Countries In sub-Saharan Africa Research Articles

Studying eruption patterns of mandibular third molars for forensic age assessment: Introducing current reference data from a population of black South Africans.

Evaluation of the eruption of mandibular third molars in orthopantomograms (OPGs) is a method of forensic age assessment. The objective of our study was to provide valid reference data for this trait within a population of black South Africans. The study was guided by the criteria for reference studies in age assessment. A study population from Pretoria, South Africa comprising 670 OPGs obtained from 338 black females and 332 black males aged between 15.00 and 25.97 years was analysed. All OPGs were performed for medical indication during the period from 2011 to 2022 and were retrospectively evaluated. From the 670 OPGs, a total of 1021 mandibular third molars were evaluated. The assessment of mandibular third molars was conducted using the staging scale presented by Olze et al. in 2012. Two experienced dentists evaluated the OPGs independently of each other. If the two examiners diverged in their assessments, a consensus stage was assigned. As expected, the mean, median and minimal age increased with higher stages for both teeth and both sexes. The minimum age recorded for stage D, indicating complete tooth eruption, was 15.79 years in females and 16.62 years in males. As it is the case for previous reference studies in other countries, placing exclusive reliance on the evaluation of mandibular third molar eruption is inadequate for ascertaining the age of majority among Black South Africans. Future studies need to examine if our results are transferable to other countries in Sub-Saharan Africa.

A cross-sectional study of ERG expression and the relationship with clinicopathological features of Prostate cancer in Southwestern Uganda

BackgroundProstate cancer is the leading cause of cancer-related death and the second most commonly diagnosed cancer among men in Uganda and most countries in Sub-Saharan Africa (SSA). The TMPRSS2-ERG fusion gene is the most common genetic alteration seen among prostate cancer patients. There are several contradicting reports about the association of ERG protein with poor prognosis, high PSA, and Gleason score. This study determined the prevalence of ERG expression and the relationship with PSA, Gleason score, and Age of prostate cancer patients in Southwestern Uganda.MethodsWe reviewed 130 archived prostate biopsy (needle and TURP) specimens from patients of age ≥ 50 years who had a histological diagnosis of prostate cancer. We obtained their biodata, and preoperative PSA, from the archived records. We did Immunohistochemistry (IHC) to determine the prevalence of ERG expression.ResultsThe mean patient age in our study was 74.64 ± 10.19 years. Pre-operative PSA levels had been done for 79.2% of the participants. Most cancers (58.46%) were of high grade (grade group 3–5). ERG expression prevalence was 75.4% and its expression was independent of age, re-operative PSA, and Gleason score.ConclusionThere is a significantly higher prevalence of ERG expression in our study compared to what is reported in other African-based studies. The expression of the ERG is independent of age, Gleason score, and serum PSA levels. A high proportion of our prostate cancer has high-grade disease at the time of diagnosis.

Drivers of success in global health outcomes: A content analysis of Exemplar studies.

Applying a positive outlier lens is one effective approach for generating evidence to inform global health policy, program, and funding decisions. Exemplars in Global Health (EGH) is a program that studies positive outlier countries that have made extraordinary progress in health outcomes (despite limited resources) and disseminates their successes through multiple types of outputs. To date, EGH has studied, or is studying, 14 global health topics in 28 countries. This paper aims to identify findings, summarized as themes and sub-themes, that appear among all completed EGH studies. We developed a conceptual framework and used a content analysis approach to identify the top thematic areas that appear as drivers for programmatic success across EGH studies that were completed between June 2020-May 2023. The EGH studies (N = 31) spanned six topics including under-five child mortality (n = 6), childhood stunting (n = 5), community health workers (CHW) (n = 4), vaccine delivery (n = 3), COVID-19 response (n = 6), and newborn and maternal mortality reduction (n = 7) across 19 countries in sub-Saharan Africa, Latin America, South and Central Asia, and the Caribbean regions. Top drivers of success were defined as those critical or catalytic in achieving the intended outcome. Eight key drivers were identified: (1) efficient data collection and use for decision-making, (2) strong political commitment and health leadership, (3) effective stakeholder coordination, (4) a local, connected, and capacitated workforce, (5) intentional women's empowerment and engagement, (6) effective adoption and implementation of national policies, (7) effective and sustainable financing, and (8) equitable, efficient outreach and targeting. These cross-cutting drivers span a broad range of development outcomes, sectors, and populations, and indicate a need to effectively integrate people, systems, and sectors to improve global health outcomes. Findings from this study aim to support peer learning among countries and support evidence-based decision-making for funders, policymakers, and other key stakeholders.

