Jamhuriya University of Science and Technology

Introduction:Childhood anaemia remains a major public health problem in Ghana, with marked regional and socioeconomic disparities. Conventional regression may not fully capture complex, non-linear relationships among biological, maternal, and household factors. We used supervised machine learning to predict anaemia among children aged 6-59 months using nationally representative survey data. Methods:We analysed the 2022 Ghana Demographic and Health Survey, including de facto children aged 6-59 months with valid haemoglobin and complete covariates (weighted N = 3,382). Anaemia was defined as altitude-adjusted haemoglobin <11.0 g/dL. Twenty-one predictors were included. Data were split into training (80%) and testing (20%) sets using stratified sampling. Six models (logistic regression, decision tree, random forest, gradient boosting, support vector machine, and artificial neural network) were tuned via grid search with 10-fold cross-validation. Results:The weighted prevalence of childhood anaemia was 48.95% (n = 1,655). Gradient boosting showed the best overall discrimination (AUC = 0.72; F1 = 68.99%; accuracy = 66.27%). Support vector machine and logistic regression achieved the highest sensitivity (recall = 72.73% and 71.74%). Random forest showed overfitting (100% training accuracy; test accuracy = 65.23%). Decision tree and neural network performed poorly (AUC = 0.57 and 0.63). Key predictors across models and SHAP were child age, malaria status, maternal anaemia, region, and household wealth (with feature rankings varying by algorithm). Conclusion:Machine learning models achieved moderate predictive performance for childhood anaemia in Ghana. Gradient boosting provided the strongest discrimination, while support vector machine and logistic regression offered higher sensitivity for screening. However, these sensitivities imply that approximately 28-30% of anaemic children may be missed, which should be considered when applying these models in public health screening. Identified determinants support targeted, malaria-integrated nutrition and maternal-child interventions in high-risk groups.

Background:Preventing outbreaks, antibiotic resistance, and healthcare-associated infections (HAIs), infection prevention and control (IPC) is the cornerstone of safe, robust health systems. There is little data on IPC readiness across the country in Somalia due to its weak health system. The study aims to evaluate the preparedness of IPC systems in Somali healthcare facilities by looking at policies, fundamental procedures, and essential resources; to find gaps that guide focused interventions to improve patient safety and the resilience of the health system. Methods:We carried out a cross-sectional secondary analysis of the 2024 Harmonized Health Facility Assessment (HHFA), which included 1,219 healthcare facilities of various categories spread over six states. Data were collected through structured interviews, observations, and facility record reviews. IPC indicators were presented using descriptive and inferential statistics. STATA Version 16 was used for the analyses, and a significance level of p < 0.05 was used. Results:All Somali facilities have inadequate IPC readiness. Just 24% and 18%, respectively, have rules for standard precautions and healthcare waste management; 21% reported waste management training for workers. Hand hygiene supplies (39%), sterilizing equipment (26%), gloves (87%), masks (61%), and protective gowns (61%) were among the critical resources that differed in availability. There were significant regional differences (p < 0.001), with Benadir frequently having better resources than Southwest, Jubaland, Puntland, Galmudug, and Hirshabelle. Conclusion:This study identifies significant gaps in the infection prevention and control (IPC) systems of Somali healthcare facilities, such as a lack of resources, procedures, and regulations that are critical to patient safety. Geographical disparities were apparent. These results underline the necessity of targeted, system-wide interventions to raise IPC readiness, increase resource accessibility, and guarantee uniform policy integration and training, all of which will contribute to the development of a more secure and robust healthcare system in Somalia.

