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IntroductionSevere acute respiratory syndrome coronavirus 2 also called coronavirus disease 2019 was first reported in the African continent on 14 February 2020 in Egypt. As at 18 December 2020, the continent reported 2,449,754 confirmed cases, 57,817 deaths and 2,073,214 recoveries. Urban cities in Africa have particularly suffered the brunt of coronavirus disease 2019 coupled with criticisms that the response strategies have largely been a 'one-size-fits-all' approach. This article reviewed early evidence on urban health nexus with coronavirus disease 2019 preparedness and response in Africa.MethodsA rapid scoping review of empirical and grey literature was done using data sources such as ScienceDirect, GoogleScholar, PubMed, HINARI and official websites of World Health Organization and Africa Centres for Disease Control and Prevention. A total of 26 full articles (empirical studies, reviews and commentaries) were synthesised and analysed qualitatively based on predefined inclusion criteria on publication relevance and quality.ResultsOver 70% of the 26 articles reported on coronavirus disease 2019 response strategies across Africa; 27% of the articles reported on preparedness towards coronavirus disease 2019, while 38% reported on urbanisation nexus with coronavirus disease 2019; 40% of the publications were full-text empirical studies, while the remaining 60% were either commentaries, reviews or editorials. It was found that urban cities remain epicentres of coronavirus disease 2019 in Africa. Even though some successes have been recorded in Africa regarding coronavirus disease 2019 fight, the continent's response strategies were largely found to be a 'one-size-fits-all' approach. Consequently, adoption of 'Western elitist' mitigating measures for coronavirus disease 2019 containment resulted in excesses and spillover effects on individuals, families and economies in Africa.ConclusionAfrica needs to increase commitment to health systems strengthening through context-specific interventions and prioritisation of pandemic preparedness over response. Likewise, improved economic resilience and proper urban planning will help African countries to respond better to future public health emergencies, as coronavirus disease 2019 cases continue to surge on the continent.

Background: Female genital schistosomiasis (FGS) is a gynaecological complication of urinary schistosomiasis (US) with an estimated burden of 20–120 million cases in endemic areas. A neglected sexual and reproductive health disease in sub-Saharan Africa, FGS increases susceptibility to sexually transmitted infections including cervical cancer and infertility among other morbidities. However, there appears to be limited FGS knowledge among practicing and pre-service health providers with implications for control. We assessed FGS awareness among final-year midwifery students who would soon be delivering primary maternal and reproductive health care. Methods: A cross-sectional study was conducted among 193 randomly selected final-year students from all three midwifery training institutions in the Volta region of Ghana in August/September, 2022. Data on participants' demographics and knowledge of the transmission, signs and symptoms, complications, treatment and prevention of both FGS and US were collected using structured questionnaires. Summary statistics were presented as frequencies, proportions and percentages. Results: Only 23.3% (44/189) of participants had heard about FGS compared to 64% (123/192) for US. Of the former, 42 (95%), 40 (91%) and 36 (81.8%) respectively identified genital itching/burning sensation, bloody vaginal discharge and pelvic pain/pain during intercourse as part of the symptoms of FGS. Less than a third (13/44) and about half (25/44) of those who indicated hearing about FGS knew it can be a risk for ectopic pregnancies and infertility respectively. Majority of these participants, 40 (91%), wrongly selected antibiotics as treatment for FGS while 9 indicated it is prevented by sleeping in insecticide-treated nets. Conclusion: Awareness of FGS was limited among the study participants. The high prevalence of knowledge of some FGS symptoms related to the genitalia needs cautious interpretation. Health care training institutions must make deliberate efforts to highlight FGS in the training of midwives as the condition has diagnostic and management implications for some sexual and reproductive health conditions. [ABSTRACT FROM AUTHOR]

