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Timing of seasonal influenza epidemics for 25 countries in Africa during 2010-19: a retrospective analysis.

BACKGROUND: Using country-specific surveillance data to describe influenza epidemic activity could inform decisions on the timing of influen … e (12%) had a primarily southern hemisphere pattern with some northern hemisphere epidemics (Ghana, Kenya, and Uganda). Three (12%) had a southern hemisphere pattern (Central African Republic, South Africa, and Zambia). Five (20%) had no clear pattern (Côte d'Ivoire, DR Congo, Madagascar, Mauritius, and Rwanda). INTERPRETATION: Most countries had ident …

Novel FujiLAM assay to detect tuberculosis in HIV-positive ambulatory patients in four African countries: a diagnostic accuracy study.

BACKGROUND: Development of rapid biomarker-based tests that can diagnose tuberculosis using non-sputum samples is a priority for tuberculosis control. We aimed to compare the diagnostic accuracy of the novel Fujifilm SILVAMP TB LAM (FujiLAM) assay with the WHO-recommended Alere Determine TB-LAM Ag test (AlereLAM) using urine samples from HIV-positive patients. METHODS: We did a diagnostic accuracy study at five outpatient public health facilities in Uganda, Kenya, Mozambique, and South Africa. Eligible patients were ambulatory HIV-positive individuals (aged ≥15 years) with symptoms of tubercu…

Ageing with HIV: Medicine Optimisation Challenges and Support Needs for Older People Living with HIV: A Systematic Review.

BACKGROUND: Older people living with HIV (PLWH) are at increased risks of co-morbidities and polypharmacy. However, little is known about fa … Canada (n = 5), Spain (n = 9), and the UK (n = 5). Ten studies originated from Sub-Saharan Africa (Kenya n = 1, South Africa n = 6, Tanzania n = 1, Uganda n = 1, Zimbabwe n = 1). The rest of the studies were from China (n = 1), France (n = 1), Germany (n = 1), Italy (n = 1), the Netherlands (n = 1), Pakistan (n = 1), Switzerland (n = 1), Saudi Arabia ( …

Assessment of Clinical Outcomes Among Children and Adolescents Hospitalized With COVID-19 in 6 Sub-Saharan African Countries.

IMPORTANCE: Little is known about COVID-19 outcomes among children and adolescents in sub-Saharan Africa, where preexisting comorbidities are prevalent. OBJECTIVE: To assess the clinical outcomes and factors associated with outcomes among children and adolescents hospitalized with COVID-19 in 6 countries in sub-Saharan Africa. DESIGN, SETTING, AND PARTICIPANTS: This cohort study was a retrospective record review of data from 25 hospitals in the Democratic Republic of the Congo, Ghana, Kenya, Nigeria, South Africa, and Uganda from March 1 to December 31, 2020, and included 469 hospitalized pa…

Primary and Triage Cervical Screening Diagnostic Value of Methods for the Detection of Cervical Dysplasia.

BACKGROUND: Cervical cancer is a leading cause of mortality among women globally. Approaches to reduce cervical cancer incidence and mortali … ing and colposcopy-biopsy test as a positive-confirmatory test in the Referral Hospitals of Eastern Kenya. RESULTS: A total of 317 (HIV negative: 156/317 (49.2%) and HIV positive: 161/317 (50.8%)) women were enrolled. Of these 81/317 (25.6%), 84/317 (26.5%), 96/317 (30.2%), and 78/122 (63.9%) participants had VIA, HPV DNA-PCR, Pap smear, and cervical h …

Whole genome sequences of multi-drug resistant Escherichia coli isolated in a Pastoralist Community of Western Uganda: Phylogenomic changes, virulence and resistant genes.

BACKGROUND: The crisis of antimicrobial resistance is already here with us, affecting both humans and animals alike and very soon, small cut … from human and 8/12 from cattle. Whole Genome Sequencing (WGS) was carried out at the facilities of Kenya Medical Research Institute-Wellcome trust, Kilifi, to determine the phylogenomic changes, virulence and resistant genes. RESULTS: At household level, the genomes from both human and animals clustered away from one another except for one instance wh …

Treatment of advanced AIDS-associated Kaposi sarcoma in resource-limited settings: a three-arm, open-label, randomised, non-inferiority trial.

