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Crohn's disease (CD) is primarily characterised by chronic gastrointestinal inflammation; however, its systemic nature frequently leads to musculoskeletal complications. Among these, clinically significant foot pathologies can impair mobility and negatively impact patients' overall quality of life. Despite their relevance, the specific influence of podiatric manifestations on health-related quality of life in individuals with CD remains insufficiently explored, underscoring a critical gap in current disease management. The aim of this study was to assess the extent to which foot-related health issues affect the quality of life in people living with CD compared with a healthy population. This multicenter observational case–control study was conducted across five provinces in southern Spain—Málaga, Granada, Jaén, Sevilla, and Cádiz—between January 2024 and February 2025. The study included 110 participants, evenly divided between individuals diagnosed with CD (n = 55) and healthy controls (n = 55), matched for age, sex, and body mass index. All participants completed the validated Spanish version of the Foot Health Status Questionnaire (SFHSQ), which assesses four foot-specific domains and four general health domains. Due to the non-normal distribution of the data, non-parametric statistical methods were applied, with the Mann–Whitney U test used to evaluate differences between groups. Participants with CD exhibited significantly lower scores across all domains of the SFHSQ, with the exception of the Footwear domain, which showed no statistically significant difference (p = 0.406). Compared with healthy controls, individuals in the CD group reported greater impairments in foot pain, foot function, general foot health, and in broader health-related domains including general health, physical activity, and social capacity (p < 0.01 for all). CD significantly compromises foot-related QoL. These results highlight the need to include podiatric evaluations as part of comprehensive, multidisciplinary care approaches aimed at enhancing mobility, functional capacity, and general well-being in affected individuals.
by Felix A. Andong, Olufemi Olasoji, Abdifatah Ahmed A. Afyare, Ezekiel S. Mayowa, Praise O. Nwanozie, Emmanuel E. Osayi, Ruth A. Agyo, Vincent C. Ejere
In wild birds, the breeding season involves a convergence of metabolically demanding life-history stages, including reproduction, moult, and immune defense. We investigated the relationships between microfilarial infection, moult, redox homeostasis, and plumage quality in breeding male village weavers (Ploceus cucullatus) at the Amurum Forest Reserve, Nigeria. We compared four groups (n = 148 total) sampled within 3 mins post-capture: infected-moulting (IM), infected-non-moulting (IN), non-infected-moulting (NM), and non-infected-non-moulting (NN). Physiological condition was assessed using the erythrocyte glutathione ratio (GSH:GSSG) and circulating glucose, while plumage reflectance traits were integrated into a composite quality axis (PC1). Microfilarial infections were present in 52.0% (n = 77) of individuals; mean parasite intensities were 6.13 ± 0.35 mf/µL (IN) and 6.45 ± 0.41 mf/µL (IM). Physiological indices varied strongly across groups. The GSH:GSSG ratio was reduced in infected birds, indicating altered redox balance (rs = −0.65). Circulating glucose was highest in the infected non-moulting group (IN) but substantially reduced in the infected moulting group (IM). Across physiological and ornamental traits, individuals experiencing both infection and moult (IM group) exhibited the strongest reductions relative to all other groups. However, this pattern reflects a statistically supported Infection × Moult interaction, rather than an untested synergistic or non-linear effect, as evidenced by significant IN vs. IM contrasts in glucose (Table 3; z = 33.43, Pby Camilla Bjelland, Joseph Sieka, Veronica Millicent Dzomeku, HaEun Lee, Wahdae-Mai Harmon-Gray, Emmanuel K. Nakua, Jody R. Lori
BackgroundTo address the delayed provision of obstetric emergency care in Ghana and Liberia, our team previously implemented a mobile obstetric emergency referral system (MORES) connecting rural health facilities (RHFs) and district hospitals through a South-South-North triangular collaboration. This secondary qualitative data analysis aimed to synthesize the perceived barriers and benefits associated with the adoption of MORES in Ghana and Liberia. To guide this cross-context synthesis, we utilized Rogers’ Diffusion of Innovation Theory.
MethodsThe analysis included individual interviews conducted among 29 district hospital providers and 33 rural health facility (RHF) workers in Liberia. In Ghana, 11 midwives at a district hospital participated in a focus group discussion. The codes were developed utilizing an inductive process. Thematic analysis was utilized to compare adoption across countries through the Diffusion of Innovation Theory.
FindingsFour themes were identified from the healthcare workers in Ghana and Liberia: compatibility, relative advantage, resource barriers, and limited implementation. According to healthcare workers, MORES was compatible with everyday workflow and had significant relative advantage, contributing positively to adoption. Healthcare workers were able to prioritize patient conditions upon presentation with increased referral information. Resource barriers and the limited implementation across districts restricted widespread adoption of MORES. Healthcare workers in both countries cited inconsistent access to ambulances as a barrier to complete obstetric referrals and in Liberia, the need for financial support for data and network connectivity was referenced. There were nuances by country, within the four themes. In Ghana, providers used MORES to facilitate follow-up on patients who did not complete referrals, contributing to MORES’ relative advantage.
