African Region Research Articles

Independent Correlates of Glycemic Control among Adults with Diabetes in South Africa

Background: Globally, the prevalence of diabetes is increasing, especially in low- and middle-income countries (LMICs), including those in the sub-Saharan African region. However, the independent socioeconomic correlates of glycemic control as measured by hemoglobin A1C have yet to be identified. Therefore, the aim of this analysis was to understand the independent correlates of glycemic control in South Africa. Methods: Data from the 2016 South Africa Demographic and Health Survey on adults with diabetes were used for this analysis. The dependent variable, glycemic control, was defined using hemoglobin A1c (HbA1c). Independent variables included: age, gender, ethnicity, marital status, region, urban/rural residence, ability to read, education, insurance, wealth, occupation, and employment in the last year. Analysis of variance was used to test for differences in mean HbA1c for each category of all independent variables, and a fully adjusted linear regression model was used to identify independent correlates of glycemic control (HbA1c). Results: Among the 772 people included in this analysis, there were significant differences in mean HbA1c by age (p < 0.001), ethnicity (p < 0.001), place of residence (p = 0.024), wealth index (p = 0.001), and employment in the last year (p = 0.008). Independent correlates of HbA1c included age, ethnicity, and wealth index. Conclusions: This study used data from a large diverse population with a high prevalence of diabetes in sub-Saharan Africa and provides new evidence on the correlates of glycemic control and potential targets for interventions designed to lower HbA1c and improve diabetes-related health outcomes of adults in South Africa.

The role of Niger’s uranium supply to France’s electricity export potential in Europe

This article examines the role of stability of Niger uranium supply to France for the volume of electricity export to Europe, as well as the possible role of Russia in resolving the uranium deficit for nuclear power plants in France. France is considered one of the world’s largest producers and exporters of nuclear energy. For more than 50 years, one of the main suppliers of uranium to France has been its former colony, represented by Niger. Due to the events of 27 July 2023 in the Niger, there is a high risk of a complete cut in the supply of Niger uranium to France, which threatens the energy security not only of France, but of all its neighbors: Germany, the United Kingdom, Spain, Italy, Switzerland and others. Also in this work, the statistical data on uranium shipments from other countries to France are analyzed, the possible risks associated with the changing political situation in the African region are predicted and various measures are presented, which could be taken to mitigate the impact of the disruption of uranium supplies from the Niger to France’s nuclear sector. 

Public Health Evaluation of COVID-19 Vaccine Acceptability and Health Behaviors in South Africa: Past, Current, and Future Implications (2020–2022)

South Africa is facing a high burden of COVID-19 pandemic with low-vaccine coverage in the African Region. We aimed to investigate the temporal changes and impacts in health behaviors on vaccine acceptability in pre-, during-, and post-vaccine roll-out periods. In this cross-sectional study, we used the combined data from the nationally conducted “COVID-19 Vaccine Surveys (CVACS)” (May 2020–February/March 2022). Semiparametric regression models were used to capture the nonlinear association between the vaccine acceptability and health behaviors. Our study provided compelling evidence for a substantial decline in COVID-19 vaccine trust which shifted from 62%–70% to 26%–42% overtime. Participants younger than 40 years of age were less likely to receive the vaccine before it became available. However, this association changed in the postvaccine period with significant uptake in vaccine acceptance in younger groups. South Africans who identified themselves as black were more likely to intend to receive (aORs ranged: 1.93−3.60) and to trust the vaccine’s safety and efficacy (aORs ranged:1.79−1.23) in all time periods. “Mask wearing” and “frequent hand washing” were the most commonly reported behaviors. Given the lower rates of vaccine acceptability and a reduction in preventative health behaviors, monitoring the spread of infections is crucial and may have significant clinical and epidemiological implications.

