Research In sub-Saharan Africa Research Articles

Household food insecurity in South Africa from 1999 to 2021: a metrics perspective.

To review and synthesize studies on household food security in South Africa. Systematic mapping review of metrics (methodological review). Electronic databases, including EBSCOHost, Scopus and Web of Science, were searched for studies and reports on household food security in South Africa, reporting household food security published between 1999 and 2021. Searching, selecting and reporting were performed according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) statement. South African households. Forty-eight articles reporting on six national surveys (one repeated annually since 2002) and forty sub-national studies meeting the inclusion criteria were selected. Various metrics, with different recall periods and ways of categorizing food security levels, were identified. Surveys that used similar metrics showed that the percentage of South African households that have experienced food insecurity and hunger has decreased over the review period yet remains concerning. However, the multitude of metrics used to assess the different components and levels of food security limits the comparability of the results to evaluate the scope and scale of the problem. There is growing support for developing multi-variable approaches for food security research in sub-Saharan Africa. Future research should focus on finding the most appropriate combination of complementary metrics that would allow comparable data while holistically capturing food security and providing insight into the causes and consequences.

Opportunities and challenges for decentralised clinical trials in sub-Saharan Africa: a qualitative study

IntroductionDigital health has gained traction in research and development, and clinical decision support systems. The COVID-19 pandemic accelerated the adoption of decentralised clinical trials (DCTs) as a mitigation and efficiency...

Beyond translations, perspectives for researchers to consider to enhance comprehension during consent processes for health research in sub-saharan Africa: a scoping review

BackgroundLiterature on issues relating to comprehension during the process of obtaining informed consent (IC) has largely focused on the challenges potential participants can face in understanding the IC documents, and the strategies used to enhance comprehension of those documents. In this review, we set out to describe the factors that have an impact on comprehension and the strategies used to enhance the IC process in sub-Saharan African countries.MethodsFrom November 2021 to January 2022, we conducted a literature search using a PRISMA tool. We searched electronic databases (PubMed, EMBASE, EBSCOHOST) to identify relevant peer reviewed studies. We then reviewed the references of these articles to find additional literature that might have been missed through the initial search. We were particularly interested in full text articles in English that focused on the IC process in SSA published between 2006 and 2020. We included systematic reviews, and studies from Western and Asian countries that included data about SSA. We excluded articles that focused on medical interventions and studies that did not require IC.ResultsOut of the 50 studies included most were multi-country (n = 13) followed by single country studies in South Africa (n = 12); Kenya, Tanzania, Uganda (n = 5) each; Gambia, Ghana and Nigeria (n = 2)each ; and one each for Botswana, Malawi, Mali, Mozambique. We identified three areas of focus: (1) socio-cultural factors affecting IC; (2) gaps in the ethical and legal frameworks guiding the IC process; and (3) strategies used to improve participants’ understanding of IC.ConclusionOur review showed wide recognition that the process of achieving IC in SSA is inherently challenging, and there are limitations in the strategies aimed at improving comprehension in IC. We suggest that there is a need for greater flexibility and negotiation with communities to ensure that the approach to IC is suited to the diverse socio-cultural contexts. We propose moving beyond the literal translations and technical language to understanding IC comprehension from the participants’ perspectives and the researchers’ views, while examining contextual factors that impact the IC process.

The role of an ethics advisory committee in data science research in sub-Saharan Africa.

The role of an ethics advisory committee in data science research in sub-Saharan Africa.

Trends and Challenges in Comprehensive Sex Education (CSE) Research in Sub-Saharan Africa: a Narrative Review.

