East Africa Research Articles

Antibiotic Residues in Animal Products from Some African Countries and Their Possible Impact on Human Health.

This review investigates the levels of antibiotic residues in animal products, types of antibiotics, and their possible impact on human health in Africa. The literature search involved the use of a systematic survey using data that were published from Africa from 2015 to 2024. The search terms used the Boolean operators with keywords such as antibiotics, antibiotic residues, antibiotics in animal products in Africa, and impact on human health. Only research conducted in Africa was used in the present study. The findings showed that the most prevalent groups of antibiotic residues were aminoglycoside, macrolides, β-lactams, fluoroquinolones, tetracyclines sulfonamides, and phenicols. Tetracycline showed the most prevalent antibiotic residue with 43% mostly from East Africa, followed by sulfonamides at 19%, and β-lactams at 16%; most of the antibiotic residue levels were higher than the World Health Organization permissible limit. Noncompliance with withdrawal periods and maximum residue limits for antibiotics used in food-producing animals may lead to negative outcomes such as allergic reactions, teratogenicity, carcinogenicity, microbiome alterations, and, most notably, antibiotic resistance. As a result, there is a need for constant monitoring of antibiotic residues in animal products in addition to the consideration of alternatives to antibiotics in order to avoid their health implications.

Farmer Managed Natural Regeneration and Community Development: An analysis of Impact in Selected Countries

Purpose: This paper explores the relationship between community development and Farmer-Managed Natural Regeneration (FMNR) as a strategy for resource conservation and community empowerment. It highlights how FMNR contributes to ecological sustainability and rural household livelihoods in selected countries in West and East Africa, including Niger, Ghana, Mali, Uganda, Tanzania, and Kenya. Methodology: A content review of FMNR practices was conducted, focusing on their adoption, spread, and impact on community development. The analysis emphasized economic empowerment, ecological sustainability, best practices, challenges, and mitigation strategies. Findings: The study found that FMNR enhances community livelihoods by promoting sustainable natural resource use and reducing environmental degradation. It strengthens community capacity for resource management and supports rural economic development. However, challenges such as land fragmentation, technological gaps, and limited adoption were noted. Unique Contribution to Theory, Practice and Policy: To scale up FMNR, stakeholders should prioritize community training, strengthen institutional frameworks, and provide policy support for sustainable resource management. Addressing technological and socio-economic barriers is essential to maximize FMNR's potential in improving livelihoods and achieving ecological sustainability.

The Impact of Exchange Rate and Inflation on Economic Growth: Empirical Evidence from the MENA region using Panel Data Analysis

The volatility of exchange rates and inflation represents a critical challenge to economic stability in the MENA (Middle East and North Africa) region. This study delves into the complex relationship between these macroeconomic factors and economic growth from 2000 to 2023, with a focus on providing actionable insights for policymakers. Using a panel dataset of nine MENA countries, the research employs Feasible Generalized Least Squares (FGLS) to address issues of heteroskedasticity, serial correlation, and cross-sectional dependence, offering a robust analysis of the dynamic interactions. The findings reveal that inflation significantly hampers GDP growth, confirming that rising inflation undermines investment and creates economic uncertainty. In contrast, a more competitive Real Effective Exchange Rate (REER) fosters economic growth by improving export competitiveness, especially in non-oil sectors. Interestingly, the analysis also highlights that imports have a positive effect on GDP growth, emphasizing their role in supporting domestic production through the provision of essential goods and technologies. This study calls for targeted policy measures in the MENA region to stabilize inflation, enhance exchange rate competitiveness, and diversify exports. Such strategies are essential for sustaining economic growth and ensuring long-term economic stability.

Two new species of Boaedon from Ethiopia and Somalia, with a review of the species of East Africa

We conducted a molecular study based on 112 mitochondrial 16S rRNA sequences, which revealed 20 monophyletic species-level groups in Africa, five of these in East and Northeast Africa. Based on genetic data, we describe two new species, B. broadleyi sp. nov. from Ethiopia and B. subniger sp. nov. from Somalia, and we elevate B. fuliginosus arabicus to full species level. We detected further morphologically divergent specimens that may represent a distinct taxon but refrain from a formal description due to insufficient data. The morphological variation of the recently described B. montanus from Central Africa is shown and discussed over its whole distribution area. Moreover, we provide a new country record for Sudan and South Sudan, namely of B. paralineatus. Finally, we provide an updated distribution map for all Boaedon species occurring in Northeast and East Africa.

