Search

Background: Epidemiological modelling studies in snakebite envenoming research are evolving. Their techniques can be essential in filling the knowledge gap needed to attain the World Health Organization's (WHO) goal of halving the burden of snakebite envenoming by complementing the current data scarcity. Hence, there is a need for a systematic review to summarise epidemiological models used in estimating the burden of snakebite envenoming., Methods: We conducted a systematic review by searching PubMed, EMBASE, and Scopus to identify articles reporting epidemiological models in snakebite envenoming from database inception to 31st December 2023. A narrative synthesis was performed to summarise types of models, methodologies, input parameters, model outputs, and associating factors., Results: Thirty-nine modelling studies were included from 2426 retrieved articles, comprising statistical models (76.9%) and mathematical models (23.1%). Most of the studies were conducted in South Asia, (35.9%) and Latin America (35.9%), and only a few (5.1%) were a global burden estimation. The eligible studies constructed 42 epidemiological models, of which 33 were statistical models that included regression, (60.6%) geostatistical (21.2%), and time series, (18.2%) while 9 mathematical models comprised compartmental, (44.4%) agent-based, (22.2%) transmission dynamics, (11.1%) network, (11.1%) and a simple mathematical model (11.1%). The outputs of the models varied across the study objectives. Statistical models analysed the relationship between incidence, (83.3%) mortality, (33.3%) morbidity (16.7%) and prevalence (10.0%) and their associating factors (environmental, [80%] socio-demographic [33.3%] and therapeutic [10.0%]). Mathematical models estimated incidence, (100%) mortality (33.3%), and morbidity (22.2%). Five mathematical modelling studies considered associating factors, including environmental (60%) and socio-demographic factors (40%)., Conclusion: Mathematical and statistical models are crucial for estimating the burden of snakebite envenoming, offering insights into risk prediction and resource allocation. Current challenges include low-quality data and methodological heterogeneity. Modelling studies are needed, and their continued improvement is vital for meeting WHO goals. Future research should emphasise standardised methodologies, high-quality community data, and stakeholder engagement to create accurate, applicable models for prevention and resource optimization in high-burden regions, including Africa and Asia., (© 2025 John Wiley & Sons Ltd.)

There is a growing political interest in health reforms in Africa, and many countries are choosing national health insurance as their main financing mechanism for universal health coverage. Although vaccination is an essential health service that can influence progress toward universal health coverage, it is not often prioritized by these national health insurance systems. This paper highlights the potential gains of integrating vaccination into the package of health services that is provided through national health insurance and recommends practical policy actions that can enable countries to harness these benefits at population level.

A rapid review was conducted to explore the implementation determinants of human papillomavirus (HPV) vaccination in the World Health Organization African Region and describe their dynamic relationship. PubMed and Google Scholar were searched in October 2023 to find relevant literature. A total of 64 published studies that reported factors affecting HPV vaccination were identified. Analysis of identified factors yielded 74 implementation determinants of HPV vaccination across the five domains of the Consolidated Framework for Implementation Research (CFIR): two (2.70%) were in the innovation domain, seven (9.46%) were in the outer setting domain, 14 (18.92%) were in the inner setting domain, 37 (50%) were in the individual domain and 14 (18.92%) were in the implementation process domain. A causal loop diagram of these implementation determinants revealed four balancing and seven reinforcing loops. Applying systems lens promoted a more holistic understanding of the implementation determinants of HPV vaccination, exposing leverage points for interventions.

Despite the availability of effective vaccines for preventing common childhood infectious diseases, there is still significant disparities in access and utilization across many low- and middle-income countries (LMIC). The factors that drive these disparities are often multilevel, originating from individuals, health facilities, health systems and communities, and also multifaceted. Implementation science has emerged as a field to help address "know-do" gaps in health systems, and can play a significant role in strengthening immunization systems to understand and solve implementation barriers that limit access and uptake within their contexts. This article presents a reflexive perspective on how to position implementation research in immunization programmes to improve coverage equity. Furthermore, key points of synergy between implementation research and vaccination are highlighted, and some potential practice changes that can be applied within specific contexts were proposed. Using a human rights lens, it was concluded that the cost that is associated with implementation failure in immunization programmes is significant and unjust, and future directions for implementation research to optimize its application in practice settings have been recommended.

Background: Stroke frequently leads to motor impairments, with almost half of the affected individuals experiencing diminished sensation, impacting their overall quality of life and autonomy. Rehabilitation efforts, however, often overlook somatosensory functions of the lower limbs. While plantar sensory stimulation activates receptors in the foot sole, its precise impact on the motor functions and gait of individuals with stroke is yet to be ascertained., Objectives: This systematic review and meta-analysis aimed to examine the effects of sensory interventions on gait and lower limb motor function in individuals with stroke., Methods: We searched eight databases from inception to December 2023 for randomized controlled trials that investigated sensory interventions targeting gait or lower limb motor function in stroke patients. The primary outcomes included changes in gait and motor function, reported as standardized mean differences (SMD) and assessed heterogeneity (I2)., Results: A total of [number] studies were included, covering different sensory modalities such as textured insoles, plantar vibration, and cognitive sensorimotor exercises. The interventions showed varying effectiveness, with plantar vibration therapy exhibiting a large effect size (SMD = 2.03 [1.13, 2.94]) for improving lower limb motor function, while textured insoles showed moderate effectiveness (SMD = 0.58 [0.24, 0.92]) with no heterogeneity (I2 = 0%). For gait, significant enhancement was seen with plantar vibration (SMD = 3.17 [2.05, 4.29]) and cognitive sensorimotor training (SMD = 2.85 [1.69, 4.02]). However, overall heterogeneity was moderate to high (I2 = 65% for motor function, 85% for gait), indicating variability across different studies and intervention types., Conclusion: The findings of this review and meta-analysis suggest that plantar somatosensory stimulation has the potential to improve lower limb motor function and gait in people with stroke. However, to firmly establish its efficacy as a rehabilitative tool, larger-scale and high-quality studies are requisite., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ahmad et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background Investigating changes in brain electroencephalogram activity during blood pressure measurement in sitting and standing positions is clinically significant for understanding the neural correlates of postural changes, which may affect cerebral perfusion and autonomic regulation. Shifts in blood pressure can influence visual cortical activity, potentially altering cognitive and sensory processing. This research holds clinical relevance in evaluating disorders like orthostatic hypotension and syncope, where postural changes compromise cerebral blood flow. Furthermore, it can help refine diagnostic protocols and management strategies for neurovascular and autonomic dysfunction. The study also highlighted the possibility of using polygraphs to identify and manage discrepancies in blood pressure measurement caused by posture-induced changes in brain activities for accurate diagnosis. Methodology The electroencephalogram of healthy normotensive female individuals undergoing blood pressure measurements at sitting and standing positions was investigated. Ten healthy young adult females who satisfy the inclusion criteria were selected. Electroencephalographic (EEG) waves were recorded with the aid of Powerlab 26T (ADInstruments Pty Ltd., Bella Vista, Australia). Blood pressure and pulse rate measurements were conducted using a sphygmomanometer and stopwatch. Results During sitting and standing blood pressure positions, diastolic blood pressure and pulse rate were higher when compared to baseline values but the standing blood pressure position showed a higher pulse rate than the sitting blood pressure position. Although alpha wave frequency was higher during both sitting and standing blood pressure measurement positions, the standing blood pressure position caused lower alpha wave frequency when compared with the sitting blood pressure measurement position. While a strong negative correlation was found between alpha wave frequency and pulse rate, beta wave frequency positively correlated with pulse rate during sitting blood pressure measurement position. Furthermore, during standing blood pressure measurement position, the alpha wave did not correlate with pulse rate nor was there a correlation between beta wave frequency and pulse rate. In conclusion, the present study indicated that both sitting and standing blood pressure measurement positions caused a decrease in alpha wave frequency when compared with baseline, but the standing blood pressure measurement position elicited a lower alpha wave frequency when compared with the sitting blood pressure measurement position., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Departmental Ethical Committee, Physiology Department, College of Medical Sciences, Edo State University Uzairue issued approval EO35. The research was approved in June 2021, and it was conducted over five days in September 2021 at the Technologically Enhanced Laboratory unit of the Department of Physiology, College of Medical Sciences, Edo State University Uzairue, situated in Etsako West Local Government Area of Edo State, Nigeria. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Adeniyi et al.)