BACKGROUND: Optimal treatment regimens for AIDS-associated Kaposi sarcoma, a frequent contributor to morbidity and mortality among people wi … anced stage AIDS-associated Kaposi sarcoma attending 11 AIDS Clinical Trials Group sites in Brazil, Kenya, Malawi, South Africa, Uganda, and Zimbabwe. Eligible participants were randomly assigned (1:1:1) with a centralised computer system to receive either intravenous bleomycin and vincristine or oral etoposide (the investigational arms), or intravenous …

Evaluating the potential impact and cost-effectiveness of dapivirine vaginal ring pre-exposure prophylaxis for HIV prevention.

BACKGROUND: Expanded HIV prevention options are needed to increase uptake of HIV prevention among women, especially in generalized epidemics … ong female sex workers and among other women ≤21 years or >21 years with multiple male partners, in Kenya, South Africa, Uganda, and Zimbabwe. In these scenarios, we varied antiretroviral therapy (ART) coverage, dapivirine ring coverage and ring effectiveness (encompassing efficacy and adherence) by risk group. Following discussions with stakeholders, t …

Anthropometric Characterization of Impaired Fetal Growth: Risk Factors for and Prognosis of Newborns With Stunting or Wasting.

IMPORTANCE: Stunting (short length for age) and wasting (low body mass index [BMI] for age) are widely used to assess child nutrition. In contrast, newborns tend to be assessed solely based on their weight. OBJECTIVE: To use recent international standards for newborn size by gestational age to assess how stunted and wasted newborns differ in terms of risk factors and prognoses. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional study with follow-up until hospital discharge was conducted at urban sites in Brazil, China, India, Italy, Kenya, Oman, England, and the United States that are part…

Network analysis of cross-income-level collaboration on multiple myeloma in sub-Saharan Africa.

Cross-income-level collaboration (CILC) is crucial for developing global health approaches that benefit low- and middle-income countries (LMICs). Multiple myeloma (MM) is a representative example of a complex, understudied disease in sub-Saharan Africa (SSA). Based on publications, we developed a network analysis tool to assess scientific collaborations. Here, we present findings from a systematic analysis of publications retrieved from PubMed between January 2002 and June 2022. We evaluated individual institutional contributions and collaboration patterns using undirected weighted networks. O

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… Fig. 5 Keyword-search subnetworks. a Network graph centred on the University of Kwazulu-Natal. b Network graph of institutions in Kenya. … The sub-network graph was derived from a search for the exact keyword ‘Kenya’. It includes all Kenyan institutions, as well as the neighbours. …

Association between parental death during childhood and health and wellbeing in adulthood in 22 countries and regions: a retrospective, outcome-wide analysis.

BACKGROUND: Clinical and epidemiological evidence suggests that adults who have experienced the death of a parent or caregiver in childhood … ions (ie, Argentina, Australia, Brazil, Egypt, Germany, Hong Kong, India, Indonesia, Israel, Japan, Kenya, Mexico, Nigeria, the Philippines, Poland, South Africa, Spain, Sweden, Tanzania, Türkiye, the UK, and the USA) to examine associations between retrospectively recalled parental death during childhood (yes or no) and current health and wellbeing. We …

A systematic review of water, sanitation, and hygiene practices in developing countries: exploring the effects on public health.

BACKGROUND: Lack of proper access to safe Water, Sanitation, and Hygiene (WASH) is a pervasive cause of preventable disease and mortality in … female education, and political stability. Several countries (e.g., Nigeria, Bangladesh, Ethiopia, Kenya, and India) have low sanitation coverage, whereas others (China and South Africa) do better. Improved sanitation facilities limit pathogen exposure, improve child nutrition by reducing intestinal infections, and increase economic and environmental s …

Aspirin and Preterm Birth Among Pregnant People With Increased Heat Exposure: Secondary Analysis of a Randomized Clinical Trial.

IMPORTANCE: Scalable interventions are urgently needed to mitigate the adverse effects of heat on pregnancy and newborn health. OBJECTIVE: … from June 2024 to June 2025. The study settings included the Democratic Republic of Congo, Zambia, Kenya, Guatemala, Pakistan, and Belagavi and Nagpur, India. Participants included nulliparous individuals between 6 and 13 weeks' gestation recruited through local clinics and communities, with delivery at 20 or more weeks' gestation. EXPOSURES: Prenatal …

Strategies, interventions, and uptake of catch-up vaccination among adolescent and adult migrants, refugees, and internally displaced persons (IDPs) in low- and middle-income countries (LMICs): A systematic review.

