Background: Road traffic accidents (RTAs) involving motorcycle taxi operators (Bodaboda drivers) represent a significant and growing public health crisis in Tanzania. According to the World Health Organization (WHO), RTAs are a leading cause of death and injury, with over 90% of fatalities occurring in low- and middle-income countries. Despite the severity of this problem, there is a lack of empirical data on the knowledge, attitudes, and practices of Bodaboda drivers, particularly in smaller municipalities like Singida. Objective: This study aimed to assess the knowledge, attitudes, and practices of Bodaboda drivers in Singida Municipal Council (MC), Tanzania, focusing on helmet use, compliance with traffic laws, and accident risk factors. Methods: A cross-sectional survey was conducted between January 2024 and February 2025 among 400 Bodaboda drivers randomly selected from 30 registered and 5 unregistered stands. Data were collected using structured questionnaires and analyzed using descriptive statistics, Chi-square tests, logistic regression, and thematic analysis for qualitative responses. Results: The majority of respondents were young males (65 % aged 20–39 years), with 57 % having only primary education. While 62 % of drivers were aware of traffic laws, only 48 % reported consistent helmet use. Education level was significantly associated with helmet use (χ2 = 14.23, p = 0.002), and prior road safety training increased the likelihood of helmet compliance (OR = 2.31, p = 0.001). Key barriers to helmet use included discomfort, cost, and peer influence. Thematic analysis revealed concerns about weak law enforcement and poor road infrastructure as major contributors to accidents. Conclusion: The study highlights critical gaps in road safety knowledge and compliance among Bodaboda drivers. Targeted interventions, including mandatory safety training, subsidized helmets, stricter law enforcement, and public awareness campaigns, are needed to enhance road safety and reduce motorcycle-related injuries in Tanzania. Our findings are consistent with and contribute to the existing literature from the East African region, offering a specific focus on a less-researched geographic area.
ObjectivesThis study aimed to determine the prevalence and factors associated with maternal and neonatal sepsis in sub-Saharan Africa.MethodsThis systematic review and meta-analysis used the PRISMA guideline on sepsis data in sub-Saharan Africa. The bibliographic search was carried out on the following databases: Medline/PubMed, Cochrane Library, African Index Medicus, and Google Scholar. Additionally, the reference lists of the included studies were screened for potentially relevant studies. The last search was conducted on 15 October 2022. The Joanna Briggs Institute quality assessment checklist was applied for critical appraisal. Estimates of the prevalence of maternal and neonatal sepsis were pooled using a random-effects meta-analysis model. Heterogeneity between studies was estimated using the Q statistic and the I2 statistic. The funnel plot and Egger’s regression test were used to assess the publication bias.ResultsA total of 39 studies were included in our review: 32 studies on neonatal sepsis and 7 studies on maternal sepsis. The overall pooled prevalence of maternal and neonatal sepsis in Sub-Saharan Africa was 19.21% (95% CI, 11.46–26.97) and 36.02% (CI: 26.68–45.36), respectively. The meta-analyses revealed that Apgar score < 7 (OR: 2.4, 95% CI: 1.6–3.5), meconium in the amniotic fluid (OR: 2.9, 95% CI: 1.8–4.5), prolonged rupture of membranes >12 h (OR: 2.8, 95% CI: 1.9–4.1), male sex (OR: 1.2, 95% CI: 1.1–1.4), intrapartum fever (OR: 2.4, 95% CI: 1.5–3.7), and history of urinary tract infection in the mother (OR: 2.7, 95% CI: 1.4–5.2) are factors associated with neonatal sepsis. Rural residence (OR: 2.3, 95% CI: 1.01–10.9), parity (OR: 0.5, 95% CI: 0.3–0.7), prolonged labor (OR: 3.4, 95% CI: 1.6–6.9), and multiple digital vaginal examinations (OR: 4.4, 95% CI: 1.3–14.3) were significantly associated with maternal sepsis.ConclusionThe prevalence of maternal and neonatal sepsis was high in sub-Saharan Africa. Multiple factors associated with neonatal and maternal sepsis were identified. These factors could help in the prevention and development of strategies to combat maternal and neonatal sepsis. Given the high risk of bias and high heterogeneity, further high-quality research is needed in the sub-Saharan African context, including a meta-analysis of individual data.Systematic review registration: PROSPERO (ID: CRD42022382050).
