ABSTRACTBackgroundSurgery remains the cornerstone of treatment for rhabdomyosarcoma (RMS) in children. However, there is considerable variation in surgical management practices worldwide, highlighting the need for standardized Clinical Practice Guidelines (CPG).MethodsThe CPG development involved assembling a multidisciplinary group, prioritizing 10 key topic areas, conducting evidence searches, and synthesizing findings. Recommendations were voted on using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methodology.RecommendationsThe panel recommended regional lymph node evaluation for patients with paratesticular RMS who are more than 10 years old and extremity RMS. Other suggestions included pretreatment re‐excision for incompletely resected RMS, preoperative radiation therapy for unresectable tumors, maintaining a 0.5 cm resection margin, and tumor bed marking with surgical clips. The panel also suggests resection of residual metastatic disease following chemotherapy, resection of relapsed disease, and the least invasive approach for managing patients presenting with obstruction.ConclusionThis CPG provides evidence‐based surgical management recommendations for RMS that can be adapted to diverse resource settings.

BACKGROUND:Circumcision of a male child is an integral part of some African cultures. An ideal technique of neonatal circumcision should be simple, safe and heal satisfactorily with good cosmetic appeal. The aim was to compare conventional dissection (CD), Plastibell (PB) and Gomco (GM) techniques of circumcision in neonates in terms of wound healing, wound healing complications, cosmetic outcome and parental satisfaction. MATERIALS AND METHODS:A total of 144 male neonates were randomised into three study groups: CD, GM and PB groups. All procedures were performed under local anaesthesia as day case. Superficial wound healing was assessed on the 7 th post-operative day. The cosmetic outcome of the three techniques was assessed by a plastic surgeon and the parents using a 4-point Likert scale on the 4 th post-operative week. RESULTS:The three groups were comparable in terms of age ( P = 0.207) and weight ( P = 0.098) at circumcision. There was satisfactory wound healing in 48 (100%) patients in the GM group, compared to 47 (97.8%) in the CD group and 45 (93.8%) in the PB group ( P = 0.324). Wound healing complications were recorded in seven patients, 1 (2.1%) in the CD group with wound infection, 5 (10.4%) in the PB group with moderate pain despite the use of analgesia and 1 (2.1%) patient with skin bridge in the CD group. The plastic surgeon and the parents rated the cosmetic outcome of CD higher than the other two techniques. CONCLUSION:There is no significant difference in superficial wound healing amongst the three circumcision techniques. The cosmetic outcome of CD was significantly better than that of GM and PB circumcisions.

Introduction: Enteral nutrition is the mainstay of nutritional support in surgical patients. Ileus is the temporary inhibition of peristalsis. Primary post-operative ileus (PPI) occurs postoperatively; thence patients are traditionally kept on nil per oris (NPO) until PPI resolves, due to safety concerns. This study aims to determine the necessity or otherwise of this practice in paediatric surgical patients. Materials and methods: A prospective, randomized control trial, in patients younger than 15 years. The early feeding group (EFG) commenced enteral feeding on the first post-operative day while controls commenced feeding after resolution of PPI. Data was analyzed using SPSS version 20.0, P <= 0.05 was regarded as significant. The primary outcome was tolerability of enteral feeds while secondary outcomes were complication rates, time to full enteral diet, and duration of hospital stay. Results: There were 56 patients, 28 in each study group. Tolerability of oral feeds at initial commencement was similar in both groups (24 (85.7%) EFG versus 27 (96.4%) controls P = 0.16). Full enteral feeding was achieved faster in EFG than in controls (71.1 f 28.7 hours versus 92.5 f 31.4 hours, p=0.011). Post-operative hospital stay was shorter in EFG than controls (7.46 f 3.8 days versus11.1 f 5.2 days, p=0.009). Conclusions: Early enteral feeding was well tolerated, brought about a faster return to a full enteral diet, and shorter post-operative hospital stay, it also did not cause a higher complication rate. Therefore, delaying feeding until the resolution of PPI after laparotomy appears unnecessary.

