRISMA methodology was used in this study.The study revealed that there are no data-driven models for monitoring pregnant women and under-five children in Sub-Saharan Africa,with the available digital health technologies mainly based on SMS and websites.Thus,the current digital health systems in SSA do not support real-time,ubiquitous,pervasive and data-driven healthcare.Their main applicability is in non-real-time pregnancy moni-toring,education and information dissemination.Unless new and more effective approaches are implemented,SSA might remain with the highest and unacceptable maternal and under-five mortality rates globally.The study proposes feasible emerging technologies that can be used to provide data-driven healthcare for MNCH in SSA,and the recommendations on how to make the transition successful as well as the lessons learn from other regions.展开更多
Climate change adaptation strategies provide a cushion for smallholder farmers,especially in subSaharan Africa against the risks posed by climate hazards such as droughts and floods.However,the decision-making process...Climate change adaptation strategies provide a cushion for smallholder farmers,especially in subSaharan Africa against the risks posed by climate hazards such as droughts and floods.However,the decision-making process in climate adaptation is complex.To better understand the dynamics of the process,we strive to answer this question:what are the potential trade-offs and synergies related to decision-making and implementation of climate adaptation strategies among smallholder farmers in sub-Saharan Africa region?A systematic literature review methodology was used through the Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA)statement with the four-stage inclusion/exclusion criteria to identify the literature from selected databases(Scopus and Google Scholar).The climate adaptation strategies are organized into five broad categories(crop management,risk management,soil/land management,water management,and livestock management strategies).Evidence suggests that potential trade-offs may arise concerning added costs,additional labor requirements,and competition among objectives or available resources.The synergies,on the other hand,arise from implementing two or more adaptation strategies concurrently in respect of increased productivity,resilience,yield stability,sustainability,and environmental protection.Trade-offs and synergies may also differ among the various adaptation strategies with minimum/zero tillage,comparatively,presenting more tradeoffs.The development and promotion of low-cost adaptation strategies and complementary climate adaptation options that minimize the trade-offs and maximize the synergies are suggested.Skills and knowledge on proper implementation of climate change adaptation strategies are encouraged,especially at the local farm level.展开更多
The majority of the population on the African continent is unable to access basic electricity services,this despite the abundance of renewable energy sources(RESs).The inability to adequately tap into these RESs has l...The majority of the population on the African continent is unable to access basic electricity services,this despite the abundance of renewable energy sources(RESs).The inability to adequately tap into these RESs has led to the continued dependence on non-renewable energy sources such as coal for electricity generation,and kerosene for cooking and lighting,the resulting use of which is poor health conditions.The use of Microgrids(MGs)is being extensively researched as a feasible means of tackling the challenge of electrification,especially in rural and remote areas.Recent times have seen an increasing number of research works focusing on Sub-Saharan Africa(SSA),which is one of the regions with the lowest electrification rates in the world.MGs provide the most suitable means to integrate RESs into the electricity generation process,paving the way towards clean energy for the African continent.This paper presents a review of recent literature on the usage of MG technology for rural electrification,with a specific focus on the applicability of MGs in the SSA context.The paper additionally presents the challenges and opportunities to date.Research findings indicate that SSA has already begun the transition towards clean energy via implementation of RES-based MGs.However,two resonating challenges in the literature are adequate support via policy,and proper planning of project implementation.These two major barriers are needed to be overcome in order to fully utilize MGs for rural electrification in SSA.The key methodology derived from this study is that any effort towards rural electrification requires a sufficient amount of investigation,incorporating both the technological and socio-economic aspects into a suitable design for the target location.展开更多
