East Africa Research Articles

Characteristics of longitudinal maternal health studies in sub-Saharan Africa: A systematic mapping of literature between 2012 and 2022.

High maternal mortality rates in sub-Saharan Africa necessitate the need for aligned research focusing on prevalent causes and neglected conditions in the region. This mapping review aimed to describe the characteristics of longitudinal maternal health studies between 2012 and 2022 in sub-Saharan Africa and identify gaps in priority conditions or geographical locations. We identified references through a Medline (PubMed) search covering September 2012 to June 2022. We included prospective cohort or clinical trials that enrolled at least 1000 pregnant women, with a study site in sub-Saharan Africa, and published in English or French. Screening and data extraction were done in duplicate using EPPI-reviewer software. Descriptive analysis was used to summarize the results, identifying patterns in studies across time, country, study design, topics, and funders. We identified 213 eligible studies, which were covered in 534 publications. We identified studies in 33 of the 48 sub-Saharan African countries, with the majority in east and southern Africa. The predominant study topics were HIV (36.4%), nutrition (20%), and malaria (16.3%), with very few publications on hypertensive disorders of pregnancy (6.4%), ante/postpartum hemorrhage (3.7%), and sexually transmitted infections (3.2%). More studies were cohorts (115/213; 54%) than clinical trials. The National Institutes of Health (31.5%), Bill and Melinda Gates Foundation (22.1%), and USAID (10.8%) were the largest research funders. Identifying research trends and mismatches between research topics and disease burden provides useful information for guiding future research prioritization. In particular, gaps exist for studies on hypertensive disorders of pregnancy and ante/postpartum hemorrhage, among the top causes of maternal mortality in sub-Saharan Africa.

Bridging the Knowledge Divide: Journalism Education and Industry Needs in East and Southern Africa

This study explores the perceived gap between journalism education and professional practice in Tanzania and Zambia. Through interviews with educators and journalists and an analysis of 12 journalism curricula, the findings reveal that both educators and journalists acknowledged a gap, with a shared desire for improved alignment between academic programs and industry needs. Educators expressed a commitment to incorporating contemporary content, but face challenges like limited industry collaboration and resource constraints. Journalists, however, observed a hesitancy among educators in implementing recommendations from the industry. Both groups see the need for integrating theory and practice into the curricula.

The extended recovery ring-stage survival assay is a scalable alternative for artemisinin susceptibility phenotyping of fresh Plasmodium falciparum isolates.

Artemisinin partial resistance (ART-R) has emerged in eastern Africa, necessitating regular surveillance of susceptibility of Plasmodium falciparum to artemisinins. The microscopy-based ring-stage survival assay (RSA) provides a laboratory correlate of ART-R but is limited by low throughput and subjectivity of microscopic counts of viable parasites. The extended recovery ring-stage survival assay (eRRSA) replaces microscopy with efficient quantitative PCR (qPCR) readouts but has been studied only with culture-adapted P. falciparum clones. We measured susceptibility to dihydroartemisinin (DHA) after a 6-h incubation with 700-nM DHA, followed by culture without drug, by comparing survival with that of untreated controls by microscopy (the RSA) or qPCR (the eRRSA) and also performed standard growth inhibition (half-maximal inhibitory concentration [IC50]) assays for 122 P. falciparum isolates freshly collected in eastern and northern Uganda from March to July 2022. The median values for RSA survival, eRRSA fold change, and DHA IC50 were 3.0%, 46.2, and 3.2 nM, respectively. RSA percent survival and eRRSA fold changes correlated strongly (Spearman correlation coefficient [rs] = -0.7411, P < 0.0001), with modest associations between the presence of validated P. falciparum Kelch13 ART-R mutations (C469Y or A675V) and RSA (median survival 2.6% for wild type [WT] vs 4.1% for mutant, P = 0.01), or eRRSA (median fold change 63.4 for WT vs 30.9 for mutant, P = 0.003) results. Significant correlations were also observed between DHA IC50 values and both RSA percent survival (rs = 0.4235, P < 0.0001) and eRRSA fold changes (rs = -0.4116, P < 0.0001). The eRRSA is a scalable alternative for phenotyping fresh P. falciparum isolates, providing similar results with improved throughput.