Background: Evidence-based practice (EBP) is the integration of current best evidence with clinical expertise by considering patient preferences and values. Evidence based practice has not been well studied in Ethiopia. Therefore, this study aimed to assess EBP and its determinants among health professionals working at primary public hospitals in the Central Gondar zone, Northwest Ethiopia., Methods: A facility-based cross-sectional study was conducted on 422 health professionals. A simple random sampling technique was used to select the study participants. The data were entered into EpiData version 4.6 and exported to SPSS version 25 for analysis. The descriptive, bivariable, and multivariable logistic regression analysis were conducted. Adjusted Odds Ratio (AOR) with 95% confidence intervals and p -value <0.05 were used to assess association of explanatory variables with EBP and declare statistical significance, respectively., Result: About 44.1% (95%CI: 39, 50%) of healthcare professionals had good evidence-based practice. Educational status (AOR: 3.05, CI: 1.07-8.66), spare time (AOR: 1.90, CI: 1.09, 3.31), good knowledge (AOR: 7.95, CI: 4.83, 13.08), good skill (AOR: 2.39: CI: 1.27, 4.53), training (AOR: 2.13, CI: 1.26, 3.58), and internet access (AOR = 2.02: 95% CI: 1.25-3.27) were found to be significant predictors of evidence-based practice., Conclusion: This study revealed that EBP was low compared to national standards. Moreover, having good knowledge and skill about evidence-based practice, being trained, having spare time and internet access and upgrading educational status of health care professionals would enhance good evidence-based practice., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Melkamu, Asemahagn, Walle and Tsega.)

The second dose of measles-containing vaccines (MCV2) has significant programmatic relevance in the current immunisation landscape because it serves as both an opportunity to reduce measles immunity gaps and strengthen second year of life vaccination platforms. However, MCV2 coverage remains suboptimal across countries in the World Health Organization (WHO) African Region and this puts a significant number of children at risk of morbidity and mortality from measles despite the availability of an effective vaccine. There is an urgent need to strengthen the implementation of MCV2 but this requires a thorough and systematic understanding of contextual factors that influence it. The literature that describes the determinants of implementation of MCV2 in a manner that adequately accounts for the complexity of the implementation context is scarce. Therefore, the purpose of this rapid review was to explore the implementation determinants of MCV2 in the WHO African Region using systems thinking. Literature search in two databases (PubMed and Google Scholar) were conducted. After screening, a total of 17 eligible articles were included in the study. Thematic analysis of extracted data was performed to identify the implementation determinants, after which they were mapped using the Consolidated Framework for Implementation Research (CFIR). A causal loop diagram (CLD) was used to illustrate the linkages between identified determinants. We found 44 implementation determinants across the five CFIR domains, i.e., innovation, outer setting, inner setting, individual, and implementation process. The majority of identified determinants are within the individual domain followed by the inner setting domain. The CLD showed that multiple contingent connections and feedback relationships exist between the identified implementation determinants within and across CFIR domains. The linkages between the implementation determinants revealed three balancing and reinforcing loops each. The findings suggest that implementation determinants of second-dose measles vaccination in the WHO African Region are complex, with multiple interconnections and interdependencies, and this insight should guide subsequent policies. There is an urgent need for further implementation research with embedded CLD in specific settings to inform the design of tailored systemic strategies to improve the implementation effectiveness of MCV2.

Landfill leachate, which is a complicated organic sewage water, presents substantial dangers to human health and the environment if not properly handled. Electrochemical technology has arisen as a promising strategy for effectively mitigating contaminants in landfill leachate. In this comprehensive review, we explore various theoretical and practical aspects of methods for treating landfill leachate. This exploration includes examining their performance, mechanisms, applications, associated challenges, existing issues, and potential strategies for enhancement, particularly in terms of cost-effectiveness. In addition, this critique provides a comparative investigation between these treatment approaches and the utilization of diverse kinds of microbial fuel cells (MFCs) in terms of their effectiveness in treating landfill leachate and generating power. The examination of these technologies also extends to their use in diverse global contexts, providing insights into operational parameters and regional variations. This extensive assessment serves the primary goal of assisting researchers in understanding the optimal methods for treating landfill leachate and comparing them to different types of MFCs. It offers a valuable resource for the large-scale design and implementation of processes that ensure both the safe treatment of landfill leachate and the generation of electricity. The review not only provides an overview of the current state of landfill leachate treatment but also identifies key challenges and sets the stage for future research directions, ultimately contributing to more sustainable and effective solutions in the management of this critical environmental issue., (© 2023. Crown.)

This study evaluates models for predicting volatile fatty acid (VFA) concentrations in sludge processing, ranging from classical statistical methods (Gaussian and Surge) to diverse machine learning algorithms (MLAs) such as Decision Tree, XGBoost, CatBoost, LightGBM, Multiple linear regression (MLR), Support vector regression (SVR), AdaBoost, and GradientBoosting. Anaerobic bio-methane potential tests were carried out using domestic wastewater treatment primary and secondary sludge. The tests were monitored over 40 days for variations in pH and VFA concentrations under different experimental conditions. The data observed was compared to predictions from the Gaussian and Surge models, and the MLAs. Based on correlation analysis using basic statistics and regression, the Gaussian model appears to be a consistent performer, with high R 2 values and low RMSE, favoring precision in forecasting VFA concentrations. The Surge model, on the other hand, albeit having a high R 2 , has high prediction errors, especially in dynamic VFA concentration settings. Among the MLAs, Decision Tree and XGBoost excel at predicting complicated patterns, albeit with overfitting issues. This study provides insights underlining the need for context-specific considerations when selecting models for accurate VFA forecasts. Real-time data monitoring and collaborative data sharing are required to improve the reliability of VFA prediction models in AD processes, opening the way for breakthroughs in environmental sustainability and bioprocessing applications., (© 2024. The Author(s).)

The COVID-19 pandemic caused a surge in the number of unimmunized and under-immunized children in Africa. The majority of unimmunized (or zero-dose) children live in hard-to-reach rural areas, urban slums, and communities affected by conflict where health facilities are usually unavailable or difficult to access. In these settings, people mostly rely on the informal health sector for essential health services. Therefore, to reduce zero-dose children, it is critical to expand immunization services beyond health facilities to the informal health sector to meet the immunization needs of children in underserved places. In this perspective article, we propose a framework for the expansion of immunization services through the informal health sector as one of the pillars for the big catch-up plan to improve coverage and equity. In African countries like Nigeria, Ethiopia, Tanzania, and the Democratic Republic of Congo, patent medicine vendors serve as an important informal health sector provider group, and thus, they can be engaged to provide immunization services. A hub-and-spoke model can be used to integrate patent medicine vendors into the immunization system. A hub-and-spoke model is a framework for organization design where services that are provided by a central facility (hub) are complimented by secondary sites (spokes) to optimize access to care. Systems thinking approach should guide the design, implementation, and evaluation of this model., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Adamu, Jalo, Ndwandwe and Wiysonge.)

