Youth in sub-Saharan Africa (SSA) face limited access to professional mental health resources. A comprehensive assessment of the prevalence of mental disorders would build an understanding of the scope of the need.

We conducted systematic searches in PsycInfo, Pubmed, AfriBib and Africa Journals Online to identify prevalence rates for five disorders (anxiety, depression, conduct disorder, attention problems and post-traumatic stress) among SSA youth with a mean age of less than 19 years. We calculated a random-effects pooled prevalence for each disorder and assessed possible moderators.

The meta-analysis included 63 studies with 55,071 participants. We found the following pooled prevalence rates: 12.53% post-traumatic stress disorder (PTSD), 15.27% depression, 6.55% attention-deficit hyperactivity disorder, 11.78% anxiety and 9.76% conduct disorder. We found high heterogeneity across the studies, which may have resulted from differences in samples or measurement tools. Reported prevalence rates were not explained by the sample (i.e., special or general population), but whether the psychometric tool was validated for SSA youth affected the reported prevalence of PTSD and anxiety. In a meta-regression, prevalence rates were associated with the disorder type, with a higher prevalence of depression and PTSD. We found the mean age significantly moderated the prevalence in univariate meta-regression, with increased age correlated with greater prevalence.

Our findings suggest there is a need to explore reasons for varying prevalence rates further and to develop interventions that support youth mental health in SSA, particularly interventions for depression and PTSD. Limitations included a lack of standardization in psychometric tools and limited reporting on research methods, which influenced quality rating. Importantly, the search only considered studies published in English and was conducted 2 years ago. Although recent estimates reported slightly higher than our prevalence estimates, these reviews together highlight the prevalence and importance of youth mental health difficulties in SSA.

Although most people in sub-Saharan Africa are very religious, state support for religion (such as through policies legislating religious values and supporting religious institutions) is very low in the region. Why is this? This paper explores this phenomenon using data from Pew Research Centre and Religion and State Project. While population religiosity is ordinarily correlated with state support for religion elsewhere in the world, sub-Saharan Africa is indeed anomalous. Yet contrary to popular explanations, this is not explained by limited state capacity, weak democracies, religious and ethnic pluralism, or majority religion. Using case studies of Rwanda and Mozambique, the paper considers whether challenges to the moral authority of religious actors as leaders of “the nation” may help explain why state support for religion is so low in sub-Saharan Africa. Taken together, these findings challenge assumptions that high religiosity in sub-Saharan Africa is a threat to secular governance.

This review summarises studies on distribution, diversity, and prevalence of gastrointestinal helminth infections in wild ruminants in sub-Saharan Africa. The results showed that 109 gastrointestinal tract (GIT) helminth species or species complexes were recorded in 10 sub-Saharan African countries. South Africa reported the highest number of species because most studies were carried out in this country. Eighty-eight nematode species or species complexes were recorded from 30 wild ruminant species across eight countries. The genus Trichostrongylus recorded the highest number of species and utilised the highest number of wild ruminant species, and along with Haemonchus spp., was the most widely distributed geographically. Fifteen trematode species or species complexes were reported from seven countries. The genus Paramphistomum recorded the highest number of species, and Calicophoron calicophoron was the most commonly occurring species in sub-Saharan African countries and infected the highest number of hosts. Six cestode species or species complexes from one family were documented from 14 wild hosts in seven countries. Moniezia spp. were the most commonly distributed in terms of host range and geographically. Impala were infected by the highest number of nematodes, whilst Nyala were infected by the highest number of trematode species. Greater kudu and Impala harbored the largest number of cestodes. The prevalence amongst the three GIT helminths taxa ranged between 1.4% and 100% for nematodes, 0.8% and 100% for trematodes, and 1.4% and 50% for cestodes. There is still limited information on the distribution and diversity of GIT helminths in wild ruminants in most sub-Saharan African countries.

Aphidius colemani is an important biological control agent, used in greenhouses and open fields against aphid pests. Despite this economical importance, A. colemani, along with A. transcaspicus and A. platensis, has gone through a complex taxonomical history. The three species have only recently gained status as separate species again, comprising the morphologically defined Aphidius colemani species group. Other than sporadic records probably as a consequence of escape from greenhouses, the A. colemani species group members prefer warmer regions and there are numerous records from South America, Southern Europe and Asia. Based on slide-mounted material collected in the period 1964–2001 in Africa, we describe five new species belonging to this group, and report A. colemani, A. transcaspicus and A. platensis from several African countries. This data opens questions about the origin of the group and presents potential for the diversification of biological control agents against aphid pests.