Adolescent sexual and reproductive health remains a major public health challenge in Sub-Saharan Africa (SSA). Comprehensive sex education (CSE) has been hailed as a key strategy to inform young people about sexual health and wellbeing and prevent negative health outcomes. This paper presents an overview of the trends and challenges around sex education in SSA and puts forth key recommendations for future research and policy initiatives. This review employed a narrative approach to synthesize evidence on the implementation of comprehensive sex education in SSA. The literature review elicited four key themes: (i) comprehensiveness of CSE curricula, (ii) gender norms in CSE, (iii) prominence of 'fear' narratives in CSE implementation, and (iv) CSE delivery methods. Additionally, the authors propose a fifth theme-'Future-proofing CSE programs', based on their learnings from implementing sex education interventions during the COVID-19 pandemic. These five themes are presented through a narrative description of current research accompanied by reflections from the authors on the implementation of a parent-focused sex education program in Uganda. Based on the insights from the literature review and the authors' reflections, three recommendations are put forward to guide the design of further CSE initiatives: (i) stakeholder engagement in determining CSE priorities and strategies, (ii) diverse delivery pathways for CSE programs, and (iii) active engagement of both boys and girls to challenge gender norms in CSE.

Bibliometric trends of geopolymer research in Sub-Saharan Africa

In recent years, geopolymers have been widely utilized as a potential alternative to ordinary Portland cement (OPC) to address issues related to CO2 emissions and solid waste management. Unlike OPC, the mix design of geopolymers involves different parameters such as aluminosilicate precursors, alkaline activators, curing conditions, silica/alumina ratio, and liquid/binder ratio, to achieve satisfactory mechanical and structural properties. However, little is known about the trends and development of geopolymer research in Sub-Saharan Africa. Therefore, this study aims to examine the bibliometric status quo to understand the evolution and progress of geopolymer research in Sub-Saharan Africa (SSA) in the last 10 years. Scopus database and VOSviewer software were used for bibliometric data retrieval and network visualization. A total of 251 publications were retrieved from Scopus and showed steady growth from 2012 to 2022. It is found that the Construction and Building Materials journal (impact factor of 7.693 and h-index of 198) is the leading publication source having 41 publications and 1488 citations. The top journals in terms of average citation per publication are Ceramics International (n = 53.22), Construction and Building Materials (n = 36.29), and Cement and Concrete Composites (n = 36.2). Keywords with the highest occurrences are geopolymers, inorganic polymers, and compressive strength. Authors with the highest number of publications are Elie Kamseu (n = 56), Cyriaque Rodrigue Kaze (n = 37), and Herve Kouamo Tchakoute (n = 34) whilst those with the highest average citation per publication are Antoine Elimbi (n = 68.5), Patrick Lemougna (n = 44.36), and Uphie Chinje Melo (n = 33.4). The SSA countries with the highest number of publications are Cameroon (n = 117), Nigeria (n = 58), and South Africa (n = 44) contributing 45.45%, 22.57%, and 17.12% of the total publications, respectively. Compared to global publication trends, geopolymer research remains underexplored in SSA contributing less than 4.3% of worldwide geopolymer publications. Therefore, this bibliometric study provides insights into the scientific agenda and evolution status of geopolymer research in SSA to foster and identify future collaborative research areas and help address CO2 emissions and solid waste management concerns in the built environment which is in line with circularity and sustainable development goals number 9, 11, 12, and 13.

Multiple Sclerosis Research Across the African Continent: A Systematic Review (P5-3.002)

