East Africa Research Articles

Community-Engagement in Nature-Positive Food Systems Programming in East and South Africa: A Review

There is strong and rapid momentum in the international conservation and developments spaces towards ‘nature-positive’ systems and programs. Nature positive food programs and/or interventions exist in a variety of social and geographic contexts. Alongside the movement towards nature-positives systems is a need to work towards social justice, community engagement, and collaboration in the delivery of new programs and approaches. To support the transition and future research in this area we conducted a review that focused regionally on East and South Africa. The focus on these regions was determined based on their long histories of food programs and increasing attention on new nature-positive food programming. Key findings from our review include clear links between actors at different regional scales, such as international agencies, research institutes, governments, and local NGOs; significant barriers to community engagement opportunities in nature-positive food systems seem to fit within three distinct categories (social, environmental, and political/strategic ); and lastly, we find that the outcomes of nature-positive food system programs include benefits for the natural environment (i.e., environmental conservation and management, wildlife conservation, and soil quality improvement) as well as benefits for local communities (i.e., alleviating social issues such as poverty, food insecurity, and gender inequality).

Microlevel structural poverty estimates for southern and eastern Africa

Microlevel structural poverty estimates for southern and eastern Africa

Epidemiology of urinary tract infections in the Middle East and North Africa, 1990–2021

ObjectiveThis research reports the incidence, mortality, and disability-adjusted life years (DALYs) associated with urinary tract infections (UTIs) in the Middle East and North Africa (MENA) region, stratified by sex, age, and Socio-demographic Index (SDI) from 1990 to 2021.MethodsData were sourced from the Global Burden of Disease 2021 study, encompassing all 21 countries in the region. Metrics such as absolute counts, age-standardised rates, and percentage changes from 1990 to 2021 are presented with 95% uncertainty intervals (UIs).ResultsIn 2019, the MENA region recorded an incidence rate of 4,033.4 per 100,000 (95% UIs: 3,553.7–4,548.7) and 7,687 deaths (95% UIs: 6,663–8,969). The DALY rate was 41.3 per 100,000 (95% UIs: 36.1–47.2), which was highest among older adults, reaching a peak in the 80–89 age range, and increasing with age, particularly from the 50 + age groups. A non-linear relationship was identified between the burden of UTIs and the SDI, with higher-than-expected rates in lower SDI countries such as Syria and Lebanon.ConclusionDespite a substantial increase in the total number of UTI cases and DALYs in the region from 1990 to 2021, the age-standardised rates remained stable. The larger burden in lower SDI countries highlights the urgent need for targeted public health interventions. Improving healthcare access and antibiotic stewardship is crucial to mitigating the growing burden of UTIs, particularly among older populations in the region.

Awareness and knowledge of diabetic retinopathy in diabetics and non-diabetics: A descriptive cross-sectional study.

Early diagnosis and management of the ever-increasing global consequences of diabetes is of concern to all nations. The populations of developing countries in particular, account for about 75% of the estimated total number of those afflicted. The Middle East and North Africa Region have around 35.4 (24.3-47.4) million diabetics with a prevalence of around 10.5% in the Middle East. A high proportion of these are undiagnosed. The aim of this study was to assess the awareness of and knowledge about the ocular impacts of diabetes as diabetic retinopathy (DR) in Jordanians by comparing those with and those without diabetes. In this cross-sectional study, diabetic and non-diabetic patients attending different clinics at the National Center for Diabetes, Endocrinology and Genetics (NCDEG) were interviewed face-to-face using a questionnaire, to assess the level of knowledge about diabetic retinopathy (DR). The questionnaire was assessed beforehand by ophthalmologists from the School of Medicine, the University of Jordan, in Amman Results: A total of 214 subjects participated in this study (108 males:106 females). The mean age was 58.2 ± 10.6 years; (28 to 88 years) ~70% were diabetic. More than 98% were aware that diabetes can have ocular consequences. Only 17.3% however, had an adequate knowledge of DR. Around 40% did not know the treatment options although 75.7% of the diabetics carried out regular blood sugar checks in <6 months, and 73.4% had their last eye checkups in <one year. The main source of information about DR was the media (33.6%) though healthcare personnel made a minor contribution to raising the knowledge level (5.6%). The participants in this study had good awareness of DR but their knowledge of this ocular condition and treatment options is limited. Health-education programs and awareness campaigns should be initiated at health and eye care centers. Enrichment of social media and internet websites with evidence-based information by medical professionals are promising options for upgrading knowledge about this common global cause of blindness.

