High burden of abnormal cervical smears in South African primary health care: health programmes implications.

Cervical cancer is the second most common malignancy among South African women and the load of abnormal cervical smears has clinical, programmatic and policy implications. This cross-sectional study of women who presented for cervical cancer screening aimed to determine the prevalence of abnormal cervical smears and associated factors in primary health care (PHC) facilities in Gauteng-the most densely populated province in South Africa. A questionnaire collected data on socio-demography, tobacco use, sexual behaviours, HIV status, past treatment for sexually transmitted infections (STI) and cervical cancer screening in the past 10 years.

Advancing Sustainable HIV Services Through Integration in Primary Healthcare in Sub-Saharan Africa: A Perspective on Practical Recommendations.

Sub-Saharan Africa continues to bear a disproportionate burden of the global HIV epidemic. Integrating HIV services into primary healthcare is a crucial strategy to accelerate progress towards ending the epidemic. However, several challenges hinder effective integration, including underfunding, human resource shortages, infrastructure limitations, weak health systems, and sociocultural factors.

Cervical dysplasia in women with HIV in the modern treat-all era: Elevated risk remains despite long-term ART and normal CD4 count.

Objective: To evaluate the impact of ART duration and CD4 count on risk for high grade cervical dysplasia in women with HIV (WWH) compared to women without HIV in the treat-all era with integrase strand inhibitors (INSTIs).

Design: Prospective longitudinal cohort study in Botswana.

Methods: From February 2021 to August 2022, baseline HPV self-sampling was offered to women with and without HIV.

High Detection Rate of Rotavirus Infection Among Children Admitted with Acute Gastroenteritis to Six Public Hospitals in Luanda Province After the Introduction of Rotarix Vaccine: A Cross-Sectional Study.

Rotavirus group A (RVA) is a major cause of pediatric acute gastroenteritis (AGE). Vaccination is an effective public health strategy and Angola implemented it in 2014. This hospital-based study aimed to estimate the prevalence of RVA infection and the severity of AGE in children under five years of age treated at six hospitals in Luanda Province.

High prevalence of reverse transcriptase inhibitors associated resistance mutations among people living with HIV on dolutegravir-based antiretroviral therapy in Francistown, Botswana.

Objectives: We assessed HIV-1 drug resistance profiles among people living with HIV (PLWH) with detectable viral load (VL) and on dolutegravir-based antiretroviral therapy (ART) in Botswana.

Methods: The study utilised available 100 residual HIV-1 VL samples from unique PLWH in Francistown who had viraemia at-least 6 months after initiating ART in Botswana's national ART program from November 2023 to January 2024. Viraemia was categorized as low-level viraemia (LLV) (VL: 200-999 copies/mL) or virologic failure (VF) (VL ≥1000 copies/mL).

Emergence of Omicron FN.1 a descendent of BQ.1.1 in Botswana.

Botswana, like the rest of the world, has been significantly impacted by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In December 2022, we detected a monophyletic cluster of genomes comprising a sublineage of the Omicron variant of concern (VOC) designated as B.1.

The spatial distribution of intimate partner violence prevalence and its associated factors among women aged 15-49 years in Zambia: evidence from the 2018 Demographic and Health Survey.

Background: Intimate partner violence (IPV) includes any physical, sexual, or emotional harm experienced in any intimate relationship that results in negative outcomes. Zambia is one of the countries with the highest prevalence of IPV amongst women in sub-Saharan Africa. This study aims to investigate and describe the prevalence, associated risk factors, and geo-spatial distribution of IPV amongst women aged 15-49 years from the 2018 Zambia Demographic and Health Survey (ZDHS).

Genomic epidemiology and immune escape of SARS-CoV-2 recombinant strains circulating in Botswana.

Objectives: We characterized the molecular and mutational landscape of SARS-CoV-2 recombinant strains in Botswana.

Methods: We performed genomic, phylogenetic, and immunoinformatic analyses of 5254 near-complete genomes from 2020 to 2023. We assessed the presence of mutations of interested (MutOI) that may be associated with immune escape .

Undernutrition and antibody response to measles, tetanus and Haemophilus Influenzae type b (Hib) vaccination in pre-school south African children: The VHEMBE birth cohort study.

Background: Under-vaccination is undoubtedly driving recent worldwide measles outbreaks, but undernutrition may also be playing a role in low- and middle-income countries. Studies have shown reduced immune response to vaccines in undernourished children but few have followed children beyond infancy, when they are more likely to be exposed to infectious diseases.

Methods: In the Venda Health Examination of Mothers, Babies and the Environment (VHEMBE) South African birth cohort study, we examined the relationship between undernutrition, as measured by stunting and other growth measures, and vaccine-specific serum antibody level to three different vaccine types: measles, tetanus and Haemophilus influenzae type b (Hib).

The feasibility and impact of deploying a four-tests panel at antenatal care in primary health care facilities of a developing country, Kenya.

Introduction: Contracting HIV, syphilis, hepatitis B virus (HBV), and malaria during pregnancy significantly affects the health of the woman, the pregnancy, and the unborn child. The World Health Organization (WHO) recommends testing pregnant women for these infections to achieve triple elimination of mother-to-child transmissions. However, this goal has not been fully realized in low- to medium-income countries, primarily due to segmented testing practices.