Background: Wilms' tumor (WT) is the most common paediatric renal tumor and is one of the most treatment -responsive solid tumours. Survival from Wilms tumour (WT) in sub-Saharan Africa remains dismal as a result of late presentation, treatment abandonment and infrastructure de ficit. The purpose of this study was to analyze the clinical outcome of children with Wilms tumour managed in a Nigerian referral centre over a 15 -year period. Methods: This is a retrospective study of children with WT (nephroblastoma) who were treated at our institution between January 2006 and December 2020. Clinical characteristics, treatments, and outcomes were analyzed. Results: Thirty- five patients were identi fied. The median age at diagnosis was 36 months including 22 (62.9 %) females. Twenty-six (74.3 %) had advanced (stage III & IV) disease. Con firmatory histology was available for 16 patients ((45.7 %) among which 10 (62.5 %) were mixed type. The right kidney was affected in 18 patients (51.4 %), left in 15 (42.9 %) and 2 were not documented. Preoperative chemotherapy was given in 22 (62.9 %) patients and 13 (37.1) patients had primary nephrectomy. Eight (22.9 %) patients died during treatment (from disease or treatment related causes), and one abandoned treatment. A total of 26 patients completed treatment. Out of these, 8 (30.8 %) were lost to follow up, four patients died and 14 (53.8 %) patients survived at a median follow-up period of 18 months. The survival decreased with advancing stages of the disease, p 1 / 4 0.002. Conclusions: Majority of children with Wilms tumour in our practice presented with advanced disease. Death during treatment, treatment abandonment and lost to follow up were common. Level of Evidence: Level II. Type of Study: Retrospective Study. (c) 2023 Elsevier Inc. All rights reserved.

Limb amputation refers to the removal of a limb or part of a limb through the bone. It is one of the oldest surgical procedures known to man. In the western world, dysvascular amputations (secondary to complications from diabetes mellitus and peripheral vascular disease) account for most of the amputations done. Traditionally, trauma and complications from badly managed traumatic injuries continue to account for most of the major limb amputations in Nigeria. We sought to evaluate the indications and patient characteristics amongst patients who had major limb amputations over a four-year period at a University Teaching Hospital in North-Central Nigeria. Eighty-seven patients had major limb amputations in the period under review. The majority (63%) of the amputees were male and 78% of the amputees had lower limb amputations. Dysvascular amputations (45.8%) and complications of trauma (43.4%) accounted for similar proportions of the causes of amputations in the study. Two peak age groups were involved: the third decade of life where traumatic causes predominated; and the seventh decade of life where dysvascular causes predominated. Public health interventions need to be intensified to improve management of traumatic injuries to reduce the rate of amputations in this cohort while improved education and management of diabetic patients will reduce the rate of dysvascular amputations.

Abstract Introduction The introduction of the diphtheria−tetanus−pertussis (DTP) vaccine into childhood immunization programs resulted in its widespread elimination in high‐income countries. However, Nigeria is currently experiencing an outbreak. The primary cause of diphtheria outbreaks and its high mortality rates in Nigeria was waning herd immunity due to low DTP coverage and a lack of diphtheria antitoxin (DAT), respectively. However, the underlying causes of Nigeria's low DTP coverage and DAT supply remain unknown. Method Relevant studies and reports included in our review were obtained by a search through Google Scholar, PubMed, and organization websites using the terms “Diphtheria−Pertussis−Tetanus vaccine OR Diphtheria antitoxin and Nigeria OR Diphtheria Outbreak.” All articles considering diphtheria outbreaks, DTP vaccine, and DAT supply in Nigeria were considered without time restriction due to the paucity of data. We used the narrative synthesis approach to critically appraise, analyze, and draw inferences from the selected articles. Results The main causes of low DTP coverage are insufficient supply, an inefficient cold chain system, and low uptake due to poor health literacy and negative sociocultural and religious beliefs, whereas the key barriers to DAT availability are insufficient production by pharmaceutical industries because of low demand and priority. Conclusion The underlying causes of Nigeria's low DTP coverage and DAT supply are multifactorial. Both short‐term and long‐term measures are needed to control this outbreak and prevent future occurrences.

The birth of babies sharing body part(s) and surviving independently is indeed a scientific marvel. Conjoined twinning is a rare phenomenon with various presentations, having an estimated incidence of 1 per 200,000 live births. The successes recorded by experts in developed countries in the separation of conjoined twins in recent times, especially among those with complex unions are indeed fascinating. The management of conjoined twins presents a great challenge to medical and surgical teams in tropical African countries such as ours where we are faced with challenges of limited resources and facilities, even amidst the presence of well-trained experts. The incidence of conjoined twins is difficult to report in our practice because of failures that accompanied previous cases that were managed and not reported. This is the first successful separation after two previous failed attempts at our center. We report a case of successful surgical separation of thoraco-omphalopagus conjoined twins who were undiagnosed prenatally and delivered by emergency cesarean section following prolonged labor by a primiparous woman. Babies were joined from the lower chest and the upper abdomen and they shared a single umbilicus and omphalocele sac. No internal viscus was shared apart from the torso wall. They were cared for from 12 h of live until 127 days of live when they were successfully separated by a team of medical and surgical experts. This is a report of a successful separation of conjoined twins at the University of Ilorin Teaching Hospital in North Central Nigeria. Careful interdisciplinary conduct of expert activities will ensure the survival of rare congenital malformations such as conjoined twinning even in underdeveloped climes.