In 2019, national immunization programs in Ghana, Kenya, and Malawi commenced the implementation of RTS,S/AS01 vaccination in large-scale pilot schemes. Understanding the implementation context of this malaria vaccination in the pilot countries can provide useful insights for enhancing implementation outcomes in new countries. There has not yet been a proper synthesis of the implementation determinants of malaria vaccination programs. A rapid review was conducted to identify the implementation determinants of the pilot malaria vaccination programs in Ghana, Kenya, and Malawi, and describe the mechanism by which these determinants interact with each other. A literature search was conducted in November 2023 in PubMed and Google Scholar to identify those studies that described the factors affecting malaria vaccine implementation in Ghana, Kenya, and Malawi. Thirteen studies conducted between 2021 and 2023 were included. A total of 62 implementation determinants of malaria vaccination across all five domains of the consolidated framework for implementation research (CFIR) were identified. A causal loop diagram showed that these factors are interconnected and interrelated, identifying nine reinforcing loops and two balancing loops. As additional countries in Africa prepare for a malaria vaccine roll-out, it is pertinent to ensure that they have access to adequate information about the implementation context of countries that are already implementing malaria vaccination programs so that they understand the potential barriers and facilitators. This information can be used to inform context-specific systems enhancement to maximize implementation success. Going forward, primary implementation studies that incorporate the causal loop diagram should be integrated into the malaria vaccine implementation program to enable immunization program managers and other key stakeholders to identify and respond to emerging implementation barriers in a timely and systematic manner, to improve overall implementation performance.

Nigerian bituminous tar sands are among the world's largest deposits of bitumen and heavy oil. They are estimated to contain 38-40 billion barrels of heavy oil and bitumen, spanning approximately 120 km in length and 4-6 km in breadth. With global commitments to net zero emissions and various energy transition plans, improvements in the recovery methods for heavy oil and bitumen are being sought. To address this, renewable energy electrothermal enhanced oil recovery is considered an eco-friendly alternative. In our study, we introduce a novel Reservoir-Waveguide-Debye model. This model explores the enhancement of penetration for radio-frequency electromagnetic (EM) waves, which can be generated from renewable energy sources. These waves facilitate the viscosity reduction of heavy oil and bitumen. Through a comprehensive 2D numerical simulation employing the bulk properties of bituminous tar sands, we assess the propagation of EM fields within porous media. We utilize the industrial heating radio-frequency bandwidth of 1-60 MHz to conduct frequency domain investigations. Our analysis delves into propagation modes using eigenfrequency analysis, pinpointing the EM resonance of the tar sands. Furthermore, we investigate the impact of mesh refinement on the EM eigenfrequencies of porous media at both the microscale (400 μm) and macroscale (100 m in radial distance). Our results demonstrate the occurrence of resonance phenomena at complex eigenfrequencies around 27.12 and 54.24 MHz in both the microscale and macroscale models of the bituminous sands. This breakthrough research offers promising insights into harnessing renewable energy-driven EM waves for efficient thermal recovery processes in the Nigerian bituminous tar sands, thus fostering sustainable and eco-friendly energy solutions., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

Introduction: The history of African health is closely entwined with the history of the continent itself-from precolonial times to the present day. A study of African health histories is critical to understanding the complex interplay between social, economic, environmental and political factors that have shaped health outcomes on the continent. Furthermore, it can shed light on the successes and failures of past health interventions, inform current healthcare policies and practices, and guide future efforts to address the persistent health challenges faced by African populations. This scoping review aims to identify existing literature on African health histories., Methods and Analysis: The Arksey and O'Malley's framework for conducting scoping reviews will be utilised for the proposed review, which will be reported in compliance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines. The main review question is 'What literature exists on the history of health practices and healthcare delivery systems in Africa from the precolonial era through to the sustainable development goal era?' Keywords such as Africa, health and histories will be used to develop a search strategy to interrogate selected databases and grey literature repositories such as PubMed, Scopus, Web of Science and WHOLIS. Two authors will independently screen titles and abstracts of retrieved records. One author will extract data from articles that meet the inclusion criteria using a purposively designed data charting. The data would be coded and analysed thematically, and the findings presented narratively., Ethics and Dissemination: The scoping review is part of a larger project which has approval from the WHO AFRO Ethics Research Committee (Protocol ID: AFR/ERC/2022/11.3). The protocol and subsequent review will be submitted to the integrated African Health Observatory and published in a peer-reviewed journal., Registration Details: https://osf.io/xsaez/., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

There is an urgent need for countries in Africa to allocate more domestic financial resources to immunization so that national immunization programmes can attain self-reliance in line with World Health Organization's Immunization Agenda 2030. However, resource allocation is fundamentally a political process because other competing needs exist. Political economy analysis (PEA) can guide policy influencers in their engagement with decision makers to tilt their interest in support of sustainable immunization financing. PEA can provide a deeper understanding of the potential constraints and facilitators of a policy direction to expand the fiscal space for immunization using domestic resources within the context of a country's socioeconomic and political realities. To further advance the usefulness of PEA for decision making, a systems thinking lens should be applied to account for the inherent complexity of the social systems involved in resource allocation and implementation. Several methods and tools of systems thinking already exist and can be employed. Causal loop diagrams, when incorporated in a PEA of sustainable financing for immunization can aid the identification of feedback loops which can be used as leverage points for intervention., Competing Interests: Declarations of competing interest The authors have no competing interests to declare., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background and Aims: Antimicrobial resistance (AMR), a global health crisis of mounting urgency, has been further complicated by the ongoing COVID-19 pandemic. The intricate relationship between these two phenomena is especially pronounced in low- and middle-income countries (LMICs) due to the distinct obstacles encountered by their healthcare systems and policy structures. This study aims to explore the complex challenges arising from the coexistence of these two crises in LMICs and proffer specific recommendations for holistic management., Methods: An exhaustive bibliographic survey was executed, employing search queries in specialized databases such as PubMed, SCOPUS, and Web of Science's SCI-EXPANDED index. The timeframe for the literature search extended from January 2020 to January 2023. The search strategy employed key terms including antibiotic resistance, AMR, COVID-19 pandemic, low- and middle-income countries, SARS-CoV-2, and LMICs., Results: The pandemic has aggravated various drivers of AMR in LMICs, including limited capabilities, weak frameworks, and socioeconomic factors. New challenges have emerged, such as disruptions in the antibiotic supply chain and an increased risk of healthcare-associated infections. The interaction between these drivers presents a complex problem that demands a coordinated response. Specific recommendations include strengthening health systems, funding research and innovation, and enhancing infection prevention control measures., Conclusion: The coexistence of AMR and the COVID-19 pandemic in LMICs demands an integrated approach involving multiple stakeholders. Emphasis must be placed on constructing aligned regulatory frameworks, nurturing regional collaborations, and focusing on accessible therapeutic options. The study underscores the necessity for actionable strategies to achieve sustainable access to clean water and sanitation and also highlights the importance of long-term planning, funding, and specialized expertise in emerging modalities like phage therapy., Competing Interests: The authors declare no conflicts of interest., (© 2023 The Authors. Health Science Reports published by Wiley Periodicals LLC.)

Background: Among the numerous challenges that Africa faces in improving its healthcare systems, the paucity of health data stands out as paramount. This study aims to examine the challenges related to the paucity of health data in Africa and its impact on the implementation of digital health and evidence-based practice. The findings of the study reveal that health data availability in Africa is both limited and frequently of poor quality. Several factors contribute to this concerning situation, encompassing inadequate infrastructure, a shortage of resources, and cultural barriers. Furthermore, the available data, despite its limitations, is often underutilized due to a lack of capacity and expertise in data analysis and interpretation. Policy Options and Recommendations: To improve healthcare delivery in Africa, we recommend implementing novel strategies for data collection. It's important to recognize that effective information technology service is crucial for enhancing healthcare delivery, and a holistic approach is necessary to achieve this. Conclusion: This brief presents information to help policymakers develop long-term solutions to Africa's health data poverty. Taking action based on this evidence can assist in addressing the problem., Competing Interests: The authors declare that they do not have any conflicts of interest., (Copyright © 2023 Musa, Haruna, Manirambona, Eshun, Ahmad, Dada, Gololo, Musa, Abdulkadir and Lucero-Prisno III.)

