Introduction:this study aims to assess the prevalence of hookah use and its associated factors among pupils and students in the prefecture of Labé. Methods:a cross-sectional study was conducted from March 28 to April 30, 2022. Data were collected using a structured questionnaire administered to 1,043 participants in four secondary schools and two higher education institutions in the city of Labé. The data collected were entered into Excel before being analysed using SPSS version 26 software. Results:a total of 1,043 pupils and students participated in this study. Approximately 22.7% of participants, including 55.7% of pupils and 44.3% of students, reported having used shisha. The prevalence of regular use was 2.7%. In addition, the study revealed a higher prevalence among men than among women, with socio-cultural distinctions still evident in smoking habits. Analysis of differences in the distribution of the phenomenon studied showed more frequent consumption among men, people over the age of 18, and those living in urban areas. Belonging to a group of friends who were consumers was also significantly linked to hookah consumption, while attending public or private school had no influence. Conclusion: this study highlights the dangers of hookah smoking, which has become an increasing concern for younger generations.
Secondary hyperparathyroidism (SHPT) is a frequent complication in dialysis patients arising from disrupted calcium-phosphate metabolism. While calcimimetics offer alternatives to traditional treatments, comparative effectiveness data between cinacalcet and etelcalcetide remain limited. This study aimed to systematically compare their efficacy and safety in managing SHPT in adult dialysis patients. A systematic review and meta-analysis were conducted following PRISMA guidelines. PubMed, Embase, Scopus, Web of Science, and Cochrane Library were searched through August 2024. Eligible studies included randomised controlled trials of adult dialysis patients with SHPT receiving cinacalcet or etelcalcetide. Primary outcomes were PTH reduction, calcium and phosphorus changes, and adverse events. Data were analysed using Review Manager 5.4 with random-effects models. From 2,623 identified records, 33 studies met inclusion criteria (26 contributing to meta-analysis). The cinacalcet group included 6,587 patients versus 4,876 controls; etelcalcetide included 1,150 patients versus 1,055 controls. Both agents achieved >30% PTH reduction (cinacalcet: RR 3.36, 95% CI: 2.13-5.30; etelcalcetide: RR 6.49, 95% CI: 2.49-16.97), with no significant difference between drugs (P=0.22). Both reduced serum calcium by 0.78-0.90 mg/dl and phosphorus by 0.45-0.83 mg/dl over 12 months. Common adverse events included nausea, vomiting, and hypocalcemia. Etelcalcetide was associated with significantly increased muscle spasms. Both cinacalcet and etelcalcetide effectively manage SHPT with comparable efficacy in reducing PTH, calcium, and phosphorus levels. Etelcalcetide's intravenous administration may enhance adherence but increases muscle spasm risk. Treatment selection should consider individual patient factors and preferences.
Introduction: noncommunicable diseases (NCDs) are rising in Somaliland, yet evidence on implementing effective prevention and control in resource-limited settings remains scarce. In 2022, Somaliland launched its first pilot NCD clinic at Hargeisa Group Hospital, modelled after package of essential noncommunicable (PEN-plus) in Rwanda, treating heart failure, hypertension, diabetes, chronic obstructive pulmonary disease (COPD), and asthma. It is staffed by nurses and general practitioners under the supervision of an Internal Medicine specialist and has enrolled over 2000 patients. We evaluate the clinic´s impact on hypertension control to inform improvements and national scale-up. Methods: a quasi-experimental pre-post design with mixed-effect models was used, analyzing data from 2022-2024. The outcome was a change in systolic blood pressure (SBP) and diastolic blood pressure (DBP) from initial to follow-up visits among hypertensive patients with at least one follow-up. Results: three hundred and forty-eight (348) patients (56.6 years and 60% female) were included and had a median follow-up of 3 visits (IQR 3) over 114 days (IQR 185). Baseline mean BP was 148.6/96.0 mmHg (95% CI: 139.0-158.3 / 91.9-100.9). Clinic attendance was associated with a significant reduction in SBP, ranging from 10.3 mmHg (95% CI: -12.8, -7.7) at first follow-up to 17.3 mmHg (95% CI: -23.4, -11.1) at last follow-up; DBP dropped 5.6 mmHg (95% CI: -7.1, -4.1) to 8.0 mmHg (95% CI: -11.6, -4.3). Conclusion: the NCD clinic markedly improved hypertension control. Sustaining this reduction in BP could contribute to reducing the risk of major cardiovascular disease events and overall NCD-related mortality in Somaliland. Lessons from this pilot will guide the national scale-up of NCD clinics in Somaliland.
