With approximately 11 million strokes occurring annually worldwide, and over 6.5 million deaths annually, stroke has made its place as one of the major killers in the world. Although developing countries make up more than 4/5 of the global stroke burden, well-grounded information on stroke epidemiology remains lacking there. This systematic review study aimed to provide a synthesis of studies on the incidence and prevalence of stroke among adults in sub-Saharan Africa (SSA), subsequently deduce the associated risk factors and public health implications (mortality rates and economic costs) of the disease on the population of this region. A systematic review of studies carried out in the region and published on PUBMED. Eligibility criteria were established using the PEO (Population/Patient, Exposure, Outcome) format. Research articles investigating either (or all) of the following: ischemic or haemorrhagic stroke, incidence, prevalence, and risk factors of stroke in adults (≥ 18 years old), in at least one region of SSA were included. Exclusion criteria comprised studies involving populations younger than 18 years old, research conducted outside the designated research region, and articles inaccessible in full text. The PRISMA guidelines were used for the search strategy. Fifty-two studies were included review. Among them, over 11 studies investigated the prevalence of the disease. Some older studies within the continent (Nigeria, 2011) showed a prevalence of 1.3 per 100 while more recent studies (Zambia, 2021) showed a prevalence of 4.3 per 1000. The highest prevalence noted in this region was in Madagascar (2017) with 48.17 per 100, while the lowest was recorded in (Zimbabwe, 2017) with 0.61 per 100. The study in Tanzania showed a crude incidence of 94·5 per 100 000 (76·0-115·0) while the study in Ghana in 2018 showed an incidence of 14.19 events per 1000 person-years [10.77-18.38]. The identified risk factors included hypertension, diabetes, smoking, alcohol consumption, physical inactivity, poor diets (more salt, less vegetables), dyslipidaemia, HIV/AIDS co-infection, heart disease (cardiomyopathies, cardiac arrhythmias), obesity, previous stroke and/or family history of stroke. Over 21 studies investigated the mortality rates due to stroke in SSA, with most of the studies being in West Africa. These studies revealed mortality rates as high as 43.3% in Ghana, and as low as 10.9% in Cameroon. Few studies reported on the economic costs of stroke in the region; two in Benin, two in Nigeria and one in Tanzania. The increasing incidence/prevalence, lifestyle factors and interactions with other diseases, including major communicable diseases, stroke is becoming a pressing public health problem for SSA. Reducing the incidence of stroke in Africa will surely lower mortality, morbidity, disability, and the neurological as well as cognitive aftereffects of stroke, as is clear from the experience of higher-income nations. We recommend a collective intervention involving the governments of nations, international organizations, civil society, and the private sector for greater impact and sustainable outcomes reducing the epidemiology and implications of stroke in SSA.

Climate change significantly impacts health globally, especially in densely populated, rapidly industrialising and ecologically diverse countries like Nigeria. We analysed climate change policies, studies, programs, and events at the national and subnational levels in Nigeria and explored their effects on public and respiratory health. Using the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMAScR) checklist, we searched PubMed, African Journals Online (AJoL), Google Scholar and government data repositories on January 10, 2024. We synthesised results using an adapted sector-level framework based on the World Health Organization (WHO) guidelines. Our searches returned 262 items, of which 32, including research studies, reports and grey documents, were retained for synthesis. Although some policies and programmes, like the Climate Change Act and Nigerian Climate and Health Observatory, exist, implementation is limited across many settings. Key reported respiratory pollutants in Nigeria include particulate matter (PM2.5, PM10), gaseous emissions (CO, SO₂, NOx), agricultural by-products (NH₃, H₂S), greenhouse gases (CH₄, CO₂), and microbial contaminants, which collectively increase the risk of respiratory inflammation, infections, and exacerbations of chronic respiratory symptoms and diseases. Our findings underscore a clear link between climate change and worsening respiratory health in many Nigerian settings. The current policies and programmes’ have limited impact, calling for comprehensive reforms, including improved enforcement and targeted action against major pollution sources, recognition of environmental rights, and stronger public health initiatives and community action.

There is limited empirical evidence on whether Coronavirus disease 2019 (COVID-19) related lockdown restrictions precipitate or perpetuate musculoskeletal (MSK) disorders. This study was aimed to synthesis literature that assessed the impact of COVID-19 related lockdown restrictions on MSK health. A literature search was conducted using MEDLINE, CINAHL, PsycINFO, Allied and Complementary Medicine Database (AMED), Web of Science, and Scopus databases. Studies meeting the following criteria were included in the review: the condition being considered was MSK health, the intervention was COVID-19 related lockdown restrictions, cross sectional studies, cohort studies, case controlled, prospective studies and retrospective studies. Data were extracted by 2 independent researchers. Risk of bias was assessed by the Newcastle–Ottawa quality assessment scale. Evidence from included studies was summarised using narrative synthesis. Fourteen studies comprising 22,471 participants of the general population from Turkey (n = 5), Italy (n = 1), Poland (n = 1), Australia (n = 2), Jordan (n = 1), Bangladesh (n = 1), Estonia (n = 1), the Netherlands (n = 1) and Saudi Arabia (n = 1) have met the inclusion criteria. The sample size of populations studied ranged from 91 to 1054. The included studies used questionnaire, visual analogic scale, or growth mixture modelling. Except for one study, all the included studies reported increased prevalence and incidence of MSK disorders due to COVID-19 related lockdown restrictions. The findings suggest that COVID-19 related lockdown restriction led to increased MSK disorders. Home-based strategies such as physical activity programmes and ergonomic workspace could potentially guide public health authorities to avoid MSK health problem.