Female genital schistosomiasis as a result of chronic infection with Schistosoma haematobium (commonly known as bilharzia) continues to be largely ignored by national and global health policy-makers. International attention for large-scale action against the disease focuses on whether it is a risk factor for the transmission of human immunodeficiency virus (HIV). Yet female genital schistosomiasis itself is linked to pain, bleeding and sub- or infertility, leading to social stigma, and is a common issue for women in schistosomiasis-endemic areas in sub-Saharan Africa. The disease should therefore be recognized as another component of a comprehensive health and human rights agenda for women and girls in Africa, alongside HIV and cervical cancer. Each of these three diseases has a targeted and proven preventive intervention: antiretroviral therapy and pre-exposure prophylaxis for HIV; human papilloma virus vaccine for cervical cancer; and praziquantel treatment for female genital schistosomiasis. We discuss how female genital schistosomiasis control can be integrated with HIV and cervical cancer care. Such a programme will be part of a broader framework of sexual and reproductive health and rights, women's empowerment and social justice in Africa. Integrated approaches that join up multiple public health programmes have the potential to expand or create opportunities to reach more girls and women throughout their life course. We outline a pragmatic operational research agenda that has the potential to optimize joint implementation of a package of measures responding to the specific needs of girls and women. [phrase omitted] [phrase omitted] La schistosomiase genitale feminine, resultant d'une infection chronique a Schistosoma haematobium (egalement connue sous le nom de bilharziose), continue d'etre largement ignoree par les responsables des politiques de sante nationales et internationales. Si le monde lui accorde son attention en vue de mener une action a grande echelle contre la maladie, c'est surtout pour determiner s'il s'agit d'un facteur de risque pour la transmission du virus de l'immunodeficience humaine (VIH). Pourtant, la schistosomiase genitale feminine est associee a des douleurs, des saignements et peut engendrer l'hypofertilite, voire la sterilite. Par consequent, celles qui en souffrent sont souvent stigmatisees, et le probleme est courant dans les regions endemiques d'Afrique subsaharienne. Cette maladie doit donc etre consideree comme composante a part entiere d'une approche globale de la sante et des droits humains pour les femmes et filles africaines, a l'instar du VIH et du cancer du col de l'uterus. Chacune de ces trois maladies fait l'objet d'une intervention preventive ciblee qui a deja fait ses preuves: le traitement antiretroviral et la prophylaxie pre-exposition pour le VIH; le vaccin contre le papillomavirus humain pour le cancer du col de l'uterus; et l'administration de praziquantel pour la schistosomiase genitale feminine. Le present document se penche sur la maniere d'integrer la schistosomiase genitale feminine dans la prise en charge du VIH et du cancer du col de l'uterus. Un tel programme fera partie d'un cadre plus vaste consacre aux droits et a la sante sexuelle et reproductive, a l'emancipation des femmes et a la justice sociale en Afrique. Les approches integrees qui regroupent plusieurs programmes de sante publique permettent d'elargir des perspectives ou de creer des opportunites visant a atteindre un plus grand nombre de filles et de femmes tout au long de leur vie. Nous exposons les grandes lignes d'un programme de recherches pragmatiques et operationnelles capable d'optimiser la mise en reuvre conjointe d'une serie de mesures qui repondent aux besoins specifiques des filles et des femmes. [phrase omitted] Los responsables de formular las politicas sanitarias nacionales y globales siguen ignorando en gran medida la esquistosomiasis genital femenina como consecuencia de la infeccion cronica por Schistosoma haematobium (conocida comunmente como bilharziasis). La atencion internacional para adoptar medidas de gran alcance contra la enfermedad se centra en determinar si es un factor de riesgo para la transmision del virus de la inmunodeficiencia humana (VIH). Sin embargo, la propia esquistosomiasis genital femenina esta vinculada al dolor, las hemorragias y la infertilidad o subfertilidad, lo que conduce al estigma social, ademas de ser un problema comun para las mujeres de las areas en donde la esqulstosomlasls es endemica en el Africa subsaharlana. Por consiguiente, la enfermedad debe ser reconocida como otro componente de un programa integral de salud y de derechos humanos para las mujeres y las ninas de Africa, junto con el VIH y el cancer de cuello uterino. Cada una de estas tres enfermedades tiene una intervencion preventiva especifica y comprobada: la terapia antirretroviral y la profilaxis previa a la exposicion para el VIH; la vacuna contra el virus del papiloma humano para el cancer de cuello uterino; y el tratamiento con praziquantel para la esquistosomiasis genital femenina. Se analiza como el control de la esquistosomiasis genital femenina se puede integrar con la atencion del VIH y el cancer de cuello uterino. Ese programa formara parte de un marco mas amplio de salud y de derechos sexuales y reproductivos, de empoderamiento de la mujer y de justicia social en Africa. Los enfoques integrados que unen multiples programas de salud publica tienen el potencial de ampliar o crear oportunidades para llegar a mas ninas y mujeres a lo largo de sus vidas. Se describe a grandes rasgos un programa de investigacion operacional pragmatico que tiene el potencial de optimizar la implementacion conjunta de una serie de medidas que respondan a las necesidades especificas de las ninas y de las mujeres., Introduction Gynaecological schistosomiasis as a result of chronic infection with Schistosoma haematobium (commonly known as bilharzia) has been described in the medical literature since the 1940s. (1,2) In the early [...]