<h3>Objective:</h3> To summarize the contemporary state of MS research across the African continent and to identify knowledge gaps from the current research landscape. <h3>Background:</h3> MS remains considered a rare neurological disorder among African populations, despite the fact that original MS research based in African countries is extremely limited or non-existent. <h3>Design/Methods:</h3> Boolean searches on the PubMed, SCOPUS and Embase databases were conducted for articles published from 1990 to February 2022. Two reviewers evaluated the title and abstract of each identified record for inclusion based on pre-defined eligibility criteria. Discrepancies between reviewers were resolved by discussion until consensus was reached. Full-text review and data extraction were conducted by a single reviewer for all articles which passed the initial title and abstract screening process. <h3>Results:</h3> After removal of duplicates, 2491 records were initially identified and underwent screening. 332 records were then selected for full-text review and 251 were deemed eligible for inclusion. The majority of included studies were from the Northern African region (<i>n</i>=204; 81%), particularly from Egypt (<i>n</i>=166; 66%), and had a case-control study design (<i>n</i>=145; 58%). Studies based in Egypt, Tunisia and South Africa accounted for ≥90% of included studies. Over 50% (<i>n</i>=150) of selected studies were published from 2016–2022, highlighting the substantial increase in research output in recent years. Studies investigating the utility of diagnostic tools (i.e. blood/serum biomarkers and neuroimaging technology) were most common (<i>n</i>=105; 42%), followed by studies investigating MS risk factors (<i>n</i>=41; 16%). <h3>Conclusions:</h3> The majority of MS research from the African continent comes from only a few countries with virtually no data from the majority of African countries. Notable gaps and barriers in our knowledge of the burden of MS in Africa remain, and further efforts to promote clinical and epidemiological MS research in sub-Saharan Africa are needed to improve our understanding of the burden of MS amongst African patients. <b>Disclosure:</b> Mr. Hwang has nothing to disclose. The institution of Dr. George has received research support from Biogen. Dr. Garcia-Dominguez has nothing to disclose. Dr. Salasky has nothing to disclose. The institution of Dr. Vishnevetsky has received research support from National MS Society. The institution of Dr. Vishnevetsky has received research support from NIH (NeuroNext). Dr. Miskin has nothing to disclose. Andy Tran has nothing to disclose. Dr. Chiluba has nothing to disclose. The institution of Dr. Saylor has received research support from National Institutes of Health. The institution of Dr. Saylor has received research support from National Multiple Sclerosis Society. The institution of Dr. Saylor has received research support from American Academy of Neurology. The institution of Dr. Saylor has received research support from United States Department of State. Dr. Saylor has a non-compensated relationship as a Member of multiple committees and task forces focused on improving access to MS medications to people across the world with Multiple Sclerosis International Federation that is relevant to AAN interests or activities. Dr. Saylor has a non-compensated relationship as a Member of the Neurology and COVID19 committee with World Health Organization that is relevant to AAN interests or activities. Dr. Saylor has a non-compensated relationship as a Member of the International Outreach Committee, Junior and Early Career Membership Committee, and Educational Innovation Commitees with American Neurological Association that is relevant to AAN interests or activities.

"Strengthening research and partnerships for Sub-Saharan health"

In sub-Saharan Africa, infectious diseases are causing illness, death and impacting income, education and economic growth and development. There is a need for global action. The European and Developing Countries Clinical Trials Partnership (EDCTP) supports global health research in sub-Saharan Africa and the United Nations Sustainable Development Goals (SDGs). It does this by funding clinical research for medical tools to detect, treat and prevent poverty-related infectious diseases in sub-Saharan Africa. EDCTP1 supported clinical trials on drugs, vaccines, microbicides and diagnostics, with a focus on HIV/ AIDS, tuberculosis and malaria. EDCTP2 was set up in 2014 and will run until 2024. It is supported by Horizon 2020 and will advance international and national health policy and practise for poverty-related diseases. The Global Health EDCTP3 Joint Undertaking (GH EDCTP3 JU) was launched in May 2022 and will run until the end of 2031. At its launch, Commissioner Mariya Gabriel delivered an opening speech in which she celebrated the progress made by EDCTP to date. 'So far, we have jointly invested over 1.4 billion euros in 440 grants, including 140 clinical trials projects and over 210 fellowships' she said. Impacts include a malaria vaccine for children and a child-friendly tablet formulation of the medication to treat the acute and chronic disease caused by parasitic worms. Gabriel said that four EDCTP Regional Networks of Excellence have been established in order to facilitate high-quality clinical research and networking and praised EDCTP's resiliency through the COVID-19 pandemic.

The role of developmental ‘buzzwords’ in the international refugee regime: Self-reliance, resilience, and economic inclusion