Introduction: Gout is considered uncommon among Black Africans. It is commoner in men and associated with obesity, hypertension, and chronic kidney disease (CKD). This study aims to determine the pattern and frequency of gout and its associated factors in Maiduguri, north-eastern Nigeria., Method: A retrospective study of gout patients managed at the rheumatology clinic of the University of Maiduguri Teaching Hospital (UMTH), Nigeria, from January 2014 to December 2021. Diagnosis of gout was made using the Netherlands 2010 criteria, and CKD was defined as an estimated glomerular filtration rate (eGFR) of < 60 ml/min/1.73m 2 using the 2021 CKD-epidemiology collaboration (CKD-EPI) creatinine equation. A P-value of < 0.05 was considered statistically significant., Results: Out of 1409 patients seen during the study period, 150 (10.7%) had gout. They comprised 57.0% males, mostly presented with mono-articular disease (47.7%) with the ankle predominantly involved (52.3%). First metatarsophalangeal and knee joint involvement were commoner among males than females (59% vs 39%, p = 0.052 and 55.7% vs 34.8%, p = 0.05 respectively). The mean serum uric acid (SUA) level was 557.6 ± 176.2 mmol/l, and the levels did not differ between gender (p = 0.118, CI [- 126.6 to 14.5]). Ninety (84.1%) had CKD with 20.6% in end-stage renal disease (eGFR < 15 ml/min/1.73m 2 ). Polyarticular involvement and tophi were commoner among patients with CKD (21.1% versus 11.8% p = 0.652 and χ = 4.364, p = 0.022 respectively) Serum uric acid levels positively correlated with serum creatinine (p = 0.006) and negatively correlated with eGFR (p = 0.001). The best predictor of SUA level was the eGFR (B =  - 2.598, p < 0.001)., Conclusion: Gout in north-eastern Nigeria constitutes about 11% of all rheumatic diseases and is typically monoarticular; however, polyarticular form and tophi were commonly seen in patients with CKD. Further studies will be needed to evaluate the relationship between the pattern of gout and CKD in the region. Key Points • Gout in Maiduguri is commonly monoarticular; however, polyarticular presentations and tophi are commoner among gout patients with chronic kidney disease (CKD). • The increase in the burden of CKD might have resulted in the increase in the number of females with gout. • The use of the validated and simple Netherlands criteria for the diagnosis of gout is useful in developing countries to overcome the challenges associated with the use of polarized microscope and thereby allowing further research on gout. • There is a need for further research on the pattern and prevalence of gout and its relationship with CKD in Maiduguri, Nigeria., (© 2023. The Author(s), under exclusive licence to International League of Associations for Rheumatology (ILAR).)

Background: Vaccination remains the most effective means of reducing the burden of infectious disease among children. It is estimated to prevent between two to three million child deaths annually. However, despite being a successful intervention, basic vaccination coverage remains below the target. About 20 million infants are either under or not fully vaccinated, most of whom are in Sub-Saharan Africa region. In Kenya, the coverage is even lower at 83% than the global average of 86%. The objective of this study is to explore the factors that contribute to low demand or vaccine hesitancy for childhood and adolescent vaccines in Kenya., Methods: The study used qualitative research design. Key Informant Interviews (KII) was used to obtain information from national and county-level key stakeholders. In-depth Interviews (IDI) was done to collect opinions of caregivers of children 0-23 months and adolescent girls eligible for immunization, and Human papillomavirus (HPV) vaccine respectively. The data was collected at the national level and counties such as Kilifi, Turkana, Nairobi and Kitui. The data was analyzed using thematic content approach. A total of 41 national and county-level immunization officials and caregivers formed the sample., Results: Insufficient knowledge about vaccines, vaccine supply issues, frequent healthcare worker's industrial action, poverty, religious beliefs, inadequate vaccination campaigns, distance to vaccination centers, were identified as factors driving low demand or vaccine hesitancy against routine childhood immunization. While factors driving low uptake of the newly introduced HPV vaccine were reported to include misinformation about the vaccine, rumors that the vaccine is a form of female contraception, the suspicion that the vaccine is free and available only to girls, poor knowledge of cervical cancer and benefits of HPV vaccine., Conclusions: Rural community sensitization on both routine childhood immunization and HPV vaccine should be key activities post COVID-19 pandemic. Likewise, the use of mainstream and social media outreaches, and vaccine champions could help reduce vaccine hesitancy. The findings are invaluable for informing design of context-specific interventions by national and county-level immunization stakeholders. Further studies on the relationship between attitude towards new vaccines and connection to vaccine hesitancy is necessary., (© 2023. The Author(s).)

Background: Computed tomographic angiography (CTA) is a promising tool for the rapid characterisation of the anatomy and structural lesions of the vascular system., Aim/objectives: The aims/objectives of the study were to determine the frequency and pattern of vascular lesions in northern Nigeria. We also set to determine the agreement between clinical and CTA diagnosis of vascular lesions., Materials and Methods: We study patients that had CTA studies over a 5-year period. In total, 361 patients were referred for CTA, but only the records of 339 of them were retrieved and analysed. The information about patients' characteristics, clinical diagnosis, and the findings on CTA was also retrieved and analysed. The categorical data results were expressed as proportions and percentages. The Cohen's kappa coefficient (κ statistic) was used to determine the agreement between the clinical and CTA findings. A P value of <0.05 was considered statistically significant., Results: The mean (standard deviation) age of the subjects was 49.3 (17.9) years with a range of 1-88 years, consisting of 138 (40.7%) females. Up to 223 patients had various abnormalities on CTA. There were 27 (8.0%) cases of aneurysms, eight (2.4%) cases of arteriovenous malformations, and 99 (29.2%) cases of stenotic atherosclerotic disease. There was a significant agreement between the clinical diagnosis and corresponding findings on CTA showed for intracranial aneurysms ( k = 15.0%; P < 0.001), for pulmonary thromboembolism ( k = 4.3%; P < 0.001), and for coronary artery disease ( k = 34.5%; P < 0.001)., Conclusions: The study found that close to 70% of the patients referred for CTA have abnormal findings, out of which stenotic atherosclerosis and aneurysm are the common findings. Our findings highlighted the diagnostic value of CTA variety of clinical conditions and underscored the prevalence of many vascular lesions in our environment, which hitherto were regarded as uncommon., (Copyright: © 2023 Journal of the West African College of Surgeons.)

Several efforts to repurpose drugs for COVID-19 treatment have largely either failed to identify a suitable agent or agents identified did not translate to clinical use. Reasons that have been suggested to explain the failures include use of inappropriate doses, that are not clinically achievable, in the screening experiments, and the use of inappropriate pre-clinical laboratory surrogates to predict efficacy. In this study, we used an innovative algorithm, that incorporates dissemination and implementation considerations, to identify potential drugs for COVID-19 using iterative computational and wet laboratory methods. The drugs were screened at doses that are known to be achievable in humans. Furthermore, inhibition of viral induced cytopathic effect (CPE) was used as the laboratory surrogate to predict efficacy. Erythromycin, pyridoxine, folic acid and retapamulin were found to inhibit SARS-CoV-2 induced CPE in Vero cells at concentrations that are clinically achievable. Additional studies may be required to further characterize the inhibitions of CPE and the possible mechanisms., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Bello, Yunusa, Adamu, Imam, Bello, Shuaibu, Igumbor, Habib, Popoola, Ochu, Bello, Deeni and Okoye.)

Corrosion prevention has been a global phenomenon, particularly in metallic and construction engineering. Most inhibitors are expensive and toxic. Therefore, developing nontoxic and cheap corrosion inhibitors has been a way forward. In this work, L-arginine was successfully grafted on chitosan by the thermal technique using a reflux condenser. This copolymer was characterized by Fourier-transform infrared spectroscopy (FTIR), thermogravimetric analysis (TGA), and X-ray diffraction (XRD). The corrosion inhibition performance of the composite polymer was tested on mild steel in 0.5M HCl by electrochemical methods. The potentiodynamic polarization (PDP) and electrochemical impedance spectroscopy (EIS) results were consistent. The inhibition efficiency at optimum concentration rose to 91.4%. The quantum chemical calculation parameters show good properties of the material as a corrosion inhibitor. The molecular structure of the inhibitor was subjected to density functional theory (DFT) to understand its theoretical properties, and the results confirmed the inhibition efficiency of the grafted polymer for corrosion prevention.

