Search Results (59)

Background/Objectives: Telemedicine has emerged as a transformative solution to healthcare access challenges in Sub-Saharan Africa, where many populations remain underserved. This systematic review focuses on the adoption, implementation, and technological prospects of telemedicine in South Africa, Kenya, and Nigeria, three countries leading the region in healthcare innovations. Methods: A systematic search of PubMed, Scopus, and Web of Science, guided by PRISMA protocols, identified 567 studies published between 2014 and 2024, of which 53 met the inclusion criteria with a focus on telemedicine adoption, implementation, and technological prospects in the selected countries. A structured critical appraisal was used to assess potential biases in the included studies’ design, selection criteria, and reporting, while findings were thematically analysed to provide actionable and comparative insights. Results: The findings reveal that South Africa has the highest adoption rate, focusing on specialist teleconsultations, chronic disease management, and mental health services. Kenya demonstrates strong mHealth integration and advanced mobile applications, particularly in maternal health, HIV care, and sexual and reproductive health. While facing infrastructural and regulatory constraints, Nigeria is advancing innovations for remote diagnosis and teleconsultation. Conclusions: By synthesising evidence from peer-reviewed literature, the review identifies adoption trends, enabling factors, and opportunities for scaling telemedicine in these contexts. Despite these advancements, challenges persist, including regulatory gaps, digital literacy limitations, and infrastructure constraints. Addressing these barriers requires targeted investments in broadband expansion, policy harmonisation, and healthcare workforce training to optimise telemedicine’s impact and ensure its sustainability as a healthcare delivery model in Sub-Saharan Africa. Full article

In sub-Saharan Africa, municipal solid waste management faces significant challenges, including inadequate infrastructure, increasing waste generation, and limited resources, leading to severe environmental and public health issues. Innovations in waste management are essential to address these pressing problems, as they can enhance efficiency, reduce pollution, and promote sustainable practices while fostering sustainable development. To select sustainable and contextually relevant solutions, it is vital to investigate their potential sustainability impacts based on the Sustainable Development Goals (SDGs) beforehand and to involve local stakeholders in the innovation process. Besides, engaging stakeholders increases community buy-in and fosters collaboration, leading to more effective and sustainable outcomes. This paper develops and applies a sustainability assessment methodology for innovations in municipal solid waste management systems in sub-Saharan Africa, with a case study in Ethiopia. The proposed methodology emphasizes the importance of involving local stakeholders in the SDG-based indicator assessment and offers suggestions for a data collection strategy. The case study on a composting process in Bishoftu Town demonstrates that stakeholder participation in selecting innovations positively influences the outcomes. However, the analysis indicates mixed effects of the innovation in the three sustainability dimensions, highlighting areas for optimization. Consequently, the presented method can support the innovation process of municipal solid waste management systems, fostering sustainable municipal development. Full article

There is a paucity of information on the prevalence, risk factors, and clinical correlates of people living with HIV (PLWH) who are co-infected with Cryptosporidium spp. in the post-combined antiretroviral therapy era in Ghana. To provide such data, in this observational study, stool samples of 640 HIV-positive and 83 HIV-negative individuals in Ghana were screened for Cryptosporidium spp. Additionally, sociodemographic parameters, clinical symptoms, medication intake, and immunological parameters were assessed. The prevalence of Cryptosporidium spp. was 11.8% (n = 73) in HIV-positive and 1.2% (n = 1) in HIV-negative participants (p < 0.001). Within the group of HIV-positive participants, the prevalence reached 26.0% in patients with CD4+ T cell counts below 200 cells/µL and 46.2% in the subgroup with CD4+ T cell counts below 50 cells/µL. The frequencies of the clinical manifestation of weight loss and gastrointestinal symptoms were significantly higher in patients with Cryptosporidium spp. compared to those without co-infection (45.8% vs. 21.4%, p < 0.001 and 22.2% vs. 12.2%, p = 0.031, respectively). In the modern post-cART era, the acquisition of Cryptosporidium spp. among PLWH in Ghana is driven largely by the degree of immunosuppression. Access to cART and screening for Cryptosporidium spp. as part of routine care might help control and reduce the burden of the infection. Full article