Trends and projections of age-appropriate vaccination coverage in 41 low- and middle- income countries in Asia and Sub-Saharan Africa, 2000–2030

IntroductionRoutine immunization programs have focused on increasing vaccination coverage, which is equally important for decreasing vaccine-preventable diseases (VPDs), particularly in low- and lower-middle-income countries (LMICs). We estimated the trends and projections of age-appropriate vaccination coverage at the regional and national levels, as well as place of residence and wealth index in LMICs.MethodsIn total, 174 nationally representative household surveys from 2000 to 2020 from 41 LMICs were included in this study. Bayesian hierarchical regression models were used to estimate trends and projections of age-appropriate vaccination.ResultsThe trend in coverage of age-appropriate Bacillus Calmette-Guérin (BCG), third dose of diphtheria, tetanus, and pertussis (DTP3), third dose of polio (polio3), and measles-containing vaccine (MCV) increased rapidly from 2000 to 2020 in LMICs. Findings indicate substantial increases at the regional and national levels, and by area of residence and socioeconomic status between 2000 and 2030. The largest rise was observed in East Africa, followed by South and Southeast Asia. However, out of the 41 countries, only 10 countries are estimated to achieve 90% coverage of the BCG vaccine by 2030, five of DTP3, three of polio3, and none of MCV. Additionally, by 2030, wider pro-urban and -rich inequalities are expected in several African countries.ConclusionSignificant progress in age-appropriate vaccination coverage has been made in LMICs from 2000 to 2020. Despite this, projections show many countries will not meet the 2030 coverage goals, with persistent urban–rural and socioeconomic disparities. Therefore, LMICs must prioritize underperforming areas and reduce inequalities through stronger health systems and increased community engagement to ensure high coverage and equitable vaccine access.

The effects of local economic development on female obesity (overweight) in sub‐Saharan Africa

AbstractObesity (overweight) is a widespread concern not only in high‐income nations but also in low‐income countries across sub‐Saharan Africa (SSA). Although many studies attribute this trend to economic development triggering a shift in nutrition patterns within SSA, they tend overlook a critical factor: the level at which these determinants are measured. Assessing them nationally while drawing comparisons with individual‐level obesity data introduces a statistical challenge known as the ecological fallacy. To address this, we utilize local‐level night light data as a proxy for local economic development. Analyzing demographic and health surveys from 44 SSA countries spanning the period 1992–2019, we find that local development is associated with a 0.002% increase in the body mass index of women. In addition, we find that night light intensity is associated with 0.2%–0.3% increases in probabilities of a woman being overweight and obese. Our results remain robust when we employ an instrumental variable approach by using a control function based on peer effect. In terms of policy implication, our research highlights that local development may entail potential health costs, emphasizing the need for African governments to invest in healthcare and also build physical infrastructure that can promote active lifestyles.

Youth inclusion in value chain development: a case of the aquaculture in Nigeria

Many countries in Sub-Saharan Africa (SSA) have made youth inclusion a top priority in their development agendas. This is aimed at overcoming social, technical, and institutional obstacles and providing fair and significant opportunities for the growth of young people. Inclusive agricultural value chain development (VCD) is being used to address youth unemployment in the region. The Nigerian government and its partners have invested in aquaculture VCD to create employment opportunities for young men and women, but the participation rate is low, at around 2%. Further, research and practices focusing on rural youth inclusion in VCD is scant, with biases towards urban youth inclusion. This study explored youth engagement in the aquaculture value chain and how the chain features and context shape inclusive mechanisms/patterns of youth inclusion in VCD processes. We used the integrated livelihood asset framework, access approach, and VCD approaches to present an analysis of conditions influencing the inclusion of young men and women in the aquaculture VCD in Nigeria. Accordingly, two youth inclusion strategies were identified: investment and risk management strategies. Young men and women from better-off households adopt investment strategy and dominate the production function. They use their resources, social networks and support from youth-focused aquaculture projects to invest in production functions. Those adopting a risk management strategy dominate the processing, distribution, and marketing functions. They dominantly use social networks, support from aquaculture projects, and Information Communication Technologies (ICTs) to mitigate risks. The high demand for fresh and processed fish, supportive policies, and youth-centered aquaculture projects encourages the engagement of young men and women to adopt either of the strategies. However, they face challenges such as high-cost and low-quality inputs, lack of tailored services, inadequate infrastructure, and sociocultural norms. This study contributes to youth inclusion literature, provides a comprehensive theoretical lens for understanding youth inclusion in VCD, and offers insights into the specific case of young men and women’s engagement in the aquaculture sector in Nigeria.