Background: The WHO recommended the use of the RTS,S/AS01 malaria vaccine (RTS,S) based on a pilot evaluation in routine use in Ghana, Kenya, and Malawi. A longitudinal qualitative study was conducted to examine facilitators and barriers to uptake of a 4-dose RTS,S schedule. Methods: A cohort of 198 caregivers of RTS,S-eligible children from communities where RTS,S was provided through the pilot were interviewed three times over a ≈22-month, 4-dose schedule. The interviews examined caregiver perceptions and behaviors. Children's vaccination history was obtained to determine dose uptake. Results: 162 caregivers remained at round 3 (R3); vaccination history was available for 152/162 children. Despite early rumors/fears, the uptake of initial doses was high, driven by vaccine trust. Fears dissipated by R2, replaced with an enthusiasm for RTS,S as caregivers perceived its safety and less frequent and severe malaria. By R3, 98/152 children had received four doses; 34 three doses; 9 one or two doses; and 11 zero doses. The health system and information barriers were important across all under-dose cases. Fears about AEFIs/safety were important in zero-, one-, and two-dose cases. Competing life/livelihood demands and complacency were found in three-dose cases. Regardless of the doses received, caregivers had positive attitudes towards RTS,S by R3. Conclusions: Findings from our study will help countries newly introducing the vaccine to anticipate and preempt reasons for delayed acceptance and missed RTS,S doses. [ABSTRACT FROM AUTHOR]

Background In low- and middle-income countries (LMICs), the continuum of care (CoC) for maternal, newborn, and child health (MNCH) is not always complete. This study aimed to evaluate the effectiveness of an integrated package of CoC interventions on the CoC completion, morbidity, and mortality outcomes of woman-child pairs in Ghana. Methods and findings This cluster-randomized controlled trial (ISRCTN: 90618993) was conducted at 3 Health and Demographic Surveillance System (HDSS) sites in Ghana. The primary outcome was CoC completion by a woman-child pair, defined as receiving antenatal care (ANC) 4 times or more, delivery assistance from a skilled birth attendant (SBA), and postnatal care (PNC) 3 times or more. Other outcomes were the morbidity and mortality of women and children. Women received a package of interventions and routine services at health facilities (October 2014 to December 2015). The package comprised providing a CoC card for women, CoC orientation for health workers, and offering women with 24-hour stay at a health facility or a home visit within 48 hours after delivery. In the control arm, women received routine services only. Eligibility criteria were as follows: women who gave birth or had a stillbirth from September 1, 2012 to September 30, 2014 (before the trial period), from October 1, 2014 to December 31, 2015 (during the trial period), or from January 1, 2016 to December 31, 2016 (after the trial period). Health service and morbidity outcomes were assessed before and during the trial periods through face-to-face interviews. Mortality was assessed using demographic surveillance data for the 3 periods above. Mixed-effects logistic regression models were used to evaluate the effectiveness as difference in differences (DiD). For health service and morbidity outcomes, 2,970 woman-child pairs were assessed: 1,480 from the baseline survey and 1,490 from the follow-up survey. Additionally, 33,819 cases were assessed for perinatal mortality, 33,322 for neonatal mortality, and 39,205 for maternal mortality. The intervention arm had higher proportions of completed CoC (410/870 [47.1%]) than the control arm (246/620 [39.7%]; adjusted odds ratio [AOR] for DiD = 1.77; 95% confidence interval [CI]: 1.08 to 2.92; p = 0.024). Maternal complications that required hospitalization during pregnancy were lower in the intervention (95/870 [10.9%]) than in the control arm (83/620 [13.4%]) (AOR for DiD = 0.49; 95% CI: 0.29 to 0.83; p = 0.008). Maternal mortality was 8/6,163 live births (intervention arm) and 4/4,068 live births during the trial period (AOR for DiD = 1.60; 95% CI: 0.40 to 6.34; p = 0.507) and 1/4,626 (intervention arm) and 9/3,937 (control arm) after the trial period (AOR for DiD = 0.11; 95% CI: 0.11 to 1.00; p = 0.050). Perinatal and neonatal mortality was not significantly reduced. As this study was conducted in a real-world setting, possible limitations included differences in the type and scale of health facilities and the size of subdistricts, contamination for intervention effectiveness due to the geographic proximity of the arms, and insufficient number of cases for the mortality assessment. Conclusions This study found that an integrated package of CoC interventions increased CoC completion and decreased maternal complications requiring hospitalization during pregnancy and maternal mortality after the trial period. It did not find evidence of reduced perinatal and neonatal mortality. Trial registration The study protocol was registered in the International Standard Randomised Controlled Trial Number Registry (90618993)., Author(s): Akira Shibanuma 1, Evelyn Korkor Ansah 2,3, Kimiyo Kikuchi 1,4, Francis Yeji 5, Sumiyo Okawa 1,6, Charlotte Tawiah 7, Keiko Nanishi 1, Sheila Addei 8, John Williams 8, Kwaku [...]