Fintech, financial inclusion, and sustainable development in the African region

In this study, we explore the nexus between sustainable development and finance, with a specific focus on the African region–a critical yet underexplored context in the existing literature. Against the backdrop of evolving challenges in financial inclusion, improved access, and the growing prevalence of financial technology (FinTech), we aim to fill a research gap by investigating the connection between FinTech, financial inclusion, and sustainable development. The empirical exploration spans 25 African countries from 2011 to 2019, employing econometric methods such as dynamic panel (SGMM two-steps) and static panel (OLS, FE, LSDV). Utilizing key indicators like Adjusted Net Savings (ANS) and Gross Saving rate (GS), our findings reveal a substantial positive impact of financial inclusion and FinTech on sustainable development. However, an intriguing discovery emerges as the interaction between these variables exhibits a weak negative and significant effect. As a unique contribution to the existing literature, we estimate marginal effects at various levels of FinTech and financial inclusion on sustainable development. Beyond insights, our study offers vital policy recommendations, emphasizing the necessity for improved collaboration among financial service providers to avoid redundancy. Furthermore, we highlight the critical need to expand financial infrastructure, advocate for FinTech promotion, and foster inter-African cooperation.

COVID-19 Vaccination Coverage - World Health Organization African Region, 2021-2023.

With the availability of authorized COVID-19 vaccines in early 2021, vaccination became an effective tool to reduce COVID-19-associated morbidity and mortality. Initially, the World Health Organization (WHO) set an ambitious target to vaccinate 70% of the global population by mid-2022. However, in July 2022, WHO recommended that all countries, including those in the African Region, prioritize COVID-19 vaccination of high-risk groups, including older adults and health care workers, to have the greatest impact on morbidity and mortality. As of December 31, 2023, approximately 860 million doses of COVID-19 vaccine had been delivered to countries in the African Region, and 646 million doses had been administered. Cumulatively, 38% of the African Region's population had received ≥1 dose, 32% had completed a primary series, and 21% had received ≥1 booster dose. Cumulative total population coverage with ≥1 dose ranged by country from 0.3% to 89%. Coverage with the primary series among older age groups was 52% (range among countries=15%-96%); primary series coverage among health care workers was 48% (range=13%-99%). Although the COVID-19 public health emergency of international concern was declared over in May 2023, current WHO recommendations reinforce the need to vaccinate priority populations at highest risk for severe COVID-19 disease and death and build more sustainable programs by integrating COVID-19 vaccination into primary health care, strengthening immunization across the life course, and improving pandemic preparedness.

AN EVALUATION OF ALTERNATIVE DISPUTE RESOLUTION MECHANISMS IN THE AFRICAN REGION

Alternative dispute resolution (ADR) in Africa is growing and flourishing but the region is not a global leader in conflict resolution. The African region still has many challenges to overcome. The region has the potential to expand, grow and thrive with foreign direct investment to boost its economies and ensure stability for its infrastructure. The African region is rich in many natural resources, but, unfortunately, interstate conflict causes instability to social, political and economic rights. This article explores the weaknesses and challenges within the African region with a view to activating the potential of the region to become a global leader in alternative dispute resolution. The enforcement and implementation mechanisms of alternative dispute resolution require an evaluation of current systems to ensure that there is an animate thrust of dispute resolution. The African systems have their strengths, but an evaluation of any system always exposes weaknesses. Corruption within the African region is a common theme, since government does not play an active role in deterring corruption, and this causes the public to mistrust all initiatives that stem from government influence. The article discusses the situation in four African countries, showing that corruption, lack of education and a lack of skilled ADR practitioners cause a dysfunctional system that cannot embrace ADR. For an ADR system to function smoothly, numerous ADR practitioners are needed to resolve conflict competently. Furthermore, a selective system of favouring laws that support only the government as opposed to investors causes an imbalance, and discourages investors from investing in Africa. A way needs to be paved, not to negate international practices relating to investor disputes, but rather to work holistically with national laws, to harmonise laws and overcome any conflict of law within the region.

