Introduction Despite Ethiopia’s remarkable progress in reducing deaths among children under five, neonatal mortality remains high. The provision of immediate Kangaroo Mother Care (iKMC) for clinically unstable preterm and low-birth-weight (LBW) newborns has proven effective in lowering neonatal mortality related to preterm newborns. This study aimed to assess Ethiopia’s health system readiness to integrate iKMC into Level 2 small and sick newborn care (SSNC) units, with a focus on a selected network-of-care facilities in the Sidama region. Methods We employed a mixed-method design. Through a cross-sectional quantitative facility mapping across a network of 25 facilities, data were electronically captured and analyzed in SPSS using descriptive statistics. The qualitative assessment included in-depth interviews and focus group discussions with mothers and family members of preterm or LBW newborns and a range of stakeholders. Data were coded, thematized, and analyzed using the World Health Organization health systems building blocks and the SSNC continuum of care. Results Out of the 25 facilities, 8 (32.0%) had inpatient newborn care units (NCUs) and attended to 16,843 (68.4%) of all mapped births, 1,044 (96.6%) of all preterm births, and 1,143 (94.0%) of all LBW births recorded in the 12-months preceding the assessment. Four facilities with NCUs, admitting 93.4% of preterm and 88.2% of LBW newborns from the catchment area, were identified as eligible to introduce iKMC. All four iKMC-eligible facilities provided antenatal corticosteroids, had trained dedicated health workers to care for preterm or LBW newborns, and offered KMC. Although insufficient, they also had SSNC devices and infrastructure. The qualitative assessment identified facilitators and barriers related to the health system, families’ knowledge, attitudes, engagement, and support, and mothers’ household responsibilities. Conclusion Despite notable health system gaps, hospitals with inpatient NCUs demonstrated modest readiness and willingness to introduce iKMC and create a mother-newborn couplet model of care approach.
Background Inclusion of data on services provided by community health workers (CHWs) and pharmacies and drug shops (PDS) in national health management information systems (HMIS) is important for planning and decision-making related to these family planning high impact practices (HIPs) and to family planning programming more broadly. Yet little is known on the extent to which information on CHW and PDS family planning activities effectively feeds into HMIS. Methods We conducted a review of HMIS tools in Burkina Faso, Mozambique, Nepal, Nigeria and Uganda to examine availability of family planning data elements on CHWs and PDS. Participatory discussions held as part of a subsequent webinar generated considerations for advancing measurement of these two HIPs through national HMIS. Results CHW registers and reporting forms include data elements on method provision and referrals in four of the five countries, but only include data elements on counseling in one country. Data flows vary substantially across countries. There is very limited integration of PDS data into the HMIS. Participatory discussions coalesced around a recommendation to capture information on CHW method provision and for leaving additional indicators on counseling and referrals at the discretion of countries. For PDS, discussions centered on challenges and experiences with enabling private sector reporting. Conclusion The review and discussions highlight the value and complexities of integrating data on community sources into the HMIS and the need for context-specific solutions. Interest and opportunities exist to align CHW indicators across settings. For PDS, more discussion on how to incentivize reporting and on feasible reporting platforms and processes is needed.
This paper considers large-scale vaccination campaigns, a major platform for vaccine access in a lot of the world, as a recapture estimate of the target population marked by routine immunization. Framing the campaign as a measurement, we learn about its properties, including the campaign’s coverage of the target population and some implied sampling properties of post-campaign coverage surveys (PCCSs), the current gold-standard in implementation quality measurement. We develop this idea in the context of the 2023 measles campaign in Kano State, Nigeria, where we have detailed implementation data collected by vaccination teams involved in that effort. Looking specifically at the teams’ tally sheets, the daily records of who they vaccinated, we find significant discrepancies between the recapture estimates and those from the corresponding PCCS. Exploring a variety of bias models applied to both the tally sheets and the PCCS helps clarify how anecdotal issues from the field relate to this discrepancy. Overall, we find that the tally sheets, despite being an unorthodox population sample, provide a tractable perspective on implementation and measurement, one that’s in principle available nearly instantly and at high resolution for any vaccination touchpoint.
