Prenatal exposure to genocide and subsequent adverse childhood events are associated with DNA methylation of SLC6A4, BDNF, and PRDM8 in early adulthood in Rwanda.

We investigated associations between prenatal genocidal trauma, including maternal rape, and postnatal adverse childhood experiences (ACEs) on DNA methylation of genes associated with the stress response. In a comparative cross-sectional study of 91 Rwandan young adults, categorized by prenatal exposure to genocide and maternal rape, genocide without rape, and unexposed controls, we analyzed DNA methylation from dried blood spots and assessed ACEs and depression and anxiety symptoms at age 24. Prenatal exposure to maternal rape was associated with DNA methylation changes in BDNF and SLC6A4, with the association in BDNF attenuated after including ACE exposure in the model.

Interventions to ensure access to and continuity of HIV care for international migrants: an evidence synthesis.

International migrants, especially those belonging to key populations, face a considerable HIV burden. However, continuity of HIV care for this group is often challenged along the migration route. We assess the available evidence on the existing interventions that aim to strengthen community and health systems to ensure the continuity of HIV care for international migrants.

Ethical considerations in surgical research conducted in African LMICs: a comprehensive narrative review.

Introduction: Surgical research has revolutionized healthcare by improving the efficacy, safety, and efficiency of surgical interventions. This research has the potential to significantly impact healthcare delivery in Africa, where surgical diseases pose a major public health burden. Studies suggest surgery alone could reduce the global disease burden by 11%, with a substantial portion stemming from conditions prevalent in sub-Saharan Africa like traumatic injuries, childbirth complications, and surgical infections.

Rwanda's success in advancing midwifery education: a blueprint of a sustainable, nationally driven curriculum standardization.

The International Confederation of Midwives (ICM) defines and sets the Essential Competencies for Midwifery Practice and provides a framework for developing and reviewing midwifery curricula. This framework ensures that pre-service midwifery education designed for students leads to the demonstration of the required midwifery specific competencies. The development of the ICM competencies in 2024 confirms the timeliness of the effort of Rwanda to update its national curricula.

The screening and management of skin diseases in remote African regions: a narrative review.

Introduction: Skin diseases in remote African regions are often exacerbated due to a lack of resources and expertise with little current research addressing the challenges that patients and healthcare systems experience. Although skin diseases in remote African regions are prevalent and pose a substantial health burden, they remain neglected and understudied. This review aims to explore current challenges in the diagnosis and management of skin diseases in African regions and focus on the need for enhanced understanding and improved healthcare strategies.

Rwanda's Single Project Implementation Unit: An Effective Donor Coordination Platform in the Journey to Achieving Universal Health Coverage.

Following the devastating 1994 Genocide, the Government of Rwanda and its citizens have worked relentlessly to rebuild the country and reassemble a strong health system. Immediately after the genocide, global development partners sought to swiftly provide aid and support to the country to address urgent health system needs. However, inadequate coordination of the influx of aid resulted in duplicated efforts and inefficient health sector management.

The Pan-African Surgical Healthcare Forum: An African qualitative consensus propagating continental national surgical healthcare policies and plans.

Access to equitable, safe, affordable, timely, and quality surgical healthcare in Africa remains limited. Few African countries have surgical healthcare plans or policies. Where these exist, there are significant gaps in dissemination, funding, and implementation.

Leveraging single-dose human papillomavirus vaccination dose-efficiency to attain cervical cancer elimination in resource-constrained settings.

Background: In low- and middle-income countries, resource constraints remain a critical factor limiting access to cervical cancer preventive measures. The option of single-dose immunization could help improve access to human papillomavirus vaccination and attain cervical cancer elimination.

Methods: With simulation models adapted to country-specific data and scenarios for single-dose protection derived from International Agency for Research on Cancer India vaccine trial data, we estimated the expected impact of single-dose vaccination in India, Rwanda, and Brazil, three countries with varying profiles of cervical cancer risk and vaccination timelines.

Evaluating potential program cost savings with a single-dose HPV vaccination schedule: a modeling study.

Background: There is limited evidence on the magnitude of the potential program cost savings associated with the World Health Organization-endorsed single-dose schedule for the human papillomavirus (HPV) vaccine. The objective of this analysis was to model the delivery and vaccine procurement cost implications of the new schedule.

Methods: The analysis leveraged primary data during a study evaluating the HPV vaccine delivery costs and operational context in 5 countries (Ethiopia, Guyana, Rwanda, Sri Lanka, and Uganda) implementing a two-dose schedule.

Discontinuation of family planning use among women of reproductive age in Rwanda: analysis from three Rwandan Demographic Health Survey (RDHS) 2010-2020.

Background: Family planning (FP) is fundamental in addressing unwanted pregnancies, unplanned pregnancies, unsafe abortions, maternal and child mortalities. It plays a crucial role in achieving the Sustainable Development Goals (SDGs), especial Goal 3. However, despite a high FP discontinuation percentage of 30% in Rwanda, there is limited studies on the contributing factors.