Rising substance use disorders in Malawi: analysis of hospital-based data (2010 to 2019)

Background Africa has a long history of substance abuse, mostly limited to alcohol, tobacco and cannabis, with the East African region being home to one of the world’s highest rates. There are reports of increasing substance abuse in Malawi but limited research evidence to provide details on the extent and nature of the issue. Despite indications of high prevalence, help seeking behaviour among the population is minimal. Mental health services are underfunded by government, and not a key health priority. Access to affordable psychosocial treatment for substance abuse is limited. This paper reports analysis of service utilisation patterns among those assessed at the St John of God (SJOG) Hospital and referred for psychosocial services for substance abuse treatment since its establishment in 2010. This is the first study in Malawi reporting routinely collected patient data related to substance abuse treatment from outpatient psychosocial services. Methods We descriptively analysed retrospective routinely collected data related to substance use disorders from two SJOG hospital sites that provide psychosocial or psychopharmacological treatment to service users at the mental health clinic from 2010 to 2019. Results Analysis of routinely collected data indicated increasing substance abuse treatment within SJOG psychosocial services between 2010 to 2019, with alcohol, chamba (cannabis) and tobacco related substance use disorders being predominant conditions among service users. Age-related data from 2018–2019 showed 22% of service users were under 18 years, indicating evidence of youth substance abuse. Conclusions These findings indicate growing service utilisation for substance use treatment in outpatient psychosocial services over the last decade in Malawi. Importantly, there is need for better electronic health data recording infrastructure to facilitate monitoring of incidents to inform extent of substance use issues and evidence-based solutions for treatment services in Malawi.

Undiagnosed and uncontrolled hypertension in rural African adults: a scoping review protocol of primary health care interventions

IntroductionNon-communicable diseases cause 74% of global deaths, with cardiovascular diseases as the major contributor. Hypertension, a primary risk factor for cardiovascular disease, is highly prevalent in Africa. Diagnosis, treatment and...

Predictors of maternal health services uptake in West African region: a multilevel multinomial regression analysis of demographic health survey reports

BackgroundPursuant to studies, receiving the three key maternal health services (Antenatal Care, Skilled Delivery Service, and Postnatal Care) in a continuum could prevent 71% of global maternal deaths. Despite the Western African region being known for its high maternal death and poor access to maternal health services, there is a dearth of studies that delve into the spectrum of maternal health services uptake. Hence, this study aimed to assess the level and predictors of partial and adequate utilization of health services in a single analytical model using the most recent Demographic and Health Survey (DHS) data (2013–2021).MethodsThis study was based on the appended women's (IR) file of twelve West African countries. STATA software version 16 was used to analyze a weighted sample of 89,504 women aged 15–49 years. A composite index of maternal health service utilization has been created by combining three key health services and categorizing them into ‘no’, ‘partial’, or ‘adequate’ use. A multilevel multivariable multinomial logistic regression analysis was carried out to examine the effects of each predictor on the level of service utilization. The degree of association was reported using the adjusted relative risk ratio (aRRR) with a corresponding 95% confidence interval, and statistical significance was declared at p < 0.05.Results66.4% (95% CI: 64.9, 67.7) and 23.8% (95% CI: 23.3, 24.2) of women used maternal health services partially and adequately, respectively. Togo has the highest proportion of women getting adequate health care in the region, at 56.7%, while Nigeria has the lowest proportion, at 11%. Maternal education, residence, wealth index, parity, media exposure (to radio and television), enrolment in health insurance schemes, attitude towards wife beating, and autonomy in decision-making were identified as significant predictors of partial and adequate maternal health service uptake.ConclusionThe uptake of adequate maternal health services in the region was found to be low. Stakeholders should plan for and implement interventions that increase women's autonomy. Program planners and healthcare providers should give due emphasis to those women with no formal education and from low-income families. The government and the private sectors need to collaborate to improve media access and increase public enrolment in health insurance schemes.

Toward the elimination of hepatitis B: networking to promote the prevention of vertical transmission of hepatitis B virus through population-based interventions and multidisciplinary groups in Africa

