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Résumé: Le phénomène de la traite des Noirs a laissé une histoire douloureuse et inoubliable dans la pensée des Noirs. Les moralistes, les religieux, les philosophes, les humanistes, les artistes, les écrivains, etc., ne cessent d’en parler dans le monde contemporain, malgré le nombre d’années écoulées (Huberman, G. 2023). Cet article examine l’œuvre littéraire d’Aimé Césaire et met en exergue l’effort qu’a fourni ce dernier pour conserver le phénomène de la traite des Noirs à la mémoire de la génération du monde noir. Pour déclencher nos débats, nous nous sommes posé des questions suivantes : comment Aimé Césaire a-t-il documenté l’histoire de l’Homme noir dans ses ouvrages littéraires et quels sont les avantages que les Noirs peuvent tirés de cette documentation dans le but de revendiquer contre la discrimination raciale ? En passant par la méthode qualitative, nous nous sommes servis de cinq ouvrages d’Aimé Césaire comme sources secondaires et la méthode d’échantillonnage arbitraire où les analyses ont été facilitées par les théories des races, de la civilisation de l’universelle et de l’ethnostylistique. Les résultats de nos analyses ont montré que Césaire par sa justesse et par sa documentation a donné des illustrations qui décrivent le phénomène de la traite des Noirs que l’on peut lire dans ses écrits tels que : Et les Chiens se taisaient, La Tragédie du Roi Christophe, Une Saison au Congo, Une Tempête et Cahier d’un retour au pays natal et qui sont fondées sur le réel. A la lecture de ces ouvrages, on est ému aux larmes par la souffrance des nègres et par la sympathie qu’éprouve Césaire à travers ses expressions stylistiques qui servent de témoignages concrets et qui font appel à un coup de clairon révolutionnaire pour la prise de conscience de la présente et future génération du monde noir contre la discrimination raciale. Mots-clés : traite des Noirs, conserver l’histoire, prise de conscience de la présente et future génération du monde noir contre la discrimination raciale.

Résumé : L’égalité entre les races reste un combat qui, depuis des siècles, préoccupe les défenseurs de droit de l’homme, les politiciens, les gens de médias, les écrivains, les artistes, entre autres dans la vie quotidienne du monde contemporain, Clermidy, B. (2015). Aimé Césaire, écrivain plurilittéraire, a très tôt fait un brusque bond dans ce combat à l’âge de dix-sept ans. Cet article consiste à faire une juxtaposition entre « Le retour d’un enfant Prodigue » et « Cahier d’un retour au pays natal » d’Aimé Césaire afin de voir comment la prise de conscience de Césaire a influencé l’émancipation de la race noire contre la discrimination raciale. Pour faire avancer nos investigations, nous nous sommes posés les questions suivantes : Quelles similarités existent entre le Retour d’un enfant prodigue et le Cahiers d’un retour au pays natal vis-à-vis de la prise de conscience ? Comment le Cahier d’un retour au pays natal a-t-il influencé la prise de conscience de Césaire et l’émancipation de race noire contre la discrimination raciale ? En passant par la méthode qualitative, la théorie pragmatique et la théorie des races, nos analyses des ouvrages choisis ont révélé qu’ils existent des similarités socio-politiques et littéraires entre ces deux ouvrages. En outre, l’étude a démontré une prise de conscience chez Césaire pour la reconnaissance de son identité et la lutte césarienne contre la discrimination raciale qui est encore pertinente pour le monde actuel divisé sur la base des races, des religions, etc. Mots-clés : égalité, combats, discrimination raciale, émancipation, prise de conscience.