ConclusionsMORES has the potential to reduce obstetric emergency referral delays in Ghana and Liberia. If the resource barriers and limited implementation of MORES are addressed, healthcare workers may continue to adopt and use the MORES system. Policy makers can address referral delays through the scale up of MORES, a compatible intervention with great relative advantage.
The aim was to validate the Spanish/Spain version of the Wound-QoL-14. Clinical data were prospectively collected from participants who completed the questionnaire at baseline and at a follow-up visit. COSMIN guidelines were followed to evaluate feasibility, reliability, construct validity and responsiveness. Overall, 323 participants (71.1 ± 14.6 years; 52% males) were included. Feasibility was excellent (missing items: 0.95%). Reliability was good (very good internal consistency [McDonald's omega: 0.934] and test–retest reliability [concordance correlation coefficient: 0.915; 95% CI: 0.837–0.956. Standard error of measurement: 0.141]). Regarding construct validity, the survey showed good structural validity since the three factors extracted after the exploratory factor analysis were confirmed (Comparative fit index: 0.942. Tucker–Lewis index: 0.927. Standardized root mean square residual: 0.042. Root mean square error of approximation: 0.089; 90% CI: 0.077–0.102) and good known-groups and convergent validities (4/4 and 7/9 predefined hypotheses supported, respectively). Criterium validity was excellent (Spearman's rho with Wound-QoL-17 global score: 0.934). Finally, the instrument was suitable to detect improvement (Floor effect: 0.3%. Ceiling effect: 1.5%. Area under the receiving operator characteristic curve: 0.795; 95% CI: 0.732–0.858; p < 0.001. Standardized effect size: 0.928. Standardized response mean: 0.852). The Spanish/Spain version of the Wound-QoL-14 is a reliable and valid instrument to assess the health-related quality of life in Spanish patients with chronic wounds.
This study aimed to co-design a tailored model of care for older people with long COVID.
Using a human-centred design approach, semistructured interviews were conducted with patients and health professionals from a long COVID service to explore their experiences. Insights were further developed during a co-design workshop involving patients, health professionals and community members who identified as older people and who had experience with chronic illness. Key themes were identified and used to map an ideal patient journey and inform the final model of care.
Long COVID outpatient service in a tertiary hospital in Adelaide, South Australia.
Four patients and four health professionals participated in the interviews. The workshop included four patients, five health professionals and seven community members.
The co-design process identified challenges experienced by people with long COVID, including lack of validation, delayed multidisciplinary care, mental health deterioration and difficulties navigating the healthcare system. These challenges were described as having particular relevance for older adults. In response, a model of care was developed focused on comprehensive assessment, coordinated multidisciplinary care, education for self-management, mental health support and opportunities for research participation.
A comprehensive and adaptable model of care is needed to address the complex and multifaceted nature of long COVID. This human-centred design approach ensured the model was grounded in lived experience, clinically informed and aligned with patient priorities. While not unique to older adults, the findings highlight areas that may require particular attention in this population, including care coordination, validation and support for comorbidities and social vulnerabilities. While developed in a single tertiary service, these principles may inform the design of services for similar populations in other healthcare settings.
by Amma Aboagyewa Larbi, Moses Etsey, Obed Brew, Bismark Koduah, Rosemond Enam Mawuenyega, Emmanuel Kobla Atsu Amewu, Nehemiah Kweku Essilfie, Solomon Wireko, Alexander Kwarteng, Ben Adu Gyan
The human gut microbiome, consisting of bacteria, archaea, fungi, and viruses, influences various physiological processes of the body. The gut microbiome composition is shaped by factors such as diet, geography, and antibiotic use. Malaria has been a global health challenge over the years, especially in low- and middle-income countries. This study investigated how asymptomatic malaria infection altered gut microbial communities in Ghanaian children, offering insights for novel malaria control strategies. Standard aseptic phlebotomy procedures were employed to collect venous blood samples for Plasmodium species detection. The gut microbial community was profiled by sequencing the 16S rRNA V4 region, and sequence data were processed using the DADA2 pipeline in R. Asymptomatic malaria infections were predominantly mixed with P. falciparum and P. malariae. Microbiome analysis revealed that Firmicutes and Bacteroidetes comprised nearly 70% of the total microbial population. Asymptomatic individuals showed a decrease in Firmicutes abundance from 52.5% to 44.0% and an increase in Bacteroidetes from 34.7% to 45.6%. There was also a slight increase in the abundance of Proteobacteria from 3.0% to 4.8%. At the genus level, Prevotella_9 was the most abundant and exhibited the highest variability in the infected groups. The Alloprevotella and Streptococcus genera increased in both infected groups, but Escherichia-Shigella was significantly elevated in only those with mixed infections. Faecalibacterium significantly declined in asymptomatic malaria-infected individuals compared to healthy controls, with variability further reduced in mixed infections. Beta-diversity analysis indicated a significant effect of malaria status on microbial composition (PERMANOVA, pby José Manuel García-Moreno, Tyler Adams, Amber Beynon, Janine Vlaar Olthuis, Stephan U. Dombrowski, Richelle Witherspoon, Niels Wedderkopp, Jeffrey J. Hébert
BackgroundRehabilitation and behavior change interventions are commonly used after lumbar surgery to improve recovery, but their effects on physical capacity and physical activity remain unclear. This study aimed to investigate the effectiveness of rehabilitation and behavior change interventions on physical capacity and physical activity behavior in patients following lumbar surgery for degenerative disease.