Buzzwords play an important role in setting up the scope and direction of aid policies. Alongside the growing focus on development-led approaches in the international refugee regime, three buzzwords – self-reliance, resilience, and economic inclusion – have achieved particular prominence in recent refugee policy-making. Drawing upon a review of policy documents and multi-sited empirical research in Sub-Saharan Africa, this article gives a detailed analysis of how these buzzwords intersect with one another and elucidates the roles they play in shaping development-oriented approaches to refugees. While this trifecta is painted with positive connotations, empirical research shows that developmental approaches underpinned by these buzzwords can have detrimental effects on both refugees and hosts. Building upon this analysis, it offers a theoretical approach to understand the current mainstreaming of developmental support within the international refugee regime from a lens of ‘reframing’, which is a strategy to redefine social problems and thereby control discourses around their solutions. The study shows that as a discursive apparatus, this triad of buzzwords is instrumentalised by policymakers to reframe the absence of solutions for ‘displacement crisis’ as ‘development opportunities’ in order to protect the damaged global refugee system. In so doing, such buzzwords play a crucial role in redefining the responsibility of refugees and their hosts in undertaking neoliberal development, while simultaneously reducing the ambit of responsibility of the international refugee regime. By analysing these popular buzzwords as a set, the article contributes to a deepened understanding of the ways in which these innocuous words are embedded in a broader ‘ideological project’ informed by the political and economic incentives of the global policymakers. It also sheds light on the possible wider consequences of the current mainstreaming of development-led approaches for refugee rights and protection issues.

Mapping and assessing ecosystem services for sustainable policy and decision-making in Eritrea

The mapping and assessment of ecosystems and their services (MAES) is key to inform sustainable policy and decision-making at national and sub-national levels. Responding to the paucity of research in sub-Saharan Africa, we conduct a pilot study for Eritrea that aims to map and assess the temporal dynamics of key ecosystems and their services. We reviewed policy and legal documents, analyzed land cover changes and estimated the potential for ecosystem services supply through an expert-based matrix approach. Our results showed that from 2015 to 2019, the potential supply of the ecosystem services analyzed (e.g., crop provisioning, water supply and recreation) increased, with the exception of wood supply. Overall, our study presents policy-relevant insights as to where to conserve, develop, or restore ecosystem services supply in Eritrea. Our approach is transferable to similar data scarce contexts and can thereby support policies toward more sustainable land development for people and nature.

Multimorbidity research in Sub-Saharan Africa: Proceedings of an interdisciplinary workshop

As life expectancies rise globally, the number of people living with multiple chronic health conditions – commonly referred to as ‘multimorbidity’ – is rising. Multimorbidity has been recognised as especially challenging to respond to in countries whose health systems are under-funded, fragmented, and designed primarily for acute care, including in sub-Saharan Africa. A growing body of research in sub-Saharan Africa has sought to better understand the particular challenges multimorbidity poses in the region and to develop context-sensitive responses. However, with multimorbidity still crystallising as a subject of enquiry, there remains considerable heterogeneity in conceptualising multimorbidity across disciplines and fields, hindering coordinated action. In June 2022, 60 researchers, practitioners, and stakeholders with regional expertise from nine sub-Saharan African countries gathered in Blantyre, Malawi to discuss ongoing multimorbidity research across the region. Drawing on insights from disciplines including epidemiology, public health, clinical medicine, anthropology, history, and sociology, participants critically considered the meaning, singular potential, and limitations of the concept of multimorbidity in sub-Saharan Africa. The workshop emphasised the need to move beyond a disease-centred concept of multimorbidity to one foregrounding patients’ values, needs, and social context; the importance of foregrounding structures and systems rather than behaviour and lifestyles; the value of a flexible (rather than standard) definition of multimorbidity; and the need to leverage local knowledge, expertise, resources, and infrastructure. The workshop further served as a platform for exploring opportunities for training, writing, and ongoing collaboration.

Financing and Resourcing International Collaboration in African Higher Education

This article discusses the financing of international collaboration in African higher education. It notes that mutual aid and the public good are slowly being embraced as the rationale for international collaboration. Drawing on a critical perspective, the article discusses the modalities and effectiveness of resourcing international collaboration which is generally seen as a panacea to revitalise higher education research in subSaharan Africa. Collaboration between Africa and Global North countries manifests in international partnerships for research, student and staff mobility, teaching, and funding. While most collaborations have tended to be dominated by Global North partners, South-South collaborations are increasingly taking centre stage. Emerging issues in international collaboration are also identified and the article notes that, in general, the politics of power and control still characterise both North-South and South-South international collaborations.

Strengthening ethics committees for health-related research in sub-Saharan Africa: a scoping review

ObjectiveHealth-related research in sub-Saharan Africa (SSA) has grown over the years. However, concerns have been raised about the state of research ethics committees (RECs). This scoping review examines the literature...

