Impact of multiple maize technology package adoption on the production efficiency and food security of smallholder farmers in Ethiopia: Evidence from the Sidama region.

This study aimed to investigate the individual or combined impacts of multiple maize technology package adoption on the production efficiency and food security of smallholder farmers in the selected districts of Sidama region of Ethiopia. The cross-sectional data of 424 sample farmers owing 545 maize plots were collected using multistage sampling approaches. The selection-bias corrected multinomial endogenous switching regression (MESR) model was employed to assess the impact of improved maize seed, chemical fertilizers, and row planting adoption on the production efficiency and food security of smallholder maize-producing farmers.

Determinants of hypertension-related knowledge, attitude, and practices (KAP) among caregivers in Neno, rural Malawi: A cross-sectional study.

Background: Hypertension, a significant health concern, increases the risk of cardiovascular disease and premature mortality. Caregivers play a crucial role in ensuring optimal care for hypertensive patients and reducing associated complications. Caregivers' basic knowledge, good attitude, and relevant practices are necessary to ensure high-quality care for patients with hypertension.

Looking under the hood of a hybrid two-way texting intervention to improve early retention on antiretroviral therapy in Malawi: an implementation fidelity evaluation.

Background: While key to interpreting findings and assessing generalizability, implementation fidelity is underreported in mobile health (mHealth) literature. We evaluated implementation fidelity of an opt-in, hybrid, two-way texting (2wT) intervention previously demonstrated to improve 12-month retention on antiretroviral therapy (ART) among people living with HIV (PLHIV) in a quasi-experimental study in Lilongwe, Malawi.

Methods: Short message service (SMS) data and ART refill visit records were used to evaluate adherence to 2wT content, frequency and duration through the lens of the Conceptual Framework for Implementation Fidelity.

Dynamic co-evolution of transposable elements and the piRNA pathway in African cichlid fishes.

Background: East African cichlid fishes have diversified in an explosive fashion, but the (epi)genetic basis of the phenotypic diversity of these fishes remains largely unknown. Although transposable elements (TEs) have been associated with phenotypic variation in cichlids, little is known about their transcriptional activity and epigenetic silencing. We set out to bridge this gap and to understand the interactions between TEs and their cichlid hosts.

An exploration of unusual antimicrobial resistance phenotypes in Salmonella Typhi from Blantyre, Malawi reveals the ongoing role of IncHI1 plasmids.

Typhoid fever is a significant public health problem endemic in Southeast Asia and Sub-Saharan Africa. Antimicrobial treatment of typhoid is however threatened by the increasing prevalence of antimicrobial resistant (AMR) Typhi, especially in the globally successful lineage (4.3.

Examination of adolescent and youth modern contraceptive users' perceptions on how religion influences contraceptive use and their rationale and circumstances of use: qualitative evidence from Burkina Faso, Kenya and Niger.

While religion is a key determining factor of contraceptive use, few studies examine how religion influences adolescent and youth contraceptive attitudes, beliefs, and use. We use recently collected (August-November 2022) qualitative data from Burkina Faso, Kenya, and Niger among young users of modern contraception who practice Christianity or Islam. In-depth interviews with married and unmarried young women ages 18-24 years were conducted in two sites in each country to obtain a mix of religions and method users.

Creating codes of ethics for public health professionals and institutions.

Background: The World Health Organization and the Association of Schools of Public Health in the European Region called for the professionalization of the public health workforce, including the creation of codes of ethics. In this article, the Public Health Ethics and Law Network provides guidance on creating such codes, based on values and principles commonly identified for public health.

Methods: Our interest was in codes addressing public health broadly rather than disciplines within public health.

High unmet needs for cervical cancer screening among women living with HIV in six African countries: A population-based study.

Background: Cisgender women living with HIV (WLWH) are disproportionately impacted by cervical cancer. Nevertheless, disparities in uptake and implementation of cervical cancer services persist in sub-Saharan Africa, where population-level estimates of screening coverage remain scarce.

Methods: We pooled data from nationally representative Population-based HIV Impact Assessment (PHIA) surveys conducted in Ethiopia, Malawi, Rwanda, Tanzania, Zambia, and Zimbabwe (2015-2019).

