In 2021, the leading causes of death in Africa were lower respiratory infections, malaria, and stroke. That year, lower respiratory infections resulted in around 65 deaths per 100,000 population in Africa. Leading causes of death in Africa vs the world Worldwide, the top three leading causes of death in 2021 were heart disease, COVID-19, and stroke. At that time, some of the leading causes of death in Africa, such as lower respiratory infections and stroke, were among the leading causes worldwide, but there were also stark differences in the leading causes of death in Africa compared to the leading causes worldwide. For example, malaria, diarrheal disease, and preterm birth complications were among the top ten leading causes of death in Africa, but not worldwide. Furthermore, HIV/AIDS was the eighth leading cause of death in Africa at that time, but was not among the top ten leading causes worldwide. HIV/AIDS in Africa Although HIV/AIDS impacts every region of the world, Africa is still the region most impacted by this deadly virus. Worldwide, there are around 40 million people currently living with HIV, with about 20.8 million found in Eastern and Southern Africa and 5.1 million in Western and Central Africa. The countries with the highest HIV prevalence worldwide include Eswatini, Lesotho, and South Africa, with the leading 20 countries by HIV prevalence all found in Africa. However, due in part to improvements in education and awareness, the prevalence of HIV in many African countries has decreased. For example, in Botswana, the prevalence of HIV decreased from 26.1 percent to 16.6 percent in the period from 2000 to 2023.

Lower respiratory infections were the leading cause of death in Africa in 2021. Lower respiratory infections accounted for 8.6 percent of all deaths in Africa that year, followed by malaria, which was responsible for 6.5 percent of deaths. Although HIV is not one of the leading causes of death worldwide, it remains within the top 10 leading causes of death in Africa. As of 2023, the top 15 countries with the highest prevalence of new HIV infections are all found in Africa. HIV/AIDS HIV (human immunodeficiency virus) is an infectious sexually transmitted disease that is transmitted via exposure to infected semen, blood, vaginal and anal fluids and breast milk. HIV weakens the human immune system, resulting in the affected person being unable to fight off opportunistic infections. HIV/AIDS was the eighth leading cause of death in Africa in 2021, accounting for around 4.6 percent of all deaths, or around 405,790 total deaths. HIV Treatment Although there is currently no effective cure for HIV, death can be prevented by taking HIV antiretroviral therapy (ART). Access to ART worldwide has increased greatly over the last decade; however, there are still barriers to access in some of the countries most impacted by HIV. The African countries with the highest percentage of HIV infected children who were receiving antiretroviral treatment were Eswatini, Lesotho, and Uganda.

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Understanding the Global Distribution of HIV/AIDS Deaths

Introduction:

HIV/AIDS remains one of the most significant public health challenges globally, with its impact varying widely across countries and regions. While the overall share of deaths attributed to HIV/AIDS stands at around 1.5% globally, this statistic belies the stark disparities observed on a country-by-country basis. This essay delves into the global distribution of deaths from HIV/AIDS, examining both the overarching trends and the localized impacts across different regions, particularly focusing on Southern Sub-Saharan Africa.

Understanding Global Trends:

At a global level, HIV/AIDS accounts for approximately 1.5% of all deaths. This figure, though relatively low in comparison to other causes of mortality, represents a significant burden on public health systems and communities worldwide. However, when zooming in on specific regions, such as Europe, the share of deaths attributable to HIV/AIDS drops significantly, often comprising less than 0.1% of total mortality. This pattern suggests varying levels of prevalence and effectiveness of HIV/AIDS prevention and treatment strategies across different parts of the world.

Regional Disparities:

The distribution of HIV/AIDS deaths is not uniform across the globe, with certain regions experiencing disproportionately high burdens. Southern Sub-Saharan Africa emerges as a focal point of the HIV/AIDS epidemic, with a significant portion of deaths attributed to the virus occurring in this region. Factors such as limited access to healthcare, socio-economic disparities, cultural stigmatization, and insufficient education about HIV/AIDS contribute to the heightened prevalence and impact of the disease in this area.

Southern Sub-Saharan Africa: A Hotspot for HIV/AIDS Deaths:

Within Southern Sub-Saharan Africa, countries such as South Africa, Botswana, and Swaziland stand out for their exceptionally high rates of HIV/AIDS-related mortality. In these nations, HIV/AIDS can account for up to a quarter of all deaths, highlighting the acute nature of the epidemic in these regions. The reasons behind this disproportionate burden are multifaceted, encompassing issues ranging from inadequate healthcare infrastructure to socio-cultural barriers inhibiting prevention and treatment efforts.

Challenges and Responses:

Addressing the unequal distribution of HIV/AIDS deaths necessitates a multi-faceted approach that encompasses both prevention and treatment strategies tailored to the specific needs of affected communities. Efforts to expand access to antiretroviral therapy (ART), promote comprehensive sexual education, combat stigma, and strengthen healthcare systems are crucial components of an effective response. Moreover, fostering partnerships between governments, civil society organizations, and international entities is essential for coordinating resources and expertise to tackle the HIV/AIDS epidemic comprehensively.