HIV-associated myopathy is a frequent neuromuscular complication characterised mainly by inflammatory or toxic muscle involvement, leading to proximal muscle weakness. We report the case of an HIV-positive patient presenting with myopathy confirmed by electromyography. The clinical presentation was marked by symmetrical proximal muscle weakness, asthenia, anorexia, weight loss, and anaemia. A muscle biopsy was not performed. This case highlights the importance of early clinical and electrophysiological recognition for proper management.
Stress is prevalent among health science students, particularly in rural settings where access to mental health resources is limited. Mobile health (mHealth) interventions offer a promising avenue for providing accessible support for stress management. This scoping review aims to identify existing mHealth interventions, evaluate their feasibility and acceptability, and explore the specific needs of students within these contexts. This scoping review will be conducted using the Arksey and O'Malley framework, a structured approach that consists of six stages: identifying the research question, searching for relevant studies, selecting studies, charting the data, collating and summarising the results, and consulting stakeholders. The search will include a comprehensive range of electronic databases and grey literature sources to ensure broad coverage of relevant studies. The Joanna Briggs Institute (JBI) guidelines will be used to enhance the methodology, ensuring rigour and transparency throughout the review process. A systematic search strategy will be employed across multiple databases to gather relevant literature on mHealth interventions targeting stress management among health science students. The findings of this review, which will be disseminated through academic journals and conferences, are crucial in informing policymakers, researchers, and educators about effective mHealth strategies tailored for health science students. By highlighting gaps in current research and practice, this review will contribute valuable insights that can guide future intervention development and implementation in rural settings. The findings from this review will help shape a contextually appropriate mHealth program designed to support stress management for health science students studying in rural university settings.
Chronic kidney disease (CKD) is a significant health burden globally, associated with high healthcare costs and mortality rates. In Africa, the prevalence of CKD is estimated at around 10-15% in adults, with factors such as HIV, diabetes mellitus, hypertension, and cardiovascular disease contributing to its prevalence. We performed a systematic review to evaluate the prevalence of chronic kidney disease in sub-Saharan Africa between 2018 and 2023. We searched Google Scholar, PubMed, and Cochrane Review from 2018 until 2023, and we included studies that looked at the prevalence of chronic kidney disease. The secondary outcome of interest was patient as defined by any cause of mortality. A comprehensive search yielded 10 studies for analysis, reporting a prevalence rate of CKD ranging from 9.8% to 29.9%. Factors such as age, hypertension, and diabetes mellitus were found to be associated with CKD prevalence. A total of 6,963 patients were involved in the studies. However, none of the included studies explored the outcome of mortality among CKD patients. The study was found to have a good assessment using the Ottawa-Newcastle scoring for cross-sectional studies. The prevalence of chronic kidney disease is high. The outcomes of chronic kidney disease are poorly explored in sub-Saharan Africa.