Baseline infection prevalence, risk factors and treatment outcomes of visceral leishmaniasis in Northeastern Uganda: A cross-sectional study.

Visceral leishmaniasis (VL) also known as Kala-azar is one of the neglected tropical diseases (NTD) of public health importance. Despite being a disease of a long history, the condition remains poorly studied especially in East Africa. For instance, whereas, the geographical location of the disease is known, there is a stark paucity of data on the burden, risk factors and clinical outcomes of this contribution in Northeastern Uganda. Therefore, the disease picture in these settings is incomplete. The overarching aim for this study was to describe pre-elimination prevalence, associated factors and treatment outcomes of VL in Moroto District. We conducted a cross-sectional study in which community cases were identified at baseline. They were followed up at Amudat Hospital Kala-azar Treatment Centre for the treatment outcomes. We used a customized data collection tool to elicit data on demographic characteristics, socio-economic and anthropometry. Data were entered on excel database and exported to Stata software for analyses. Proportions and measures of central tendency were computed. Binary associations were determined using Chi-square statistical test. In addition, variables independently associated with VL were determined via logistic regression analyses. At follow up stage, the outcomes were determined. The overall prevalence of VL infection in Moroto district was 5.21% (95%CI: 3.15% - 8.48%) with varying county level prevalence at Matheniko, Tepeth and Mororo at 6.90%, 4.49% and 3.61%; respectively. The common risk factors for VL infection included lack of knowledge of habitat for Sand flies, AOR 5.33 (95%CI: 1.69-16.82). Patients with VL presented with fever, headache, abdominal pain and swelling, coughing, night sweats, diarrhea, fatigue, breathlessness, and nose bleeding. The average hospitalization for VL was 17 days. All the patients who were treated at the hospital cured. The prevalence of VL in Moroto district was 5.21% and within elimination threshold. The high-risk factors for VL infection included lack of knowledge about the habitat for Sand flies. The average hospitalization for VL was 17 days.

A new chemotype of <i>Cananga odorata</i> flowers for improved extraction of essential oils with bioeconomic perspectives in Eastern Africa

Due to its geographical position, Burundi benefits from several soil genesis factors and large variations in microclimates to which are added water resources, which give to Burundi a floral heritage of great diversity. This study therefore aimed to assess the physicochemical properties (density, refractive index, acid index and ester index) as well as the associated organoleptic characteristics (odor, color and appearance), of the essential oil extracted by hydrodistillation from fresh flowers of Annonaceae family tropical trees C. Odorata, a chemotype cultivated and grown in Bujumbura, Burundi. Analyses of physicochemical properties values were done and compared to reference values. It appears that for the refractive index, density and acid number, the findings of this study are within the pre-established standards. More interesting, the value of ester number was very beyond the norm by a factor of almost two, breaking the record already registered by AFNOR, therefore suggesting of an essential oil of exceptional quality. The findings presented in this study also highlight the importance of C. Odorata chemotype from the plains of Burundi as a promising potential candidate for bio-based products of public interests such as bio-based cosmetics and bio-based pharmaceuticals products, and therefore offer new insights bioeconomics in health and well-being. Finally, this plant can easily be cultivated, not only in Burundi, but also in countries of the Eastern Africa that share the same geoclimatic conditions as the Great African Rift.