Lessons Learned and Future Directions:

The global distribution of deaths from HIV/AIDS underscores the importance of context-specific interventions that take into account the unique social, economic, and cultural factors influencing the spread and impact of the disease. While progress has been made in reducing HIV/AIDS-related mortality in some regions, much work remains to be done, particularly in areas where the burden of the epidemic remains disproportionately high. Going forward, sustained investment in research, healthcare infrastructure, and community empowerment initiatives will be vital for achieving meaningful reductions in HIV/AIDS deaths worldwide.

Conclusion:

In conclusion, the global distribution of deaths from HIV/AIDS reveals a complex landscape characterized by both overarching trends and localized disparities. While the overall share of deaths attributable to HIV/AIDS may seem relatively modest on a global scale, the stark contrasts observed across different countries and regions underscore the need for targeted interventions tailored to the specific contexts in which the epidemic is most pronounced. By addressing the underlying social, economic, and healthcare-related factors driving the unequal distribution of HIV/AIDS deaths, the global co...

The leading cause of death in low-income countries worldwide in 2021 was lower respiratory infections, followed by stroke and ischemic heart disease. The death rate from lower respiratory infections that year was 59.4 deaths per 100,000 people. While the death rate from stroke was around 51.6 per 100,000 people. Many low-income countries suffer from health issues not seen in high-income countries, including infectious diseases, malnutrition and neonatal deaths, to name a few. Low-income countries worldwide Low-income countries are defined as those with per gross national incomes (GNI) per capita of 1,045 U.S. dollars or less. A majority of the world’s low-income countries are located in sub-Saharan Africa and South East Asia. Some of the lowest-income countries as of 2023 include Burundi, Sierra Leone, and South Sudan. Low-income countries have different health problems that lead to worse health outcomes. For example, Chad, Lesotho, and Nigeria have some of the lowest life expectancies on the planet. Health issues in low-income countries Low-income countries also tend to have higher rates of HIV/AIDS and other infectious diseases as a consequence of poor health infrastructure and a lack of qualified health workers. Eswatini, Lesotho, and South Africa have some of the highest rates of new HIV infections worldwide. Likewise, tuberculosis, a treatable condition that affects the respiratory system, has high incident rates in lower income countries. Other health issues can be affected by the income of a country as well, including maternal and infant mortality. In 2023, Afghanistan had one of the highest rates of infant mortality rates in the world.

The global landscape of mortality has undergone significant changes from 1990 to 2021, but cardiovascular diseases remain the leading cause of death worldwide. In 2021, cardiovascular diseases accounted for 28.6 percent of all deaths, followed by cancers at 14.6 percent. Notably, COVID-19 emerged as the third leading cause of death in 2021, responsible for 11.6 percent of global fatalities. Impact of the COVID-19 pandemic The emergence of COVID-19 as a major cause of death underscores the profound impact of the pandemic on global health. By May 2023, the virus had infected over 687 million people worldwide and claimed nearly 6.87 million lives. The United States, India, and Brazil were among the most severely affected countries. The pandemic's effects extended beyond direct mortality, influencing healthcare systems and potentially exacerbating other health conditions. Shifts in global health priorities While infectious diseases like COVID-19 have gained prominence, long-term health trends reveal significant progress in certain areas. The proportion of neonatal deaths decreased from 6.4 percent in 1990 to 2.7 percent in 2021, reflecting improvements in maternal and child health care. However, challenges persist in addressing malnutrition and hunger, particularly in Sub-Saharan Africa and South Asia. The Global Hunger Index 2024 identified Somalia, Yemen, and Chad as the countries most affected by hunger and malnutrition, highlighting the ongoing need for targeted interventions in these regions.

BackgroundStroke in adults is a critical clinical condition and a leading cause of death and disability globally. Epidemiological data on stroke in sub-Saharan Africa are limited. This study describes incidence rates, stroke types and antecedent factors among patients hospitalized with stroke in Zanzibar.MethodsThis was a prospective, observational study of stroke patients at hospitals in Unguja, Zanzibar. Socioeconomic and demographic data were recorded alongside relevant past medical history, medicine use and risk factors. The modified National Institute of Health Stroke Scale (mNIHSS) was used to assess admission stroke severity and, when possible, stroke was confirmed by neuroimaging.ResultsA total of 869 stroke admissions were observed from 1st October 2019 through 30th September 2020. Age-standardized to the World Health Organization global population, the yearly incidence was 286.8 per 100,000 adult population (95%CI: 272.4–301.9). Among these patients, 720 (82.9%) gave consent to participate in the study. Median age of participants was 62 years (53–70), 377 (52.2%) were women, and 463 (64.3%) had a first-ever stroke. Known stroke risk factors included hypertension in 503 (72.3%) patients, of whom 279 (55.5%) reported regularly using antihypertensive medication, of whom 161 (57.7%) had used this medication within the last week before stroke onset. A total of 460 (63.9%) participants had neuroimaging performed; among these there was evidence of intracerebral hemorrhage (ICH) in 140 (30.4%). Median stroke severity score using mNIHSS was 19 (10–27).ConclusionZanzibar has high incidence of hospitalization for stroke, indicating a very high population incidence of stroke. The proportion of strokes due to ICH is substantially higher than in high-income countries. Most stroke patients had been in contact with health care providers prior to stroke onset and been diagnosed with hypertension. However, few were using antihypertensive medication at the time of stroke onset.www.ClinicalTrial.gov registration NCT04095806.