This study investigates the determinants of trade openness in Somalia by examining how the agricultural sector and key macroeconomic factors-including foreign direct investment (FDI), exchange rates, and trade integration-jointly influence trade performance. Drawing on classical and modern trade theories, such as comparative advantage, export performance, and endogenous growth, the study employs annual data spanning 1990-2020 and applies an Autoregressive Distributed Lag (ARDL) model with an Error Correction Mechanism (ECM) to capture both short- and long-run dynamics. The stationarity of the series is assessed using the Augmented Dickey-Fuller (ADF), Phillips-Perron (PP), and KPSS tests. The long-run results indicate that agricultural exports significantly enhance trade openness, highlighting the central role of the agricultural sector in promoting Somalia's integration into international markets. In contrast, FDI inflows exhibit a negative long-term effect, suggesting that investments are often directed to non-trade-oriented sectors, limiting their contribution to trade performance. Short-run dynamics reveal that export growth and exchange-rate stability are crucial for trade performance, whereas exchange-rate volatility can impede trade flows. Comprehensive diagnostic tests confirm the model's robustness and stability. These findings underscore the importance of strengthening agricultural export capacity, maintaining macroeconomic stability, and strategically allocating FDI to trade-enhancing sectors to improve Somalia's participation in global markets.

Objectives To identify the individual and community-level factors associated with barriers to accessing healthcare services among currently married women in Somalia.Design A cross-sectional analysis using data from the 2020 Somalia Demographic and Health Survey.Setting Somalia.Participants A nationally representative sample of 30 311 currently married women aged 15–49 years with complete data on outcome and explanatory variables.Primary outcome measures The primary outcome was ‘reporting at least one barrier to accessing healthcare’, a composite binary variable based on four specific problems: obtaining permission to go for treatment, getting money for treatment, distance to the health facility and not wanting to go alone.Results A substantial majority (77.06%) of married women reported experiencing at least one barrier to accessing healthcare. Financial cost was the most common barrier (69.91%), followed by distance to health facilities (65.95%), reluctance to go alone (49.64%) and the requirement for permission (46.03%). Multilevel analysis confirmed that higher household wealth was strongly protective (richest vs poorest: adjusted OR (aOR)=0.27, 95% CI 0.24 to 0.32). Paradoxically, factors typically considered protective were associated with increased barriers: women with secondary education (aOR=1.19, 95% CI 1.00 to 1.41) and those with educated husbands (aOR=1.23, 95% CI 1.14 to 1.33) reported more obstacles. Similarly, urban residents faced higher odds of barriers than their nomadic counterparts (aOR=1.40, 95% CI 1.27 to 1.55). Significant regional disparities were evident, with community-level context explaining 26.30% of the total variance in reporting barriers.Conclusion Access to healthcare for married women in Somalia is predominantly hindered by economic, educational and community-level constraints. Targeted interventions addressing socioeconomic disparities, infrastructural deficits and specific community contexts are essential to alleviate these barriers.

Introduction and importance: Meckel’s diverticulum (MD) is the most common congenital anomaly of the gastrointestinal tract, resulting from incomplete obliteration of the vitelline duct. Although usually asymptomatic, it may rarely present as an umbilical lesion resembling an umbilical granuloma, creating diagnostic challenges in low-resource settings. Presentation of case: A 4-month-old Somali male infant presented with a persistent umbilical mass and mucous discharge. The lesion had previously been diagnosed as an umbilical granuloma and treated with silver nitrate without improvement. Examination showed a red granulation-like mass at the umbilicus. During surgical exploration, the lesion was found to be a narrow-based Meckel’s diverticulum connected to the ileum through a persistent vitelline duct. A wedge resection with end-to-end anastomosis was performed. The postoperative course was uneventful, and the infant remained well at 1-month follow-up. Clinical discussion: MD affects about 2% of the population and typically presents with bleeding, obstruction, or diverticulitis. Presentation as an umbilical lesion is extremely rare and occurs when the vitelline duct remains patent. Diagnosis often relies on imaging such as a Meckel scan, but none was done here due to presumed granuloma. Surgical resection is the treatment of choice when MD is identified intraoperatively. Conclusion: Persistent or atypical umbilical lesions that fail to respond to conservative treatment should raise suspicion for vitelline duct remnants, including MD. Early surgical evaluation is essential to avoid complications and ensure accurate diagnosis, particularly in resource-limited settings like Somalia.