MethodsEMBASE, MEDLINE, PsycINFO, and CENTRAL were searched from inception to September 2025 and reference lists were hand-searched. Randomized controlled trials assessing rehabilitation or behavior change interventions on physical capacity or physical activity behavior in adults with lumbar degenerative disc disease who underwent lumbar surgery were included. Review author pairs independently extracted data and assessed included studies. Risk of bias was assessed with the Cochrane tool, and study quality with the Grading of Recommendations Assessment, Development and Evaluation classification. Results were pooled using random-effects models and reported as standardized mean differences (SMD) with 95% confidence intervals (CI).
ResultsExercise was more effective than minimal or usual care in improving trunk extension endurance in the immediate term (SMD, 1.54; 95% CI, 0.93–2.16). Supervised exercise outperformed self-directed exercise in improving trunk extension endurance in the immediate term (SMD, 1.28; 95% CI, 0.75–1.81). Psychologically informed rehabilitation was more effective than minimal or usual care in increasing physical activity levels in the intermediate term (SMD, 0.26; 95% CI, 0.02–0.49), but not in the immediate term (SMD, 0.17; 95% CI, −0.14 to 0.49). Physical activity advice did not increase physical activity levels compared to minimal or usual care in the immediate term (SMD, 0.21; 95% CI, −0.13 to 0.55). Prehabilitation was more effective than minimal or usual care in increasing physical activity levels in the intermediate term (SMD, 0.28; 95% CI, 0.03–0.53). Certainty of evidence ranged from low to moderate.
ConclusionsFor adults with lumbar degenerative disease who underwent lumbar surgery, exercise, especially supervised programs, improved trunk extension endurance in the immediate term. Psychologically informed rehabilitation and prehabilitation increased physical activity levels in the intermediate term, while physical activity advice showed no benefit. Findings are limited by low certainty of evidence and high risk of bias.
by Verner N. Orish, Renosten E. Tetteh, David Adzah, Chinecherem A. Ndiokwelu, Emmanuel A. Allotey, Evans A. Yeboah, Sylvester Y. Lokpo, Kenneth Ablordey, Duneeh R. Vikpebah, Ekene K. Nwaefuna, Precious K. Kwadzokpui, Noble D. Dika, Elom Y. Dzefi, Kokou H. Amegan-Aho, Aninagyei Enoch, Senyo Tagboto
BackgroundToxoplasma gondii (T. gondii) is a successful protozoan parasite infecting up to a third of the human population. It has varied transmission routes including ingestion of food and water contaminated by cat feces containing oocysts of the parasite and ingestion of bradyzoites in poorly cooked meat. Blood transfusion is another possible route of transmission especially among people with medical conditions requiring blood transfusion, such as those with sickle cell disease (SCD). This study aimed at finding out the prevalence of T. gondii infection and the association of blood transfusion among patients with SCD.
MethodThis study was a cross-sectional study involving SCD patients attending the SCD clinic at the Ho Teaching Hospital in the Volta Region of Ghana. Questionnaire administration was employed to obtain sociodemographic information, cat ownership, consumption of poorly cooked meat, as well as blood transfusion history. A blood sample was collected and anti-T. gondii IgG and IgM were detected using Rapid Diagnostic Test (RDT), while Enzyme-linked Immunosorbent Assay (ELISA) was used as the gold standard and reference. Seropositivity was defined as either positive for IgG, IgM or both. Data was analyzed using SPSS version 23, with frequency distribution done for the sociodemographic variables and the prevalence of RDT and ELISA anti-T. gondii IgG and IgM. Pearson Chi-square analysis was performed to find any significant association between diagnosis of T. gondii infection with sociodemographic variables and blood transfusion. Logistic regression analysis was performed to investigate the odds of seropositivity (ELISA) with sociodemographic variables and blood transfusion.