Background: The morbidity and mortality of systemic lupus erythematosus are largely due to accelerated atherosclerosis. This is partly related to the high prevalence of traditional cardiovascular risk factors. The aim...Background: The morbidity and mortality of systemic lupus erythematosus are largely due to accelerated atherosclerosis. This is partly related to the high prevalence of traditional cardiovascular risk factors. The aim of our study was to determine the frequency of these factors in lupus patients compared to a control population in a department of internal medicine. Methods: We realized a case-control study in patients with systemic lupus erythematosus according to ACR criteria in 1997. Patients were matched by age and gender with controls subjects without autoimmune disease. We studied the frequency of traditional cardiovascular risk factors in both populations. The study was done in the department of internal medicine of Aristide Le Dantec teaching Hospital, in Senegal, during the period from August 2017 to December 2018. The statistical analysis was performed with SPSS 23.0 software and the level of significance was retained for a p-value Results: We recruited 100 subjects including 50 patients and 50 controls. The mean age was 33.5 ± 11.3 years in cases and 33.3 ± 11.3 years in controls. Dyslipidemia was significantly associated with systemic lupus erythematosus (p = 0.009). Levels of triglycerides (p Conclusion: Traditional cardiovascular risk factors including dyslipidemia and hyperuricemia were more common in patients. Similarly, renal failure was associated with lupus.展开更多
文摘Background: Unsafe abortion (USA) is defined as the termination of a non-desired pregnancy, performed by an unqualified person or in an environment without minimum medical standards, or both. It can impact negatively the fertility in the future by tubo-peritoneal lesions. The current study aimed to highlight the infertility factors associated with USA. Material and Methods: From January 1st 2000 to December 31st 2021, a total of 3876 patients that sought care for infertility in the University Clinic of Kinshasa and the Edith Medical Center were enrolled. The socio-demographic, clinical and paraclinical variables were recorded and analyzed in relation to USA history. Results: The patients’ average age was 33.4 ± 5.7 years. Half of them were housewives;about sixty percent of the patients were nulliparous (59.31%). Seventy percent had a secondary infertility with 43.33% having a history of unsafe abortion. The main diagnosis was genital infections and uterus myoma. The chronic endometritis, bilateral tubal occlusion and Uterine synechiae were more associated with USA group. The spermogram anomalies and other partners’ lesions seemed of infectious origin. Conclusion: The USA remains a more frequent phenomenon in our setting. The chronic endometritis, bilateral tubal occlusion, uterine synechiae and indirectly uterus myoma were the infertility factors related to USA. The genital infection of any origin seems to be the main denominator underlying the female and the male infertility in our setting.
文摘Objectives This study aimed to determine the current prevalence of nurse retention in Sub-Saharan Africa(SSA),evaluate the strategies and interventions in SSA countries used to retain their nurses,and identify the key challenges impeding nurse retention.Methods A systematic review and meta-analysis were conducted.An electronic search was performed in August 2024 across multiple databases,including PubMed,Ovid Medline,Embase,CINAHL,Scopus,and grey literature sources.The studies were screened using Covidence,and quality assessments were conducted using the Mixed Methods Appraisal Tool.Results A total of 31 articles were included in the review.Meta-analysis revealed that the pooled nurses’retention rate in SSA was 53%(95%CI:38%–67%;I2=97%),while the pooled intention to stay(ITS)rate at work was 57%(95%CI:43%–71%;I2=99%).Subgroup analysis by region showed that the ITS rate was highest in East Africa(65%),followed by West Africa(63%),and lowest in Southern Africa(35%).Effective retention strategies included financial and non-financial incentives,increased production and training of nurses,steering students to shortage specialties,adequate rural housing,facility level improvements,availability of career and professional progression opportunities,nurses’recognition and involvement,employment terms,transparency and predictable management of human resources,supportive work environments,leadership,religious factors,and stakeholders’collaborations.Key challenges to nurses’retention include inadequate healthcare funding,governance issues,poor remuneration and working conditions,political interference,high unemployment rates,ineffective mobility management,unregulated international migration,and active recruitment by wealthier nations.Conclusions Nurse retention in SSA remains critically low.Interventions should be formulated for the above-mentioned effective improvement strategies to address these systemic challenges in order to retain nurses in SSA.
文摘Since 1960,there have been more than thirty UN peacekeeping missions across Africa,the most of any region in the context of the conflicts that have plagued the region for decades.It has become increasingly evident that official diplomacy is not enough to resolve these crises.Experience shows that given the people’s reliance on religion,religion has continued to act as a force of conflict prevention and resolution in the region.The role played by faith-based diplomats has gained the trust of the conflict parties such that it would be unwise for national and international actors to neglect their role in policy making and conflict prevention and resolution.
