Neonatal intestinal atresia remains a significant cause of morbidity and mortality despite advances in neonatal intensive care, anesthesia, and neonatal surgical management. This systematic review and meta-analysis aimed to identify and quantify global prognostic factors associated with mortality and major postoperative morbidity in the modern surgical era. A comprehensive systematic literature review and meta-analysis was conducted in major databases from January 2000 to February 2026. Studies reporting mortality or major morbidity (anastomotic leak, unplanned reoperation, sepsis) after surgical repair of intestinal atresia in neonates were included. Data were pooled using a random-effects model. Subgroup and sensitivity analyses were performed to explore heterogeneity. Certainty of evidence was assessed with GRADE. Twenty-one studies comprising 2,040 neonates were included. The pooled mortality rate was 10% (95% CI 5-19%; I²=84%). Mortality was significantly higher in low- and middle-income countries and African studies (p < 0.001). Sensitivity analyses confirmed the robustness of the findings. The pooled unplanned reoperation rate was 15.1% (95% CI 12.7-17.6%; I²=31%) and anastomotic leak rate was 7.5% (95% CI 4.8-13.0%; I²=53%). Independent prognostic factors for adverse outcomes included prematurity (OR 4.9), low birth weight (OR 28.27), associated anomalies (OR 35.34), meconium peritonitis (OR 3.29), and surgical technique (primary anastomosis vs. Bishop-Koop). Sensitivity analyses confirmed robustness of the findings. Certainty of evidence was moderate for mortality and high for reoperation. In the modern era, mortality after neonatal intestinal atresia repair remains substantial, with marked disparities between high-income and low- and middle-income settings. Key modifiable and non-modifiable prognostic factors were identified that can inform risk stratification and clinical decision-making. Targeted, context-appropriate interventions in resource-limited settings are urgently needed to close the global survival gap.

Early identification of individuals at high risk of developing type 1 diabetes (T1D) remains a major public health priority. Islet autoantibodies are widely recognised as key biomarkers of autoimmune beta-cell destruction and disease progression; however, their predictive performance across diverse populations, particularly in African settings, has not been comprehensively synthesised. This study systematically reviews and synthesises evidence on the predictive value of islet autoantibodies for T1D development, with particular attention to emerging evidence from Africa. A systematic review was conducted in accordance with PRISMA 2020 guidelines. Literature searches were performed across PubMed, Scopus, Web of Science, and Embase for studies published between 2000 and 2026. Eligible studies included longitudinal and observational investigations assessing the relationship between islet autoantibody positivity and subsequent T1D development. Data were extracted on study characteristics, autoantibody profiles, and effect measures. Qualitative synthesis was conducted for all eligible studies, while a restricted random-effects quantitative synthesis was undertaken for studies reporting sufficiently comparable outcomes. Risk of bias and certainty of evidence were assessed using established frameworks. Forty-seven studies were included in the qualitative synthesis, including eight studies conducted in African populations or specifically addressing African diabetes phenotypes. A restricted subset of studies contributed to the quantitative synthesis. Across these studies, elevated autoantibody titres and multiple-autoantibody positivity were consistently associated with increased risk of progression to T1D. The restricted quantitative synthesis suggested an approximately threefold higher risk among individuals with elevated or multiple-autoantibody profiles (RR = 3.47, 95% CI: 2.57-4.68), although interpretation should be cautious given the limited number of comparable studies. High-affinity autoantibodies measured using advanced assays demonstrated stronger predictive performance. African studies highlighted substantial heterogeneity in disease phenotype, including lower autoantibody prevalence, later age at diagnosis, preserved endogenous insulin secretion, and evidence of non-autoimmune insulin-deficient diabetes, indicating that predictive models developed in high-income settings may not be directly transferable. Islet autoantibodies remain important predictors of T1D development, particularly when multiple antibodies are present. However, substantial regional heterogeneity exists, especially in African populations, where atypical diabetes phenotypes are increasingly recognised. These findings support the clinical utility of autoantibody-based risk stratification while underscoring the need for region-specific validation studies, longitudinal African cohorts, and contextually appropriate screening strategies before widespread implementation.

