Polio eradication in Ghana: past, present, and future

IntroductionGhana joined the Global Polio Eradication Initiative in 1996 to interrupt wild poliovirus transmission in the country. This was a collaborative effort by the Ghana Health Service (Disease Surveillance Department and the Expanded Program on Immunization) and the Polio Laboratory in the Noguchi Memorial Institute for Medical Research, University of Ghana.MethodsThe polio surveillance started from the southern regions and was extended to the northern regions over time. Surveillance officers were sensitized to improve case detection. The most important surveillance indicators—annualized non-polio AFP rate and stool adequacy—continued to improve, and the WHO targets for laboratory indicators of timeliness were met. The introduction of the oral polio vaccine in 1978 by the Expanded Program on Immunization led to a significant reduction in polio cases. The routine immunization coverage increased from 72% in 1999 to 94% in 2007, with an improvement in supplementary immunization activities.ResultsMolecular characterization of wild poliovirus from Ghana between 1995 and 2008 and vaccine-derived poliovirus from 2019 to 2022 revealed that the transmission of wild poliovirus and vaccine-derived poliovirus can be interrupted with active acute flaccid paralysis surveillance and adequate and efficient implementation of immunization activities. The country attained a polio- free status in 2015 after successfully submitting documentation to the Regional Certification Committee. Analysis of vaccine-derived polioviruses contributed to a better understanding of the poliovirus transmission, showing that the VDPV is indistinguishable from wild poliovirus and therefore poses a risk as a source of paralytic polio in a polio-free world.DiscussionGhana will sustain efforts to maintain polio- free status; intensify routine immunization to improve equity and OPV3 coverage; improve vaccine management and logistics; and enhance surveillance and outbreak preparedness, community engagement, and mobilization to eliminate the circulating vaccine-derived poliovirus. Furthermore, the country will strengthen partnerships with the WHO, UNICEF, CDC, Rotary International, and other stakeholders and secure dedicated funding to ensure consistent support for immunization and surveillance activities

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance.

Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times and more-regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and illuminate the distinct dispersal dynamics of variants of concern-particularly Alpha, Beta, Delta, and Omicron-on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve while the continent faces many emerging and reemerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Prevalence and risk factors of readmission among patients with cardiovascular diseases in Africa: a systematic review protocol

Cardiovascular diseases (CVDs) continue to pose a major threat to global health. In Africa, the burden of heart diseases remains disproportionately high compared to global figures. Moreover, hospital readmissions among patients with cardiovascular diseases contribute substantially to this burden. This review seeks to map the available evidence on the prevalence and risk factors associated with readmissions among patients with cardiovascular diseases in Africa. This review will be guided by the guidelines proposed by Aromataris & Pearson (2014) and is expected generate evidence that will inform targeted, evidence-based interventions aimed at reducing CVD-related readmission and mortality in Africa. Additionally, the findings will contribute to achieving Sustainable Development Goal 3, specifically target 3.4, which aims to reduce premature mortality from non-communicable diseases

Attitude and perception of medical assisted suicide among health workers: a scoping review

Despite the increasing global dialogue on MAS, literature on the topic remains fragmented. In countries where MAS is legal, health workers may be provided with clear guidelines and support systems. However, in regions where it remains illegal or unregulated, healthcare professionals often operate in legal grey zones with little institutional guidance or ethical clarity. This can result in professional burnout, moral distress and inconsistencies in patient care. Different health workers engage with MAS at different points along the care range assessment of eligibility, management of medications, presence during administration and aftercare for families. These roles require deep understanding and training, which many health workers may not receive. This make it essential to synthesize the existing literature to gain a comprehensive picture of how MAS is perceived by health workers, what factors shape their attitudes and how their roles differ across systems and countries. This scoping review seeks to map and examine available evidence from the past decade (January 2015 to June 2025) concerning the attitudes and perceptions of health workers towards medical assisted suicide and clarify how these attitudes are formed, identify what ethical, cultural, legal and professional factors influence perceptions and determine the implications for practice, policy, and future research

Impact of Bullying and Incivility on the Quality of life Among Nurses: A scoping Review in Africa

Bullying and incivility are prevalent issues that affect various healthcare settings, particularly among nurses. These activities affect nurses worldwide and influence their quality of life, which leads to emotional exhaustion, burnout, and lower job satisfaction. Evidence suggests that prioritizing psychosocial safety climate (PSC) within healthcare facilities is vital to protecting the well-being of healthcare providers and improving patient outcomes (Amoadu et al, 2025). Workplace bullying and incivility is a multifaceted concepts characterized by a range of actions and inactions in the workplace (Dapilah, 2024)

