Journal of Public Health in Africa最新文献

{"title":"A systematic review of implementation strategies to improve timely initiation of antenatal care among pregnant women in sub-Saharan Africa.","authors":"Olatubosun Akinola, Rabson Zimba, Kutha Banda, Caroline L Mangani, Hilda Shakwelele, Ibrahim Abdallah, Angel Mwiche, Cindy Chirwa, Mutale Sampa, Ronald Fisa, Mercy W Monde, Choolwe Jacobs","doi":"10.4102/jphia.v17i1.1461","DOIUrl":"https://doi.org/10.4102/jphia.v17i1.1461","url":null,"abstract":"<p><strong>Background: </strong>Despite the availability of antenatal care (ANC) services, fewer than 40% of pregnant women in sub-Saharan Africa initiate ANC within the first trimester, indicating suboptimal early utilisation of maternal health services in the region.</p><p><strong>Aim: </strong>This review aimed to identify and synthesise evidence on interventions that improve the timely initiation of ANC among pregnant adolescents and women in sub-Saharan Africa.</p><p><strong>Setting: </strong>All studies included in the review were conducted in sub-Saharan Africa.</p><p><strong>Method: </strong>A systematic search guided by Preferred Reporting Items for Systematic Review and Meta-Analyses across seven databases (PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature [CINAHL], Scopus, and the Cochrane Database of Systematic Reviews - and grey literature sources including ProQuest Dissertations & Theses Global and African Journals Online [AJOL]) identified eligible English-language studies (1990-2022), including randomised and non-randomised trials, controlled before-and-after studies, and interrupted time-series. The review was conducted between September 2022 and October 2022, and the protocol was registered with PROSPERO (CRD42022380283).</p><p><strong>Results: </strong>Eleven studies met the inclusion criteria. Three types of intervention approaches were identified: community-based, facility-based, and a combination of both. Facility-based interventions, such as mobile phone reminders, for instance, the wired mothers innovation and quality improvement initiatives, showed improvements in early ANC attendance ranging from a 5% increase to more than triple the uptake. Community-based interventions also proved effective, with gains of up to 200%, as in Malawi, where early ANC increased from 10% to 29%. These mechanisms included home visits, education, male involvement, and engagement with traditional leaders.</p><p><strong>Conclusion: </strong>Integrated community and facility-based interventions offer promising strategies to improve timely ANC. Future efforts should consider cost-effectiveness and implementation research to enhance decision-making.</p><p><strong>Contribution: </strong>This study demonstrates the potential of underutilised interventions to enhance first-trimester ANC attendance and maternal health outcomes across sub-Saharan Africa.</p>","PeriodicalId":44723,"journal":{"name":"Journal of Public Health in Africa","volume":"17 1","pages":"1461"},"PeriodicalIF":0.8,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socio-ecological analysis of nurses' roles and challenges in choice on termination of pregnancy services in South Africa: A scoping review.","authors":"Vutlhari A Ndlovu, Tshepo A Ntho, Masenyani O Mbombi, Mxolisi W Ngwenya","doi":"10.4102/jphia.v17i1.1600","DOIUrl":"https://doi.org/10.4102/jphia.v17i1.1600","url":null,"abstract":"<p><strong>Background: </strong>Choice on termination of pregnancy remains a sensitive and complex aspect of reproductive healthcare, particularly in settings where cultural, religious, legal and institutional factors intersect.</p><p><strong>Aim: </strong>To identify nurses' roles and challenges in providing choice on termination of pregnancy services in South Africa using a socio-ecological framework.</p><p><strong>Setting: </strong>The review was conducted using findings from studies on nurses regarding the provision of choice on termination of pregnancy services in South Africa.</p><p><strong>Method: </strong>A scoping review was conducted following the Arksey and O'Malley framework and aligned with the Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Electronic databases include ScienceDirect, EBSCOhost, PsycINFO, PubMed and regional databases like African Index Medicus. Literature published between January 1996 and December 2024 was searched; only English-language studies were included.</p><p><strong>Results: </strong>Twenty-one studies, published between 1998 and 2023, were included. The results show diverse and in-depth insights into the multifaceted challenges of nurses involved in choice on termination of pregnancy services, highlighting emotional and moral challenges, interpersonal dynamics, organisational constraints, sociocultural influences and legal gaps.