Wearable activity trackers have emerged as valuable tools for health research, providing high-resolution data on measures such as physical activity. While most research on these devices has been conducted in high-income countries, there is growing interest in their use in the global south. This perspective discusses the challenges faced and strategies employed when using wearable activity trackers to test the effects of a school-based intervention for depression and anxiety among Kenyan youth. Lessons learned include the importance of validating data output, establishing an internal procedure for international procurement, providing on-site support for participants, designating a full-time team member for wearable activity tracker operation, and issuing a paper-based information sheet to participants. The insights shared in this perspective serve as guidance for researchers undertaking studies with wearables in similar settings, contributing to the evidence base for mental health interventions targeting youth in the global south. Despite the challenges to set up, deploy and extract data from wearable activity trackers, we believe that wearables are a relatively economical approach to provide insight into the daily lives of research participants, and recommend their use to other researchers.

An adequate alpha-tocopherol status is important for females at reproductive age. We studied the dietary intake and sources of alpha-tocopherol and alpha- and gamma-tocopherol status indicators in 14–19-year-old girls in Central Mozambique. We also explored factors associated with alpha- and gamma-tocopherol status. The participants (n 508) were from the cross-sectional ZANE Study that was conducted in 2010. We recruited two separate samples, one in January–February and the other in May–June. We collected venous blood samples and conducted 24 h dietary recall interviews. At the time of blood sampling, 11 % of participants were pregnant and 10 % were lactating. In the total sample, both seasons combined, the median intake of alpha-tocopherol was 6⋅7 mg/d, the mean plasma alpha- and gamma-tocopherol concentrations were 13⋅5 and 0⋅75 μmol/l, respectively, and the prevalence of vitamin E inadequacy (alpha-tocopherol <12 μmol/l) was 36⋅7 % (95 % CI: 31⋅9–42⋅0 %). Season and lactation status were significant predictors of alpha-tocopherol status regardless of which the three indicators (plasma concentration, alpha-tocopherol:total cholesterol ratio, gamma-tocopherol:alpha-tocopherol ratio) were used. Being a lactating mother was negatively associated and having a blood sample taken in January–February, when the main sources of alpha-tocopherol were mango and dark green leafy vegetables, was positively associated with alpha-tocopherol status. In conclusion, vitamin E inadequacy was common in Central Mozambique, and the status may fluctuate due to seasonal changes in the diet. We suggest that lactating mothers are specifically at risk of poor alpha-tocopherol status in resource-poor settings.

Undernutrition in elders remains under-detected, under-treated, and under-resourced and leads to further weight loss, increased infections, and delay in recovery from illness as well as increased hospital admissions and length of stay. The reports of the findings were fragmented and inconsistent in Ethiopia. Therefore, the main objective of this meta-analysis was to estimate the pooled prevalence of undernutrition and its association with dietary diversity among older persons in Ethiopia. Online databases (Medline, PubMed, Scopus, and Science Direct), Google, Google Scholar, and other grey literature were used to search articles until the date of publication. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed. The random effect model was used to estimate the pooled prevalence; whereas subgroup analysis and meta-regression were performed to identify the probable source of heterogeneity using Stata version 14.0 software. Out of 522 studies accessed, 14 met our criteria and were included in the study. A total of 7218 older people (aged above 60 years old) were included in the study. The pooled proportion of undernutrition among older persons in Ethiopia was 20⋅6 % (95 % CI 17⋅3, 23⋅8). Elders who consumed low dietary diversity scores were strongly associated with undernutrition among older persons. Therefore, promoting appropriate intervention strategies for elders to improve dietary diversity practices and nutritional status is crucial.

The government of Uganda introduced an education reform that eliminated school fees for primary school-age children in 1997. This paper finds that an increase in education, generated by the reform, has a positive impact on women's empowerment. Specifically, an increase in schooling, due to the reform, improves women's involvement in decision making within the household by increasing their likelihood of having a final say on issues related to their own health, about large household expenses, and regarding visits to family or relatives. Education enhances women's cognitive ability but has no impact on women's labor market opportunities and attitudes toward gender-based violence.