In the years following the Covid-19 pandemic, immunization programmes have increasingly focused on the capacity to conduct and monitor catch-up vaccination—for doses administered later than the recommended schedule. However, it is unclear whether information systems are able to monitor delayed vaccination. We analyzed WHO/UNICEF Joint Reporting Form data from 194 countries (2016–2022) to understand if systems for tracking delayed childhood vaccination are available and quantify catch-up doses of the first dose of a measles-containing vaccine (MCV1). For Latin American and Caribbean countries, we also explored data for the third dose of diphtheria-tetanus-pertussis vaccine (DTP3). We assessed the completeness and consistency of reporting, the proportion of delayed doses, and vaccination coverage considering both timely and delayed administration. Analyses were disaggregated by WHO Region, World Bank income classification, and Gavi support eligibility. Results show substantial variability across regions and income groups in countries’ ability to capture delayed doses. Between 2016 and 2022, the proportion of countries reporting a system to record delayed doses ranged from 55.5% to 64.4% annually, with the Region of the Americas (AMR) consistently reporting a higher proportion (77.1%–82.9%). Among countries with available data, the median proportion of delayed MCV1 doses was 4.4%, suggesting that including catch-up doses in cohort monitoring would increase reported coverage by approximately 4 percentage points. This increase was smaller in Gavi-eligible countries compared with non-eligible countries. The study summarizes global differences in information systems to monitor catch-up vaccination, presents examples of cohort coverage monitoring and illustrates the need to further improve immunization information systems and explore the potential for improving vaccination coverage and population immunity through catch-up activities.
Introduction Information on journal visibility helps researchers decide where to publish. Some quality indicators used are directly associated with the journal’s editorial practices. By understanding the barriers, challenges, and opportunities, this study aims to explore existing editorial practices among African journals, explore the underlying factors affecting the editorial practices of African journals, and understand the views and preferences of authors regarding the choice of journals for publication. Methodology This study triangulated the sources of information and qualitative design data-gathering techniques to allow for nuances and deeper insights into the performance and visibility of African Journals. We conducted In-depth Interviews (IDIs), Key Informant Interviews (KIIs), and Focus Group Discussions (FGDs) in Kenya, Ethiopia, Nigeria and Mozambique. The study population comprised journal editors-in-chief, representatives from African-wide journal databases/indexers, institutional repository representatives, and authors. A purposive sampling technique was used to identify participants. Ethical approval was obtained from the relevant bodies. Qualitative data from the audio-recorded interviews were transcribed using MS Word and exported to NVivo software for analysis. Results The key structural issues on editorial practices among African journals established by the study included adherence to internationally accepted editorial practices on peer review decision-making and challenges in implementing measures of transparency and rigor. Some of the underlying factors affecting African journal editorial practices that were highlighted included financial constraints, challenges in peer review, challenges in maintaining editorial integrity, and challenges in technological and digital infrastructure. African journals also face challenges of credibility and trustworthiness among authors. Participants outlined how the longstanding neglect of African journals and lack of funding have created cultures of editorial mismanagement, publishing inconsistency, and other logistical issues, all of which contribute to perceptions of African journals as inferior to Northern ones.
Background Immediate Kangaroo Mother Care (iKMC) involves the initiation of skin-to-skin contact (SSC) between the mother (or an additional caregiver) and preterm and/or LBW infants within the first hours of birth, with exclusive breastfeeding. While KMC has traditionally been initiated after the infant stabilizes, immediate initiation of SSC has proven more effective in reducing neonatal mortality. However, despite its proven benefits, the adoption of immediate KMC remains a challenge. This study aims to develop and test an implementation model for integrating immediate KMC into the routine care of small and sick newborns in level 2 Special Newborn Care Units (SNCUs) in Bangladesh, Ethiopia, India, and Nigeria. Methods This multicountry implementation research study will develop and evaluate a scalable model for integrating iKMC into newborn care across six study sites in four countries. The study will involve developing and optimizing an implementation model using a mixed-methods design, combining both qualitative and quantitative approaches. Formative research will be conducted to identify barriers and facilitators to the effective implementation of iKMC, guiding the development of the initial model. The study will benefit from concurrent programme learning, using both qualitative insights and outcome measurements, to iteratively refine the model and ensure high-quality, widespread implementation of iKMC. Conclusion The study will provide insights into the effective integration of iKMC into existing health systems, addressing key challenges in low-resource settings. Findings will inform scalable strategies for widespread implementation, contributing to global efforts to enhance newborn care and reduce neonatal mortality.