Advancing global health and the sustainable development goals through transdisciplinary research and equitable publication practices

Advancing global health and the sustainable development goals through transdisciplinary research and equitable publication practices

Review of methodologies for research uptake in eco-health projects conducted in rural communities in Sub-Saharan Africa

This review analyses research uptake methods which have been used by researchers in sub-Saharan Africa to determine which methods are effective for communities. The key area of thestudy is research uptake methods applicable at rural community level. The study analyses howeffective these methods are in getting research findings adopted by the community, stirringbehaviour change and raising awareness about a problem. The review makes recommendationsfor research projects that seek to conduct research uptake in the rural areas of sub-Saharan Africa.A systematic search for articles was done using Medline, PubMed and Google Scholar. Articleson the uptake of eco-health research findings at a community level were screened and analysedusing narrative synthesis. Results showed that strategies involving media, educational materialsand interpersonal communication with the communities worked most effectively. Some examplesof these were use of radio programmes, film productions, community theatre, field workers,community meetings, educational programmes, peer education and point of care displays. Thestudy concluded that to enhance research uptake in communities, innovative methods whichcapture the context of the communities involved need to be used. Selected strategies should usethe eco-health approach, engage the community and incorporate indigenous knowledge systems.

Recommendations from Cardiovascular Disease Research in Sub-Saharan Africa; A Literature Review

Cardiovascular diseases (CVDs) in sub-Saharan Africa (SSA) have been a major challenge over the past decade. This has increased the mortality rate amongst the indigenous people of the sub-region. It is expected that this constant CVDs increase could result in an eminent epidemic and lead to high regional burdens due to the high number of Low-middle income countries in the SSA. Despite this, there is, however a low level of literature and research focus on CVDs in SSA, and this has created difficulty in advancing knowledge in this field and hence policy makers and the scientific community are less informed in their quest to fight against CVDs in SSA. This study is aimed at reviewing selected publications on CVDs in SSA to identify important trends and recommendations that could guide stake holders in properly developing the right strategies in reducing CVDs in SSA. The study identified an eminent epidemic of CVDs in SSA and recommends that all stake holders come on board the fight against CVDs. It is expected that the information provided in this review can serve as a guide for future research towards improved management of CVDs. Keywords: Africa, Cardio diseases, Health, Non-communicable.

Twenty years of Prevention of Mother to Child HIV Transmission: research to implementation at a national referral hospital in Uganda.

Over 90% of new paediatric HIV infections are acquired through mother to child transmission. Prevention of mother to child HIV transmission (PMTCT) research in sub-Saharan Africa informed WHO guidelines which enabled implementation of PMTCT programs globally. To describe Makerere University-Johns Hopkins University (MU-JHU) perinatal HIV prevention research and implementation of the Mulago National Referral Hospital (MNRH) PMTCT program. Perinatal HIV prevention studies conducted at MU-JHU between 1997-2016 were summarized. Program aggregated data was extracted and analyzed using STATA 15. In 1999, the HIVNET 012 study demonstrated that single-dose nevirapine (sdNVP) to the mother at onset of labor and to her newborn, reduced MTCT by nearly 50%. In 2016, the PROMISE study documented the safety and efficacy of ART during pregnancy and breastfeeding period. Program implementation at MNRH started in 2000. Uptake of HIV testing increased from 70% to 99% from 2006 onwards. sd NVP was the initial ARV regimen but by 2012, MOH recommended Option B+(triple therapy). MTCT rates reduced from 16.9% in 2001 to 2.3% in 2020. Perinatal HIV prevention clinical trials conducted at MU-JHU provided evidence to inform WHO PMTCT guidelines. MNRH program evaluation demonstrated the significant decline in MTCT rates over the last two decades.