Background: Self-efficacy has been defined as "people's beliefs about their capabilities to produce designated levels of performance that exercise influence over events that affect their lives." In stroke survivors, impairments in motor, sensory/perceptual, and cognitive functions greatly reduce self-efficacy., Aim: To translate and cross-culturally adapt the Stroke Self-Efficacy Questionnaire (SSEQ) into Hausa language., Method: Two independent experts who are fluent in Hausa and English languages did the forward and backward translations, respectively. A group of experts reviewed the translation according to Beaton's guidelines. The English and the final Hausa versions were administered to 75 patients with stroke once and twice, respectively (on the first day and a week later). Construct validity between the English and the Hausa version, and internal consistency and structural validity of the Hausa version were assessed using Spearman's correlation coefficient, kappa statistics, and Rasch analysis, respectively., Results: There was a significant correlation (r = 0.96, p < .001) between the Hausa version of the SSEQ and the original English version. The scale also demonstrated an excellent test-retest reliability (r = 0.99, p < .001) on two different administrations. The Hausa version also demonstrated an excellent internal consistency on two different administrations, Cronbach alpha, 0.99. Similarly, the two versions were found to be perfect fit, having the same measure of construct [infit and outfit mean-square (MNSQ) and standardized (ZSTD) fit statistics values for the Hausa version and the English version of SSEQ were (1.00, Z = -0.2)]., Conclusion: Hausa version of SSEQ is valid and reliable at assessing self-efficacy among Hausa-speaking stroke survivors.

Background: The burden of tuberculosis (TB) in Nigeria remains high, and diagnosis in children, a challenge. We aimed to document yield from Xpert Mycobacterium tuberculosis/rifampicin (MTB/RIF) as a mode of diagnosis for children and the variables associated with a positive result., Methods: This was a retrospective review of TB treatment cards of children aged 0-15 years managed from January 2017 to December 2021 across six public tertiary institutions in Nigeria. The data obtained were analyzed using the descriptive and inferential statistics. Statistical significance was set at P < 0.05., Results: Of 1489 children commenced on TB treatment, 1463 (97.9%) had sufficient data for analysis the median age of study participants was 60 months (interquartile range [IQR]: 24, 120), and 814 (55.6%) were males. Xpert MTB/RIF test was performed in 862 (59%) participants and MTB was detected in 171 (19.8%) participants, of which 6.4% (11/171) had RIF resistance reported. The use of Xpert MTB/RIF rose from 56.5% in 2017 to 64% in 2020 but fell to 60.9% in 2021. We found that older age (> 10 years), the presence of pulmonary TB (PTB), and a negative human immunodeficiency virus (HIV) status were associated with positive Xpert MTB/RIF tests (P = 0.002, 0.001, and 0.012, respectively)., Conclusion: The utilization of Xpert MTB/RIF in children increased in the years before the COVID-19 pandemic. Factors associated with MTB detection by Xpert MTB/RIF include older age, the presence of PTB, and a negative HIV status. Clinical and radiological evaluation continues to play vital roles in the diagnosis of childhood TB in Nigeria., Competing Interests: None

Background: Hepatocellular carcinoma (HCC) is associated with a high mortality rate due to early recurrence and its metastasis features. To this day, effective treatment options for metastatic HCC remain a major challenge to patient treatment. Flavokawain B (FKB) is a naturally occurring chalcone molecule capable of providing effective therapy against this life-threatening disease., Objective: This study investigated the anti-metastatic effects of FKB on the growth and development of metastatic HCC., Methods: HepG2 cells were used in this study and a neutral red assay was performed to determine the IC 50 value of FKB. Cell scratch and exclusion zone assays were performed to assess the rate of cell migration and invasion. Relative mRNA levels of UCK2, STAT3, VEGF and HIF-1α genes were quantified using RT-qPCR., Results: FKB inhibited the proliferation of HepG2 cells at an IC 50 value of 28 μM after 72 h of incubation. Its cytotoxic effect was confirmed to induce apoptosis through the phase-contrast inverted microscope. Cell migration and invasion were significantly inhibited at 7, 14, and 28 μM of FKB as compared to untreated cells. The inhibition in the cell migration significantly increased with the increasing concentrations of the bioactive compound. The relative expression levels of the UCK2 gene and its downstream genes, STAT3, VEGF and HIF-1α , were significantly downregulated after 72 h exposure to FKB treatment., Conclusion: Our data suggest that FKB inhibited HepG2 proliferation and further suppressed its metastasis partly by regulating the STAT3/Hif-1α/VEGF signalling pathway. FKB could be a potential alternative and viable strategy against HCC., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

The emergence of antibiotic-resistant pathogens has threatened not only our ability to deal with common infectious diseases but also the management of life-threatening complications. Antimicrobial resistance (AMR) remains a significant threat in both industrialized and developing countries alike. In Africa, though, poor clinical care, indiscriminate antibiotic use, lack of robust AMR surveillance programs, lack of proper regulations and the burden of communicable diseases are factors aggravating the problem of AMR. In order to effectively address the challenge of AMR, antimicrobial stewardship programs, solid AMR surveillance systems to monitor the trend of resistance, as well as robust, affordable and rapid diagnostic tools which generate data that informs decision-making, have been demonstrated to be effective. However, we have identified a significant knowledge gap in the area of the application of fast and affordable diagnostic tools, surveillance, and stewardship programs in Africa. Therefore, we set out to provide up-to-date information in these areas. We discussed available hospital-based stewardship initiatives in addition to the role of governmental and non-governmental organizations. Finally, we have reviewed the application of various phenotypic and molecular AMR detection tools in both research and routine laboratory settings in Africa, deployment challenges and the efficiency of these methods., (© 2022. The Author(s).)

Background: The contribution of vaccination to global public health and community wellbeing has been described as one of the greatest success stories of modern medicine. However, 13.5 million children still miss at least one of their routine vaccinations, and this contributes to about 1.5 million deaths from vaccine-preventable diseases. One of the contributing factors has been associated with vaccine hesitancy. Vaccine hesitancy is the delay or refusal of vaccines despite their availability. The study explored factors from multiple perspectives that influence hesitancy among caregivers of children and adolescent girls eligible for childhood routine immunisation and the Human Papillomavirus vaccine in Malawi., Methods: The methodology used was qualitative such as key informant interviews and focus-group discussion. Information was obtained from caregivers, community and religious leaders, leaders of civil society groups, teachers in schools where Human Papillomavirus vaccine were piloted, healthcare workers, national and district-level officials of the expanded program on immunisation. There were 25 key informant interviews and two focus-group discussions, with 13 participants. The study was conducted between April to May 2020. The Interviews and discussions were audio-recorded, transcribed, and analysed using a thematic content approach., Results: Most vaccine-hesitancy drivers for routine immunisation were also relevant for the HPV vaccine. The drivers included inadequate awareness of the vaccination schedule, rumours and conspiracy theories exacerbated by religious beliefs, low literacy levels of caregivers, distance and transport to the vaccination clinic, gender role and a disconnect between community healthcare workers and community leaders., Conclusions: The study demonstrated that a network of factors determines vaccine hesitancy for childhood Routine Immunisation and Human Papillomavirus, and some of them are interrelated with one another. This has implications both for current levels of vaccine acceptance and the introduction of any new vaccine, such as those against Malaria, HIV/AIDS, HPV or COVID-19 (coronavirus disease 2019). Therefore, strategies developed to address vaccine hesitancy must be multi-component and wide-ranging., (© 2022. The Author(s).)