Sub-Saharan Africa, with its hot and humid climate, is a conducive zone for tick proliferation. These vectors pose a major challenge to both animal and human health in the region. However, despite the relevance of emerging diseases and evidence of tick-borne disease emergence, very few studies have been dedicated to investigating zoonotic pathogens transmitted by ticks in this area. To raise awareness of the risks of tick-borne zoonotic diseases in sub-Saharan Africa, and to define a direction for future research, this systematic review considers the trends of research on tick-borne bacteria, parasites, and viruses from 2012 to 2023, aiming to highlight the circulation of these pathogens in ticks, cattle, sheep, goats, and humans. For this purpose, three international databases were screened to select 159 papers fitting designed inclusion criteria and used for qualitative analyses. Analysis of these studies revealed a high diversity of tick-borne pathogens in sub-Saharan Africa, with a total of 37 bacterial species, 27 parasite species, and 14 viruses identified. Among these, 27% were zoonotic pathogens, yet only 11 studies investigated their presence in humans. Furthermore, there is growing interest in the investigation of bacteria and parasites in both ticks and ruminants. However, research into viruses is limited and has only received notable interest from 2021 onwards. While studies on the detection of bacteria, including those of medical interest, have focused on ticks, little consideration has been given to these vectors in studies of parasites circulation. Regarding the limited focus on zoonotic pathogens transmitted by ticks, particularly in humans, despite documented cases of emerging zoonoses and the notable 27% proportion reported, further efforts should be made to fill these gaps. Future studies should prioritize the investigation of zoonotic pathogens, especially viruses, which represent the primary emerging threats, by adopting a One Health approach. This will enhance the understanding of their circulation and impact on both human and animal health. In addition, more attention should be given to the risk factors/drivers associated to their emergence as well as the perception of the population at risk of infection from these zoonotic pathogens. Full article

This pioneering study evaluates the digital divide and advances in virtual education (VE) and e-learning research in the Global South Countries (GSCs). Using metadata from bibliographic and World Bank data on research and development (R&D), we conduct quantitative bibliometric performance analyses and evaluate the connection between R&D expenditures on VE/e-learning research advances in GSCs. The results show that ‘East Asia and the Pacific’ (EAP) spent significantly more on (R&D) and achieved the highest scientific literature publication (SLP), with significant impacts. Other GSCs’ R&D expenditure was flat until 2020 (during COVID-19), when R&D funding increased, achieving a corresponding 42% rise in SLPs. About 67% of ‘Arab States’ (AS) SLPs and 60% of citation impact came from SLPs produced from global north and other GSCs regions, indicating high dependence. Also, 51% of high-impact SLPs were ‘Multiple Country Publications’, mainly from non-GSC institutions, indicating high collaboration impact. The EAP, AS, and ‘South Asia’ (SA) regions experienced lower disparity. In contrast, the less developed countries (LDCs), including ‘Sub-Sahara Africa’, ‘Latin America and the Caribbean’, and ‘Europe (Eastern) and Central Asia’, showed few dominant countries with high SLPs and higher digital divides. We advocate for increased educational research funding to enhance innovative R&D in GSCs, especially in LDCs. Full article

The Sahara Desert is the largest contributor of global atmospheric dust aerosols impacting regional climate, health, and ecosystems. The climate effects of these dust aerosols remain uncertain due, in part, to climate model uncertainty of Saharan source region contributions and aerosol microphysical properties. This study distinguishes source region elemental signatures of Saharan dust aerosols sampled during the 2015 Aerosols Ocean Sciences Expedition (AEROSE) in the tropical Atlantic. During the 4-week campaign, cascade impactors size-dependently collected airborne Saharan dust particulate upon glass microfiber filters. Inductively Coupled Plasma Mass Spectrometry (ICP-MS) analysis differentiated metal isotope concentrations within filter samples from various AEROSE dust sampling periods. Back-trajectory analysis and NOAA satellite aerosol optical depth retrievals confirmed source regions of AEROSE ’15 dust samples. Pearson correlational statistics of source region activity and dust isotope concentrations distinguished the elemental signatures of North African potential source areas (PSAs). This study confirmed that elemental indicators of these PSAs remain detectable within dust samples collected far into the marine boundary layer of the tropical Atlantic. Changes detected in dust elemental indicators occurred on sub-weekly timescales across relatively small sampling distances along the 23W parallel of the tropical Atlantic. PSA-2 emissions, covering the western coast of the Sahara, were very strongly correlated (R² > 0.79) with Ca-44 isotope ratios in AEROSE dust samples; PSA-2.5 emissions, covering eastern Mauritania and western Mali, were very strongly correlated with K-39 ratios; PSA-3 emissions, spanning southwestern Algeria and eastern Mali, were very strongly correlated with Fe-57 and Ti-48 ratios. The abundance of Ca isotopes from PSA-2 was attributed to calcite minerals from dry lakebeds and phosphorous mining activities in Western Sahara, based on source region analysis. The correlation between K isotope ratios and PSA-2.5 was a likely indicator of illite minerals near the El Djouf Desert region, according to corroboration with mineral mapping studies. Fe and Ti ratio correlations with PSA-3 observed in this study were likely indicators of iron and titanium oxides from Sahelian sources still detectable in Atlantic Ocean observations. The rapid changes in isotope chemistry found in AEROSE dust samples provide a unique marker of Saharan source regions and their relative contributions to desert outflows in the Atlantic. These elemental indicators provide source region apportionments of Sahara Desert aerosol flux and deposition into the Atlantic Ocean, as well as a basis for model and satellite validation of Saharan dust emissions for regional climate assessments. Full article