Positive Psychology rapidly developed into an influential field of study and intervention, initially situated in Psychology, and later becoming multidisciplinary. Research interest in the study of (psychological) well-being has gained global popularity, with increasing salience in Africa. Although the global trends of these developments are relatively well-known, a bibliometric analysis of positive psychology research in Africa was necessary to shed light on the present hotspots and trends and future trajectories in this region of the world. The data source of the present bibliometric analysis study was Scopus, from which Positive Psychology and well-being research literature from Africa between 1983 and 2023 were searched. Using biblioshiny and VOSviewer, the 622 extracted articles were analysed, from which findings about the current condition, research hotspots, and thematic developmental patterns could be made. Africa experienced an initial slow growth period from 1983 until 2005, after which a rapid growth in research productivity, relevance and impact was experienced. In this regard, the results show that the focal point of scientific productivity is South Africa, with the dominance of South African institutions, particularly the North-West University, from where most positive psychology research is produced and cited. Even with potential access to international journal, African researchers seem to prefer to place their publications in the regional journals such as Journal of Psychology in Africa and South African Journal of Psychology. The research reviewed tends to be characterised by more dominant thematic clusters of positive psychology, psychological well-being, and subjective wellbeing, with a focus on human individuals. An increasing concern for contextual factors and potential antecedents and dynamics of well-being is also observed. The findings provide a good map from which identification of future research priorities can be deduced. As such, we speculate that future positive psychology research in Africa ought to be concerned with the following: greater distribution and intercountry collaborations across the continent, questions of conceptual clarity of terms, better understanding of contextual factors which influence well-being, and well-being research embracing the complexity of bio-psychosocial- ecological well-being, and science concerned with health-promotion interventions. [ABSTRACT FROM AUTHOR]

Objective: This review explores the ethico-cultural and implementation challenges associated with the individual-based informed consent (IC) model in the relatively collectivistic African context and examines suggested approaches to manage them. Methods: We searched four databases for peer-reviewed studies published in English between 2000 to 2023 that examined the ethico-cultural and implementation challenges associated with the IC model in Africa. Results: Findings suggest that the individual-based IC model largely misaligns with certain African social values and ethos and subverts the authority and functions of community gatekeepers. Three recommendations were proffered to manage these challenges, that researchers should: adopt a multi-step approach to IC, conduct a rapid ethical assessment, and generate an African-centered IC model. Conclusions: A pluriversal, context-specific, multi-step IC model that critically harmonizes the cultural values of the local population and the general principles of IC can minimize ethics dumping, safeguard the integrity of the research process, and promote respectful engagement. [ABSTRACT FROM AUTHOR]

This article, titled "Breaking the mental health stigma for people with substance use disorders," explores the pervasive stigma surrounding substance use disorders (SUDs) and its detrimental effects on individuals. The research topic aims to present empirical and theoretical insights into the impact of stigma and propose strategies to mitigate its effects. The articles included in this research topic offer diverse perspectives and frameworks on stigma in various contexts and propose interventions to address these challenges. The findings emphasize the importance of addressing stigma at multiple levels and the need for culturally responsive care to reduce stigma and improve treatment outcomes for individuals with SUDs. [Extracted from the article]

A potentially fructuous approach to fostering mental health and flourishing in Africa is to leverage traditional African proverbs and maxims aligned with positive psychology themes and constructs within the framework of positive psychology interventions (PPIs). This paper explores the potential for integrating (African) proverbs into PPIs to foster well-being and flourishing among African populations. I reference specific proverbs to explore their literal, metaphorical, moral, and epistemological import and inherent values, as well as their prospective utilization in promoting positive relationships, kindness and empathy, teamwork and collaboration, gratitude, truthfulness and honesty, and patience and humility, demonstrating how proverbs hold promise for promoting flourishing in the African context. I propose the CAPPI (Customization and Application of Proverbs in Positive Interventions) framework to guide researchers and practitioners in exploring and incorporating (African) proverbs into interventions. By embracing diverse cultural perspectives, positive psychology can enhance its impact on global well-being and create a more inclusive approach to research and intervention design. [ABSTRACT FROM AUTHOR]

