University of Africa

The CD4/CD8 ratio is a pivotal metric in assessing the status of the immune system, crucially implicated in human immunodeficiency virus (HIV) infection dynamics. This review elucidates the multifaceted roles of CD4 and CD8 T cells in immune surveillance and response orchestration. We explore the intricate mechanisms governing their equilibrium and the consequential impact on immune homeostasis. Moreover, we dissect how HIV undermines this delicate balance, precipitating a cascade of immune dysregulation culminating in AIDS progression. Insights into the CD4/CD8 ratio's prognostic value for disease trajectory and treatment efficacy are discussed, highlighting its potential as a pivotal biomarker in clinical management. Additionally, it interrogates emerging therapeutic modalities leveraging the manipulation of CD4/CD8 ratios as a strategic avenue for HIV intervention. Immunomodulatory agents and gene-based approaches aimed at restoring immune balance hold promise in bolstering host defenses against HIV. By harnessing a deeper understanding of the interplay between CD4 and CD8 T cells, novel therapeutic strategies seek to fortify the immune landscape against HIV-induced immunopathogenesis. This review underscores the significance of CD4/CD8 ratios as not only diagnostic indicators but also as potential targets for therapeutic intervention, heralding new horizons in the battle against HIV/AIDS.

Occult hematopoietic malignancies are a subset of blood cancers that evade conventional diagnostic methods, often presenting with minimal or non-specific clinical features. These hidden neoplasms, including early-stage leukemias and lymphomas, pose significant challenges due to their potential for rapid progression and transformation into aggressive disease. Advances in molecular diagnostics, immunophenotyping, and imaging have improved detection of subclinical malignancies, revealing complex interactions between malignant clones and the bone marrow microenvironment. This narrative review synthesizes current insights into the pathophysiology, clinical presentation, and prognostic implications of occult hematopoietic malignancies. Emphasis is placed on emerging diagnostic strategies, risk stratification, and the clinical significance of early detection in guiding therapeutic decisions and improving patient outcomes.

Chronic myeloid leukemia (CML) and chronic lymphocytic leukemia (CLL) predominantly affect older adults, presenting unique challenges in early detection and long-term management. The growing elderly population globally has intensified the public health burden of these chronic leukemias, particularly in low-resource settings. This narrative review synthesizes current evidence on the epidemiology, clinical features, early detection, and long-term care of CML and CLL in elderly populations, with a focus on public health implications and region-specific considerations. A structured literature search was conducted across PubMed, Scopus, Web of Science, and Google Scholar, including studies published from 2000 to 2025. Risk-based screening protocols, economic burden, and disparities in low-resource settings were emphasized. CML and CLL incidence increases with age, with median diagnosis ages of 67 and 70 years, respectively. Early detection is often delayed due to non-specific symptoms, limited molecular diagnostics, and sociocultural factors. Long-term management is complicated by comorbidities, treatment adherence challenges, and fragmented care systems. Evidence-based strategies, including risk-based screening, multidisciplinary care, and community-based interventions, improve outcomes. In low-resource settings such as Zimbabwe, disparities in diagnostic capacity, drug availability, and supportive care significantly affect disease outcomes. Economic analyses highlight that early detection and guideline-adherent monitoring are cost-effective, reducing complications and optimizing resource utilization. Effective management of CML and CLL in elderly populations requires integrated strategies combining early detection, personalized care, and health system strengthening. Tailored interventions addressing both clinical and socioeconomic determinants of health, particularly in low-resource environments, are essential to improve survival, quality of life, and cost efficiency.

Dominant development paradigms remain largely anthropocentric, positioning the natural environment as a passive resource rather than an active participant in development. This study analyses Indigenous environmental ethics as a decolonial framework for reconfiguring human-environment relations. Drawing on insights from Birchenough Bridge and Honde Valley in Zimbabwe, the study employs a collaborative Indigenous research methodology involving purposive and relational sampling, engaging 29 participants in Birchenough Bridge and nine in Honde Valley. Data were generated through walking discussions, storytelling, environmental observations, site visits, and co-analysis. The findings show that the environment functions as a moral agent shaping human behaviour through relational reciprocity, ecological restraint, and community governance practices. Environmental elements such as rivers, trees, soils, and seasons informed ethical conduct, risk awareness, and livelihood decisions. At the same time, the erosion of these ethics through commercialisation, religious shifts, and environmental exploitation reveals tensions between Indigenous moral systems and contemporary development pressures. The study further demonstrates how Indigenous environmental ethics contribute to advancing the Sustainable Development Goals, particularly those related to environmental justice and sustainability. It also highlights implications for eco-social policy, calling for frameworks that recognise the environment as a co-participant in development processes.

This narrative review investigates the implications of out-of-pocket (OOP) payments for malaria treatment in developing countries by synthesizing evidence from peer-reviewed articles, reports, and policy documents. A thematic approach was employed to analyze key areas, including economic impacts on households, barriers to accessing care, and the overall effectiveness of malaria control interventions. The review also evaluated alternative financing mechanisms and their potential to mitigate the financial burden on vulnerable populations. The findings reveal that OOP payments significantly hinder timely access to malaria treatment, disproportionately affecting low-income and rural households. Delayed treatment-seeking behavior, underutilization of preventive measures such as insecticide-treated nets, and suboptimal use of diagnostics were identified as major challenges. Furthermore, the financial burden of OOP payments exacerbates health inequities, increasing morbidity and mortality among marginalized groups. Effective alternatives, such as government subsidies, community health insurance, and donor-funded programs, were highlighted as solutions to reduce these barriers. The review concludes that reducing OOP payments is critical to improving malaria control and ensuring equitable healthcare access in developing countries. It recommends scaling up subsidized care, strengthening public health systems, and engaging in public-private partnerships to enhance the availability and affordability of malaria interventions. Policymakers are urged to prioritize financial protection strategies to achieve sustainable progress in malaria eradication efforts.