Sustained adherence to antiretroviral therapy (ART) is essential for maintaining viral suppression among people with HIV (PWH), yet adherence fluctuates over time and is imperfectly captured by routine viral load monitoring in many settings where measurements are often infrequent. We aimed to identify longitudinal ART adherence trajectories using electronic dose monitoring (EDM) and assess their association with viral non-suppression in a South African cohort. We analyzed data from a prospective cohort of PWH in Cape Town, South Africa on tenofovir-based ART. Daily adherence was measured using EDM over 12 months and summarized as monthly counts of dose events. Group-based trajectory modelling was applied to monthly adherence proportions to identify distinct adherence patterns. Associations between trajectory membership and time to viral non-suppression (HIV-1 RNA > 50 copies/mL) were assessed using Kaplan-Meier methods and log-rank tests. Among 238 PWH, 5 adherence trajectories were identified: persistently high (49.6%), gradually declining (22.7%), delayed declining (9.6%), rapidly declining (8.0%), and consistently suboptimal adherence (10.1%). Rapidly declining and delayed declining trajectories were associated with earlier and higher incidence of viral non-suppression compared with persistently high and gradually declining trajectories (log-rank p < 0.001). Younger PWH were more likely to be in lower-adherence trajectories; baseline psychosocial characteristics did not differ across groups. ART adherence is dynamic and heterogeneous; early declines in electronically measured adherence are associated with increased viral non-suppression risk. Longitudinal adherence trajectories may offer clinically actionable signals before routine viral load testing, informing differentiated HIV care programmes.

This article interrogates the long-standing tension between aesthetics and politics in the South African literary landscape. Dominant institutional frameworks have historically privileged an apolitical conception of the aesthetic – art for art’s sake – while dismissing politically inflected cultural expression as mere ‘craft’. Against this backdrop, I argue that Black poetic production in South Africa, particularly in the work of Mzwakhe Mbuli (The Beat) and Modise Sekgothe (Zulu Helios), resists this bifurcation. Drawing on the conceptual and methodological intervention of the Black Archive, I show how their poetry stages an ontological protest – where art is not merely expressive, but functional, insurgent, and epistemically generative. Through close readings of both texts, I examine how poetic form operates as a vehicle of political critique and historical memory. Mbuli’s performative cadence and thematic invocation of dispossession, alongside Sekgothe’s cosmological lyricism and embodied poetics, demonstrate how Black artistic expression refuses the colonial separation of aesthetic form and political function. Rather than occupying the margins of literary value, these works call for a reconstitution of the literary canon – one that recognises the epistemic validity of performance, orality, and vernacular modes of knowing. The article thus contributes to ongoing debates in African and decolonial literary studies by offering a theoretical model for reading poetry as archival praxis.

Africa has a uniquely rich cattle diversity of ~150 breeds comprising the Bos taurus indicus sub-species, Bos taurus taurus, and their crosses. These represent ~23% of the global cattle population. However, high quality, representative assemblies are limited for African cattle and especially for indicine breeds. Here we built high quality de novo assemblies for five important African indigenous cattle breeds using PacBio HiFi sequencing: Lagune (Bos taurus taurus), Gudali, Iringa Red and Singida White (Bos taurus indicus), and Mpwapwa (Bos taurus taurus x Bos taurus indicus). These new assemblies are the most contiguous and complete African cattle assemblies produced so far, with genome sizes of 3.25-3.36 Gb, contiguity N50s ranging from 83.59 Mb to 97.87 Mb and scaffold N50s from 100.30 Mb to 113.37 Mb. BUSCO genome completeness scores were also higher than 99.68%, indicative of highly contiguous assemblies. These improved and highly contiguous genome assemblies are consequently a valuable resource for future African and global livestock genomic studies.

