Background: Coronavirus disease 2019 (COVID-19) vaccination is crucial for healthcare workers (HCWs). Understanding their vaccine uptake and perceptions is vital to promote acceptance. Aim: This study assessed COVID-19 vaccine uptake, associated factors and HCW willingness to recommend vaccination in Zimbabwe. Setting: The study was conducted through a cross-sectional survey involving 200 HCWs in seven central healthcare facilities from May 2023 to June 2023. Methods: Data on demographics, vaccination status, knowledge, attitudes and trust in information sources were collected. Descriptive statistics and modified Poisson regression identified factors associated with vaccine uptake. Results: Of the respondents (female: 68%, median age [interquartile range {IQR}: 34]; [28–43] years), 94% (188/200) had received at least one dose of the COVID-19 vaccine, with 49.5%, 41% and 3.5% having been fully vaccinated, received a booster and partially vaccinated, respectively. Also, 74% of the HCWs would recommend the COVID-19 vaccines to their patients. Out of the total, 15% of HCWs identified that vaccine safety was their major barrier to getting vaccinated. The vaccination rate among nurses and midwives was 9.6% (prevalence ratio [PR]: 0.904; 95% confidence interval [CI]: 0.833, 0.981) lower when compared to physicians. The study also identified that the booster vaccination rate was higher in older HCWs (PR: 1.02; 95% CI: 1.01, 1.03). Conclusion: High COVID-19 vaccine uptake was observed among HCWs in Zimbabwe. However, concerns about vaccine safety persist. Targeted interventions addressing these concerns are needed to maximise vaccine acceptance in this key population. Contribution: This study reveals specific reasons for vaccine hesitancy among HCWs in Zimbabwe.

Background: COVID-19 vaccination is critical in sub-Saharan Africa to reduce the disease burden. This study assessed real-world vaccine effectiveness (VE) in Zimbabwe. Aim: To determine COVID-19 VE and factors associated with disease severity and mortality in Zimbabwe. Setting: The study setting comprised a test-negative case-control study across health facilities in Harare and Bulawayo (May 2023 – August 2023). Methods: Adults (≥ 18 years) were recruited from COVID-19 registers (1:1 case-control; matched by sex, age and clinic visit date). Telephone interviews assessed vaccination status, disease severity (cases) and comorbidities. Conditional logistic regression estimated VE (1 – odds ratio*100), with stratification by age and comorbidities. Ordinal and simple logistic regression analysed factors associated with disease severity and vaccination–variant relationships. Results: Overall vaccination coverage was 38% (fully vaccinated including boosters), with 62% unvaccinated. The median age was 38 years (interquartile range [IQR]: 30–50) with more females (n = 352). Overall VE against any COVID-19 infection was 32.2% (95% CI: 8.9, 49.5). Older age (45+ years) and chronic conditions were associated with increased hospitalisation risk. Among cases, hospitalisation rate was 34.8% (n = 174/500) and COVID-19-related mortality rate was 11.6% (n = 58/500). Conclusion: This study found a moderate VE of COVID-19 vaccines in Zimbabwe, potentially influenced by age, comorbidities and variants. We highlight the need for targeted vaccination strategies and public health measures informed by these findings. Contribution: This research informs public health strategies to optimise vaccination efforts and improve health outcomes across Africa, aligning with the journal’s focus on public health issues.

African Traditional Medicine (ATM) remains an important component of primary healthcare in South Africa; however, evidence for plants used in cutaneous wound care is dispersed across ethnobotanical, pharmacological, toxicological, and conservation literature. This narrative review integrates these evidence streams and proposes a conservation- and safety-aware translational prioritization framework for wound-healing botanicals used in South African ethnomedical practice. A structured search of PubMed, ScienceDirect, Web of Science, Google Scholar, and SciFinder identified eligible peer-reviewed ethnobotanical and preclinical studies published between January 1999 and June 2026. After taxonomic harmonization, 173 accepted taxa were documented from South African ethnobotanical reports as being traditionally used for wound care. Only seven taxa had direct wound closure evidence in relevant in vitro or in vivo models, while twenty-eight taxa had wound-relevant anti-inflammatory evidence. Reported mechanisms included keratinocyte and fibroblast migration, collagen-associated responses, angiogenesis, wound contraction, and inflammatory modulation. The evidence base remains uneven: many taxa are supported primarily by traditional use, while dose, formulation, treatment frequency, duration of use, dermal safety, and sustainable sourcing are poorly reported. Safety concerns were identified for selected toxic or irritant taxa, and destructive harvesting of roots, bulbs, corms, rhizomes, and bark may increase conservation risk. Overall, the review highlights a substantial gap between ethnomedical documentation and pharmacological validation, and it provides a prioritization strategy to guide future phytochemical, mechanistic, formulation, dermal-safety, and preclinical wound-healing research in South Africa.

Product Shezi (PS) is a polyherbal African traditional medicine (ATM) formulated from six known South African medicinal plants and is used for treating cutaneous wounds. However, its ethnopharmacological properties have not been scientifically validated. This study aimed to evaluate the antioxidant, anti-inflammatory, and antimicrobial activities of PS in vitro. Aqueous and methanolic extracts were prepared and qualitatively screened for phytochemical constituents. Cytotoxicity in fibroblasts and macrophages was assessed using an ATP-based viability assay. Antioxidant activity was evaluated using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging and a hydrogen peroxide (H₂O₂)-induced oxidative stress model. Anti-inflammatory effects in lipopolysaccharide (LPS)-stimulated macrophages were measured using the Griess reagent system, a human prostaglandin E₂ (PGE₂) ELISA, and a bovine serum albumin (BSA) anti-denaturation assay. Antimicrobial activity was assessed by twofold serial broth microdilution, agar well diffusion, and a crystal violet biofilm assay. Phytochemical screening confirmed the presence of saponins, alkaloids, tannins, glycosides, terpenoids, flavonoids, and steroids. PS exhibited IC₁₀ values of 3 and 10 μg/mL in fibroblasts and macrophages, respectively. PS (1–5 μg/mL) showed 70% DPPH scavenging potential and potent H₂O₂ cytoprotection (p < 0.001). Nitric oxide inhibition was non-significant (p > 0.05) whilst PGE₂ decreased significantly (p < 0.05) compared to LPS-stimulated cells. BSA denaturation was inhibited in a dose-dependent manner (p < 0.05). Staphylococcus aureus and S. epidermidis were the only microorganisms susceptible to PS (MIC 650–5000 μg/mL) with low SI (SI ≈ 0.05–0.06), while others were resistant. PS showed no antibiofilm activity (crystal-violet assay). Overall, PS demonstrated antioxidant and anti-inflammatory activities and selective antibacterial effects against planktonic bacteria in vitro. However, further optimization of extraction methods, detailed mechanistic studies, and in vivo investigations are warranted to substantiate therapeutic relevance.