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Background Intimate partner violence (IPV) includes any physical, sexual, or emotional harm experienced in any intimate relationship that results in negative outcomes. Zambia is one of the countries with the highest prevalence of IPV amongst women in sub-Saharan Africa. This study aims to investigate and describe the prevalence, associated risk factors, and geo-spatial distribution of IPV amongst women aged 15–49 years from the 2018 Zambia Demographic and Health Survey (ZDHS). Methods This study is a secondary data analysis of the 2018 ZDHS, which used the women’s individual dataset to extract a representative sample of 9 503 women from the domestic violence module. Analyses were adjusted using survey weights to account for unequal sampling probabilities. The bivariate and multivariable logistic regression models were applied to determine the factors associated with IPV. Stata MP version 14 was used to perform all analyses and QGIS software was used to map the geospatial distribution of IPV across provinces. Results The overall IPV prevalence amongst women aged 15–49 years in this study was 36.5% (95%CI: 34.9 to 38.2), with Muchinga province having the highest prevalence at 55.2% (95% CI 50.4 to 59.8) and North western with the lowest prevalence at 22.6% (95% CI 19.9 to 25.6). In the adjusted analyses, women who justified wife beating were at a higher odds of experiencing IPV compared to those who did not (aOR = 1.75; 95% CI: 1.37 to 2.25; p  < 0.001). Women with husbands or partners who consume alcohol were at higher odds of experiencing IPV (aOR = 3.81; 95% CI: 3.21 to 4.53; p  < 0.001). The study also found that women who reported witnessing parental violence from their father to mother had increased odds of experiencing IPV (aOR = 1.75, 95% CI: 1.45 to 2.12; p  < 0.001). Conclusion This study has shown that women who witnessed parental violence from father to mother, justified wife beating, or had partners who consumed alcohol, had increased odds of experiencing IPV in Zambia. There is need to tailor interventions that address the cessation of alcohol consumption, and the promotion of awareness and education on IPV and its associated harms, especially in hot spot provinces.

In this systematic review, we estimate the prevalence of six types of arthritis in Africa; namely rheumatoid arthritis, osteoarthritis, juvenile arthritis, psoriatic arthritis, gout, and ankylosing spondylitis. We comprehensively searched literature on 31 August 2014 in MEDLINE, EMBASE, Web of Science and the Cochrane Library to identify eligible studies from 1975 up to 31 July 2014. Two review authors independently selected studies, extracted data, and appraised studies. We carried out random effects meta-analysis of prevalence of arthritis and assessed heterogeneity through subgroup analyses. We performed separate analyses for population- and hospital-based studies, as well as rural and urban settings. We included 27 cross-sectional studies (20 population-based and 7 hospital-based) from Africa reporting on the prevalence of arthritis. The majority of the studies were from South Africa (44.4%, 12/27). Rheumatoid arthritis in urban settings ranged from 0.1% in Algeria, 0.6% in the DRC, to a meta-analysis overall prevalence of 2.5% in South Africa, and in rural settings ranged from a meta-analysis overall prevalence of 0.07% in South Africa, 0.3% in Egypt, to 0.4% in Lesotho. Osteoarthritis was the most prevalent form of arthritis and in urban settings it was 55.1% in South Africa and in rural settings, all in South Africa, ranged from 29.5%, 29.7%, up to 82.7% among adults aged over 65 years. Other results include highest prevalence of 33.1% for knee osteoarthritis in rural South Africa, 0.1% for ankylosing spondylitis in rural South Africa, 4.4% for psoriatic arthritis in urban South Africa, 0.7% for gout in urban South Africa, and 0.3% for juvenile idiopathic arthritis in urban Egypt. A third of the included studies had a low risk of bias (33.3%, 9/27), 40.8% (11/27) moderate risk, and 25.9% (7/27) had a high risk of bias. In this systematic review, we have identified the paucity of latest prevalence data on arthritis in Africa. More studies are needed to address the prevalence and the true burden of this disease in Africa.

Intimate partner violence (IPV) is very high in Africa. However, information obtained from the increasing number of African studies on IPV among pregnant women has not been scientifically analyzed. This paper presents a systematic review summing up the evidence from African studies on IPV prevalence and risk factors among pregnant women. A key-word defined search of various electronic databases, specific journals and reference lists on IPV prevalence and risk factors during pregnancy resulted in 19 peer-reviewed journal articles which matched our inclusion criteria. Quantitative articles about pregnant women from Africa published in English between 2000 and 2010 were reviewed. At least two reviewers assessed each paper for quality and content. We conducted meta-analysis of prevalence data and reported odds ratios of risk factors. The prevalence of IPV during pregnancy ranges from 2% to 57% (n = 13 studies) with meta-analysis yielding an overall prevalence of 15.23% (95% CI: 14.38 to 16.08%). After adjustment for known confounders, five studies retained significant associations between HIV and IPV during pregnancy (OR1.48-3.10). Five studies demonstrated strong evidence that a history of violence is significantly associated with IPV in pregnancy and alcohol abuse by a partner also increases a woman's chances of being abused during pregnancy (OR 2.89-11.60). Other risk factors include risky sexual behaviours, low socioeconomic status and young age. The prevalence of IPV among pregnant women in Africa is one of the highest reported globally. The major risk factors included HIV infection, history of violence and alcohol and drug use. This evidence points to the importance of further research to both better understand IPV during pregnancy and feed into interventions in reproductive health services to prevent and minimize the impact of such violence.