The burden of prostate cancer in the North Africa and Middle East Region from 1990 to 2021

Prostate cancer ranks among the most prevalent malignancies affecting males globally. This study sought to document the incidence, deaths and disability-adjusted life-years (DALYs) that were due to prostate cancer in the Middle East and North Africa (MENA) region, and its 21 countries, from 1990 to 2021. We analysed publicly accessible data from the Global Burden of Disease 2021 study to present findings on the incidence, deaths, and disability-adjusted life years (DALYs) associated with prostate cancer. These metrics were reported as counts and age-standardised rates, each accompanied by 95% uncertainty intervals. In 2021, the age-standardised incidence of prostate cancer in the region was 27.4 per 100,000 population, representing a 125.1% increase from 1990. The age-standardised mortality rate was 10.1, and the age-standardised DALY rate was 173.6, neither of which showed significant increases since 1990. Qatar recorded the highest age-standardised DALY rate in 2021, while Algeria had the lowest. The largest number of incident cases, deaths, and DALYs in 2021 were found in the 65–69, 80–84, and 70–74 age groups, respectively. Additionally, from 1990 to 2021, the burden of prostate cancer largely increased with the socio-demographic index (SDI) at the regional level. The burden of prostate cancer in the MENA region rose markedly between 1990 and 2021. Further studies into the underlying causes of this increasing incidence are essential to devise effective strategies for the early detection and prevention of the disease.

Climate Change Challenges on Environmental and Sustainable Development

The environmental unsustainability becomes constantly aggressive Globally and that causes threats to human life and nature in general. Climate change consists of multivariant like storms, heatwaves, floods, and earthquakes and all these are caused by human pollution to the environment. Recently, the Eastern Africa in 2024 April was severely attack by the floods where humanitarian were the casualties. In Kenya over 300 people were reported dead while in Tanzania, Malawi, Mozambique, and Sudan was also very high number of fatalities. People lost their homes and belongings, while agricultural damages were also very severe and that resulted in food shortages. South Africa and Brazil were also affected by the floods which killed and caused damages. The KwaZulu-Natal floods were so strong where 139 Schools were destroyed and both industrial and residential were demolished. The purpose of this article is to identify the causes of climate change and how to ensure environmental sustainability to eradicate this threat. The most affected population in African countries are the rural villages as they don’t have quality household structures and infrastructures. Commonly, no household in rural villages is registered with the Deeds office in South Africa and again, they are not insured against natural disasters of this nature. There no such a thing of stormwater facilities and engineers in the rural villages. The methodology followed in this article is a pure reliable literature review analysis. The research employed non empirical research by deeply focusing on theoretical systematic and thematic analysis of literature. The findings of this research will contribute significantly to addressing the cause of aggressive climate change and to provide solution to sustainable rural villages living environment.

The Effect of Digitalization on Energy Trilemma in the MENA region

The Middle East and North Africa (MENA) region faces numerous challenges while ensuring energy security, affordability, and environmental sustainability. A wide range of studies suggest that digitalization, alongside efficient energy conversion technologies, can help address the three conflicting energy trilemma dimensions (i.e., energy security, affordability, and environmental sustainability) (Salah et al., 2022). The study will investigate the effect of digitalization on the energy trilemma dimensions individually and collectively by creating an energy trilemma index using the Principal component analysis (PCA). The study employed the generalized method of moment (GMM) for 11 MENA countries over the period 2000–2021 to investigate the effect of digitalization on the energy trilemma and its dimensions in the short run while employing the fully modified ordinary least squares (FMOLS) to investigate the same effect in the long run. The GMM results reveal that digitalization has an insignificant effect on the energy trilemma index and its three dimensions in the short run, while the FMOLS results reveal a positive effect of digitalization on the energy trilemma index and its three dimensions in the long run. These findings emphasize the paramount importance of digitalization in improving energy trilemma dimensions.

Sustainable Water Management Practices in Agriculture: The Case of East Africa

This study dives into the essential issue of sustainable water management techniques in East Africa. Recognizing water as a key component of sustainable agricultural development, the study highlights the importance of a complete approach that takes into account technological, socio-economic, and environmental issues. A detailed, comprehensive review of 109 scientific research articles published between 1993 and 2024 was conducted to acquire a thorough grasp of current sustainable water resource management techniques in East Africa. This in-depth investigation sought to uncover major regional trends, challenges, and opportunities in water resource management. Furthermore, the evaluation aimed to identify specific knowledge gaps impeding the region’s implementation of sustainable water management techniques. As East Africa faces rising problems from climatic variability and change, which have a direct impact on water availability and agricultural output, the need for comprehensive policies becomes clear. The review reveals significant gaps in previous research, including a lack of focus on the socio-economic consequences of water management methods, gender dynamics, long-term assessments, indigenous knowledge integration, and climate change adaptation. By highlighting these areas, the study emphasizes the necessity of future research in addressing these gaps and developing more effective and sustainable water management solutions for East Africa.