The WHO African Region had 81 million people with chronic hepatitis B in 2019, which remains a silent killer. Hepatitis B virus (HBV), hepatitis delta virus (HDV), and HIV can be transmitted from the mother to child. If the HBV infection is acquired at infancy, it may lead to chronic hepatitis B in 90% of the cases. WHO reports that 6.4 million children under 5 years live with chronic hepatitis B infection worldwide. The prevention of mother-to-child transmission (PMTCT) of HBV is therefore critical in the global elimination strategy of viral hepatitis as we take lessons from PMTCT of HIV programs in Africa. We sought to create a network of multidisciplinary professional and civil society volunteers with the vision to promote cost-effective, country-driven initiatives to prevent the MTCT of HBV in Africa. In 2018, the Mother–Infant Cohort Hepatitis B Network (MICHep B Network) with members from Cameroon, Zimbabwe, and the United Kingdom and later from Chad, Gabon, and Central African Republic was created. The long-term objectives of the network are to organize capacity-building and networking workshops, create awareness among pregnant women, their partners, and the community, promote the operational research on MTCT of HBV, and extend the network activities to other African countries. The Network organized in Cameroon, two “Knowledge, Attitude and Practice” (KAP) surveys, one in-depth interview of 45 health care workers which revealed a high acceptability of the hepatitis B vaccine by families, two in-person workshops in 2018 and 2019, and one virtual in 2021 with over 190 participants, as well as two workshops on grant writing, bioethics, and biostatistics of 30 postgraduate students. Two HBV seroprevalence studies in pregnant women were conducted in Cameroon and Zimbabwe, in which a prevalence of 5.8% and 2.7%, respectively, was reported. The results and recommendations from the MICHep B Network activities could be implemented in countries of the MICHep B Network and beyond, with the goal of providing free birth dose vaccine against hepatitis B in Africa.

Systematic review of the impact of restrictive wildlife trade measures on conservation of iconic species in southern Africa.

Trade restrictions are often advocated and implemented as measures to protect wild species threatened by overexploitation. However, in some instances, their efficacy has been questioned, notably by governments in the southern African (SADC) region, which tend to favor a sustainable use approach to wildlife management. We conducted a systematic review of published literature guided by the PRISMA process to examine the effectiveness of trade restrictions and directly related control measures in addressing threats to species conservation in the SADC region, with a focus on elephants (Loxodonta sp.), rhinoceroses (Ceratotherium simum, Diceros bicornis), lions (Panthera leo), and pangolins (Manis sp.). We focused in particular on the direct conservation impact of trade restrictions at species or population level, indirect conservation impact at human behavior or attitude level, and socioeconomic impact on rural livelihoods and well-being and on national economies. Research on these topics was uneven and focused strongly on the effects of trade restrictions and law enforcement on crime-related behavior. Research gaps include socioeconomic impacts of trade restrictions, including effects of international restrictions on local livelihoods and consequent secondary conservation impacts, and evaluations of attempts to disrupt criminal networks. Based on the reviewed impact evidence, the effectiveness of international trade restrictions depends on a range of fully aligned measures in countries of origin, transit, and consumption. For example, our results suggest positive ecological short-term but negative or unknown long-term socioeconomic impacts of domestic restrictions. Based on these findings, key policy requirements include more nuanced approaches to incorporate a range of appropriate measures in range, transit, and consumer countries, that focus on capacity development for early detection and apprehension of incursions inside protected areas; measures for constructive engagement with relevant local communities outside protected areas; and future research to improve understanding of the socioeconomic contribution of wildlife.

Aflatoxin B1 and Epstein–Barr virus-induced CCL22 expression stimulates B cell infection

Epstein-Barr Virus (EBV) infects more than 90% of the adult population worldwide. EBV infection is associated with Burkitt lymphoma (BL) though alone is not sufficient to induce carcinogenesis implying the involvement of co-factors. BL is endemic in African regions faced with mycotoxins exposure. Exposure to mycotoxins and oncogenic viruses has been shown to increase cancer risks partly through the deregulation of the immune response. A recent transcriptome profiling of B cells exposed to aflatoxin B1 (AFB1) revealed an upregulation of the Chemokine ligand 22 (CCL22) expression although the underlying mechanisms were not investigated. Here, we tested whether mycotoxins and EBV exposure may together contribute to endemic BL (eBL) carcinogenesis via immunomodulatory mechanisms involving CCL22. Our results revealed that B cells exposure to AFB1 and EBV synergistically stimulated CCL22 secretion via the activation of Nuclear Factor-kappa B pathway. By expressing EBV latent genes in B cells, we revealed that elevated levels of CCL22 result not only from the expression of the latent membrane protein LMP1 as previously reported but also from the expression of other viral latent genes. Importantly, CCL22 overexpression resulting from AFB1-exposure in vitro increased EBV infection through the activation of phosphoinositide-3-kinase pathway. Moreover, inhibiting CCL22 in vitro and in humanized mice in vivo limited EBV infection and decreased viral genes expression, supporting the notion that CCL22 overexpression plays an important role in B cell infection. These findings unravel new mechanisms that may underpin eBL development and identify novel pathways that can be targeted in drug development.