BackgroundSevere maternal outcome (SMO) encompasses women who survive life-threatening conditions either by chance or due to treatment quality, or who die. This concept assumes that severe maternal morbidity predicts mortality risk, enabling the analysis of risk factors for life-threatening outcomes and improving our understanding on the causes of maternal death. This study aims to determine the incidence of SMO and its leading causes in East Gojjam during a period of regional conflict.MethodsA prospective follow-up study was conducted at Debre Markos Comprehensive Specialized Hospital in East Gojjam from July 1, 2023, to February 30, 2024. The study included 367 women admitted with potentially life-threatening conditions, including 8 maternal deaths, using sub-Saharan Africa (SSA) and WHO Maternal Near-Miss (MNM) criteria. Data were entered into Epi Data v.4.6 and analyzed using SPSS v.27. The WHO MNM approach assessed SMO indicators and maternal health care quality were utilized.ResultsDuring the eight-month period, there were 3,167 live births, 359 potentially life-threatening conditions (PLTC), and 188 SMO cases (180 MNM and 8 maternal deaths). The SMO ratio was 59.4 per 1,000 live births (95% CI: 51, 68 per 1,000 live births). The MNM to mortality ratio, mortality index, and maternal mortality ratio were 22.5:1, 4.2%, and 252.6 per 100,000 live births, respectively. Over 80% of women with SMO showed evidence of organ dysfunction upon arrival or within 12 h of hospitalization. The leading causes of SMO were hypertensive disorders of pregnancy (HDP) and obstetric hemorrhage, including uterine rupture, with uterine rupture contributing to half of the maternal deaths.ConclusionThis study found that the incidence of SMO was comparable to that reported in most other studies. HDP was the primary cause of SMO, followed by obstetrical hemorrhage, consistent with other studies in Ethiopia. Uterine rupture was identified as the leading cause of maternal death. As this study was conducted in a single institution and in the period of severe armed conflict, it may not fully capture the range of maternal health issues across populations with varying healthcare access and socio-economic backgrounds. Caution should be exercised when generalizing these findings to the wider population.

Background: Stroke is a leading cause of death and disability in sub-Saharan Africa with increasing incidence. In Kenya, it is a neglected condition with a paucity of evidence despite its need for urgent care and hefty economic burden. Therefore, we reviewed studies on stroke epidemiology, care, and outcomes in Kenya to highlight existing evidence and gaps on stroke in Kenya.Methods: We reviewed all published studies on epidemiology, care, and outcomes of stroke in Kenya between 1 January 1990 to 31 December 2020 from PubMed, Web of Science, EBSCOhost, Scopus, and African journal online. We excluded case reports, reviews, and commentaries. We used the Newcastle-Ottawa scale adapted for cross-sectional studies to assess the quality of included studies.Results: Twelve articles were reviewed after excluding 111 duplicates and 94 articles that did not meet the inclusion criteria. Five studies were of low quality, two of medium quality, and five of high quality. All studies were hospital-based and conducted between 2003 and 2017. Of the included studies, six were prospective and five were single-center. Stroke patients in the studies were predominantly female, in their seventh decade with systemic hypertension. The mortality rate ranged from 5 to 27% in-hospital and 23.4 to 26.7% in 1 month.Conclusions: Our study highlights that stroke is a significant problem in Kenya, but current evidence is of low quality and limited in guiding policy development and improving stroke care. There is thus a need for increased investment in hospital- and community-based stroke care and research.

Life expectancy from birth in Africa was just over 37 years in 1950. As a wave of independence movements and decolonization swept the continent between the 1950s and early 1970s, life expectancy rose greatly in Africa; particularly due to improvements and control over medical services, better sanitation and the widespread promotion of vaccinations in the continent resulted in a sharp decrease in child mortality; one of the most significant reasons for Africa’s low life expectancy rates. Life expectancy in the continent would continue to steadily increase for much of the second half of the 20th century; however, life expectancy would slow down in the latter half of the 1980s, as the HIV/AIDS epidemic quickly grew to become one of the leading causes of death in the continent. After hovering around the low-fifties in the 1980s to and 1990s, life expectancy would begin to rise again at the turn of the millennium, and is estimated to be over 64 years in 2023.