Simplifying acquisition of essential diagnostics: A comprehensive costing tool for anatomic pathology.

Objectives: Histopathology is the core diagnostic tool for cancer in pathology laboratories around the world, but there are disparities in access to diagnostics globally. As recognition of the need for cancer care and treatment grows, especially in the wake of World Health Organization programs for cervical, breast, and pediatric cancers, policymakers and health care funders are seeking tools and processes that allow for the largest number of patients to receive a diagnosis at the lowest cost.

Methods: As histopathology represents the most cost-effective diagnostic method by sheer number of tumor types and volume, understanding the detailed logistics and costs for histology as well as the impactful benefits of economies of scale (ie, larger volumes are less expensive per patient) and scope (ie, the multiple stains available after basic histology sectioning) is paramount to planning an effective publicly funded or government laboratory.

Investigating whether offshore immigration detention and processing are associated with an increased likelihood of psychological disorders.

Immigration policies designed to deter people from seeking asylum are gaining traction in many Western nations, with the UK recently attempting to establish an offshore immigration processing centre in Rwanda. This letter outlines emerging evidence from Australia on the negative long-term psychological effects of offshore processing on people seeking asylum.

Exploring the experiences of traditional practitioners while managing hypertension in Rwanda.

Background: Hypertension (HTN) is a major global health concern, affecting approximately 1.28 billion adults worldwide. In Rwanda, hypertension contribute to 2.

Factors associated with perceived health of school-aged children in rural Rwanda: an opportunity to leverage community health workers to enhance school health promotion and primary healthcare systems linkages.

Background: In many low-income countries, enhancing the health of school-aged children is often impeded by insufficient or limited knowledge regarding their health status. Further, hands-on health promotion interventions are nearly non-existent due to the lack of designated health workers. The disconnection between schools and primary care facilities further exacerbates this issue.

Diagnostic potential of salivary IL-1β, IL-8, SAT, S100P, and OAZ1 in oral squamous cell carcinoma, oral submucous fibrosis, and oral lichen planus based on findings from a Sri Lankan cohort.

The research examined the salivary concentrations of various biomarkers, such as OAZ1, SAT, S100P, IL-1β, and IL-8 aiming to detect early-stage oral squamous cell carcinoma (OSCC). These biomarkers show potential as indicators for detecting both pre-cancerous and cancerous states within the oral cavity. Analyzing these specific molecules in saliva could help clinicians enhance diagnostic accuracy and refine early detection methods for OSCC.

Uptake and perceptions of voluntary medical male circumcision among HIV-negative men in serodiscordant relationships in Zambia (2012-2015).

Voluntary medical male circumcision (VMMC) is a recommended HIV prevention strategy that few studies have promoted to HIV-negative men in serodiscordant relationships. We conducted a cross-sectional study on uptake and perceptions of VMMC among serodiscordant couples between 2012 and 2015. Heterosexual couples attending couples voluntary counselling and testing for HIV who had discordant results (M-, F+) were referred for VMMC.

Great ape abundance and per capita carbon storage in their habitats.

The ecological importance of great apes is widely recognised, yet few studies have highlighted the role of protecting great apes' habitats in mitigating climate change, particularly through carbon sequestration. This study used GIS tools to extract data from various sources, including the International Union for Conservation of Nature database, to examine carbon quantity and great ape abundance in African great ape habitats. Subsequently, we employed a generalised linear model to assess the relationship between locally measured great ape populations abundance and carbon storage across areas with different levels of protection.

Environmentally sustainable surgical systems.

Surgeons, anaesthetists, wider surgical teams and hospital managers are a large global group that has the capacity and power to play a leadership role to contribute to change. Hospitals are a good target for improvement since they are centres of communities, linking together surrounding healthcare facilities and influencing wider determinants of the environment. District and rural hospitals are good sites to start since they serve large populations, have the least sustained energy and clean water supplies and will benefit most from quality improvement.

Midwives' knowledge, attitude, practices, and experiences toward trauma-informed abortion care in urban district hospitals in Rwanda.

In Rwanda, many abortion services are not currently providing trauma-informed abortion care (TIAC) due to laws that restrict service provision and the incorporation of potentially traumatizing procedures with little attention to the woman's experience and support needs. Midwives working in abortion services often lack adequate training to effectively support clients with trauma. The authors aim to evaluate midwives' knowledge, attitudes, practices, and experiences toward TIAC.

An exploratory cross-cultural study of community-based health literacy interventions to promote the mental well-being of disadvantaged and disabled young Africans: a multi-method approach.

Background: This study explores the impact of community-based health literacy interventions on the health and mental well-being of disadvantaged young Africans in Zambia, Sierra Leone, Rwanda, and South Africa. The pandemic has exacerbated mental health problems amongst children and young people, underscoring the urgent need for equitable access to mental healthcare resources. Emphasizing the importance of equitable access to mental healthcare resources, the research addresses educational and income disparities in low- and middle-income countries (LMICs), particularly amongst young Africans with disabilities or vulnerabilities.