Human Rights Implications of Stroke Biobanking and Genomics Research in Sub-Saharan Africa

Abstract Stroke is a major cause of death in Sub-Saharan Africa (ssa) and genetic factors appear to play a part in its pathogenesis. This led to the development of stroke biobanking and genomics research in ssa. Existing stroke studies have focused on causes, incidence rates, fatalities and effects. However, scant attention has been paid to the legal issues about stroke biobanking and genomics research in the sub-region. Therefore, this article examines the legal implications of stroke biobanking and genomics research in Sub-Saharan Africa from a human rights perspective. The study argues that the right to dignity of the human person, the right to privacy, the right to freedom of information, the right to freedom from discrimination, the right to own property, the right to self-determination and the right to health may be implicated. The study concludes that the court may have to be involved in balancing one right against the other which may prove somewhat herculean depending on the circumstances of each case.

Skills Capacity Building For Health Care Services and Research Through the Sickle Pan African Research Consortium.

Skills development, the building of human capacity, is key to any sustainable capacity building effort, however, such undertakings require adaptable and tailored strategies. The Sickle Pan-African Research Consortium (SPARCo) is building capacity in sickle cell disease (SCD) management and research in sub-Saharan Africa, including a multi-national SCD patient registry, this is underpinned by skills development activities in data, research, and SCD management. Method: The SPARCo Skills Working Group was set up with the mandate of coordinating skills development activities across the three SPARCo sites in Ghana, Nigeria and Tanzania. To tailor activities to the requirements of the consortium, a needs assessment was conducted at the start of the project which identified skills required for SCD management and research and catalogued existing external and internal training programmes. The needs assessment highlighted differences in skill levels between the sites and different organisational structures which required tailored skills development activities at individual, site and consortium levels. Strategy: Based on the needs and the resources available, different types of training activities were implemented: these included online, blended and face to face activities. In order to create a sustainable skills development programme, existing short, medium, long-term, on-job training activities were used wherever possible. World Sickle Cell Day (19th June) was leveraged for training and health education activities. Results: SPARCo has recorded 1,726 participants in skills development activities across the three sites. Skills have been enhanced in data management, SCD and research to underpin the core deliverables of SPARCo. Conclusion and Lessons Learned: The baseline needs assessments and continual review and adjustment were critical for development of an effective skill development strategy for the consortium. This adaptability was particularly valuable during the COVID-19 pandemic. The sustainability plan leveraged existing programmes and activities and has created a pool of people with required skills for health care and research in SCD. To be effective, skills development programmes need to take into account existing capacity, training opportunities and local conditions. The model was applied to SCD and is adaptable to other skills development in healthcare and research in low and middle- income countries.

Community engagement in research in sub-Saharan Africa: approaches, barriers, facilitators, ethical considerations and the role of gender - a systematic review protocol.

IntroductionMeaningful community engagement (CE) is increasingly being considered the major determinant of successful research, innovation and intervention uptake. Community leaders, policy makers and funders have expressed the need to engage communities in research. CE in research empowers the host community to participate in addressing its own health needs and health disparities while ensuring that researchers understand community priorities. Thus, appropriate CE opens a unique way to promote coproduction, coimplementation and coevaluation, which may strengthen both the sense of inclusion, ownership and the effectiveness of the research life-cycle. The aim of this review is to synthesise available evidence on how to engage communities in research in a gender-sensitive, ethical, culture-appropriate and sustainable way in sub-Saharan Africa (SSA). This protocol has been developed following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols and follows the guidance provided by the Cochrane Handbook for Systematic Reviews.Methods and analysisA combination of key text words and medical subject headings such as ‘Community Engagement’ or ‘Community Involvement’ will be used to search 009 databases for all literature published between 1 January 2000 and 31 July 2021. Citations retrieved from database searches will be exported into EndNote X9 to remove duplicate citations and imported into Rayyan QCRI for screening. Two independent reviewers will conduct the screening and data extraction process. Disagreements between review authors will be resolved through discussions, consensus a third reviewer serving as a tiebreaker. The risk of bias will be assessed using the 10-item Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research. The three-staged process described by Thomas and Harden will be used for the thematic and narrative synthesis of findings.Ethics and disseminationThis is a systematic review which uses already collected data thus ethical approval not required. Findings will be published in an open access peer-reviewed journal and presented in relevant conferences and workshops.PROSPERO registration numberThis protocol has been submitted for registration in PROSPERO and has been published under registration number CRD42021282503.