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Stroke is increasingly becoming a challenging public health issue in Africa, and the non-availability of data has limited research output and consequently the response to this burden. This study aimed to estimate the incidence and prevalence of stroke in Africa in 2009 towards improved policy response and management of the disease in the region. A systematic search of Medline, EMBASE and Global Health for original population-based or hospital-based studies on stroke was conducted. A random effect meta-analysis was conducted on crude stroke incidence and prevalence rates, and a meta-regression-like epidemiological model was applied on all data points. The fitted curve generated from the model was used to estimate incident cases of stroke and number of stroke survivors in Africa at midpoints of the United Nation population 5-year age groups for the year 2009. The literature search yielded a total of 1227 studies. 19 studies from 10 African countries were selected. 483 thousand new stroke cases among people aged 15 years or more were estimated in Africa in 2009, equivalent to 81.2 (13.2-94.9)/100,000 person years. A total of 1.89 million stroke survivors among people aged 15 years or more were estimated in Africa in 2009, with a prevalence of 317.3 (314.0-748.2)/100,000 population. Comparable figures for the year 2013 based on the same rates would amount to 535 thousand (87.0-625.3) new stroke cases and 2.09 million (2.06-4.93) stroke survivors, suggesting an increase of 10.8% and 9.6% of incident stroke cases and stroke survivors respectively, attributable to population growth and ageing between 2009 and 2013. The findings of this review suggest the burden of stroke in Africa is high and still increasing. There is need for more research on stroke and other vascular risk factors towards instituting appropriate policy, and effective preventive and management measures.

The burden of hypertension is high in Africa, and due to rapid population growth and ageing, the exact burden on the continent is still far from being known. We aimed to estimate the prevalence and awareness rates of hypertension in Africa based on the cut off \"≥140/90 mm Hg\". We conducted a systematic search of Medline, EMBASE and Global Health. Search date was set from January 1980 to December 2013. We included population-based studies on hypertension, conducted among people aged ≥15 years and providing numerical estimates on the prevalence of hypertension in Africa. Overall pooled prevalence of hypertension in mixed, rural and urban settings in Africa were estimated from reported crude prevalence rates. A meta-regression epidemiological modelling, using United Nations population demographics for the years 1990, 2000, 2010 and 2030, was applied to determine the prevalence rates and number of cases of hypertension in Africa separately for these four years. Our search returned 7680 publications, 92 of which met the selection criteria. The overall pooled prevalence of hypertension in Africa was 19.7% in 1990, 27.4% in 2000 and 30.8% in 2010, each with a pooled awareness rate (expressed as percentage of hypertensive cases) of 16.9%, 29.2% and 33.7%, respectively. From the modelling, over 54.6 million cases of hypertension were estimated in 1990, 92.3 million cases in 2000, 130.2 million cases in 2010, and a projected increase to 216.8 million cases of hypertension by 2030; each with an age-adjusted prevalence of 19.1% (13.9, 25.5), 24.3% (23.3, 31.6), 25.9% (23.5, 34.0), and 25.3% (24.3, 39.7), respectively. Our findings suggest the prevalence of hypertension is increasing in Africa, and many hypertensive individuals are not aware of their condition. We hope this research will prompt appropriate policy response towards improving the awareness, control and overall management of hypertension in Africa.

We reflect on our experiences of using Generative Pre-trained Transformer ChatGPT, a chatbot launched by OpenAI in November 2022, to draft a research article. We aim to demonstrate how ChatGPT could help researchers to accelerate drafting their papers. We created a simulated data set of 100 000 health care workers with varying ages, Body Mass Index (BMI), and risk profiles. Simulation data allow analysts to test statistical analysis techniques, such as machine-learning based approaches, without compromising patient privacy. Infections were simulated with a randomized probability of hospitalisation. A subset of these fictitious people was vaccinated with a fictional vaccine that reduced this probability of hospitalisation after infection. We then used ChatGPT to help us decide how to handle the simulated data in order to determine vaccine effectiveness and draft a related research paper. AI-based language models in data analysis and scientific writing are an area of growing interest, and this exemplar analysis aims to contribute to the understanding of how ChatGPT can be used to facilitate these tasks.