Scholars conducting cross-cultural research in mental health often import intervention programs found to be efficacious in one social context (e.g., Western) and directly implement them in other contexts (e.g., African and Asian) without recourse to the sociocultural disparities between the target populations and the theoretical foundations of the constructs and principles underpinning the intervention programs. Such efforts mistakenly assume that positive psychology interventions (PPIs), most of which were developed from Western perspectives and assumed individualistic cultural orientation and value systems, operate equally across all contexts. Drawing on the extant literature and on insights from designing, implementing, and evaluating group-based (mental) health behavior change intervention programs across several communities in Ghana, we discuss some sociocultural, theoretical, and methodological issues that can significantly constrain the design, uptake, and effectiveness of PPIs in the rural, low literate, socioeconomically disadvantaged, highly collectivistic context of Ghana, and sub-Saharan Africa more generally. In all illustrations, we offer suggestions to guide the design and implementation processes to ensure culturally appropriate, highly acceptable, and potentially effective intervention programs. We argue that PPIs can be potentially fructuous in the sub-region when adapted to, or embedded in, the cultural values of the target population and tailored to the needs, capacities, and circumstances of participants. [ABSTRACT FROM AUTHOR]

In spite of several decades of research and treatment efforts, the rate of relapse to substance abuse remains high, averaging about 75% within a 3- to 6-month duration after treatment. Recent research has focused on exploring contextually relevant relapse prevention approaches. This study explores relapse prevention strategies utilized by individuals to support their abstinence efforts four years after treatment for poly-substance use disorders in a Psychiatric Rehabilitation Unit in Ghana. Using a qualitative exploratory approach (descriptive phenomenology), semi-structured interviews were conducted with 14 individuals previously treated for poly-substance use disorders. Interviews were digitally recorded, transcribed verbatim, and analyzed thematically with an inductive approach. Participants employed a multitude of factors and strategies, including finding a sense of purpose and meaning in life, religious and spiritual engagements, family and social support, and self-initiated schemes to maintain long-term sobriety. Clinicians should collaborate with and thoroughly explore personal, familial, and contextual factors and strategies that support the abstinence efforts of individuals recovering from poly-substance use disorder. [ABSTRACT FROM AUTHOR]

The dual-continua model of mental health provides a contemporary framework for conceptualising and operationalising mental health. According to this model, mental health is distinct from but related to mental illness, and not the opposite or merely the absence of psychopathology symptoms. To examine the validity of the dual-continua model, previous studies have either applied variable-based analysis such as confirmatory factor analysis (CFA), or used predetermined cut-off points for subgroup division. The present study extends this contribution by subjecting data from an African sample to both CFA and latent class analysis (LCA) to test the dual-continua model in Africa. We applied CFA separately for the Mental Health Continuum—Short Form (MHC-SF) and Patient Health Questionnaire—9 (PHQ-9); and LCA on combined item responses. College students (N = 892; average age = 22.74, SD = 4.92; female = 58%) from Ghana (n = 309), Kenya (n = 262), Mozambique (n = 232), and South Africa (n = 89) completed the MHC-SF and PHQ-9. With minor modifications to the measurement models, the CFA results of this study confirm the three-factor structure of the MHC-SF, and a unidimensional solution for the PHQ-9. LCA results show the presence of three distinct latent classes: languishing with moderate endorsement of depressive symptoms (25.9%), flourishing with low endorsement of depressive symptoms (63.7%), and moderate mental health with high endorsement of depressive symptoms (10.4%). These findings further contribute to affirming the evidence for the dual-continua model of mental health, with implications for the assessment of mental health, to inform policy, practise, and future research in community and clinical settings in Africa. [ABSTRACT FROM AUTHOR]