Towards black methods in research with refugees

Abstract Critical approaches to forced displacement and migration studies gesture towards methodologies and theoretical orientations that are contextualized within the complex socialities of refuge lifeworlds and ways of being. This article offers methodological approaches that account for the forces of displacement as well as the layered and textured experiences of forcibly displaced people. Turning to black studies and black feminist thought, the article examines how forcibly displaced people navigate and contest resettlement processes in the USA. Thinking with empirical material from a research study engaging with forcibly displaced interlocutors from East and Central Africa and refugee resettlement personnel, the article illuminates critical methods of interpreting the experiences of refugees and forms of resettlement through the lenses of black studies and black feminist thought.

Phylogenetic placement of Mt Bamboutos endemic skink, Trachylepis mekuana (Chirio and Ineich, 2001)

African skinks of the genus Trachylepis is one of the most diverse genera of lizards in Africa. Although, many species have not been validated phylogenetically in recent years. In this study we evaluate the phylogenetic status of the Cameroon Volcanic Line endemic montane skink, Trachylepis mekuana. We recover this species as part of the larger Trachylepis varia group, with sister relationship to the morphological similar skinks from Eastern Africa Trachylepis megalura and central Africa Trachylepis raymondlaurenti. Low sequence divergence (&lt;1.6% 16S) have been observed among the three species. Based on some morphological and colouration differences, as well as mostly allopatric distribution we regard them as good species.

Not Indian, Not African: Classifying the East African Asian Population in Aotearoa New Zealand

This paper explores the challenges of measuring and classifying the East African Asian population in Aotearoa New Zealand. As a particularly diverse country, New Zealand has a significant and varied population of immigrants from South Asia, including India, Pakistan and Bangladesh, along with immigrants of South Asian origin, from Fiji, Southeast Asia, the Caribbean and East Africa. New Zealand’s system of ethnic classification relies on self-identification, with a broad definition of ethnicity encompassing heritage, ancestry, culture, language and feelings of belonging. However, the collection of this information at a granularity that enables detailed analysis is constrained for the South Asian population, regardless of origin or identification. People are typically presented with the choice of selecting “Indian” ethnicity as a tick box, or providing ethnicities under “Other” as write-in descriptors, which in turn are coded to a limited set of categories within the classification being used. This practice potentially conceals a diversity of ethnicities, which can only partially be hinted at by responses to questions relating to religions, languages and birthplaces, especially for second or third-generation descendants of migrants. Ethnic classification at the highest level, moreover, includes East African Indians as Asian, rather than African, reflecting diasporic heritage as a shorthand for ancestry and overlooking the relevance of layers of identity associated with the double diaspora. Drawing on Peter J. Aspinall’s work on collective terminology in ethnic data collection and categorizing the “Asian” ethnic group in the UK, this paper looks at the overlaps and disconnects between heritage, ethnicity and national belonging in classifying less clearcut identities. We explore the strengths and limitations of New Zealand’s self-identification approach to ethnic identity, and query what exactly is being asked of groups on the margins: when self-identification does not match external perception, are we looking for geographic, cultural, or genetic origins? A focus on the East African Asian population in Aotearoa highlights the complexity of identity for diasporic groups with distant ancestral links with India, as lived experience of cultural connection extends far beyond the bounds of ethnicity, language and even ancestry.

Addressing barriers to post-graduate research training in low resource settings: an innovative approach in an institution of higher learning in Kenya

BackgroundNumerous barriers hinder health research training in Post-Graduate Medical Education Programs, especially in developing countries. Research training is pivotal for medical residency, providing essential knowledge and skills for dissertation completion, fostering evidence-based medical practice, and nurturing future independent clinical researchers. A holistic approach to research education is imperative to surmount these barriers. We describe here a dissertation-centric research curriculum, delivered longitudinally, an innovative strategy undertaken by Aga Khan University's Medical College in East Africa (AKU-MCEA) to deliver postgraduate research.MethodsA review of AKU-MCEA post-graduate research methods curriculum was conducted based on implementing Departments' experience, institutional policies, and residency program output.Program implementationThe Master of Medicine program requires a well-executed dissertation for graduation. Residents undergo structured research training across four modules, with interactive sessions and workshops supporting their research milestones. Protected time allows residents to develop and report on their dissertation work. Faculty receive specialized training in dissertation supervision to ensure residents benefit from expert guidance in producing high-quality research.OutcomesThis approach achieves a dissertation completion and graduation rate of 98–100%. Notably, 68.5% (n = 126) of those who graduated in 2013–2023 have published two or more papers (i.e., range 2–36) in their current portfolio, demonstrating a commitment to ongoing research endeavors even after graduation. Residents' research covers diverse themes and is disseminated through departmental presentations, university-wide Faculty Academic Rounds, peer-reviewed journals, conferences, and the Annual Early Career Researchers symposium.Lessons learntA comprehensive approach featuring a structured research curriculum, longitudinal delivery with predetermined milestones, dedicated supervision, financial and resource support, protected research time, ongoing faculty development in dissertation supervision, and clear institutional research policies accelerates dissertation completion and enhances effective research dissemination.

