Prevalence and determinants of full immunization among children under five in sub-Saharan Africa: A systematic review and meta-analysis (2013-2025).

ABSTRACT Persons with disabilities face a lack of economic opportunities and challenges with inclusion in the workplace. Their challenges are more profound in developing countries, especially in Sub-Saharan Africa, denying them the opportunity to contribute to their personal development and communities. Despite increasing interest in the subject, comparative studies covering Ethiopia, Somalia, and South Sudan remain limited. Hence, this study attempted to explore workplace inclusivity in the three East African countries, employing an action research method and a systems approach. It deployed key informant interviews, workshops, focus group discussions, and document review to collect information from persons with disabilities and key stakeholders. The study identified challenges to inclusive workplaces, such as negative attitudes towards disability, insufficient inclusivity in workplaces and communities, a lack of supportive policies and financing, and poor leadership. It also highlighted opportunities for progress in promoting inclusive workplaces, including raising awareness, enhancing legislative support, increasing investment in inclusivity, and expanding training. The study highlights systems theory as a key framework in disability studies, enabling structured analysis of inclusion barriers and actionable guidance for stakeholders, and advocating for intersectional and context-specific research to advance inclusive, equitable, and sustainable workplaces for persons with disabilities.

Purpose This study examined the effect of health expenditure on income inequality in sub-Saharan Africa (SSA) using data for 30 SSA countries covering the period 2007 to 2022. Design/methodology/approach The study employed the fixed effect estimator with Driscoll and Kraay standard errors. A sensitivity analysis was conducted involving an estimation for the aggregate sample and a sub-sample of low-income and middle income countries. Three measures of health expenditure such as out of pocket health expenditure, private health expenditure and public health expenditure were considered. Findings The results showed that out of pocket expenditure and private health expenditure significantly increased income inequality while public health expenditure had a significant reduction effect. The results are consistent for both the aggregate sample and the sub-sample of middle-income countries. It was also similar to the results for the case of low-income countries except for the effect of out of pocket expenditure which was not significant. Originality/value This study considered three measures of health expenditure in order to determine their differential effect. This study accounted for possible heterogeneity by considering the sensitivity of the samples used. It therefore established the case for low- and middle-income countries separately.

Long COVID is a condition characterized by persistent symptoms of COVID-19 that continue to occur in patients after apparent recovery. Given that, these symptoms may vary from person to person due to clinical, demographic, and genetic factors as well as comorbidities, our review aims to identify and analyze risk factors associated with persistent symptoms of COVID-19 (long COVID) in the specific context of sub-Saharan Africa. Article searches were conducted in the PubMed, Scopus, African Journals Online (AJOL), Science Direct and Google Scholar databases using the keywords "long COVID" or "long-term COVID-19" or "post-COVID condition" or "post-acute sequelae of COVID-19" and "sub-Saharan Africa" or "sub-Saharan Africans". The obtained data were entered into software for duplication checking. Two reviewers selected and extracted the data. Due to substantial heterogeneity in definitions and study designs, a narrative synthesis approach was adopted. Fifteen studies were included in this review, totaling 8,233 participants previously infected with SARS-CoV-2, with approximately 2,011 patients with long COVID from six countries. Six studies were cross-sectional, three were retrospective, three were cohort studies, two were case-control, and one was a case report. The review found that the prevalence of long COVID in sub-Saharan Africa ranged from 2% in Ghana to 66.7% in South Africa. The persistent COVID-19 symptoms most commonly experienced by people living in sub-Saharan Africa were fatigue (reported in 12 studies, 25-66% of patients), cough (7 studies, 9-86%), chest pain (9 studies, 9%-29%), dyspnea (10 studies, 15-45%), palpitations (4 studies, 10-30%), headache (9 studies, 12-38%), and cognitive impairment (6 studies, 8-20%). The main risk factors for the occurrence of persistent COVID-19 symptoms were older age (˃ 60 years), female sex, low education level, hypertension, type 2 diabetes, cardiovascular disease, length of hospitalization during the acute episode, number of initial COVID-19 symptoms, and initial disease severity. Long COVID is a reality in sub-Saharan Africa. Fatigue and hypertension have proven to be the most common symptom and risk factor, respectively. The heterogeneity of long COVID definitions across studies limits direct prevalence comparisons. Given the socio-economic challenges, pre-existing comorbidities and differences in health systems in the sub-Saharan region, it is therefore necessary to develop new strategies for care, rehabilitation and treatment (specific to the realities of the sub-Saharan region) targeted at each persistent symptom of COVID-19 in order to resolve this emerging problem and allow patients to have a good quality of life. Not applicable.