Although several theories and studies have explored human strengths and mental well‐being at the global level, these insights are rarely tested and translated into practice in sub‐Saharan Africa. This study aims to describe the development of a 10‐session multicomponent positive psychology intervention, the Inspired Life Program (ILP), designed to promote mental health and reduce symptoms of depression and negative affect in rural adults in Ghana. Guided by the Medical Research Council's framework for developing complex interventions, a seven‑step iterative community‐based participatory research approach was adopted to develop the ILP, based on constructs and principles of positive psychology and cognitive‐behavioral model. The final intervention components included a 10‐session, two‐hourly, once‐weekly manualized program designed to promote meaningful and purposeful living, self‐acceptance, personal growth, goal‐setting and problem‐solving skills, and positive thinking through group discussion and activity sessions. We describe the program theory and implementation strategy of the final intervention, and reflect on the challenges and lessons learned from applying this framework in the study context. The development of strengths‐based interventions and practicality of methods to promote positive mental health in rural adults are feasible, and have important policy implications for mental health and social care in sub‐Saharan Africa. [ABSTRACT FROM AUTHOR]

Introduction: There is growing evidence that group-based mental health intervention programmes can encourage the development of peer support, psychosocial skills, and collaborative therapeutic relationships with longer lasting effects. This study explored participants' experiences of, perceived benefits of, and recommendations to improve a 10-session group-based multicomponent positive psychology intervention (mPPI)—the Inspired Life Programme (ILP)—designed to promote positive mental health and reduce symptoms of depression and negative affect in a sample of rural Ghanaian adults. Method: Face-to-face semi-structured individual interviews were conducted with 18 randomly selected programme participants three months after their participation in the ILP. Data were analysed thematically with an inductive approach. Results: Participants described their experience of the ILP as a forum for growth that granted them the opportunity to introspect, practicalise and situate everyday life challenges, connect with others, and to develop a sense of mutual accountability. Results indicate that the ILP led participants to develop a stronger sense of positivity and well-being, fructify their ideas, and to cultivate stronger social networks and relationships that led to increased vocational productiveness. Participants recommended that researchers include facets of physical health promotion in the programme and invite close relations of participants to participate in the programme. Conclusion: This study provides the first insight into participants' experiences of a group-based mPPI in Ghana. These findings may provide useful information to inform the design of context-appropriate community-based mental health interventions to fit participants' specific needs, capacities, and circumstances. [ABSTRACT FROM AUTHOR]

Objectives: With increasing survival rates of children with sickle cell disease (SCD) reaching adulthood, there has been a growing interest in the quality of life and mental health functioning of affected individuals. Positive mental health is recognised as a significant dimension of human health that plays an important role in advancing well-being. This study explored the prevalence of positive mental health and functioning among a sample of Ghanaian adults with SCD. Methods: A quantitative cross-sectional survey design was implemented for data-gathering. A random sample of 62 adult SCD patients (21 to 56 years; mean age of 29 years) receiving treatment at the Sickle Cell Clinic of the Ghana Institute of Clinical Genetics at the Korle-Bu Teaching Hospital completed the Mental Health Continuum-Short Form (MHC-SF). Descriptive statistics and reliability indices were estimated for the MHC-SF. We implemented Keyes's criteria for the assessment and categorisation of levels of mental health to determine the prevalence of positive mental health and functioning. Results: We found a high level of positive mental health (66% flourishing; 26% moderately mentally healthy; 8% languishing) and functioning, with no significant difference between the genders. A total of 34% of the participants were functioning at suboptimal levels and were at risk of psychopathology. Conclusion: This study gives the first overview of the prevalence of positive mental health and functioning in a clinical population in Ghana. Although the majority of participants were flourishing, contextually appropriate positive psychological interventions are needed to promote the mental health of SCD patients who are functioning at suboptimal levels, which would, inherently, also buffer against psychopathology. [ABSTRACT FROM AUTHOR]