Epidemiologic and genomic characterization of an outbreak of Rift Valley fever among humans and dairy cattle in northern Tanzania.

A peri-urban outbreak of Rift Valley fever virus (RVFV) among dairy cattle from May through August 2018 in northern Tanzania was detected through testing samples from prospective livestock abortion surveillance. We sought to identify concurrent human infections, their phylogeny, and epidemiologic characteristics in a cohort of febrile patients enrolled from 2016-2019 at hospitals serving the epizootic area. From September 2016 through May 2019, we conducted a prospective cohort study that enrolled febrile patients hospitalized at two hospitals in Moshi, Tanzania. Archived serum, plasma, or whole blood samples were retrospectively tested for RVFV by PCR. Human samples positive for RVFV were sequenced and compared to RVFV sequences obtained from cattle through a prospective livestock abortion study. Phylogenetic analysis was performed on complete RVFV genomes. Among 656 human participants, we detected RVFV RNA in four (0.6%), including one death with hepatic necrosis and other end-organ damage at autopsy. Humans infected with RVFV were enrolled from June through August 2018, and all resided in or near urban areas. Phylogenetic analysis of human and cattle RVFV sequences demonstrated that most clustered to lineage B, a lineage previously described in East Africa. A lineage E strain clustering with lineages in Angola was also identified in cattle. We provide evidence that an apparently small RVFV outbreak among dairy cattle in northern Tanzania was associated with concurrent severe and fatal infections among humans. Our findings highlight the unidentified scale and diversity of inter-epizootic RVFV transmission, including near and within an urban area.

The economic, social, and environmental impact of ecologically centered integrated pest management practices in East Africa

Agricultural pest management faces mounting challenges with increasing pressure to reduce chemical pesticide use while ensuring food security, and environmental sustainability. Ecologically centered approaches, such as integrated pest management (IPM), offer promising sustainable agroecological crop protection alternative solutions to pesticides. This study assesses the investment viability and environmental sustainability of two IPM interventions—mango fruit fly IPM (FF-IPM) and push-pull technology (PPT) in Kenya and Uganda, using project investment and adoption data from 2007 to 2021. The study also evaluates these technologies contribution to food security and poverty reduction. FF-IPM integrates biological control, cultural practices, and targeted bait traps to manage fruit flies in mango production, while PPT employs Desmodium and Brachiaria grass to control stemborers and striga weed. The findings highlight that these IPM interventions achieved a combined net present value of $500 million, with a benefit-cost ratio of about 8:1, and an internal rate of return of 21%, comparable to returns from improved crop varieties. These technologies also improved food security for 641,000 people, lifted 445,349 people above the poverty line, representing 2% of the poor population in both countries, and generated an average income increase of $5 per capita in Kenya and Uganda annually. Environmentally, they sequestered 2.7 million tons of CO2 equivalent, valued at $12.2 million, and are reducing pesticide use by 86,000 to 204,000 L per year. These results demonstrate the potential of IPM approaches to simultaneously enhance livelihoods, local economies, and generate global environmental public goods, suggesting that addressing adoption barriers could further amplify these positive outcomes.