Tracing HIV treatment clients who have interrupted or disengaged from care is a common, guideline-recommended practice globally. Most guidelines prioritize tracing based on clinical condition or HIV transmission risk, not likelihood of client traits that may affect return to care after tracing. Targeting tracing to those most likely to return could increase efficiency substantially. We conducted a systematic review to identify characteristics of clients most likely to return after tracing. We searched PubMed, EMBASE, and Web of Science for studies published between 1/2004 and 7/2025 that reported outcomes of tracing interventions in sub-Saharan Africa. Eligible studies reported characteristics of clients who interrupted care, were eligible for a tracing intervention with the intent to return them to care (i.e., not solely research to determine client outcomes after interruption) and were subsequently traced or had tracing attempted. Our primary outcome was client characteristics associated with return to care after tracing, compared to those who did not return after tracing or attempted tracing. We identified 13,208 articles; 9 met the inclusion criteria. Older age and female sex were the most consistent predictors of return after tracing. Earlier tracing (relative to last missed visit) was associated with return in 3 studies; 1 found the opposite. Frequent contact attempts, rural location, and psychosocial factors (stigma, disclosure) were also associated with return. Clinical characteristics (CD4 counts and WHO stage) showed mixed or null associations with tracing effectiveness. Characteristics of clients who return to care after tracing, compared to those who are traced or for whom tracing is attempted and do not return, are rarely reported, making it difficult to evaluate this intervention. Using a "high-benefit" approach to targeting tracing-i.e., prioritizing based on likely benefit generated by a successful response, rather than clinical need-may potentially improve the efficiency of HIV programming.

Maternal malaria and its sequelae, including maternal mortality and neonatal infection, represent a growing public health crisis in Sub-Saharan Africa, often exacerbated by underlying socioeconomic factors. The study seeks to assess the associations between maternal socioeconomic indicators, maternal malaria, and neonatal peripheral parasitaemia in a Nigerian hospital. A cross-sectional analysis of 85 mother-infant pairs was conducted at a hospital in Osogbo, Osun state, Nigeria. Well-structured questionnaires were used to collect maternal demographics, socioeconomic indicators, and preventive practices. Mother, cord blood, and neonatal peripheral blood samples were collected for parasitemia through microscopy. Descriptive statistics, Fisher exact and chi-square tests were used for categorical variables, and univariate logistic regression for continuous predictors. The prevalence of neonatal peripheral parasitemia was 8.2% (7/85). Maternal parasitemia strongly predicted neonatal infection. All positive neonates were born to mothers with positive microscopy (7/19), whereas no neonates from parasitemia negative mothers were infected (p < 0.001). No statistically significant associations were found between neonatal parasitemia and maternal education (p = 0.912), occupation (p = 0.183), insecticide treated net use (p = 0.413), or intermittent preventive therapy uptake (p = 1.000). The present study revealed maternal parasitemia as a primary risk factor for neonatal malaria. While socioeconomic factors showed no significant association in this small cohort, these preliminary findings highlighted the need for larger studies with refined socioeconomic measures to fully elucidate these relationships. This highlights the critical need for strengthening antenatal malaria screening, ensuring timely treatment of maternal infection, and enhancing community-based malaria education to reduce vertical transmission in high-burden regions like Osun State, Nigeria.