Background:Despite the declining malaria burden in endemic countries, reports of febrile episodes do not align with the current patterns of malaria transmission. This highlights the presence of non-malarial febrile illnesses (NMFIs), which are difficult to distinguish from malaria. This study assessed the country-wide prevalence of NMFIs and their patterns across various malaria transmission settings in Mainland Tanzania. Methods:A cross-sectional study recruited patients aged ≥ 6 months from 86 health facilities in all 26 regions of Tanzania. All patients were tested for malaria using rapid diagnostic tests (RDTs). For this study, patients with fever who tested negative by RDT were operationally classified as having NMFIs and their prevalence was determined accordingly, Logistic regression was used to determine factors associated with NMFIs. Results:Of the 18,568 patients tested, 8,273 (44.6%) were considered to have NMFIs because they tested negative by RDT. Higher prevalence of NMFIs occurred in females (45.8%) than in males (42.8%), adults (aged ≥ 15 years, with 50.6%) compared to under-fives (42.6%) and school children (aged 5 -< 15 years, 34.3%), and in very low (65.5%) compared to high transmission areas (34.5%). NMFIs were significantly more likely in females than in males (aOR = 1.18, 95% CI = 1.10-1.26), under-fives (aOR = 1.60, 95% CI = 1.47-1.76) and less likely in high transmission areas (aOR = 0.11, 95% CI = 0.08-0.13), and school children (aOR = 0.70, 95% CI = 0.64-0.77). Conclusion:The findings show a high prevalence of NMFIs overall, and higher prevalence and odds of NMFIs in females and individuals from low and very low transmission areas. These groups should be targeted with appropriate point-of-care tests and treatment strategies.
This paper presents evidence on the role of institutional trust in the formation and formalization of government-supported women’s savings groups, known as Women Affinity Groups (WAGs) and implemented through the Nigeria for Women Project (NFWP). While existing research has shown the vital role of peer trust in the operation and effectiveness of savings groups, less is known about how institutional trust affects the formalization and scale up of savings groups. This paper examines how underlying drivers of institutional trust and mistrust shape savings group formalization processes and outcomes. In-depth interviews and focus group discussions with participants, community members, and staff of the NFWP suggest that project implementers were able to overcome initial mistrust of the NFWP by leveraging community structures, demonstrating consistency, and providing promised services. Community mobilization through reputable social networks contributed to the facilitation of group formation, which in turn helped address challenges associated with a weak institutional environment and poor experiences with previous livelihood interventions. A demonstrated record of success also enabled building the credibility of the project.
Despite global gains in vaccination coverage, Pakistan continues to lag in achieving universal immunization, with vaccine-preventable diseases (VPDs) contributing to approximately 15% of all deaths annually. We explored missed opportunities for vaccination (MOV) when eligible children failed to receive vaccines when their mothers visited healthcare facilities for unrelated medical needs. Secondary data analysis was conducted using the Pakistan Social and Living Standards Measurement Survey (PSLM) 2019-20, comprising 195,000 households and 103,464 eligible children. MOV was defined as the failure to administer an age-appropriate dose of either pentavalent (Penta-1, 2, 3) or measles (Measles-1, 2) vaccines during a maternal health visit. Weighted multivariate binomial logistic regression was used to explore the association between maternal visits to private healthcare facilities and MOV, adjusting for sociodemographic variables. Geospatial analysis was used to visualize district-level disparities using ArcGIS. Approximately 25% of children aged 1-5 years missed at least one dose of pentavalent or measles vaccination with regional variations. The rates of missed doses were similar for the first, second, and third antigen doses. Rural areas, male children, and households with uneducated mothers had more missed vaccinations, while missed opportunities were more common when mothers visited private healthcare facilities, particularly in urban settings (adjusted Odds Ratio (OR): 1.563 for Penta-1, Confidence Interval (CI): 1.519-1.608) where the private sector predominates and because the public sector accounts for nearly all vaccinations. However, since nearly all vaccinations are in the public sector and the bulk of healthcare seeking is in the private sector, opportunities to vaccinate missed children are lost. Policy and technological solutions that can identify and refer to these children for vaccination can close the national gap in universal vaccination.