Inborn errors of metabolism (IEM) are a group of over 500 heterogeneous disorders resulting from a defect in functioning of an intermediate metabolic pathway. Individually rare, their cumulative incidence is thought to be high, but it has not yet been estimated globally. Although outcomes can often be good if recognised early, IEM carry a high fatality rate if not diagnosed. As a result, IEM may contribute significantly to the burden of non-communicable childhood morbidity. We conducted a systematic literature review of birth prevalence and case fatality of IEM globally, with search dates set from 1980 to 2017. Using random-effects meta-analysis, we estimated birth prevalence of separate classes of IEM and all-cause IEM, split by geographical region. We also estimated levels of parental consanguinity in IEM cases and global case fatality rates and resultant child deaths from all-cause IEM. 49 studies met our selection criteria. We estimate the global birth prevalence of all-cause IEM to be 50.9 per 100 000 live births (95% confidence intervals (CI) = 43.4-58.4). Regional pooled birth prevalence rates showed the highest rates of IEM to be in the Eastern Mediterranean region (75.7 per 100 000 live births, 95% CI = 50.0-101.4), correlating with a higher observed rate of parental consanguinity in studies from this area. We estimate case fatality rates to be 33% or higher in low- and middle-income countries (LMICs), resulting in a minimum of 23 529 deaths from IEM per year globally (95% CI = 20 382-27 427), accounting for 0.4% of all child deaths worldwide. IEM represent a significant cause of global child morbidity and mortality, comprising a notable proportion of child deaths currently not delineated in global modelling efforts. Our data highlight the need for policy focus on enhanced laboratory capacity for screening and diagnosis, community interventions to tackle parental consanguinity, and increased awareness and knowledge regarding management of IEM, particularly in LMICs.

In recent years, global accessibility to large 'big data' repositories that enable 'open research' - such as the UK Biobank, National Health and Nutrition Examination Survey (NHANES), and Global Burden of Disease (GBD) datasets - has created unprecedented opportunities for researchers worldwide to conduct secondary data analyses. This development is particularly beneficial for early-career researchers in low- and middle-income countries (LMICs), as it lets them access large and otherwise costly datasets without the need for local infrastructure, potentially curbing brain drain. However, through our work at the Journal of Global Health (JoGH), we have identified emerging concerns that must be addressed to help preserve the integrity and scientific value of this otherwise positive trend. These include: the risk of 'paper mills' mass-producing superficial papers with questionable authorship practices; duplicate publications produced through republishing already available results or by multiple groups testing the same hypothesis using identical datasets and methods without awareness of each other's work; proliferation of false-positive findings due to inadequate adjustment for multiple testing in large datasets; and the inappropriate or undisclosed use of artificial intelligence (AI) tools in generating manuscripts. To counter these issues while continuing to support legitimate and innovative secondary data analyses, JoGH is introducing guidelines for authors submitting such work for consideration and peer review. These guidelines require authors to declare transparently: their previous published work based on similar datasets or hypotheses; the originality of their research question and design in the context of other similar research; their awareness of related published studies using the same dataset; how they addressed multiple testing statistically; and the role of AI, if any, in manuscript preparation or data analysis. A new, mandatory section in such submitted manuscripts - 'Adherence to JoGH's Guidelines for Reporting Analyses of Big Data Repositories Open to the Public (GRABDROP)' - will summarise these declarations, with full details provided in a supplemental file. This proactive editorial policy aims to safeguard scientific quality while empowering global researchers. By improving transparency and accountability, JoGH seeks to ensure that the benefits of open big data are not undermined by unethical or careless practices. We suggest that other publishers engage in an open discussion on how to address these challenges and consider adopting JoGH's GRABDROP guidelines or similar measures to maintain trust in scientific outputs derived from secondary analyses. Through these steps, JoGH remains committed to fostering reproducible and equitable global health research.