Introduction:WHO and other partners initiated Big Catch-up (BCU) to catch up children aged 12 to 59 months (about 5 years) who have never been vaccinated or are under-vaccinated because of the COVID-19 pandemic. Among the eligible countries are 16 from Central and West Africa. This study aims to analyze challenges and opportunities for this global initiative's success. Methods:this was a secondary analysis of aggregated program data conducted in 16 countries in Central and West Africa eligible for the BCU. Data were collected through the BCU plans developed by countries, on vaccination coverage for each antigen included, epidemiological surveillance data for vaccine-preventable diseases (VPD) in countries and narrative reports on the implementation of BCU. The proportions of remaining targets to be achieved by country are obtained by dividing the number of children vaccinated in the numerator by the targets for zero doses or under-immunized children in the denominator by antigen. A simple logistic regression was performed to establish relationships between vaccination and the occurrence of vaccine-preventable diseases after COVID-19 and the implementation of BCU. Results:outbreaks of VPD increase significantly in post-COVID-19 cases and during BCU implementation. All countries except Nigeria still have at least 70% of targets to catch up by December 2025. Two countries are categorized as making good progress, having achieved more than 50% vaccination coverage and DTP and measles: Nigeria and Mali. Cameroon, Côte d'Ivoire and Burkina Faso are making average progress in terms of vaccination coverage of the same antigens between 20-49%. Conclusion:this initiative helped to curb the occurrence of VPD epidemics. However, the challenges are enormous. Countries must continue to organize further large-scale catch-up rounds and seize every opportunity for vaccination to significantly reduce ZD and Ui and thus VPD epidemics.
Health systems (HSs) in sub-Saharan Africa (SSA) face significant challenges. Integrated HSs approach has been considered a feasible option for eliminating HIV, syphilis and hepatitis B (triple elimination). We performed a systematic review to determine the extent of utilisation of the integrated HSs approach towards triple elimination in SSA countries. We registered the systematic review protocol on PROSPERO (ID: CRD420251011221). We adopted Arksey and O'Malley's review methodology framework for article searching on databases: Medline (using PubMed interface), EMBASE and EBSCOHOST. Studies published from March 2015 to March 2025 were assessed by two reviewers independently. Joanna Briggs' checklist was used to assess the quality of included studies. Thematic analysis was performed, and results were reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. A total of 533 studies were identified from databases. Eighteen studies were fully reviewed. Five themes were developed: Effectiveness of HSs integration, Barriers to HSs integration, Facilitators for HSs integrated approach on triple elimination, Improved case detection, and Recommendations to HSs integration. All themes but one were developed from sub-themes that were built around six blocks of the health systems, according to the World Health Organization. Progress in the integrated approach exists. A fully integrated HSs approach for triple elimination remains unmet in SSA. Facilitators and barriers within the WHO's HSs building blocks can work for or against an integrated approach towards triple elimination, offering a roadmap for future efforts to strengthen HSs. Further enquiry into HSs integrated approach needs to be considered towards triple elimination.
Introduction: stroke is a leading cause of motor disability globally. Robot-assisted gait training (RAGT) is increasingly used to support post-stroke gait rehabilitation by providing repetitive, task-specific walking practice. This narrative review examines recent evidence on exoskeleton, end-effector and hybrid limb guidance systems in RAGT and their effects on functional outcomes in patients with stroke. Methods: a structured narrative review of clinical studies published between January 2021 and December 2025 was conducted. PubMed, Scopus and Web of Science were searched on 13 March 2026. Studies were included if they involved adult stroke survivors, investigated exoskeleton, end-effector or hybrid RAGT, included a control or comparison group, and reported at least one functional outcome related to gait, balance, mobility, motor function or activities of daily living. Results: twenty-one studies involving 1,168 participants were included. Fifteen studies evaluated exoskeleton systems only, three evaluated end-effector systems only, two evaluated hybrid systems, and one directly compared exoskeleton and end-effector RAGT with conventional overground gait training. Exoskeleton studies commonly reported improvements in gait speed, walking endurance, balance, lower-limb motor function and functional independence. End-effector studies showed promising findings for gait-related outcomes, but evidence remains limited. Hybrid systems did not consistently show superiority over conventional rehabilitation. Most studies were limited by small sample size, short intervention duration and limited follow-up. Conclusion: current evidence suggests that RAGT may support functional recovery after stroke, particularly when combined with conventional physiotherapy. Larger trials with direct device comparison, standardised outcomes and longer follow-up are needed.