Iyonu J Onaghinor, Izuchukwu B Achusi, Olumuyiwa E Ariyo
Introduction: Breast tuberculosis (TB) is a rare extra-pulmonary presentation of tuberculosis. In the western world, this accounts for less than 0.1% of breast conditions (all breast conditions, not limited to TB or extra-pulmonary TB), but can be up to 3-4% in regions endemic for TB such as in Africa and Asia.
Case presentation: We report a case of a 54-year- old human immunodeficiency virus (HIV)-positive lady who presented with six months history of multiple masses on the left breast which were initially suspected to be cancer of the breast. However, histology report of the mass confirmed TB of the breast.
Conclusions: Presentation of TB can be non-specific and atypical in patients with HIV infection, especially when it presents in extra-pulmonary forms.
Alison C. Castle, Yumna Moosa, Helgard Claassen
et al.
Abstract Background Growing evidence suggests that chronic inflammation caused by tuberculosis (TB) may increase the incidence of diabetes. However, the relationship between post-TB pulmonary abnormalities and diabetes has not been well characterized. Methods We analyzed data from a cross-sectional study in KwaZulu-Natal, South Africa, of people 15 years and older who underwent chest X-ray and diabetes screening with hemoglobin A1c testing. The analytic sample was restricted to persons with prior TB, defined by either (1) a self-reported history of TB treatment, (2) radiologist-confirmed prior TB on chest radiography, and (3) a negative sputum culture and GeneXpert. Chest X-rays of all participants were evaluated by the study radiologist to determine the presence of TB lung abnormalities. To assess the relationships between our outcome of interest, prevalent diabetes (HBA1c ≥6.5%), and our exposure of interest, chest X-ray abnormalities, we fitted logistic regression models adjusted for potential clinical and demographic confounders. In secondary analyses, we used the computer-aided detection system CAD4TB, which scores X-rays from 10 to 100 for detection of TB disease, as our exposure interest, and repeated analyses with a comparator group that had no history of TB disease. Results In the analytic cohort of people with prior TB (n = 3,276), approximately two-thirds (64.9%) were women, and the average age was 50.8 years (SD 17.4). The prevalence of diabetes was 10.9%, and 53.0% of people were living with HIV. In univariate analyses, there was no association between diabetes prevalence and radiologist chest X-ray abnormalities (OR 1.23, 95%CI 0.95–1.58). In multivariate analyses, the presence of pulmonary abnormalities was associated with an 29% reduction in the odds of prevalent diabetes (aOR 0.71, 95%CI 0.53–0.97, p = 0.030). A similar inverse relationship was observed for diabetes with each 10-unit increase in the CAD4TB chest X-ray scores among people with prior TB (aOR 0.92, 95%CI 0.87–0.97; p = 0.002), but this relationship was less pronounced in the no TB comparator group (aOR 0.96, 95%CI 0.94–0.99). Conclusions Among people with prior TB, pulmonary abnormalities on digital chest X-ray are inversely associated with prevalent diabetes. The severity of radiographic post-TB lung disease does not appear to be a determinant of diabetes in this South African population.
Samuel T. Boland, Dina Balabanova, Susannah Mayhew
Abstract The 2013–2016 West Africa Ebola Epidemic is the largest outbreak of Ebola in history. By September, 2014 the outbreak was worsening significantly, and the international president of Médecins Sans Frontières called for military assistance. In Sierra Leone, the British and Sierra Leonean militaries intervened. They quickly established a National Ebola Response Centre and a constituent network of District Ebola Response Centres. Thereafter, these inherently militarised centres are where almost all Ebola response activities were coordinated. In order to examine perspectives on the nature of the militaries’ intervention, 110 semi-structured qualitative interviews were conducted and analysed. Military support to Sierra Leone’s Ebola response was felt by most respondents to be a valuable contribution to the overall effort to contain the outbreak, especially in light of the perceived weakness of the Ministry of Health and Sanitation to effectively do so. However, a smaller number of respondents emphasised that the military deployments facilitated various structural harms, including for how the perceived exclusion of public institutions (as above) and other local actors from Ebola response decision making was felt to prevent capacity building, and in turn, to limit resilience to future crises. The concurrent provision of life-saving assistance and rendering of structural harm resulting from the militaries’ intervention is ultimately found to be part of a vicious cycle, which this article conceptualises as the ‘political economy of expedience’, a paradox that should be considered inherent in any militarised intervention during humanitarian and public health crises.
