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Original Research Article
ABSTRACT
Background: Malaria remains a major public-health challenge in sub-Saharan Africa, where transmission varies geographically and over time and is influenced by climatic, environmental, demographic and health-system factors. Objective: To map geospatial approaches used to describe and predict malaria transmission in sub-Saharan Africa, including predictors, modelling methods, early-warning applications and implications for malaria control. Methods: The manuscript was structured using the Population–Concept–Context framework and PRISMA-ScR guidance, with a planned evidence window of 2021–2025. The original database search exports and screening records were unavailable; a supplementary targeted public-web search was conducted on 17 October 2026 to verify selected studies and expand the evidence chart. This supplementary search did not generate a complete deduplicated record set, so PRISMA flow counts remain pending and have not been fabricated. Results: Verified candidate studies illustrate GIS hotspot analysis, remote sensing, Bayesian geostatistics, model-based geostatistics and spatiotemporal modelling in Ghana, Kenya, Ethiopia and Nigeria. Recurring predictors include rainfall, temperature, vegetation, aridity, land cover, intervention coverage and access to health services. Conclusion: Geospatial methods can support malaria risk stratification, but operational value depends on data quality, local validation, uncertainty reporting and translation of maps into public-health decisions. The manuscript requires complete database searches, formal screening, evidence charting and a final PRISMA-ScR flow diagram before it can be represented as a completed reproducible scoping review. Objective: This review synthesises recent evidence on how geospatial mapping and spatial modelling are being used to characterise and predict malaria transmission in sub-Saharan Africa, with particular attention to environmental and climatic predictors, modelling approaches,
Original Research Article
ABSTRACT
Background: Malaria remains the leading cause of morbidity and mortality among children in sub-Saharan Africa, yet fine-scale geospatial data on its distribution and environmental determinants at the primary care level are scarce in the Federal Capital Territory (FCT), Abuja, Nigeria. This study mapped the geospatial distribution of malaria prevalence across all six area councils of the FCT and identified environmental determinants of malaria risk among children attending primary health care (PHC) facilities. Methods: A cross-sectional analytical study was conducted from October to December 2025 across 12 PHC facilities in six area councils of the FCT. A total of 385 children were enrolled using multi-stage sampling. Malaria diagnosis was performed by both rapid diagnostic test (RDT) and light microscopy. Environmental conditions was divided into household and peridomestic environmental risk factors were assessed using structured questionnaires. Geospatial analysis employed kernel density estimation (KDE) and Getis-Ord Gi* statistics using QGIS 3.28 and Python. Binary logistic regression identified independent predictors of malaria positivity. Results: Overall RDT-confirmed malaria prevalence was 38.4% (148/385; 95% CI: 33.5–43.4%) and microscopy prevalence was 32.2% (124/385). Significant spatial heterogeneity was observed: Abaji area council recorded the highest prevalence (RDT: 48.4%; microscopy: 50.0%) and was confirmed as a primary hotspot by Getis-Ord Gi* analysis; Kwali was a secondary hotspot (42.2%); and Gwagwalada had the lowest burden (29.7%). Significant temporal decline from October (58.3%) to December (22.5%) was documented (χ²=37.039, p<0.0001). None of the household factors were statistically significant However among peridomestic environmental factors, stagnant water (p=0.005), nearby bushes (p=0.004), gutters (p=0.042), car tyres (p=0.009), and abandoned containers (p=0.016) were all significantly associated with higher malaria prevalence. Compound
