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Background Despite a global drop of under-five mortality by 59% between 1990 and 2019, it remains high in Low- and Middle- income Countries (LMICs)with a preponderance in Sub-Saharan Africa (SSA), Southern and Central Asia. Besides preterm and intrapartum complications, undernutrition contributes 45% of the deaths in these developing regions. In Africa, under-five mortality due to severe acute malnutrition (SAM) has stagnated at 10–40%, higher than WHO targets and the SDGs projections. Methods We searched MEDLINE (via PubMed), Scopus, Web of Science, Science direct, Google Scholar, Cochrane Library and Open Grey databases for literature reporting under-five mortality due to SAM in Africa from 2014 to 2024. Estimates of the primary and secondary outcomes were pooled using a random-effects meta-analysis due to the anticipated between study heterogeneity. Results Fifty-two out of 82 studies (63.4%) analyzed reported an overall under-five mortality of 11% (95%CI: 0.08–0.13). Diarrheal diseases, human immunodeficiency virus (HIV) and pneumonia were the three most frequently reported risk factors associated with mortality by 21 (40.1%), 20 (38.5%), and 14 (26.9%) studies, respectively. No significant regional variation was found. Conclusion Under-five mortality due to SAM in Africa is still high as reported in the included studies. There were no regional variations. Diarrheal diseases, HIV and pneumonia were the most frequently reported risk factors associated with under-five mortality due to SAM in Africa.

Monoclonal antibodies with broad reactivity against antigens on the parasite that causes malaria, Plasmodium falciparum , are isolated from two subjects and are found to have an unusual insertion of an immunoglobulin-like domain from a different chromosome, illustrating a new mechanism of antibody diversification. Broadly reactive anti-malarial antibodies This paper reports the isolation of monoclonal antibodies with broad reactivity against Plasmodium falciparum antigens from two subjects living in a malaria-endemic region in Kilifi, Kenya. The antibodies are unusual in that they carry large insertions of an immunoglobulin-like domain from LAIR1, an Ig superfamily inhibitory receptor encoded on chromosome 19. The antibodies bind to polymorphic surface antigens on the parasite surface; binding depends on the mutated form of the insert. These findings illustrate a novel mechanism of antibody diversification, and the existence of conserved epitopes that may be suitable candidates for the development of a malaria vaccine. Plasmodium falciparum antigens expressed on the surface of infected erythrocytes are important targets of naturally acquired immunity against malaria, but their high number and variability provide the pathogen with a powerful means of escape from host antibodies 1 , 2 , 3 , 4 . Although broadly reactive antibodies against these antigens could be useful as therapeutics and in vaccine design, their identification has proven elusive. Here we report the isolation of human monoclonal antibodies that recognize erythrocytes infected by different P. falciparum isolates and opsonize these cells by binding to members of the RIFIN family. These antibodies acquired broad reactivity through a novel mechanism of insertion of a large DNA fragment between the V and DJ segments. The insert, which is both necessary and sufficient for binding to RIFINs, encodes the entire 98 amino acid collagen-binding domain of LAIR1, an immunoglobulin superfamily inhibitory receptor encoded on chromosome 19. In each of the two donors studied, the antibodies are produced by a single expanded B-cell clone and carry distinct somatic mutations in the LAIR1 domain that abolish binding to collagen and increase binding to infected erythrocytes. These findings illustrate, with a biologically relevant example, a novel mechanism of antibody diversification by interchromosomal DNA transposition and demonstrate the existence of conserved epitopes that may be suitable candidates for the development of a malaria vaccine.

Plasmodium falciparum antigens expressed on the surface of infected erythrocytes are important targets of naturally acquired immunity against malaria, but their high number and variability provide the pathogen with a powerful means of escape from host antibodies1–4. Although broadly reactive antibodies against these antigens could be useful as therapeutics and in vaccine design, their identification has proven elusive. Here, we report the isolation of human monoclonal antibodies that recognize erythrocytes infected by different P. falciparum isolates and opsonize these cells by binding to members of the RIFIN family. These antibodies acquired broad reactivity through a novel mechanism of insertion of a large DNA fragment between the V and DJ segments. The insert, which is both necessary and sufficient for binding to RIFINs, encodes the entire 100 amino acid collagen-binding domain of LAIR-1, an Ig superfamily inhibitory receptor encoded on chromosome 19. In each of the two donors studied, the antibodies are produced by a single expanded B cell clone and carry distinct somatic mutations in the LAIR-1 domain that abolish binding to collagen and increase binding to infected erythrocytes. These findings illustrate, with a biologically relevant example, a novel mechanism of antibody diversification by interchromosomal DNA transposition and demonstrate the existence of conserved epitopes that may be suitable candidates for the development of a malaria vaccine.

Despite its great potential as a food, feed and for industrial application, its processing and marketing remains economically unexploited. A cross-sectional baseline survey was undertaken in Western (Migori and Busia) and Coastal (Kilifi and Kwale) regions of Kenya between March 2013 and February 2014 using structured questionnaires to assess the post-harvest practices, opportunities and constraints in cassava processing. Results indicate that cassava processing is predominantly (58%) a women affair, males accounting for 42% with modal processors age being 32 years. Flour was the most common processed cassava product in the Coast (33%) while dried chips was highly produced in Migori and Busia in equal proportion of 43%. Other important products included cassava crisps and composite flour. Coast region had a greater diversity of products which are none existent in other regions. Most of the processing across the regions are small scale with workers mostly being the owners and activities take place in open yards with majority of these being in Busia (85 %) followed by Migori (67 %) and Coast region (57 %). Constraints during cassava processing were ranked in the following order: irregular and inadequate supply coupled with low seasonal demand for cassava and cassava products; high perishability of cassava roots; lack of value addition and processing tools; poor group dynamics, cohesion and management structure; lack of capacity building in production and processing technologies. There is very limited value addition to cassava in the study regions and hence the need to develop innovative technologies as well as new domestic and industrial products. Consumer sensitization and awareness on utilization of cassava and cassava products may be key to its promotion.