Background: By 11 March 2022, there were 450,229,635 coronavirus disease (COVID-19) cases and 6,019,085 deaths globally, with Nigeria reporting 254,637 cases and 3142 deaths. One of the essential healthcare services that have been impacted by the pandemic is routine childhood immunization. According to the 2018 National Demographic and Health Survey, only 31% of children aged 12-23 months were fully vaccinated in Nigeria, and 19% of eligible children in the country had not received any vaccination. A further decline in coverage due to the pandemic can significantly increase the risk of vaccine-preventable-disease outbreaks among children in Nigeria. To mitigate such an occurrence, it is imperative to urgently identify how the pandemic and the response strategies have affected vaccination services, hence, the goal of the study., Methods: The research method was qualitative, including in-depth interviews of healthcare workers and focus group discussions (FGDs) with caregivers of children aged 0-23 months. We selected one state from each of the three zones of Nigeria: northern, central, and southern. Within each state, 10 local government areas and 20 healthcare facilities were purposively selected. In each facility, 10 healthcare workers were invited for interviews. Overall, 517 healthcare workers were interviewed. For the focus group discussion, 30 communities were selected. Within each selected community, six consenting caregivers were included. Overall, 180 caregivers participated. The data were analyzed using thematic inductive content analysis., Results: Three significant impacts that were observed are: difficulties in accessibility to immunization services, declining immunization demand and uptake among caregivers due to varying factors, and erosion of vaccine confidence among both caregivers and healthcare workers. Movement restriction and lockdown had numerous major impacts, such as decreased general healthcare service delivery, increased transportation costs, fewer engagements that promote vaccine uptake, and cessation of mobile vaccination campaigns that target hard-to-reach communities. Moreover, misinformation, conspiracy beliefs about the pandemic and COVID-19 vaccines, and risk perception negatively influenced general vaccine confidence., Conclusion: The results of this early impact study show that immunization was directly affected by the pandemic and provide insights into areas where interventions are needed for recovery.

Despite the substantial efforts at ensuring universal access to routine immunisation services among children in South Africa, major gaps in immunisation coverage remain. This study assessed the magnitude of missed opportunities for vaccination (MOV) and associated factors among children aged 0-23 months attending primary health care (PHC) facilities in Cape Town. We used multilevel binomial logistic regression models to explore individual and contextual factors associated with MOV, with children aged 0-23 months at Level 1, nested within PHC facilities (Level 2). A total of 674 children and their caregivers were enrolled. MOV prevalence was 14.1%, ranging from 9.1% to 18.9% across sub-districts. Dose-specific MOV prevalence was highest for the second dose of measles vaccine (9.5%) and lowest for the first dose of rotavirus vaccine (0.6%). The likelihood of a child experiencing MOV was significantly associated with caregivers' low level of education (Odds ratio (OR) = 3.53, 95% credible interval (CrI): 1.13-11.03), recent receipt of immunisation messages (OR = 0.46, 95%CrI: 0.25-0.87), shared immunisation decision making by both parents (OR = 0.21, 95%CrI: 0.07-0.62) and health facility staff number (OR = 0.18, 95%CrI: 0.06-0.61). The burden of MOV among children in Cape Town is influenced by individual and contextual factors, which provide important opportunities for quality improvement and broader strategies to improve routine immunisation service delivery.

Background: Schistosoma mansoni infection is endemic in Ethiopia. The epidemiology of S. mansoni and the efficacy of praziquantel among schoolchildren have not been well documented in different parts of the country including our study area. Therefore, this study aimed to determine the status of S. mansoni infection and evaluate the therapeutic efficacy of praziquantel among school children in northeast Ethiopia., Methods: A comparative cross-sectional study was conducted among 499 children of two preschool children. Stool specimens were collected and microscopically examined using Kato-Katz (41.7 gram) methods. Positive children were treated with a single oral dose of praziquantel at 40 mg/kg body weight. Egg reduction and cure rates were assessed 4 weeks post-treatment to evaluate the therapeutic efficacy of praziquantel against S. mansoni infection., Results: The overall prevalence of S. mansoni infection among the schoolchildren was 52.1% with a mean intensity of 546 eggs per gram of stool. Majorities of the S. mansoni infections were moderate to heavy intensity, with only 5.0% light infections. Praziquantel administered at a single oral dose of 40 mg/kg achieved a cure rate of 91.7% and reduced the egg rate by 86.8%. Twenty-one schoolchildren remained infected at 4 weeks post-treatment, among which 6 and 15 children had moderate and light infections, respectively., Conclusions: S. mansoni prevalence among primary school children in Northeast Ethiopia was high, highlighting the need to implement school-based chemotherapy with annual frequency. The efficacy of praziquantel at 40 mg/kg is sufficient to permit continued use in treating S. mansoni-infected schoolchildren., (© 2022 Meslo Sema Berhanu et al.)

Nigeria has a high burden of tuberculosis (TB) and low case detection rates. Nigeria's large private health sector footprint represents an untapped resource for combating the disease. To examine the quality of private sector contributions to TB, the USAID-funded Sustaining Health Outcomes through the Private Sector (SHOPS) Plus program evaluated adherence to national standards for management of presumptive and confirmed TB among the clinical facilities, laboratories, pharmacies, and drug shops it trained to deliver TB services. The study used a standardized patient (SP) survey methodology to measure case management protocol adherence among 837 private and 206 public providers in urban Lagos and Kano. It examined two different scenarios: a "textbook" case of presumptive TB and a treatment initiation case where SPs presented as referred patients with confirmed TB diagnoses. Private sector results were benchmarked against public sector results. A bottleneck analysis examined protocol adherence departures at key points along the case management sequence that providers were trained to follow. Except for laboratories, few providers met the criteria for fully correct management of presumptive TB, though more than 70% of providers correctly engaged in TB screening. In the treatment initiation case 18% of clinical providers demonstrated fully correct case management. Private and public providers' adherence was not significantly different. Bottleneck analysis revealed that the most common deviations from correct management were failure to initiate sputum collection for presumptive patients and failure to conduct sufficiently thorough treatment initiation counseling for confirmed patients. This study found the quality of private providers' TB case management to be comparable to public providers in Nigeria, as well as to providers in other high burden countries. Findings support continued efforts to include private providers in Nigeria's national TB program. Though most providers fell short of desired quality, the bottleneck analysis points to specific issues that TB stakeholders can feasibly address with system- and provider-level interventions., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: authors AOA and CO were employees of USAID, the funder of the research and of the SHOPS Plus project; authors BOF, AAA, and FN were employees of the SHOPS Plus project in Nigeria, which implemented the intervention studied in this research; the SHOPS Plus project is implemented by Abt Associates globally and authors LAR, SF, BJ, EMB, and MKS are employees of Abt Associates., (Copyright: This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.)

Rift Valley fever (RVF) is a complex emerging arboviral hemorrhagic disease that causes significant illness in animals and humans. Camel trade across the land borders between Nigeria and the Niger Republic occurs frequently and poses a significant risk for RVF transmission to pastoralists and traders. We carried a cross-sectional study between November 2016 and April 2017 in two northern States (Katsina and Jigawa) known for camel trade in Nigeria to investigate the seroprevalence and potential risk factors for RVFV occurrence. We collected 720 sera and administered questionnaire to pastoralists. We used the competitive enzyme-linked immunosorbent assay (c-ELISA) to determine the previous exposure to RVFV infection. We retrieved  environmental information from public data sources that might explain RVFV seropositivity at  the LGA level. To asses potential risk factors,we categorized LGAs with RVFV as "1" and those without a case" 0". We fitted a logistic model to the data  and estimated odds ratios and 95% confidence intervals. An overall 19.9% prevalence was reported among camel herd-the highest seropositivity (33.3%) was recorded in SuleTankarkar LGA. In the multivariable model, only rain-fed croplands was significantly associated with RVFV antibodies occurrence p  = 0.048 (OR = 0.87, 95% CI: 0.76-0.99). Only a minority of the respondents, 19.3% ( n  = 17/88), knew that RVF is zoonotic. Separation of healthy animals from the infected animals was carried out by 53.4% (47/88) pastoralists while 59.1% (52/88) pastoralists still use ethnoveterinary practices to control or mitigate disease outbreaks. Our study demonstrates the presence of RVFV antibodies among camel in Nigeria and the associated risk factors. These findings highlight the need for enhancing surveillance and control efforts and the public health education of camel pastoralists. Further investigation to unravel the zoonotic transmission potential to pastoralists and other animal species is pertinent., Competing Interests: The authors declare no conflict of interests regarding the publication of this study., (© 2021 Published by Elsevier B.V.)