Overcoming the TB epidemic requires moving past expanding the coverage of healthcare services and looking to improve the quality of TB services. During COVID-19, the suboptimal state of TB services has further deteriorated, and little is known about how these services have fared after the pandemic. The study aims to assess the quality TB diagnostic services in primary health care (PHC) clinics in the eThekwini district, South Africa. Twenty-one clinics with the lowest and highest headcounts from each region of eThekwini were purposively selected. An audit tool adapted from the United States Agency for International Development (USAID) and the national TB guidelines was used to collect data on six different audit components. To assess quality, a 3-point scale was used where clinics could get a rating of either excellent, moderate, or poor performance. Descriptive statistics were employed to summarize and analyze clinic scores in Stata v15.1. Additionally, associations between clinic scores and clinic characteristics were investigated using Pearson’s pairwise correlation coefficient and a linear regression model, where p < 0.05 was the measure of statistical significance. The audit found that the quality of diagnostic services in eThekwini was moderate. The gaps that required addressing were the lack of TB training among staff, adherence to infection prevention and control practices, and contact screening. Without feasible solutions, these will hinder current TB management strategies and slow progress toward ending the TB epidemic.

Access to point-of-care (POC) diagnostics in resource-limited settings, where laboratory-based diagnostics are limited, depends on efficient supply chain management (SCM). This study evaluated the SCM for SARS-CoV-2 POC diagnostic services in resource-limited settings to determine the effect of SCM on accessibility to SARS-CoV-2 POC tests and to identify barriers and enablers of accessibility to SARS-CoV-2 diagnostic services in Mopani District, Limpopo Province, South Africa. We purposively assessed 47 clinics providing POC diagnostic services between June and September 2022. One participant per clinic completed an audit tool developed by the authors with guidance from the World Health Organization and the Management Sciences for Health guidelines. The audit tool evaluated the following SCM parameters: selection, quantification, storage, procurement, quality assurance, distribution, redistribution, inventory management, and human resource capacity. Percentage rating scores between 90–100% indicated that the facility was compliant with SCM guidelines, while rating scores < 90% indicated non-compliance. The clinic audit scores were summarized and compared across clinics and sub-districts. Clinics had compliance scores ranging from 60.5% to 89.2%. Compliance scores were the highest for procurement, redistribution, and quality assurance (all 100%), followed by storage (mean = 95.2%, 95% CI: 90.7–99.7), quantification (mean = 89.4%, 95% CI: 80.2–98.5), and selection (mean = 87.5%, 95% CI: 87.5%–87.5%). Compliance scores were the lowest for inventory management (mean = 53.2%, 95% CI: 47.9%–58.5%), distribution (mean = 48.6%, 95% CI: 44.6%–52.7%), and human resource capacity (mean = 50.6%, 95% CI: 43.3%–58.0%). A significant correlation was found between compliance score and clinic headcount (r = 0.4, p = 0.008), and compliance score and ideal clinic score (r = 0.4, p = 0.0003). Overall, the 47 clinics audited did not comply with international SCM guidelines. Of the nine SCM parameters evaluated, only procurement, redistribution, and quality assurance did not need improvement. All parameters are key in ensuring full functionality of SCM systems and equitable access to SARS-CoV-2 POC diagnostics in resource limited settings.

We assessed the impact of the pandemic on TB diagnostics at primary healthcare clinics (PHCs) during the different stages of COVID-19 in eThekwini district, South Africa. Data from the District Health Information System (DHIS) were used to conduct an interrupted time series analysis that assessed the changes in TB investigations and confirmed TB cases during four pandemic periods: lockdown and the subsequent three peaks of infection compared to the two years prior (2018–2022). The initial lockdown resulted in − 45% (95% CI − 55 to − 31) and − 40% (95% CI − 59 to − 28) immediate declines in TB investigations and confirmed cases, respectively. Both indicators showed substantial recovery in the months after the first wave (p < 0.05). However, while TB investigations sustained smaller declines throughout the pandemic, they rebounded and surpassed pre-COVID-19 levels by the end of the investigation period. On the other hand, confirmed cases experienced reductions that persisted until the end of the investigation period. TB diagnostic services at PHCs were considerably disrupted by COVID-19, with the confirmation of cases being the most adversely affected throughout the pandemic. The reasons for these persistent declines in TB detection must be determined to inform the development of sustainable diagnostic systems that are capable of withstanding future pandemics.