Sub-Saharan Africa (SSA) faces persistent challenges in achieving sustainable agricultural production and food and nutrition security. Traditional farming methods, climate change, poor infrastructure, obsolete technology, declining resources, and limited access to finance and markets, are factors exacerbating these problems. Meanwhile, availability of reliable and accurate data is crucial for efficient resource allocation and management in critical sectors of developing countries, including agriculture. In countries where resources are scarce, efficient resource use will not only reduce waste but also ensure appropriate prioritization of the countries’ developmental needs. Development will forever remain a mirage in countries where there are no accurate data to learn from the past, manage the present sustainably, and understand the future trajectories of problems and prospects for accelerated progress in key sectors. This paper adopts a nuanced approach to explore how accurate agricultural data and innovation jointly influence food security in Africa. The methodology follows a multistage process, beginning with an extensive search of peer-reviewed journals, policy documents, and regional case studies to establish a rigorous evidence base. It then provides careful contextualisation, drawing on credible sources and relevant examples within and beyond Africa to clarify key concepts and terminologies. Through this approach, the study identifies the core problem, unravels knowledge gaps, and highlights issues often overlooked in the literature. In SSA, data-driven innovations have been documented to assist in strengthening resilience against climate shocks and other agriculture-related risks through the facilitation of tailored advisory services, predictive analytics and early warning systems. The availability and accessibility of technologies that combine weather forecasts, soil data, and historical yield trends can help farmers to be proactive in planning for climatic risks, optimizing planting schedules, and improving crop yields. Also, data-enabled platforms are transforming access to credit and insurance through digital profiling and risk assessment models that evaluate farm-level data to determine creditworthiness and underwrite agricultural insurance more effectively. Thus, data-driven approaches leveraging advances in technology such as remote sensing, mobile platforms, big data analytics, and precision agriculture offer transformative opportunities in these countries. The productivity improvement and social inclusion objectives of the government and relevant stakeholders can only be achieved with accurate and timely data. The paper concludes by highlighting the prime place of data-driven innovation in agricultural sustainability for improved nutrition and food security as well as the key initiatives and policy re-engineering required to transform African food systems in general. Key words: Data, Africa, Sustainability, Agriculture, Digital technology, Food security

Prevalence and associated factors of hypertension among adults in Sub-Saharan Africa: a systematic review and meta-analysis of community-based studies.

This study examines how non-governmental organizations (NGOs) in Uganda navigated the dual health crises of Ebola and COVID-19, focusing on the crisis management strategies and resilience-building mechanisms employed to sustain operations and deliver essential health services. The research seeks to understand how organizational structures, leadership approaches, and community engagement contributed to adaptive capacity in the face of severe public health disruptions. A qualitative research design was employed, involving in-depth, semi-structured interviews with 30 program managers and emergency response coordinators from leading NGOs, including BRAC, AMREF, and the Uganda Red Cross. Data were analyzed using thematic analysis, guided by a resilience and crisis management framework, to identify patterns and strategies relevant to health emergency contexts. The analysis revealed five core strategies underpinning resilience: (1) preparedness and early warning systems that enabled rapid mobilization and proactive risk mapping, (2) adaptive leadership and decentralized decision-making that ensured timely, context-specific responses, (3) resource mobilization and partnership networks that leveraged local and international collaborations for operational continuity, (4) staff well-being and psychosocial support mechanisms that maintained workforce motivation and safety, and (5) organizational learning and post-crisis adaptation, where lessons from previous outbreaks strengthened agility and coordination with government and international health agencies. The findings provide actionable insights for NGOs, policymakers, and global health actors on integrating resilience principles into health crisis management. Strengthening local partnerships, embedding flexible operational structures, and investing in staff well-being are critical to maintaining service continuity in resource-limited settings during public health emergencies. This study is among the first to provide a comparative qualitative analysis of NGO crisis management practices across two major infectious disease outbreaks in Uganda. By integrating perspectives from frontline managers and coordinators, it offers context-specific lessons on resilience that bridge humanitarian action and health systems strengthening in Sub-Saharan Africa.

