Background Although surgical site infection (SSI) is one of the most studied healthcare-associated infections, the global burden of SSI after appendectomy remains unknown. Objective We estimated the incidence of SSI after appendectomy at global and regional levels. Design Systematic review and meta-analysis. Participants Appendectomy patients. Data sources EMBASE, PubMed and Web of Science were searched, with no language restrictions, to identify observational studies and clinical trials published between 1 January 2000 and 30 December 2018 and reporting on the incidence of SSI after appendectomy. A random-effect model meta-analysis served to obtain the pooled incidence of SSI after appendectomy. Results In total, 226 studies (729 434 participants from 49 countries) were included in the meta-analysis. With regard to methodological quality, 59 (26.1%) studies had low risk of bias, 147 (65.0%) had moderate risk of bias and 20 (8.8%) had high risk of bias. We found an overall incidence of SSI of 7.0 per 100 appendectomies (95% prediction interval: 1.0–17.6), varying from 0 to 37.4 per 100 appendectomies. A subgroup analysis to identify sources of heterogeneity showed that the incidence varied from 5.8 in Europe to 12.6 per 100 appendectomies in Africa (p<0.0001). The incidence of SSI after appendectomy increased when the level of income decreased, from 6.2 in high-income countries to 11.1 per 100 appendectomies in low-income countries (p=0.015). Open appendectomy (11.0 per 100 surgical procedures) was found to have a higher incidence of SSI compared with laparoscopy (4.6 per 100 appendectomies) (p=0.0002). Conclusion This study suggests a high burden of SSI after appendectomy in some regions (especially Africa) and in low-income countries. Strategies are needed to implement and disseminate the WHO guidelines to decrease the burden of SSI after appendectomy in these regions. Prospero registration number CRD42017075257.

Background: Overweight and obesity are major public health problems worldwide, with projections suggesting a proportional increase in the number of affected individuals in developing countries by the year 2030. Evidence-based preventive strategies are needed to reduce the burden of overweight and obesity in developing countries. We assessed the prevalence of, and factors associated with overweight and obesity in selected health areas in West Cameroon. Methods: Data were collected from a community-based cross-sectional study, involving the consecutive recruitment of participants aged 18 years or older. Overweight and obesity were defined according to the WHO classification. The statistical software R (version 3.5.1, The R Foundation for statistical computing, Vienna, Austria) was used for statistical analysis. Multivariable logistic regression analysis was used to assess independent factors associated with overweight and obesity, and obesity. Results: Records of 485 participants were included for analysis. The age and sex-standardized prevalence of overweight, obesity, and overweight and obesity were 31.1% (95% CI, 27.0–35.2), 18.9% (95% CI, 14.9–22.9), and 50.1% (95% CI, 45.7–54.6), respectively. In multivariable analysis, being female (adjusted OR [aOR] = 2.79, 95% CI = 1.69–4.63), married (aOR = 3.90, 95% CI = 2.23–6.95), and having secondary or tertiary education (aOR = 3.27, 95% CI = 1.77–6.17) were associated with higher odds of overweight and obesity, while current smokers had lower odds of overweight and obesity (aOR = 0.37, 95% CI = 0.16–0.82) when compared to their respective counterpart. Compared to their respective reference categories, being female being (aOR = 3.74, 95% CI = 2.01–7.30), married (aOR = 2.58, 95% CI = 1.37–5.05) and having secondary or tertiary education (aOR = 2.03, 95% CI = 1.00–4.23) were associated with higher odds of obesity after adjustments for confounding. Conclusion: We observed a high prevalence of overweight and obesity in this study. The odds of overweight and obesity was higher in females, married participants, and those with higher levels of education. Community-based interventions to control overweight and obesity should consider targeting these groups.

Introduction: Globally, acute generalised peritonitis (AGP) is a common medical and surgical emergency which is a major contributor to non-trauma deaths despite improvements in diagnosis and surgical and intensive care management. In order to determine the global burden of AGP, geared at tailoring key interventions to curb its morbidity and mortality, we proposed this first ever systematic review and meta-analysis to estimate the contemporary prevalence, and to determine the most frequent AGP and the case fatality rate of AGP, at the global scene. Methods and analysis: We intend to search Africa n Journal s Online , Americana em Ciências da Saúde, Citation index, EMBASE, Global Index Medicus, Literatura Latino Africa Index Medicus, Medline and Scientific Electronic Library Online databases from 1 January 2009 to 31 July 2019 to identify studies that reported the prevalence, types of AGP, and case fatality rate of AGP in the global population without any language restrictions. Study selection, data extraction and risk of bias assessment will be conducted independently at each level by a pair of independent investigators. Random-effects meta-analysis will be used to pool studies judged to be clinically homogeneous. The presence of heterogeneity will be evaluated using the χ² test on Cochrane’s Q statistic and quantified with the I² statistics. Publication bias will be evaluated statistically and visually using the Egger’s test and funnel plots, respectively. Findings will be reported and compared by countries, WHO regions and globally. Ethics and dissemination: Since this study will be based on published data, it does will not require an ethical approval. The findings will be published in a scientific peer-reviewed journal. They will also be presented at scientific conferences and to relevant public health actors. PROSPERO registration number: CRD42019143331.

