Assessing the scalability of health system interventions in Africa: protocol for a Delphi study.

Background: There is widespread enthusiasm for scaling interventions to strengthen health systems. However, little is known about the scalability of such interventions in Africa. In this study, we seek to assess the scalability of interventions for improving the functionality of health systems in Africa, as a key to large-scale implementation strategy of interventions with potential for impact.

Rationale and development of a prehospital goal-directed bundle of care to prevent rearrest after return of spontaneous circulation.

In patients with out-of-hospital cardiac arrest (OHCA) who attain return of spontaneous circulation (ROSC), rearrest while in the prehospital setting represents a significant barrier to survival. To date, there are limited data to guide prehospital emergency medical services (EMS) management immediately following successful resuscitation resulting in ROSC and prior to handoff in the emergency department. Post-ROSC care encompasses a multifaceted approach including hemodynamic optimization, airway management, oxygenation, and ventilation.

Projected health workforce requirements and shortage for addressing the disease burden in the WHO Africa Region, 2022-2030: a needs-based modelling study.

Introduction: An adequate health workforce (HWF) is essential to achieving the targets of the Sustainable Development Goals (SDG), including universal health coverage. However, weak HWF planning and constrained fiscal space for health, among other factors in the WHO Africa Region, has consistently resulted in underinvestment in HWF development, shortages of the HWF at the frontlines of service delivery and unemployment of qualified and trained health workers. This is further compounded by the ever-evolving disease burden and reduced access to essential health services along the continuum of health promotion, disease prevention, diagnostics, curative care, rehabilitation and palliative care.

Physicochemical attributes and acceptability of marula wine fermented with natural and .

The aim of the study was to test the acceptability and physico-chemical characteristics of marula wine fermented with known cultures of natural and . The LAB and dominate the fermentation of marula wine throughout the fermentation period. These were isolated and identified from the spontaneously fermented marula wine and re-inoculated as single cultures and as mixed cultures to ferment marula juice into wine.

Financing health system elements in Africa: A scoping review.

Countries that are reforming their health systems to progress towards Universal Health Coverage (UHC) need to consider total resource requirements over the long term to plan for the implementation and sustainable financing of UHC. However, there is a lack of detailed conceptualization as to how the current health financing mechanisms interplay across health system elements. Thus, we aimed to generate evidence on how to utilize resources from different sources of funds in Africa.

Increasing Clinical Trial Participation of Black Women Diagnosed with Breast Cancer.

Despite racial disparities in breast cancer mortality, Black women remain underrepresented in clinical trials. In this mixed methods research, 48 Black women were engaged via focus group discussions and in-depth interviews to better understand the lived experience of women with breast cancer. The results of this qualitative study informed the development of a subsequent online survey to identify barriers, motivators, and other factors that influence decision-making by Black women diagnosed with breast cancer when considering clinical trial participation.

Making districts functional for universal health coverage attainment: lessons from Ghana.

Ensuring the sub national level in the health system can function effectively is central to attainment of health results in countries. However, the current health agenda has not prioritized how districts can deploy their existing resources effectively, to maximize the efficiency equity and effectiveness in their use. Ghana initiated a self-assessment process to understand the functionality of districts to deliver on health results.

Exploring the lived experiences of parents caring for infants with gastroschisis in Rwanda: The untold story.

Pediatric surgery is a crucial pillar of health equity but is often not prioritized in the global health agenda, especially in low-and middle-income countries. Gastroschisis (GS) is a type of structural congenital anomaly that can be treated through surgical interventions. In Rwanda, neonatal surgical care is only available in one hospital.

Impact of the Implementation of Laboratory Information System (WWDISA) on Timely Provision of HIV-1 Viral Load Results in a Rural Area, Inhambane, Mozambique.

WWDISA is an optional module of the DISA Laboratory Information system (LIS) that offers a web portal that allows access to test results over the internet for patient clinical management. This study aims to assess the applicability of using the WWDISA web application, and the lessons learned from its implementation in six health facilities in Mabote district, Inhambane province. Data from 2463 and 665 samples for HIV-viral load (HIVVL) tests, extracted from paper-based and WWDISA systems, respectively, were included, from January to December 2020.

School feeding contributed valuable dietary energy and nutrients despite suboptimal supply to school-age children and adolescents at primary schools in Addis Ababa, Ethiopia.

Objectives: This study investigated the nutritional quality and adequacy of school meals served to school-age children and adolescents.

Methods: A total of 55 food samples were collected from 11 food types served for breakfast and lunch at 15 selected school kitchens. Each meal was weighed using a digital scale.

COVID-19 in the 47 countries of the WHO African region: a modelling analysis of past trends and future patterns.

Background: COVID-19 has affected the African region in many ways. We aimed to generate robust information on the transmission dynamics of COVID-19 in this region since the beginning of the pandemic and throughout 2022.

Methods: For each of the 47 countries of the WHO African region, we consolidated COVID-19 data from reported infections and deaths (from WHO statistics); published literature on socioecological, biophysical, and public health interventions; and immunity status and variants of concern, to build a dynamic and comprehensive picture of COVID-19 burden.

Prehospital Buprenorphine Treatment for Opioid Use Disorder by Paramedics: First Year Results of the EMS Buprenorphine Use Pilot.

Background: Prehospital initiation of buprenorphine treatment for Opioid Use Disorder (OUD) by paramedics is an emerging potential intervention to reach patients at greatest risk for opioid-related death. Emergency medical services (EMS) patients who are at high risk for overdose deaths may never engage in treatment as they frequently refuse transport to the hospital after naloxone reversal. The potentially important role of EMS as the initiator for medication for opioid use disorder (MOUD) in the most high-risk patients has not been well described.