BackgroundTetanus is a vaccine-preventable, neglected disease that is life threatening if acquired and occurs most frequently in regions where vaccination coverage is incomplete. Challenges in vaccination coverage contribute to the occurrence of non-neonatal tetanus in sub-Saharan countries, with high case fatality rates. The current WHO recommendations for the management of tetanus include close patient monitoring, administration of immune globulin, sedation, analgesia, wound hygiene and airway support [1]. In response to these recommendations, our tertiary referral hospital in Tanzania implemented a standardized clinical protocol for care of patients with tetanus in 2006 and a subsequent modification in 2012. In this study we aimed to assess the impact of the protocol on clinical care of tetanus patients and their outcomes.Methods and findingsWe examined provision of care and outcomes among all patients admitted with non-neonatal tetanus to the ICU at Bugando Medical Centre between 2001 and 2016 in this retrospective cohort study. We compared three groups: the pre-protocol group (2001–2005), the Early protocol group (2006–2011), and the Late protocol group (2012–2016) and determined associations with mortality by univariable logistic regression.We observed a significant increase in provision of care as per protocol between the Early and Late groups. Patients in the Late group had a significantly higher utilization of mechanical ventilation (69.9% vs 22.0%, p< 0.0001), provision of surgical wound care (39.8% vs 20.3%, p = 0.011), and performance of tracheostomies (36.8% vs 6.7%, <0.0001) than patients in the Early group. Despite the increased provision of care, we found no significant decrease in overall mortality in the Early versus the Late groups (55.4% versus 40.3%, p = 0.069), or between the pre-protocol and post-protocol groups (60.7% versus 50.0%, p = 0.28). There was also no difference in 7-day ICU mortality (30.1% versus 27.8%, p = 0.70). Analysis of the causes of death revealed a decrease in deaths related to airway compromise (30.0% to 1.8%, p<0.001) but an increase in deaths due to presumed sepsis (15.0% to 44.6%, p = 0.018).ConclusionThe overall mortality in patients suffering non-neonatal tetanus is high (>40%). Institution of a standardized tetanus management protocol, in accordance with WHO recommendations, decreased immediate mortality related to primary causes of death after tetanus. However, this was offset by an increase in death due to later ICU complications such as sepsis. Our results illustrate the complexity in achieving mortality reduction even in illnesses thought to require few critical care interventions. Improving basic ICU care and strengthening vaccination programs to prevent tetanus altogether are essential components of efforts to decrease the mortality caused by this lethal, neglected disease.

Between January and April 2021, 201 migrants died on the African continent. Over 1,000 deaths were reported throughout the previous year. In the years under review, the peak of mortality among migrants was recorded at 1,912 in 2019. Sub-Saharan Africa was the most common region of origin of the migrants.

BackgroundSmoking and alcohol use frequently co-occur and are the leading causes of preventable death in sub-Saharan Africa (SSA) and are common among people living with HIV (PLWH). While alcohol use has been shown to be associated with reduced adherence to antiretroviral treatment (ART), which may affect HIV viral suppression, the independent effect of smoking on HIV outcomes in SSA is unknown. We aimed to 1) describe the prevalence of current smoking and correlates of smoking; 2) assess the association of smoking with viral suppression, adjusting for level of alcohol use; 3) explore the relationship between smoking and CD4 cell count <350 cells/mm3, among participants who are virally suppressed.MethodsWe analyzed data from the Drinkers Intervention to Prevent Tuberculosis (DIPT) and the Alcohol Drinkers’ Exposure to Preventive Therapy for TB (ADEPTT) studies conducted in Southwest Uganda. The studies enrolled PLWH who were on ART for at least 6 months and co-infected with latent tuberculosis and dominated with participants who had unhealthy alcohol use. Current smoking (prior 3 months) was assessed by self-report. Alcohol use was assessed using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C, modified for prior 3 months) and phosphatidylethanol (PEth), an alcohol biomarker. We used logistic regression to estimate the cross-sectional association between smoking and lack of virological suppression (≥40 copies/ml), adjusting for level of alcohol use and other covariates, and to examine the association between smoking and CD4 cell counts among PLWH with viral suppression.ResultsOf the 955 participants enrolled from 2017 to 2021 who had viral load (VL) results, 63% were men, median age was 40 years (interquartile range [IQR] 32–47), 63% engaged in high/very high-risk alcohol use (AUDIT-C≥6 or PEth≥200 ng/mL), and 22% reported smoking in the prior 3 months. Among 865 participants (91%) with viral suppression and available CD4 count, 11% had a CD4 cell count <350 cells/mm3. In unadjusted and adjusted analyses, there was no evidence of an association between smoking and lack of virological suppression nor between smoking and CD4 count among those with viral suppression.ConclusionsThe prevalence of smoking was high among a study sample of PLWH in HIV care with latent TB in Southwest Uganda in which the majority of persons engaged in alcohol use. Although there was no evidence of an association between smoking and lack of virological suppression, the co-occurrence of smoking among PLWH who use alcohol underscores the need for targeted and integrated approaches to reduce their co-existence and improve health.

