Osaretin Christabel Okonji

Hemoglobinopathies and hemolytic anemias (HHA) are genetic blood disorders associated with diverse clinical complications, affecting an estimated 2.1 billion people worldwide. The World Health Organization (WHO) African Region accounts for approximately 425.8 million individuals, or 20% of the global HHA prevalence, yet comprehensive assessments of this burden have been lacking. We present the first systematic analysis of HHA burden in the WHO African Region from 2000–2021 using data from the Global Burden of Disease (GBD) 2021 study. We estimated regional, sex-, and age-specific rates (per 100,000 population) of mortality, incidence at birth, and years lived with disability (YLDs) in five-year intervals. Mortality estimates were generated using the Cause of Death Ensemble model (CODEm), supplemented with spatiotemporal Gaussian process regression. Incidence at birth was estimated using DisMod-MR 2.1, a Bayesian meta-regression tool, while YLDs were calculated by multiplying prevalence by disability weights reflecting severity and duration. Between 2000 and 2021, the WHO African Region experienced persistently higher age-standardized death rates from HHA compared to global levels, although regional mortality declined over the period. Sickle cell disorder (SCD) was the predominant contributor, with the highest mortality [3.68 deaths (95% UI 2.04–6.29) per 100,000] and disability burden [41.08 YLDs (95% UI 26.09–58.61)], while thalassemias contributed the least. Disability-adjusted life years (DALYs) were concentrated in western sub-Saharan Africa, accounting for 71.3% of the regional burden. Age-specific estimates revealed that children under five years faced a disproportionate share of mortality and disability. Despite overall declines in mortality, the WHO African Region continues to bear a disproportionate global burden of HHA, particularly affecting young children. These findings underscore the urgent need for strengthened newborn screening, early treatment, and health system interventions to reduce preventable deaths and disability.

Background: Human immunodeficiency virus (HIV) self-testing (ST) is a convenient and discreet practice to know HIV status. It is required to reach the underserved population subgroups. We examined the uptake and factors associated with HIVST among reproductive-aged South African women. Methods: A sample of 8182 women from 2016 South African Demographic and Health Survey data were analysed. Percentage and multivariable logistic regression model were conducted. The significance level was set at p < 0.05. Results: Approximately 3.1% of women had HIVST uptake. Respondents with primary education had a 75% reduction in the odds of HIVST, compared with women who had no formal education. Women who are employed were 1.44 times as likely to have HIVST uptake compared to those not employed. Women aged 20–24 years, 25–29 years, 30–34 years, and 40–44 years had about two times higher odds of HIVST, when compared with women aged 15–19 years. Women who read newspaper or magazine less than once a week or at least once a week were 1.90 and 2.25 times as likely to have HIVST uptake, respectively, when compared with those who do not read at all. Conclusion: The prevalence of HIVST uptake was low. HIVST was associated with women’s sociodemographic characteristics. The findings highlight the importance of addressing women’s needs to know their HIV status. Contribution: This study adds to the body of literature in understanding the utilisation patterns of HIVST across women in South Africa.

Maternal mortality ratios in sub-Saharan Africa remain high and worrisome. Moreover, maternal health indicators have remained poor despite large efforts in the last two decades. This study assesses maternal mortality patterns by age and country. The demographic and health survey data were used for the study. Based on the results, countries with the lowest adult female mortality rate include Senegal, Comoros, Rwanda, Mauritania, Sao Tome and Principe, Gambia, and Ethiopia. In addition, Chad (44.7%), Niger (38.7%), the Congo Democratic Republic (34.8%), Nigeria (34.2%), Mauritania (32.0%), Senegal (29.2%), Liberia (28.8%), Benin (27.8%), and Guinea (27.5%), respectively, reported the highest female deaths that are pregnancy-related. Overall, Lesotho (1024; 95% CI: 731–1318), Liberia (913; 95% CI: 638–1189), Chad (860; 95% CI: 728–993), Congo Democratic Republic (846; 95% CI: 690–1003), Sierra Leone (796; 95% CI: 632–960) and Guinea (724; 95% CI: 531–916) had the leading pregnancy-related mortality ratio per 100,000 live births. The study found that the patterns of death vary across different countries. There is a need for concerted efforts to reduce pregnancy-related deaths in sub-Saharan countries.