Scars of birth: caesarean delivery and fertility intentions among women of reproductive age in sub-Saharan Africa.

Fine particulate matter (PM₂.₅) pollution poses a serious environmental and public health threat in rapidly urbanizing regions in Africa, yet high-quality, long-term measurements remain rare across sub-Saharan Africa. This two-year study (2021-2022) delivers one of the few spatiotemporally resolved PM₂.₅ datasets in Ghana, generated using USEPA Federal Reference Method (FRM) gravimetric samplers. Over 300 samples were collected at three contrasting sites in Accra, Ghana: Adabraka (AD), adjacent to the Agbogbloshie e-waste burning area; Dansoman (DA), a mixed residential-commercial neighborhood; and Legon (UG), a suburban reference site. Mean 24-h concentrations exceeded WHO guidelines by a factor of about 3-4 at all sites, with AD recording the highest levels (60.76µg/m3 in 2021; 60.54µg/m3 in 2022) due to persistent, localized emissions. While interannual variability was minimal, spatial contrasts were pronounced, reflecting stable and dominant anthropogenic sources. Principal component analysis identified temperature (positive correlation) and relative humidity (negative correlation) as key meteorological drivers of PM₂.₅ variability. Health risk assessment indicated hazard quotients (HQ) above 1 for both adults and children, with markedly higher risks in children due to physiological and behavioral factors. Beyond its local implications, this dataset fills a critical regional gap, providing a benchmark for validating satellite-based estimates and regional chemical transport models, and informing targeted interventions in resource-limited regions.

Artificial intelligence (AI) is also becoming an acknowledged game-changer in the world of agriculture, and it has the potential to increase productivity, efficiency, and food security. This paper discussed how AI can transform agriculture in Nigeria, its present use, opportunities, challenges and the possible effects. Qualitative research design was used, and semi-structured interviews with major stakeholders of active Nigerian agribusiness firms using AI were used. The companies offered their experience with AI-driven tools such as chatbots, predictive analytics, recommender systems, and pest detection models. The results showed that the early adoption of AI is transforming the agricultural practices by enhancing crop monitoring, improving farmer-market connections, optimising the use of inputs, and minimizing losses after harvesting. The companies cited positive effects of AI on productivity, farmer earnings, and rural development, and it was considered essential in enhancing food security and financial inclusion. But still, there were recurring issues that were found such as inadequate digital infrastructure, disjointed datasets, lack of digital literacy, and high implementation expenses. To solve these, companies implemented strategies like incremental implementation, open source technologies, offline solutions and collaborations with research institutions. The report concludes that AI can revolutionize the agricultural industry in Nigeria and lead to a tremendous economic growth, as long as systemic obstacles are overcome. Strategies to improve rural digital infrastructure, building centralised agricultural data systems, improving digital literacy, establishing inclusive financing systems, and collaboration between government, academia and the business sector are all recommended. These results can play a role in the continued discussion of digital agriculture and can serve as a means to implement AI usage in Sub-Saharan Africa on a larger scale.

Despite biomedical explanations for diseases being increasingly accepted in sub-Saharan Africa, traditional African explanatory models of illness remain widespread. This study sought to understand local explanatory models for illness and patient experiences with different traditional health practitioners (THPs) among a population of rural women in Limpopo, South Africa. This was a cross-sectional qualitative study in which eighty-two in-depth interviews were conducted, and the data were thematically analysed. Study findings indicate that 68% of participants believed illnesses can be caused by bewitchment, and these diseases were often considered too taboo to even be discussed. High percentages of participants also believe that THPs can cure illnesses that medical doctors cannot treat. Additionally, several illnesses were identified related to traditional practices and cultural beliefs, which can only be cured traditionally, via THPs. While the hospital/clinic is often first approached, its failure to resolve illness can often be seen as a sign of the spiritual origin of the ailment. This study is a pre-context for more research around biomedical/traditional medicine collaborations.