文摘Burkitt’s lymphoma(BL)is among the most common pediatric cancers in Sub-Saharan African children,accounting for 30-50%of malignancies in Sub-Saharan African children,with a strong etiological link with Epstein-Barr virus(EBV)infection.The disease is especially aggressive in nature,with more than 70%mortality when diagnosed at advanced stages which is frequent and resulting from poor healthcare infrastructure and limited access to diagnostic facilities.Liquid biopsy approaches,which detect tumor-derived components in bodily fluids,offer promising potential for early,minimally invasive detection of EBV-positive BL.Emerging evidence suggests liquid biopsy methods can reduce diagnostic delays from weeks to≤48 h without compromising>85%concordance with tissue biopsy,demonstrated in Malawi and Kenyan pilot trials(2021-2023).According to the WHO-AFRO report(2023),due to administrative and cost burdens,only 15%of regional clinics are offering liquid biopsy testing as liquid biopsy test costs approximately 120/test as compared to histopathology,which costs$35.This review critically evaluates the technical and implementation challenges associated with developing liquid biopsy assays specifically tailored for BL detection in resource-limited settings across Sub-Saharan Africa.We discuss recent technological advances in circulating tumor DNA(ctDNA)analysis,EBV biomarker detection as technical validations of ctDNA and EBV marker assays have 90-95%sensitivity in early studies,and point-of-care diagnostics,alongside the logistical,economic,and sociocultural barriers to their effective implementation.Additionally,we propose strategic frameworks for overcoming these challenges through collaborative international partnerships,capacity building initiatives,and context-appropriate technology adaptation.Through all these cross-sector partnerships and approaches could transform BL outcomes by enabling stage-shift to 80%early-stage diagnoses,reducing mortality rates by 50%,potentially doubling survival rates in high-burden regions.
文摘There has been an increase in mental health problems in Sub-Saharan Africa.Considering this,it is critical to track the region’s level of mental health literacy(MHL)to identify key mental health priorities and to direct the most effective interventions.The purpose of this study was to review the existing literature on MHL in sub-Saharan Africa.EBSCOhost(inclusive of Academic Search Ultimate,MEDLINE,APA PsycINFO,APA Psych Articles,and Global Health),CINAHL with full text,Wiley Online Library,Taylor and Francis Online Journals and Google Scholar databases were searched to retrieve relevant articles.The study only considered original full-text,peer-reviewed,English-written research on MHL carried out in sub-Saharan Africa and published between 2015 and 2023.Scoping review steps by Arksey and O’Malley(2005)were followed.Grey literature,review studies,and review protocols were excluded.The data was analysed using reflexive thematic analysis(RTA).The results showed that MHL varies within the region,making it difficult to determine the exact state.Furthermore,the study uncovered factors that contribute to both poor and better MHL in the region.Poor MHL was linked to residing in the township and being male.Better MHL was associated with higher education levels,being female,urban residence,and having a history of mental illness,among other factors.The studyfindings provide evidence-based recommendations for regional,policy,or legislative-led interventions and prioritisations of mental health education programs and public mental health campaigns to increase awareness of mental health.
基金an integral component of the TRUSTFARM Project,supported by the European Union’s Horizon 2020 research and innovation programThe TRUSTFARM Project was carried out under the European Research Area Network Cofund on Food Systems and Climate(ERA-NET FOSC,862555)+1 种基金built upon and supported by the experience from the Joint Programming Initiative on Agriculture,Food Security&Climate Change(FACCE-JPI)the European Research Area Network Cofund on Long-term Europe-Africa Partnership on Agricultural Research for Development(LEAP-Agri).