Current and future burden of female breast cancer in the Middle East and North Africa region using estimates from GLOBOCAN 2022.

Breast cancer is the most diagnosed female cancer and the most common cause of cancer death in women in the Middle East and North Africa (MENA) region. In this study, we aimed to describe the current patterns of breast cancer among women in the MENA region and estimate the burden for the year 2050. We used the estimates of the breast cancer incidence and mortality from the GLOBOCAN 2022 database and predicted the burden of breast cancer in 2050 according to different scenarios. With 118,200 new breast cancer cases and 41,000 deaths, breast cancer contributed to 25% of cancer incidence and almost 20% of cancer mortality among women in MENA. The highest incidence rates were in Algeria and Iraq (≥60/100,000) and the lowest rates in Saudi Arabia and Yemen (<30/100,000). The highest mortality rates were in Iraq, Syrian Arab Republic, Algeria, and Sudan (>20/100,000), and the lowest in Saudi Arabia (7.6/100,000). While the incidence rates were low compared to other world regions, the mortality rates (16.9/100,000) were higher than in any other world region except Sub-Saharan Africa. The incidence rates for women <50 years in MENA were 5.5 times lower than in women aged ≥50 years, and lower than for women <50 years in Western countries. By 2050, the burden of breast cancer is estimated to increase to 219,000 new cases and to 88,900 deaths (86% and 117%, respectively). Scaling up cancer control to curb the rising burden alongside improved surveillance is vital to develop targeted interventions and improving outcomes.

The dynamics of translation from and into Arabic in the Arab world: bibliometric analysis of the Index Translationum UNESCO database (1979–2012)

This bibliometric study aims to analyze the translated literature in the Arab nations that exhibit the highest levels of dynamism spanning from 1979–2012, using the Index Translationum database. Furthermore, it aims to determine the status of the Arabic language in the translation industry by identifying the most frequently translated Arabic works into other languages and the languages with the highest number of translations into Arabic. The study inclusion criteria consider several factors: the source language (Arabic), the target language (Arabic), the Arab nations included in The Index Translationum, and the foreign languages that are most frequently translated to and from Arabic. It is found that despite the rich history and extensive usage of the Arabic language in the Middle East and North Africa, it is ranked 29th among the top 50 languages for translated literature. However, it is noted that the Index, which makes it possible to observe the mapping of translation in the Arab world in accordance with specific parameters, provides no statistics on certain Arab countries beyond 2012. Therefore, the Index does not provide up-to-date information. Further, the ranking of Arab countries in the Index does not seem to align with the official data of certain countries such as Egypt, Lebanon, Saudi Arabia, and Algeria.

A thorny tale: The origin and diversification of Cirsium (Compositae).

Widely distributed plant genera offer insights into biogeographic processes and biodiversity. The Carduus-Cirsium group, with over 600 species in eight genera, is diverse across the Holarctic regions, especially in the Mediterranean Basin, Southwest Asia, Japan, and North America. Despite this diversity, evolutionary and biogeographic processes within the group, particularly for the genus Cirsium, remain underexplored. This study examines the biogeographic history and diversification of the group, focusing on Cirsium, using the largest molecular dataset for the group (299 plants from 251 taxa). Phylogenomic analyses based on 350 nuclear loci, derived from target capture sequencing, revealed highly resolved and consistent phylogenetic trees, with some incongruences likely due to hybridization and incomplete lineage sorting. Ancestral range estimations suggest that the Carduus-Cirsium group originated during the Late Miocene in the Western Palearctic, particularly in the Mediterranean, Eastern Europe, or Southwest Asia. A key dispersal event to tropical eastern Africa around 10.7 million years ago led to the genera Afrocarduus and Afrocirsium, which later diversified in the Afromontane region. The two subgenera of Cirsium-Lophiolepis and Cirsium-began diversifying around 7.2-7.3 million years ago in the Western Palearctic. During the Early Pliocene, diversification rates increased, with both subgenera dispersing to Southwest Asia, where extensive in situ diversification occurred. Rapid radiations in North America and Japan during the Pleistocene were triggered by jump-dispersals events from Asia, likely driven by geographic isolation and ecological specialization. This added further layers of complexity to the already challenging taxonomic classification of Cirsium.Keywords: Biogeography; Carduinae; Cirsium; Diversification; North Hemisphere; Target-enrichment; Taxonomy.