Need for standardization and compliance to treatment protocols for COVID-19 within the African Region of the World Health Organization

COVID-19 pandemic changed the face of global health and brought about new issues in global health security and economy. The World Health Organization published guidelines for clinical management of COVID-19 four months after declaration of COVID-19 as a pandemic. Scholarly reviews and studies from member states within WHO AFRO reveals significant deviation from the WHO published protocols on COVID-19. Assessment of national treatment protocols of 30 of 47 WHO AFRO member states showed widespread inappropriate use of antimicrobial agents for patients, which may worsen the global and concerning threat of antimicrobial resistance. There is need for adopting interventions that optimize antimicrobial use in the context of pre- and post-pandemic preparedness to ensure long-term effectiveness and sustainability for antimicrobials. Treatment guidelines are to be adopted or adapted depending on best clinical evidence available. Non-compliance with guidelines might lead to mismanagement of infectious diseases with attendant negative consequences including antimicrobial resistance and misdirection of critical resources and supplies amongst others.

Metastatic patterns and hormone receptor status among breast cancer patients in Tanzania

Introduction: Metastatic breast cancer is a common presentation in Tanzania. Estrogen-receptor (ER)-positive tumors are known to metastasize to the bones and require hormonal treatment as first-line therapy. Challenges with accessing immunohistochemistry services can delay information on breast cancer subtypes, further delaying treatment with effective hormonal therapy. Objectives: This study aimed to assess the pattern of distribution of metastatic lesions in patients with metastatic breast cancer and evaluate its association with their hormone and HER-2 status, which could help provide recommendations on the use of front-line hormone therapy in areas where access to immunohistochemistry is a challenge. Methods: A retrospective study covering histologically confirmed breast cancer patients in 2020 with metastatic lesions and complete medical records at Ocean Road Cancer Institute. Clinical information on the number, state and sites of metastasis, presence of symptoms and treatment received, and pathological variables, including histology, ER, PR and HER-2 status, were documented. Results: Forty-nine (96.1%) of 51 patients analysed were female, with a mean age of 49.5 years. 47% presented with up-front metastatic disease. Lung was the most common metastatic site (76.5%) followed by bone/spine (53%). About half the patients had multiple sites involved. ER-positive tumors accounted for 47%, PR positive for 31% and HER-2 positive 39.2%. ER-positive tumors were more likely to present as a recurrence than up-front metastasis. ER-positive tumors were significantly more likely to be associated with bone and spine metastasis (59%) compared to ER-negative tumors (29%) Conclusion: The clinical and pathological features of MBC in Tanzanian women are similar in many ways to those in other African regions. However, the ER positivity rate is lower. This study found a significant association between ER-positive tumours and skeletal metastasis, which has implications for the up-front treatment of these patients, especially where access to immunohistochemistry can be a challenge.

TRIPS‐PLUS provisions in the economic partnership agreements with the EU: The CARIFORUM's experience and lessons for West Africa

AbstractNegotiation for the Economic Partnership Agreement (EPA) between the European Union (EU) and six African, Caribbean and Pacific (APC) regions has been ongoing for over a decade. These negotiations are at different phases in the seven APC regions and have faced significant challenges, hindering ratification in most of them. However, the Caribbean Forum (CARIFORUM) is the first regional group to have completed the process. It is currently implementing the EPA. Most significantly, CARIFORUM is the only region to have negotiated and ratified a comprehensive EPA that goes beyond trade in goods to include other elements such as services and intellectual property. This paper seeks to understand why CARIFORUM opted for a comprehensive EPA with the EU. Keeping in mind the downsides of intellectual property (IP) globalization, it fleshes out lessons, particularly on IP rights, that West African countries, and other non‐Caribbean ACP regions, can draw from the CARIFORUM's experience to adequately equip themselves in anticipation of negotiations with the EU for their EPAs.