BACKGROUND: Catch-up vaccination helps close immunity gaps among migrants, refugees and internally displaced people (IDPs) in low- and middl … s 16 LMICs. Most studies were conducted in Uganda (n = 6), Bangladesh (n = 4), Lebanon (n = 3), and Kenya (n = 3). Interventions reached ≥48,000 migrants, refugees, and IDPs (primarily Rohingya refugees in Bangladesh during COVID-19 catch-up campaigns). Populations targeted included mostly refugees (n = 16 studies; 43.2%), general migrants (n = 14; 37.8 …

Evolutionary and Spatiotemporal Dynamics of Foot-and-Mouth Disease Virus in Ethiopia (1957-2025): A Molecular Perspective on Serotype Persistence and Emergence.

Foot-and-mouth disease (FMD) represents a significant global economic burden and remains the primary constraint on Ethiopia's livestock econ … the continued circulation of serotypes O and A, and the first emergence of Serotype SAT 2 near the Kenya-Ethiopia border, which temporarily disappeared until its major re-emergence in 2007. Period III is characterized by a significant intensification and modernization of FMD virus (FMDV) outbreak investigation that provided more granular data on viral …

Evolutionary dynamics and molecular adaptation of Rift Valley fever virus across human and non-human outbreaks in Africa.

BACKGROUND: Rift Valley fever virus (RVFV) is an emerging zoonotic virus of major public health and veterinary concern across Africa. Althou … mutations were identified, ranging from 2-20 per isolate. RVFV isolates collected in South Africa, Kenya and Madagascar exhibited the highest genomic diversity. Comparative analysis revealed higher mutation burdens in the L and S segments than in the M segment, with broader diversity among non-human hosts. Phylogenetic reconstruction showed that human- …

SARS-CoV-2 Detection in International Travelers Through Wastewater-Based Epidemiology at the Kigali International Airport: Genomic Surveillance Study.

BACKGROUND: Traditional infectious disease surveillance systems face significant limitations, including delayed detection, underreporting of … m 11 countries, with variants frequently found in flights from the United Kingdom, France, Belgium, Kenya, Tanzania, and South Africa. Sample collection capacity increased from 6 in week 1 to 33 by week 27. SARS-CoV-2 positivity rates showed seasonal variation, with a marked decline in June-July 2023. CONCLUSIONS: Genomics-enhanced WBE demonstrated a h …

Global Variation in Lipoprotein(a) Levels Among Patients With Coronary Heart Disease: Insights From the INTERASPIRE Study and Implications for Emerging Lp(a)-Lowering Therapies.

BACKGROUND: Lipoprotein(a) [Lp(a)] is a common risk factor for atherosclerotic cardiovascular disease, potentially more atherogenic per part … (a) levels were available in 13 countries across 6 World Health Organization (WHO) regions: Africa (Kenya, Nigeria, Tanzania), Americas (Argentina, Colombia), Eastern Mediterranean (UAE), Europe (Poland, Portugal), South-East Asia (Indonesia), and Western Pacific (China, Malaysia, Philippines, Singapore). Lp(a) measurements were performed once and centr …

Effectiveness of intrapartum azithromycin to prevent infections in planned vaginal births in low-income and middle-income countries: a post-hoc analysis of data from a multicentre, randomised, double-blind, placebo-controlled trial.

BACKGROUND: In 2023, the Azithromycin Prevention in Labor Use (A-PLUS) trial showed intrapartum azithromycin reduces maternal sepsis or deat … in labour at 28 weeks' gestation (or later) at eight sites in the Democratic Republic of the Congo, Kenya, Zambia, Bangladesh, India, Pakistan, and Guatemala and found that azithromycin reduced the incidence of maternal sepsis or death. The primary outcome of the present analysis was the incidence of any maternal infection in the azithromycin versus pla …

Knowledge, attitudes and practices of the general population towards Marburg virus disease in sub-Saharan African countries: a cross-sectional study.

BACKGROUND: Marburg virus disease (MVD) is categorized among viral hemorrhagic fevers. MVD is associated with high rates of morbidity and mortality. This study aimed to identify factors affecting MVD knowledge, attitudes and practices in sub-Saharan African countries. METHODS: Using a validated questionnaire, a cross-sectional survey was conducted from 21 April to 23 May 2023 in eight English-speaking sub-Saharan African countries (Ethiopia, Ghana, Kenya, Lesotho, Nigeria, Senegal, South Africa and Tanzania). RESULTS: Of 3142 participants, 51% were males, 66.0% were aged 18-29 y, 74.4% were …