Over a billion people are affected by a class of parasitic and bacterial infections known as neglected tropical diseases (NTDs), with Africa being the most severely affected continent1. NTDs are especially problematic in conflict-affected parts of Africa where individuals have a harder time getting medical care1. Despite eradication in several parts of the global North, the menace of NTDs has thrived long in Africa2. A whopping 40% of the 1.7 billion global burden of these diseases is contributed by Africa2. The global NTD Community set out to eradicate NTDs through the London Declaration on NTDs, which was an offshoot of the World Health Organization’s 2020 Roadmap on NTDs; however, the achievement of this goal is marred by several challenges3. This is worse in conflict-affected areas as management of health care in fragile settings, such as this is cumbersome. NTDs cause significant illness and disability in many African countries and are, therefore, a challenge for health care in the region. For a region with poor health systems, the challenge of NTD control and elimination is worsened by conflict, as they affect the “lowest of the low” income earners who cannot afford to pay out of pocket for treatment3. Areas with conflict experience problems with water safety, sanitation, and adequate access to health care which worsens NTDs and in turn, perpetuates the spread of other conditions, especially communicable diseases. This is evidenced by the high geographic overlap between certain NTDs and malaria and human immunodeficiency virus, demonstrating a high degree of coinfection as documented in the literature4. The challenges influencing the NTDs in conflict-affected areas include a lack of effective government ownership of NTD control and elimination initiatives, a lack of adequate integration of these illnesses into mainstream health programs, poor intervention targeting, limited treatment coverage among particular subgroups, a lack of surveillance systems that can achieve the end goal of disease eradication’s sensitivity and specificity requirements, a lack of funds, and the coronavirus disease 2019 pandemic’s impacts. Furthermore, insufficient diagnostic and data management capabilities, poor health infrastructure, and international insecurity are some other issues. The lack of government funding for health care professionals is causing a brain drain in the health care sector. Also, there is a lack of knowledge and research regarding the cost-effective integrated community-based management of skin NTDs4,5. In Africa’s conflict-affected regions, NTDs can have a negative health impact. NTDs may result in serious health issues, such as blindness, deformity, persistent discomfort, and even death5. People may not have access to proper medical care in conflict-affected areas when health care systems are disrupted or destroyed, which raises the rates of morbidity and mortality. NTDs can significantly affect the economic well-being of people, families, and communities which might further create a burden on the affected conflicts situation they are facing6. For instance, some NTDs, such as river blindness, can lead to blindness, which can reduce movement for protections, and can also lead to financial losses because they have no eyes to see whether they want to work to provide for their families, they are stuck with the diseases6. Furthermore, the expense of treating NTDs can be high, straining already scarce resources. NTDs can have a negative social impact, leading to shame and prejudice7. The existence of NTDs can worsen tensions that already exist in conflict-affected areas among various ethnic or religious groups. Access to health care, particularly NTD therapies, is frequently restricted in conflict-affected communities. Even if medicines are available, security or transportation concerns may prevent people from accessing them8. Moreover, NTDs have a major negative impact on people and communities in Africa’s conflict-affected regions8. The already heavy burden of these diseases is made even worse by the disruption of health care systems, a lack of resources, and insecurity. Effective approaches, such as enhancing health care access, increasing funding for NTD control initiatives, and fostering peace and stability are required to combat NTDs in conflict-affected areas9. Nevertheless, with the introduction of the global roadmap for NTDs in 2021 and the creation of the African Tropical and Vector-borne Disease framework for 2022–2030, WHO hopes to build on the knowledge gained from earlier programs for NTDs among vulnerable people, including new developments resulting from the coronavirus disease 2019 pandemic response, to assist nations in creating long-term master plans. Hence, to combat NTDs, the emphasis will be on establishing national ownership through domestic funding, using a comprehensive strategy, and assessing impact to monitor execution. Ethical approval The information provided in the manuscript does not require an ethics application or approval. Sources of funding None. Author contribution A.T.A: study concept or design. A.T.A., A.F.O., L.L., N.A., R.B., T.Y.O., A.-M.S.A., A.A.O., and F.A.A.: research data/images generation, and manuscript writing and revision. Conflicts of interest disclosure The authors declare that they have no financial conflict of interest with regard to the content of this report. Research registration unique identifying number (UIN) None. Guarantor Fatima Abdirazak Ahmed.