Fraser syndrome is a rare genetic disorder that often presents with ocular, renal, genital and limb’s congenital anomalies. The prognosis of this genetic disorder depends on the severity of the combination of congenital malformations, some of which may be fatal. The diagnosis of Fraser syndrome is based on established clinical criteria and genetic tests. The criteria enabling clinical diagnosis are visible dysmorphic features present at birth, hence, Fraser syndrome can easily diagnosed at birth, except when health professionals are inexperienced in clinical recognition. Herein, we report a case of Fraser syndrome missed out at birth and fortuitously diagnosed at the age of six months in a bid to raise clinicians’ awareness, particularly in resource-limited settings. We report a case of a six-month-old Cameroonian female infant, born at home and taken the following day to a primary healthcare facility for neonatal care. Her mother had no antenatal care until birth. She presented at our health center with respiratory distress and fever. She had a temperature of 38.8 °C and signs of left lung basal consolidation, suggestive of a left lower lober pneumonia, confirmed on chest x-ray. Other incidental clinical findings were several dysmorphic features like bilateral cryptophthalmos, nasal malformation, anal imperforation (with a perianal fistula), an external genital anomaly and syndactyly characteristic of Fraser syndrome associated with pneumonia. The patient responded well to intravenous antibiotics for the treatment of her pneumonia. Thereafter, she was referred to a pediatric surgeaon for surgical corrections of her bilateral cryptophthalmos, anal imperforation, external genital defect and syndactyly. Here we presented a case of Fraser syndrome in a Cameroonian infant whose diagnosis was missed out at birth and fortuitously made at six months of age. In view of the serious and potentially fatal complications of this genetic disorder, we draw clinicians’ attention, especially obstetricians, midwives and pediatricians for a high index of clinical suspicion geared at a timely diagnosis and management. Also, for a timely diagnosis, health education on regular antenatal and postnatal follow ups of the mother-infant couple respectively, cannot be overemphasized.

Background: The occurrence of pressure injuries ( PIs ) in an inpatient is a serious medical condition that requires a rigorous clinical evaluation. Management of these lesions should be comprehensive, including general measures and local care. Wound care occupies a large part of the treatment. For large skin loss, the treatment requires plastic surgery techniques for reconstruction. Myocutaneous advancement flaps are a good therapeutic option due to the provision of vascularized tissue within the skin defect. To ensure the success of the surgery, a good surgical technique preceeded by careful preparation of the patient in conjunction with the anesthesia team is imperative. Case presentation: We report the case of a 60-year-old bed ridden man for more than two months following an ischemic stroke with left spastic hemiplegia and loss of sensitivity. He was transferred to our surgical unit for the management of a chronic stage 4 PIs in the sacral area complicated with cellulitis, subcutaneous abscess and severe sepsis. Initial management consisted of resuscitation measures combining fluid therapy, antibiotic therapy, analgesics, blood transfusion, nutritional support, physioteherapy, wound care as well as preventive measures and psychological support. Once the granulation tissues were fully developed, the patient underwent reconstruction surgery with a V–Y myocutaneous advancement flap. The graft was successful with complete wound healing thereafter. Conclusion: PIs are a multifactorial, complex and disabling pathology that requires multidisciplinary care. Surgeons, anesthetists, nutritionists, physiotherapists, nurses must act in agreement in order to provide optimal treatment. Prevention is the rule. Highlights:

Background: Climate change‑related events such as floods, droughts, and wildfires have been shown to affect global mental health. As climate change worsens, extreme weather events increase, leading to more climate‑related mental health disorders globally. Objective: This review article assesses the impact of mental health and climate change in Africa to identify trends, research gaps, and potential interventions. Methods: A scoping review methodology, in accordance with the PRISMA‑ScR guidelines, was employed. A search strategy was developed using MeSH and synonym terms to search PubMed, Web of Science, and African Journal Online databases from January 2000 to April 2025. A total of 2332 titles and abstracts were screened. Results: Sixteen articles were included in our final analysis. The studies included were conducted in three East African countries, three North African countries, two West African countries, two Central African countries, and one Southern African country. They were published between 2015 and 2024. Most (56%; n = 9) of the studies were cross‑sectional studies. Climate change‑related events, such as flooding, drought, and sea‑level rise, have been found to affect mental health outcomes in countries like Ghana, Namibia, Nigeria, and Kenya. Commonly cited mental health outcomes included higher anxiety levels and lower well‑being among relocated individuals, persistent stress and anxiety due to flooding in Ghana, and significant post‑traumatic stress disorder symptoms among schoolchildren in Namibia. Vulnerable populations like children, adolescents, women, climate migrants, people living with HIV, and rural populations were found to be most impacted by climate change‑related events. Conclusion: While this review highlights an increasing trend in the impact of climate change on the mental health of individuals in Africa, more studies are necessary to establish the relationship between mental health and climate change, and to develop interventions and policies that address the growing mental health burden resulting from climate change.