Cognitive development in young adulthood among people living with HIV (PLWH) is not well understood, especially in the context of food insecurity (FI). Nutrient-based interventions may have unique cognitive benefits dependent on age and HIV status. Our analysis included participants enrolled in the African Cohort Study (AFRICOS). AFRICOS enrolls PLWH and without HIV (PLWoH) across 12 PEPFAR-supported facilities in Kenya, Nigeria, Tanzania, and Uganda. All participants were 15-27 years old and on antiretroviral therapy (ART) ≥ 6 months if PLWH. Annual neuropsychological assessments included the WHO Auditory Verbal Learning Test (AVLT; learning and memory), Trail Making Test Part A (TMT-A; processing speed), Color Trails 1 (CT1; processing speed), Color Trails 2 (CT2; executive functions), and Verbal Fluency (VF; language generativity). FI was determined by self-reporting not enough to eat or having < 3 meals per day. Linear mixed models assessed independent and interactive effects of age, HIV status, and time-varying FI on longitudinal cognitive outcomes. From 2013 to 2023 we collected data from 1,012 participants, of whom 575 (56.8%) were female and 476 (47.0%) ever FI. Overall, increasing age was associated with better cognitive performance. Despite ART experience, PLWH performed worse than PLWoH on language generativity (VF; β=-0.47, p = 0.032) and executive functions (CT2; β = 8.10, p = 0.004). FI was associated with worse memory performance at younger ages (βFI*age = 0.17 [95%CI: 0.07, 0.27], pFI*age=0.001) and poorer executive functions at older age (βFI*age = 1.63 [95%CI: 0.56, 2.70], pFI*age=0.003). Additional cognitive interventions may be needed for young PLWH including nutrient-based interventions that are developmentally tailored to unique cognitive domains.

ABSTRACT This article reconceptualises the Red Sea as an interregional geopolitical space central to the contemporary political geography that connects North Africa and West Asia. It challenges territorially bounded and land-centric approaches to regionhood that dominate International Relations and North African studies, arguing that such frameworks obscure the geopolitical significance of maritime corridors and chokepoints. Drawing on a hybrid analytical framework that combines International Relations with Political Geography, the article foregrounds spatiality, mobility, infrastructure, and circulation as key mechanisms through which regional order is produced. Focusing on the Red Sea corridor linking the Arabian Peninsula, the Nile Valley, and the Horn of Africa, the analysis demonstrates how security dynamics emerge through the governance of movement rather than territorial enclosure. Empirical illustrations, including maritime insecurity linked to the war in Yemen, Gulf state engagements across the Red Sea littoral, Djibouti’s role as a nodal hub, Ethiopia’s pursuit of maritime access, and the governance legacies of piracy, highlight how localised developments acquire interregional significance when embedded within critical maritime infrastructures. By framing the Red Sea as a constitutive space of regional formation, the article contributes to studies of North Africa by foregrounding maritime governance as a core dimension of interregional politics.

Successful health system transformation depends on organisational readiness, yet few African studies have applied structured excellence frameworks to assess change capacity. This study evaluated the readiness of two district health systems in South Africa’s North West Province using the European Foundation for Quality Management Excellence Model (EFQM). A descriptive cross-sectional survey was conducted using a standardised, EFQM-based, self-administered questionnaire. The questionnaire was distributed to 200 senior and middle-level health managers, chief executive officers, and clinical leaders across the Bojanala Platinum and Ngaka Modiri Molema districts. Quantitative EFQM domain scores were calculated and compared across districts. A total of 193 responses were received (96.5%), including complete European Foundation for Quality Management Excellence Model process data from 112 participants. The combined sample achieved a mean EFQM -PER score of 75.45 (SD = 16.61) and a median of 76.00 (IQR: 66.50–87.25). Bojanala recorded higher EFQM-PER performance (mean = 77.74, SD = 14.88; median = 80.45, IQR: 72.00–89.00) than Ngaka Modiri Molema (mean = 74.06, SD = 17.54; median = 74.80, IQR: 64.00–86.50). Leadership (76.94%) and Policy and Strategy (72.79%) were the strongest-performing EFQM Excellence Model domains, falling within the strengthening range (greater than 70%). People (51.81%) and Partnerships and Resources (45.5%) scored below the readiness threshold, identifying critical vulnerabilities in human resource engagement and resource coordination. No significant associations were observed between readiness scores and socio-demographic characteristics. Health system readiness in the North West province is supported by strong leadership and policy alignment; however, weaknesses in workforce empowerment and partnership management pose substantial risks to sustainable reform. Targeted strengthening of these underperforming domains is essential to translate strategic intent into resilient, people-centred health system change.