文摘Climate change poses substantial challenges to agricultural productivity and sustainability,particularly in Mediterranean and Sub-Saharan Africa regions.Local smallholder farmers’adaptation strategies to climate change are crucial for mitigating these impacts.Therefore,this study investigated the socioeconomic factors influencing smallholder farmers’perceptions and adaptation strategies to climate change in four countries(Morocco,Egypt,Italy,and Senegal)of Mediterranean and Sub-Saharan Africa regions using a binary logistic regression(BLR)model.The results indicated that educational level,farming experience,agricultural income,farm size,participation in agricultural workshops,and training in Good Agricultural Practices(GAPs)significantly impacted smallholder farmers’perceptions and adaptation strategies to climate change(such as smallholder farmers adopting drought-tolerant crops).Higher educational level was linked to the greater possibility of smallholder farmers adopting drought-tolerant crops in Italy and Egypt,while gaps in rural education limited the possibility of smallholder farmers adopting drought-tolerant crops in Morocco and Senegal.Farming experience and agricultural income also enhanced the possibility of smallholder farmers adopting drought-tolerant crops,with notable variations across countries due to systemic barriers such as limited infrastructure in Senegal.Larger farm size and participation in agricultural workshops further improved the possibility of smallholder farmers adopting drought-tolerant crops,particularly in Morocco and Egypt.The findings highlighted the importance of tailored interventions and policy measures to support smallholder farmers in effectively responding to the challenges of climate change under diverse agricultural contexts.By understanding the specific needs and circumstances of smallholder farmers in these countries,policymakers can develop more effective adaptation strategies to enhance agricultural resilience and sustainability under the context of climate change.
文摘Francophone countries in sub-Saharan Africa had been more resistant to induced abortion.Their cultural heritage from France had been influential in strengthening their pronatalist position regarding contraception and abortion.Most of them inherited the judicial system and cultural value from France,which have been transmitted to Francophone countries.However,cultural and behavioral changes in reproductive health have begun in Francophone sub-Saharan Africa since the mid-1990s after the paradigm shift on population policy with the International Conference on Population and Development(ICPD)in 1994.Some women have started to use contraception for birth limitation.Induced abortion to prevent unintended pregnancy has been increasingly liberalized in some settings.In this study,the changing contexts for induced abortion in Francophone countries will be reviewed.Recent step undertaken by Benin to legalize abortion in most circumstances shows that Francophone countries may be overcoming their cultural barriers and adapting universal human rights based reproductive behaviors.
文摘Low levels of environmental education,energy consumption,and other anthropogenic factors strongly contribute to the rising temperature in the world's atmosphere.As such,this study reveals how energy consumption and education affect the ecological footprint(EF)and also determines the education thresholds for EF sustainability in sub-Saharan Africa(SSA).The estimation methods in this study are strictly second-generation econometric techniques because of the problems of slope heterogeneity and cross-sectional dependence discovered in the preliminary analysis.The results confirm cointegration,warranting the need for long-run parameter estimators.The Augment Mean Group estimator suggests that natural resources,non-renewable energy consumption(NRE),and economic growth increase the EF.Although renewable energy consumption(REN)and globalization reduce the EF,these indicators are insignificant.The results of the Method of Moment Quantile Regression(MMQR)reveal that REN exacts an indirect effect on the EF via education.Furthermore,the education thresholds required for ecological sustainability have been established.In line with these outcomes,it is proposed that the region redesign its energy policy to encourage eco-friendly consumption by leaning more on pro-environmental strategies and tightening environmental regulations.
文摘Research background: Breast cancer remains a major public health problem, with a high number of new cases and deaths each year. However, despite advances in research to improve this disease, there is a high rate of late detection, leading to diagnosis at an advanced stage and a reduced chance of survival. Objective: The aim of this study is to identify the factors associated with late detection of breast cancer in women in Sub-Saharan Africa from 2014 to 2020.Setting: This systematic review focuses on sub-Saharan Africa. Methods: We searched for articles in four databases (PubMed, Embase, Global-Health and CINAHL) between 2014 and 2020 and performed a narrative synthesis to organize and group the different factors associated with late breast cancer detection. Result: After reviewing 583 publications, 6 studies were selected, highlighting factors such as lack of awareness, knowledge gaps, difficulties in accessing health services and financial constraints associated with late breast cancer screening. The participants, who ranged in number from 20 to 1776, were mainly aged between 18 and 25, with a mean age of 25 years and 6 months. Conclusion: The analysis enabled us to identify various factors associated with late breast cancer screening. Collaboration between health professionals, community organizations and policy-makers is essential to foster an environment conducive to the prevention and early detection of breast cancer.