The Role of Anthropogenic Climate Change on March–April–May (MAM) Drought Trends Across Global Land

ABSTRACTUnderstanding the influence of human‐induced climate change on drought is critical for addressing global challenges. This study uses the Standardised Precipitation Index (SPI) and the Standardised Precipitation Evapotranspiration Index (SPEI) to identify detection and attribution of global drought patterns during the March–April–May (MAM) season. SPI focuses on rainfall, while SPEI accounts for both Precipitation and potential evapotranspiration. We analysed spatial trends using ensemble mean data from 15 global climate models in the Coupled Model Intercomparison Project Phase 6 (CMIP6). Simulations incorporating both natural and anthropogenic forcings (ALL) were compared with those limited to natural forcings (NAT) to evaluate human impacts on drought patterns. Results based on SPI from both observational data (OBS) and ALL simulations reveal wetting trends in Southwest Asia, South America, Eastern Europe, and Central Africa, and drying trends in Northwestern Europe, Southeastern China, India, North America, East Africa, and Australia. SPEI shows wetting in Northeast Asia, Europe, Southeastern North America, and Northwest Africa, with drying in North America, Southeastern Africa, Europe, and Southeastern China. Significantly, the drying trends in ALL simulations are stronger than in NAT, highlighting anthropogenic climate change as a key driver of worsening drought patterns. Detection analysis confirms a strong ALL signal in SPI and SPEI observations, while NAT remains undetected. Lastly, Severe droughts (indices &lt; −2) were examined, in terms of likelihood ratio in All and NAT, show human activities significantly influence precipitation in Southeast Asia, tropical rainforests, and East Africa, with temperature variations driving droughts in Central Asia and other tropical regions.

Variants of unknown significance in BRCA1 and BRCA2 among breast cancer patients in Middle Eastern and North African populations: A systematic review

Breast cancer (BC) is a growing global health challenge, particularly in low- and middle-income countries. Variants of unknown significance (VUS) in BC genes, BRCA1 and BRCA2, complicate genetic counseling and treatment decisions, emphasizing the need for reclassification. This systematic review aimed to determine the spectrum of VUS in BRCA1 and BRCA2 among BC patients from the Middle East and North Africa (MENA) region and to evaluate the current understanding and potential reclassification of these variants. A comprehensive search was conducted across electronic databases, including PubMed, Google Scholar, and Embase, for studies published up to early 2024. The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria encompassed studies conducted in the MENA region that focused on BRCA1 and/or BRCA2 in BC and/or ovarian cancer, reported on VUS prevalence, and analyzed coding regions or known mutations. Data extraction was performed using a standardized form, and VUS was reviewed through multiple databases. The review identified 34 eligible studies, with a slight predominance of Middle Eastern studies (n = 18) over North African (n = 16) studies. On reclassification using the ClinVar database, 26% of the VUS were reclassified as benign or likely benign, 34.5% presented conflicting interpretations of pathogenicity, 2% were reclassified as pathogenic or likely pathogenic, and 16.5% remained uncertain. The remaining variants were either not reported or lacked classification. The included studies covered multiple countries in the MENA region, providing insights into the prevalence and characteristics of BRCA1 and BRCA2 VUS in BC patients. The continuous reclassification of VUS is essential for enhancing genetic counseling for BC patients, as it helps clarify the clinical implications of these variants. The findings contribute to understanding the genetic factors in BC susceptibility and may inform clinical practices in genetic counseling and risk assessment in this population.

Bioactive Polyphenolic and Terpenoid Compounds from Stem Bark and Flowers of Terminalia brownii