Despite global gains in vaccination coverage, Pakistan continues to lag in achieving universal immunization, with vaccine-preventable diseases (VPDs) contributing to approximately 15% of all deaths annually. We explored missed opportunities for vaccination (MOV) when eligible children failed to receive vaccines when their mothers visited healthcare facilities for unrelated medical needs. Secondary data analysis was conducted using the Pakistan Social and Living Standards Measurement Survey (PSLM) 2019-20, comprising 195,000 households and 103,464 eligible children. MOV was defined as the failure to administer an age-appropriate dose of either pentavalent (Penta-1, 2, 3) or measles (Measles-1, 2) vaccines during a maternal health visit. Weighted multivariate binomial logistic regression was used to explore the association between maternal visits to private healthcare facilities and MOV, adjusting for sociodemographic variables. Geospatial analysis was used to visualize district-level disparities using ArcGIS. Approximately 25% of children aged 1-5 years missed at least one dose of pentavalent or measles vaccination with regional variations. The rates of missed doses were similar for the first, second, and third antigen doses. Rural areas, male children, and households with uneducated mothers had more missed vaccinations, while missed opportunities were more common when mothers visited private healthcare facilities, particularly in urban settings (adjusted Odds Ratio (OR): 1.563 for Penta-1, Confidence Interval (CI): 1.519-1.608) where the private sector predominates and because the public sector accounts for nearly all vaccinations. However, since nearly all vaccinations are in the public sector and the bulk of healthcare seeking is in the private sector, opportunities to vaccinate missed children are lost. Policy and technological solutions that can identify and refer to these children for vaccination can close the national gap in universal vaccination.
This paper presents evidence on the role of institutional trust in the formation and formalization of government-supported women’s savings groups, known as Women Affinity Groups (WAGs) and implemented through the Nigeria for Women Project (NFWP). While existing research has shown the vital role of peer trust in the operation and effectiveness of savings groups, less is known about how institutional trust affects the formalization and scale up of savings groups. This paper examines how underlying drivers of institutional trust and mistrust shape savings group formalization processes and outcomes. In-depth interviews and focus group discussions with participants, community members, and staff of the NFWP suggest that project implementers were able to overcome initial mistrust of the NFWP by leveraging community structures, demonstrating consistency, and providing promised services. Community mobilization through reputable social networks contributed to the facilitation of group formation, which in turn helped address challenges associated with a weak institutional environment and poor experiences with previous livelihood interventions. A demonstrated record of success also enabled building the credibility of the project.
Background:The persistent transmission of circulating vaccine-derived poliovirus type 2 (cVDPV2) in Northern Nigeria, especially in the Axis of Intractable Transmission (AIT) states, Kebbi, Sokoto, Katsina, and Zamfara, despite national certification of wild poliovirus interruption, is strongly associated with fragmented settlement visibility, population denominator inaccuracies, and uneven implementation of Supplementary Immunization Activities (SIAs). This study examines whether these geospatial investments as broader ecosystem of interventions improve immunization reach and operational quality during cVDPV2 SIAs. Methods:A retrospective operational analysis was conducted using data from nine consecutive SIAs (April 2024-June 2025). We extracted state-level indicators from the Master List of Settlements (MLoS) geospatial records and campaign data, which included (1) geospatial completeness, defined as the proportion of settlements with validated coordinates; (2) settlement tracking coverage; (3) MLoS-derived population targets for children; and (4) number of children vaccinated. Descriptive statistics, bivariate exploratory relationships, and temporal learning analysis were performed to evaluate how geospatial status influenced tracking outcomes. Results:Geospatial completeness ranged from 92.1% (Zamfara) to 100% (Kebbi) and was associated with higher, more stable tracking coverage. Kebbi, with complete geolocation of settlements, demonstrated consistently strong tracking performance (mean 93%). Settlement tracking correlated positively with vaccination outputs in Kebbi and Sokoto but demonstrated saturation effects in Katsina and diminishing returns in Zamfara. Operational learning was observed in Sokoto, Katsina, and Zamfara, each demonstrating 8 to 10 percentage point improvements in tracking coverage across rounds. Conclusion:In addition to other contributory factors, settlement-level geolocation improves the quality and reach of cVDPV2 SIAs by strengthening visibility of target populations and promoting more reliable tracking. The MLoS updates and tracking of settlements and vaccination teams demonstrated transformative potential in optimizing vaccination campaigns by improving equity, accountability, and efficiency. Its deployment offers valuable lessons for enhancing immunization efforts in resource-constrained and security-compromised settings, emphasizing the importance of strategic integration and sustained investments in public health innovation.