Knowledge and attitude to HIV pre exposure prophylaxis among women in five sub-Saharan African countries: a multilevel model analysis of population-based survey 2021–2022

BackgroundHIV Pre-Exposure Prophylaxis (HIV PrEP) may help reduce the rate of HIV infection among women in sub-Saharan Africa (SSA). This study aimed to assess women’s knowledge and attitudes toward PrEP, a crucial component of HIV prevention, using nationwide data. It is the first study of its kind conducted in five SSA countries: Burkina Faso, Ghana, Côte d’Ivoire, Kenya, and Tanzania. The primary objective was to examine women’s knowledge and attitudes toward PrEP for the prevention of HIV infection, as well as to explore individual- and community-level factors associated with it.MethodsThe current study utilized the 2021/22 demographic and health survey datasets from five African nations, namely Burkina Faso, Côte d’Ivoire, Ghana, Kenya, and Tanzania. The analysis was performed using Stata 17. A weighted sample of 77,052 women of reproductive age participated in the survey. Univariate and multivariable multilevel logistic regressions were conducted to assess parameters related to knowledge and attitudes toward PrEP in these countries. In both the univariate regression and the final model, the significance of variables was determined using P values of ≤ 0.2 and < 0.05.ResultsOverall, only about 13.88 (95% CI: 13.64,14.12) of women had knowledge and attitudes toward HIV PrEP. The highest (34.29%) and lowest (5.61%) values were observed for Kenya and Tanzania respectively. Higher rates of knowledge, and attitude toward HIV PrEP among women were independently associated with age 25–34 years old (AOR = 1.52, 95% CI:1.41,1.64), and 35–49 years old (AOR = 1.56, 95% CI:1.43,1.69), primary education level (AOR = 1.79,95% CI:1.65,1.95), and secondary/higher education level (AOR = 2.92, 95% CI: 2.67,3.20), richer (AOR = 1.14, 95% CI:1.02,1.27), and richest (AOR = 1.21, 95% CI:1.06,1.37), employed women (AOR = 1.82, 95% CI:1.65,1.99), had media exposure (AOR = 1.49,95% CI:1.40,1.59),knowledge of modern contraception (AOR = 2.62, 95% CI: 1.94,3.43), had at least one ANC visit (AOR = 1.99, 95% CI:1.47,2.69), gave birth at health institutions (AOR = 1.17, 95% CI: 1.02,1.37), ever had given birth (AOR = 1.53, 95% CI: 1.41,1.66), female household heads (AOR = 1.24, 95% CI:1.17,1.31), rural women (AOR = 0.83, 95% CI: 0.76,0.89). Similarly, women from communities with high ANC coverage (AOR = 1.84, 95% CI: 1.61,2.11), high community mass media exposure (AOR = 1.62, 95% CI: 1.39,1.88), and high community wealth level (AOR = 1.48, 95% CI: 1.30,1.68), and women from the high illiteracy rate community (AOR = 0.71, 95% CI: 0.61,0.82) showed statistically significant associations with the outcome variable in the final model.ConclusionsLess than one-seventh of women exhibited knowledge of and positive attitudes toward HIV PrEP. All stakeholders involved in HIV/AIDS prevention and control have recognized the significance of the factors mentioned above. Enhancing maternal health services, such as promoting institutional delivery, contraception, antenatal care (ANC), and women’s empowerment, alongside harnessing the power of media and embracing these transformative changes, will contribute to a greater understanding of and more favorable attitudes toward HIV PrEP within the population.

Re‐examining the effect of heat and water stress on agricultural output growth: How is Sub‐Saharan Africa different?