A review of the Attagenus (Coleoptera: Dermestidae) species from South Africa and an image-based key to identification

The Dermestidae is a relatively poorly studied family of insects but with a high rate of species discovery. The South African region is particularly rich in Attagenus spp. many of which are distinctively patterned. This study provides an updated list of Attagenus spp. in South Africa with a complete literature review and an image-based identification key to the Attagenus species within South Africa. Images of most species are provided. With the rise in significance of citizen science recording schemes, this study facilitates image-based identification and encourages both entomologists and citizen scientists to further contribute to the understanding of this beautiful Coleopteran family.

ICDP workshop on the Lake Victoria Drilling Project (LVDP): scientific drilling of the world's largest tropical lake

Abstract. Lake Victoria, which is bordered by Uganda, Tanzania, Kenya, and has a catchment that extends to Rwanda and Burundi, is home to the largest human population surrounding any lake in the world and provides critical resources across eastern Africa. Lake Victoria is also the world's largest tropical lake by surface area, but it is relatively shallow and without a major inlet, making it very sensitive to changes in climate, and especially hydroclimate. Furthermore, its size creates abundant habitats for aquatic fauna, including the iconic hyper-diverse cichlids, and serves as a major geographic barrier to terrestrial fauna across equatorial Africa. Given Lake Victoria's importance to the eastern African region, its sensitivity to climate, and its influences on terrestrial and aquatic faunal evolution and dispersal, it is vital to understand the connection between the lake and regional climate and how the lake size, shape, and depth have changed through its depositional history. This information can only be ascertained by collecting a complete archive of Lake Victoria's sedimentary record. To evaluate the Lake Victoria basin as a potential drilling target, ∼ 50 scientists from 10 countries met in Dar es Salaam, Tanzania, in July 2022 for the International Continental Scientific Drilling Program (ICDP)-sponsored Lake Victoria Drilling Project (LVDP) workshop. Discussions of the main scientific objectives for a future drilling project included (1) recovering the Pleistocene and Holocene sedimentary records of Lake Victoria that document the dynamic nature of the lake, including multiple lacustrine and paleosol sequences; (2) establishing the chronology of recovered sediments, including using extensive tephra fingerprinting and other techniques from deposits in the region; (3) reconstructing past climate, environment, lacustrine conditions, and aquatic fauna, using an integrated multi-proxy approach, combined with climate and hydrologic modeling; and (4) connecting new records with existing sedimentary snapshots and fossils exposed in deposits around the lake, tying archaeological, paleontological, sedimentological, tectonic, and volcanic findings to new drilling results. The LVDP provides an innovative way to address critical geological, paleontological, climatological, and evolutionary biological questions about Quaternary to modern landscapes and ecosystems in eastern Africa. Importantly, this project affords an excellent opportunity to help develop conservation and management strategies for regional responses to current and future changes in climate, land use, fisheries, and resiliency of at-risk communities in equatorial Africa.

Analysis of Total Electron Content over the African low-latitude Region during the maximum phase of Solar Cycle 24 (2012-2014)

This study examined the ionospheric variation over the African low-latitude region using Total Electron Content (TEC) and its wavelet power spectrum (WPS). TEC data were obtained from five Global Positioning System (GPS) stations located in the trough and crests of the equatorial ionization anomaly (EIA) in both hemispheres during quiet periods of the maximum phase of solar cycle 24 (2012-2014). Our results revealed a striking equinoctial asymmetry (EA) with stronger TEC and higher solar flux in September equinox than March equinox of 2012 to 2013, with the reverse being the case in 2014. As such, the difference in solar flux between both equinoxes might have played a dominant role in driving the EA. Furthermore, we found a hemispheric asymmetry in TEC with higher value towards the crest in the northern hemisphere (southern hemisphere) in September equinox (March equinox) of 2012 to 2013. In 2014, nevertheless, TEC was remarkably higher towards the crest located in the southern hemisphere in September equinox only. The chaotic time series methods used to examine the TEC variations showed positive Lyapunov exponents (LE) at all stations. This indicated the presence of chaoticity in the African EIA. Nevertheless, stations located towards the southern crest (Eldoret and Dodoma) had the maximum LE values while those at the magnetic equator (Adis Ababa) and northern crest (Nama and Al Wajh) had the minimum values. Consequently, the changes in the internal dynamics of the equatorial ionosphere have impacts on its chaotic behavior.