Type 2 diabetes (T2D) is a metabolic disorder characterised by hyperglycaemia, reduced insulin secretion, and increased insulin resistance, yet its mechanisms are not fully understood. While genetic predisposition contributes to the variable disease presentation across different ethnic populations, it does not fully explain the burden of T2D. Global 5-methylcytosine (5-mC) has emerged as an important regulator of gene expression, influencing disease pathogenesis through interactions with environmental factors. In parallel, circulating exosomes have attracted significant attention in research due to their role in mediating cell-to-cell communication and their capability to transport bioactive molecules, including methylated genomic DNA, that influence gene expression and metabolic pathways. The combined contribution of 5-mC and circulating exosome concentration to T2D pathogenesis in African populations remains poorly understood. A South African community case-control study of 40 T2D cases and 40 healthy controls quantified exosomes and 5-mC using their corresponding enzyme-linked immunosorbent assay. Associations of variables with T2D were evaluated using linear and logistic regression models. Serum exosome concentrations were positively correlated with global 5-mC (r = 0.269, p = 0.016). Global 5-mC levels were positively associated with triglycerides (r = 0.232, p = 0.038) and inversely correlated with weight in the diabetic group (r = -0.342, p = 0.038), while exosomes showed a sex-specific inverse association with diastolic blood pressure in males (r = -0.585, p = 0.028). However, neither biomarker independently predicted T2D after adjustment for confounders. These findings suggest a modest interplay between epigenetic modification and exosome signalling, warranting further investigation in larger studies.

Background:Organophosphate esters (OPEs) metabolites are frequently detected in human samples. Their structural similarity to organophosphate pesticides raises concerns about potential neurotoxicity. Animal and limited human studies suggest prenatal exposure to OPEs may affect offspring’s neurobehaviors.Objectives:We investigated the association between maternal OPE exposure and internalizing/externalizing behaviors in children age 2–5 years from the South African Drakenstein Child Health Study (N = 702).Methods:We measured urinary metabolites of OPEs, bis(1,3-dichloro-2-propyl) phosphate (BDCPP) and diphenyl phosphate, during the second trimester of pregnancy or at birth, using a targeted multiclass assay. Childhood behaviors were assessed at 24, 42, and 60 months using the Child Behavior Checklist (CBCL). We used linear mixed-effects models with random intercepts and slopes to estimate associations.Results:BDCPP detection was associated with higher externalizing behavior scores at earlier ages, with attenuation over time (β = −1.57, 95% confidence interval: −2.74, −0.40 per 18-month increment). Age-specific estimates were 2.91 (1.08, 4.75) at 24 months, 1.34 (0.09, 2.59) at 42 months, and −0.23 (−1.81, 1.35) at 60 months. No consistent time-varying association was observed for internalizing behaviors, although a significant association was noted at 24 months (β = 2.28; 95% confidence interval: 0.20, 4.37). Diphenyl phosphate showed no associations with CBCL outcomes. Both metabolites were associated with higher CBCL scores among males, particularly for externalizing behaviors.Conclusions:Prenatal OPE exposures, particularly BDCPP, were associated with worse behavior outcomes in early childhood with attenuation over time. Further research is needed to clarify exposure timing and sex-specific susceptibility in low- and middle-income countries settings.