文摘Introduction: Hepatitis B is an infectious disease that remains a real public health problem in Africa. Students represent a group at risk for this disease. The objective of this study was to estimate the hepatitis B vaccination coverage rate among students in sub-Saharan Africa. Methods: A systematic search of databases (PubMed, AJOL) and a manual search of Google Scholar was conducted to retrieve all published studies reporting hepatitis B vaccination coverage among students in sub-Saharan Africa. The pooled coverage rate was estimated with a 95% confidence interval (CI) in a random-effects meta-analysis. Results: A total of 35 studies were included and included 20,520 students. The mean age was 22.1 ± 5.1 years with a predominance of female sex (sex ratio F/M = 1.05). The vaccination coverage rate was 28.8% [95% CI: 22.9% - 34.7%]. Disaggregation allowed to estimate coverage rates of 29.8% [95% CI: 22.9% - 36.7%], 23.4% [95% CI: 9.4% - 37.4%] and 17.0% [95% CI: 14.4% - 19.5%] respectively in West Africa, East Africa and Central Africa. Conclusion: Less than a third of students in sub-Saharan Africa are protected against hepatitis B. However, the majority of this target group is at risk of infection. It would be relevant to screen and, if necessary, vaccinate all new students.
文摘The aim of this study is to examine the qualities that auditors engaged in detecting potential fraud within multinational corporations in Sub-Saharan Africa should possess.To achieve this goal,a quantitative approach was used to develop and test a research model based on three theories:agency theory,attribution theory,and cognitive dissonance theory.Responses from a panel of two hundred and nine(209)auditors who conducted a legal audit mission in a Sub-Saharan multinational were analyzed using SmartPLS 3.3.3 software.The results emphasize the crucial importance of auditors’competence and continuous training in fraud detection.However,professional skepticism and time pressure were found to be non-significant in this context.This conclusion provides essential insights for auditors,highlighting the key qualities needed to effectively address fraud detection within multinational corporations in Sub-Saharan Africa.
文摘Background: Evidence-based practice (EBP) is vital for high-quality patient care, yet its implementation among physiotherapists in sub-Saharan Africa (SSA) faces significant challenges. This scoping review explores the barriers and facilitators of EBP in this region. Objectives: To identify barriers and facilitators of EBP at individual, organisational, and extra organisational levels among physiotherapists in SSA. Methods: A comprehensive literature search was conducted across PubMed, Sabinet, BioMed Central, and Google Scholar. Seven studies from Ghana, Nigeria, Cameroon, Benin, Kenya, Zimbabwe and South Africa met the inclusion criteria. Results: Key barriers at the practitioner level included lack of time, insufficient knowledge of EBP, limited access to information resources, and inadequate research skills. Facilitators comprised positive attitudes toward EBP and a desire for further knowledge. At the organisational level, resource unavailability emerged as a major barrier. Notably, no studies addressed extra organisational factors. Conclusion: This review highlights critical barriers and facilitators of EBP among SSA physiotherapists and emphasises the need for further research on extra organisational influences. Addressing systemic challenges is essential for enhancing physiotherapist engagement in EBP, ultimately improving patient care and outcomes in sub-Saharan Africa.
文摘This study assesses the role of mobile money innovations on income inequality and gender inclusion in 42 sub-Saharan African countries from 1980 to 2019 using interactive quantile regressions.It finds that,first,income inequality unconditionally reduces the involvement of women in business and politics.Second,mobile money innovations interact with income inequality to have a positive impact on women in business and politics.Third,the net effects of mobile money innovations on gender inclusion through income inequality are consistently negative.Fourth,as the positive conditional or interactive effects and negative net effects are consistent across the conditional distribution of gender inclusion,thresholds at which mobile money innovations can completely dampen the negative effect of income inequality on gender inclusion are provided.Therefore,policymakers should work toward improving conditions for mobile money innovations.They should also be aware that reducing both income inequality and enhancing mobile money innovations simultaneously leads to more inclusive outcomes in terms of gender inclusion.