Background: Several studies recently confirmed the emergence of resistance to antimalarial drugs in sub-Saharan Africa. Multiple first-line treatment (MFT) is one of the measures envisaged to respond to the emergence and spread of this resistance. The aim of this study was to identify the perceived advantages and disadvantages of several MFT deployment strategies and to better understand potential implementation drivers and barriers. Methods: A qualitative survey was conducted in seven sub-Saharan countries amongst key opinion leaders, national decision makers, and end users. A total of 200 individual interviews were conducted and findings were analyzed following a thematic inductive approach. Results: From a policy perspective, the new MFT intervention would require endorsement at the global, national, and regional levels to ensure its inclusion in guidelines. Funding of the MFT intervention could be a bottleneck due to costs associated with additional training of healthcare workers, adaptation of drug delivery mechanisms, and higher costs of drugs. Concerning the MFT deployment strategies, a slight preference for the segmentation strategy was expressed over the rotation and geographic approaches, due to the perception that a segmentation approach is already in place at country level. Conclusions: The findings highlighted the need for a collective approach to MFT deployment through the engagement of stakeholders at all levels of malaria management. Full article

The Anomaly hotSpots of Agricultural Production (ASAP) Decision Support System was launched operationally in 2017 for providing timely early warning information on agricultural production based on Earth Observation and agro-climatic data in an open and easy to use online platform. Over the last three years, the system has seen several methodological improvements related to the input indicators and to system functionalities. These include: an improved dataset of rainfall estimates for Africa; a new satellite indicator of biomass optimised for near-real-time monitoring; an indicator of crop and rangeland water stress derived from a water balance accounting scheme; the inclusion of seasonal precipitation forecasts; national and sub-national crop calendars adapted to ASAP phenology; and a new interface for the visualisation and analysis of high spatial resolution Sentinel and Landsat data. In parallel to these technical improvements, stakeholders and users uptake was consolidated through the set up of regionally adapted versions of the ASAP system for Eastern Africa in partnership with the Intergovernmental Authority on Development (IGAD) Climate Prediction and Applications Centre (ICPAC), for North Africa with the Observatoire du Sahara et du Sahel (OSS), and through the collaboration with the Angolan National Institute of Meteorology and Geophysics (INAMET), that used the ASAP system to inform about agricultural drought. Finally, ASAP indicators have been used as inputs for quantitative crop yield forecasting with machine learning at the province level for Algeria’s 2021 and 2022 winter crop seasons that were affected by drought. Full article

The poultry industry in sub-Saharan Africa faces significant sustainability challenges associated with social equity, economic stability, and environmental degradation. As the sector expands due to population and income growth, a major concern remaining is how to ensure a sustainable future for the industry. This paper assessed the knowledge capabilities of poultry farmers for sustainable production using southeast Nigeria as a model region for all riparian regions in sub-Saharan Africa. Sixty poultry farms and 180 participants were sampled. Data were collected from both primary and secondary sources, including relevant literature, participant observations, and in-depth interviews. Data were analyzed with the percentage, bar chart, regression, and Pearson Moment Correlation. Findings revealed that only 13.9% of the respondents had a high knowledge of environmental sustainability. The number of years spent in school (t = 1.992; p = 0.048), access to veterinary service (t = 2.161; p = 0.032), and membership in a social organization (t = 2.306; p = 0.022) were socio-economic factors that significantly influenced knowledge capabilities. Knowledge (r = 0.252; p < 0.005), rather than income, significantly influenced the use of sustainability practices. Low knowledge of sustainability practices could mean a gross violation on the part of farmers. Specialized programs for educating poultry farmers on the realities of the environmental impacts of their livelihood are paramount. Full article