Background The need for detailed built-up area data for applications such as population modelling, urban planning, and environmental research is growing due to the pace of global population changes, particularly in the Global South, where existing datasets have limitations. Methods Here, we processed the Google Open Buildings Temporal (OBT) dataset to derive six 100-m spatial resolution datasets per year on building characteristics. The characteristics include building count, total perimeter, total area, total volume, height variance, and mean distance to the nearest building edges. These were calculated using arithmetic operations, convolutions, and spatial aggregation. The derived data was validated against a set of existing largescale open spatial datasets on buildings and human settlement extents for single timepoints. Additionally, temporal consistency was assessed, with polynomial fitting explored to test suitability for smoothing the data where significant fluctuations were seen. Results The new dataset strongly correlated with the Google Open Buildings Polygons dataset (e.g., building count: r = 0.88; building area: r = 0.90) but showed systematic perimeter underestimation in dense areas due to blending effects. Weaker correlations were found with other datasets due to methodological differences. Internally, building height variance correlated moderately with total volume ( r = 0.47). A strong positive correlation ( r > 0.8) existed between building count, area, volume, and population. Temporal analysis revealed significant fluctuations in most characteristics, especially height-related metrics, with second-order polynomial fitting proving optimal for smoothing. Conclusions A validated 100-m resolution building characteristics dataset for the Global South, covering each year from 2016 to 2023, derived from Google OBT, was produced. While showing consistency with similar largescale spatial datasets, temporal fluctuations indicate a need for further processing for time-series applications.
Background Mass Drug Administration (MDA) of azithromycin for the elimination of trachoma and, more recently, for the reduction of child mortality, are public health strategies shown, with mixed results, to contribute to the development of azithromycin resistance in treated communities. The objective of this study was to monitor bacterial resistance to azithromycin among children targeted by bi-annual MDA-azithromycin campaigns to improve child survival in eight high-mortality regions of Côte d’Ivoire. Methods Two rounds of cross-sectional surveys were carried out in targeted health districts using a 2-stage cluster sampling to select representative samples of children aged 1–11 months at the time of the most recent MDA. Parents/primary caregivers were interviewed about the child’s overall health and exposure to MDA, azithromycin, and other antibiotics. Nasopharyngeal swabs were collected to estimate the carriage of Streptococcus pneumoniae and the prevalence of macrolide-resistant S. pneumoniae using erythromycin as a proxy for azithromycin. Phenotypic and genotypic determinants of macrolide resistance were tested in a subsample of resistant bacteria using duplex PCR. Results A total of 606 and 692 eligible children in 2022 and 2023, respectively, were included in the analyses. Prevalence of S. pneumoniae carriage was 28.8% (95%CI:22.4, 35.3) in 2022 and 30.8% (95%CI:25.0, 36.7) in 2023 (p=0.6506). There was no statistically significant difference in the prevalence of erythromycin-resistant S. pneumoniae between the two surveys (32.8% (95%CI:25.3, 40.2) versus 26.2% (95%CI:19.8, 32.6); p=0.0537). The majority of macrolide resistance phenotypes in both surveys were predominantly constitutive macrolide-lincosamide-streptogramin B (MLSb), carried by erm(B)-type genes. Conclusions Community-level bacterial resistance to azithromycin in our samples of S. pneumoniae did not increase significantly between the two surveys. As countries weigh the benefits and costs to implement MDA azithromycin, more is needed to interpret the relevancy and clinical impact of observed antimicrobial resistance.