Monkey Pox and its Impact on the Human Health in the World

This editorial was conducted in year 2023 in which main aim was to investigate Monkeypox (MPX) impact on the human health worldwidely. Several studies were searched through different online available sources including google scholar, pubmed, and researchgate. All studies were critically reviewed and analyzed the findings. MPX was first appeared in Denmark in 1958 among Monkeys, which were kept for research, later it appeared in a nine (9) months old boy in Democratic Republic of the Congo in 1970. The monkey pox was caused by Monkey Pox virus (MPXV) which is double stranded DNA virus. It belongs to Orthopoxvirus genus in Poxviridae family which consist of Variola, Cowpox, Vaccina and other viruses. The two genetic clades of the virus were clades I and II. The natural reservoir of MPXV was unknown and various small mammals such as squirrels and monkeys were susceptible. The sign and symptoms includes, rashes, swollen lymph nodes, sore throat, headache, muscle aches, back pain and muscle fatigue. MPXV transmits through respiratory droplets which creates due to face to face talking, breathing, kissing and also transmit through body touching. It was observed that the virus entered through broken skin, mucosal surfaces or through respiratory tract. Moreover, sexual partners is also the source of spreading MPXV. MPXV virus spread from one region to another through exports which affect different countries of the world. The virus spread to Europe and America from African region and outbreak occurred in 2022-2023. Mostly tecovirimat and smallpox treatment were used for management of MPXV. Several individuals died and also many were severely ill. This mortality and morbidity also affects the world economy. Due to MPXV, many health problems were raised including anxiety, depression and social stigma. Based on studies analysis, it is recommended to implement the quarantine strategy throughout the world for prevention and spreading of MPXV. Focus should be on transportation, imports, and exports of goods region to region. High quality healthcare centers should be design to tackle such outbreaks. Preferred to wash hand properly with sanitizer and soap. Better research laboratories is also advised for better, early and timely diagnosis of MPXV. Stay at home is another strategy in such situation. Moreover, awareness and medical counseling center is also important to aware public about the transmission, diagnosis and treatment of MPXV. Counseling center are important to reduce and remove the social stigma among general public.

Review of Genetic and Artificial Intelligence approaches to improving Gestational Diabetes Mellitus Screening and Diagnosis in sub-Saharan Africa.

Background: Adverse outcomes from gestational diabetes mellitus (GDM) in the mother and newborn are well established. Genetic variants may predict GDM and Artificial Intelligence (AI) can potentially assist with improved screening and early identification in lower resource settings. There is limited information on genetic variants associated with GDM in sub-Saharan Africa and the implementation of AI in GDM screening in sub-Saharan Africa is largely unknown. Methods: We reviewed the literature on what is known about genetic predictors of GDM in sub-Saharan African women. We searched PubMed and Google Scholar for single nucleotide polymorphisms (SNPs) involved in GDM predisposition in a sub-Saharan African population. We report on barriers that limit the implementation of AI that could assist with GDM screening and offer possible solutions. Results: In a Black South African cohort, the minor allele of the SNP rs4581569 existing in the PDX1 gene was significantly associated with GDM. We were not able to find any published literature on the implementation of AI to identify women at risk of GDM before second trimester of pregnancy in sub-Saharan Africa. Barriers to successful integration of AI into healthcare systems are broad but solutions exist. Conclusions: More research is needed to identify SNPs associated with GDM in sub-Saharan Africa. The implementation of AI and its applications in the field of healthcare in the sub-Saharan African region is a significant opportunity to positively impact early identification of GDM.