Special situations and conditions, Medical emergencies. Critical care. Intensive care. First aid
Terracing, predominantly for agriculture, is surprisingly common across the African continent. A range of terracing types are in evidence, from trash and brush lines pilled across fields to well‐built drystone terraces which can be combined with irrigation and drainage features. Although poorly studied and dated, most terracing appears to date to the last five hundred years and is largely associated with the cultivation of sorghum, pearl millet, finger millet, and more recently maize. In several parts of the continent, sophisticated terracing systems work in conjunction with largescale irrigation and are linked to complex settlement structures and patterns.
Vansina's scope is breathtaking: he reconstructs the history of the forest lands that cover all or part of southern Cameroon, Gabon, Equatorial Guinea, the Congo, Zaire, the Central African Republic, and Cabinda in Angola, discussing the original settlement of the forest by the western Bantu; the periods of expansion and innovation in agriculture; the development of metallurgy; the rise and fall of political forms and of power; the coming of Atlantic trade and colonialism; and the conquest of the rainforests by colonial powers and the destruction of a way of life. "In 400 elegantly brilliant pages Vansina lays out five millennia of history for nearly 200 distinguishable regions of the forest of equatorial Africa around a new, subtly paradoxical interpretation of 'tradition.'" -Joseph Miller, University of Virginia "Vansina gives extended coverage . . . to the broad features of culture and the major lines of historical development across the region between 3000 B.C. and A.D. 1000. It is truly an outstanding effort, readable, subtle, and integrative in its interpretations, and comprehensive in scope. . . . It is a seminal study . . . but it is also a substantive history that will long retain its usefulness."-Christopher Ehret, American Historical Review
Moluk Pouralizadeh, Masoomeh Ghasemi Ghoreishi, Maryam Niknami
et al.
Background: Pain is one of the most common challenging complaints of patients and can lead to significant complications. It is important to identify pediatric nurses’ knowledge about pain control methods and the management in children using clinical practice guidelines. Objectives: The purpose of this study was to investigate the relationship between nurses’ knowledge and their perceived practice based on clinical practice guidelines of pediatrics’ pain in the central pediatrics’ hospital of Guilan University of Medical Sciences (GUMS). Methods: In an analytical-cross sectional study, 164 nurses were selected by a census method from the central pediatrics’ hospital of GUMS. The study tool was a researcher-made questionnaire developed from the valid pediatrics’ pain guidelines. The data were analyzed by SPSS 21. Results: There was no significant relationship between total scores of knowledge and practice. There was a significant relationship between total scores of knowledge and interventions of pain control (P = 0.045, r = 0.157). Also, general knowledge had a significant correlation with total practice (P = 0.003, r = 0.227), intervention of pain assessment (P = 0.002, r = 0.245) and intervention of pain control (P = 0.035, r = 0.165). General knowledge in pain control (P = 0.006, OR = 1.032) was considered as the predictor of the practice. Conclusions: The results of this study showed that nurses’ general knowledge about clinical guidelines for pain in children was a predictor for their perceived practice. Also, experience and education were related to higher practice. These findings can provide awareness among nurse managers and health care policymakers to update the nurses’ knowledge of pediatric pain management guidelines.
In its quest to restore land to millions of its citizens dispossessed under colonial and apartheid regimes, South Africa adopted a Restitution of Land Rights Act and set up a Land Claims Court in 1994 and 1996, respectively. This article uses select judgments of the Land Claims Court to critique the interpretative mindset of judges and the ideological neutrality of certain definitions in the Restitution Act. It argues that the colonial legacy of legal positivism and 20th century anthropological imagery inhibits the access to justice of dispossessed Africans living on the periphery of land rights. It uses the word ‘chained’ to describe communities whose restitution of land rights depends on their ability to (re)imagine themselves through a judicial prism of fossilized colonial ideas of traditional structures, lineage, and unbroken practices. The article recommends measures for promoting a South African legal culture that is sensitive to legal pluralism, mindful of indigenous law’s flexibility, and distrustful of undue standardization that stifles people’s access to justice.