AbstractWe examine the impact of climate driven heat and water stress on aggregate crop production growth, paying particular attention to the Sub‐Saharan Africa (SSA) region as opposed to studies with a global or Non SSA focus. Using gridded data on temperature and precipitation, which is crop weighted and averaged to the national level, we generate measures of stressors that capture average temperature and precipitation shocks, and extreme punctuated events like dry spells and heat waves for 38 countries in Sub Saharan Africa between 1979 and 2016. We find in general that compared to estimates with a global or non SSA focus, the detrimental effect of increased annual temperature has been overstated, while the damage caused by shorter‐term extremes like dry spells and heat waves has been understated. This implies that region specific analysis is key in developing a more comprehensive understanding of climate change. Such analyses are pivotal for climate policy development allowing for more spatially efficient allocation of limited financial resources, and greater accuracy in estimating adaptation effects.

Prevalence of oral rehydration solution use and its determinants in the treatment of diarrhea among under-five children in sub-Saharan Africa.

Diarrhea is the second leading cause of under-five deaths claiming half a million children every year. Most of these deaths occurred in sub-Saharan Africa and South Asia. Oral rehydration solution (ORS) has been described as the most effective treatment of diarrhea. However, only 36% of children with diarrhea received ORS in sub-Saharan Africa. This study examined the factors associated with ORS use for children with diarrhea in the sub-region. Demographic and Health Surveys (DHS) data sets of 31 countries in sub-Saharan Africa were used in this study. The data involved 30,102 under-five children with diarrhea. The multivariable analysis involved binary logistic regression. Prevalence of ORS use was 38% in sub-Saharan Africa with countries such as Namibia (71.8%), Zambia (66.4%) and Malawi (63.8%) having the highest rates. Use of ORS was most common among children whose mothers had secondary or higher education (45%), were exposed to media (41%) and attended antenatal care (41%). ORS use was significantly associated with secondary or higher education (OR = 1.63; 95%CI: [1.47-1.81]; p<0.001), exposure to media (OR = 1.17; 95%CI: [1.07-1.27]; p<0.001), antenatal care attendance (OR = 2.33; 95%CI: [1.08-1.27]; p<0.001), child's age (OR = 1.46; 95%CI: [1.35-1.59]; p<0.001), child's size at birth (OR = 1.08; 95%CI: [1.00-1.17]; p<0.05), household size (OR = 1.28; 95%CI:[1.06-1.54]; p<0.05) and source of drinking water (OR = 1.18; 95%CI: [1.09-1.29]; p<0.001). This study revealed a 38% prevalence of ORS use during diarrhea episodes in sub-Saharan Africa. This is low as it is less than the 44% recorded for developing countries as a whole. While this study emphasises the need for a further study on effects of severity of diarrhea on ORS use and factors determining differences in ORS use among countries, it also calls for interventions that will increase use of ORS is sub-Saharan Africa. Such interventions should include increase in literacy rate among girls and women, increase in the proportion of women with access to media, involvement of health workers in programmes that would promote antenatal care utilization among women at community level and provision of social amenities like pipe-borne water.

Township entrepreneurship, Unemployment and Economic Development: Myth or Reality in Sub-Saharan African Countries

This study aims to perform a comparative analysis of the influence of township entrepreneurship on unemployment and economic development among the Francophone and Anglophone countries in sub-Saharan Africa. The study employed a descriptive and quantitative research design where a longitudinal data was sourced from the World Development Indicators (WDI) and World Bank Entrepreneurship databases on 12 and 9 Francophone and Anglophone countries respectively. A Fixed Effect panel regression model was employed to attain the objectives of the study. The findings of the study revealed that there is a significant negative effect of township entrepreneurship on unemployment; and also, township entrepreneurship has a positive significant effect on economic development. Both relationships were found to have insignificant differences between Anglophone and Francophone countries suggesting that the ability of township entrepreneurship to minimize the rate of unemployment and boost economic development is generic and irrespective of cultural and social differences. This study was anchored on the behavioral theory of social entrepreneurship to provide empirical contribution to existing literature.