</p><p><strong>Conclusion: </strong>This review reveals that nurses' roles in providing choice on termination of pregnancy services are shaped by multiple levels of influence, with moral beliefs, stigma and systemic barriers hindering the delivery of quality care.</p><p><strong>Contribution: </strong>This review enhances understanding of the multi-level barriers nurses face in providing choice on termination of pregnancy services in South Africa and underscores the need for targeted interventions to improve access to sexual and reproductive health services.</p>","PeriodicalId":44723,"journal":{"name":"Journal of Public Health in Africa","volume":"17 1","pages":"1600"},"PeriodicalIF":0.8,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons learned in implementing an Alcoholics Anonymous peer support model in Lilongwe, Malawi.","authors":"Katherine Boyd, Chifundo S Tepeka, Thomas W Psyata, Tommy Mthepheya, Thuy Bui, Caroline Kensler, Phillip Wagner","doi":"10.4102/jphia.v17i1.1343","DOIUrl":"https://doi.org/10.4102/jphia.v17i1.1343","url":null,"abstract":"","PeriodicalId":44723,"journal":{"name":"Journal of Public Health in Africa","volume":"17 1","pages":"1343"},"PeriodicalIF":0.8,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with completion of 6 months of isoniazid preventive therapy among under-five children exposed to tuberculosis patients in Blantyre, Malawi.","authors":"Glory T Mzama, Kruger Kaswaswa, Tobias Chirwa, Juliana Kagura, Latifat Ibisomi","doi":"10.4102/jphia.v17i1.1528","DOIUrl":"https://doi.org/10.4102/jphia.v17i1.1528","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization recommends 6 months of isoniazid preventive therapy (IPT) to children who have been exposed to tuberculosis (TB) patients to prevent active TB. Although IPT is an efficacious intervention, it is underutilised.</p><p><strong>Aim: </strong>The aim of this study was to examine factors associated with the completion of IPT among children under 5 years who have been exposed to TB patients.</p><p><strong>Setting: </strong>This was a secondary data analysis; the primary study was conducted in Blantyre, Malawi.</p><p><strong>Methods: </strong>This study was a secondary analysis of a randomised controlled trial with follow-up at 3 months and 6 months. Univariable and multivariable logistic regression models were used to identify factors associated with the completion of IPT.</p><p><strong>Results: </strong>One hundred and twenty-eight children were included, of whom 58 (45.3%) completed IPT. Index patient human immunodeficiency virus (HIV)-positive status (adjusted odds ratio [aOR] = 0.39, 95% confidence interval [CI]: 0.16-0.94) and longer distance (> 5 km) (aOR = 0.25, 95% CI: 0.07-0.89) were associated with lower IPT completion. Wealth status, household health-seeking decision maker and type of contact tracing were associated with higher IPT completion, with aOR = 3.42 (95% CI: 1.19-9.88) for children coming from households of high wealth status, aOR = 3.17 (95% CI: 1.19-8.42) in which the health-seeking decision maker was the parent compared to other guardians, and aOR = 3.13 (95% CI: 1.25-7.84) for children who were identified through patient-conducted tracing compared to routine contact tracing.</p><p><strong>Conclusion: </strong>Human immunodeficiency virus status, wealth status, household health-seeking decision maker, proximity to health facility and type of contact tracing are key determinants of IPT completion among children.</p><p><strong>Contribution: </strong>This study provides valuable insights into the factors that affect the completion of IPT. By addressing these factors, completion of IPT can be improved, thereby preventing TB among children.</p>","PeriodicalId":44723,"journal":{"name":"Journal of Public Health in Africa","volume":"17 1","pages":"1528"},"PeriodicalIF":0.8,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presence and prevalence of single nucleotide sequence polymorphisms in <i>TP53</i> and <i>BRCA2</i> genes as of cervical and ovarian cancers in women using hormonal contraceptives in Abuja, Nigeria.","authors":"Omorinsola F Odebiyi, Adedapo Kehinde, Mohammed S Abdulsalami, Deborah M Dibal","doi":"10.4102/jphia.v17i1.1453","DOIUrl":"https://doi.org/10.4102/jphia.v17i1.1453","url":null,"abstract":"<p><strong>Background: </strong>Cancer remains a major health burden in sub-Saharan Africa, characterised by high incidence and mortality rates as a result of late diagnosis, limited access to treatment and poor outcomes. Among gynaecological malignancies, cervical and ovarian cancers are of particular concern. Emerging evidence suggests that hormonal contraceptives may influence genetic susceptibility through single nucleotide polymorphisms (SNPs) in cancer-related genes such as <i>TP53</i> and <i>BRCA2</i>.