Original Research Article
ABSTRACT
Background: Human papillomavirus (HPV) vaccination is a cornerstone of cervical-cancer prevention, but acceptance, intention and actual uptake remain uneven in Nigeria. Women attending tertiary health-care facilities are important information recipients, caregivers and decision-makers for vaccination of eligible daughters and wards. This review synthesises evidence relevant to knowledge, awareness and multilevel determinants of HPV vaccine acceptance, with particular interpretive emphasis on Nasarawa State and comparable North-Central Nigerian settings. Objective: To systematically identify and synthesise evidence on knowledge, awareness, acceptance, willingness, uptake and determinants of HPV vaccination among women, mothers, caregivers and closely related adult decision-makers in Nigeria, and to determine the implications for women attending tertiary health-care facilities in Nasarawa State. Methods: The review was structured in accordance with PRISMA 2020 and informed by Joanna Briggs Institute evidence-synthesis principles. The search strategy was expanded into reproducible database-specific syntax for PubMed/MEDLINE, Embase, Scopus, Web of Science, CINAHL and African Journals Online (AJOL). The formal search cut-off was 30 August 2026. Accessible indexed records and publisher/database pages were rechecked during the September 2026 update, and recent Nigerian primary studies and systematic reviews were incorporated into the evidence map. Eligibility covered quantitative, qualitative and mixed-methods studies involving women, mothers, caregivers or relevant adult decision-makers, with outcomes involving HPV knowledge, awareness, acceptance, willingness, hesitancy or uptake. Because subscription databases cannot be queried through this environment with an authenticated institutional account, exact hit counts for Embase, Scopus, Web of Science and CINAHL are not fabricated; the manuscript therefore provides the complete reproducible search strings and a transparent
Original Research Article
ABSTRACT
Introduction: The diagnosis of acute leukemia relies on the integration of morphological and immunophenotypic findings. Flow cytometry is of particular value in morphologically ambiguous cases or in myeloperoxidase (MPO)-negative cases. Objective: To evaluate the contribution of flow cytometric immunophenotyping to the diagnosis and classification of acute leukemias and to assess its concordance with cytological findings. Methods: A retrospective study was conducted in 62 patients with acute leukemia. Demographic, clinical, hematological, and cytological data were collected. Flow cytometric immunophenotyping was performed to determine lineage and characterize antigen expression by blast cells. Concordance between cytological and immunophenotypic classifications was assessed. Results: The study population comprised 43 men (69.35%) and 19 women (30.65%), with a median age of 62 years. Anemia and thrombocytopenia were observed in 91.94% and 88.71% of patients, respectively. Cytology identified 33 cases of acute myeloid leukemia (AML) and 21 MPO-negative acute leukemias. Immunophenotyping classified 41 cases as AML and 14 as acute lymphoblastic leukemia (ALL). Overall concordance between the two approaches was 83.87%, whereas discordance was observed in 16.13% of cases. Among AML cases, CD33 (80.49%), MPO (78.05%), CD13 (75.61%), and CD117 (75.61%) were the most frequently expressed markers. Aberrant CD7 expression was observed in 29.27% of cases. Conclusion: Flow cytometric immunophenotyping provides an important complementary diagnostic contribution, particularly in MPO-negative acute leukemias and discordant cases. Its combination with cytological examination improves lineage assignment and classification of acute leukemias.