Sickle cell disease (SCD) is a common haematological disorder, affecting millions of people worldwide. It is most prevalent in malarial endemic areas in the tropics where outcomes are often poor due to resource constraints, resulting in most children dying before reaching adulthood. As increasing progress is made towards reducing under 5 mortality from infectious causes, non-communicable diseases (NCDs) including SCD have risen to the forefront of the global health agenda. Despite this, the global mortality burden of SCD remains poorly understood. This study aimed to estimate the incidence and mortality of SCD in children under 5 years of age in order to inform policy and develop sustainable strategies to improve outcomes. We performed a systematic literature search of Medline, EMBASE, Journals@Ovid, and Web of Science for studies on the incidence and mortality of SCD in children under 5, with search dates set from January 1980 and July 2017. We conducted random effects meta-analysis to obtain pooled meta-estimates of birth prevalence and mortality rates globally, and for each World Health Organization (WHO) region. 67 papers were found with relevant data. 52 contained data on incidence and prevalence and 15 contained data on mortality. The overall pooled estimate of mortality from the limited data available was 0.64 per 100 years of child observation (95% CI = 0.28-1.00) with the highest rate seen in Africa 7.3 (95% CI = 4.03-10.57). The global meta-estimate for the birth prevalence of homozygous sickle cell disease was 112 per 100 000 live births (95% CI = 101-123) with a birth prevalence in Africa of 1125 per 100 000 (95% CI = 680.43-1570.54) compared with 43.12 per 100 000 (95% CI = 30.31-55.92) in Europe. There were a number of limitations in the depth and breadth of available data however it is clear that both the highest prevalence and highest mortality of SCD is in Africa. In order to address this burden, there is a need for national comprehensive newborn screening to identify patients, and the development of holistic SCD care programmes to provide therapeutics and education for families and children with SCD. This targeted funding should form part of a broader increased global focus on NCDs in childhood.

Monitoring infectious diseases is essential for preventing and controlling outbreaks, especially in low- and middle-income countries (LMICs), where issues like poor infrastructure, lack of trained staff, and limited resources can make data collection challenging. Digital tools such as mobile health apps and electronic reporting systems show promise in addressing these problems. However, it's still unclear how well these tools actually improve the quality of data, like how quickly information is reported, how accurate it is, whether all necessary data is captured, and if the data can be trusted. This review aims to explore three main points: (1) how digital tools influence the quality of infectious disease data in LMICs; (2) what factors help or hinder their successful use; and (3) what recommendations can be made for policymakers and health workers based on the evidence. We will search several databases, including PubMed/MEDLINE, EMBASE, Scopus, CINAHL, and Google Scholar, for studies published from January 2000 to July 2025. To further reduce publication bias, we will search the following institutional repositories (African Health Observatory and Indian Council of Medical Research). The types of studies are randomised trials, quasi-experimental studies, and mixed-methods evaluations that compare digital solutions with traditional methods in LMIC settings. Data extracted will include outcomes such as delays in reporting, error rates, and completeness, and factors like infrastructure and workforce readiness. The quality of each study will be assessed using ROBINS-I for non-randomized studies and ROB2 for randomized controlled trials. Where possible, we will combine data statistically using meta-analysis and analyse qualitative findings for deeper insights. This review will offer a clear picture of how effective digital tools are in improving disease surveillance. It will identify common challenges, such as poor connectivity and issues with system integration, and emphasize factors that lead to success, like proper training and government support. Overall, the findings will help shape better strategies to strengthen digital disease monitoring, finally contributing to stronger global health security.