History of Africa, African languages and literature
Mark Moseley, Kovashnee Naidoo, Armanda Bastos
et al.
Abstract Background Rattus spp. are frequently implicated as key reservoir hosts for leptospirosis, one of the most common, but neglected, bacterial zoonoses in the world. Although leptospirosis is predicted to be a significant public health threat in Africa, studies from the continent are limited. Methods Rattus spp. (n = 171) were sampled (January–May 2016) across the City of Johannesburg, South Africa’s largest inland metropole. Rattus spp. genetic diversity was evaluated by full length (1140 bp) cyt b sequencing of 42 samples. For comparison, a further 12 Rattus norvegicus samples collected in Cape Town, South Africa’s largest coastal metropole, were also genotyped. Leptospira infections were identified and genotyped using real-time PCR and multi-locus (lfb1, secY and lipL41) DNA sequencing. Results Five R. norvegicus haplotypes were identified across Johannesburg, four of which have not previously been detected in South Africa, and one in Cape Town. Across Johannesburg we identified a Leptospira spp. infection prevalence of 44% (75/171) and noted significant differences in the prevalence between administrative regions within the metropole. Multi-locus sequence analyses identified a clonal genotype consistent with L. borgpetersenii serogroup Javanica (serovar Ceylonica). Discussion The prevalence of infection identified in this study is amongst the highest detected in Rattus spp. in similar contexts across Africa. Despite the complex invasion history suggested by the heterogeneity in R. norvegicus haplotypes identified in Johannesburg, a single L. borgpetersenii genotype was identified in all infected rodents. The lack of L. interrogans in a rodent community dominated by R. norvegicus is notable, given the widely recognised host-pathogen association between these species and evidence for L. interrogans infection in R. norvegicus in Cape Town. It is likely that environmental conditions (cold, dry winters) in Johannesburg may limit the transmission of L. interrogans. Spatial heterogeneity in prevalence suggest that local factors, such as land use, influence disease risk in the metropole. Conclusions In South Africa, as in other African countries, leptospirosis is likely underdiagnosed. The high prevalence of infection in urban rodents in Johannesburg suggest that further work is urgently needed to understand the potential public health risk posed by this neglected zoonotic pathogen.
Recent debates in social anthropology on land acquisitions highlight the need to go further back in history in order to analyse their impacts on local livelihoods. The debate over the commons in economic and ecological anthropology helps us understand some of today’s dynamics by looking at precolonial common property institutions and the way they were transformed by Western colonization to state property and then, later in the age of neoliberalism, to privatization and open access. This paper focuses on Africa and refers to the work of critical scholars who show that traditional land tenure was misinterpreted as customary tenure without full property rights, while a broader literature on the commons shows that common-pool resources (pasture, fisheries, wildlife, forestry etc.) have been effectively managed by locally-developed common property institutions. This misinterpretation continues to function as a legacy in both juridical and popular senses. Moreover, the transformation of political systems and the notion of customary land tenure produced effects of central importance for today’s investment context. During colonial times a policy of indirect rule based on new elites was created to manage customary lands of so-called native groups who could use the land as long as it was of no value to the state. However, this land formally remained in the hands of the state, which also claimed to manage common-pool resources through state institutions. The neoliberal policies that are now demanded by donor agencies have had two consequences for land and land-related common-pool resources. On the one hand, states often lack the financial means to enforce their own natural resource legislation and this has led to de facto open access. On the other hand, land legally fragmented from its common-pool resources has been transformed from state to private property. This has enabled new elites and foreign investors to claim private property on formerly commonly-held land, which also leads to the loss of access to land related common-pool resources for more marginal local actors. Thus, the paper argues that this process does not just lead to land grabbing but to commons grabbing as well. This has furthermore undermined the resilience and adaptive capacity of local populations because access to common-pool resources is vital for the livelihoods of more marginal groups, especially in times of crisis. Comparative studies undertaken on floodplains in Botswana, Cameroon, Mali, Tanzania and Zambia based on a New Institutional Political Ecology (NIPE) approach illustrate this process and its impacts and show how institutional transformations are key to understanding the impacts of large-scale land acquisitions (LSLA) and investments in Africa.