</p><p><strong>Aim: </strong>This study investigated the prevalence of SNPs in the <i>TP53</i> and <i>BRCA2</i> genes and their association with cervical and ovarian cancer risk in a selected population.</p><p><strong>Setting: </strong>Civil Defence Medical Centre, Abuja, Nigeria.</p><p><strong>Methods: </strong>A total of 108 samples were analysed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) to detect gene polymorphisms. Single nucleotide polymorphisms were confirmed at the nucleotide level using purified PCR products, and deoxyribonucleic acid (DNA) fragments were sequenced with a Genetic Analyzer 3130xl (Applied Biosystems). BioEdit and MEGA 6 software were used for genetic analysis.</p><p><strong>Results: </strong>Polymorphisms were detected in the <i>TP53</i> gene, but not in BRCA2. The TP53 variants were predominantly missense mutations, including G > A (40%) and G > C (60%) substitutions. Among 98 hormonal contraceptive users, 5 (5.1%) had TP53 SNPs. No BRCA2 SNPs were identified. Fisher's exact test showed marginal statistical significance (<i>p</i> = 0.059).</p><p><strong>Conclusion: </strong>The findings underscore the relevance of TP53 screening in populations at risk of cervical cancer, while BRCA2 screening may be less applicable in this cohort. Larger studies across diverse populations are recommended.</p><p><strong>Contribution: </strong>However, further research is needed with larger sample sizes in other geographical regions and additional genetic markers to fully understand the genetic risk landscape for both cancers in hormonal contraceptive users within the population.</p>","PeriodicalId":44723,"journal":{"name":"Journal of Public Health in Africa","volume":"17 1","pages":"1453"},"PeriodicalIF":0.8,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weaknesses and strengths in the emergency response and management of the first mpox case in The Gambia.","authors":"Sheikh O Bittaye, Lamin Manneh, Morikebba Danso, Sheriffo Jagne, Amadou W Jallow, Ya Fatou B M Jobe, Mary Bobb, Ebrima K Jallow, Momodou Kalisa, Kebba Jobarteh, Modou L Sanneh, Haddijatou Allen, Ifeanyi L Udenweze, Pius Ononigwe, Abdoulie Badjan, Mustapha Bittaye, Momodou T Nyassi","doi":"10.4102/jphia.v17i1.1648","DOIUrl":"https://doi.org/10.4102/jphia.v17i1.1648","url":null,"abstract":"<p><p>Mpox is a zoonotic virus that can infect humans and animals. The director general of the World Health Organization (WHO) declared the mpox outbreak a public health emergency of international concern on 14 August 2024, with the greatest burden in Africa. The Gambia registered its first case of mpox on 18 July 2025. This case study, therefore, assesses the weaknesses and strengths in the emergency response and management of the first mpox case in The Gambia. The patient is a 26-year-old female Gambian, who presented with a two-day history of a skin rash which was associated with fever, headache and myalgia. This patient was seen at the health centre, and swab samples were collected for mpox testing before she returned home. The samples were delivered to the National Public Health Laboratories (NPHL) a day later, and the polymerase chain reaction tests were conducted 8 days later, which confirmed the presence of mpox virus infection. The confirmed mpox case initially presented challenges with compliance, as the patient could not be readily located for isolation and treatment. However, through the coordinated efforts of the police, mobile operators, the village health worker (VHW), field investigators, surveillance officers, public health officers, regional health directorate staff, the head of the village or community, and the nurse at the Fajikunda Health Centre (FJKHC), the case was successfully traced. The assessment of the emergency response and management of the first mpox case in The Gambia revealed notable strengths and weaknesses. Surveillance efforts at the primary healthcare level were effective, leading to the detection of the case and a well-coordinated overall response. However, significant challenges emerged in the laboratory analysis of collected samples, including delays in processing as a result of an unreliable electricity supply and gaps in appropriate infection prevention and control measures.