Renewable energy, carbon footprints, natural resources depletion and economic growth in Africa

Purpose This study aims to examine the interplay between renewable energy consumption, carbon footprints, natural resources depletion and economic growth. Design/methodology/approach It engaged 45 African countries using the generalized method of moments (GMM) approach. Data from the World Development Indicators for the period 2000–2023 are used to analyse the relationships among these variables. Findings The result indicates a positive and significant effect of greenhouse gas emissions on economic growth in all regions of Africa, except for Southern Africa. Regarding the depletion of natural resources, the authors observe a dominant negative effect on economic growth. Thus, an increase in the depletion of natural resources contributes to the reduction of economic growth in most regions of Africa, notably West Africa, East Africa and sub-Saharan Africa as a whole. Moreover, the depletion of natural resources can also have negative social impacts, such as conflicts over access to remaining resources, which can indirectly influence economic stability and growth. Originality/value This study contributes to the existing literature by providing empirical evidence of the positive effects of renewable energy consumption on carbon footprints, natural resource depletion and economic growth. By quantifying these relationships, the study offers valuable insights into the potential of renewable energy to address pressing environmental and economic challenges.

An Examination of Ethiopian Data on the Coffee Value Chain from a Systemic Perspective

Ethiopia&amp;apos;s principal export crop is coffee. Currently, one of the most profitable exports for nations in East Africa, including Ethiopia, Uganda, Kenya, and Tanzania, is coffee. Ethiopia is recognized as the source and major hub of Arabica coffee varietal. Global coffee production is insignificant, with over 70 nations and approximately 25 million growers producing coffee. Seventeen percent of coffee producers worldwide are from Ethiopia. Ethiopia, which produces 4.46 percent of the world&amp;apos;s coffee, is the world&amp;apos;s fifth-largest producer, behind only Brazil, Vietnam, Colombia, and Indonesia. the biggest and most prolific grower in Africa, making up around 43.15% of the continent. Ethiopian coffee varieties vary greatly in terms of genetic variety. The nation has also captured the attention of the world because of its inherent. More than 60% of the world&amp;apos;s coffee is produced by the top three countries—Brazil, Vietnam, and Colombia together. Ethiopia is the eighth-largest supplier of coffee to the world market, accounting for 3–3.7 percent. Sixty countries import coffee from Ethiopia. The top 10 countries to import Ethiopian coffee, in terms of value, were Italy, Germany, Saudi Arabia, Japan, Belgium, South Korea, China, the United Arab Emirates, and Taiwan. They make up 84% of the whole. Japan moved up from sixth place in 2020–2021 to fourth place in the world for coffee imports in 2021–2022.

Genotypic and phylogeographic insights into a pre-epidemic variant of Wesselsbron virus detected in sylvatic Aedes mcintoshi from Semuliki Forest, Uganda.

Wesselsbron virus (WSLV) is a neglected mosquito-borne virus within the yellow fever subgroup in the genus Orthoflavivirus of the Flaviviridae family. Despite being primarily a veterinary pathogen able to cause stillbirths, congenital malformations, and mortality in ruminants, WSLV also infects humans, causing a usually self-limiting febrile illness, or may lead to neurological complications in rare cases. WSLV causes sporadic outbreaks in Southern Africa, but findings in mosquitoes from other African countries suggest a wider distribution. Here, we report the detection and isolation of WSLV from an Aedes mcintoshi mosquito collected in a pristine ecosystem within Semuliki National Park, western Uganda. The detected strain M5937-UG-2018 was impaired in infectivity, replication, and production of infectious particles in cell lines derived from different hosts compared to an epidemic reference strain, SA H177. Full-genome sequencing by next-generation sequencing from the mosquito homogenate revealed a maximum nucleotide identity of 98.1% to a WSLV isolate from a human sample collected in South Africa in 1996. M5937-UG-2018 grouped in phylogenetic analyses with strains from South Africa and Senegal. Reconstruction of the temporal and spatial dispersal of WSLV across Africa estimated a likely origin of WSLV in South Africa in the early 19th century and spread in Southern Africa in the following decades. Long-distance movement toward Western and Eastern Africa was modeled to have occurred in the early 21st century. However, displacing the origin of M5937-UG-2018 did not decrease the likelihood of the model supporting the hypothesis that WSLV is widely distributed in Africa.IMPORTANCEWSLV is a neglected mosquito-borne virus causing teratogenicity in ruminants and febrile illness in humans. WSLV is mainly endemic to Southern Africa, but findings in other regions suggest a wider distribution on the continent. Knowledge of the distribution of WSLV is impaired as differential diagnostics are rarely performed in livestock and humans presenting with symptoms compatible with WSLV infection. Our work investigating viral infections in mosquitoes from a remote tropical rainforest region demonstrates that WSLV is endemic in Uganda. The isolated virus was less infective and showed lower replication ability in vitro compared to an epidemic isolate from South Africa. Phylogeographic reconstruction of spatial and temporal movements, along with the displacement of the origin of the newly detected strain, suggests that WSLV may be widely distributed across Africa. Our data show that the geographic distribution of WSLV and its impact on human and animal health are likely underestimated.