Late planting due to erratic onset of the rainy season is becoming more frequent in the Sahelo-Sudanian climate where cotton is grown, causing seed cotton yield (SCY) loss and higher risk of drought at the end of the crop cycle. Therefore, cultivars should be adapted to late (from July 10) planting date (PD) in Senegal. The aim of this study was to analyse the interaction between genotypes and PD on SCY in Senegal under rainfed conditions. Field experiments were conducted in 2018 and 2019 using a split-plot design (two PDs, eight cultivars) at three experimental stations. Robust analysis of SCY was used to moderate the effect of potential outliers. The average SCY was 1404 kg/ha under early planting, and 714 kg/ha under late planting. The best SCY was obtained under early planting conditions, in environments with good rainfall. The loss due to late planting was significantly affected by cultivar choice. None of the cultivars performed best under both early and late PD. Under early PD, cultivar CS 50 gave the best SCY, while under late PD it was cultivar IRMA Q302. The best performing cultivar on average depended on the proportion of early plantings. A model was developed to identify the best overall cultivar based on the expected proportion of early planting, as a decision support tool for the cotton development company, if only one cultivar is released. The benefit of releasing a second cultivar for late-planted fields is considered.

Ethiopia’s commitment to achieving universal health coverage (UHC) requires an efficient and equitable health priority-setting practice. The Ministry of Health aims to institutionalize health technology assessment (HTA) to support evidence-based decision making. This commentary highlights key considerations for successful formulation, adoption, and implementation of HTA policies and practices in Ethiopia, based on a review of international evidence and published normative principles and guidelines. Stakeholder engagement, transparent policymaking, sustainable financing, workforce education, and political economy analysis and power dynamics are critical factors that need to be considered when developing a national HTA roadmap and implementation strategy. To ensure ownership and sustainability of HTA, effective stakeholder engagement and transparency are crucial. Regulatory embedding and sustainable financing ensure legitimacy and continuity of HTA production, and workforce education and training are essential for conducting and interpreting HTA. Political economy analysis helps identify opportunities and constraints for effective HTA implementation. By addressing these considerations, Ethiopia can establish a well-designed HTA system to inform evidence-based and equitable resource allocation toward achieving UHC and improving health outcomes.

Depression is highly prevalent in people living with HIV (PLWH) and has negative consequences for daily life and care. We evaluated for the first time the acceptability, feasibility and benefits of group interpersonal therapy (IPT), combined with a task-shifting approach, to treat depression in PLWH in Senegal. PLWH with depression received group IPT following the World Health Organization protocol. Acceptability and feasibility criteria were defined from the literature data. The PHQ-9, the WHODAS, and the 12-item-stigma scale were used, pre- and post-treatment, including a 3-month follow-up, to assess depressive symptom severity, functioning and stigma, respectively. General linear mixed models were used to describe changes in outcomes over time. Of 69 participants, 60 completed group IPT. Refusal to enroll and dropout rates were 6.6 and 12.7%, respectively. Ninety-seven percent of participants attended at least seven out of eight sessions. Patients and facilitators endorsed group IPT, with willingness to recommend it. Depressive symptoms and disability improved drastically and sustainably. We showed that group IPT is well accepted and feasible in Senegal as treatment for depression in PLWH. Combined with a task-shifting approach, it can narrow the gap in mental health treatment. Implementation may be enhanced by refining patient identification procedures and increasing treatment accessibility.

This study identifies the link between women's asset ownership and women's empowerment. Women's empowerment is measured by their decision-making role related to their health, large household purchases, and their social interaction. Using Demographic and Health Surveys data for 18 countries from South Asia, the Middle East, and sub-Saharan Africa, we found that the women who owned assets were 14% more likely to be empowered compared with the women who did not own any asset (odds ratio: 1.14, 95% confidence interval: 1.10–1.185). At a disaggregated country level, asset ownership was positively and significantly associated with women's empowerment in nine countries, negatively associated in one country, and had no significant association in the other eight countries. This study provides important insights into the link between women's asset ownership and empowerment and may inform public policy related to gender equality through women's empowerment.