Neuroscience research in Africa remains sparse. Devising new policies to boost Africa's neuroscience landscape is imperative, but these must be based on accurate data on research outputs which is largely lacking. Such data must reflect the heterogeneity of research environments across the continent's 54 countries. Here, we analyse neuroscience publications affiliated with African institutions between 1996 and 2017. Of 12,326 PubMed indexed publications, 5,219 show clear evidence that the work was performed in Africa and led by African-based researchers - on average ~5 per country and year. From here, we extract information on journals and citations, funding, international coauthorships and techniques used. For reference, we also extract the same metrics from 220 randomly selected publications each from the UK, USA, Australia, Japan and Brazil. Our dataset provides insights into the current state of African neuroscience research in a global context.

Background: Implementation research has emerged as part of evidence-based decision-making efforts to plug current gaps in the translation of research evidence into health policy and practice. While there has been a growing number of initiatives promoting the uptake of implementation research in Africa, its role and effectiveness remain unclear, particularly in the context of universal health coverage (UHC). Hence, this scoping review aimed to identify and characterise the use of implementation research initiatives for assessing UHC-related interventions or programmes in Africa., Methods: The review protocol was developed based on the methodological framework proposed by Arksey and O'Malley, as enhanced by the Joanna Briggs Institute. The review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). MEDLINE, Scopus and the Cochrane Library were searched. The search also included a hand search of relevant grey literature and reference lists. Literature sources involving the application of implementation research in the context of UHC in Africa were eligible for inclusion., Results: The database search yielded 2153 records. We identified 12 additional records from hand search of reference lists. After the removal of duplicates, we had 2051 unique records, of which 26 studies were included in the review. Implementation research was used within ten distinct UHC-related contexts, including HIV; maternal and child health; voluntary male medical circumcision; healthcare financing; immunisation; healthcare data quality; malaria diagnosis; primary healthcare quality improvement; surgery and typhoid fever control. The consolidated framework for implementation research (CFIR) was the most frequently used framework. Qualitative and mixed-methods study designs were the commonest methods used. Implementation research was mostly used to guide post-implementation evaluation of health programmes and the contextualisation of findings to improve future implementation outcomes. The most commonly reported contextual facilitators were political support, funding, sustained collaboration and effective programme leadership. Reported barriers included inadequate human and other resources; lack of incentives; perception of implementation as additional work burden; and socio-cultural barriers., Conclusions: This review demonstrates that implementation research can be used to achieve UHC-related outcomes in Africa. It has identified important facilitators and barriers to the use of implementation research for promoting UHC in the region.

Introduction: There is a dearth of literature on vaccine hesitancy in Africa. In this study, we aimed to explore the drivers of hesitancy toward recommended childhood vaccines in Kenya, Malawi, and Ethiopia., Methods: A scoping review methodology was used as this evidence synthesis approach is suitable for mapping existing literature and identifying knowledge gaps. For this study, we systematically searched four electronic databases for published and unpublished literature from the three African countries. The methodological framework that was used is in line with Arksey and O'Malley's recommendations as modified by Levac., Results: A total of 23 publications met the inclusion criteria and were included in the study. Majority of the studies were published after 2012. In these three African countries, hesitancy toward recommended childhood vaccines is driven by a mix of caregiver-related factors, health systems-related factors as well as the influence of community context., Conclusion: This study demonstrated that vaccine hesitancy in Kenya, Malawi, and Ethiopia is a complex phenomenon that is driven by multiple interrelated and interconnected factors.

Polyols of palm olein/polyethylene terephthalate (PET) were synthesized by means of incorporating recycled PET from waste drinking bottles in different proportions into palm olein alkyd in the presence of ethylene glycol. The polyols were characterized by FTIR, and theirs hydroxyl value (OHV), acid value (AV) and viscosity were determined. The formulation of the polyurethane coating was carried out by dissolving the polyol in mixed solvent of cyclohexanone/tetrahydrofuran (THF) (4 : 1) followed by reacting 1 hydroxyl equivalent of the polyol with 1.2 equivalents of methylene diphenyldiisocyanate and 0.05% dibutyltin dilaurate (DBTDL) catalyst. The coating cured through the cross-linking reactions between hydroxyl and isocyanate groups. The formation of urethane linkages was established by FTIR spectroscopy. The set films were characterized by thermal analysis. To study their anticorrosion properties, polarization measurements and EIS in 3.5% NaCl solution were determined. The coatings displayed good thermal stability and anticorrosion properties which were supported by XRD analysis. The PU7 coating, with the highest proportion of PET (up to 15% w/w), displayed significantly improved thermal stability and anticorrosion properties. It is evident that the performance of the polyurethane (PU) coatings could be enhanced by the incorporation of PET., (© 2021 The Authors.)

The purpose of this research is to measure the combing impact of corporate social responsibility on company performance and to conduct a comparative analysis among local and foreign companies in this context. This research aims to conduct an empirical analysis about how corporate social responsibility contributes to company performance. The study utilizes AHP and fuzzy TOPSIS theory to conduct research. The results revealed that environmental corporate social responsibility has a vital role in the development of organizational reputation and employee commitment. It can be observed from the results that the weights of environmental CSR, corporate CSR, financial CSR, and social CSR are 0.30, 0.25, 0.24, and 0.21, respectively. The preference of these four criteria is environmental CSR > corporate CSR > financial CSR > social CSR. The corporate CSR criterion got the maximum weight of 0.30, whereas the social CSR criteria received the lowest weight of 0.21. The financial CSR get weights of criteria 0.25, and the commercial potential obtained 0.24 weights, while the financial CSR got the 2nd highest criteria weight of 0.25, and the social CSR get weights of criteria 0.21 lowest weighted. The research provides valuable information for decision-makers. The study provides a valuable information for policy makers.

Introduction: Implementation research has emerged as part of evidence-based decision-making efforts to plug current gaps in the translation of research evidence into health policy and practice. While there has been a growing number of institutions and initiatives promoting the uptake of implementation research in Africa, their role and effectiveness remain unclear, particularly in the context of universal health coverage (UHC). This review aims to extensively identify and characterise the nature, facilitators and barriers to the use of implementation research for assessing or evaluating UHC-related interventions or programmes in Africa., Methods and Analysis: This scoping review will be developed based on the methodological framework proposed by Arksey and O'Malley and enhanced by the Joanna Briggs Institute. It will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. A comprehensive search of the following electronic databases will be conducted: Medline (via PubMed), Scopus and the Cochrane Library. Relevant grey literature and reference lists will also be searched. All publications describing the application of implementation research in the context of UHC will be considered for inclusion. Findings will be narratively synthesised and analysed using a predefined conceptual framework. Where applicable, quantitative evidence will be aggregated using summary statistics. There will be consultation of stakeholders, including UHC-oriented health professionals, programme managers, implementation researchers and policy-makers; to provide methodological, conceptual and practical insights., Ethics and Dissemination: The data used in this review will be sourced from publicly available literature; hence, this study will not require ethical approval. Findings and recommendations will be disseminated to reach a diverse audience, including UHC advocates, implementation researchers and key health system stakeholders within the African region. Additionally, findings will be disseminated through an open-access publication in a relevant peer-reviewed journal., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.)

Rotaviruses have a worldwide distribution and the infection is associated with diarrhea in young of ruminants as well as children. However, limited data exist on its prevalence and types in Yobe state, Nigeria. Detection of rotavirus A and types in ruminant population in Yobe state was the aim of the study. A total of 470 diarrheic fecal samples were collected and tested for rotavirus and types using serology and molecular techniques respectively. A prevalence rate of 2.98% (14/470) was found in the three species with specific rates of 2.9% (6/202), 3.8% (6/158), and 1.8% (2/110) in goat, sheep, and cattle respectively. The prevalence rates of 3.6% (12/331), 1.2% (1/84), and 1.8% (1/55) were for those aged < 1-3, 4-6, and 7-9 months old, respectively, while 4.9% (9/185) and 1.7% (5/285) were in males and females respectively. Rotavirus genes VP7 and VP4 were detected in 2 (14.3%) out of the 14 ELISA-positive samples while deduced amino acid sequences of the major variable regions revealed the genes to belong to types G3P[11] strain. Significant association was found between the infection and sex (P < 0.05) unlike in the species and age groups of the ruminants. The circulation of rotavirus virus in ruminants and type G3P[11] in cattle has been confirmed in the study. Hence, there is a need for continuous surveillance, awareness campaign, and assessment of the economic losses and public health implications of rotavirus infection in Nigeria.