ResultsA total of 156 SCD patients participated in this study of which 124 (79.5%) and 32(20.5%) were HbSS and HbSC respectively. Among the study participants, 105 (67.3%) had a history of blood transfusion. A total of 60 (38.5%) and 83 (53.2%) patients were positive for RDT and ELISA respectively. No significant association was seen between T. gondii diagnosis and cat ownership (RDT,20[37.7%], p = 0.891; ELISA, 27[50.9%], p = 0.673) and consumption of poorly cooked meat (RDT,37[41.6%],p = 0.370;ELISA,53[59.6%], p = 0.211). However there was a significant association between T. gondii diagnosis and age, with seropositive results predominantly seen among older patients (≥20 years) (RDT, 38[52.1%], p = 0.002; ELISA 49 [67.1%, p = 0.002]. Blood transfusion had a significant association with T.gondii diagnosis (RDT, p = 0.003; ELISA, p = 0.001). A total of 66 (62.9%) of SCD patients who had history of blood transfusion tested positive for ELISA and they had 3 times the odds of testing positive for ELISA (adjusted OR 3.14[95% CI 1.50–6.58]; p = 0.002).
ConclusionThe prevalence of T. gondii infection was higher by ELISA (53.0%) than by rapid diagnostic testing (RDT) (38.5%), and sickle cell disease patients with a transfusion history had higher odds of seropositivity. These findings highlight the need to strengthen transfusion safety protocols and consider screening strategies for T. gondii among high-risk populations such as patients with sickle cell disease. Also, there is the need for longitudinal research to help elucidate the true contribution of blood transfusion transmission of T. gondii since a cross-sectional study, causality could not be established.
by Cecilia Aguilar-Vega, Jaime Bosch, Satoshi Ito, Benjamin Ivorra, Hyunkyu Jeong, José Manuel Sánchez-Vizcaíno
African swine fever (ASF) is a lethal disease of swine that has spread across Asia since its introduction in 2018. South Korea first reported the disease in September 2019 in domestic pigs, and since then, more than 4,000 cases have been reported in wild boars during its expansion up to August 2024. Due to the high number of ASF notifications in wild boars in South Korea, contrasted with their scarcity in most Asian countries, analyzing the spatiotemporal spread of the disease in a setting with active surveillance provides valuable insights. In this study, we performed a trend-surface analysis on temporally gridded case data to characterize the overall geographic spread and direction of ASF in wild boars across South Korea, from its emergence to August 2022. Additionally, we propose a novel approach distinct from previous studies, to estimate spread velocity by incorporating an upper threshold to avoid unrealistic values. The model described the spread of ASF in the study area. The disease showed greater expansion in the east of the country. Initially, a south and eastward direction was estimated. The estimated median velocity was 19.53 km/month, with cell-level velocities ranging from 2.45 to 69.99 km/month. Velocity increased notably from autumn 2021 onward and varied substantially across years. Our results show the dynamics of ASF in wild boars of South Korea, providing new evidence of their role in the epidemiology of the disease.by Laura Sánchez-Bermejo, Pedro Jesús Milla-Ortega, José Manuel Pérez-Mármol
ObjectiveTo cross-cultural adapt the ADL Observation Scale and evaluate its psychometric properties in a sample of Spanish-speaking patients with stroke.
MethodsA validation study that included cross-cultural adaptation, structural validity assessment, reliability, and diagnostic accuracy analysis. The study followed COSMIN and STARD criteria. Translation and cross-cultural adaptation of the ADL Observation Scale followed a backward translation process. Structural validity was assessed with confirmatory factor analysis, and internal consistency was analyzed using Cronbach’s alpha and McDonald’s omega coefficient. Cut-off points were estimated using ROC analysis, and diagnostic accuracy was evaluated using sensitivity, specificity, and positive and negative predictive values. Internal consistency, cut-off points, and diagnostic accuracy were calculated for two different age groups (≥65 years; > 65 years).
ResultsThe Spanish version of the ADL Observation Scale was obtained after cross-cultural adaptation. The psychometric properties were tested in a sample of 180 patients with stroke. Structural validity showed a four-factor structure of the scale (RMSEA = 0.078; CFI = 0.952; TLI = 0.934). Internal consistency for each factor indicated Omega values between 0.641, 95% CI [0.495, 0.753], and 0.915, 95% CI [0.882, 0.936]. Cut-off points, also calculated for each factor, ranged from ≥1 to ≥4 points. Sensitivity, specificity, and positive and negative predictive values showed high values, indicating the scale’s discriminatory capacity for correctly classifying patients with praxis deficits.