Background: This study assessed the potential cost-effectiveness of high (80–100%) vs low (21–35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, published literature, and a cost survey in Nigeria, India, and South Africa. Effectiveness was measured as percentage of SSIs at 30 days after surgery, a healthcare perspective was adopted, and costs were reported in US dollars ($). Results: High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was $216 compared with $222 for low FiO2 leading to a −$6 (95% confidence interval [CI]: −$13 to −$1) difference in costs. In India, the average cost for high FiO2 was $184 compared with $195 for low FiO2 leading to a −$11 (95% CI: −$15 to −$6) difference in costs. In South Africa, the average cost for high FiO2 was $1164 compared with $1257 for low FiO2 leading to a −$93 (95% CI: −$132 to −$65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a −1.05 (95% CI: −1.14 to −0.90) percentage point reduction in SSIs. Conclusion: High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this.

Foreign body ingestion is a common problem in children due to their tendency for exploring these objects in their mouth. Most ingested foreign bodies pass without any problems, but certain objects like pins and nails may be dangerous. The tendency of ingested multiple magnetic beads to attract each other results in significant morbidity and mortality even in the face of its high prevalence.Modes of presentation after multiple magnet ingestion vary, making diagnosis difficult, especially when there is no eye witness to the act of ingestion.

Background: Airway compromise is a major criterion that determines the outcome of care in oesophageal atresia (OA). The maintenance of dry throat through suction of the airway and throat is a vital step to the survival of neonates with OA. This prevents aspiration of saliva and mucus plugging of the airway which can compromise pulmonary function. Pre-operative aspiration pneumonitis increases the morbidity and possible mortality of neonatal OA. The Replogle® tube is usually not readily available and costly for caregivers in most centres in the low-income countries. Objective: To introduce a local adaptation of suction tubing for clearance of the airway in OA. Method and Case Series: The Abdur-Rahman Ilorin Suction oEsophageal (ARISE) suction tube is constructed with a size 6 Fr feeding tube which was tunnelled from a side opening into the lumen of a 10 Fr feeding tube. The distance of the pouch from the incisor is first measured and multiple fenestrations (1 cm apart) are made on the wall of the outer tubes sparing about 2 cm from the measured length near the incisor. Three side fenestrations are made 1.5 cm apart from the tip on the side of the inner tube. The ARISE tube is placed in the upper OA pouch to suck saliva and prevent aspiration in the neonate. The tip of tube is positioned about 0.5 cm above the blind end of the oesophageal pouch. The inner (small lumen) tube is connected to a low-pressure suction machine at 0.2KPa (−15 to −35 cm H2O) for continuous drainage of saliva and the outer (big lumen) tube functions as air vent and irrigation channel. This protects the mucosal from being sucked into the inner tube lumen. Irrigation of tube is done with 2–3 ml of 0.9% saline every 4 h and as necessary. Result: This ARISE suction tube allowed adequate and continuous suction of the pouch and throat with the baby being calm, and caregivers also stress free. The patient maintained good arterial oxygen saturation and there was no aspiration into the airway. Conclusion: The ARISE double-lumen suction tube can easily be constructed in many resource-poor health institutions where OA is managed. This will improve the pre-operative management of neonatal OA in such environment making the baby’s condition optimal for surgical intervention.

Objectives Paediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs. Design A multicentre, international, collaborative cohort study. Setting 91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020. Participants Patients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin’s lymphoma, Hodgkin lymphoma, Wilms’ tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer. Main outcome measure All-cause mortality at 30 days and 90 days. Results 1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (p<0.001). After adjusting for confounders, patients with paediatric cancer in LMICs had 15.6 (95% CI 3.7 to 65.8) times the odds of death at 30 days (p<0.001). Conclusions The COVID-19 pandemic has affected paediatric oncology service provision. It has disproportionately affected patients in LMICs, highlighting and compounding existing disparities in healthcare systems globally that need addressing urgently. However, many patients with paediatric cancer continued to receive their normal standard of care. This speaks to the adaptability and resilience of healthcare systems and healthcare workers globally.