基金supported by the Agricultural Science and Technology Innovation Program of CAAS and China Agriculture Research System (CARS-04) awarded to T.Han of CAAS and S.E.Ibrahim of Agricultural Research Corporation(ARC)Soybean Research Program,Wad Medani,Sudan
文摘Soybean(Glycine max(L.) Merr.) is a non-native and non-staple crop in sub-Saharan Africa(SSA) with potential to be a commercial crop owing to its wide range of uses as food, feed,and industrial raw material. Soybean was first introduced to SSA by Chinese traders in the19 th century and was cultivated as an economic crop as early as 1903 in South Africa. In the past four decades, soybean cultivation area and production in SSA has increased exponentially, from about 20,000 ha and 13,000 t in the early 1970 s to 1,500,000 ha and2,300,000 t in 2016. Soybean yield has been stagnant in SSA for decades at about 1.1 t ha^(-1),much lower than the world average, representing one of the most challenging issues in the soybean industry in SSA. The low soybean yield in SSA can be attributed to the use of poorperforming varieties and to the limited application of fertilizers and rhizobial inoculants in soils with no history of soybean production. South Africa, Nigeria, Zambia, and Uganda are the leading soybean producers in SSA. Soybean research in SSA is conducted by international and national research institutions, including IITA, national soybean improvement programs, universities, and the private sector. Between 1970 and 2011, 195 soybean varieties were released by IITA, private breeders, and national soybean improvement programs in SSA. This paper reviews the history and current state of soybean production and of the utilization and adoption of tropical varieties in SSA, addresses the major soybean yield-limiting factors across the region, and discusses the potential of the soybean industry in SSA. It also highlights soybean improvement efforts and lessons learned from previous soybean improvement efforts and the current progress of some national soybean improvement programs in SSA. Opportunities for scaling up tropical soybean as a major crop across SSA countries are promising.
文摘Background: Hypertensive patients with insulin resistance (IR) are at greater risk of cardiovascular disease and may represent a particular subset of hypertension (HTN) requiring special medical attention. Quantitative measurements of the IR are not suitable for routine clinical practice. Met-abolic syndrome (MetS) or simply abdominal obesity (AO) is surrogate of IR. The performance of the recently proposed Sub-Saharan Africa cut-off point of abdominal obesity for identifying IR in hypertensive patients has never been evaluated. Aims: The main objective was to compare the performance of the newly proposed Sub-Saharan Africa specific threshold of abdominal obesity (AO-SSA) to that of IDF (AO-IDF) in identifying IR in Congolese Black Hypertensive Patients. Methods: A cross-sectional study was conducted at the Heart of Africa Cardiovascular Center, Lomo Medical Clinic, Kinshasa Limete, DR Congo, between January 2007 and January 2010. Homeostatic model assessment (HOMA) index was calculated to determine IR. Multivariate logistic regression analysis was used to assess the independent determinants of IR. The intrinsic (sensitivity and specificity) and extrinsic (positive predictive value and negative predictive value) characteristics of the AO-SSA, AO-IDF, AO-ATP III, MetS-SSA, MetS-IDF, and MetS-ATP III were calculated. The kappa statistic was determined for agreement between the ATPIII, IDF and SSA defined AO and MetS with HOMA-IR. Results: Men represented the majority of the enrolled patients: 105 (64.4%) and the mean age of all participants were 57 ± 11 years. Insulin resistance was found in 79.1% of the study population with 88.7, 79.3, 84.6, 71.4, 75.5, 91.1, 60.3 and 44.8 respectively among patient with MetS-ATP, MetS-IDF, MetS-SSA, AO-ATP III, AO-IDF, AO-SSA, diabetics and non-obese non-diabetic hypertensive patients. In multivariate analysis, the risk of IR was associated independently and significantly (p < 0.05) with cigarette smoking, low-HDL-C, hyperuricemia, and diastolic HTN, as shown in the following equation: Y = ﹣1.404 + 1.054 Cigarette Smoking + 0.872 low HDL-C + 0.983 hyperuricemia + 0.852 diastolic hypertension. The AO-SSA, with 87.7% sensitivity and 67.6% specificity, was the only surrogate who showed an acceptable agreement with the HOMA-IR index. Abdominal obesity defined according to other thresholds and the metabolic syndrome whatever the used diagnostic criteria have a slight agreement with the HOMA-IR index. Conclusion: IR was found to be prevalent in our study population. Cigarette smoking, low-HDL-C, hyperuricemia, and isolated diastolic HTN magnify IR. The AO-SSA is an easy and cost efficient method to diagnose IR in Congolese Black Hypertensive Patients. Further study in wider group is indicated to validate our findings.