ABSTRACT
For decades, fear of “contrast-induced nephropathy” has led clinicians to delay or withhold contrast-enhanced computed tomography (CT) in emergency patients whose outcome depended on a rapid diagnosis, based on observational literature that lacked adequate non-contrast control groups. This review synthesises current evidence on the true risk of acute kidney injury (AKI) after intravenous iodinated contrast administration in the emergency department (ED) and proposes a practical, table-based approach for the front-line clinician, drawing on the guidelines of the European Society of Urogenital Radiology, the American College of Radiology and National Kidney Foundation consensus statement, the Kidney Disease: Improving Global Outcomes initiative, and the principal propensity-matched cohort studies and the PRESERVE randomised trial. The most methodologically robust propensity score-matched studies do not show a significant excess risk of AKI, dialysis, or mortality after intravenous contrast-enhanced CT in patients with an estimated glomerular filtration rate (eGFR) of 30 mL/min/1.73 m² or higher, compared with unenhanced CT in matched controls; risk remains uncertain, though probably not negligible, below this threshold or in the presence of established AKI — a reading reinforced by a large contemporary multicentre study finding significantly higher odds of AKI in this range. The term “contrast-induced nephropathy” has consequently given way to the causally more cautious “contrast-associated acute kidney injury” (CA-AKI). The PRESERVE trial showed no benefit of sodium bicarbonate over isotonic saline, nor of N-acetylcysteine over placebo, in patients at high cardiovascular risk undergoing angiography. In the unstable patient, or when the diagnosis under consideration is life- or organ-threatening, contrast administration should almost never be delayed to “wait for creatinine.” Rational prevention rests on targeted risk stratification, simple hydration in stable high-ri
Original Research Article
ABSTRACT
Objective: This article argues for a reorganization of health systems in Africa, and Cameroon in particular, that brings together biomedical and local knowledge rather than treating them as opposites. Introduction: African health systems remain built on an imported biomedical model grounded in Western positivism and determinism, which prioritizes investment in so-called dominant pathologies. Documentation on the profile of patients currently underserved by the health system reveals conditions such as mystical illnesses, cardiovascular diseases, psychological disorders, home births, HIV/AIDS, epilepsy, tuberculosis, and non-communicable chronic diseases across five major zones of Cameroon. Most patients appear to navigate a system that, in practice, has made no provision for their health problems beyond symptomatic care. Stroke, mystical illnesses arising from failure to honour the last wishes of the deceased, and epilepsy fall within a witchcraft-related register, whereas HIV/AIDS, tuberculosis, and chronic diseases reveal more material system failures. Methodology: A descriptive and analytical study using a qualitative approach was conducted from January to August 2024 in eighteen health areas spread across the six health districts of the Noun Subdivision (West Region). Data collection combined semi-structured interviews, focus group discussions, and participant observation with patients, caregivers, health personnel, traditional healers, and health authorities, supplemented by a literature review and a comparison across five major socio-cultural and health zones of Cameroon. Results: Therapeutic pluralism emerges as a structural fact: patients follow multiple therapeutic pathways combining traditional healers, exorcists, religion, and biomedicine. A tripartite typology of causes (natural, individual mystical, and ancestral), identified through the case of Yiémum (or hemiplegia) in the Noun Subdivision recurs in varying forms for epilepsy, malaria, infant malnutrit
Original Research Article
ABSTRACT
Quality Improvement (QI) has become a central strategy for strengthening primary healthcare systems, particularly in low- and middle-income countries where gaps between clinical guidelines and routine practice persist. This study examined the Quality Improvement initiatives implemented in three primary healthcare facilities in Sunyani, Ghana Seventh Day Adventist Hospital, Rafchik Health Centre, and Nkrankrom Community-Based Health Planning and Services compound and explored how these initiatives influence healthcare providers’ adherence to quality guidelines and protocols. A qualitative case study design was employed, guided by an interpretivist paradigm. Semi-structured interviews were conducted with twenty-one healthcare providers purposively selected for their involvement in clinical care and Quality Improvement activities. Data were analysed thematically to identify recurring patterns and meanings. The findings show that Quality Improvement activities across the facilities were organised around four main initiatives: peer review, community engagement, participation in the SafeCare programme, and the routine use of patient satisfaction surveys and clinical protocols. These initiatives focused on improving patient care, infection prevention and control, preventive health services, and operational efficiency. Healthcare providers reported that Quality Improvement initiatives contributed to better patient outcomes, smoother workflows, increased staff motivation, and improved performance in external assessments. Providers demonstrated a high level of familiarity with quality guidelines and generally strong adherence to protocols. However, full compliance was sometimes constrained by resource shortages, emergency care pressures, and the technical complexity of certain procedures. Internal supervision, peer review processes, and external inspections were identified as critical mechanisms for monitoring practice and reinforcing accountability.