Financial and economic costs of healthcare associated infections in Africa

Healthcare associated infections (HAI) remain a global health challenge and have elevated rates in Sub-Saharan Africa. HAIs impact patients and their families by causing illness, prolonged hospital stay, potential disability, excess costs and sometimes death. The costs of HAI are increasing due to spreading antimicrobial resistance. A major risk factor for HAIs is lack of water, sanitation, and hygiene (WASH), environmental cleaning and healthcare waste management. In Sub-Saharan Africa these services are lacking in at least 50% of healthcare facilities. This study estimated the costs associated with HAIs at national level in fourteen countries in Sub-Saharan Africa. Economic methodologies were employed to estimate the medical costs, productivity losses and value of premature death from HAIs, drawing on national statistics and published studies to populate the economic model. In 2022, the number of HAIs was estimated at 4.8 million, resulting in 500,000 deaths. Health-related economic losses amounted to US$13 billion per year, equivalent to 1.14% of combined GDP and US$15.7 per capita. Healthcare costs were US$500 per HAI and represented 5.6% of total health expenditure. The costs of providing basic WASH were US$0.91 per capita, which, if they reduced HAIs by 50%, resulted in benefit-cost ratios of 1.6 (financial health care savings only) and 8.6 (including all economic benefits). HAIs have a major health and economic burden on African societies, and a significant share can be prevented. It is critical that health policy makers and practitioners dedicate policy space, resources, and training to address HAIs.

The burden of hospital-acquired infections (HAI) in sub-Saharan Africa: a systematic review and meta-analysis

Hospital-acquired infections (HAI) are a leading cause of morbidity and mortality globally. These infections are diverse, but the majority are lower respiratory tract infection (LRTI), surgical site infection (SSI), bloodstream infection (BSI), and urinary tract infection (UTI). For most sub-Saharan African countries, studies revealing the burden and impact of HAI are scarce, and few systematic reviews and meta-analysis have been attempted. We sought to fill this gap by reporting recent trends in HAI in sub-Saharan Africa (SSA) with attention to key patient populations, geographic variation, and associated mortality. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a literature search of six electronic databases (Web of Science, Pubmed, APA PsycInfo, CINAHL, Embase, and the Cochrane Library) to identify studies assessing the prevalence of HAI in SSA countries. Studies published between 01 January 2014 and 31 December 2023 were included. We applied no language or publication restrictions. Record screening and data extractions were independently conducted by teams of two or more reviewers. Using the R software (version 4.3.1) meta and metafor packages, we calculated the pooled prevalence estimates from random-effect meta-analysis, and further explored sources of heterogeneity through subgroup analyses and meta-regression. This study is registered with PROSPERO, CRD42023433271. Forty-one relevant studies were identified for analysis, consisting of 15 from West Africa (n=2107), 12 from Southern Africa (n=2963), 11 from East Africa (n=2142), and 3 from Central Africa (n=124). A total of 59.4% of the patient population were associated with paediatric admissions. The pooled prevalence of HAI was estimated at 12.9% (95% CI: 8.9-17.4; n=7336; number of included estimates [k]=41, p<0.001). By subregions, the pooled current prevalence of HAI in the West Africa, Southern Africa, East Africa and Central Africa were estimated at 15.5% (95% CI: 8.3-24.4; n=2107; k=15), 6.5% (95% CI: 3.3-10.7; n=2963; k=12), 19.7% (95% CI: 10.8-30.5; n=2142; k=11) and 10.3% (95% CI: 1.1-27.0; n=124; k=3) of the patient populations respectively. We estimated mortality resulting from HAI in SSA at 22.2% (95% CI: 14.2-31.4; n=1118; k=9). Our estimates reveal a high burden of HAI in SSA with significant heterogeneity between regions. Variations in HAI distribution highlight the need for infection prevention and surveillance strategies specifically tailored to enhance prevention and management with special focus on West and East Africa, as part of the broader global control effort. No funding was received for this study.

Environmental sustainability, terrorism, and military expenditure in Sub-Saharan Africa: Evidence from panel quantile ARDL regression and panel causality

The prevalence of terrorism and military expenditure in Sub-Saharan Africa (SSA) is experiencing rapid and significant growth over time. This study investigates the impact of terrorism and military expenditure on environmental sustainability in 35 economies in SSA from 1990 to 2021, utilizing panel quantile autoregressive distributed lag regression and causality analysis techniques to bridge the gap in existing studies on the military expenditure, environmental sustainability, and terrorism nexus. The study's novelty is evident because it assesses the short-term and long-term impacts of military expenditure and other covariates across various quantiles of CO2 emissions. The study achieves this by categorizing SSA nations based on their varying levels of CO2 emissions, specifically low, moderate, and high, an approach that is extremely rare among SSA countries. The study's findings revealed that terrorism and military expenditure have a positive impact on CO2 emissions across the quantiles, implying that these variables contribute to environmental degradation in the region. The study also reveals a bidirectional relationship between CO2 emissions and the selected predictors (terrorism, military expenditure, trade, and economic growth). Thus, the study proposes military strategies and macroeconomic policies that ensure environmental sustainability.