</p>","PeriodicalId":44723,"journal":{"name":"Journal of Public Health in Africa","volume":"17 1","pages":"1648"},"PeriodicalIF":0.8,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147646884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Charting Africa's digital public health future: Five priorities for action.","authors":"Ngashi Ngongo, Nebiyu Dereje, Shanelle Hall, Jean Kaseya","doi":"10.4102/jphia.v17i1.1857","DOIUrl":"https://doi.org/10.4102/jphia.v17i1.1857","url":null,"abstract":"","PeriodicalId":44723,"journal":{"name":"Journal of Public Health in Africa","volume":"17 1","pages":"1857"},"PeriodicalIF":0.8,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traditional health practices in child care: Perceptions of caregivers in a township community.","authors":"Eugene M Makhavhu","doi":"10.4102/jphia.v17i1.1578","DOIUrl":"https://doi.org/10.4102/jphia.v17i1.1578","url":null,"abstract":"<p><strong>Background: </strong>For women of childbearing age in South Africa, using different traditional healthcare practices is common. The use is intended for differing reasons, including aiding with conception and care of the baby during the neonatal phase and of the mother during the nursing stages. This is particularly so in underserved communities; however, perceptions of those who use such treatments are not widely explored.</p><p><strong>Aim: </strong>This study explored the perceptions of caregivers in township communities regarding traditional practices in healthcare.</p><p><strong>Setting: </strong>This study was conducted in a township in a metropolitan city in Gauteng.</p><p><strong>Methods: </strong>The study used a qualitative exploratory design, and data were collected using a semi-structured interview guide from 15 participants who were sampled conveniently.</p><p><strong>Results: </strong>Three themes were generated: (1) critical perspectives on traditional healthcare practices use, (2) benefits of using traditional healthcare and (3) the preference and influence on continued traditional healthcare use. Results indicated continued traditional healthcare practice use because of the belief systems and trust enshrined in individual families and communities. Benefits such as the ability to use multiple healthcare modalities were also a strong indication.</p><p><strong>Conclusion: </strong>This study highlights a strong need to understand the traditional healthcare practices to foster safe and comprehensive healthcare delivery and meet the health needs of communities.</p><p><strong>Contribution: </strong>The study contributes to literature on the use of traditional health practices and has captured the perceptions of caregivers in a South African township.</p>","PeriodicalId":44723,"journal":{"name":"Journal of Public Health in Africa","volume":"17 1","pages":"1578"},"PeriodicalIF":0.8,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the concordance between nasopharyngeal and oropharyngeal swabs in the detection of COVID-19.","authors":"Michel C Tommo Tchouaket, Joseph Fokam, Ezéchiel N Semengue, Yagai Bouba, Collins A Chenwi, Alex D Nka, Mirice Mbazo'o, Désiré Takou, Samuel M Sosso, Grâce A Beloumou, Aude C Ka'e, Aurelie M Ngueko, Nadine Fainguem, Laeticia Y Heunko, Sandrine C Ndjeyep, Willy L Pabo, Davy-Hyacinthe G Anguechia, Naomi-Karell Etame, Evariste Molimbou, Rachel A Mundo, Aissatou Abba, Gregory-Edie Halle-Ekane, Anne-Cecile Z-K Bissek, Vittorio Colizzi, Carlo-Federico Perno, Alexis Ndjolo","doi":"10.4102/jphia.v17i1.1236","DOIUrl":"https://doi.org/10.4102/jphia.v17i1.1236","url":null,"abstract":"<p><strong>Background: </strong>Nasopharyngeal swabs (NASO) cause discomfort for patients, which can discourage them from getting tested for COVID-19 and limit case detection. It is therefore necessary to consider an alternative, more comfortable swab.</p><p><strong>Aim: </strong>Evaluated the concordance between nasopharyngeal and oropharyngeal sampling for COVID-19 diagnosis in the Cameroonian context.</p><p><strong>Setting: </strong>This study was carried out at \"Chantal Biya\" International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB) in Yaoundé, Cameroon.