Introduction: non-small cell lung cancer accounts for most lung cancer-related deaths worldwide. Although tumour-node-metastasis staging remains the cornerstone of prognostication, histological subtype and tumour differentiation may provide additional prognostic value, particularly in low- and middle-income countries where advanced molecular testing is limited. Evidence on these factors in Ethiopia is scarce. Methods: an institution-based retrospective cohort study was conducted among 202 adult patients who received follow-up care at three specialised hospitals in Ethiopia between January 2020 and January 2025. Data were extracted from medical records and supplemented with telephone follow-up to ascertain survival outcomes. Overall survival was estimated using the Kaplan-Meier method, and Cox proportional hazards regression models were applied to identify independent predictors of mortality, with statistical significance set at p < 0.05. Results: the median overall survival was 10 months. Patients with squamous cell carcinoma had significantly better survival than those with non-squamous cell carcinoma (log-rank p = 0.020). Survival also differed significantly by histological differentiation (log-rank p = 0.001). In multivariate analysis, advanced primary tumour stage, contralateral nodal involvement, distant metastasis, non-squamous histology, moderately or poorly differentiated /undifferentiated tumours, and poor performance status were independently associated with worse survival. Similarly, Patients aged 40-59 years and ≥ 60 years had significantly lower hazards of death compared with patients aged under 40 years. Conclusion: histological subtype and tumour differentiation are independent predictors of survival among NSCLC patients in Ethiopia, beyond conventional TNM staging. These findings provide context-specific evidence from an Ethiopian cohort, where advanced molecular profiling is limited, and highlight the prognostic value of routinely available histopathological features in guiding clinical decision-making in resource-constrained settings.
Introduction: to describe the clinical and paraclinical characteristics as well as early treatment outcomes of patients with postoperative peritonitis following gastrointestinal surgery. Methods: a retrospective observational descriptive study was conducted on 33 patients diagnosed with localised or generalised postoperative peritonitis at Hanoi Medical University Hospital between January 2021 and August 2022. Data regarding demographic characteristics, clinical manifestations, laboratory and imaging findings, treatment methods, and short-term outcomes were collected from medical records. Descriptive statistics and exploratory subgroup analyses using Chi-square or Fisher's exact tests were performed using SPSS version 25.0. Results: the mean age was 51.74 ± 15.3 years, and 60.7% of patients were aged ≥50 years. Localised peritonitis accounted for 72.7% of cases, whereas generalised peritonitis accounted for 27.3%. Abdominal pain was the most common symptom (78.8%), and elevated white blood cell count was observed in 57.6% of patients. Tachycardia and abdominal wall reaction were more frequently observed in generalised peritonitis (p<0.05). CT imaging commonly identified intra-abdominal abscesses, free fluid, and anastomotic leakage. Most localised cases were managed conservatively or with image-guided percutaneous drainage, whereas all generalised cases underwent surgical treatment (p<0.01). No early postoperative complications or mortality were documented during hospitalisation. Length of hospital stay was shortest in the medical treatment group and longest among surgically managed patients. Conclusion: postoperative peritonitis is more prevalent in older adults and presents with variable clinical features. CT imaging plays a key diagnostic role. Early detection and appropriate treatment, conservative for localised and surgical for generalised cases, are critical for favourable short-term outcomes.
Disease outbreaks are non-random public health phenomena attributed to known or idiopathic human, animal, and animal-based factors; a realm referred to as the One Health concept; a new global public health order for control and prevention of epidemics, endemics, and pandemics. These are diseases of viral, prion, bacterial, fungal, and parasitic origin, transmitted between vertebrate animals and humans and vice versa. Emergence and re-emergence of zoonotic diseases such as rabies, Ebola, COVID-19, monkeypox, avian influenza, anthrax, brucellosis, leptospirosis, and Lyme disease continue to affect populations across the world, pointing to unexpected budget impacts of the affected countries.