Introduction Terminalia brownii Fresen (Combretaceae) extensively used in Eastern, Southern, and Western Africa herbal remedies in treatment of variety of diseases including liver cirrhosis. Bioassay – guided fractionation was used to isolate the compounds responsible for these actions. Aim of the Study The study sought to extract, characterize and determine the antimicrobial activities of the components of the commonly used stem bark and hitherto uninvestigated regeneratable flowers of T.brownii. Materials and Methods Column chromatography was used to fractionate and isolate the compounds followed by thin layer chromatography. The isolates were structurally elucidated using FTIR, 1H NMR, 13C NMR and HRESI-MS spectral data. The isolated compounds' antimicrobial activities were evaluated against Candida albicans, Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli. Results Bioassay – guided fractionation of methanol and 50% dichloromethane: methanol extracts of Terminalia brownii stem bark and flowers yielded seven known metabolites; termiglaucescin (1), arjunglucoside-I (2), sericoside (3), 23-galloyl arjungenin (4), 28-O-β-D-glucopyranosyl-2,3,6-trihydroxy-23-galloylolean-12-dien-28-oate (5), 3,3',4',5-tetrahydroxy-7-methoxyflavone (9), 3,3',4',5,7-pentahydroxyflavone (10) and three new metabolites: 1,4,7-tri-O-galloyl hept-6-deoxyheptose (6), 1,2,4-tri-O-galloyl-8,9-dideoxynonose (7), Rhamnetin-3-O-(2,3,6-trigalloyl)-β-D-glucopyranoside (8). Among these molecules, compound (6) was extremely potent toward E. coli (16.5±0.7 mm) while (1) showed substantial inhibitory effects on Candida albicans (16.0±5.7 mm). Compounds 6, 7, 8, 9, and 10 were extracted and identified for the first time from 50% dichloromethane/methanol flower extract. The extract yielded three novel bioactive compounds (6, 7 and 8) that shown substantial activity on P.aeruginosa, E. coli, C. albicans, S. aureus. Conclusion For the first time, the results of this investigation demonstrate that flower extract possess strong antibacterial and antifungal qualities, akin to those of stem bark extract. As a result, more environmentally friendly flower extracts should be considered for treatment of bacterial and fungal infection.

Review of the book “Capital Penetration and the Peasantry in Southern and Eastern Africa - Neoliberal Restructuring”

"Capital Penetration and the Peasantry in Southern and Eastern Africa - Neoliberal Restructuring" is part of the Advances in African Economic, Social and Political Development book series to be published in 2022. The aim of this review is to present the contents of the book and to draw attention to the significance of the essays in the volume. It also aims to provide a brief recommendation for all those experts and researchers who are interested in the evolution, development and problems of agriculture and food security in sub-Saharan Africa.

Barriers and facilitators to maternal healthcare in East Africa: a systematic review and qualitative synthesis of perspectives from women, their families, healthcare providers, and key stakeholders

BackgroundIn East Africa, women face significant challenges accessing maternal healthcare during pregnancy, childbirth, and the postnatal period. While several studies have examined barriers and facilitators to maternal care, there is no comprehensive review reflecting the various perspectives of women, their families, healthcare providers, and key stakeholders. We systematically reviewed qualitative literature on maternal healthcare in East Africa, synthesizing insights from multiple perspectives and exploring barriers and facilitators across socioecological levels.MethodsA qualitative evidence synthesis focused on studies from East Africa published between January 2015 and June 2024. We searched electronic databases, including PubMed, Embase, Scopus, Cochrane, Web of Science, and ProQuest, and used citation tracking to find additional references. Eligible studies were critically appraised using the Critical Appraisal Skills Program, and a thematic synthesis was performed to identify barriers and facilitators.ResultsOf the 3181 records identified, 81 studies (63 qualitative and 18 mixed method) met the inclusion criteria, representing 4816 individuals from six East African countries. This review identified barriers at various levels: individual barriers included a lack of awareness and knowledge, fear of being treated poorly, and financial constraints; interpersonal barriers comprised limited family support, communication challenges, and a lack of decision-making autonomy; health facility barriers included poor quality of healthcare, poor infrastructure, limited medical supplies, provider shortages, abusive behaviors from healthcare providers, lack of transportation, and high service costs; community-level barriers involved socio-cultural norms, societal stigma, and gender-based disparities; and policy-level barriers included poor focus on maternal health, a lack of male accompaniment policies, and conflicts. Key facilitators identified included improved healthcare understanding and women's self-efficacy at the individual level, family support and positive social influences at the interpersonal level, high-quality services, reliable transportation, compassionate care, and health education at the health facility level, community initiatives, gender equality, and maternity waiting homes at the community level, as well as free maternity services and health extension programs at the policy level.ConclusionThe synthesis identified key barriers and facilitators to the maternal healthcare in East African countries, ranging from individual to policy levels. We recommend that future initiatives focus on addressing these barriers while enhancing facilitators across individual, interpersonal, health facility, community, and policy levels through woman-centered, evidence-based strategies. Moreover, fostering collaboration among governments, healthcare providers, and communities is essential for improving access to the maternal continuum of care.