BackgroundGlobally, road traffic accidents are the eighth-leading cause of death for all age groups. The estimated number of road traffic deaths in low income countries was more than three times as high as in high-income countries. Africa had the highest rate of fatalities attributed to road traffic accidents. Ethiopia has the highest number of road traffic fatalities among Sub-Saharan African countries. The main objective of this study was to determine the incidence and predictors of mortality among road traffic victims admitted to hospitals in Hawassa City.MethodsA facility-based retrospective cohort study was conducted using secondary data from hospital records. A total of 398 road traffic accident victims admitted to selected hospitals in Hawassa city from January 2019 to December 2021 participated in the study. Data were analyzed using STATA version 14.1. The Cox regression model was used to determine the predictors of mortality. A hazard ratio with a 95% confidence interval and a cut-off value of P

Abstract

The 1992 Namibia Demographic and Health Survey (NDHS) is a nationally representative survey conducted by the Ministry of Health and Social Services, assisted by the Central Statistical Office, with the aim of gathering reliable information on fertility, family planning, infant and child mortality, maternal mortality, maternal and child health and nutrition. Interviewers collected information on the reproductive histories of 5,421 women 15-49 years and on the health of 3,562 children under the age of five years.

The Namibia Demographic and Health Survey (NDHS) is a national sample survey of women of reproductive age designed to collect data on mortality and fertility, socioeconomic characteristics, marriage patterns, breastfeeding, use of contraception, immunisation of children, accessibility to health and family planning services, treatment of children during episodes of illness, and the nutritional status of women and children. More specifically, the objectives of NDHS are: - To collect data at the national level which will allow the calculation of demographic rates, particularly fertility rates and child mortality rates, and maternal mortality rates; To analyse the direct and indirect factors which determine levels and trends in fertility and childhood mortality, Indicators of fertility and mortality are important in planning for social and economic development; - To measure the level of contraceptive knowledge and practice by method, region, and urban/rural residence; - To collect reliable data on family health: immunisations, prevalence and treatment of diarrhoea and other diseases among children under five, antenatal visits, assistance at delivery and breastfeeding; - To measure the nutritional status of children under five and of their mothers using anthropometric measurements (principally height and weight).

MAIN RESULTS

According to the NDHS, fertility is high in Namibia; at current fertility levels, Namibian women will have an average of 5.4 children by the end of their reproductive years. This is lower than most countries in sub-Saharan Africa, but similar to results from DHS surveys in Botswana (4.9 children per woman) and Zimbabwe (5.4 children per woman). Fertility in the South and Central regions is considerably lower (4.1 children per woman) than in the Northeast (6.0) and Northwest regions (6.7).

About one in four women uses a contraceptive method: 29 percent of married women currently use a method (26 percent use a modem method), and 23 percent of all women are current users. The pill, injection and female sterilisation are the most popular methods among married couples: each is used by about 7 to 8 percent of currently married women. Knowledge of contraception is high, with almost 90 percent of all women age 15-49 knowing of any modem method.

Certain groups of women are much more likely to use contraception than others. For example, urban women are almost four times more likely to be using a modem contraceptive method (47 percent) than rural women (13 percent). Women in the South and Central regions, those with more education, and those living closer to family planning services are also more likely to be using contraception.

Levels of fertility and contraceptive use are not likely to change until there is a drop in desired family size and until the idea of reproductive choice is more widely accepted. At present, the average ideal family size (5.0 children) is only slightly lower than the total fertility rate (5.4 children). Thus, the vast majority of births are wanted.

On average, Namibian women have their first child when they are about 21 years of age. The median age at first marriage is, however, 25 years. This indicates that many women give birth before marriage. In fact, married women are a minority in Namibia: 51 percent of women 15-49 were not married, 27 percent were currently married, 15 percent were currently living with a man (informal union), and 7 percent were widowed, divorced or separated. Therefore, a large proportion of children in Namibia are born out of wedlock.

The NDHS also provides inlbrmation about maternal and child health. The data indicate that 1 in 12 children dies before the fifth birthday. However, infant and child mortality have been declining over the past decade. Infant mortality has fallen from 67 deaths per 1,000 live births for the period 1983-87 to 57 per 1,000 live births for the period 1988-92, a decline of about 15 percent. Mortality is higher in the Northeast region than elsewhere in Namibia.