Background: There is growing evidence that positive psychology interventions (PPIs) enhance positive mental health and lead to a decrease in symptoms of psychopathology. This study examines the effectiveness of a 10‐week multicomponent PPI (the Inspired Life Program; ILP) in promoting positive mental health and reducing symptoms of depression and negative affect in a sample of rural poor adults in Ghana. Methods: Using a quasi‐randomized controlled trial design, participants from four rural poor communities were randomly allocated to intervention (n = 40) or control (n = 42) conditions. The intervention group participated in the 10‐week ILP. Both groups completed a battery of mental health measures, including the Mental Health Continuum‐Short Form, at pre‐intervention, immediately after the intervention, and at 3 months follow‐up. Hierarchical linear modeling was applied to evaluate whether the intervention was effective. Results: There was a greater improvement in positive mental health, with a marked reduction in symptoms of depression in the intervention group compared to the control group, immediately and 3 months after the intervention. There were also larger increases in the proportion of flourishers in the intervention group compared to the control group, immediately and three months after the intervention. Conclusions: The observed effects of the ILP intervention program suggest that group‐based PPIs can promote positive mental health and buffer against psychopathology among people living in rural poor communities in sub‐Saharan Africa. [ABSTRACT FROM AUTHOR]

Background: Mental health is considered an integral part of human health. Reliable and valid measurement instruments are needed to assess various facets of mental health in the native language of the people involved. This paper reports on five studies examining evidence for the factorial validity of the Twi versions of five mental health and well-being measurement instruments: Affectometer-2 (AFM-2); Automatic Thought Questionnaire–Positive (ATQ-P); Generalized Self-Efficacy Scale (GSEs); Patient Health Questionnaire-9 (PHQ-9); and Satisfaction with Life Scale (SWLS) in a rural Ghanaian adult sample. Method: Measures were translated and evaluated using a research-committee approach, pilot-tested, and administered to adults (N = 444) randomly selected from four rural poor communities in Ghana. We applied confirmatory factor analysis (CFA), bifactor CFA, exploratory structural equation modeling (ESEM), and bifactor ESEM to the AFM-2, ATQ-P, and the PHQ-9, and CFA to the GSEs and the SWLS. The omega coefficient of composite reliability was computed for each measure. Results: A two-factor bifactor ESEM model displayed superior model fit for the AFM-2. The total scale and the Negative Affect subscale, but not the Positive Affect subscale, attained sufficient reliability. Two models (a four-factor 22-item bifactor ESEM model and a 5-factor 22-item ESEM model) fitted the data best for the ATQ-P. The bifactor ESEM model displayed a high reliability value for the total scale and satisfactory reliability values for three of its four subscales. For the GSEs, a one-factor CFA model (residuals of items 4 and 5 correlated) demonstrated superior model fit with a high reliability score for the total scale. A two-factor ESEM model outperformed all other models fitted for the PHQ-9, with moderate and satisfactory reliability scores for the subscales. A one-factor CFA model (residuals of item 4 and 5 correlated) demonstrated superior model fit for the SWLS, with a satisfactory reliability value for the total scale. Conclusions: Findings established evidence for the factorial validity of the Twi versions of all five measures, with the global scores, but not all subscale scores, demonstrating satisfactory reliability. These validated measurement instruments can be used to assess mental health and well-being in the research and practice contexts of the current sample. [ABSTRACT FROM AUTHOR]

Objective: Drug dependency has been typified as a persistent relapsing disorder. Overall, 65% of people with substance use disorders relapse within one year after treatment. Recent interventions have focussed on contextually relevant relapse prevention strategies. This study explored relapse prevention strategies utilised by patients recovering from poly-substance use disorders one year after treatment at a Psychiatric Rehabilitation Unit in Ghana. Methods: The study adopted a descriptive phenomenology design and was conducted at the Psychiatric Rehabilitation Unit of the Regional Hospital, Sunyani, Ghana. A purposive sample of 15 patients recovering from poly-substance use disorders were recruited. Data were collected through in-depth interviews with a semistructured guide and analysed using the content analysis procedures. Results: Five key themes emerged from the analysis of the data that described participants' relapse prevention strategies. These include clinical strategies, self-initiated tactics, spirituality and religious engagements, communalism and social support network. Conclusions: The evidence from this study supports a multilevel treatment strategy for patients with poly-substance disorders. We found that a combination of clinical, individual and contextual factors significantly contribute to relapse prevention efforts in the Ghanaian context. Clinicians and treatment services should explore, evaluate, strengthen and incorporate these emerging themes into their relapse prevention interventions protocols. [ABSTRACT FROM AUTHOR]