To estimate the lifetime and 12-month prevalence of occupational exposure to body fluids among health-care workers in Africa. Embase®, PubMed® and CINAHL databases were systematically searched for studies published between January 2000 and August 2017 that reported the prevalence of occupational exposure to blood or other body fluids among health-care workers in Africa. The continent-wide prevalence of exposure was estimated using random-effects meta-analysis. Of the 904 articles identified, 65 studies from 21 African countries were included. The estimated pooled lifetime and 12-month prevalence of occupational exposure to body fluids were 65.7% (95% confidence interval, CI: 59.7-71.6) and 48.0% (95% CI: 40.7-55.3), respectively. Exposure was largely due to percutaneous injury, which had an estimated 12-month prevalence of 36.0% (95% CI: 31.2-40.8). The pooled 12-month prevalence of occupational exposure among medical doctors (excluding surgeons), nurses (including midwives and nursing assistants) and laboratory staff (including laboratory technicians) was 46.6% (95% CI: 33.5-59.7), 44.6% (95% CI: 34.1-55.0) and 34.3% (95% CI: 21.8-46.7), respectively. The risk of exposure was higher among health-care workers with no training on infection prevention and those who worked more than 40 hours per week. The evidence available suggests that almost one half of health-care workers in Africa were occupationally exposed to body fluids annually. However, a lack of data from some countries was a major limitation. National governments and health-care institutions across Africa should prioritize efforts to minimize occupational exposure among health-care workers.

•We estimated full hepatitis B vaccination coverage among health-care workers (HCWs) in Africa.•We found that only a quarter of HCWs in Africa are fully vaccinated against Hepatitis B virus.•We observed marked variation in hepatitis B vaccination coverage across African regions. To estimate full hepatitis B vaccination coverage (uptake of ≥3 doses of vaccine) among health-care workers (HCWs) in Africa. We systematically searched the PubMed®, Embase®, CINAHL and Psych-Info databases for studies published from January 2010 to October 2017 that reported full hepatitis B vaccination coverage among HCWs in Africa. A random effects meta-analysis was conducted to determine pooled estimates of full vaccination coverage. Of the 331 articles identified, 35 studies from 15 African countries met the inclusion criteria and were included in the review. The estimated full hepatitis B vaccination coverage was 24.7% (95% CI: 17.3–32.0). Regional coverage was highest in northern Africa (62.1%, 95% CI: 42.5–81.7) and lowest in central Africa (13.4%, 95% CI: 4.5–22.3). Doctors were more likely (OR: 2.6, 95% CI: 1.8–3.7) to be fully vaccinated than Nurses with estimated pooled estimates of 52.4% (95% CI: 31.1–73.8) and 26.3% (95% CI: 9.7–42.9), respectively. Also, HCWs with 10 or more years of experience were more likely to be vaccinated than those with less than 10 years of experience (OR: 2.2, 95% CI: 1.5–3.3). The common reasons identified for non-vaccination of HCWs were unavailability of vaccine 50.5% (95% CI: 26.5–74.4), busy work schedule 37.5% (95% CI: 12.6–62.4) and cost of vaccination 18.4% (95% CI: 7.1–29.7). The evidence available suggests that many HCWs in Africa are at risk of Hepatitis B infection as only a quarter of them were fully vaccinated against Hepatitis B virus. This study highlights the need for all African governments to establish and implement hepatitis B vaccination policies for HCWs.

To estimate the burden of road traffic injuries and deaths for all road users and among different road user groups in Africa. We searched MEDLINE, EMBASE, Global Health, Google Scholar, websites of African road safety agencies and organizations for registry- and population-based studies and reports on road traffic injury and death estimates in Africa, published between 1980 and 2015. Available data for all road users and by road user group were extracted and analysed. We conducted a random-effects meta-analysis and estimated pooled rates of road traffic injuries and deaths. We identified 39 studies from 15 African countries. The estimated pooled rate for road traffic injury was 65.2 per 100 000 population (95% confidence interval, CI: 60.8-69.5) and the death rate was 16.6 per 100 000 population (95% CI: 15.2-18.0). Road traffic injury rates increased from 40.7 per 100 000 population in the 1990s to 92.9 per 100 000 population between 2010 and 2015, while death rates decreased from 19.9 per 100 000 population in the 1990s to 9.3 per 100 000 population between 2010 and 2015. The highest road traffic death rate was among motorized four-wheeler occupants at 5.9 per 100 000 population (95% CI: 4.4-7.4), closely followed by pedestrians at 3.4 per 100 000 population (95% CI: 2.5-4.2). The burden of road traffic injury and death is high in Africa. Since registry-based reports underestimate the burden, a systematic collation of road traffic injury and death data is needed to determine the true burden.