A causal association between occupational asbestos exposure and lung disease, including pneumoconiosis and mesothelioma, is well established. Elevated mortality among former asbestos miners is expected. However, large-scale South African studies examining all-cause mortality in this population are lacking. We assessed all-cause mortality among former asbestos miners recorded in the Asbestos and Kgalagadi Relief Trusts' Inyosi database. All-cause standard mortality ratios (SMRs) and crude mortality rates (CMRs) were calculated for 11,343 ex-miners. Mortality predictors were modeled using Cox regression analysis, and mortality trends were assessed by examining annual all-cause CMRs and SMRs over the 20-year study period. The cohort's all-cause mortality exceeded that of the general population by 4% (SMR = 1.04; 95% CI: 1.01-1.07), with excess mortality confined to women (SMR = 1.17; 95% CI: 1.09-1.25). Increasing ILO radiographic profusion category strongly predicted mortality, with adjusted hazard ratios (aHRs) ranging from 1.13 (95% CI: 1.05-1.23) to 2.42 (95% CI: 1.58-3.71). Severely reduced lung function was also associated with increased risk, including forced expiratory volume in 1 s and forced vital capacity z-scores below -3.0 (aHR = 1.60; 95% CI: 1.41-1.81 and aHR = 1.26; 95% CI: 1.12-1.42, respectively). Additional predictors included body mass index less than 18.5 kg/m² (aHR = 1.46; 95% CI: 1.36-1.58) and previous smoking (aHR = 1.43; 95% CI: 1.35-1.53). SMRs declined over time. Radiological and spirometric indicators were key predictors of mortality. These findings support risk stratification and targeted interventions, particularly early management of respiratory complications and smoking cessation, to reduce mortality. The excess female mortality highlights the occupational hazards of aboveground asbestos activities, gender‑specific work practices, and insufficient control measures in this setting. Although standardized mortality was only modestly elevated, interpretation was limited by incomplete data.

During early HIV-1 infection, robust Cytotoxic T-lymphocyte (CTL) responses are mostly targeted at immunodominant Gag p24 epitopes to reduce HIV-1 viraemia to a set-point. The aim of this study was to review the current body of knowledge on HIV-1 Gag CTL epitopes in the southern African region where subtype C is prevalent. Peer-reviewed records were obtained from three databases: PubMed Central, Web of Science Core Collection, and Scopus, using the following search terms: HIV subtype C Gag epitopes, and HIV clade C Gag epitopes. The search results were restricted to countries within the southern African region, and only data published in English and between the years 2000-2025 were considered for this review. The search from the three databases produced a total of 2103 peer-reviewed records, and 49 records were included in the review. The majority of studies (58.44%) were conducted in South Africa, followed by Botswana (15.58%), Zambia (10.39%), Malawi (7.79%), Zimbabwe (6.49%) and Angola (1.30%). There were no studies identified from other southern African countries. A total of 60 Gag CTL epitopes were identified, of which 17 (28.33%) were located within the matrix protein (p17), 33 (55.00%) within the capsid protein (p24), and 4 (6.67%) within the Gag polyprotein (p2p7p1p6). The commonly detected immunodominant epitopes were mostly located within the Gag p24 protein; and included TPQDLNTML (TL9, Gag p24 48-56) and TSTLQEQIGW (TW10, Gag p24 108-117) present at 16.00% and 13.3%, respectively. The proportion of HLA-A, B and C allotypes in this systematic review were 18%, 78%, and 4%, respectively. The more common HLA-B allotypes that restrict immunodominant Gag epitopes and facilitate better control of HIV-1 were HLA-B*57, -B*58:01, -B*42:01 and -B*81:01. This systematic review has provided important insights into the description of immunodominant Gag epitopes and HLA-I alleles that contribute to the control of HIV-1 viraemia in the southern African region. It has also exposed that some CTL epitopes identified in the southern African studies are not reported on the Los Alamos HIV database (LANL HIV database). This highlights a need to have this database updated with this information as it is used as a reference for epitopes. This review could provide insights into the design of an epitope-based HIV-1 vaccine that would also be effective in the southern African region.