The epidemiology of laboratory-confirmed Hepatitis B Virus infection in the general population of South Africa, 2016-2018.

Introduction: despite the introduction of the Hepatitis B Virus (HBV) vaccine in South Africa in 1995, HBV remains endemic. South Africa's HBV vaccine coverage for the third dose was 71% in 2015. Information on the HBV prevalence in South Africa in recent years is limited, therefore, we estimated HBV prevalence and described annual trends.

Survival rate of diabetic-related lower extremity amputees in hospitals in the Eastern Cape.

Background: Diabetes mellitus (DM) is a global health concern that has greatly affected South Africa. The gap in the current management of DM has resulted in complications such as lower extremity amputations (LEAs) and death. Eastern Cape province reflects this struggle, with disparities in access to healthcare and poor health outcomes.

Curable Sexually Transmitted Infections Among a Population of South African Nonhealth Seeking Men Who Have Sex With Men Who Were Invited for Screening-A Brief Report.

This study assessed sexually transmitted infection (STI) results among nonhealth-seeking men who have sex with men (MSM) who had not previously screened for curable STIs. Secondary data analysis of a sample of 164 MSM who were STI infection naïve was performed. Data were collected in the Clinical Research Unit (MeCRU) among the MSM in the Tshwane North area, South Africa.

The integrated care costs of HIV and non-communicable diseases in South Africa.

Setting: In sub-Saharan Africa, the syndemic of HIV and non-communicable diseases (NCDs) poses a significant challenge. To address this, leading global think tanks like the WHO advocate for integrated HIV/NCD care at primary healthcare levels. However, comparative empirical data on the costs of integrated care are limited.

The Prevalence of Childhood Asthma, Respiratory Symptoms and Associated Air Pollution Sources Among Adolescent Learners in Selected Schools in Vhembe District, South Africa.

Unlabelled: This study investigated the prevalence of childhood asthma and respiratory symptoms with their associated air pollution sources among adolescents aged 13-14 years residing in a Malaria-endemic region.

Methods: A cross-sectional survey was conducted with 2855 adolescents from fourteen (14) selected schools in communities exposed to high levels of air pollution from indoor residual spraying (IRS) that is used for malaria vector control in the Vhembe region. Data were collected using a self-administered standardized International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire.

Qualitative study exploring reintegration of clinical trial participants with HIV to public health services in Johannesburg, South Africa.

Objective: People living with HIV (PLHIV) are often recruited from primary healthcare clinics (PHC) into clinical trials. On trial completion, they are transferred back to the facility for continued care and support in managing their condition, potentially leading to better health outcomes. Because transferring PLHIV back to PHCs post-clinical trials may result in decreased access to specialised care or resources that were available during the trial, this study explored insights into challenges faced during reintegration from clinical trial settings into PHCs and antiretroviral therapy (ART) adherence post-clinical trials.

Schools of public health as a cornerstone for pandemic preparedness and response: the Africa COVID-19 experience.

Background: The Coronavirus disease (COVID-19) pandemic caused significant morbidity and mortality in Africa, in addition to other socio-economic consequences. Across the continent, Schools of Public Health (SPHs) played several roles in supporting national, regional, and global response to the pandemic. Following a published and grey literature search, this paper reviews and analyses the contribution of SPHs in Africa during the COVID-19 pandemic.

Rural women's preferences for cervical cancer screening via HPV self-sampling: a discrete choice experiment study in chidamoyo, Hurungwe District, Zimbabwe.

Background: Cervical cancer screening using HPV self-sampling presents a valuable opportunity to enhance access for underserved and never-screened women in Zimbabwe. However, to ensure the successful implementation of this innovative approach, it is crucial to understand the preferences of key stakeholders, particularly women, with regard to the various components of an HPV self-sampling intervention.

Objective: This study aimed to elicit rural women's preferences for HPV self-sampling.

Did socioeconomic inequalities in overweight and obesity in South African women of childbearing age improve between 1998 and 2016? A decomposition analysis.

Overweight and obesity in adult women contribute to deaths and disability from non-communicable diseases (NCDs) and obesity-related health problems in their offspring. Globally, overweight and obesity prevalence among women of childbearing age (WCBA) has increased, but associated socioeconomic inequality remains unclear. This study, therefore, assesses the changing patterns in the socioeconomic inequality in overweight and obesity among South African non-pregnant WCBA between 1998 and 2016.

Concentrations of potentially toxic metals and trace elements in pregnant women and association with birth outcomes: A cross-sectional study in Malawi.

Potentially toxic metals and trace elements have been used in Malawi for a long time. However, data on exposure to these elements by susceptible groups like pregnant women and its associations with reproductive health outcomes in Malawi and southern hemisphere is limited. We investigated the concentrations of potentially toxic metals as well as trace elements in pregnant women and assessed the relationship between the levels these elements in maternal blood and sociodemographic factors, dietary habits and birth outcomes.

Incompleteness and Misclassification of Maternal Deaths in Zimbabwe: Data from Two Reproductive Age Mortality Surveys, 2007-2008 and 2018-2019.

Introduction: We implemented two cross-sectional reproductive age mortality surveys in 2007-2008 and 2018-2019 to assess changes in the MMR and causes of death in Zimbabwe. We collected data from health institutions, civil registration and vital statistics, the community, and surveillance. This paper analyses missingness and misclassification of deaths in the two surveys.