Impact of school meals on educational outcomes in Addis Ababa, Ethiopia.

Objective: This study evaluated the impact of the Addis Ababa School Feeding Program (SFP) on educational outcomes.

Design: Single-group repeated measurement/longitudinal study design and multistage stratified sampling design were followed. Effect sizes estimates, repeated measures ANOVA, Chi-square, Generalised Additive Mixed Model and mixed effects negative binomial regression were used.

Knowledge, attitude and practice of antibiotics and their determinants in Eritrea: an urban population-based survey.

Objective: To measure knowledge, attitude and practice of antibiotics and antibiotic resistance (ABR) and their determinants in the Eritrean urban population.

Design: A population-based, nation-wide, cross-sectional study.

Setting: Urban settings of Eritrea.

Elevated glycolysis imparts functional ability to CD8 T cells in HIV infection.

The mechanisms inducing exhaustion of HIV-specific CD8 T cells are not fully understood. Metabolic programming directly influences T-cell differentiation, effector function, and memory. We evaluated metabolic profiles of ex vivo CD8 T cells in HIV-infected individuals.

Prehospital Initiation of Buprenorphine Treatment for Opioid Use Disorder by Paramedics.

Prehospital initiation of buprenorphine treatment for Opioid Use Disorder (OUD) by paramedics is an emerging potential intervention. Many patients who may be at high risk for overdose deaths may never engage in treatment because they frequently refuse transport. Recent data have demonstrated a significant increase in both short and long term mortality following an opioid overdose.

Planting Material of Enset (), a Key Food Security Crop in Southwest Ethiopia, Is a Key Element in the Dissemination of Plant-Parasitic Nematode Infection.

Enset (), is a perennial herbaceous plant belonging to the family Musaceae, along with banana and plantain. Despite wild populations occurring in eastern, central and southern Africa, it is only in Ethiopia that the crop has been domesticated, where it is culturally and agriculturally symbolic as a food security crop. Although an under-researched orphan crop, enset serves as a staple food for about 20% of the Ethiopian population, comprising more than 20 million people, demonstrating its value in the country.

Traditional medicine among the community of Gash-Barka region, Eritrea: attitude, societal dependence, and pattern of use.

Background: Despite the growing conventional healthcare coverage in Eritrea, traditional medicine (TM) remains an essential source of healthcare service to the population. This study, therefore, aims at exploring the attitude, societal dependence, and pattern of TM use of the Gash-Barka community.

Methods: A cross-sectional study was conducted between December 2018 and January 2019 in Gash-Barka region, one of the six regions of Eritrea.

A suspended graphene-based optical interferometric surface stress sensor for selective biomolecular detection.

Graphene-based sensors are of great interest in research due to their high specific surface area and high electron mobility that make them suitable for numerous advanced applications. In this paper, selective molecular detection using an antigen-antibody reaction on suspended graphene with a cavity-sealing structure was demonstrated. The suspended graphene sealed nanocavities in a pre-patterned Si substrate, which increased robustness and allowed the use of wet chemical processes for surface functionalization of the suspended graphene to achieve selective molecular binding.

Mortality in children with severe acute malnutrition.

Background: Malnutrition is a major contributor to the global disease burden, accounting for more than one-third of child deaths worldwide. Severe Acute Malnutrition is a disease that is an underlying condition in many under five admissions in the study area of Hiwot Fana Specialized University Hospital, Harare and in Ethiopia as a whole.

Objective: The main objective of the study is to identify the prevalent cause of mortality in Severe Acute Malnutrition, among children aged 6-59 months, admitted to Hiwot Fana Specialized University Hospital, Pediatric ward, Nutrition Rehabilitation Unit from 2013 to 2015.

Identification of preferential CD4+ T-cell targets for HIV infection in the cervix.

A better understanding of the cellular targets of HIV infection in the female genital tract may inform HIV prevention efforts. Proposed correlates of cellular susceptibility include the HIV co-receptor CCR5, peripheral homing integrins, and immune activation. We used a CCR5-tropic pseudovirus to quantify HIV entry into unstimulated endocervical CD4(+) T cells collected by cytobrush.

Working toward a sustainable laboratory quality improvement programme through country ownership: Mozambique's SLMTA story.

Background: Launched in 2009, the Strengthening Laboratory Management Toward Accreditation (SLMTA) programme has emerged as an innovative approach for the improvement of laboratory quality. In order to ensure sustainability, Mozambique embedded the SLMTA programme within the existing Ministry of Health (MOH) laboratory structure.

Objective: This article outlines the steps followed to establish a national framework for quality improvement and embedding the SLMTA programme within existing MOH laboratory systems.

Analysis of the paramedic administration of fentanyl.

Introduction: Pain is a common complaint among emergency medical services patients. When compared with the most commonly used morphine, fentanyl has a shorter onset of action, shorter duration, and far fewer side effects making it an appealing candidate for prehospital pain management. This study's intent is to prospectively assess the feasibility and safety of fentanyl for pain in prehospital patients in comparison with morphine.

Seroprevalence of transfusion-transmissible infections and evaluation of the pre-donation screening performance at the Provincial Hospital of Tete, Mozambique.

Background: The World Health Organization recommends universal and quality-controlled screening of blood donations for the major transfusion-transmissible infections (TTIs): human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV) and syphilis. The study objectives were to determine the seroprevalence of these TTIs among blood donors at the Provincial Hospital of Tete, Mozambique, and to assess the local pre-donation screening performance.

Methods: All consenting voluntary and replacement candidate blood donors were consecutively included from February to May 2009.