The leading causes of death are diarrhoea, undemutrition, acute respiratory infection (pneumonia) and malaria: each of these conditions was associated with about one-fifth of under-five deaths. Among neonatal deaths low birth weight and birth problems were the leading causes of death. Neonatal tetanus and measles were not lbund to be major causes of death.

Maternal mortality was estimated from reports on the survival status of sisters of the respondent. Maternal mortality was 225 per 100,000 live births for the decade prior to the survey. NDHS data also show considerable excess male mortality at ages 15-49, which may in part be related to the war of independence during the 1980s.

Utilisation of maternal and child health services is high. Almost 90 percent of mothers received antenatal care, and two-thirds of children were bom in health facilities. Traditional birth attendants assisted only 6 percent of births in the five years preceding the survey. Child vaccination coverage has increased rapidly since independence. Ninety-five percent of children age 12-23 months have received at least one vaccination, while 76 percent have received a measles vaccination, and 70 percent three doses of DPT and polio vaccines.

Children with symptoms of possible acute respiratory infection (cough and rapid breathing) may have pneumonia and need to be seen by a health worker. Among children with such symptoms in the two weeks preceding the survey two-thirds were taken to a health facility. Only children of mothers who lived more than 30 km from a health facility were less likely to be taken to a facility.

About one in five children had diarrhoea in the two weeks prior to the survey. Diarrhoea prevalence was very high in the Northeast region, where almost half of children reportedly had diarrhoea. The dysentery epidemic contributed to this high figure: diarrhoea with blood was reported for 17 percent of children under five in the Northeast region. Among children with diarrhoea in the last two weeks 68 percent were taken to a health facility, and 64 percent received a solution prepared from ORS packets. NDHS data indicate that more emphasis needs to put on increasing fluids during diarrhoea, since only I 1 percent mothers of children with diarrhoea said they increased the amount of fluids given during the episode.

Nearly all babies are breastfed (95 percent), but only 52 percent are put on the breast immediately. Exclusive breastfeeding is practiced for a short period, but not for the recommended 4-6 months. Most babies are given water, formula, or other supplements within the first four months of life, which both jeopardises their nutritional status and increases the risk of infection. On average, children are breastfed for about 17 months, but large differences exist by region. In the South region children are breastfed lor less than a year, in the Northwest region for about one and a half years and in the Northeast region for almost two years.

Most babies are weighed at birth, but the actual birth weight could be recalled for only 44 percent of births. Using these data and data on reported size of the newborn, for all births in the last five years, it was estimated that the mean birth weight in Namibia is 3048 grams, and that 16 percent of babies were low birth weight (less than 2500 grams).

Stunting, an indication of chronic undemutrition, was observed for 28 percent of children under five. Stunting was more common in the Northeast region (42 percent) than elsewhere in Namibia. Almost 9 percent of children were wasted, which is an indication of acute undemutrition. Wasting is higher than expected for Namibia and may have been caused by the drought conditions during 1992.

Matemal height is an indicator of nutritional status over generations. Women in Namibia have an average height of 160 cm and there is little variation by region. The Body Mass Index (BM1), defined as weight divided by squared height, is a measure of current nutritional status and was lower among women in the Northwest and the Northeast regions than among women in the South and Central regions.

On average, women had a health facility available within 40 minutes travel time. Women in the Northwest region, however, had to travel more than one hour to reach the nearest health facility. At a distance of less than 10 km, 56 percent of women had access to antenatal services, 48 percent to maternity services, 72 percent to immunisation services, and 49 percent to family planning services. Within one hour of travel time, fifty-two percent of women had antenatal services, 48 percent delivery services, 64 percent immunisation services and 49 percent family planning services. Distance and travel time were greatest in the Northwest region.

Geographic coverage

The sample for the NDHS was designed to be nationally representative. The design involved a two- stage stratified sample which is self-weighting within each of the three health regions for which estimates of fertility and mortality were required--Northwest, Northeast, and the combined Central/South region. In order to have a sufficient number of cases for analysis, oversampling was necessary for the Northeast region, which has only 14.8 percent of the population. Therefore, the sample was not allocated proportionally across regions and is not completely