</p><p><strong>Methods: </strong>A comparative study was conducted in April 2021 among consenting participants tested for COVID-19 at \"Chantal Biya\" International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB) in Yaoundé, Cameroon. Sampling began with nasopharyngeal swabs, followed by oropharyngeal swabs, all taken by the same technician, and analysis was carried out using polymerase chain reaction (PCR) tests on the Abbott platform. Statistical analyses were performed using GraphPad version 6.0; <i>p</i> < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 154 participants were enrolled (59.7% male, median age 38 years, interquartile range [IQR]: 30-49). Following PCR testing, the overall COVID-19 positivity rate was 36.36% (56/154), with 34.41% (<i>n</i> = 53/154) in nasopharyngeal versus 16.23% (<i>n</i> = 25/154) in oropharyngeal samples, <i>p</i> < 0.0002. The overall concordance rate was 78% (<i>n</i> = 120/154), with 39.28% positive concordance and 74.24% negative concordance (kappa = 0.441 [0.289-0.513]). According to severe acute respiratory syndrome coronavirus 2 viral load, the positive concordance was improved with high viral load (cycle threshold [CT]: ≤ 25): 61% (<i>n</i> = 11/18) versus 31% (<i>n</i> = 11/35) with low viral load (CT > 25), <i>p</i> = 0.037; odds ratio (OR) = 3.43. According to gender, the positive concordance was higher in men, 55% (<i>n</i> = 16/29), versus 25% (<i>n</i> = 6/24) in women, <i>p</i> = 0.021; OR = 0.27. Using nasopharyngeal swab as the gold standard, oropharyngeal swab had a sensitivity of 41.50% (<i>n</i> = 22/53), specificity 97.02% (<i>n</i> = 98/101), positive predictive value (PPV) 88% (<i>n</i> = 22/25) and negative predictive value (NPV) 76% (<i>n</i> = 98/129).</p><p><strong>Conclusion: </strong>Our evidence suggests a superiority effect of nasopharyngeal in detecting cases of COVID-19. However, the overall high PPV of oropharyngeal swab, and its improved performance with high viral load.</p><p><strong>Contribution: </strong>Therefore, in case of counter-indication to nasopharyngeal swabbing, oropharyngeal can be an acceptable alternative.</p>","PeriodicalId":44723,"journal":{"name":"Journal of Public Health in Africa","volume":"17 1","pages":"1236"},"PeriodicalIF":0.8,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prioritisation and risk ranking of epidemic-prone diseases for emergency preparedness and response in Eastern Africa using a multi-criteria decision analysis framework, 2023.","authors":"Neema Kamara, Motuma Guyassa, Georgios Theocharopoulos, Anouar S Mohamed, Halifa M Said, Despina Pampaka, Jonathan Suk, Lul P Riek, Merawi Aragaw","doi":"10.4102/jphia.v17i1.1496","DOIUrl":"https://doi.org/10.4102/jphia.v17i1.1496","url":null,"abstract":"<p><strong>Background: </strong>Resources to respond to emerging and re-emerging infectious disease emergencies are limited.</p><p><strong>Aim: </strong>To support preparedness planning and resource allocation, a prioritisation methodology was applied to rank epidemic-prone diseases in Eastern Africa.</p><p><strong>Setting: </strong>The study took place in the eastern region of Africa representing 14 member states.</p><p><strong>Methods: </strong>A multi-criteria decision analysis (MCDA) combined with a modified Delphi approach, adapted from the Africa Centres for Disease Control and Prevention (CDC's) continental prioritisation framework was employed. A planning team of epidemiologists and infectious disease experts designed the exercise, implemented through a three-day workshop in Comoros from 9 May 2023 to 11 May 2023. The workshop convened 43 experts from Eastern Africa member states and partner organisations to rank diseases. Participants assessed each disease against 19 predefined criteria, grouped into four overarching domains: risk trajectory, epidemic potential, disease severity, and preparedness and medical countermeasures. Overall risk was calculated as the product of risk trajectory, epidemic potential, and disease severity.</p><p><strong>Results: </strong>Twenty-eight experts (88%, 28 of the eligible participants, <i>n</i> = 32) prioritised 22 potential epidemic-prone diseases. The top 10 were Ebola virus disease (risk = 12.7), Marburg virus disease (11.8), cholera (11.1), coronavirus disease 2019 (COVID-19) (9.9), influenza (8.9), measles (8.6), yellow fever (8.5), Crimean-Congo haemorrhagic fever (8.2), malaria (8.0) and Rift Valley fever (7.9). The unknown disease, defined as one caused by a hypothetical novel pathogen (often referred to as 'Disease X'), Crimean-Congo haemorrhagic fever, Rift Valley fever and mpox received the lowest preparedness rating.</p><p><strong>Conclusion: </strong>Ebola virus disease (EVD), Marburg virus disease (MVD) and cholera ranked highest in risk, while unknown disease and zoonoses showed the lowest preparedness.</p><p><strong>Contribution: </strong>Amid current funding constraints, these findings provide evidence to guide Africa CDC and partners in strengthening emergency preparedness and response in Eastern Africa, highlighting priority diseases while underscoring the need for further analysis of capacity gaps.</p>","PeriodicalId":44723,"journal":{"name":"Journal of Public Health in Africa","volume":"17 1","pages":"1496"},"PeriodicalIF":0.8,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}