ConclusionThe ADL Observation Scale has a four-factor structure, and it is a reliable instrument for evaluating the levels of praxis function in daily living among Spanish-speaking patients with stroke. The scale also has adequate diagnostic accuracy in detecting patients with praxis deficits.
by Roberto Germano, Owen Alexander Higgins, Emanuela Cristiani, Alessia Galbusera, Carmen Esposito, Dulce Neves, Carmine Pellegrino, Alessandra Sperduti, Giorgio Manzi, Luca Bondioli, Alessia Nava
This study investigates health, dental development, diet, and human-environment interactions in individuals buried in the necropolises of Pontecagnano (Campania, Italy, 7th-6th century BCE), using an integrated approach merging dental histomorphometry and calculus micro-residue analysis. The sample consists of 30 permanent teeth (canines, first and second molars) from 10 individuals. Histomorphometric analysis of dental thin sections allowed the estimation of crown formation times, initial cusp formation, crown completion, and enamel extension rates. The prevalence of Accentuated Lines, marking physiological stress events, was analyzed chronologically across tooth classes. Dental calculus analysis was performed on five individuals, identifying plant micro-remains and fungal spores. Crown formation times varied by tooth class, with canines forming the longest (mean = 1,977 ± 295 days), followed by second molars (mean = 1,176 ± 179 days) and first molars (mean = 1,094 ± 154 days). Initial cusp formation values, estimated through chronological overlap between teeth, allowed for a more accurate reconstruction of crown completion timing. Accentuated Lines prevalence peaked at 12 and 44 months, likely reflecting early childhood dietary transitions and the differential recording of stress events across different crown regions. Calculus analysis identified starch granules from cereals (Triticeae) and legumes (Fabaceae), fungal spores (Saccharomyces), and plant fibers, indicating diverse dietary practices, food processing, and extra-masticatory activities. This interdisciplinary approach reinforces the validity of combining histomorphometric and micro-residue analyses to reconstruct childhood health, adult diet, and lifestyle. Our findings align with previous research while emphasizing population-specific variations. This study enhances understanding of Iron Age biocultural adaptations, offering insights into developmental and dietary behaviors in this ancient Italian community.by Wendy C. Hernández-Mazariegos, Felipe I. Torres, Manuel Rodríguez, Christian M. Ibáñez, Luis E. Escobar, Federico J. Villatoro
Cockroaches are vectors of pathogens and parasites that pose public health risks, especially in developing countries with poor hygiene and inadequate infrastructure. This study aimed to identify the household factors associated with the occurrence of cockroaches and the helminth parasites they carry in a rural community. Data on household infrastructure, presence of domestic animals, and insect control methods were collected from 70 households in rural Guatemala. Cockroaches were captured using traps and manually. A Generalized Linear Mixed Model revealed that households with concrete roofs had 94% lower abundance of cockroaches than those with metal sheet roofs, while the presence of cats increased cockroach abundance by 2.6 times (p Moniliformis moniliformis, were identified, marking the first report of such parasites in household cockroaches in Guatemala. These results highlight the need for improved housing infrastructure and integrated pest management strategies to mitigate the risks associated with cockroach-borne parasites in vulnerable communities.by Helena Tinnerholm Ljungberg, Martina Wallberg, Emmanuel Aboagye, Gunnar Bergström, Christina Björklund, Lydia Kwak, Susanna Toivanen, Irene Jensen
The prevalence of telework increased dramatically during the COVID-19 pandemic, and today it is not uncommon to refer to hybrid work as “the new normal” in work life. Leadership plays a pivotal role in hybrid work transitions, underscoring the need for research on post-pandemic managerial practices. This qualitative interview study with 15 professional service managers at a Swedish medical university, working in either central administration or a research department, provides a nuanced understanding of the experiences of implementing hybrid work in a higher education setting. The qualitative content analysis resulted in three main themes and six sub-themes: New ways of organising work (sub-themes: Hybrid work brings new opportunities and needs, and Hybrid work as an ongoing process of change); Changes for employees (sub-themes: Social interaction and sense of community, and Increased work-life balance); and Changes in leadership (sub-themes: Communication with employees and New expectations on managers). The findings of this study provide a more fine-grained understanding of how managers experienced both challenges and opportunities in implementing and managing hybrid working arrangements. Challenges included managing employee expectations and relations, while opportunities included potential improvements in work-life balance. A key conclusion of this study is that managers in hybrid work environments adjust their leadership, especially when communicating and managing relationships within teams and across the organization. Despite the identified challenges and despite managers’ wish to see their employees in person and on site, the interviewed managers are generally optimistic about hybrid work and see it as the future. To address the identified challenges, managers may benefit from networking and exchanging information with other managers in similar situations, as well as support from their organisation.by Bwambale Jonani, Emmanuel Charles Kasule, Bwire Roman Herman, Joel Fredrick Arturo, Mwesigwa Calvin Mugambwa, Ssebulime Stephen, John Bosco Mundaka, Richard Kwizera, Gerald Mboowa, Felix Bongomin
IntroductionSickle Cell Anemia (SCA) is a significant genetic disorder in Africa; however, comprehensive data on its prevalence and geographic distribution remain limited. We aimed to estimate the pooled prevalence of SCA (HbSS) in African populations and examine regional, demographic, and temporal variations from 1994–2024.