Sexually transmitted infection refers to a group of clinical syndromes that can be acquired and transmitted through sexual activity and are caused by a variety of pathogens such as bacteria, fungi, viruses, and parasites. Methods: Demographic and Health Survey data involving women aged 15–49 years were analyzed for this study. The surveys were conducted between 2006–2021. Statistical significance was determined at p < 0.05. Results: From the results, Liberia (33.0%), Mali (14.0%), Guinea (13%), Uganda, and Sierra Leone (12.0% each) had the highest STI prevalence. Prominently from Western sub-Saharan Africa sub-region, Liberia (40.0%), Guinea (31.0%), Mali (28.0%), Cote d’Ivoire (24.0%), Ghana (23.0%) and Mauritania (22.0%) have the highest prevalence of reporting a bad smelling or abnormal genital discharge. In addition, Liberia (30.0%), Uganda (13.0%) and Malawi (10.0%) have the highest prevalence of reporting genital sores or ulcers. Liberia (48.0%), Guinea (34.0%), Mali (32.0%), Ghana and Mauritania (25.0% each) and Uganda (24.0%) reported the leading prevalence of STI, genital discharge, or a sore or ulcer. Conclusion: The prevalence of vaginitis varied according to women’s characteristics. In many countries, younger women, urban dwellers, educated women, rich and unmarried women reported a higher prevalence of STI, genital discharge, or a sore or ulcer. Women should be educated on the advantages of proper hygiene, and prevention and control of STIs. Program planners and policymakers should assess and improve the collaboration and coordination of nutritional and family health programs aimed at addressing women’s health issues.

Background: Overweight and obesity in adults are on the rise around the world, contributing significantly to noncommunicable disease deaths and disability. Women bear a disproportionate burden of obesity when compared with men, which has a negative impact on their health and the health of their children. The objective of this study was to examine the country-level prevalence of overweight and obesity among women of reproductive age in sub-Saharan countries. Methods: A total of 504,264 women from 2006 to 2021 were examined using cross-sectional Demographic and Health Surveys data. The outcome variables for this study include: (a) women who are overweight according to body mass index (BMI) (25.0–29.9kg/m²); (b) women who are obese according to BMI (≥30.0 kg/m²). Results: Eswatini (28%), Mauritania (27%), South Africa (26%), Gabon, Lesotho and Ghana (25% each) had the highest prevalences of overweight. In addition, obesity prevalence was highest in South Africa (36%), Mauritania (27%), Eswatini (23%), Lesotho (20%), Gabon (19%) and Ghana (15%), respectively. Overweight and obesity were more prevalent among older women, those living in urban areas, women with secondary/higher education and those in the richest household wealth quintiles. Conclusion: The risk factors for overweight and obesity, as well as the role that lifestyle changes play in preventing obesity and the associated health risks, must be made more widely known. In order to identify those who are at risk of obesity, we also recommend that African countries regularly measure their citizens’ biometric characteristics.

In May 2022, monkeypox virus (MPXV) outbreak was confirmed amid the coronavirus disease 2019 (COVID-19) pandemic in many parts of the world including Africa. This is the largest outbreak since monkeypox (MPX) was first detected in humans in 1970. The MPX outbreak in Africa is an added burden to the fragile healthcare systems that are already overburdened with several reoccurring epidemics. Although several efforts are in place to effectively contained the outbreak. Several measures such as improved surveillance and diagnostic are necessary to contain the spread of the disease in Africa. This commentary highlights the challenges with the MPX outbreak in Africa and discusses the measures that can be taken to limit the spread of the disease, particularly in high-risk countries.

Background: Access to safe, effective, affordable, and quality medicines is an essential component of the right to health and is also one of the targets in the global development agenda. In this review article, we extensively discuss the challenges and issues surrounding access to medicines in the African region as well as provides recommendations for ensuring medicines security on the continent.Methods: We conducted narrative review with the use of data reported in published literature, reports, and grey literature available in African countries on topics pertaining access to medicines. The authors also snowballed further data to gather information for this review and narrative synthesis was conducted.Results: Africa faces a double burden of infectious and non‐communicable diseases and the need for effective universal access to medicines cannot be deemphasized. However, access to medicines on the continent is not without issues and challenges. Some of which are the high burden of infectious diseases and non‐infectious diseases, limited pharmaceutical industries and high costs of raw materials, overdependence on countries abroad for medicines, poor supply chain systems, lack of government investment in the pharmaceutical sector, unfavourable manufacturing conditions, limited health workforce, lack of sustainable health financing mechanisms, lack of infrastructures and technical know‐how, low investment on research and development, and circulation of fake and counterfeit medicines among others.Conclusion: This review reifies that access to medicines in Africa faces numerous challenges and it emphasizes the urgent need to address these issues as the continent geared towards strengthening its health systems for universal health coverage.