The COVID-19 pandemic has greatly impacted TB diagnostic services in high TB burden settings. This has caused cases to go undetected and increased the number of TB deaths in 2020. Renewed efforts to improve the resilience of TB services during pandemics are required. Therefore, the current study aims to propose a novel approach for conducting TB diagnostic services in high burden settings during the pandemic. The proposed study will be conducted in three phases. During the first phase, a geospatial analysis to assess the geographic accessibility of TB diagnostic services will be conducted. In the second phase, the effect of COVID-19 on TB diagnostic services will be determined using an interrupted time series analysis. During the third phase, the barriers and enablers of TB diagnostic services will be explored using patient interviews and a vertical audit. The fourth phase of the study will be guided by the outcomes of the previous three phases where a nominal group technique with key stakeholders will be conducted to propose a novel means for conducting TB diagnostic services during the pandemic. The data of the study will be analyzed using the latest version of ArcGIS, Stata software. The study has received full ethical approval from ethics committees. The results together with input from relevant TB stakeholders will be used to develop a new approach to conducting TB diagnostic services at Primary healthcare clinics.

IntroductionSub-Saharan Africa (SSA) is faced with the dual epidemics of HIV/AIDS and non-communicable diseases (NCDs). Cardiovascular diseases, cancers, chronic respiratory diseases, diabetes and mental illnesses are the five major NCDs, causing death globally with low-income and middle-income countries, contributing 78% of all NCD deaths and 85% of premature deaths. There has been increased interest in the integration of HIV and NCDs care, especially in SSA that accounts for 55% of people living with HIV (PLHIV) globally. This systematic review and meta-analysis will estimate the overall prevalence or incidence of NCDs (or its risk factors) among adults living with HIV in SSA.Methods and analysisThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines will be used. Two authors will independently screen the title and abstracts of the articles identified from the search. Study participants will be any adult (≥18 years old) living with HIV in SSA. Exposure of interest will be HIV (with or without ART). Outcomes of interest are prevalence or incidence of any NCD/NCD risk factors. A random-effects meta-analysis will be used to estimate pooled prevalence or incidence of the five major NCDs among PLHIV, using Stata software. χ2 test and I2 statistic will be used to measure statistical heterogeneity between studies. If there is significant heterogeneity, subgroup analysis will be used to investigate potential sources. Publication bias will be assessed using funnel plots and the Stata ‘metabias’ command.Ethics and disseminationEthical review will not be required because it is a systematic review. Data will be kept in the institutional data repository. Study findings will be disseminated through peer-reviewed publications and conference presentations.PROSPERO registration numberCRD42021258769.

In South Africa, 30.9% of children under five years with Severe Acute Malnutrition (SAM) died in 2018. We aimed to identify factors associated with mortality among children under five years hospitalized with SAM in Limpopo province, South Africa. We conducted a cross-sectional study including children under five years admitted with SAM from 2014 to 2018 in public hospitals of Limpopo province. We extracted socio-demographic and clinical data from hospital records. We used logistic regression to identify factors associated with mortality. We included 956 children, 50.2% (480/956) male and 49.8% (476/956) female. The median age was 13 months (inter quartile range: 9-19 months). The overall SAM mortality over the study period was 25.9% (248/956). The most common complications were diarrhea, 63.8% (610/956), and lower respiratory tract infections (LRTIs), 42.4% (405/956). Factors associated with mortality included herbal medication use (adjusted Odds Ratio (aOR): 2.2, 95% Confidence Interval (CI): 1.4-3.5, p = 0.001), poor appetite (aOR: 2.7, 95% CI: 1.4-5.2, p = 0.003), Mid-upper circumference (MUAC) <11.5 cm (aOR: 3.0, 95% CI: 1.9-4.7, p<0.001), lower respiratory tract infections (LRTIs) (aOR: 1.6, 95% CI: 1.2-2.0, p<0.001), anemia (aOR: 2.5, 95% CI: 1.1-5.3, p = 0.021), hypoglycemia (aOR: 12.4, 95% CI: 7.1-21.8, p<0.001) and human immunodeficiency virus (HIV) infection (aOR: 2.3, 95% CI: 1.6-3.3, p<0.001). Herbal medication use, poor appetite, LRTIs, anemia, hypoglycemia, and HIV infection were associated with mortality among children with SAM. These factors should guide management of children with SAM.

Sub-Saharan Africa bears the heaviest burden of HIV/AIDS. Kenya alone has an estimated 1.4 million people living with HIV. Therefore, this study determined HIV testing prevalence and associated factors among men aged 15–54 years in Kenya. The study is a secondary data analysis of the 2022 Kenya Demographic and Health Survey, a nationally representative population-based cross-sectional survey. A multivariable logistic regression model was used to determine factors associated with HIV testing. Survey weights were used to adjust analyses for unequal sampling probabilities. Out of 14,453 men included in the study, the prevalence of self-reported HIV testing was 73.5%, which was higher among men aged 30–34 years old compared to the 15–19 years (90.2% vs. 33.3%), married or living with a partner (89.1% vs. 55.5%), residing in urban areas (82.5% vs. 67.8%), with higher education (90.6% vs. 58.4%), employed (80.5% vs. 43.1%), richest (83.8% vs. 60.4%), and those with three or more sexual partners (81.7% vs. 68.0%) groups. Targeted interventions to encourage more men to participate in regular HIV testing are needed. This can be achieved by bringing HIV testing sites closer to males through HIV self-testing and community testing, particularly home-based testing.