MethodsWe systematically searched PubMed, Scopus, Google Scholar, and BASE databases for studies reporting SCA prevalence in African populations. Screening and quality assessments were performed using JBI tools. A random-effects meta-analysis with logit transformation was performed, with subgroup analyses by region, age, sex, and study design. Meta-regression explored heterogeneity sources, including geographic region, age category, diagnostic method, study design, and publication year.
ResultsFrom 115 studies with 1,203,839 participants and 17,458 confirmed HbSS cases, the pooled prevalence was 1.43% (95% CI: 1.08%–1.88%), with substantial heterogeneity (I2 = 99.1%) and a prediction interval of 0.21%–8.91%. Central Africa showed the highest prevalence (1.99%), and Southern Africa showed the lowest (0.59%). Children exhibited a higher prevalence (1.65%) than adults (0.45%), while sex differences were non-significant (males 2.71%, females 1.74%; p = 0.694). The prevalence has remained stable over three decades despite a six-fold increase in research output, although wide prediction intervals indicated substantial between-study variability. Electrophoretic techniques predominated (86.4% of cases). Diagnostic method (χ² = 16.73, p = 0.033) and age category (χ² = 33.66, p 2 = 98.6%). Leave-one-out sensitivity analysis showed that no single study significantly impacted the pooled estimates.
ConclusionSCA represents a substantial and geographically variable public health challenge across Africa. These findings highlight the need for region-specific interventions, expanded newborn screening programs, improved diagnostic accessibility with quality assurance for point-of-care technologies, and continued surveillance to address geographic gaps.
by Emmanuel O. Adewuyi, Asa Auta, Olumuyiwa Omonaiye, Mary I. Adewuyi, Victory Olutuase, Kazeem Adefemi, Olumide A. Odeyemi, Yun Zhao, Gizachew A. Tessema, Gavin Pereira
IntroductionNigeria currently has the highest maternal mortality ratio and one of the highest neonatal mortality rates worldwide. Home birth—childbirth outside health facilities, often without skilled attendance or timely access to emergency obstetric care—may contribute to these disproportionate and avoidable adverse maternal and neonatal outcomes. National estimates often mask substantial sub-national disparities. This study examines the prevalence of home birth and associated factors across national, rural, and urban settings in Nigeria.
MethodsWe analysed data from the nationally representative cross-sectional Nigeria Demographic and Health Survey 2018, guided by Andersen’s Behavioural Model. Multivariable logistic regression was used to examine the associations between home birth and various predictor variables at the national level, as well as separately for rural and urban areas in Nigeria.
ResultsNationally, 58.1% (95% CI: 56.5, 59.7) of mothers gave birth at home, with prevalence twice as high in rural areas (72.4%, 95% CI: 70.7, 74.0) compared to urban areas (36.1%, 95% CI: 33.6, 38.7) (p Conclusion
Home birth remains highly prevalent in Nigeria, particularly in rural settings and in the northern and South-South regions, where prevalence is disproportionately high. Reducing home births requires a comprehensive approach that addresses the interplay of factors identified in this study. From a social justice and health determinants perspective, these factors are interconnected and can influence both access to and use of services. In rural areas, policies should enhance women’s decision-making autonomy, reduce distance barriers, and address region-specific challenges (e.g., insecurity in northern regions). In urban areas, it is essential to address financial barriers, support young mothers, and provide culturally and religiously sensitive care. Nationally, efforts should focus on improving education, expanding and strengthening antenatal care, and increasing access to media and the internet. From an equity perspective, interventions must be tailored to specific contexts to reduce unsafe home births and ensure that all mothers, regardless of location, have equitable access to skilled, respectful, and high-quality childbirth care.
by Emmanuel Timmy Donkoh, Iddrisu Wahab Abdul, Abraham Kwadzo Ahiakpa, Isaac Williams, Rita Nyaaba Akologo, Stephen Danyo, Chrysantus Kubio, Kofi Effah, Joseph Emmanuel Amuah
BackgroundCervical cancer, though preventable, remains the second most diagnosed cancer and the primary cause of cancer-related deaths among females in Sub-Saharan Africa. The significance of coordinated screening programmes for reducing the burden of cervical cancer in Africa is not well documented. This systematic review will summarize published reports from key databases, grey literature and programme reports to assess the performance of cervical cancer prevention programmes in Ghana.