Background The persistent transmission of circulating vaccine-derived poliovirus type 2 (cVDPV2) in Northern Nigeria, especially in the Axis of Intractable Transmission (AIT) states, Kebbi, Sokoto, Katsina, and Zamfara, despite national certification of wild poliovirus interruption, is strongly associated with fragmented settlement visibility, population denominator inaccuracies, and uneven implementation of Supplementary Immunization Activities (SIAs). This study examines whether these geospatial investments as broader ecosystem of interventions improve immunization reach and operational quality during cVDPV2 SIAs. Methods A retrospective operational analysis was conducted using data from nine consecutive SIAs (April 2024–June 2025). We extracted state-level indicators from the Master List of Settlements (MLoS) geospatial records and campaign data, which included (1) geospatial completeness, defined as the proportion of settlements with validated coordinates; (2) settlement tracking coverage; (3) MLoS-derived population targets for children; and (4) number of children vaccinated. Descriptive statistics, bivariate exploratory relationships, and temporal learning analysis were performed to evaluate how geospatial status influenced tracking outcomes. Results Geospatial completeness ranged from 92.1% (Zamfara) to 100% (Kebbi) and was associated with higher, more stable tracking coverage. Kebbi, with complete geolocation of settlements, demonstrated consistently strong tracking performance (mean 93%). Settlement tracking correlated positively with vaccination outputs in Kebbi and Sokoto but demonstrated saturation effects in Katsina and diminishing returns in Zamfara. Operational learning was observed in Sokoto, Katsina, and Zamfara, each demonstrating 8 to 10 percentage point improvements in tracking coverage across rounds. Conclusion In addition to other contributory factors, settlement-level geolocation improves the quality and reach of cVDPV2 SIAs by strengthening visibility of target populations and promoting more reliable tracking. The MLoS updates and tracking of settlements and vaccination teams demonstrated transformative potential in optimizing vaccination campaigns by improving equity, accountability, and efficiency. Its deployment offers valuable lessons for enhancing immunization efforts in resource-constrained and security-compromised settings, emphasizing the importance of strategic integration and sustained investments in public health innovation.
Background The need for detailed built-up area data for applications such as population modelling, urban planning, and environmental research is growing due to the pace of global population changes, particularly in the Global South, where existing datasets have limitations. Methods Here, we processed the Google Open Buildings Temporal (OBT) dataset to derive six 100-m spatial resolution datasets per year on building characteristics. The characteristics include building count, total perimeter, total area, total volume, height variance, and mean distance to the nearest building edges. These were calculated using arithmetic operations, convolutions, and spatial aggregation. The derived data was validated against a set of existing largescale open spatial datasets on buildings and human settlement extents for single timepoints. Additionally, temporal consistency was assessed, with polynomial fitting explored to test suitability for smoothing the data where significant fluctuations were seen. Results The new dataset strongly correlated with the Google Open Buildings Polygons dataset (e.g., building count: r = 0.88; building area: r = 0.90) but showed systematic perimeter underestimation in dense areas due to blending effects. Weaker correlations were found with other datasets due to methodological differences. Internally, building height variance correlated moderately with total volume (r = 0.47). A strong positive correlation (r > 0.8) existed between building count, area, volume, and population. Temporal analysis revealed significant fluctuations in most characteristics, especially height-related metrics, with second-order polynomial fitting proving optimal for smoothing. Conclusions A validated 100-m resolution building characteristics dataset for the Global South, covering each year from 2016 to 2023, derived from Google OBT, was produced. While showing consistency with similar largescale spatial datasets, temporal fluctuations indicate a need for further processing for time-series applications.
