Since the outbreak of COVID-19 was decreed by the World Health Organization as a public health emergency of worldwide concern, the epidemic has drawn attention from all around the world. The disease has since spread globally in developed and developing countries. The African continent has not been spared from the pandemic; however, the low number of cases in Africa compared to developed countries has brought about more questions than answers. Africa is known to have a poor healthcare system that cannot sustain the emerging infectious disease pandemic. This study explored climatic and environmental elements influencing COVID-19 transmission in Africa. This study involved manuscripts and data that evaluated and investigated the climatic and environmental elements of COVID-19 in African countries. Only articles written in English were considered in the systematic review. Seventeen articles and one database were selected for manuscript write-ups after the review process. The findings indicated that there is evidence that suggests the influence of climatic and environmental elements on the spread of COVID-19 in the continent of Africa; however, the evidence needs more investigation in all six regions of Africa and at the country level to understand the role of weather patterns and environmental aspects in the transmission of COVID-19.

Acute human African trypanosomiasis (rHAT) caused by Trypanosoma brucei rhodesiense is associated with high mortality and is fatal if left untreated. Only a few studies have examined the psychological, social and economic impacts of rHAT. In this study, mixed qualitative and quantitative research methods were used to evaluate the socio-economic impacts of rHAT in Mambwe, Rufunsa, Mpika and Chama Districts of Zambia. Individuals diagnosed with rHAT from 2004 to 2014 were traced using hospital records and discussions with communities. Either they, or their families, were interviewed using a structured questionnaire and focus group discussions were conducted with affected communities. The burden of the disease was investigated using disability adjusted life years (DALYs), with and without discounting and age-weighting. The impact of long-term disabilities on the rHAT burden was also investigated. Sixty four cases were identified in the study. The majority were identified in second stage, and the mortality rate was high (12.5%). The total number of DALYs was 285 without discounting or age-weighting. When long-term disabilities were included this estimate increased by 50% to 462. The proportion of years lived with disability (YLD) increased from 6.4% to 37% of the undiscounted and un-age-weighted DALY total. When a more active surveillance method was applied in 2013–2014 the cases identified increased dramatically, suggesting a high level of under-reporting. Similarly, the proportion of females increased substantially, indicating that passive surveillance may be especially failing this group. An average of 4.9 months of productive time was lost per patient as a consequence of infection. The health consequences included pain, amnesia and physical disability. The social consequences included stigma, dropping out of education, loss of friends and self-esteem. Results obtained from focus group discussions revealed misconceptions among community members which could be attributed to lack of knowledge about rHAT. The social and economic impact of rHAT on rural households and communities is substantial. Improved surveillance and strengthening of local medical services are needed for early and accurate diagnosis. Disease prevention should be prioritised in communities at risk of rHAT, and interventions put in place to prevent zoonotic disease spill over from domestic animals and wildlife. Supportive measures to mitigate the long-term effects of disability due to rHAT are needed.

The COVID-19 pandemic has overwhelmed health systems, especially in sub-Saharan African countries. Vaccination is one of the easily accessible interventions that can help reduce the burden on the health system. However, vaccination coverage remains low in sub-Saharan African countries. The determinants of vaccine acceptance and hesitancy among adolescents and youths remain unknown. Therefore, this study explored the pooled prevalence and determinants of COVID-19 vaccine acceptance and hesitancy among adolescents and youths in sub-Saharan African Countries. A systematic literature search of Scopus, PubMed Central, PubMed, Embase, African Journal Online, Research 4 Life, Embase, and Google Scholar was performed from 6^th May to 31^st December 2023, using developed keywords with a focus on sub-Saharan African countries. Twenty-three (N = 23) studies were finally selected for analysis. The pooled prevalence of vaccine acceptance among adolescents and youths was 38.7% (n = 23). The subgroup analysis of the pooled prevalence of acceptance among adolescents was 36.1% (n = 36.1) while youths were 42% (n = 10). At the region level, West Africa had 42.2% (n = 13), East Africa had 39.8% (n = 6), Central Africa had 33% (n = 1), and Southern Africa had 24.2% (n = 3). The determinants of vaccine acceptance were the desire for self-immunity (AOR = 1.97, 95%, CI, 1.083.47, I² = 94.15%, p < 0.05), receiving Health Officers’ information (AOR = 4.36, 95%, CI, 2.28-8.32, I² = 97.74, p < 0.001), the effectiveness of COVID-19 vaccine (AOR = 2.14, 95%, CI, 1.14-4.05, I² = 97.4%, p < 0.05). The odds of having an unconfirmed source of information (AOR = 0.22, 95% CI, 0.10-0.45, I² = 94.09%, p< 0.001) was responsible for vaccine hesitancy. The findings indicate the low pooled prevalence of COVID-19 vaccine acceptance and high levels of hesitancy among adolescents and youths in sub-Saharan African countries. Therefore, there is a need to ensure that extensive research is undertaken into age-appropriate health promotion messages and strategies to encourage the uptake of vaccines. PROSPERO ID number CRD42023403071.

