Coronavirus disease 2019 (Covid-19) poses an important occupational health risk to health workers (HWs) that has attracted global scrutiny. To date, several thousand HWs globally have been reported as infected with the severe acute respiratory syndrome coronavirus 2 virus that causes the disease. It is therefore a public health priority for policymakers to understand risk factors for this vulnerable group to avert occupational transmission. A rapid review was carried out on 20 April 2020 on Covid-19 risk factors among HWs in PubMed, Google Scholar, and EBSCOHost Web (Academic Search Complete, CINAHL Complete, MEDLINE with Full Text, CINAHL with Full Text, APA PsycInfo, Health Source—Consumer Edition, Health Source: Nursing/Academic Edition) and WHO Global Database. We also searched for preprints on the medRxiv database. We searched for reports, reviews, and primary observational studies (case control, case cross-over, cross-sectional, and cohort). The review included studies conducted among HWs with Covid-19 that reported risk factors irrespective of their sample size. Eleven studies met the inclusion criteria. Lack of personal protective equipment, exposure to infected patients, work overload, poor infection control, and preexisting medical conditions were identified as risk factors for Covid-19 among HWs. In the context of Covid-19, HWs face an unprecedented occupational risk of morbidity and mortality. There is need for rapid development of sustainable measures that protect HWs from the pandemic.

An abnormal vaginal discharge is a frequent manifestation of reproductive tract infections, including sexually transmitted infections (STIs) and vulvovaginal candidiasis. It is also a manifestation of bacterial vaginosis, which has a prevalence of up to 50% among women of reproductive age. Reproductive tract infections are associated with a range of reproductive health challenges and increase the risk of HIV acquisition. This study was performed to critically review and discuss the current diagnostic and treatment approaches to abnormal vaginal discharge among women of reproductive age in sub-Saharan Africa, and to call for a paradigm shift from the syndromic approach to specific pathogen identification and directed antimicrobial therapy. Young women have the highest incidence of HIV infection in sub-Saharan Africa. Countries in sub-Saharan Africa where the prevalence of both STIs and bacterial vaginosis is very high have been employing a syndromic approach for the treatment of abnormal vaginal discharge since around 1984. However, the syndromic approach has several limitations, with the potential to miss infections, over-diagnose and over-treat STIs, and propagate antimicrobial resistance, which is one of the greatest global health challenges of the 21^st century. The low to middle-income countries of sub-Saharan Africa must innovate and leverage improved diagnostics to capacitate primary health care and other levels for point-of-care diagnostic testing, in order to provide an immediate diagnosis and treatment for women with an abnormal vaginal discharge.

Background: In 2019, the Namibian Ministry of Health introduced HIV self-testing (HIVST) as an additional strategy to increase uptake of HIV self-testing in traditionally hard-to-reach subpopulations, such as young adults and males. It is unclear how the utilisation of HIV self-testing iw optimised in young adults. The study objective is understanding knowledge, attitudes, and perception levels amongst college-going young adults in Namibia. Methods: This quantitative study utilised a sample of 97 young college students who received a pre-test structured questionnaire. One sample t-test was used to analyse the average score from the Likert scale. A cut-off p-value of 0.05 to determine statistical significance of variables was used. Logistic regression computation was used to identify independent variables significantly associated with the dependent variable. A univariate analysis was done on awareness and acceptability with statistical significance of p<0.05 to obtain preliminary insights into the association between independent and dependent variables. The net effect variables are assessed using multivariate analysis using STATA 13.1, taking into account confounding factors. Results: Out of the 97 participants, only 23.7% knew about HIV self-testing. The logistic regression had a significant association with awareness of HIV self-testing (p≤0.05): on condom use during a first sexual encounter; being with a single sexual partner in the last 12 months; not having a sexually transmitted infection. The univariate analysis revealed an association with the acceptability of HIV self-testing from females; those who live in urban settlements; having not had sexually transmitted infection in the last twelve months. Moreover, findings reveal there are low levels of awareness, yet participants had positive attitudes and levels of acceptability to HIV self-testing. Conclusion: This study shows promise if awareness through health education and promotion about HIV self-testing can be increased. This can form part of scaling up HIV testing in Namibia.

Although Namibia started implementing pre-exposure prophylaxis (PrEP) of Human Immunodeficiency Virus (HIV) in 2016, no study to determine its budget impact has been conducted. This study, therefore, aimed to estimate the budget impact of adopting tenofovir/emtricitabine for PrEP of HIV for all eligible people in the public health sector in Namibia from 2021 to 2023. A country-specific model was developed for this budget impact analysis (BIA). PrEP has targeted all eligible people in Namibia who receive health services from the public sector. It was assumed that the adherence rate was 75% and PrEP effectiveness 60% in this study. Costs used in this study were taken from a study that included Namibian costs. The BIA suggests that adopting PrEP may be cost saving as US$104 823, US$143 620, and US$182 452 of additional HIV care costs will potentially be saved in 2021, 2022, and 2023, respectively. Cost savings rely on high adherence rates, high PrEP effectiveness rates, low PrEP costs, and a small number of people living with HIV (PLHIV). Further economic analysis could aid decision-making in Namibia, both to stress test assumptions in the BIA and conduct cost-effectiveness analysis to estimate the value for money of PrEP.