文摘Faidherbia albida is an ideal agroforestry tree commonly intercropped with annual crops like millet and groundnuts in the dry and densely populated areas of Africa. With its peculiar reverse phenology, it makes growth demands at a different time from that of crops. In addition, it deposits great amount of organic fertilizer on food crops. Leaves entering soils are comparable to fertilization of almost 50 t·ha^-1year^-1 of manure in dense stands of 50 large trees per ha. These nutrients help maximize agricultural production and reduce the need for a fallow period on poorer soils. Research has shown that millet grown under F. albida yielded 2.5 and 3.4 fold increases in grain and protein, respectively. Animals eat pods which contain mean amounts of crude protein of 20.63% and carbohydrate of 40.1% in seeds. Moreover, the continued existence ofF. albida in agroforestry parklands as in Ethiopia and Mali signifies the success of traditional conservation measures. Modem scientists have also developed much interest in the role of agroforestry in maintaining long-term biological balance between agriculture and livestock production systems. To ensure food security, which still remains a major challenge in sub-Saharan Africa, and concurrently minimize environmental degradation, promotion of agroforestry that specifically involves indigenous trees is crucial. We discuss the prospective role ofF. albida in alleviating poverty while simultaneously protecting the environment from factors associated with, for example, deforestation and loss of biodiversity. The overall aim is to promote wide-scale adoption ofF. albida as a valuable tree crop in farming systems, particularly in those areas where it remains unexploited.
文摘Sub-Saharan Africa(SSA)has the highest maternal and under-five mortality rates in the world.The advent of the coronavirus disease 2019 exacerbated the region's problems by overwhelming the health systems and affecting access to healthcare through travel restrictions and rechanelling of resources towards the containment of the pandemic.The region failed to achieve the Millenium Development Goals on maternal and child mortalities,and is poised to fail to achieve the same goals in the Sustainable Development Goals.To improve on the maternal and child health outcomes,many SSA countries introduced digital technologies for educating pregnant and nurs-ing women,making doctors'appointments and sending reminders to mothers and expectant mothers,as well as capturing information about patients and their illnesses.However,the collected epidemiological data are not being utilised to inform patient care and improve on the quality,efficiency and access to maternal,neonatal and child health(MNCH)care.To the researchers'best knowledge,no review paper has been published that focuses on digital health for MNCH care in SSA and proposes data-driven approaches to the same.Therefore,this study sought to:(1)identify digital systems for MNCH in SSA;(2)identify the applicability and weaknesses of the dig-ital MNCH systems in SSA;and(3)propose a data-driven model for diverging emerging technologies into MNCH services in SSA to make better use of data to improve MNCH care coverage,efficiency and quality.The PRISMA methodology was used in this study.The study revealed that there are no data-driven models for monitoring pregnant women and under-five children in Sub-Saharan Africa,with the available digital health technologies mainly based on SMS and websites.Thus,the current digital health systems in SSA do not support real-time,ubiquitous,pervasive and data-driven healthcare.Their main applicability is in non-real-time pregnancy moni-toring,education and information dissemination.Unless new and more effective approaches are implemented,SSA might remain with the highest and unacceptable maternal and under-five mortality rates globally.The study proposes feasible emerging technologies that can be used to provide data-driven healthcare for MNCH in SSA,and the recommendations on how to make the transition successful as well as the lessons learn from other regions.