Background The increasing insecticide resistance of malaria vectors is an urgent concern for disease control and novel vector control strategies are needed. Wolbachia are endosymbiotic bacteria that can invade mosquito populations and reduce transmission of human pathogens. Wolbachia strains in wild Anopheles (An.) malaria vectors are rare, with only two known genuine symbioses; An. moucheti with wAnM and An. demeilloni with wAnD. In this study, we set out to determine if there was a correlation between wAnD in different An. demeilloni mosquito body parts, infective stage Plasmodium (Pl.) falciparum malaria sporozoites in cephalothoraxes and the mosquito microbiome. Methods We undertook a combination of quantitative PCR, 16S rRNA amplicon sequencing and sanger sequencing of the Wolbachia surface protein (wsp) gene after isolating An. demeilloni female body parts from wild caught individuals collected in 2021 and 2024 from the Sud Kivu region of Democratic Republic of Congo. Results Wolbachia prevalence rates were significantly higher in abdomens compared to cephalothoraxes and density was also significantly higher in abdomens (P<0.0001). Overall sporozoite prevalence was 1.3% (9/704) which was not significantly different between Wolbachia-positive and Wolbachia-negative cephalothoraxes (P=0.3630) despite Pl. falciparum only detected in Wolbachia-negative cephalothoraxes. However, Wolbachia-positive abdomens were associated with a lower sporozoites rate compared to Wolbachia-negative abdomens (P=0.0329). 16S rRNA amplicon sequencing revealed no significant difference in alpha/beta diversities between abdomens and cephalothoraxes but the cephalothorax microbiome composition between Wolbachia-positive and Wolbachia-negative was significantly different (P<0.05). Conclusions Our findings indicate a significant effect of the wAnD strain on the cephalothorax microbiome and potentially the ability of sporozoites to reach Salivary glands in mosquitoes with Wolbachia-infected abdomens. Further studies are needed to determine the mechanisms in which the wAnD strain interacts with Plasmodium sporozoites in An. demeilloni and if this strain could be used for malaria biocontrol through transinfection of major malaria vectors.
The study examined child development and family human capital investment decisions in Nigeria. The study focused on household per capita income and family structure using the Nigeria living standard survey for 2018/2019 for the secondary data analysis and a field survey conducted by the researchers in six states in each of the geopolitical zones in Nigeria for the primary data analysis. The study was anchored on household utility maximization theory using the ordinary least squares (OLS) method to analyse the secondary data. Four different results were obtained. First, the result of findings from the OLS estimate revealed that per capita income had no significant impact on Family Human Capital Investment Decisions (FHCID) and male perception of the cost of education had a significant positive impact on FHCID. On the contrary, multi-dimensional poverty index and female perception of the cost of education had an inverse significant impact on FHCID. The second result revealed that average household size, family residence from 1 to 30 minutes proximity to school and 31 minutes and above proximity to school had no significant impact on FHCID. Dependency ratio showed an inverse significant impact on FHCID and family literacy level showed a significant positive impact on FHCID. The third result from the binary logistics regression showed that age, occupation and place of residence of the household head had no significant impact on FHCID. Gender (female-headed household) and education showed an inverse significant impact on FHCID. However, household head years in business or paid employment showed a positive impact on FHCID. The fourth result from the binary logistics regression revealed that marital status had no significant impact on FHCID; family size had a significant negative impact on FHCID; and family structure (type of parents) and number of girl child in the household had a direct impact on FHCID. This study showed complementarities in the home utility function, such that the marginal product of investments rises as family living standards rise. These findings highlight lifetime inequalities and necessitates a special focus on treatments for low-income households. Understanding human capital development and how diverse elements interact is critical to combating poverty and its intergenerational transmission. As a result, this study made several recommendations. First, the importance of persistent action by the government and other donor agencies such as the United Nation Children’s Fund (UNICEF) and The World Bank to address the problems of income inequality and pervasive poverty ravaging Nigeria’s economy. The study strongly recommends that family, especially parents, maintain justice and fairness within the home, to foster constructive, sympathetic and peaceful home, encouraging most children to exhibit excellent academic performance. Third, government agencies and hospitals, especially in rural areas, intensify family planning and birth control campaign to help reduce household size. Fourth, children of the poor be given opportunities for paid employment, to enhance their performance in the school. Fifth, children from poor homes be provided with access to scholarships, free instructional materials and books. Sixth, government and its agencies on education intensify sensitization and campaign for families to embrace Western education, especially in the northern region, promote compulsory primary basic education for all children and prosecute parents of out-of-school children or child labour to serve as a deterrent to others. Finally, the study recommends that non-governmental and religious organizations preach peace and tolerance within the family for the well-being and human capital development of their wards.
