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Competing Interests: We declare no competing interests. We received no grants or other financial support.

Introduction: when the first cases of COVID-19 were reported in Zimbabwe in March 2020, the local outbreak was characterised by an insidious increase in national caseload. This first wave was mainly attributable to imported cases, peaking around July 2020. By October 2020, the number of cases reported daily had declined to less than 100 cases per day signalling the end of the first wave. This pattern mirrored the global trends. In December 2020, reports of new COVID-19 variants emerged and coincided with the beginning of the second wave within the ongoing pandemic. This paper reports on the analysis conducted on the new wave of COVID-19 beginning December 2020 to January 2021. The objective of this study was to document the evolving presumptive second wave of the COVID-19 pandemic in Zimbabwe from December 2020 to January 2021., Methods: this is a retrospective analysis of secondary data extracted from the daily situation reports published by the Ministry of Health and Child Welfare, Zimbabwe and World Health Organization Country Office, Zimbabwe. The period under consideration started from 1 st December 2020 to 31 st January 2021., Results: there was a 333% increase in the number of confirmed COVID-19 cases starting 1 st December 2020, to 31 st January 2021. These new cases were mainly attributed to community transmission though there were a few imported cases. There was a 439% increase in the absolute number of deaths; however, the case fatality rate remained low at 3.6%, and comparable to that from other countries. Harare, Bulawayo and Manical and provinces accounted for 60% of the case burden, with the other seven provinces only accounting for 40%. By mid-January, the number of incident COVID-19 cases started to decline significantly, to levels similar to the residual levels seen during the first wave., Conclusion: the second wave, which lasted a period of less than 2 months, had a steep rise and sharp decline in the incident cases and fatalities. The steep rise was attributable to increased mobility, with a consequent increase in the chains of community transmission. The declines, noted from mid-January 2021, may be partly attributable to a strict national lockdown, though more in-depth exploration of the drivers of transmission is needed to tailor effective interventions for future control. Differentiated strategies maybe needed according to the case burdens in the different provinces. In anticipation of further waves, the introduction of safe and effective vaccines might be the game changer if the vaccines are widely availed to the population to levels adequate to achieve herd immunity. Meanwhile, infection prevention and control guidelines must continue to be observed., Competing Interests: The authors declare no competing interests., (Copyright: Grant Murewanhema et al.)

Introduction: the first cases of COVID-19 were reported in China in December 2019. Since then, the disease has evolved to become a global pandemic. Zimbabwe reported its first case on 20 th March 2020, and the number has been increasing steadily. However, Zimbabwe has not witnessed the exponential growth witnessed in other countries so far, and the trajectory seems different. We set out to describe the epidemiological trends of COVID-19 in Zimbabwe from when the first case was confirmed to June 2020., Methods: data were collected from daily situation reports that were published by the Zimbabwean Ministry of Health and Child Care from 20 th March to 27 th June 2020. Missing data on the daily situation reports was not imputed., Results: as of 27 th June 2020, Zimbabwe had 567 confirmed COVID-19 cases. Eighty-two percent of these were returning residents and 18% were local transmission. The testing was heavily skewed towards returnees despite a comprehensive testing strategy. Of the confirmed cases, 142 were reported as recovered. However, demographic data for the cases were missing from the reports. It was not possible to estimate the probable period of infection of an active case, and case fatality in Zimbabwe was about 1% for the first 4 months of the pandemic., Conclusion: the epidemiological trends of COVID-19 experienced in Zimbabwe between March and June 2020 are somewhat different from what has been observed elsewhere. Further research to determine the reasons for the differences is warranted, to inform public health practice and tailor make suitable interventions., Competing Interests: The authors declare no competing interests., (Copyright: Grant Murewanhema et al.)

Background: Sub-Saharan Africa (SSA) is facing a double burden of disease with a rising prevalence of non-communicable diseases (NCDs) while the burden of communicable diseases (CDs) remains high. Despite these challenges, there remains a significant need to understand how or under what conditions health interventions implemented in sub-Saharan Africa are sustained. The purpose of this study was to conduct a systematic review of empirical literature to explore how health interventions implemented in SSA are sustained., Methods: We searched MEDLINE, Biological Abstracts, CINAHL, Embase, PsycInfo, SCIELO, Web of Science, and Google Scholar for available research investigating the sustainability of health interventions implemented in sub-Saharan Africa. We also used narrative synthesis to examine factors whether positive or negative that may influence the sustainability of health interventions in the region., Results: The search identified 1819 citations, and following removal of duplicates and our inclusion/exclusion criteria, only 41 papers were eligible for inclusion in the review. Twenty-six countries were represented in this review, with Kenya and Nigeria having the most representation of available studies examining sustainability. Study dates ranged from 1996 to 2015. Of note, majority of these studies (30 %) were published in 2014. The most common framework utilized was the sustainability framework, which was discussed in four of the studies. Nineteen out of 41 studies (46 %) reported sustainability outcomes focused on communicable diseases, with HIV and AIDS represented in majority of the studies, followed by malaria. Only 21 out of 41 studies had clear definitions of sustainability. Community ownership and mobilization were recognized by many of the reviewed studies as crucial facilitators for intervention sustainability, both early on and after intervention implementation, while social and ecological conditions as well as societal upheavals were barriers that influenced the sustainment of interventions in sub-Saharan Africa., Conclusion: The sustainability of health interventions implemented in sub-Saharan Africa is inevitable given the double burden of diseases, health care worker shortage, weak health systems, and limited resources. We propose a conceptual framework that draws attention to sustainability as a core component of the overall life cycle of interventions implemented in the region.

Reduction of salt intake is an important and cost-effective way for reducing hypertension and the risk of cardiovascular diseases (CVDs). Current global salt intakes are estimated at around 10 g/day, well above the World Health Organization (WHO) recommended level of <5 g/day. The sub-Saharan Africa (SSA) region has a prevalence of hypertension of 46% among adults aged 25 and over and therefore strategies to reduce salt intake are necessary. This requires an understanding of salt intake behaviors in the population along with government commitment to increase awareness and take actions that would create an enabling environment. It is also important to have the food industry and other key stakeholders on board. A review of the developed WHO's norms and guidelines, technical support provided to countries by WHO as well as country initiatives shows that countries in the African region are at different stages in the implementation of salt reduction interventions. For example, South Africa has enacted legislation to make the food industry reduce the salt content of a number of its products while Mauritius is requesting bakery owners to reduce salt in bread. A number of countries are currently undertaking studies to measure salt intake in the populations. Overall progress is slow as the region experiences a double burden of communicable and noncommunicable diseases, competing health priorities and limited resources for health.

Study participants included 285 secondary school pupils in Zimbabwe who responded to a questionnaire assessing alcohol, tobacco, and marijuana use, and anticipated parental reaction to the pupil's drug-taking behavior. Results showed nearly 17% of the sample had used alcohol, 8% used tobacco, and 5% had used marijuana during the past seven days prior to questionnaire administration. Results regarding intentions to use alcohol, tobacco, and marijuana in the future show pupils' interest highest in using alcohol. Nearly 34% indicated intentions to use alcohol during the next year, while 16% reported intentions to use tobacco, and 12.9% indicated intentions to use marijuana. Nearly 17% reported they felt their parents would be favorable to their use of alcohol. Anticipated parental approval for tobacco and marijuana was 13.6% and 10.8%, respectively. Though current use and future intentions among the sample are not as high compared to similar populations in developed countries, this study suggests Zimbabwe should consider expanding its drug education effort in the school setting. Research to identify effective educational strategies to curb further increases in adolescent drug taking behavior also needs to be explored and identified.