Despite decades of control interventions in sub-Saharan Africa, morbidity associated with Onchocerca volvulus infection still exerts a substantial burden of disease, arising from cutaneous, ocular and neurological manifestations. We developed and integrated a morbidity sub-model into our previously published individual-based, stochastic transmission model, EPIONCHO-IBM, including both reversible (severe itch, reactive skin disease (RSD)), and irreversible (skin atrophy, depigmentation, hanging groin) cutaneous sequelae, and eye disease (blindness, visual impairment). We modelled the relationship between onchocerciasis skin disease (OSD) and infection prevalence using pre-intervention data from northern Nigeria, and between onchocerciasis ocular disease (OOD) and infection intensity using data from the Onchocerciasis Control Programme in West Africa. We simulated the impact of ivermectin mass drug administration (MDA) upon OSD and OOD using data from Cameroon, Central African Republic, Nigeria, Sudan and Uganda. Modelled age-specific OSD and OOD prevalence at baseline align well with reported prevalence estimates across the simulated range of endemicity levels but underestimate irreversible OSD in older age groups. Under MDA, we capture trends in infection prevalence, severe itch and irreversible OSD but underestimate reductions in RSD and blindness prevalence. Integrating morbidity outcomes into transmission dynamics modelling will help improve estimates of onchocerciasis disease burden and inform the effectiveness and cost-effectiveness of current and alternative interventions.

TEpiNom: A computational framework integrating population data to prioritize plasmodium falciparum T cell epitopes.

EU-Africa partnerships in health research from 2014 to 2023: Outputs and lessons learnt.

Hospital Mortality and Associated Factors in the Oncology Unit of Treichville University Hospital (Côte d'Ivoire): A Cross-Sectional Study.

Sub-Saharan Africa (SSA) is a region with a high burden of hepatitis B virus (HBV) infection. Medical students face an elevated risk of HBV exposure due to occupational hazards, particularly during clinical placement rotations. Despite the proven efficacy of HBV vaccination in preventing HBV infection, vaccination uptake remains suboptimal in many clinical settings across SSA. This study aimed to characterize HBV vaccination coverage among medical students in Tanzania. A total of 1,463 medical students from all medical universities in Tanzania completed an online survey. The questionnaire captured sociodemographic characteristics, awareness, perceptions, and access to the hepatitis B (HBV) vaccine. The outcome variable, uptake of the HBV vaccine, was measured by self-report of having received one or more doses of the vaccine. Multivariable logistic regression was used to identify factors associated with HBV vaccine uptake, and results were reported as odds ratios (ORs) with 95% confidence intervals (CIs). A p-value < 0.05 was considered statistically significant. A total of 1,463 medical students from nine medical universities in Tanzania completed an online survey, and were included in the final analysis. Male respondents accounted for the majority 932 (63.7%), the median age of 24 years (IQR: 22-25). Awareness of the HBV vaccine was notably high, with 93.98% of respondents reporting knowledge of the vaccine. Only 27.96% participants completed HBV vaccination. In adjusted logistic regression model, clinical-year students were over 10 times more likely to be vaccinated compared to those in basic years (adjusted OR = 10.27, 95% CI: 6.99-15.10), and the availability of vaccination programs in the university increased the vaccination ratio by nearly two-folds (adjusted OR = 1.83, 95% CI: 1.30-2.58). It was observed that, adverse effects also had no significant impact on vaccination likelihood (adjusted OR = 0.77, 95% CI: 0.50-1.19). Despite high awareness and knowledge of HBV infection among medical students in Tanzania, HBV vaccination coverage remains substantially low. HBV vaccine has considerably high confidence among medical students in Tanzania. We are recommending the policy makers to ensure that HBV vaccine is available free of charge across medical universities in Tanzania.

Antimalarial potential and toxicity assessment of a polyherbal combination of Azadirachta indica A. Juss., Cymbopogon citratus (DC.) Stapf., and Psidium guajava L. in rodents.

Post-traumatic superficial temporal artery arteriovenous malformation: A case report and surgical insight in Sub-Saharan Africa