MethodsTo be eligible for inclusion, interventions must target Ghanaian women with cervical cancer screening and prevention strategies using methods such as visual inspection with acetic acid (VIA), mobile colposcopy, HPV DNA testing, cytology (Pap smear), and treatment approaches such as cryotherapy, thermal ablation, loop electrosurgical excision procedure (LEEP). A comprehensive electronic search strategy will be used to identify studies published since database inception, and indexed in MEDLINE, EMBASE, CINAHL and Web of Science. The search strategy will include MeSH terms (and synonyms) relevant to cervical cancer, screening/treatment methods, geographic focus and implementing institution. We will include searches for grey literature, recognizing the value of programmatic and governmental reports that might not appear in traditional databases. Search results will be summarized in line with PRISMA guidelines. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach will be used to evaluate and document evidence certainty for all outcomes, internal validity of included reports, inconsistency, indirectness, imprecision, and publication bias. Where sufficient homogeneity exists among included studies in terms of interventions, study designs, populations, and outcome measures, we will perform a meta-analysis to calculate pooled effect estimates and their corresponding 95% confidence intervals.
SignificanceThis systematic review will assess the performance and impact of cervical cancer screening and prevention programmes conducted in Ghana to date and identify what contextual strategies have delivered the most impact as well as highlight what gaps remain in our understanding of how a nationwide screening programme can be properly construed for maximum impact.
by Emmanuel Kumah, Dorothy Serwaa Boakye, Eunice Agyei, Richard Boateng, Veronica Penaman Asamoah, Emmanuel Osei Tutu
IntroductionSince its emergence, HIV/AIDS has remained one of the most significant global health challenges, with key populations—such as sex workers, men who have sex with men (MSM), transgender people, people who inject drugs (PWID), and individuals in prisons or other closed settings—disproportionately bearing the burden of the epidemic. These groups, often at heightened risk due to social, legal, and structural vulnerabilities, face persistent barriers to accessing prevention, treatment, and care services. Despite progress in reducing new infections and improving treatment outcomes, these disparities, exacerbated by stigma, structural inequalities, and insufficient political commitment, continue to limit the effectiveness of global HIV responses.
AimThis scoping review protocol aims to systematically map the range of HIV prevention, treatment, and care interventions and strategies targeting key populations worldwide. Rather than formally evaluating effectiveness, the review will describe the nature, extent, and types of interventions implemented, identify barriers to implementation, and highlight gaps in research and practice.
MethodsFollowing the Joanna Briggs Institute (JBI) guidelines for scoping reviews, the study will systematically identify and analyze evidence from multiple databases, including PubMed, Embase, CINAHL, Scopus, and PsycINFO, alongside regional and grey literature sources. The review will include studies focusing on key populations and evidence-based interventions, such as prevention tools, treatment strategies, and policy or structural interventions. Data will be extracted and synthesized using quantitative and qualitative approaches, with results presented through descriptive statistics and thematic analysis. Findings will inform the development of a comprehensive, evidence-based framework tailored to the unique needs of key populations.
ConclusionBy mapping available interventions and strategies for HIV prevention, treatment, and care among key populations, this review will provide a comprehensive overview of existing approaches, barriers, and gaps. The findings will inform future research, policy, and practice, supporting more targeted, inclusive, and sustainable HIV responses that contribute to global efforts to end AIDS as a public health threat by 2030.
by Claude Emmanuel Koutouan, Marie Louisa Ramaroson, Angelina El Ghaziri, Laurent Ogé, Abdelhamid Kebieche, Raymonde Baltenweck, Patricia Claudel, Philippe Hugueney, Anita Suel, Sébastien Huet, Linda Voisine, Mathilde Briard, Jean Jacques Helesbeux, Latifa Hamama, Valérie Le Clerc, Emmanuel Geoffriau
Resistance of carrot to Alternaria leaf blight (ALB) caused by Alternaria dauci is a complex and quantitative trait. Numerous QTL for resistance (rQTLs) to ALB have been identified but the underlying mechanisms remain largely unknown. Some rQTLs have been recently proposed to be linked to the flavonoid content of carrot leaves. In this study, we performed a metabolic QTL analysis and shed light on the potential mechanisms underlying the most significant rQTL, located on carrot chromosome 6 and accounting for a large proportion of the resistance variation. The flavonoids apigenin 7-O-rutinoside, chrysoeriol 7-O-rutinoside and luteolin 7-O-rutinoside were identified as strongly correlated with resistance. The combination of genetic, metabolomic and transcriptomic approaches led to the identification of a gene encoding a bHLH162-like transcription factor, which may be responsible for the accumulation of these rutinosylated flavonoids. Transgenic expression of this bHLH transcription factor led to an over-accumulation of flavonoids in carrot calli, together with significant increase in the antifungal properties of the corresponding calli extracts. Altogether, the bHLH162-like transcription factor identified in this work is a strong candidate for explaining the flavonoid-based resistance to ALB in carrot.by Lakew Desta Zewude, Embialle Mengistie, Amanuel Ejeso
BackgroundIn developing countries, animals are often slaughtered and dressed in unsanitary settings, thus endangering the microbiological quality and safety of the meat obtained. In addition, slaughterhouses and retail outlets are the regions most vulnerable to cross-contamination with meat. As a result, the objective of this study was to evaluate slaughterhouse and meat retail shop hygiene practices and to determine the causes of unsanitary meat handling in slaughterhouses and retail shops.