Relapse to substance abuse is a global problem and is conceptualized as an integral component of the recovery process. Global statistics on rates of relapse after substance abuse treatment are disturbingly high, averaging about 75% within a 3- to 6-month duration after treatment. This study sought to gain full understanding of the factors that precipitate relapse among substance abusers in Ghana. Data were collected through in-depth interviews with 15 relapsed substance abusers who were previously treated for substance abuse, and three mental health professionals at a psychiatric rehabilitation unit in Ghana. Findings showed that seven factors, including positive/negative emotional reinforcements, sense of loss, interpersonal conflicts, peer influence, familial, religio-cultural, and treatment-based issues complot to instigate and maintain the relapse cycle. The findings provide valuable insights into the relapse phenomenon in Ghana. Clinicians should actively engage family members in the relapse prevention process, and provide insight into religio-cultural relapse precipitants. [ABSTRACT FROM AUTHOR]

Summary: >Background:: Cynomolgus monkeys (Macaca fascicularis) are one of the predominant primate models in experimental transplantation. Particularly in xenotransplantation experiments, they can be subjected to profound cardiovascular instability by surgical trauma, volume shifts and inflammatory mediator release. Meticulous perioperative management including deliberate intraoperative monitoring is therefore required. Methods:: 26 porcine kidneys (group A) and 3 single lung lobes (group B), obtained from unmodified pigs or from pigs transgenic for human complement regulators, were transplanted into 29 cynomolgus monkeys. In group A1 (n = 11) the monkeys were monitored intraoperatively by ECG, non-invasive arterial, and central venous blood pressure (standard cardiovascular monitoring, SCVM). In group A2 (n = 15) measurements of cardiac output (CO), intrathoracic blood volume and extravascular lung water (extended cardiovascular monitoring, XCVM) were added to the intraoperative monitoring regime. XCVM plus continuous pulse contour CO was used in the 3 monkeys undergoing porcine single lung xenotransplantation. Results: In group A2 significantly more animals had initial graft function if compared to group A1. 40% of the monkeys of group A2 but 73% of group A1 died within the first postoperative week. Group A2 displayed a trend towards greater overall survival rates, but this difference did not reach statistical significance (p = 0,07). In group B stable lung xenograft reperfusion was achieved in all 3 recipients despite recurrent phases of severe cardiovascular instability. Two lung recipients could be weaned from the ventilator, and 1 monkey survived more than 24 hours postoperatively. Conclusions:: The application of XCVM in small primates undergoing kidney xenotransplantation led to significantly better early postoperative results and longer survival times. In single lung xenotransplantation XCVM plus continuous pulse contour CO showed to be indispensable for the therapeutic management of the profound cardiovascular instabilities observed. Our data indicate that comprehensive anaesthesiologic monitoring can contribute substantially to the advancement of experimental organ transplantation in small monkeys. [Copyright &y& Elsevier]