Background: Maternal, infectious, and non-communicable causes of death combinedly are a major health problem for women of reproductive age (WRA) in sub-Saharan Africa (SSA). Little is known about the relative risks of each of these causes of death in their combined form and their demographic impacts. The focus of studies on WRA has been on maternal health. The evolving demographic and health transitions in low- and middle-income countries (LMICs) suggest a need for a comprehensive approach to resolve health challenges of women beyond maternal causes.Methods: Deaths and person-years of exposure (PYE) were calculated by age for WRA within 15–49 years of age in the Kintampo Health and Demographic Surveillance System (KHDSS) area from January 2005 to December 2014. Causes of death were diagnosed using a standard verbal autopsy questionnaire and the 10th Revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10). Identified causes of death were categorized into three broad areas, namely, maternal, infectious, and non-communicable diseases. Multiple decrements and associated single decrement life table methods were used.Results: Averting any of the causes of death was seen to lead to improved life expectancy, but eliminating infectious causes of death leads to the highest number of years gained. Infectious causes of death affected all ages and the gains in life expectancy, assuming that these causes were eliminated, diminished with increasing age. The oldest age group, 45–49, had the greatest gain in reproductive-aged life expectancy (RALE) if maternal mortality was eliminated.Discussion: This study demonstrated the existence of a triple burden. Infectious causes of death are persistently high while deaths from non-communicable causes are rising and the level of maternal mortality is still unacceptably high. It recommends that attention should be given to all the causes of death among WRA.

Maternal mortality rates can vary significantly around the world. For example, in 2022, Estonia had a maternal mortality rate of zero per 100,000 live births, while Mexico reported a rate of 38 deaths per 100,000 live births. However, the regions with the highest number of maternal deaths are Sub-Saharan Africa and Southern Asia, with differences between countries and regions often reflecting inequalities in health care services and access. Most causes of maternal mortality are preventable and treatable with the most common causes including severe bleeding, infections, complications during delivery, high blood pressure during pregnancy, and unsafe abortion. Maternal mortality in the United States In 2022, there were a total of 817 maternal deaths in the United States. Women aged 25 to 39 years accounted for 578 of these deaths, however, rates of maternal mortality are much higher among women aged 40 years and older. In 2022, the rate of maternal mortality among women aged 40 years and older in the U.S. was 87 per 100,000 live births, compared to a rate of 21 among women aged 25 to 39 years. The rate of maternal mortality in the U.S. has risen in recent years among all age groups. Differences in maternal mortality in the U.S. by race/ethnicity Sadly, there are great disparities in maternal mortality in the United States among different races and ethnicities. In 2022, the rate of maternal mortality among non-Hispanic white women was about 19 per 100,000 live births, while non-Hispanic Black women died from maternal causes at a rate of almost 50 per 100,000 live births. Rates of maternal mortality have risen for white and Hispanic women in recent years, but Black women have by far seen the largest increase in maternal mortality. In 2022, around 253 Black women died from maternal causes in the United States.

In Nigeria, Chad, South Sudan, and the Central African Republic, the maternal mortality rate was over 650 per 100,000 live births in 2023, respectively. Nigeria recorded the highest rate on the continent. That year, for every 100,000 children, 993 mothers died from any cause related to or aggravated by pregnancy or its management. The maternal death rate in Chad equaled 748. South Sudan and the Central African Republic followed with 692 deaths per 100,000 live births each.

Abstract Background Intimate partner violence (IPV) affects millions of women each year and has been recognized as a leading cause of poor health, disability, and death among women of reproductive age. However, the existing studies about the association between IPV and contraceptive use have been found to be conflicting and relatively less studied, particularly in low and middle income countries, including Eastern Sub Saharan Africa (SSA). This study examines the relationship between IPV and contraceptive use in Eastern SSA countries. Methods The Demographic and Health Surveys (DHS) from 2014 to 2017 were a multi-stage cluster sample survey of 30,715 ever married (or cohabitating) women of reproductive age from six countries. The six Eastern SSA datasets were pooled and multivariable logistic regression using a hierarchical approach was performed to examine the association between IPV and contraceptive use after adjusting for women, partners, and household and health facility factors. Result Two thirds of women 67% [66.55, 67.88] were not using any modern contraceptive methods and almost half (48%) of the women had experienced at least one form of IPV from their partners. Our analysis showed a strong association with decreased odds of physical violence [adjusted odds ratios (aOR) = 0.72, 95%CI: 0.67, 0 0.78] among women not using any contraceptive methods. Other factors associated with women not using any contraceptive methods were older women (35–49 years), illiterate couples and women from poorest households. Women who had no access to any form of communication [aOR = 1.12, 95%CI: 1.08, 1.36], unemployed partner [aOR = 1.55, 95%CI: 1.23, 1.95] and women who travelled long distances to access health services [aOR = 1.16, 95%CI: 1.06, 1.26] significantly reported increased odds of not using any contraceptive methods. Conclusion Our study indicated that physical violence was negatively associated with not using any contraceptive method among married women in Eastern SSA countries. Tailored intervention messages to reduce IPV including physical violence among women not using contraceptive methods in East Africa should target those from low-socioeconomic groups especially, older women with no access to any form of communication, unemployed partners, and illiterate couples.