Nursing interventions for Persons with Diabetic Retinopathy in Africa and Asia: A scoping Review

Diabetic retinopathy (DR) is one of the most common and vision-threatening complications of diabetes mellitus (DM), and a leading cause of preventable blindness in adults worldwide. As global diabetes prevalence rises, the current estimate is over 500 million people with the disease, and is projected to reach 700 million by 2025 (Teo et al., 2021; Wufuer et al.,2024), and likewise, the burden of DR. Nearly one in three people with diabetes is affected with DR. DR imposes significant challenges on individuals, families, and healthcare systems alike. (Hossain et al., 2024), Despite the availability of medical interventions such as laser photocoagulation, anti-VEGF therapy, and vitrectomy, individuals often seek treatment late in the disease course. Early detection, education, awareness, and ongoing support are critical to mitigating disease progression and preserving vision. These domains are where nursing interventions are essential (Dar et al., 2023)

Attitude and perception of medical assisted suicide among health workers: a scoping review

Despite the increasing global dialogue on MAS, literature on the topic remains fragmented. In countries where MAS is legal, health workers may be provided with clear guidelines and support systems. However, in regions where it remains illegal or unregulated, healthcare professionals often operate in legal grey zones with little institutional guidance or ethical clarity. This can result in professional burnout, moral distress and inconsistencies in patient care. Different health workers engage with MAS at different points along the care range assessment of eligibility, management of medications, presence during administration and aftercare for families. These roles require deep understanding and training, which many health workers may not receive. This make it essential to synthesize the existing literature to gain a comprehensive picture of how MAS is perceived by health workers, what factors shape their attitudes and how their roles differ across systems and countries. This scoping review seeks to map and examine available evidence from the past decade (January 2015 to June 2025) concerning the attitudes and perceptions of health workers towards medical assisted suicide and clarify how these attitudes are formed, identify what ethical, cultural, legal and professional factors influence perceptions and determine the implications for practice, policy, and future research

Determinants of Contraceptive Use among Adolescents in Ghana: A systematic review

Adolescents are among the most vulnerable groups in the global reproductive health landscape (Leena & Vijayalakshmi, 2024) but their contraceptive needs remain inadequately addressed (Kantorová et al., 2021). Complications from pregnancy and childbirth are among the leading causes of death for adolescent girls aged 15–19 years worldwide (WHO, 2024). Globally, contraceptive use among adolescents lags behind that of adult women, contributing to high rates of unintended pregnancies and unsafe abortions (Bellizzi et al., 2019; Ilugbami et al., 2023). Estimates suggest that more than 200 million women of reproductive age in low- and middle-income countries had an unmet need for modern contraception, a burden that disproportionately affects adolescents (Pillai & Nagoshi, 2023). Although high-income countries have achieved reductions in adolescent fertility through access to contraception and comprehensive sexuality education (Chandra-Mouli & Akwara, 2020), disparities remain stark. In sub-Saharan Africa (SSA), adolescent fertility rates are among the highest globally, while modern contraceptive use remains among the lowest (Michael et al., 2024). Only about 20% of sexually active adolescent girls in SSA use a modern contraceptive method (Boadu, 2022). Poverty, stigma around premarital sex, and limited youth-friendly services exacerbate these gaps (Aventin et al., 2021). Sociocultural and religious norms further restrict discussion of sexuality (Challa et al., 2018), leaving many adolescents without the support needed to make informed choices. A recent systematic review of qualitative studies in SSA by Bain et al. (2021) highlighted these issues. The review reported that myths and misconceptions, stigma, financial constraints and negative provider attitudes were major barriers to contraceptive use. On the other hand, peer support, confidentiality, affordability and access were reported as motivators. However, this review combined adolescents with older youth (10–24 years), limiting its ability to capture adolescent-specific determinants. In Ghana, adolescent fertility and contraceptive use mirror regional challenges. The 2014 Ghana Demographic and Health Survey reported that 14% of adolescent girls aged 15–19 had begun childbearing, while modern contraceptive prevalence remained below 20% (GSS, GHS, and ICF, 2015). Preliminary findings from the 2022 GDHS and a UNICEF report on Ghanaian adolescents suggest slight improvements in awareness and contraceptive use, although substantial gaps in use and unmet need persist (GSS & GHS, 2022; UNICEF, 2018). Evidence from Ethiopia demonstrates the value of national-level systematic reviews. Mekonnen et al. (2022) synthesized determinants of adolescent contraceptive uptake and found that individual characteristics such as age, schooling and family income, sociocultural influences such as family communication, partner pressure and harmful traditional practices, healthcare service quality and knowledge levels all shaped contraceptive use. This review consolidated fragmented findings and provided policymakers with actionable evidence. Despite similar challenges, Ghana lacks such a synthesis. While several primary studies have examined adolescent contraceptive use in Ghana, their findings are inconsistent across populations and regions, making it difficult to develop a comprehensive national picture. The absence of a systematic review leaves policymakers and practitioners without a consolidated evidence base to guide interventions. This review addresses that gap by synthesizing available evidence on the determinants of contraceptive use among adolescents in Ghana. By consolidating existing knowledge, it aims to inform policy, strengthen youth-friendly sexual and reproductive health services, and guide future research. This systematic review seeks to address this gap by examining and synthesizing existing literature on the determinants of contraceptive use among adolescents in Ghana. By consolidating existing knowledge, it aims to inform national policies, strengthen adolescent-friendly sexual and reproductive health services and guide future research. Ultimately, the review contributes to broader global development goals, including Sustainable Development Goal (SDG) 3.7 on universal access to sexual and reproductive health-care services, SDG 5.6 on reproductive rights and gender equality, and SDG 3.1 on reducing maternal mortality. By reducing unintended adolescent pregnancies, the review also indirectly supports SDG 4 by helping keep more girls in school

