Effectiveness of Health Education in Community-based Malaria Prevention and Control Interventions in sub-Saharan Africa: A Systematic Review

Objective: This review assessed the effectiveness of health education in community-based malaria prevention and control interventions in sub-Saharan Africa (SSA). Methods: We systematically reviewed published and unpublished literature, searching 7 databases and 3 websites namely Malaria Journal, World Health Organization and Centre for Disease Control and Prevention to find relevant studies. Study designs included were randomized controlled trials, non-randomized trials, quasi experiments, before and after studies, and surveys. A narrative synthesis was performed on the extracted data. Results: Seventeen studies were included in the review. Nine studies covered health education interventions on Insecticide Treated bet Nets (ITNs), three utilised health education to promote Intermittent Presumptive Treatment in pregnancy (IPTp), four reported on the effect of health education in home-based management of malaria whilst one study focused on environmental management in malaria control. Factors found to affect health education in malaria control and prevention interventions included educational level of participants, the nature of health messages and the level of community involvement. Conclusion: The results of the review suggest that health education interventions are effective and remain a valuable tool in community-based malaria prevention and control interventions in SSA. This review found moderate evidence that health education interventions influence the uptake of community-based malaria prevention and control interventions, enhance knowledge about malaria and generally improve malaria prevalence and mortality in children under five and pregnant women.   Key words Malaria, systematic review, health education, sub-Saharan Africa

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Ghanaian media coverage of violence against women and girls: implications for health promotion

Abstract Background Violence against women and girls (VAWG) is an important public health issue. Framing studies indicate that how the news media cover public health issues is critical for designing effective health promotion interventions. Notwithstanding this, there is little research particularly in low-and middle-income country context examining how the news media frame VAWG. This paper examines news coverage of VAWG in Ghana, and the implications of this for health promotion. Methods This study used frame analysis as the methodological framework in examining how VAWG in Ghana is represented by the media. Qualitative content analysis approach to frame analysis was performed on 48 news articles which constituted the unit of analysis. Results The findings indicate that media framing of VAWG was episodic in nature as the acts of violence perpetrated against women and girls were presented as individual cases without reference to the wider social contexts within which they occurred. Similarly, victim blaming language was largely used in the news articles. In framing VAWG as an individual incident and women as helpless victims, the media fail to shape society’s perception of VAWG as a social and public health issue. Conclusions For the media in Ghana to contribute to the prevention of VAWG, there is the need for news coverage to focus on social construction of the issue, and also raise awareness about support services available to victims