Socio-economic and demographic determinants of undernutrition among 6-59 months old children living in Malawian stunting hotspots: a cross-sectional community study.

Background: Malnutrition is a global burden, with 171 million under-five children stunted and 45% of child deaths linked to it. Despite high undernutrition such as stunting in Mchinji, Mangochi, and Mzimba, no study has focused on all three hot spots. This study examined socio-economic and demographic determinants of undernutrition among children aged 6-59 months, offering insights to guide targeted interventions in these areas.

Mixed vulnerabilities: the biological risk of high parity is aggravated by emergency referral in Benin, Malawi, Tanzania and Uganda.

Identification of interacting vulnerabilities is essential to reduce maternal and perinatal mortality in sub-Saharan Africa (SSA). High parity (≥ 5 previous births) is an underemphasized biological vulnerability linked to poverty and affecting a sizeable proportion of SSA births. Despite increased risk, high parity women rarely use hospitals for childbirth.

Child Death and Mothers' Subsequent Mental Health in a High-Mortality African Community.

Despite declines in child mortality rates, experiencing a child death remains a common feature of motherhood in many contemporary African populations. Yet, we lack population insights into the consequences of child death for mothers' well-being in the high-mortality regions where it concentrates. Contrasting an extensive psychology literature on the severe and long-lasting consequences of child death for parents in low-mortality settings, a long-standing thesis in multiple social science literature is that the normativity of child death in high-mortality settings can lead to a numbing effect-muting parents' reactions to child loss.

Heme oxygenase/carbon monoxide system affects the placenta and preeclampsia.

Preeclampsia affects 2% to 8% of pregnancies worldwide and results in significantly high maternal and perinatal morbidity and mortality, with delivery being the only definitive treatment. It is not a single disorder, but rather a manifestation of an insult(s) to the uteroplacental unit -whether maternal, fetal, and/or placental. Multiple etiologies have been implicated, including uteroplacental ischemia, maternal infection and/or inflammation, maternal obesity, sleep disorders, hydatidiform mole, maternal intestinal dysbiosis, autoimmune disorders, fetal diseases, breakdown of maternal-fetal immune tolerance, placental aging, and endocrine disorders.

Factors associated with delayed referrals of patients with sepsis from primary to tertiary healthcare in Blantyre, Malawi: a qualitative study.

Background: Sepsis is defined as invasion of pathogens into the blood stream together with the host response to this invasion. Thus, sepsis consists of the systemic inflammatory response syndrome (SIRS)caused by infection. It is a life-threatening condition that requires prompt detection and early definitive medical intervention.

Healthcare provider perspectives on integrating HIV care into cancer centers in Malawi, South Africa, Uganda, and Zimbabwe.

Background: In East and Southern Africa, treatment of people with concomitant cancer and HIV is complicated by siloed service delivery pathways, which exacerbate barriers to care and impact clinical decision-making. Integrating HIV care into cancer treatment centers may improve service delivery and overall patient outcomes.

Methods: We administered a questionnaire to clinicians and support staff at tertiary cancer referral centers in Malawi, Zimbabwe, Uganda, and South Africa to assess level of concern about clinical management of people with HIV (PWH) and cancer, barriers to integrating HIV service delivery into cancer treatment delivery, and beliefs related to HIV, antiretroviral therapy (ART), and integrated care.

Trajectories of HIV Visit Engagement During the Perinatal Period among Women in Lilongwe, Malawi.

Longitudinal patterns of engagement in care among women living with HIV (WHIV) during the perinatal period are poorly understood. We employed group-based trajectory modeling to (1) describe trajectories of HIV visit engagement; and (2) identify predictors of membership in suboptimal care trajectories. Data came from a prospective cohort study across five urban clinics in Lilongwe, Malawi conducted between February 2020 and August 2022.

CO-driven ion exchange for ammonium recovery from source-separated urine.

Nitrogen recovery from urine and CO utilization are both vital for achieving a circular economy and mitigating climate change. Divided engineering solutions have been proposed to address either problem, but there is still a lack of integrated technologies to simultaneously tackle the two tasks. We demonstrated CO-driven ion exchange for nitrogen recovery (CIXNR) from urine and evaluated the process in Malawi.