In hot climates, such as sub-Sahara Africa, window sizing and orientation pose challenges as they add, through solar insolation, to the building cooling energy demand and thus the cause of indoor overheating risk. This risk can be reduced through passive building-design-integrated measures, e.g., optimizing the window size, orientation and solar shading strategies. Through an IDA-ICE building performance simulation tool, the current study explores the impact of window size, optimization and building-integrated PV panels as shading strategies on cooling energy demands in three cities (Niamey, Nairobi and Harare) in sub-Sahara Africa. Results show that thermal comfort and cooling energy demand are sensitive to a window-to-wall ratio (WWR) > 70%, while the need for artificial lighting is negligible for a WWR > 50%, particularly in the north for cities in the Southern hemisphere and the south in the Northern hemisphere. A WWR > 70% in the east and west should be avoided unless shading devices are incorporated. Internal blinds perform better in improving occupant thermal comfort but increase artificial lighting while integrating PV panels, as external shading overhangs reduce cooling energy but also produce energy that can be utilized for building services, such as air conditioning. In this study, the results and implications of the optimization of window size, orientation and building-integrated shading and operation are discussed. Full article

The current wave of technological development globally necessitates certain entrepreneurial abilities for most professionals to succeed in the job market. This paper explores the factors influencing entrepreneurial skills acquisition amongst rural university students in Nigeria and South Africa. The strategic goal of setting up rural universities is to enhance the human capital of the host communities. As a result, an attempt is made to pinpoint challenges that stand in the way of achieving this objective. Data was gathered using a quantitative research methodology. A self-designed questionnaire was used to obtain primary data from 1088 randomly selected third-year students. The study’s outcome indicates that the acquisition of entrepreneurial competencies amongst undergraduates in the two higher education institutions was impacted by a number of similar factors, such as the university support system, campus entrepreneurial network, family background, availability of mentors, and entrepreneurship education curriculum. The study focuses on the necessity for universities to address skill shortages among undergraduates. Thus, the results could serve as a guide for policymakers on how to motivate rural university students to obtain globally relevant skills. Full article

This study estimated the social costs of road traffic crashes (RTCs) in Cameroon, motivated by a lack of empirical evidence for economic loss and social suffering associated with RTCs menace in developing countries particularly Sub-Sahara Africa. A model for estimation of cost based on a combination of valuation methods was developed following international guidelines, and can be adapted for other developing countries similar to Cameroon’s context. Five cost components were estimated namely: production loss; human costs; medical costs; property damage costs and administrative costs. Data from the field, secondary databases and transfer values were used together with adjustments for under-reporting of road traffic crash data that is prevalent particularly in developing countries. Total social cost of RTCs in Cameroon in 2018 was USD 3.6 Billion and is equivalent to 3.8% of GDP in 2018. This estimate is way above RTCs cost estimates obtained by studies in Sub-Sahara Africa using the human capital approach, and slightly outside the range of social cost estimates found in Lower- and Middle-Income Countries (LMICs) literature. The estimate is also larger than the conservative figures used for policy purposes such as the current National Road Safety Strategy, implying that under-reporting of RTCs data under-represents apparent socio-economic value of RTCs. The study recommends improvement in the procedures of crash data by operationalizing the recently established centralized RTCs database, as well as adoption of systematic approaches to estimation of crash costs by policy makers. Full article