Tracing the path to sustainable governance: CSR committees as mediators of board impact on ESG performance in the MENA region

Purpose This study aims to explore the mediating role of corporate social responsibility (CSR) committees in the relationship between board characteristics and environmental, social and governance (ESG) performance, specifically within the Middle East and North Africa (MENA) region. Design/methodology/approach Based on a panel of 178 firms spanning 2015–2022, the analysis uses Baron and Kenny’s (1986) mediation approach, supplemented by structural equation modeling (SEM) path analysis for robustness. Findings The findings demonstrate that CSR committees play a significant mediating role in the impact of board size, expertise and gender diversity on ESG performance. Furthermore, the study confirms the direct, positive influence of both board characteristics and the presence of CSR committees on ESG performance, underscoring their strategic importance in fostering sustainability in this regional context. Practical implications The findings highlight the strategic importance of diversifying and enhancing board skills to improve ESG performance. Companies are encouraged to recalibrate their governance frameworks to leverage the mediating influence of CSR committees and promote sustainable business practices. Social implications By demonstrating the positive effect of CSR committees on ESG performance, this study aligns with global trends in responsible business conduct and highlights the importance of corporate governance in addressing environmental and social challenges. This alignment is critical for achieving sustainable development goals and reinforcing stakeholder trust in the region. Originality/value This research provides novel empirical insights into the mediating effect of CSR committees within the MENA region, offering a unique contribution to the discourse on corporate governance and sustainability. By highlighting region-specific governance dynamics that shape ESG outcomes, it deepens the understanding of effective governance practices.

Delayed presentation of breast cancer patients and contributing factors in East Africa: Systematic review and meta-analysis.

Breast cancer remains a significant public health issue, with delayed medical attention often leading to advanced stages and poorer survival rates. In East Africa, evidence on the prevalence and factors contributing to the delayed presentation of breast cancer is limited. As a result, this study aims to assess the pooled prevalence of delayed breast cancer presentation and identify contributing factors in East Africa. We conducted a systematic review of observational studies from East Africa using PubMed, Google Scholar, Embase, Cochrane Library, Hinari, and Mednar databases. The Newcastle Ottawa 2016 Critical Appraisal Checklist assessed methodological quality. Publication bias was evaluated using a funnel plot and Egger's test, and heterogeneity was examined with the I-squared test. Data were extracted with Microsoft Excel and analyzed using Stata 11. The pooled prevalence of delayed presentation among breast cancer patients in East Africa was 61.85% (95% Confidence Interval: 48.83%-74.88%). Significant factors contributing to delayed presentation included visiting traditional healers (Adjusted Odds Ratio: 3.52; 95% CI: 1.43-5.59), low educational levels (Adjusted Odds Ratio: 3.61; 95% CI: 2.39-4.82), age>40 years (Adjusted Odds Ratio 1.87; 1.03, 2.71), absence of breast pain (Adjusted Odds Ratio 2.42; 1.09, 3.74), distance >5km away from home to health institution (Adjusted Odds Ratio 2.89; 1.54, 4.24), and rural residence (Adjusted Odds Ratio: 3.33; 95% CI: 2.16-4.49). This meta-analysis's findings demonstrated that over half of breast cancer patients in East Africa delayed detection. Significant factors associated with delayed presentation include age over 40 years, illiteracy, rural residence, use of traditional healers, distance greater than 5 km from a health facility, and absence of breast pain. Healthcare stakeholders and policymakers must be focused on raising awareness and educating people to encourage early detection and prompt therapy.