Global Trends in the Incidence and Primary Causes of Femoral Fractures, Excluding Femoral Neck Fractures: A Global Epidemiological Study.

Purpose: Fractures pose a significant global health challenge, with varying incidence trends and causes across demographics and regions. This study aims to analyze global patterns in the incidence and primary causes of femoral shaft fractures.

Methods: Data from the Global Burden of Disease database were analyzed for femoral fractures (excluding femoral neck fractures) by age, gender, and socio-demographic index regions.

A retrospective review of the common childhood illnesses and the indications for antibiotic prescription at community hospital in Malawi.

Background: Childhood remains a vulnerable period and a key determiner for adult health. Various illnesses experienced by children in their early years determine future performance and contribution to society. Acute and chronic infectious diseases, undernutrition, and early childhood non-communicable diseases have greatly been linked to intellectual disability, poor childhood development, increased morbidity, and household and healthcare economic costs.

Correction: Barriers and facilitators to implementing six monthly multi-month dispensing of antiretroviral therapy in two urban HIV clinics during the COVID-19 Era in Malawi.

[This corrects the article DOI: 10.1371/journal.pgph.

Mycotoxin management in Sub-Saharan Africa: A comprehensive systematic review of policies and strategies in Malawi.

Food safety challenges, such as mycotoxin contamination, pose severe threats to public health, agricultural productivity, and economic development across Sub-Saharan African countries and beyond. This study investigated whether government policies related to food safety adequately address these concerns, using Malawi as a case study. We systematically reviewed 29 government-authored policy documents related to food safety.

Living with psychosis in West and Southeast Africa: SUCCEED Africa's four-country situation analysis.

As part of the formative work of the SUCCEED Africa consortium, we followed a participatory process to identify existing gaps and resources needed for the development and implementation of a rights-based intervention for people with lived experience of psychosis in Malawi, Nigeria, Sierra Leone and Zimbabwe. In 2021, we conducted a desk review of published and grey literature on psychosis in the four SUCCEED countries. Using an adapted version of the PRIME situation analysis template, data were extracted across the five domains of the WHO Community-Based Rehabilitation (CBR) Matrix: health, education, livelihoods, social and empowerment.

Investigator-Initiated Clinical Pharmacokinetic Studies in Resource-Limited Settings: Minimal Requirements and Practical Guidance.

Clinical pharmacology studies are critical for determining the efficacy and safety of drugs. Due to the resource-intensive nature of these studies, most have been conducted in high-income countries, leading to a significant gap in clinical pharmacology data for patients in low- and middle-income countries. This paper provides an overview of the minimal requirements for performing a clinical pharmacology investigator-initiated trial (IIT), including pharmacokinetic sampling.

The Minimum Dietary Diversity For Women Indicator Can Be Extended To Children And Adolescents aged 4-15 Years As A Proxy Population Indicator For Good Micronutrient Adequacy Of Diets In Low- and Middle-Income Countries.

Background: The response to the global call for more data on children's and adolescents' diets and nutrition is limited by the lack of straightforward practical indicators to track their diet quality. On the basis of a food group score compiled from 10 food groups (FGS-10), the minimum dietary diversity for women, calculated as FGS-10 ≥ 5, is a validated proxy population indicator for better micronutrient intake adequacy for adult women in low- and middle-income countries (LMICs).

Objectives: This study aims to validate FGS-10 and its related cutoffs against micronutrient intake adequacy in 4-15-y-old children/adolescents in LMICs.

Neurodiversity in Saudi Arabia: Towards quality education and reduced inequalities.

Traditional educational frameworks in Saudi Arabia have historically adopted a deficit-based approach to special education, potentially overlooking the benefits of neurodiversity. As global educational paradigms shift toward inclusive practices, examining the alignment of Saudi special education laws with neurodiversity principles becomes crucial. This content analysis study aimed to explore the existing literature on special education in Saudi Arabia to ascertain whether the laws and policies support or hinder the practice of neurodiversity, a concept that is gaining international recognition but remains nascent in Saudi Arabia.