Blood count changes in malaria patients according to blood groups (ABO/Rh) and sickle cell trait

IntroductionIntroduction: Malaria continues to be the leading cause of hospitalization and death in Angola, a country in sub-Saharan Africa. In 2023, in the first quarter, 2,744,682 cases were registered, and of these 2,673 patients dieddue to malaria disease. Previous studies have shown that the ABO blood group can affect the progression ofmalaria to severe conditions after P. falciparum infection, while the sickle cell gene offers relative protection.ObjectiveWe investigated changes in the blood count according to blood groups (ABO/Rh) and sickle celltrait in patients with malaria in Luanda, capital of Angola.Methodology This was a longitudinal, prospectiveand observational study with 198 patients hospitalized for malaria.Results Of the 198 patients studied,13(6.6%) were ABRh(+), 4(2.0%) were ARh(-), 49(24.7%) were ARh(+), 42(21, 2%) were BRh (+), 5(2.5%)were ORh(-) and 85(42.9%) were ORh(+). For sickle cell trait, 145(73.2%) were AA, 37(18.7%) were AS and16(8.1%) were SS. No statistical relationship was observed between age group, sex, parasitemia, clinicalpicture, hematocrit, MCV, HCM, MCHC, leukocytes, NEUT, LINF and PTL values with blood groups(p<0.05), but there was a relationship between values of hemoglobin and ABO/Rh blood groups (p>0.05).There was no relationship between age, parasitemia, clinical condition, MCV, HCM and MCHC values,leukocytes, NEUT and LINF with sickle cell trait (p<0.05), but there was a relationship between sex,hemoglobin and PTL and sickle cell values. sickle cell trait (p>0.05).ConclusionIt is imperative todifferentiate patients with malaria based on blood groups and sickle cell trait, taking into account mainly theblood count parameters that demonstrate that there are patients who, depending on blood group or sickle celltrait, may react weakly to malaria infection regardless of the degree of parasitemia and medical prognosis.

Development of a stroke network in Kinshasa (Democratic Republic of the Congo): a humanitarian project of the Italian Stroke Association—Associazione Italiana Ictus

In sub-Saharan Africa (SSA), stroke incidence is ~316 cases per 100,000 inhabitants and in 75% of SSA countries stroke is among the top three causes of death. This epidemiological evolution results from the exponential growth of the African population as well as the lack of policies for prevention and therapy. The Democratic Republic of Congo is one of the countries included as a “low-income country” in the 2023 Organization for Economic Co-operation and Development's Development Assistance Committee List; its capital, Kinshasa, is a megalopolis with more than 18 million inhabitants. According to our knowledge, no hospital in Kinshasa is currently capable of admitting and treating patients with stroke according to international guidelines. The Italian Stroke Association—Associazione Italiana Ictus (ISA-AII) is a multidisciplinary scientific society for the fight against cerebrovascular diseases. Some members of the ISA-AII joined to form a working group dedicated to the care of stroke in Africa. In this article, we explain the project designed by ISA Africa that, in collaboration with the referral hospital of a district of Kinshasa, has the aim of building a network for diagnosing and treating stroke, including ambulance services, a stroke team in the emergency room, a stroke unit, an outpatient clinic, and primary prevention activities among the population.

Covid-19 restrictions and transport sector in Sub-Saharan Africa: insights from Douala City, Cameroon

The transportation industry is a key player in shaping today’s economy and society, but the COVID-19 outbreak in 2020 drastically reduced services as governments implemented containment measures which drastically reduced services offered by transportation systems. Developed countries are already analyzing the pandemic's impact on transportation and proposing sustainable solutions. However, little is known about how developing countries in Sub-Saharan Africa, with high urban population densities and unique mobility patterns, have responded. This study focuses on Cameroon, specifically Douala city, to examine the effects of COVID-19 restrictions on mobility patterns, transport operators, and provide recommendations to transport authorities in responding to future pandemics in the region. Interviews with 190 key informants, including taxi, bus drivers, and bike riders revealed a significant decrease in passenger demand, lower occupancy rates, reduced intra-urban and inter-urban mobility, and financial struggles for drivers, leading to layoffs. The study underscores the need for collaboration among stakeholders in the transport sector, involving public transport operators, government agents, policy makers, and the civil society in decision-making to create sustainable solutions for future pandemics.