Exploring the Cultural Significance, Medicinal Properties, and Agricultural Practice Achievements of Timiz (&amp;lt;i&amp;gt;Piper capense&amp;lt;/i&amp;gt;) in Ethiopia

Piper capense, widely known as Timiz, is an important spice from the Piperaceae family, native to East Africa, particularly in Ethiopia’s southwestern areas. Traditionally used for a myriad of health issues, Timiz holds a significant place in Ethiopian cuisine, embodying cultural traditions. The plant is distinctive in its morphology, with &amp;quot;timiz&amp;quot; in Amharic indicating its curly form. The flavor profile of Timiz is notably unique, exhibiting a milder and sweeter taste that is reminiscent of cloves and cardamom, which enhances its culinary versatility. Typically, the harvested and dried seed spikes are appreciated for their aromatic properties, which are further enhanced through traditional smoking methods. This review explores the traditional medicinal uses of Timiz, relying on ethnobotanical data that illustrate its employment among various African communities for treating ailments like digestive issues, respiratory infections, and other health problems. The results of research on the collection, conservation of accessions, agronomic practices such as watering frequency and media types, as well as propagation methods, are also highlighted. Furthermore, the review identifies challenges within the value chain, such as a lack of awareness regarding processing methods and quality control, stressing the necessity for improved practices to boost Timiz&amp;apos;s marketability. Future directions for research, production, and market integration of Timiz in Ethiopia are also discussed, underscoring the multifaceted significance of this spice in Ethiopian culture and medicine while advocating for sustainable agricultural methods to support its cultivation and conservation.

Navigating Carbon Peaking and Neutrality in MENA: The Impact of Foreign Direct Investment and Trade Openness Using Panel PCSE and FGLS Techniques

ABSTRACTIn response to the global challenge of climate change and the drive towards carbon neutrality, this study investigates the effects of foreign direct investment (FDI) and trade openness (TO) on carbon emissions (CEM) within the Middle East and North Africa (MENA) region. The research spans 18 countries from 1990 to 2022, focusing on Sustainable Development Goal 13. Utilizing Porter's hypothesis and the Environmental Kuznets Curve (EKC) theory, the study applies quantitative methods including panel corrected standard errors (PCSE) and feasible generalized least squares (FGLS) to ensure robustness. To address potential endogeneity, two‐stage least squares and lagged effect estimations are employed. The findings reveal that both FDI and TO are associated with reduced CEM, indicating positive environmental impacts. Also, the pairwise causality tests show bidirectional causality between FDI, TO, and CEM, while a unidirectional causality is found from industrialization (IND) and energy consumption (EC) to CEM. These results underscore the importance of integrating FDI and TO into strategies for achieving carbon neutrality and advancing sustainable development goals, offering actionable insights for policymakers.

Maps, Flags, and Security in the Indo-Pacific: Reframing China’s Influence in Africa

ABSTRACT Maps with flags have securitized China’s actions in Africa. This article combines spatial and cartographic analysis with securitization theory to test the role played by visual symbols in the securitization of the East African space and then compares this with on-the-ground realities. It finds that maps with flags have decisively securitized China’s presence and actions in East Africa for state actors with antithetical interests. Despite valid security concerns, securitizing China in East Africa conflates presence with hegemony and, thus, willfully ignores the sovereignty and agency of African states and peoples and simplifies East Africa to a zone on the map of great power contestation.

Societal uses of the main water bodies inhabited by malaria vectors and implications for larval source management

BackgroundLarval source management (LSM) effectively reduces mosquito populations at their breeding sites, addressing issues like insecticide resistance that limit the effectiveness of primary interventions such as insecticide-treated nets (ITNs). Although traditionally used in urban and dry areas, recent research suggests it might also be effective in rural settings in eastern and southern Africa, where Anopheles funestus thrives in permanent water bodies that sustain year-round transmission. Targeting these habitats could enhance LSM, but it requires understanding local community practices, as mosquito breeding sites often overlap with community water resources. This study examined how communities use aquatic habitats and how these practices may impact LSM strategies, with a focus on habitats used by An. funestus.MethodsThis study was conducted in three villages in the Ulanga and Malinyi districts of southeastern Tanzania using a mixed-methods approach. Quantitative data were collected through cross-sectional surveillance, and qualitative data through unstructured interviews, focus group discussions, and field observations. Data analysis integrated both quantitative and qualitative findings to develop a comprehensive understanding of community perspectives.ResultsA survey of 931 aquatic habitats found mosquito larvae in 73% of them, with late instar An. funestus present in 23%. River streams made up 41% of the habitats, while ground pools accounted for 4%. Most habitats (90%) were used by communities, including 95% of those with An. funestus larvae, for activities such as domestic chores, agriculture, livestock rearing, brickmaking, and fishing. Focus group discussions revealed a willingness to adopt LSM, with a preference for larviciding and habitat modification over habitat removal, as the water sources were vital for daily use. Community concerns centered on the safety of larvicides for humans and animals, the environmental impact, and the need for better awareness of how LSM affects health and livelihoods.ConclusionThis study highlights community perspectives on LSM, focusing on the dual function of aquatic habitats as mosquito breeding sites and essential community water sources. This dual role presents both challenges and opportunities, suggesting that LSM strategies must balance public health needs with socio-economic realities. There was a clear preference for larviciding and habitat modification over removal, with a strong emphasis on health and environmental safety. The study emphasizes the importance of educating communities on the safety and effectiveness of LSM, and tailoring LSM strategies to fit the needs and preferences of local communities.

