The use of herbal medicinal products (HMPs) has grown significantly across low-and-middle-income countries (LMICs). Consequently, the safety of these products due to contamination is a significant public health concern. This systematic review aimed to determine the prevalence, types, and levels of contaminants in HMPs from LMICs. A search was performed in seven online databases, i.e., Africa journal online (AJOL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Directory of Open Access Journals (DOAJ), Health Inter-Network Access to Research Initiative (HINARI), World Health Organization Global Index Medicus (WHO GIM), Scopus, and PubMed using appropriate search queries and reported as per the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” (PRISMA) guidelines. Ninety-one peer-reviewed articles published from 1982 to 2021 from 28 different countries across four continents were included in the study. Although metals, microbial, mycotoxins, pesticides, and residual solvents were the reported contaminants in the 91 articles, metals (56.0%, 51/91), microbial (27.5%, 25/91), and mycotoxins (18.7%, 17/91) were the most predominant. About 16.4% (1236/7518) of the samples had their contaminant levels above the regulatory limits. Samples tested for microbial contaminants had the highest proportion (46.4%, 482/1039) of contaminants exceeding the regulatory limit, followed by mycotoxins (25.8%, 109/423) and metals (14.3%, 591/4128). The proportion of samples that had their average non-essential metal contaminant levels above the regulatory limit was (57.6%, 377/655), 18.3% (88/480), 10.7% (24/225), and 11.3% (29/257) for Pb, Cd, Hg, and As, respectively. The commonest bacteria species found were Escherichia coli (52.3%, 10/19) and Salmonella species (42.1%, 8/19). This review reported that almost 90% of Candida albicans and more than 80% of moulds exceeded the required regulatory limits. HMP consumption poses profound health implications to consumers and patients. Therefore, designing and/or implementing policies that effectively regulate HMPs to minimize the health hazards related to their consumption while improving the quality of life of persons living in LMICs are urgently needed.

There is an increased need for COVID-19 vaccination since the world is gradually returning to normal. Current evidence supports vaccination activity more towards viral suppression than COVID-19 prevention. This has led to divergent views regarding vaccination which may influence anti-vaccine attitudes and vaccine hesitancy. The study examined the role of personality traits, anti-vaccine attitudes and illness perceptions on vaccine hesitancy. The study was a cross-sectional survey using snowball and convenience sampling to recruit 492 participants via social media platforms. Multivariate analysis of variance and regression analysis were used to test the hypotheses. The study found that some facets of illness perception (identity, concern, emotional representation and treatment control), extraversion, experience with COVID-19 and anti-vaccine attitudes (mistrust, profiteering, worries about unforeseen effects of vaccine) predicted vaccine hesitancy. The outcomes from this study have implications for achieving public health goals and developing strategies for reaching optimal vaccination targets and attaining herd immunity. Health-promoting programs need to be intensified and could include psychosocial perspectives on vaccine hesitancy so that specific target groups can be reached to be vaccinated.

Resource-deprived coastal peri-urban settlements in Southern Ghana are characterized by indiscriminate solid waste disposal and open defecation practices. Persons engaged in waste handling in such communities perform their activities with little or no personal protective equipment. They are thus confronted with the risk of faecal pollution of the hands and other bodily parts. A mixed method approach was used to investigate 280 waste handlers performing different activities to estimate recent faecal pollution of their hands and to observe the utilization of personal protective equipment and sanitation/hygiene facilities during work. The log concentration of E. coli on hands of waste handlers after work (8.60 ± 4.20 CFU/hand, mean ± standard deviation) was significantly higher compared with the E. coli log concentration before work (2.95 ± 1.89 CFU/hand, mean ± standard deviation) (p<0.001). The odds of faecal pollution was significantly higher (aOR 4.2; 95% CI: 1.9–9.1) for workers aged 35 years and above compared with those less than 35 years; and for workers at public toilet facilities (aOR 3.0; 95% CI: 1.0–8.4) compared with those who worked for private waste handling companies. Female workers were, however, 60% less likely (aOR 0.4; 95% CI: 0.2–0.8) to experience faecal pollution of their hands compared with males. The workers had limited access to water and sanitation and hygiene facilities, and about one-fifth (n = 59; 21.1%) did not use personal protective equipment during work. Waste handlers should be provided and instructed in proper use of personal protective equipment, have access to sanitation facilities and adopt improved hygiene behaviour to avoid the risk of faecal pollution and associated disease risk.

The presence of global threats such as coronavirus disease 2019 (COVID-19) pandemic could potentially affect the research landscape, particularly that of systematic reviews. The aim of this study was to examine disparities between countries and the role of funding availability in the publication of health-themed systematic reviews. Metadata of published literature was collected from the Scopus database as of June 30, 2023. The dataset was divided into ‘pre-COVID-19 (2017–2019)’ and ‘during COVID-19 (2020–2022)’ by utilizing filter feature of the Scopus search engine. Network visualization of co-authorship was carried out on VoSviewer to identify collaborative patterns between countries. Our results suggest that most of the systematic reviews were published by authors from the United States of America (USA), both in pre-COVID-19 (n=29,463; Total link strength, TLS=32,832) and during COVID-19 (n=35,520; TLS=45,616). During COVID-19, the trend was not much different with the USA (14.6%), the UK (8.8%), and Australia (5%) in the top position among high-income countries. China (12.3%) and Iran (2.4%) topped the upper-middle-income and low-income countries groups. Publications by those who were from low-income countries were in a concerning low number; Ethiopia ranked first in this group only occupied 0.4% of the total publications (n=1,047). Furthermore, the number of publications was proportional to the number of funded studies (as observed in the top countries). However, during COVID-19 pandemic, the proportionality between funded publications and total publications was observed less. Taken altogether, our findings stress the importance of capacity building and providing more funds for on-desk research to close the disparity among countries.

The emergence of acute, severe non hepA–E hepatitis of unknown etiology (ASHUE) has attracted global concern owing to the very young age of the patients and its unknown etiology. Although this condition has been linked to several possible causes, including viral infection, drugs and/or toxin exposure, the exact cause remains unknown; this makes treatment recommendation very difficult. In this review, we summarize recent updates on the clinical manifestations, complemented with laboratory results, case numbers with the global distribution and other epidemiological characteristics, and the possible etiologies. We also provide the proposed actions that could be undertaken to control and prevent further spread of this hepatitis. Since many etiological and pathological aspects of the acute non hepA–E hepatitis remain unclear, further research is needed to minimize the severe impact of this disease.