Background Cholera remains a significant public health challenge in Africa, where outbreaks routinely strain public health and healthcare systems. Cholera surveillance time series data could be used to inform the efficient distribution of resources like oral cholera vaccine (OCV) and emergency response personnel, spur research on the impacts of different cholera control activities, and investigate longer-term epidemiologic patterns in cholera dynamics in this region. However, public reporting of cholera surveillance data historically has been sporadic and often limited to outbreak periods, thus limiting the availability of these useful time series datasets. We sought to fill this gap by preparing, cleaning, and processing weekly consecutive time series and outbreak-specific time series from 2010 to 2023 for African countries from heterogeneous data contributed to a global cholera surveillance database. Methods Cholera incidence data in Africa from 2010 to 2023 on suspected cases, confirmed cases, and deaths were compiled from public and non-public cholera surveillance from multiple sources, including ministries of health, World Health Organization, Médecins Sans Frontières, UNICEF, and other sources. Data were processed by aggregating daily records to weekly levels, averaging duplicate entries, filling gaps and surrounding weeks with zero cases, aligning epidemic weeks, adjusting population data, and removing identifying geographic information to preserve confidentiality as appropriate. Outbreaks were subsequently extracted using a systematic definition and summary statistics were produced by spatial scale and population density. Summary outbreak metrics were compared to previously published cholera outbreak datasets for data validation. Conclusions The unified surveillance and outbreak datasets provide an extensive compilation of reported cholera activity in Africa from 2010 to 2023, serving as a valuable resource for long-term control planning and early warning systems. Public health researchers can also leverage these datasets to analyze outbreak dynamics, anticipate resource needs, and assess the theoretical impact of control strategies.
Dual-active-ingredient insecticide-treated nets (Dual-AI ITNs) combining pyrethroids with chlorfenapyr are increasingly being deployed across malaria-endemic areas. Laboratory evaluation of chlorfenapyr ITNs is challenging due to chlorfenapyr’s requirement for metabolic activation. Inspired by the tunnel test, the mini chamber test is smaller, has higher throughput, and is animal-free. We optimised the primary parameters using pyrethroid-susceptible and -resistant mosquito strains exposed to new pyrethroid-chlorfenapyr ITNs versus controls. With parameters defined, we used a draft standard operating procedure (SOP) to evaluate the mini chamber against the gold standard tunnel test in a comparator study. The generated data were used to finalise an SOP. The number of mosquitoes per bioassay had no effect on 72 hour mortality on exposure to the pyrethroid-chlorfenapyr net (10, 20, or 30 mosquitoes per mini chamber: 98% vs. 99% vs. 99%, p = 0.46), nor did the chamber orientation (horizontal vs. vertical: 70% vs. 74%, p = 0.35). Mean 72-hour mortality reduced with the length of exposure: 99% with overnight exposure, 74% with 4 hours and 35% with 2 hour exposure. In direct comparisons, the mini chamber gave 95% 72 hour mortality and the tunnel test 70% with overnight exposure. A trend was observed between chemical content (measured by high performance liquid chromatography (HPLC)) and mortality in ITN samples that had been washed 20 times or used in experimental hut trials, compared to unused comparators, when a 6 hour exposure length was used, showing potential for application to durability monitoring. A mini chamber SOP is shared (https://github.com/i2i-Data-Repository/Mini-Chamber-Test-paper-data-R-code-and-SOP), and further improvements may come from internal and multi-site validation and review of data generated. The method shows promise as an effective bioassay for use where tunnel tests are not available, for measuring the biological activity of chlorfenapyr in ITNs when measuring regeneration times, wash resistance, residual efficacy, and other studies.