Substance use disorder (SUD) is a debilitating neuropsychiatric condition characterized by persistent compulsive drug use and associated cognitive and psychiatric impairments. Emerging evidence suggests that neuroinflammatory pathways contribute to the pathophysiology of SUD. However, the relationships between neuroinflammatory-related biomarkers and psychiatric symptomatology in SUD remain poorly understood. This study aimed to investigate neuroinflammatory-related biomarkers and their association with psychiatric symptom changes in individuals with SUD. Participants with SUD (N = 100) at three local facilities in the North West Province of South Africa were enrolled. At baseline and following three weeks of treatment, psychiatric symptoms were assessed using the Brief Psychiatric Rating Scale (BPRS). Serum levels of superoxide dismutase (SOD), glutathione (GSH), glutathione disulphide (GSSG), tryptophan, kynurenine (KYN), kynurenic acid (KYNA), serotonin (5-HT), 5-hydroxyindoleacetic acid (5-HIAA), cortisol and serum S100 calcium-binding protein B (S100B) were measured. Over the 3-week treatment period BPRS scores and serum levels of tryptophan, 5-HT, 5-HIAA, KYN, KYNA, cortisol and GSH decreased, whereas SOD, S100B and GSSG levels increased. Baseline BPRS correlated with baseline serum levels of 5-HIAA, KYNA and GSSG. A decrease in BPRS correlated with baseline levels of 5HIAA, KYN and KYNA, as well as with 3-week changes in levels of select biomarkers (∆tryptophan, ∆5-HT, ∆5-HIAA, ∆KYN, ∆KYNA, ∆GSSG and ∆cortisol). The results suggest that baseline 5-HIAA, KYN and KYNA may predict psychiatric symptom improvement whereas tryptophan, 5-HT, 5-HIAA, KYN, KYNA, GSSG and cortisol may explain the neurobiological basis of changed psychiatric symptomatology.

Association between vitamin D status and bacterial vaginosis in non-pregnant women of reproductive age: a systematic review and meta-analysis.

ABSTRACT Debates on the decolonisation of African Studies have intensified, yet less attention has been paid to how African scholars negotiate epistemic authority within contemporary global knowledge structures. This article examines the contributions of Nigerian historians to the decolonisation of African history, focusing on their conceptual interventions, institutional positioning, and scholarly practices across home-based and diaspora contexts. Focusing on Nigeria as a primary empirical case, it argues that decolonisation is not solely a critique of colonial epistemologies but an ongoing struggle over visibility, relevance, and intellectual autonomy in modern Africa. The article situates Nigerian historiography within broader transformations in African higher education and the international academic system. It demonstrates that Nigerian historians advance decolonisation by re-centring African agency, interrogating internal power relations, and situating colonialism as one episode within Africa’s longer historical trajectory. While grounded in the Nigerian experience, the analysis offers wider implications for understanding the evolving dynamics of African historiography.

ABSTRACT This work examines international perspectives on hydrological drought research across its diverse manifestations, focusing on the period 2000–2024, with special emphasis on Africa. Using a structured conceptual framework, the review addresses both the thematic evolution of hydrological drought research and the methodological approaches employed. A total of 25 relevant publications were identified through Web of Science (WoS) and Scopus and manually coded according to predefined criteria, including methodology type, geographic focus, and institutional context. The findings reveal significant differences in the volume and methodological diversity of scientific production between Africa and other regions. Advanced techniques such as machine learning, statistical modeling, and integrated frameworks remain underutilized in African studies, despite the widespread use of hydrological indicators including the Standardized Precipitation Index (SPI), the Standardized Precipitation Evapotranspiration Index (SPEI), and satellite–derived data. Quantitative weighting analysis indicates that Africa lags behind global trends in drought assessment approaches. The study also highlights persistent physical and institutional challenges, including limited scientific capacity and insufficient data availability. These results emphasize the urgent need to strengthen training programs, research infrastructure, and the scientific visibility of African contributions to hydrological drought management.

African theatre scholarship has largely privileged playwright-centred criticism, foregrounding dramatic texts while giving comparatively limited attention to directing practice, rehearsal methodology, actor training, and production architecture. Across diverse regional contexts, critical discourse has prioritized literary interpretation over the processes through which directors organise performers, space, technology, and production cultures. Directing therefore warrants sustained conceptual attention as a creative, pedagogical, and organizational formation within African theatre. This article proposes Afroterradelogy (ATD) as a decolonial framework for analysing directing practice through comparative African case studies. ATD reorients the analytic grammar through which directing is conceptualized in contemporary African theatre, positioning it as an integrated field in which indigenous epistemologies intersect with rehearsal systems, technological mediation, institutional infrastructures, and material negotiation. It offers an inductively derived analytic model grounded in situated practice. Drawing on comparative performance analysis and practice-based production study across West, Southern, East, and North Africa, the article identifies recurring structural tendencies in rehearsal organization, political staging strategies, disciplined improvisation, and hybrid aesthetic mediation. Across these contexts, the director emerges as pedagogical architect and institutional mediator, structuring creative agency across spatial, technological, and material conditions. Afroterradelogy offers a disciplined analytic vocabulary for examining directing praxis as pedagogical, aesthetic, and institutional architecture across contemporary African theatre.