We report here the first step by step anchoring of a W(≡C t Bu)(CH 2 t Bu) 3 complex on a highly crystalline and mesoporous MOF, namely Zr-NU-1000, using a Surface Organometallic Chemistry (SOMC) concept and methodology. SOMC allowed us to selectively graft the complex on the Zr 6 clusters and characterize the obtained single site material using state of the art experimental methods including extensive solid-state NMR techniques and HAADF-STEM imaging. Further FT-IR spectroscopy revealed the presence of a W═O moiety arising from the in situ reaction of the W≡C t Bu functionality with the coordinated water coming from the 8-connected hexanuclear Zr 6 clusters. All the steps leading to the final grafted molecular complex have been identified by DFT. The obtained material was tested for gas phase and liquid phase olefin metathesis and exhibited higher catalytic activity than the corresponding catalysts synthesized by different grafting methods. This contribution establishes the importance of applying SOMC to MOF chemistry to get well-defined single site catalyst on MOF inorganic secondary building units, in particular the in situ synthesis of W═O alkyl complexes from their W carbyne analogues.

Background: Vaccination is one of the greatest public health interventions of all time. Vaccination coverage in South Africa has shown a steady improvement in reaching the national target. However, while there is progress nationally, there are districts within the country that are below the set target for vaccination coverage. One of the main drivers of suboptimal vaccination coverage is thought to be missed opportunities for vaccination., Objective: This study aims to understand the magnitude and determinants of missed opportunities for vaccination in South Africa., Methods: The 2016 South African Demographic and Health Survey will be used to conduct multilevel regression analyses to determine individual and contextual factors associated with missed opportunities for vaccination in South Africa. The perspectives of parents attending health care facilities in South Africa will be explored through exit interviews and focus group discussions. Similarly, perspectives of the health care providers will be sought to understand enablers and barriers to vaccination coverage at the facility level. Insights to such factors will aid in designing tailor-made interventions to improve vaccination coverage in South Africa., Results: Ethical review submission is planned for October 2020. Data collection is expected to be underway in January 2021., Conclusions: The extent of missed opportunities in South Africa coupled with the associated factors presents an opportunity for efforts to increase uptake in districts where vaccination coverage is below the national target. Population-level data such as those from the 2016 South African Demographic Health Survey will provide an idea of the magnitude of missed opportunities for vaccination in South Africa at the national and subnational levels. The findings of the study will inform national and subnational policy implementation on vaccinations and help to find context-specific interventions to improve vaccination coverage., International Registered Report Identifier (irrid): PRR1-10.2196/16672., (©Duduzile Ndwandwe, Ntombenhle J Ngcobo, Abdu A Adamu, Chukwudi Nnaji, Thandiwe Mashunye, Arlette M Leufak, Sara Cooper, Olalekan A Uthman, Charles S Wiysonge. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 28.09.2020.)

Background: Poor quality of pediatric healthcare services at health facilities is a major contributing factor to child morbidity and mortality in low- and middle-income countries, including Ethiopia, and it brings parental dissatisfaction. Eliciting parents' perception is an important method used to assess functionality or quality of pediatric healthcare services. Thus, the objective of this study was to assess the perceived quality of pediatric healthcare services and to identify factors for it in Felege-Hiwot Comprehensive Specialized Hospital, Northwest Ethiopia., Methods: A facility-based cross-sectional study was conducted among parents of childhood patients from September 15, 2019 to October 15, 2019; 407 participants were recruited. Stratified random sampling was used to select respondents and data were collected using face-to-face interviews. Frequencies, percentages, and means with standard deviations were used to describe profiles of respondents. Both bi-variable and multivariable logistic regressions were used to model the odds of perceived quality of pediatric healthcare services., Results: The proportion of perceived quality of pediatric healthcare services was 57.6% (95% CI:52.6-62.3%). College and above parental education status (AOR=5.22, 95% CI:2.39-11.38), urban residency (AOR=3.35, 95% CI:1.97-5.72), outpatient services (AOR=2.52, 95% CI:1.35-4.71), and surgical illnesses (AOR=2.18, 95% CI:1.28-3.73) were independent determinants for increased parental lower perceived level of quality. The odd of parental lower perceived level of quality was 2.42-times greater in those parents who did not prefer the hospital for revisiting (AOR=2.42, 95% CI:1.36-4.30)., Conclusion: Perceived quality of healthcare services in the hospital was low compared to the national plan which reflected that childhood patients did not receive optimal care. Educational status, place of residence, service delivering unit, illness type, and intention of hospital preference were independent determinants for parental perceived quality of pediatric healthcare service delivery. Continuous and periodic parental feedback should be considered in order to assess their satisfaction which in turn is an insight for quality improvement to be taken by the facility managers., Competing Interests: The authors have declared that no competing interests exist in this study., (© 2020 Alemu et al.)

One of the routine health services that is being disrupted by coronavirus disease 2019 (COVID-19) in Africa is childhood immunization. This is because the immunization system relies on functioning health facilities and stable communities to be effective. Its disruption increases the risk of epidemics of vaccine-preventable diseases, which could increase child mortality. Therefore, policymakers must quickly identify robust and context-specific strategies to rapidly scale-up routine immunization in order to mitigate the impact of COVID-19 on their national immunization performance. To achieve this, we propose a paradigm shift towards systems thinking and use of implementation science in immunization decision-making. Systems thinking can inform a more nuanced and holistic understanding of the interrelationship between COVID-19, its control strategies, and childhood immunization. Tools like causal loop diagrams can be used to explicitly illustrate the systems structure by identifying feedback loops. Once mapped and leverage points for interventions have been identified, implementation science can be used to guide the rapid uptake and utilization of multifaceted evidence-based innovations in complex practice settings. As Africa re-strategizes for the post-2020 era, these emerging fields could contribute significantly in accelerating progress towards universal access to vaccines for all children on the continent despite COVID-19., (Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Patent and proprietary medicine vendors (PPMVs) increase access to antibiotics through non-prescription sales in their drug retail outlets. This fosters irrational antibiotic use among people, thus contributing to the growing burden of resistance. Although training programmes on antibiotic use and resistance exist, they have disproportionately targeted health workers in hospital settings. It's unclear if there is a relationship between such trainings and non-prescription sales of antibiotics among PPMVs which are more embedded in communities. Therefore, a cross-sectional study was conducted to elicit the determinants of non-prescription antibiotic sales among PPMVs in Kano metropolis, Nigeria. Through brainstorming, causal loop diagrams (CLDs) were used to illustrate the dynamics of factors that are responsible for non-prescription antibiotic sales. Multilevel logistic regression model was used to determine the relationship between training on antibiotic use and resistance and non-prescription antibiotic sales, after controlling for potential confounders. We found that two-third (66.70%) of the PPMVs reported that they have sold non-prescribed antibiotics. A total of three CLDs were constructed to illustrate the complex dynamics of the factors that are related to non-prescription antibiotic sales. After controlling for all factors, PPMVs who reported that they had never received any training on antibiotic use and resistance were twice as more likely to sell antibiotic without prescription compared with those who reported that they have ever received such training (OR = 2.07, 95% CI: 1.27-3.37). This finding suggests that there is an association between training on antibiotic use and resistance and non-prescription sales of antibiotics. However, the complex dynamics of the factors should not be ignored as it can have implications for the development of intervention programmes. Multifaceted and multicomponent intervention packages (incorporating trainings on antibiotic use and resistance) that account for the inherent complexity within the system are likely to be more effective for this setting., (© The Author(s) 2020. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)