Background: In the United Kingdom, 20 million individuals suffer from a musculoskeletal condition, for which physical activity (PA) is a core treatment. Minority ethnic communities experience a disproportionate impact, experiencing higher levels of pain and engaging in less PA. Research has identified various factors that affect their participation in PA, including lack of access to support, limited knowledge of resources, language barriers, fear of racial harassment while exercising, and insufficient communication/information from healthcare professionals. Methods: This project adopted a realist perspective, aiming to understand “what works, in which circumstances, and for whom?” The project had 4 steps: (1) defining review scope with stakeholders; (2) searching and extracting literature, creation of initial program theories; (3) refining/validating initial program theories with stakeholders; and (4) adopting Q-methodology to highlight priority areas. Results: 17 papers were included. Three program theories were identified: (1) Lack of initial access to health service support; (2) Nature of musculoskeletal self-management support—the importance of the therapeutic relationship and value of shared conversations; and (3) Accessible long-term support for PA engagement. The Q-sort exercise highlighted priority areas: (1) complex booking procedures and inadequate translation services, (2) time constraints impact effective patient-centered care, (3) dismissive attitudes/mismatched expectations impact shared decision making, (4) rebuilding trust to strengthen therapeutic relationships, (5) cultural relevance in developing therapeutic relationships, and (6) clinician recommended PA opportunities increase knowledge of PA. Conclusions: Our findings shed light on inequities across the UK’s musculoskeletal pathways, specifically in relation to PA engagement. This points toward priority areas for future research and interventions.

Musculoskeletal disorders (MSDs) represent a substantial global health burden, and artificial intelligence (AI)-based technologies are emerging as potential approaches for their management. However, evidence regarding the cost-effectiveness of these interventions remains limited. This systematic review synthesised the available evidence on the cost-effectiveness of AI-based technologies for managing MSDs of the spine. This systematic review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. PubMed, Medline, CINAHL, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and Directory of Open Access Journals (DOAJ) databases were searched. After title and abstract screening, the remaining articles underwent full-text review by two independent reviewers, who extracted economic outcome data comparing AI-based interventions versus control. A total of 347 studies were identified, with 59 duplicates removed and 251 excluded based on title and After full-text review, seven eligible studies were included in the review. These studies represented five countries (United States ( n = 2), Germany ( n = 2), Denmark ( n = 1), Australia ( n = 1) and South Korea ( n = 1)). The studies adopted a healthcare perspective ( n = 4), a societal perspective ( n = 2) and a healthcare and societal perspective ( n = 1). Time durations varied widely, from four weeks to twelve months in trials to three years or lifetime in models, with one study using a 20-month post-implementation period. The AI components of the interventions encompassed a range of technologies, including a deep learning–based diagnostic and exercise prescription platform, AI-driven chest radiograph screening, the self-BACK application, standardised Magnetic Resonance Imaging (MRI) protocols, the Back Pain Choices online decision support tool, and the Kaia back pain application. In three studies, AI-based interventions for MSDs of the spine showed consistent positive QALY gains. Across the seven studies, five interventions (71%) were found to be cost-effective or cost-saving, four (57%) were dominant, while two (29%) were not cost-effective, indicating that most AI-based and digital interventions for MSDs of the spine provide favourable economic value compared with standard care. This is the first systematic review to synthesise evidence on the cost-effectiveness of AI-based technologies for the management of MSDs of the spine. The results suggest that AI-based interventions have the potential to contribute to more efficient healthcare resource use and may support policy and decision-making. However, their impact on reducing the economic burden of MSDs of the spine and improving health outcomes is not yet conclusive, and further standardised economic evaluations are needed to strengthen the evidence base. PROSPERO registration number : https://www.crd.york.ac.uk/PROSPERO/view/CRD42025642775 .

This study presents the evaluation of a robot telemedicine system used for initial diagnosis of patient with UK and Thai doctors. In a prior study, a set of user requirements for a robot telemedicine system were outlined based on a focus group with medical professionals and an online survey with the public. Based on these recommendations we have developed a robot telemedicine system that consists of a telepresence interface with examination functionality for doctors to control a robot that is present with patients. The system is designed for initial diagnosis of medical conditions, and Bell’s palsy diagnosis is chosen as an example use case. This paper presents the design and usability evaluation of this robot telemedicine system. The usability study was conducted using a thinking-aloud protocol, and a semi-structured interview was conducted after using the system. Study results were analysed using framework analysis. Additionally, participants were asked to give subjective ratings of the system. The study was conducted cross-culturally with doctors from the UK and Thailand, allowing us to gain a deeper understanding of system usability with groups that differ in their medical practice and user needs. Study participants rated the system with 72.19 points on the System Usability Scale, which indicates acceptable usability when interpreted semantically. The system also received a presence score of 0.691, normalized between 0 (least) and 1 (highest). Based on the framework analysis the prior set of user requirements has been refined and developed into a set of design recommendations for use in the development of future robot telemedicine systems. Additionally, study results indicate differences in medical practice between UK and Thai doctors which could be relevant to adjust the robot telemedicine system to local users.