Transport and Electricity Infrastructures and Economic Growth and Development in Selected Sub-Saharan African Countries

Economic postulations suggest that the interrelationship between changes in incomes, capital and labour which can be substituted into macroeconomic neoclassical and steady-state growth theories drives economic development. Arising from the above economic axiom, this study investigated the impact of transport and electricity infrastructures on economic development and growth in sub-Saharan Africa. The study used panel data from fifteen (15) sub-Saharan African countries. Panel data were obtained from statistical bulletins of the various countries and World Bank Indicators (WBI) from 2000-2022. Data obtained were analyzed via descriptive, diagnostic and inferential statistics. Specifically, the fixed and random effects regression revealed that while there is a significant relationship between transportation and electricity infrastructures and economic growth, an insignificant relationship was found between transportation and electricity infrastructures and economic development in the selected sub-Saharan African countries. Based on the findings, it was recommended among others that governments in sub-Saharan Africa needs to increase their contributions and support for electricity and transportation infrastructures; this can be done by increasing budgetary allocation for critical infrastructures in countries of sub-Saharan Africa

Corporate social responsibility disclosure and corporate social irresponsibility in emerging economies: Does institutional quality matter?

AbstractThe Panama Papers (2016), Paradise Leaks (2017), and Pandora Papers (2021) have revealed the extensive practice of corporate tax avoidance. Yet, the tax behavior of companies claiming to be “socially responsible” has been less examined. This study examines the association between corporate social responsibility disclosure (CSRD) and tax avoidance, particularly in developing economies, focusing on Sub‐Saharan Africa (SSA). By analyzing data from 600 firm‐year observations across 13 SSA countries using panel quantile regression, we found a negative relationship between CSRD, which includes ethical, social, and environmental dimensions, and tax avoidance. This aligns with legitimacy theory, indicating that firms are increasingly adopting CSR transparency to meet societal expectations and gain stakeholder trust, avoiding socially irresponsible behaviors. Furthermore, the quality of national governance significantly moderates the CSRD–tax avoidance relationship, supporting the concept of institutional isomorphism. This evidence is valuable for professionals and policymakers and encourages further research to deepen and broaden these findings.

Medicine Non-Adherence: A New Viewpoint on Adherence Arising from Research Focused on Sub-Saharan Africa.

Adherence is vital for medicine to have an effect, yet adherence is considered to be low, with approximately half of the patients not fully adherent. However, research into adherence tends to focus on quantitative analysis of performance, which fails to perceive how people are adherent in their many different environments. As a contribution to gaining a deeper understanding, interviews were held with thirty individuals in the UK, Egypt, Kazakhstan, and six countries in sub-Saharan Africa to understand their perceptions on adherence to a range of drugs, and these were compared with an existing well-regarded list. New or undocumented reasons for non-adherence were discovered. Reasons for non-adherence were consistent across both developing and developed worlds. A new viewpoint on adherence is suggested, which considers adherence to be a single act and therefore as an individual opportunity to be adherent, permitting greater focus on the enablers and inhibitors of adherence at any given point in time.

Estimating the prevalence of cerebral palsy in a semi-urban city in Benin: a door-to-door community-based study.

Cerebral palsy (CP) is the most common cause of pediatric motor disability. While epidemiological data are widespread in high-income countries, corresponding data in low-income countries in Sub-Saharan Africa are still rare. This study aimed to estimate the prevalence of CP in Northern Benin, a French-speaking low-income country in Sub-Saharan Africa. This study was a community-based door-to-door study involving children younger than 18 years old, in Parakou, a semi-urban city in Benin. We used a two-stage procedure. The first one consisted on children screening to identify potential cases of CP. During the second stage, suspected children were examined by neurologists with high experience with CP. In total, 2630 children were screened with 10 confirmed cases of CP, resulting in a crude prevalence (95% confidence interval) of 3.8(1.4, 6.15) per 1000 children. Of the ten confirmed cases, six were younger than 5 years old, and five were male. Eight children over ten were spastic with six bilateral spastic subtype according to the SCPE classification system. Seven children had a Gross Motor Function Classification System level III-V, and six were classified level III to V of the Manual Ability Classification System. Cerebral palsy is highly prevalent in Semi-Urban area in Northern Benin. Large studies on potential risk factors are needed for the development of effective preventive strategies.