Human African trypanosomiasis (HAT) is a neglected tropical disease that has not received much attention in Zambia and most of the countries in which it occurs. In this study, we assessed the adequacy of the healthcare delivery system in diagnosis and management of rHAT cases, the environmental factors associated with transmission, the population at risk and the geographical location of rHAT cases. Structured questionnaires, focus group discussions and key informant interviews were conducted among the affected communities and health workers. The study identified 64 cases of rHAT, of which 26 were identified through active surveillance and 38 through passive surveillance. We identified a significant association between knowledge of the vector for rHAT and knowledge of rHAT transmission (p < 0.028). In all four districts, late or poor diagnosis occurred due to a lack of qualified laboratory technicians and diagnostic equipment. This study reveals that the current Zambian healthcare system is not able to adequately handle rHAT cases. Targeted policies to improve staff training in rHAT disease detection and management are needed to ensure that sustainable elimination of this public health problem is achieved in line with global targets.

COVID-19, is still a public health threat due to uncertainties around the potential evolution of the virus, changes in clinical characteristics, and the introduction of new prevention and therapeutic modalities. Persons with Disabilities (PWDs) were among the most highly affected groups by the COVID-19 pandemic due to their underlying conditions. This study aimed to establish the prevalence and identify the determinants of COVID-19 vaccine uptake among PWDs in three selected districts of Zambia. A cross-sectional study was conducted from June to August 2023 in Lusaka, Mazabuka, and Monze Districts. Structured questionnaires were developed and administered to PWDs aged 18 years and above. Log-binomial model was used to calculate the adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for assessing COVID-19 vaccine acceptance and its determinants. Out of the sample of 985, the proportion of COVID-19 vaccine uptake was 67.6% (95% CI: 65%, 71%). Vaccine uptake was higher among the married (aPR: 1.21; 95% CI:1.06, 1.39) participants from Mazabuka District (aPR: 1.61; 95% CI: 1.34, 1.93) living in rural areas (aPR:1.27; 95% CI: 1.09, 1.49) having extra income (aPR:1.27; 95% CI: 1.09,1.50) involved in routine health checkup (aPR:1.23; 95% CI: 1.11, 1.37) previously infected with COVID-19 (aPR:1.32; 95% CI, 1.04-1.68) previously vaccinated (aPR: 1.16; 95% CI: 1.00, 1.33) and understanding safety of the vaccine (aPR: 2.33; 95% CI: 1.55, 3.49). Conversely, low vaccine uptake was observed among participants earning less than k200 from social cash transfer (aPR: 0.79; 95% CI: 0.71, 0.87). More research is needed to identify determinants of vaccine uptake among PWDs that make them more vulnerable to infectious diseases such as COVID-19. There is need to improve vaccination coverage among PWDs. A more holistic and inclusive health promotion approach needs to be adopted to ensure that PWDs are not left behind in accessing vaccines.

Progress has been made in recent years in addressing inequalities among Persons with Disabilities (PWDS), but there is still a lot to be done in most of th