By examining one ‘ethnographic’ object kept at the Royal Museum for Central Africa, this article discusses three consecutive demands for restitution of eo.0.0.7943, in 1878, in the 1960s-1970s, and in 2016. Neither informal nor official demands resulted in the actual return of the object to Congo. Instead, it featured in major exhibitions in Belgium, the Netherlands and the United States. While the Tervuren museum ‘donated’ other objects to local Congolese museums in the 1970s and 1980s, Congolese voices by now seem powerless, and debate is almost inexistent in Belgium. So what can museums and communities do? I argue that both provenance research and local expertise can provide rich and useful contemporary insights on objects and people, as well as on acquisition and exhibition history. Such objects and insights may be integrated in exhibitions Europe and Africa, with all its uplifting and darker consequences. What is more valuable: owning an object or the encounter?
This article is part of the forum 'Decolonisation and colonial collections: An unresolved conflict'
Door te kijken naar één ‘etnografisch’ object, bewaard in het Koninklijk Museum voor Midden-Afrika, bespreekt dit artikel drie opeenvolgende vragen naar restitutie van eo.0.0.7943, in 1878, de jaren 1960-1970 en in 2016. Informele, noch officiële vragen hebben echter geresulteerd in de terugkeer van het object naar Congo. Het werd daarentegen wel getoond op grote tentoonstellingen in België, Nederland en de Verenigde Staten. Het museum in Tervuren ‘schonk’ wel degelijk andere objecten aan lokale Congolese musea in de jaren 1970 en 1980, maar vandaag lijken Congolese stemmen machteloos en het debat is bijna onbestaande in België. Dus wat kunnen museums en gemeenschappen doen? Mijn inziens kunnen oorsprongsonderzoek en lokale expertise rijke en bruikbare hedendaagse inzichten opleveren over objecten en mensen, en de geschiedenis van verzamelen en tentoonstellen. Objecten en inzichten die kunnen worden geïntegreerd in tentoonstellingen in Europa en Afrika met al zijn verheffende en meer duistere gevolgen. Wat is waardevoller: een object bezitten of de ontmoeting
Dit artikel is onderdeel van het forum 'Decolonisation and colonial collections: An unresolved conflict'
Umar Ndagi, Ndumiso Mhlongo, Mahmoud E Soliman Molecular Modelling and Drug Design Research Group, School of Health Sciences, University of KwaZulu-Natal, Westville, Durban, South Africa Abstract: In the past, metal-based compounds were widely used in the treatment of disease conditions, but the lack of clear distinction between the therapeutic and toxic doses was a major challenge. With the discovery of cisplatin by Barnett Rosenberg in 1960, a milestone in the history of metal-based compounds used in the treatment of cancers was witnessed. This forms the foundation for the modern era of the metal-based anticancer drugs. Platinum drugs, such as cisplatin, carboplatin and oxaliplatin, are the mainstay of the metal-based compounds in the treatment of cancer, but the delay in the therapeutic accomplishment of other metal-based compounds hampered the progress of research in this field. Recently, however, there has been an upsurge of activities relying on the structural information, aimed at improving and developing other forms of metal-based compounds and nonclassical platinum complexes whose mechanism of action is distinct from known drugs such as cisplatin. In line with this, many more metal-based compounds have been synthesized by redesigning the existing chemical structure through ligand substitution or building the entire new compound with enhanced safety and cytotoxic profile. However, because of increased emphasis on the clinical relevance of metal-based complexes, a few of these drugs are currently on clinical trial and many more are awaiting ethical approval to join the trial. In this review, we seek to give an overview of previous reviews on the cytotoxic effect of metal-based complexes while focusing more on newly designed metal-based complexes and their cytotoxic effect on the cancer cell lines, as well as on new approach to metal-based drug design and molecular target in cancer therapy. We are optimistic that the concept of selective targeting remains the hope of the future in developing therapeutics that would selectively target cancer cells and leave healthy cells unharmed. Keywords: cancer, DNA, platinum, metal complexes, apoptosis, selective target