Contraceptive use and determinants among sexually active unmarried adolescents and young women (aged 15-24 years) in East Africa: insights from Demographic and Health Survey data.

Low contraception usage among adolescents is a significant public health issue, leading to a rise in unintended pregnancies and adolescent childbearing in sub-Saharan Africa. Despite global efforts to improve access to contraception, sexually active adolescents and young women in East Africa are often overlooked, exposing them to substantial health risks. This study explored the factors influencing contraceptive use among unmarried and sexually active adolescents and young women in East African countries. National representative data from the 2016 Demographic and Health Survey for eight East African countries were used in the analysis. Data processing and analysis were performed using STATA 17 software. A multilevel mixed-effect logistic regression was used to identify determinants of contraceptive use at p<0.05. A total of 7813 sexually active unmarried adolescents and young women were considered for the final analysis. Among these young women, 24.9% were using a contraceptive method. Age, place of residence, knowledge of contraceptive methods, employment status and educational attainment were identified as significant determining factors of contraceptive use among sexually active unmarried adolescents and young women (aged 15-24 y) in East Africa. Contraceptive utilization among sexually active unmarried adolescents and young women was relatively low in East African countries. Addressing the existing inequalities in access to contraceptive services for rural adolescents and young women in East African countries is crucial. Prioritizing policies that implement comprehensive sexual education is essential to enhance their knowledge of contraceptives and empower them to make informed decisions.

Assessing the Climatological Characteristics of Observed and Simulated Seasonal Onset of Precipitation Over Southern and Eastern Africa

ABSTRACTPrediction of seasonal onset is crucial to agriculture in southern and eastern Africa. Here, we applied two definitions of onset, namely meteorological and agricultural (crop‐germination), to evaluate CMIP6 models through the lens of rainfall onset over representative maize agricultural regions of South Africa, Tanzania, Malawi and Zambia. We use the ERA5 reanalysis as a proxy for observations, and robust regression to calculate a statistical comparison of the onset definitions for the period 1979–2021. Evaluation of ERA5 reanalysis shows similar magnitude and pattern as gauge based MSWEP. Our results show that, for meteorological onset, Johannesburg, with a subtropical highland climate, experienced earliest onset after 23 December; and an increasing trend (later onset) but not statistically significant (p = 0.2). Over Bethlehem, which has continental climate, the earliest onset date was after October 9 and an increasing interannual variability since 2000 is noted. The standard deviation of onset dates across the regions shows an East‐Central‐South gradient. We also found that the crop‐germination onset definition shows earlier onset of seasonal rains, it differs considerably across regions, and has higher interannual variability, in comparison with the meteorological definition. Over Lilongwe, Mbeya and Lusaka, late meteorological onset with a weak positive and insignificant trend is observed. The CMIP6 model's representation of onset trend differs from reanalysis data, with inter‐model differences. Late meteorological onset is underestimated by GFDL‐CM4 and MPI while INM5, MPI and NorESM overestimate the observed earliest onset. The largest bias is shown by INM and MPI which simulate earliest and latest onset as 190 (07 January) and 206 (23 January) respectively. In addition, models often fail to simulate sufficient precipitation to produce onset for seed germination and crop development. The ACCESS model showed an insignificant trend (p value = 2) and later onset over Lilongwe, an insignificant trend (p value = 0.9) over Lusaka, and an earlier onset over Mbeya. Using the agricultural onset definition, over Bethlehem, all the models and the ERA5 reanalysis did not produce enough precipitation to meet onset conditions. We suggest that rainfall onset studies use several definitions or metrics of onset and that the choice of metric be informed by the research question. Using such an ensemble of onset metrics contributes to a better understanding of variability and uncertainties in agricultural productivity.