‘Fascism on trial’: Rodolfo Graziani and the manipulation of historical consciousness in postwar Italy

Abstract This article uses the postwar trial of Fascist Italy’s most prominent general, Rodolfo Graziani, to examine issues of transitional justice and the formation of popular memory of Italian Fascism and colonialism after 1945. During the Fascist ventennio, the regime constructed Graziani as the nation’s colonial ‘hero’ despite his leading role in genocidal measures during Fascist Italy’s colonial wars in North and East Africa. His position as minister of defence in Mussolini’s Nazi-backed Salò Republic in 1943–5, however, threatened his heroic reputation as he worked with Nazi commanders and became responsible for atrocities against Italian civilians. After the Second World War, Graziani was tried for Nazi collaborationism at the Supreme Court in 1948, but his colonial conduct was left unquestioned. Unlike in the Nuremberg Trials in post-Nazi Germany, few Italians were tried for war crimes after 1945. This historical inquiry analyses the legal proceedings, transnational representation and outcome of Rodolfo Graziani’s 1948 trial as an emblematic case study to explore de-fascistisation and decolonialisation initiatives and their limitations in post-Fascist postcolonial Italy.

Long-acting family planning uptake and associated factors among women in the reproductive age group in East Africa: multilevel analysis

IntroductionThe campaign to encourage sexually active women to utilize family planning is one of the primary initiatives being undertaken globally to reduce unintended pregnancies and fertility rates. Evidence suggests that family planning measures can lower this maternal mortality ratio by nearly 25%. According to our literature search, there is no known study that has reported on the study area to assess utilization and factors associated with the use of long-acting contraceptive methods (LACMs) among women of reproductive age. Therefore, this study aimed to assess long-acting contraceptive method uptake and its associated factors among women of reproductive age in East Africa.MethodsA weighted total of 50,525 women of reproductive age were included in this study. A community-based cross-sectional study was conducted on the most recent Demographic and Health Surveys in 12 East African countries. The pooled prevalence of long-acting contraceptive uptake with a 95% confidence interval (CI) was reported and presented in a forest plot for East African countries using STATA version 14.1. Intraclass correlation coefficient, likelihood ratio (LR) test, median odds ratio, and deviance (−2 log-likelihood) values were used for model comparison and fitness. Adjusted odds ratios (AOR) with a 95% CI and p-value ≤0.05 in the multilevel logistic model were used to declare significant factors associated with long-acting contraceptive uptake.ResultsThe overall prevalence of long-acting contraceptive methods in East African countries was 19.41% (95% CI 19.07%–19.76%). In the multilevel logistic regression analysis, women in the age group of 35–49 years (AOR 1.09, 95% CI 1.06–1.17), women who were married (AOR 1.31, 95% CI 1.10–1.56), and women who were exposed to media (AOR 1.06, 95% CI 1.00–1.13) were significantly associated with LACM uptake. Moreover, living in urban areas (AOR 1.23, 95% CI 1.14–1.32) and living in the highest household wealth index (AOR 1.09, 95% CI 1.01–1.17) were also significantly associated with long-acting contraceptive uptake.ConclusionThe overall utilization of acting contraceptive methods was low. Therefore, future interventions should be planned to target women in younger age groups, with lower socioeconomic backgrounds, and those living in rural areas to improve LACM uptake.

Mitigating moral distress by enhancing healthcare workers’ understanding of challenges faced by carers of children with disabilities in low-resource settings in Kenya