Survival of Wilms tumor (WT) is >90% in high-resourcesettings but <30% in low-resource settings. Adapting astandardized surgical approach to WT is challenging in low-resourcesettings, but a local control strategy is crucial to improving outcomes.Objective: Provide resource-sensitive recommendations for the surgicalmanagement of WT. Methods: We performed a systematic review of PubMedand EMBASE through July 7, 2020, and used the GRADE approach to assessevidence and recommendations. Recommendations: Initiation of treatmentshould be expedited, and surgery should be done in a high-volumesetting. Cross-sectional imaging should be done to optimize preoperativeplanning. For patients with typical clinical features of WT, biopsyshould not be done before chemotherapy, and neoadjuvant chemotherapyshould precede surgical resection. Also, resection should include alarge transperitoneal laparotomy, adequate lymph node sampling, anddocumentation of staging findings. For WT with tumor thrombus in theinferior vena cava, neoadjuvant chemotherapy should be given before enbloc resection of the tumor and thrombus and evaluation for viable tumorthrombus. For those with bilateral WT, neoadjuvant chemotherapy shouldbe given for 6–12 weeks. Neither routine use of complex hilar controltechniques during nephron-sparing surgery, nor nephron-sparing resectionfor unilateral WT with a normal contralateral kidney is recommended.When indicated, postoperative radiotherapy should be administered within14 days of surgery. Post-chemotherapy pulmonary oligometastasis shouldbe resected when feasible, if local protocols allow omission ofwhole-lung irradiation in patients with non-anaplastic histology stageIV WT with pulmonary metastasis. Conclusion: We provide evidence-basedrecommendations for the surgical management of WT, considering thebenefits/risks associated with limited-resource settings.

Over the years, the Nigerian healthcare workforce, including doctors, nurses, and pharmacists have always been known to emigrate to developed countries to practice. However, the recent dramatic increase in this trend is worrisome. There has been a mass emigration of Nigerian healthcare workers to developed countries during the COVID-19 pandemic. While the push factors have been found to include the inadequate provision of personal protective equipment, low monthly hazard allowance, and inconsistent payment of COVID-19 inducement allowance on top of worsening insecurity, the pull factors are higher salaries as well as a safe and healthy working environment. We also discuss how healthcare workers can be retained in Nigeria through increment in remunerations and prompt payment of allowances, and how the brain drain can be turned into a brain gain via the use of electronic data collection tools for Nigerian health workers abroad, implementation of the Bhagwati’s tax system, and establishment of a global skill partnership with developed countries.

Department of Research and Education, Oli Health Magazine Organization (OHMO), Kigali, Rwanda; Department of Project and Education, Clinton Global Initiative University, New York, USA; Department of General Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey; Department of Medicine, College of Health Sciences, University of Ilorin, Kwara State, Nigeria; Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada; Department of Nursing and Midwifery, Faculty of Health Sciences, Lira University, Lira, Uganda; Department of Chemical Engineering, School of Chemical Engineering, University of Birmingham, Edgbaston, Birmingham, UK; Department of General Medicine, Kasturba Medical College, Manipal, Karnataka, India; Department of Pathology and Legal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer.

Introduction: The human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) has long affected millions of individuals across the globe. Historically, the prevalence of this disease is particularly noted within the African continent. Before the coronavirus disease 2019 (COVID-19) pandemic, many African countries struggled to effectively manage the increasing burden associated with HIV/AIDS. There is now a need to reassess this in a COVID-19 pandemic context so that the impact of COVID-19 on HIV/AIDS healthcare within Africa can be adequately evaluated. Methods: Data collection was performed on the PubMed, Ovid MEDLINE and Embase bibliographical databases with a predefined search strategy. Searches were performed in blind duplicate and all articles considering COVID-19 and HIV/AIDS within African healthcare were considered. Results: The COVID-19 pandemic has severely exacerbated the many issues surrounding HIV/AIDS care within many African countries. These impacts are noticeable in medical, psychological, and socio-political contexts. Conclusions: Before efforts are made to improve the provision of HIV/AIDS and COVID-19 care within Africa, it is important that this issue is brought to the attention of the scientific and clinical community so that the continent can receive the necessary support and aid.

Ekwunife Okechukwu H, Ameh Emmanuel A, AbdurRahman Lukman O, Ademuyiwa Adesoji, Akpanudo Emem,5 Alakaloko Felix,4 Bwala Kefas,6 Egbuchulem Ifeanyichukwu K,7 Ekenze Sebastian O,8 Ezomike Uchechukwu O, Faboya Omolara M, Ladipo-Ajayi Oluwaseun, Lawal Taiwo A, Lukong Christopher, Modekwe Victor I,1 Nasir Abdulrasheed A,3 Nwokoro Chigbundu C,11 Okafor Dave,12 Okoro Philemon E,13 Olori Samson, Orji Emmanuel, Seyi-Olajide Justina O, Sholadoye Tunde T, Sowande Oludayo, Taiwo Jones O,17 Tanimola Adebayo,16 Ugwu Jideofor O,1 Williams Omolara M,9