文摘Climate change adaptation strategies provide a cushion for smallholder farmers,especially in subSaharan Africa against the risks posed by climate hazards such as droughts and floods.However,the decision-making process in climate adaptation is complex.To better understand the dynamics of the process,we strive to answer this question:what are the potential trade-offs and synergies related to decision-making and implementation of climate adaptation strategies among smallholder farmers in sub-Saharan Africa region?A systematic literature review methodology was used through the Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA)statement with the four-stage inclusion/exclusion criteria to identify the literature from selected databases(Scopus and Google Scholar).The climate adaptation strategies are organized into five broad categories(crop management,risk management,soil/land management,water management,and livestock management strategies).Evidence suggests that potential trade-offs may arise concerning added costs,additional labor requirements,and competition among objectives or available resources.The synergies,on the other hand,arise from implementing two or more adaptation strategies concurrently in respect of increased productivity,resilience,yield stability,sustainability,and environmental protection.Trade-offs and synergies may also differ among the various adaptation strategies with minimum/zero tillage,comparatively,presenting more tradeoffs.The development and promotion of low-cost adaptation strategies and complementary climate adaptation options that minimize the trade-offs and maximize the synergies are suggested.Skills and knowledge on proper implementation of climate change adaptation strategies are encouraged,especially at the local farm level.
基金This work has received funding from the European Union Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement no.701697Major Program of the National Social Science Fund of China(Grant No.17ZDA092)+1 种基金Basic Research Programs(Natural Science Foundation)of Jiangsu Province(BK20180794)333 High-Level Talent Cultivation Project of Jiangsu Province(BRA2018332)and the PAPD fund.
文摘The majority of the population on the African continent is unable to access basic electricity services,this despite the abundance of renewable energy sources(RESs).The inability to adequately tap into these RESs has led to the continued dependence on non-renewable energy sources such as coal for electricity generation,and kerosene for cooking and lighting,the resulting use of which is poor health conditions.The use of Microgrids(MGs)is being extensively researched as a feasible means of tackling the challenge of electrification,especially in rural and remote areas.Recent times have seen an increasing number of research works focusing on Sub-Saharan Africa(SSA),which is one of the regions with the lowest electrification rates in the world.MGs provide the most suitable means to integrate RESs into the electricity generation process,paving the way towards clean energy for the African continent.This paper presents a review of recent literature on the usage of MG technology for rural electrification,with a specific focus on the applicability of MGs in the SSA context.The paper additionally presents the challenges and opportunities to date.Research findings indicate that SSA has already begun the transition towards clean energy via implementation of RES-based MGs.However,two resonating challenges in the literature are adequate support via policy,and proper planning of project implementation.These two major barriers are needed to be overcome in order to fully utilize MGs for rural electrification in SSA.The key methodology derived from this study is that any effort towards rural electrification requires a sufficient amount of investigation,incorporating both the technological and socio-economic aspects into a suitable design for the target location.
文摘Background: The morbidity and mortality of systemic lupus erythematosus are largely due to accelerated atherosclerosis. This is partly related to the high prevalence of traditional cardiovascular risk factors. The aim of our study was to determine the frequency of these factors in lupus patients compared to a control population in a department of internal medicine. Methods: We realized a case-control study in patients with systemic lupus erythematosus according to ACR criteria in 1997. Patients were matched by age and gender with controls subjects without autoimmune disease. We studied the frequency of traditional cardiovascular risk factors in both populations. The study was done in the department of internal medicine of Aristide Le Dantec teaching Hospital, in Senegal, during the period from August 2017 to December 2018. The statistical analysis was performed with SPSS 23.0 software and the level of significance was retained for a p-value Results: We recruited 100 subjects including 50 patients and 50 controls. The mean age was 33.5 ± 11.3 years in cases and 33.3 ± 11.3 years in controls. Dyslipidemia was significantly associated with systemic lupus erythematosus (p = 0.009). Levels of triglycerides (p Conclusion: Traditional cardiovascular risk factors including dyslipidemia and hyperuricemia were more common in patients. Similarly, renal failure was associated with lupus.