While there is a strong link between caregiver mental health, caregiver engagement, and child development, limited research has examined the underlying mechanisms of these associations in Africa. We examined the mediating role of dimensions of caregiver engagement in the association of caregiver psychological distress with children's academic and socioemotional outcomes in Ghana. Data came from 4,714 children (aged 5-17 years) and their caregivers in five regions of northern Ghana. Caregiver psychological distress and engagement (i.e., engagement in education, emotional supportiveness, and parenting self-efficacy) were self-reported by children's primary caregiver. Children's academic (literacy and numeracy) and socioemotional (prosocial skills and socioemotional difficulties) outcomes were directly assessed using validated measures. Structural equation modelling was used to estimate mediation models. We tested moderation by caregiver exposure to formal education, child's age, and child's sex. Fourteen percent of caregivers experienced elevated psychological distress. Higher levels of psychological distress were associated with children's poorer literacy and numeracy skills, and higher socioemotional difficulties, but not prosocial skills. The mediating role of caregiver engagement varied by caregiver exposure to formal education but not child's age or sex. Caregiver engagement in education explained the association between psychological distress and children's literacy skills (but not numeracy or socioemotional) in families where the caregiver had no formal education (indirect effect: β = 0.007 [95% CI: 0.000, 0.016]), explaining 23% of the association. No mediator explained the association of psychological distress with child outcomes among families where the caregiver had some formal education. The mechanisms through which caregiver psychological distress is associated with child outcomes in rural Ghana differ as a function of caregivers' exposure to formal education. These results highlight the importance of developing multi-component and culturally-sensitive programs to improve child outcomes. Further research in similar contexts is needed to advance scientific understanding on how to effectively promote child and family wellbeing., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ahun et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Existing studies investigating 30-day in-hospital stroke case fatality rates in sub-Saharan Africa have produced varying results, underscoring the significance of obtaining precise and reliable estimations for this indicator. Consequently, this study aimed to conduct a systematic review and update of the current scientific evidence regarding 30-day in-hospital stroke case fatality and associated risk factors in sub-Saharan Africa. Medline/PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), APA PsycNet (encompassing PsycINFO and PsychArticle), Google Scholar, and Africa Journal Online (AJOL) were systematically searched to identify potentially relevant articles. Two independent assessors extracted the data from the eligible studies using a pre-tested and standardized excel spreadsheet. Outcomes were 30-day in-hospital stroke case fatality and associated risk factors. Data was pooled using random effects model. Ninety-three (93) studies involving 42,057 participants were included. The overall stroke case fatality rate was 27% [25%-29%]. Subgroup analysis revealed 24% [21%-28%], 25% [21%-28%], 29% [25%-32%] and 31% [20%-43%] stroke case fatality rates in East Africa, Southern Africa, West Africa, and Central Africa respectively. Stroke severity, stroke type, untyped stroke, and post-stroke complications were identified as risk factors. The most prevalent risk factors were low (<8) Glasgow Coma Scale score, high (≥10) National Institute Health Stroke Scale score, aspiration pneumonia, hemorrhagic stroke, brain edema/intra-cranial pressure, hyperglycemia, untyped stroke (stroke diagnosis not confirmed by neuroimaging), recurrent stroke and fever. The findings indicate that one in every four in-hospital people with stroke in sub-Saharan Africa dies within 30 days of admission. Importantly, the identified risk factors are mostly modifiable and preventable, highlighting the need for context-driven health policies, clinical guidelines, and treatments targeting these factors., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ackah et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Early rejection of discordant porcine xenografts in primate recipients is initiated by the intragraft binding of either preformed (hyperacute xenograft rejection) or induced (acute vascular rejection) antiporcine recipient antibodies with subsequent complement activation via the classical pathway. We have investigated the efficacy of the supplemental administration of C1-inhibitor (C1-INH), a specific inhibitor of the classical complement activation pathway, for prophylaxis of xenograft rejection in a pig to primate kidney xenotransplantation setting., Methods: Based on the results of pharmacokinetic studies performed in two nontransplanted monkeys, supplemental C1-INH therapy was administered daily to three Cynomolgus monkeys receiving a life-supporting porcine kidney transplant together with cyclophosphamide-induction/cyclosporine A/mycophenolat-mofetil/steroid immunosuppressive therapy., Results: In the three monkeys receiving porcine kidney xenografts and continuous C1-INH treatment none of the grafts underwent hyperacute rejection; all xenografts showed initial function. Recipient survival was 13, 15, and 5 days. No graft was lost due to acute vascular rejection. All animals died with a functioning graft (latest creatinine 96, 112, and 96 micromol/liter) due to bacterial septicemia., Conclusion: We conclude that, in our model, supplemental C1-INH therapy together with a standard immunosuppressive regimen can be helpful for prevention of xenograft rejection in a pig to primate kidney xenotransplantation setting. The optimal dose and duration of C1-INH treatment, however, has yet to be determined.