ABSTRACT Background Little is known about the psychological wellbeing and the potential moral distress faced by female carers of children with disabilities living in low-resource settings in East Africa. In such environments, caregiving often requires resilience and resourcefulness, yet can also increase the vulnerability of caregivers and their children. Objective The objective of this study is to identify factors affecting female caregivers’ psychological well-being, and to suggest ways healthcare workers can support these caregivers’ psychological well-being to alleviate moral distress. Methods Employing an intersectional convergent parallel mixed-methods approach, the research explores the factors affecting the psychological wellbeing of caregivers in one urban and one rural low-resource setting in Kenya. Results The study identifies strengthening and inhibiting factors, across three dimensions, that moderate caregivers’ experiences of moral distress, and puts forward suggestions for healthcare workers on how to support caregivers’ psychological wellbeing. Conclusions Female carers of children with disabilities in low-resource settings in Kenya face numerous psychological, social and systemic challenges which jeopardize their caregiving, leading to moral distress. Paediatricians and nurses can contribute to enhance the caregivers’ coping-strategies and psychological well-being through simple changes, like explaining a child’s condition in non-technical language. Community health workers can help strengthen the caregivers’ already existing resources by accompanying them in the day-to-day care of their children and by helping them establish self-support groups. Consequently, improved training of healthcare- and community health workers in the field of childhood disability is needed to strengthen health systems, and to support these caregivers and their children.

Invasion of the Atlantic Ocean and Caribbean Sea by a Large Benthic Foraminifer in the Little Ice Age

The larger benthic foraminifera is a group of marine protists harbouring symbiotic algae, that are geographically confined to shallow tropical and subtropical waters, often associated with coral reefs. The resulting controls on availability of habitat and rates of dispersion make these foraminifers, particularly the genus Amphistegina, useful proxies in the study of invasive marine biota, transported through hull fouling and ballast water contamination in modern commercial shipping. However, there is limited information on the importance of these dispersal mechanisms for foraminifers in the Pre-Industrial Era (pre-1850) for the Atlantic and Caribbean region. This paper examines possible constraints and vectors controlling the invasion of warm-water taxa from the Indo-Pacific region to the Atlantic and Caribbean region. Heterostegina depressa, first described from St. Helena, a remote island in the South Atlantic, provides a test case. The paper postulates that invasions through natural range expansion or ocean currents were unlikely along the possible available routes and hypothesises that anthropogenic vectors, particularly sailing ships, were the most likely means of transport. It concludes that the invasion of the Atlantic by H. depressa was accomplished within the Little Ice Age (1350–1850 C.E.), during the period between the start of Portuguese marine trade with east Africa in 1497 and the first description of H. depressa in 1826. This hypothesis is likely applicable to other foraminifers and other biota currently resident in the Atlantic and Caribbean region. The model presented provides well-defined parameters that can be tested using methods such as isotopic dating of foraminiferal assemblages in cores and genetic indices of similarity of geographic populations.

Remittances and economic growth in East Africa

Remittances and economic growth in East Africa

Green Supply Chain Management Practices and The Performance of Alcoholic Beverages Companies in Kenya.

Today’s business environment is characterized by increasing uncertainties. GSCM has emerged as an important new approach for enterprises to achieve profit and market share objectives by reducing environmental risk and impact. Now, more than ever, the world population is aware of the negative effects caused by environmental degradation. Key environmental concerns are dumping of hazardous wastes, the depletion of the ozone layer, and global warming. The primary goal of this study was to determine the influence of green supply chain practices on the performance of alcoholic beverages companies in Kenya. This research was based on the following objectives: green sourcing, eco-design, reverse logistics and waste stream management on the performance of alcoholic beverages companies in Kenya. The Resource-based view theory, theory of planned behavior, contingency management theory, waste management theory and supply chain operations reference model were studied and used as its theoretical foundations. The study employed a cross-sectional survey approach and mainly concentrated on the top five performing alcoholic beverages companies in Kenya namely East Africa Breweries Limited, Keroche Breweries, Kenya Wine Agencies, UDV Kenya Limited and London distillers limited. In order to meet the research objectives, the respondents were chosen at random from the highest level of management, the middle level of management, and the operational level of management. The head of department, head of subsection, and two clerks/assistants in each of these departments: production, procurement, logistics, and warehousing were employed as a unit of analysis across the five firms.The primary data were collected through a self-administered questionnaire that had both open and closed ended questions, designed to obtain definite responses. Statistical Package for the Social Sciences (SPSS version 28) was used to analyze the data and present the variables through coding and summarizing the responses of all the respondents and the analyzed data was presented in form of tables. The study findings showed that green supply chain management practices namely green sourcing, eco-design, reverse logistics and waste stream management significantly influence the performance of alcoholic beverage companies in Kenya. The study concluded that performance was predicted to improve for every unit increase in these practices. The study further recommends that alcoholic beverage firms should prioritize suppliers that provide sustainable, and biodegradable materials. Some recommendations include through supplier evaluation and selection, collaboration and communication, transparency, consistency, and traceability. This will ensure improved green supply chain management and improve performance of alcoholic beverage companies.