Marriage and Steady Relationships with Women in Men Who Have Sex with Men in Sub-Saharan Africa: A Mixed-Method Systematic Review and Meta-analyses.

High HIV prevalence in Sub-Saharan African (SSA) in men who have sex with men (MSM) leads to greater risk for their wives and other steady female partners because of prolonged exposure. To provide insights into the context possibly contributing to the risk of HIV transmission from MSM to women, our mixed-method synthesis about MSM' marriage and steady relationships with cisgender women aimed to: (i) assess the extent of engagement in steady relationships with women and in risky behaviors with these women across SSA's four regions; (ii) explore the underlying dynamics within these relationships by gathering qualitative information. We used quantitative and qualitative data specifically pertaining to related to marriage or other steady relationships with women from a systematic review on men who have sex with both men and women (MSMW) in SSA (PROSPERO-CRD42021237836). Meta-analyses were performed on quantitative data for each region. Pooled proportions were calculated using random-effects models. Qualitative data were analyzed using thematic synthesis. Data were selected from 125 studies. For Southern, East and West Africa, the estimated pooled proportions of married MSM were 4% (95% CI 2-8%; n = 10 studies; 4183 MSM), 8% (6-11%; 19; 7070), and 7% (6-9%; 13; 4705). In Southern Africa, 29% (11-56%; 5; 1667) of MSM had steady female partners. In East Africa, 34% (14-61%; 5; 2003) were currently or previously married to women. Motives to marry women included a desire to have children, and to conform to heteronormative social norms and family pressure. Marriage was seen as a means to discontinue homosexual behaviors or, conversely, a way to secretly continue same-sex behaviors more freely. Procreative intentions and a desire for secrecy often deterred MSM from using HIV prevention methods with their wives. For some MSM, steady relationships with women provided them with mutual support. However, these relationships could also lead to stressful and conflict-ridden situations, potentially resulting in psychosocial and HIV-related risks for the MSM as well as their male and steady female partners. Steady relationships with women are common in MSM in SSA. Sexuality concealment strategies with steady female partners depend on the circumstances that lead MSM to enter into these relationships, and have various implications on sexual behaviors with both male and female partners. Community-based support, HIV research, prevention, and care programs should be adapted to MSM's different life situations to reduce direct HIV transmission risk to steady female partners.

Transforming the chemotherapy of human African trypanosomiasis.

SUMMARYPrior to 2019, when the orally available drug fexinidazole began its clinical use, the treatment of human African trypanosomiasis (HAT) was complex and unsatisfactory for many reasons. Two sub-species of the Trypanosoma brucei parasite are responsible for HAT, namely the rhodesiense form found in East and Southern Africa and the gambiense form found in Central and West Africa. Diseases caused by both forms manifest in two stages: stage 1 before and stage 2 after central nervous system involvement. Prior to 2019, different drugs were required for each of the two parasite sub-species at each stage. Gambiense disease required pentamidine or nifurtimox-eflornithine combination therapy, while for rhodesiense disease, suramin or melarsoprol was given for stages 1 and 2, respectively. These drugs all suffered complications including protracted administration regimens involving multiple injections with drug-induced adverse effects common. Today, a single drug, fexinidazole, can be given orally in most cases for both diseases at either stage. Another compound, acoziborole, effective in both stages 1 and 2 gambiense disease with a single dosing is anticipated to become available within a few years. Moreover, the recent engagement of multilateral organizations in seeking other compounds that could be used in HAT therapy has also been successful, and a rich vein of new trypanocides has been discovered. Here, the clinical use, modes of action, and resistance risks for drugs used against HAT are discussed.

Persistence of Ancestral KhoeSan Mitochondrial Patterns in Contemporary South African Populations.