IntroductionMyocardial Infarction (MI) is a leading cause of death worldwide. In high income countries, quality improvement strategies have played an important role in increasing uptake of evidence-based MI care and improving MI outcomes. The incidence of MI in sub-Saharan Africa is rising, but uptake of evidence-based care in northern Tanzania is low. There are currently no published quality improvement interventions from the region. The objective of this study was to determine provider attitudes towards a planned quality improvement intervention for MI care in northern Tanzania.MethodsThis study was conducted at a zonal referral hospital in northern Tanzania. A 41-question survey, informed by the Theoretical Framework for Acceptability, was developed by an interdisciplinary team from Tanzania and the United States. The survey, which explored provider attitudes towards MI care improvement, was administered to key provider stakeholders (physicians, nurses, and hospital administrators) using convenience sampling.ResultsA total of 140 providers were enrolled, including 82 (58.6%) nurses, 56 (40.0%) physicians, and 2 (1.4%) hospital administrators. Most participants worked in the Emergency Department or inpatient medical ward. Providers were interested in participating in a quality improvement project to improve MI care at their facility, with 139 (99.3%) strongly agreeing or agreeing with this statement. All participants agreed or strongly agreed that improvements were needed to MI care pathways at their facility. Though their facility has an MI care protocol, only 88 (62.9%) providers were aware of it. When asked which intervention would be the single-most effective strategy to improve MI care, the two most common responses were provider training (n = 66, 47.1%) and patient education (n = 41, 29.3%).ConclusionProviders in northern Tanzania reported strongly positive attitudes towards quality improvement interventions for MI care. Locally-tailored interventions to improve MI should include provider training and patient education strategies.

Rapid TB LAM Urine Test Devices Market Outlook

According to our latest research, the global Rapid TB LAM Urine Test Devices market size reached USD 315 million in 2024, demonstrating robust expansion driven by increasing tuberculosis (TB) prevalence and heightened demand for rapid, non-invasive diagnostic solutions. The market is projected to grow at a CAGR of 8.7% from 2025 to 2033, reaching an estimated USD 658 million by 2033. This sustained growth is propelled by advancements in diagnostic technologies, expanding healthcare access in emerging economies, and intensified focus on early TB detection, especially among immunocompromised populations.

A primary growth factor for the Rapid TB LAM Urine Test Devices market is the global burden of tuberculosis, particularly in low- and middle-income countries. The World Health Organization (WHO) estimates that TB remains one of the top 10 causes of death worldwide, with millions of new cases reported annually. The LAM (lipoarabinomannan) urine test offers a rapid, point-of-care diagnostic alternative to traditional sputum-based methods, which are often less effective in detecting TB among HIV-positive individuals and those with low bacterial loads. This unique advantage has significantly increased adoption rates, especially in high-burden regions, as healthcare systems seek to improve case detection rates and reduce TB-related mortality.

Another critical driver is the increasing emphasis on early and accurate TB diagnosis in resource-limited settings. Traditional diagnostic methods such as culture or molecular assays require sophisticated laboratory infrastructure and trained personnel, which are often lacking in remote or underserved areas. In contrast, rapid TB LAM urine test devices are portable, easy to use, and provide results within minutes, facilitating immediate clinical decision-making. Global health initiatives and funding from organizations such as the Global Fund and the Bill & Melinda Gates Foundation have further accelerated the deployment of these devices, making them an integral part of national TB control programs in several countries.

Technological advancements in lateral flow assays and enzyme-linked immunosorbent assays (ELISA) have further propelled market growth. Innovations in assay sensitivity, specificity, and user-friendliness have enhanced the reliability of rapid TB LAM urine test devices, making them suitable for a broader range of healthcare settings, including community clinics and mobile health units. Regulatory approvals for new and improved products, coupled with strategic collaborations between diagnostic companies and public health agencies, have also contributed to the market's expansion. The ongoing development of next-generation LAM assays with improved performance metrics is expected to sustain market momentum over the forecast period.

From a regional perspective, the market exhibits pronounced growth in Asia Pacific and sub-Saharan Africa, where TB incidence rates are highest. North America and Europe, while representing smaller shares of the global market, are witnessing increased adoption due to rising awareness of TB-HIV co-infection and the need for rapid diagnostics in vulnerable populations. Latin America and the Middle East & Africa are also emerging as important markets, supported by international funding and national TB elimination strategies. The regional outlook underscores the importance of tailored deployment strategies to address specific epidemiological and healthcare infrastructure challenges in each geography.

Product Type Analysis

The Product Type segment of the Rapid TB LAM Urine Test Devices market is primarily divided into Lateral Flow Assays, Enzyme-Linked Immunosorbent Assays (ELISA), and other emerging technologies. Lateral flow assays dominate the segment, owing to their simplicity, affordability, and rapid turnaround time. These assays are designed for point-of-care use, requiring minimal training and infrastructure, which makes them especially suitable for deployment in rural and resource-constrained environments. The widespread adoption of lateral flow assays is further supported by global and national health agencies, which have integrated these devices into TB screening protocols for high-risk populations, including people living with HIV and those with limited access to laboratory diagnostics.