On the MJO Phase Speed among Different Background Moisture and Zonal Wind Base States

Abstract The variability of the phase speed of the Madden–Julian oscillation (MJO) is poorly understood. The authors assess how the phase speed of the convective signal of the MJO associates with the background states over eastern Africa and the Indian Ocean. Relaxation of the coupling between tropical modes and their circulation has been previously linked to faster propagation; for example, the MJO speeds up over the eastern Pacific where its convective signal decouples from the circulation. In contrast, our results show that fast MJO events happen to exist during periods of wetter background states (&gt;90 days) from East Africa across the Indian Ocean, whereas slow MJO is associated with dry background states. We found that fast MJO exhibits strong active and inactive phases with a structure suggesting more hierarchical convection. Results indicate that the association of the phase speed of the MJO as seen in the integrated filtered moist static energy with its tendency is stronger than the association of the phase speed as observed in the dry static energy with its tendency which is consistent with the acceleration of the MJO during wet background states. Also, our results indicate that the MJO may be faster during periods of enhanced low-level moisture because these periods have anomalously weak upper-tropospheric easterly background winds, which reduce the westward advection of the MJO by the background easterly wind, resulting in higher eastward phase speed of the MJO. The acceleration of the MJO by the background zonal wind overwhelms the deceleration associated with the moist-wave dynamics. Significance Statement This study shows that the Madden–Julian oscillation (MJO), which is the dominant subseasonal weather signal in the tropics, moves eastward more quickly across eastern Africa and the Indian Ocean when the region is abnormally moist. The faster propagation does not appear to result from the higher moisture but instead from encountering weaker-than-normal upper-air winds from the east that tend to occur during moist periods.

Hybrid versus vaccine immunity of mRNA-1273 among people living with HIV in East and Southern Africa: a prospective cohort analysis from the multicentre CoVPN 3008 (Ubuntu) study.

With limited access to mRNA COVID-19 vaccines in lower income countries, and people living with HIV (PLWH) largely excluded from clinical trials, Part A of the multicentre CoVPN 3008 (Ubuntu) study aimed to assess the safety of mRNA-1273, the relative effectiveness of hybrid versus vaccine immunity, and SARS-CoV-2 viral persistence among PLWH in East and Southern Africa during the omicron outbreak. Previously unvaccinated adults with HIV and/or other comorbidities associated with severe COVID-19 received either one (hybrid immunity) or two (vaccine immunity) 100-mcg doses of ancestral strain mRNA-1273 in the first month, depending on baseline evidence of prior SARS-CoV-2 infection. In a prospective cohort study design, we used covariate-adjusted Cox regression and counterfactual cumulative incidence methods to determine the hazard ratio and relative risk of COVID-19 and severe COVID-19 with hybrid versus vaccine immunity within six months. The ongoing Ubuntu study is registered on ClinicalTrials.gov (NCT05168813) and this work was conducted from December 2021 to March2023. Between December 2021 and September 2022, 14,237 participants enrolled, and 14,002 (83% PLWH, 69% SARS-CoV-2 seropositive) were included in the analyses. Vaccinations were safe and well tolerated. Common adverse events were pain or tenderness at the injection site (26.7%), headache (20.4%), and malaise (20.3%). Severe adverse events were rare (0.8% of participants after the first and 1.1% after the second vaccination), and none were life-threatening or fatal. Among PLWH, the median CD4 count was 635cells/μl and 18.5% had HIV viraemia. The six-month cumulative incidences in the hybrid immunity and vaccine immunity groups were 2.02% (95% confidence interval [CI] 1.61-2.44) and 3.40% (95% CI 2.30-4.49) for COVID-19, and 0.048% (95% CI 0.00-0.10) and 0.32% (95% CI 0.59-0.63) for severe COVID-19. Among all PLWH the hybrid immunity group had a 42% lower hazard rate of COVID-19 (hazard ratio [HR] 0.58; 95% CI 0.44-0.77; p<0.001) and a 73% lower hazard rate of severe COVID-19 (HR 0.27; 95% CI 0.07-1.04; p=0.056) than the vaccine immunity group, but this effect was not seen among PLWH with CD4 counts <350cells/μl or HIV viraemia. Twenty PLWH had persistent SARS-CoV-2 virus at least 50 days. Hybrid immunity was associated with superior protection from COVID-19 compared to vaccine immunity with the ancestral mRNA-1273 vaccine. Persistent infections among immunocompromised PLWH may provide reservoirs for emerging variants. National Institute of Allergy and Infectious Diseases.