Southern Africa has been inhabited by hunter-gatherers for at least 20,000 years and has received diverse immigration flows in the last 2000 years. The original inhabitants have interacted with the pastoralist migrants from Eastern Africa (∼2000 ybp), followed by the southern Bantu migration arriving some 1000 ybp, and more recently with the European and Asian settlers after the 17th century. Many of the original Khoekhoe and San inhabitants have either become extinct or have disappeared through admixture in South Africa (SA), in a sex-biased manner involving KhoeSan women. In this study, we generated mitochondrial DNA (mtDNA) control region (CR) sequences for 247 South African individuals. The sampling effort was concentrated in regions and populations with historical links to the KhoeSan population groups: admixed (Coloured, Griqua), Nama (Khoekhoe) and Bantu in three provinces. Here we evaluate the composition and extent of connectivity between population groups and regions, and to assess the distribution of haplotypes for the practical application of mtDNA CR data in forensic identifications. The analysis of the newly generated sequences revealed 142 distinct haplotypes, of which 122 were unique. Haplogroup L0 was predominant (overall 71.7%). A high-frequency L0d2a haplotype dominated the pool of the admixed groups with 10%-12.5% incidence overall or per region. Comparative analysis with 545 extant mtDNA CR sequences from South African KhoeSan and admixed descendants revealed extensive population structure and high within-group haplotype sharing. The observed population and regional variations, combined with the prevalence of high-frequency haplotypes, align with patterns of matrilocality. These findings highlight the limitations of using mtDNA control region analysis for forensic applications in South Africa.

Practices and preferences in the use of magnification among endodontists and restorative dentists: A multicentre study.

Aim of the current study was to assess the perception, preference, and practice of endodontists and restorative dentists at different locations around the world about dental magnification instruments. A multicenter, cross-sectional study was ethically approved from the local committee of bioethics. After thorough literature search, a questionnaire was designed and validated. Later, the questionnaire was distributed to 10% (53 participants) of the total planned participants to conduct a pilot study. Based on the feedback from these participants, any ambiguities or discrepancies observed in the items and content of the questionnaire was modified. The questionnaire was assessed for its internal consistency as part of validating the items with Cronbach's alpha of 0.80. The completed questionnaire with an informed consent form for the participant was administered to the endodontists and restorative dentists in three different geographical regions namely MENA (Middle East and Northern Africa), British-Isles, and Indian Sub-continent using WhatsApp through the snowball convenience sampling technique. Majority of the participants were male (56.5%) and in the age group of 25-35 years (30.3%). About 68.9% were from Indian sub-continent, followed by the British-Isles (16.5%) and the least (14.6%) were from the MENA region. By large, the participants of the present study, strongly agreed that dental magnification devices improved ergonomics, quality of work, and should be considered as standard of care in modern endodontic. Flip-up magnifiers (51.1%) and medium (8x-16x) magnification were preferred by majority of the participants. About 46.3% of specialist reported that they always used devices for all operative and endodontic procedures, especially while locating hidden and canals and negotiating calcified canals. Participants practicing in British-Isles have 2.42 times (P<0.05) higher adequate perception with reference participants in Indian sub-continent. Additionally, participants with fellowship have 2.77 times more (P<0.01) adequate perception with reference to their counterparts with a master's degree. Most of the participants believe that dental magnification devices enhance the prognosis and quality of treatment of possibly all operative and endodontics procedures. Thus, emphasized on the inclusion of devices in the postgraduate curriculum and signifies the role of continuing dental education for specialist and dental assistant handling devices. However, multicenter studies with larger sample is required for generalizing the results.

Dementia incidence among a cohort of lebanese older adults: first incidence estimates from the Middle East and North Africa region.

To provide the first estimates of dementia incidence rates among elderly in Lebanon. The cohort established in 2013 consisted of 470 elderly from Beirut and Mount Lebanon, who consented to be followed-up. In 2017, we reached 341 participants/informants, achieving a response rate of 72.6%. The validated Arabic version of the 10/66 Dementia Research Group diagnostic tool was administered through face-to-face interviews. Direct age standardization was applied to the data using the Western European population distribution. Age-, sex- and location-specific incidence rates were estimated. After 3.5 years of follow up, 19 new cases of dementia were identified among 229 surviving participants. The crude incidence rate was 16.8 per 1,000 p-y, and the age standardized rate was 20.5 per 1,000 p-y. The incidence rate increased with age, going from 6.5 for those aged 65-74 years to 54.0 for those aged 85-89 years. Incidence rate was higher among females than males (20.7 vs.12.0), and higher in Mount Lebanon, as compared to the capital city Beirut (19.5 vs.14.9). Dementia incidence rate was close to European and North American countries' estimates. The use of validated tools increased the internal validity of our results. A large cohort study is warranted to confirm these results.