Challenges and Outcomes of adolescents (10 to 19 years) hospitalisation to adult psychiatric units in sub-Saharan Africa: a scoping review protocol

Adolescence is a developmental period marked by rapid physical, psychological, and social changes. Adolescence, spanning from the ages of 10 to 19, is a developmental stage characterised by physical, psychological, and social transformation this period, individuals are particularly vulnerable to mental health disorders, which represent a substantial global burden (WHO, 2022. Globally, mental health disorders constitute a significant burden among adolescents. Approximately 8% of children and 15% of adolescents experience a mental disorder however, the majority do not seek help or receive appropriate care (WHO, 2025). In Africa, access to quality mental healthcare for adolescents is further constrained by a complex interplay of socio-economic, cultural, and infrastructural barriers (Sequeira et al., 2022). One critical and under-addressed issue within this context is the routine hospitalisation of adolescents in adult psychiatric units due to the lack of age-appropriate mental health services. This practice raises serious developmental, clinical, and ethical concerns. A situational analysis in the Western Cape, South Africa, for example, reported that adolescents as young as 13 were admitted to adult psychiatric wards settings that were inadequately equipped to meet their psychological and developmental needs, thereby exposing them to environments not designed to ensure their safety or promote their well-being (Mokitimi et al., 2022). The WHO Mental Health Atlas, (2022 reports that most African countries have fewer than 0.1 child psychiatrists per 100,000 population and lack specialised adolescent mental health units. In response to urgent psychiatric crises, adolescents are often placed in adult wards, which are typically structured around the needs of older patients with severe and chronic mental disorders ( Johnson et al., 2022). Such placements may not only hinder therapeutic progress but also contravene international human rights frameworks advocating for age-appropriate and developmentally supportive mental healthcare. The placement of adolescents in adult psychiatric facilities is associated with elevated risk of psychological trauma, reduced access to developmentally tailored therapeutic interventions, and the absence of age appropriate peer support all factors that can impede recovery and negatively impact mental health outcomes; Adolescent inpatient settings often disconnect youth from family, education, and social supports, thereby undermining recovery (Stewart et al., 2022). Although these issues are becoming more recognised, there is still a gap in research on the outcomes of adolescents being hospitalised in adult psychiatric units, especially in low- and middle-income countries. A scoping review by Swart (2022) explored outcomes for pre-adolescent children in a child-specific psychiatric unit; their findings highlighted the importance of diagnostic clarity, therapeutic support, and family involvement stress on the need for age-appropriate care. However, adolescents placed in adult wards may face unique developmental and psychosocial challenges that can negatively impact their recovery. However, there is little evidence about their experiences and outcomes in Africa. The implications of adolescent mental health extend far beyond clinical outcomes. This scoping review aims to address this gap by mapping existing evidence on the challenges and outcomes of adolescents (aged 10-19) admitted to adult psychiatric inpatient settings in Africa. This review will promote rights-based adolescent mental health services by supporting SDG 3.4 (mental health and well-being), strengthening SDG 5.2 (protection of adolescent girls), and contributing to SDG 10.2 (reduced inequalities)