Hepatitis C virus transmission among people who inject drugs in the Middle East and North Africa: mathematical modeling analyses of incidence and intervention impact.

The Middle East and North Africa (MENA) region is the most affected by hepatitis C virus (HCV) infection globally. This study aimed to estimate HCV incidence among people who inject drugs (PWID) in MENA and evaluate the impact of interventions. A mathematical model was extended and applied to 13 countries with at least one data point on the population size of PWID and HCV antibody prevalence among PWID, generating estimates for the period 2024-2030. The model was calibrated using multiple datasets, primarily derived from systematic reviews and meta-analyses. Multivariable uncertainty analyses were conducted. Incidence rate among PWID in the 13 countries combined was 10.4 per 100 person-years (95% UI: 8.0-14.1), with an estimated 42,364 new infections annually (95% UI: 27,990-57,540), accounting for 16.9% (95% UI: 8.3-28.2) of all cases in these countries. These figures varied widely across countries. A 75% reduction in needle/syringe sharing decreased viremic chronic infection prevalence by 14.2% (95% UI: 11.3-17.1), incidence rate by 33.8% (95% UI: 30.2-40.5), and annual new infections by 24.4% (95% UI: 17.7-30.1). A 10% reduction in PWID numbers and a 20% reduction in injection frequency decreased chronic infection prevalence by 1.7% (95% UI: 1.4-2.5), incidence rate by 4.2% (95% UI: 3.9-4.4), and annual new infections by 11.1% (95% UI: 10.9-11.9). Achieving 75% direct-acting antiviral treatment coverage by 2030 decreased chronic infection prevalence by 65.3% (95% UI: 64.8-65.8), incidence rate by 34.5% (95% UI: 29.6-40.3), and annual new infections by 25.3% (95% UI: 19.9-29.3). Combinations of interventions reduced these epidemiologic outcomes by up to 80%. MENA experiences considerable HCV incidence among PWID. While the interventions showed potential, only large-scale or multi-intervention strategies can achieve meaningful reductions in HCV transmission. This publication was made possible by NPRP grant number 12S-0216-190,094 from the Qatar National Research Fund (a member of Qatar Foundation). The authors alone are responsible for the views expressed in this publication and they do not necessarily represent the views, decisions, or policies of World Health Organization.

Unravelling atmospheric factors associated with long rain precipitation variability in East Africa

Unravelling atmospheric factors associated with long rain precipitation variability in East Africa

Phylogenetic Perspectives and Ethnobotanical Insights on Wild Edible Plants of the Mediterranean, Middle East, and North Africa

This study investigates the phylogenetic and geographical distribution of wild food plants (WFPs) across 30 Mediterranean and North African (MENA) regions, focusing on the intersection of evolutionary lineage, ecological adaptation, and cultural utilization. A phylogenetic analysis of 111 genera of WFPs used in traditional diets reveals clusters reflecting shared ancestry, functional adaptations, and ecological resilience. Key regions such as Lebanon and Ikaria stand out as potential centers for the diversity of wild food plant use, suggesting that the Eastern Mediterranean may be a primary origin area, especially for species adapted to semi-arid climates. Major plant families including Lamiaceae, Rosaceae, and Fabaceae form distinct clusters that underscore their common ancestry and adaptability, making them foundational to traditional diets and medicinal applications across various environments. Geographical analysis indicates historical connections, such as those between Malta and Egypt, supporting the hypothesis that ancient trade routes influenced the spread and cultural exchange of wild food plant use across the Mediterranean. The study emphasizes the integration of phylogenetic and ethnobotanical perspectives, shedding light on how biodiversity, ecological adaptation, and cultural practices intersect in these regions. This research demonstrates that WFPs serve as both ecological and cultural assets, crucial for preserving traditional diets and supporting biodiversity conservation amid environmental changes. Integrating evolutionary and cultural knowledge can enrich ecological understanding and contribute to the sustainable use of plant resources in the MENA regions.