Exploring factors influencing childhood immunization status in East Africa using multilevel ordinal logistic regression analysis.

Childhood vaccinations are crucial in safeguarding children from infectious diseases and are recognized as one of the most cost-effective public health interventions. However, children in East African countries face more than a fifteen-fold increased risk of death from vaccine-preventable diseases compared to those in high-income nations. This study aimed to identify the factors influencing childhood immunization status in East Africa. A sample of 22,734 children aged 12 to 23 months was included to assess immunization status, utilizing recent data from the Demographic and Health Survey conducted between 2015 and 2022 across ten East African countries. A Level-3 multilevel generalized odds model with a logit link function was employed for the analysis. Among the 22,734 children in the sample, only 67.4% were fully immunized, 27.7% were partially immunized, and the remaining were not immunized at all. The null hypothesis of proportionality was rejected based on the Brant test. Consequently, various partial and non-proportional odds models were fitted, with the generalized odds model demonstrating the best fit compared to other ordinal regression models. The findings indicated that 43.14% of the variation in children's immunization status was attributable to differences between countries, while 18.18% was due to variations between regions. Specific factors associated with immunization status revealed that mothers who attended antenatal care were 1.23 times more likely to fully immunize their children compared to those who did not, and those who received postnatal care were 1.13 times more likely to do so. Additionally, mothers who had antenatal and postnatal services were 1.07 and 1.08 times more likely, respectively, to fully or partially immunize their children compared to those who did not. The fitted generalized odds model indicated that several factors significantly associated with childhood immunization status included maternal age, number of antenatal and postnatal care visits, tetanus injections received by mothers, vitamin A intake, presence of health documentation, place of delivery, birth order, mother's occupation, sex of the household head, distance to health facilities, maternal education, community maternal education, community wealth index, and community media exposure. Therefore, it is recommended that interventions focus on enhancing household wealth, educating mothers, and improving health systems.

Prevalence of Depression Among People Living with HIV on Antiretroviral Therapy in Africa: A Systematic Review and Meta-Analysis.

HIV is a global health issue, with the highest number of infected individuals found in sub-Saharan Africa. The coexistence of HIV with depression is a huge challenge. This study aimed to investigate the prevalence of depression in people living with HIV (PLWHIV) who are on antiretroviral therapy (ART) in Africa. PubMed, Scopus, and bibliographic screening were used to identify suitable literature. The study adhered to guidelines outlined by Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The Newcastle-Ottawa guideline was used to assess the quality of the included cross-sectional studies. Subgroup analysis and meta-regression were subsequently conducted following the meta-analyses, based on heterogeneity. A meta-analysis software online tool and Jamovi software (version 2.4.8.0) were used to analyse the data, and the results were presented as prevalence and 95% confidence intervals. Thirty-four cross-sectional studies identified from the databases were deemed relevant. The overall sample size was 21,143 PLWHIV on ART in African countries. The analysed data showed the prevalence of depression to be 36%, with 95% CI (27% to 40%), p < 0.01, in Africa. However, the subgroup showed that the highest prevalence was in Northern Africa, with a prevalence of 41% with 95% CI (20% to 50%), p < 0.01, followed by those in Southern and Eastern Africa, with a prevalence of 38% with 95% CI (27% to 49%) and 39% with 95% CI (26% to 50%), p < 0.01, respectively. The lowest prevalence was observed in Western Africa, with a prevalence of 20% with 95% CI (14% to 27%), p < 0.01. Our findings show that there is a higher prevalence of depression among PLWHIV who are on ART in Africa. It is crucial to correctly recognise and provide proper care for depression to optimise HIV treatment and enhance treatment adherence in this population.