The African viperid snake genera Atheris, Cerastes, and Proatheris are closely related, similar in size, but occupy extremely divergent ecological niches (arboreal in tropical rainforests, fossorial in deserts, and swamp-dwelling, respectively). Their venoms have not previously been subjected to comparative analyses for their action upon the coagulation of blood, most notably with significant data deficiencies from Atheris and Proatheris. In contrast, the closely related genus Echis is well-documented as capable of producing potent procoagulant effects. In light of this, we set out to compare the coagulotoxic actions of Atheris ceratophora, A. chlorechis, A. desaixi, A. nitschei, A. squamigera, C. cerastes, C. cerastes gasperettii, C. vipera, and Proatheris superciliaris and explore potential pharmacological interventions to reestablish normal blood coagulation. All venoms displayed extremely potent procoagulant effects, over twice as fast as the most potent Echis reported to date. Although Cerastes is used in the immunising mixture of two different regionally available antivenoms (Inoserp-MENA with C. cerastes, C. cerastes gasperettii, C. vipera and Saudi Arabian polyvalent with C. cerastes), none of the other species in this study are included in the immunising mixture of any antivenom. Notably, all the Cerastes species were only neutralised by the Inoserp-MENA antivenom. C. cerastes venom was not neutralised well by the Saudi Arabian antivenom, with the low levels of recognition for any of the Cerastes venoms suggesting a strong regional variation in the venom of this species, as the C. cerastes venom tested was of African (Tunisian) origin versus Saudi locality used in that antivenom’s production. The other antivenoms (Micropharm EchiTAbG, ICP EchiTAb-Plus-ICP, Inosan Inoserp Pan-Africa, Premium Serums PANAF Sub-Sahara Africa, South African Vaccine Producers Echis, South African Vaccine Producers Polyvalent) all displayed trivial-to-no ability to neutralise the procoagulant toxicity of any of the Atheris, Cerastes, or Proatheris venoms. Comparative testing of the enzyme inhibitors DMPS, marimastat, and prinomastat, revealed a very potent neutralising capacity of marimastat, with prinomastat showing lower but still significant potency at the same molar concentration, while a 5× molar concentration of DMPS had no apparent effect on procoagulant venom effects normalized by the other inhibitors. These results and methods contribute to the body of knowledge of potential clinical effects and data necessary for evidence-based advancement of clinical management strategies. Full article

This article traces the history of the medieval oasis city of Sijilmassa, southeastern Morocco, and that of its modern, continuation city of metropolitan Rissani in the Tafilalt region. Elements of mobility and transition are discussed in light of the prominent historical role of the urban settlement in Tafilalt in long-distance trans-Saharan trade infrastructure. These elements are developed with a focus on the region’s Jewish communities, their socio-spatial characteristics, the employed toponymy with respect to Sijilmassa, and the material culture. Within the material culture of Tafilalt’s Jewry until the 1950s and 1960s (that is, upon their dramatic emigration from Morocco, mostly to Israel), the article analyzes in an original manner their traditional marriage contracts (ketubah-s) as a textual and especially as an esthetic artifact. The analysis interprets the visual imagery that appears in these manuscripts—an imagery that corresponds with global Jewish symbols, with the vernacular architecture in the Tafilalt, and with wider regional, trans-Saharan conceptual motifs. Revealing the composite symbolic imagery and decoding the visual repertoire of the ketubah-s against the rich cultural histories of the pre-Sahara region—with affinity to both northern Morocco and sub-Saharan, “black”, Africa—necessitates an interdisciplinary approach. This study brings together area studies (of the Middle East and Africa), art histories (of architecture and built forms, artifacts, and manuscripts), cultural studies (critical intra-group relations between Arabs, Berbers and Jews), and human geography (forms of settlements and long-distance trade activity)—in a type of meeting that is quite uncommon in the relevant research literature. Its contribution lies in tracing the dissemination of ideas and material cultures among less researched groups (southeastern Jewry) and regions (pre-Saharan) in Morocco, through engaging a transdisciplinary lens that requires an intimate acquaintance with associated research historiographies. Full article

The (peri-)urban population in developing countries, especially sub-Saharan Africa, is rapidly increasing. As towns and cities grow, so does the demand for fish protein. While flow-through aquaculture can provide fresh, healthy and nutritious fish protein, it is plagued by extensive land requirements as well as effluent discharge and is thus unsuitable for city regions. Alternatively, small-scale Recirculating Aquaculture Systems (RAS) could improve food and nutritional security and livelihoods as well as reduce environmental degradation in (peri-)urban areas despite land and water constraints. The question, however, remains—what are the key technical, business and managerial issues surrounding small-scale RAS in (peri-)urban farming? To answer this question, first, a systematic literature review on RAS in sub-Saharan Africa is conducted. Second, the RAS prototype of the Sustainable Aquaponics for Nutritional and Food Security in Urban Sub-Saharan Africa (SANFU) II project is assessed. This assessment is based on the mass balance and stock density, relevant for fish survival and/or availability as well as net cash flow analyses. The results suggest that small-scale RAS are technically and financially viable with efficient filtration and family labor having proper aquaculture monitoring and management skills. Furthermore, access to adequate equipment and inputs as well as electricity for the recirculating system are crucial. (Peri-)urban innovation actors will adopt RAS if operations are profitable. Full article