Introduction:sensitive disease surveillance is essential for global health security, yet fragile, conflict-affected settings like Somalia face critical human resource and capacity challenges. District and regional surveillance officers are frontline personnel whose competencies in epidemiology, outbreak investigation, and data analysis directly influence early detection, rapid response, and containment of public health threats. Methods:a descriptive cross-sectional study was conducted from 1st to 30th April 2025 among all 90 active surveillance officers (72 District Surveillance Officers, 18 Regional Surveillance Officers) across Somalia's Federal Member States. A structured, self-administered questionnaire assessed demographic characteristics, training history (IDSR, FETP, outbreak investigation, rapid response, scientific reporting), and self-reported competencies in core surveillance domains. Results:of 90 invited officers, 68 completed the survey (response rate 75.6%). Participants were predominantly male (86.8%) and aged 20-39 years (95.6%), with 95.6% holding bachelor's or master's degrees. IDSR training coverage was high (96.6%), yet only 10.3% of district officers participated in FETP. Outbreak investigation experience was highest for cholera (54.4%) and measles (47.1%), but low (<20%) for AFP, malaria, diphtheria, and respiratory infections. Technical skills in Excel were widespread (≥75%), whereas GIS (25%) and Power BI (<5%) proficiency were limited. Geographic distribution was uneven, with 27.9% of officers based in Banadir and underrepresentation in peripheral regions. Conclusion:critical gaps in advanced epidemiological skills, specialized outbreak experience, and workforce equity among Somali surveillance officers undermine national disease detection and response. Prioritizing surveillance officers on FETP, targeted refresher training, technical upskilling in GIS and data visualization, and motivation are recommended.
Glycemic control is a critical component in the management of diabetes mellitus among children and adolescents. This narrative review synthesizes existing evidence on the status of glycemic control-both good and poor-and its associated factors among Ethiopian children and adolescents living with diabetes. The objective of the review was to assess the pattern of glycemic control and identify factors associated with both good and poor glycemic outcomes among children and adolescents with diabetes in Ethiopia. Relevant studies reporting on glycemic control and associated factors were identified through searches conducted in Google Scholar, PubMed/MEDLINE, African Journals Online, and the Ethiopian Medical Journal. Additional grey literature sources were also reviewed. Eligible studies were screened and narratively synthesized. The prevalence of poor glycemic control among Ethiopian children and adolescents ranged from 39.3% to 89.3%. Conversely, good glycemic control was reported in 16.4% to 60.7% of participants. Factors associated with glycemic control included socio-demographic characteristics, treatment-related variables, health system constraints, and dietary habits. Poor glycemic control is widespread among Ethiopian children and adolescents with diabetes, underscoring the urgent need for improved management strategies and targeted interventions. Strengthening diabetes education, promoting self-monitoring of blood glucose, and improving access to essential medical supplies and insulin may help enhance glycemic outcomes.
We here report the case of a 30-year-old woman presenting with acute coronary syndrome complicated by acute ischemia of the left upper limb. She underwent Fogarty thrombectomy via humeral approach, with uncomplicated postoperative course. Given the rarity of non-traumatic acute upper limb ischemia, this case highlights the importance of diagnosis and management of acute coronary syndromes to prevent potential complications that may threaten both functional and vital prognosis.
Introduction:a significant proportion of medical errors can be attributed to miscommunication between healthcare professionals. Effective interprofessional handover is heavily dependent on interprofessional collaboration, which can itself be affected by factors such as hierarchies, interprofessional differences, and unawareness of the other professionals' skillsets and expertise. The purpose of this study was to establish the potential effect(s) that interprofessional knowledge or lack thereof had on interprofessional communication and collaboration within prehospital to emergency centre (EC) patient handover. Methods:a qualitative descriptive design was used, with face-to-face, semi-structured interviews to gather data from 15 purposefully selected prehospital emergency care providers. Interviews were transcribed and imported into ATLAS.ti where they were coded using the principles of qualitative description. Data collection was concluded when saturation had been reached. Results:four dominant themes were identified relating to interprofessional knowledge as a factor in prehospital to emergency centre (EC) handover. These themes were: 1) lack of interprofessional knowledge, 2) lack of understanding of working environments, 3) prehospital understanding of pressures within the EC, and 4) the need for interprofessional education and collaboration. Conclusion:this is one of the few studies in a middle-income country relating the prehospital to the emergency centre patient handover. Improving interprofessional knowledge regarding qualification, capabilities, and working environment, interprofessional respect and communication can potentially improve interprofessional patient handover and patient safety. The findings of this study could be used to inform healthcare providers, policymakers, healthcare staff, and researchers to formulate intervention strategies to improve prehospital to emergency centre patient handover.