Methods165 butcher men from a municipal slaughterhouse and every retail meat store in Hawassa city participated in this investigation, which was carried out using an institution-based cross-sectional study design between March 22 and May 30, 2022. Data was collected through interviewer-administered standardized questionnaires and an observation checklist. Data was entered using Epidata software version 3.1.1, and it was exported for further analysis using SPSS version 25. A cutoff point of P.V Results
The prevalence of good hygienic practices was 25.5% [95% CI: (18.2–32.1)]. Attitude (fair attitude) [AOR = 0.157; 95% CI: (0.037, 0.659)], cleanness and disinfection of waste container status [AOR = 12.64; 95% CI: (3.936–40.562)], regular supervision by health offices [AOR = 0.176; 95% CI: (0.35–0.894)], health and safety training [AOR = 3.46; 95% CI: (1.054–11.344)], and Removal of personal items during meat processing [AOR = 0.036; 95% CI: (0.008–0.150)] were factors that were significantly associated with poor hygienic practices.
ConclusionThe prevalence of good hygienic practices was low. After adjusting for possible confounding factors, attitudes, cleanness and disinfection of waste containers, regular supervision by health offices, health and safety training and Removal of personal items during meat processing (behavioral factor) were significantly associated with hygienic practices. These findings could call for appropriate prevention strategies based on cognitive domains and practice.
by Mesfin Abebe, Yordanos Sisay Asgedom, Amanuel Yosef Gebrekidan, Tsion Mulat Tebeje
BackgroundBreast cancer is the leading cause of cancer-related deaths in women globally and a significant public health burden in sub-Saharan Africa, which accounts for approximately 15% of all cancer-related mortality. In sub-Saharan Africa, breast cancer incidences increased by 247% from 1990 to 2019. In Lesotho, breast cancer is the second most common cancer affecting women, a situation worsened by a fragile healthcare system and low screening rates. Despite its high morbidity and mortality, there is limited understanding of the factors influencing breast cancer screening among women of reproductive age. This study aims to identify these factors by utilizing the newly released Lesotho DHS dataset and the Anderson Behavioral Model.
MethodsThis study utilized a cross-sectional design with data from the recent Lesotho Demographic and Health Survey (LDHS), which employed a stratified two-stage sampling method across 400 Enumeration Areas and 9,976 households. This analysis included a weighted sample of 6,413 reproductive-age women (15–49 years) to determine factors of breast cancer screening. The predisposing, enabling, and need factors were examined using the Andersen Behavioral Model. Stata version 16 was used for a multilevel mixed-effects logistic regression model. Results were presented as adjusted odds ratios (AOR) with 95% confidence intervals, and a P-value less than 0.05 was considered statistically significant.
ResultsThe prevalence of breast cancer screening among women of reproductive age in Lesotho was 22.20% (95% CI 21.19–23.23). Significant factors included age 25–34 (AOR = 1.54; 95% CI 1.26–1.88), age 35–49 (AOR = 2.10; 95% CI 1.71–2.58), healthcare facility visits in the past 12 months (AOR = 1.47; 95% CI 1.26–1.71), health insurance coverage (AOR = 1.86; 95% CI 1.36–2.53), high media exposure (AOR = 1.23; 95% CI 1.01–2.52), contraceptive use (AOR = 1.18; 95% CI 1.03–1.37), and parity: multiparous (AOR = 2.29; 95% CI 1.84–2.85) and grand multiparous (AOR = 1.67; 95% CI 1.16–2.40).
ConclusionThis finding that 22.2% of reproductive age women in Lesotho underwent breast cancer screening highlights a pressing gap in preventive health efforts. The Andersen Behavioral Model underscores key determinants that significantly influence breast cancer screening uptake in our study. Significant factors included age, healthcare facility visits, health insurance coverage, media exposure, contraceptive usage, and parity. These findings underscore the need for targeted interventions that address model-based determinants to improve breast cancer screening uptake.
FreshRSS 