ABSTRACT Although marriage was highly valued in Shona traditions, missionary Christianity introduced a much more rigid, monogamous marriage in which women were domesticated as (house)wives and mothers and economically dependent on their breadwinner husbands. African feminisms, which emerged in response to Western feminist hegemony, have not always adequately interrogated this norm of marriage and its impact on women. Sidelining single women, especially divorced ones, in the African feminist agendas in the 1980s meant that many social worlds and realities remained hidden from scrutiny. This article asks: What does it mean for African feminist understandings of “African women” when the voices of divorced women are foregrounded? How do these voices complicate and challenge commonly accepted ideas relating to gender, marriage and family life in contemporary Africa? To answer these critical questions, I discuss the narratives of 44 divorced Shona women, which were gathered through life story interviews conducted during fieldwork carried out between August 2023 and March 2024 in areas of Zimbabwe predominantly occupied by the Shona people. By foregrounding the voices of divorced women, the article expands African feminist discourses and studies of singlehood through a decolonial lens.

The vascular status score (VSS) is an emerging composite index, developed to investigate early vascular changes by integrating pulse wave velocity (PWV), augmentation index (AIx), and carotid intima-media thickness (cIMT). Although prior studies have linked the VSS to inflammatory and metabolic dysfunction, its association with hypertension remains unexplored. This study compared the ability of the VSS and its individual components in identifying hypertension, regardless of phenotype, among young South African adults. We included 1,019 participants aged 20 - 30 years from a community-based cohort. Office and ambulatory blood pressures were measured, and hypertension phenotypes were defined according to the 2024 ESC guidelines. Carotid-femoral PWV, Aix, and cIMT were assessed and combined to calculate the composite VSS. Receiver operating characteristic (ROC) analyses determined optimal cut points for VSS and its components relative to normotensive and hypertensive classifications, and odds ratios were adjusted for relevant covariates. Among the indices examined, only PWV demonstrated consistent sensitivity and specificity across hypertension phenotypes. While a VSS above 4 modestly increased the odds of masked, sustained, and white-coat hypertension (odds ratios ranging from 1.74 to 2.35, all P < 0.05), only PWV accurately identified masked and sustained hypertension (odds ratios 2.25-2.70, allP < 0.01). Neither AIx nor cIMT achieved comparable diagnostic utility. Despite the promise of a composite vascular index, PWV independently outperformed the VSS and its other components in detecting hypertension in young adults. These findings suggest that PWV may be the most reliable individual biomarker for early hypertension identification in young adults.

Climate change has multiple socio-ecological impacts as recognised in Sustainable Development Goal 13 (Climate Action). There have been numerous calls by the United Nations secretary-general for effective leadership and urgent responses to mitigate these impacts. More than just knowledge and political leadership is needed; students need opportunities to enable agency to develop their environmental leadership potential. To understand students’ perspectives on climate change and environmental leadership a baseline case study was conducted at a higher education institution in South Africa. The respondents were a convenient sample of students (n = 102) within a department in the Faculty of Science. A convergent parallel mixed methods approach was applied to data collection, which involved an electronic questionnaire with open and closed questions, and individual interviews. Forty-eight students responded to the electronic questionnaire (47.1%) and six of the 48 were interviewed. The findings include: a majority (70.8%) believed that climate change is influenced by anthropogenic factors, a greater majority held the belief that people should be given tangible rewards and punishments (60.1%) to achieve objectives and the majority of students (80%) indicated that knowledge is a key driver of environmental leadership in the mitigation of climate change. Contribution: The study demonstrated the need to develop leadership attributes within the transformational Education for Sustainable Development agenda to enhance the agency and potential of higher education students to mitigate climate change. It is recommended that higher education institutional leadership take greater cognisance of environmental leadership and encourage curriculum integration, community engagement and youth-identified development programmes to support present and future students to mitigate climate change impacts.