Twenty years of African Health Sciences as infections continue to plague our continent

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In this September 2020 issue of African Health Sciences, we celebrate 20 years of existence since pioneering AHS in August 2001. Due to Covid-19, the celebrations are still pending, but we are proud to have survived infancy and adolescence: very difficult periods for people and journals! Talking of human existence, we publish two obituaries of eminent paediatricians who have greatly influenced paediatric practice in Africa: Elizabeth Hillman from Canada 1 and Peter Kazembe from Malawi. 2 . They greatly influenced the approach to child health and clinical epidemiology in Africa and we mourn their loss. In this issue, we have selected a number of papers on diverse topics.

Infectious diseases:
HIV: We have papers on the co-existence of Herpes simplex virus type 2 and two other oncoviruses and cervical lesions in women living with HIV in Nigeria 3 . The authors contend that the high prevalence of SIL in HIV+ women could be associated with viral co-infection. A seminal paper from Gabon 4 asserts that the "prevalence of intestinal parasites was higher in HIV seronegative participants but polyparasitism was more frequent in PLHIV. Keeping with HIV and coinfections. Nigeria scientists 5 report on the contributions of malaria, helminths, HIV and iron deficiency to anaemia in pregnant women attending an ante-natal clinic. They conclude that malaria and HIV predispose to anaemia more than iron deficiency. They recommend that, even though pregnant women are dewormed and given IPTp for helminths and malaria, there should be complementary routine malaria screening at ANC visits for those with HCT values <33% and those infected with HIV.
From Cameroon we have work on antibiotic susceptibility among HIV-seropositive patients attending a regional hospital 6 . Work from Uganda's remote Kara-moja region gives us a glimpse into capacity assessment for provision of quality sexual reproductive health and HIV-integrated services 7 . Ghanain workers 8 report on knowledge, attitudes and prevention practices regarding HIV/AIDS among barbers in Ho municipality); while from Nigeria we have an evaluation of the effect of an educational intervention on knowledge and adherence to HIV guidelines among frontline health workers 9 .

Bacterial infection
There are several papers on bacterial infections. We have a bench guide on the review of phenotypic assays for detection of extended-spectrum β-lactamases and carbapenemases 10 ; and a report on vancomycin intermediate resistant Staphylococcus aureus in the nasal cavity of symptomatic individuals 11 . Its followed by an evaluation of Stenotrophomonas maltophilia infections in a university hospital 12 ; bacterial meningitis in Tunisian children 13 , and "unnecessary antimicrobial prescriptions for upper respiratory tract infections in children in South Africa 14 . Other infections: From Pakistan 15 we have a report on the detection, quantification and genotype distribution of hepatitis C virus(HCV) patients by real-time PCR); while from Saudi Arabia we have a paper on haemorrhagic fever as a challenge to public health, effective management and future considerations. 16 From India 17 we bring you a short communication on COVID-19: Strengthening risk communication and community engagement for the containment of the Corona Virus Disease 2019 outbreak; while from Greece 18 we have an interesting historical letter on Dengue fever in the Corpus Hippocraticum! Back home, there is an interesting paper on "rodents as potential hosts and reservoirs of parasites along the edge of a Central African forest: Bwindi impenetrable national park, South Western Uganda. 19 The final paper in this series on infectious diseases is from Iran. 20 Their scientists report on the "distribution and molecular analysis of Blastocystis subtypes from gastrointestinal symptomatic and asymptomatic patients." Sexual and reproductive health: In this section we have a number of interesting papers. The first one is from Ethiopia 21 . It reports on "determinants of early marriage among female children in Amhara Region". They assert that "education level, family monthly income, residence, literacy level and knowledge of legal marital matters, were the main determinants of early marriage." From south central Uganda 22 we have a paper on "Socio-demographic predictors of gender inequality among heterosexual couples expecting a child". They found "that 31.1% of men had high acceptance of IPV, and 15.9% of women had low decision-making power. Predictors of gender equality included: religion, education, HIV status, age, and marital status. From Nigeria 23 we have a paper on "medication use among pregnant women at a secondary health institution: utilisation patterns and predictors of quantity", and from Turkey 24 we have a paper on "the effects of adverse childhood experiences on pregnancy-related anxiety and acceptance of motherhood role." We continue the reproductive health theme with a paper on "anaesthesia for caesarean section and failure rate" in Botswana 25 ; and one on "hazards of conducting induction of labour in high-risk pregnancies at district hospitals in low-and middle-income countries'' 26 . We have a seminal paper on "mental and personality disorders in infertile women with polycystic ovary' 27 .

Non-communicable diseases (NCDs)
Neoplasms: This section is diverse but with very interesting papers. Hence we have a paper on the "Epidemiology and survival analyses of 333 adult glioma patients from Eastern Algeria 28 ; "Prostate hyperplasia in St Mary's Hospital Lacor: utility of prostate specific antigen in screening for prostate malignancy 29 ; and "Frequency of IL-10+CD19+ B cells in patients with prostate cancer compared to patients with benign prostatic hyperplasia;" 30 and one on breast cancer and the p53 gene. 31 Continuing with the cancer theme: We have a seminal paper on "Detection of miR-1246, miR-23a and miR-451 in sera of colorectal carcinoma patients: a case-control study in Cairo University hospital;" 32 and "Effects of miR-489 targeting on SOX4 gene on proliferation and apoptosis of human hepatocellular carcinoma cells" 33 . The molecular biology subtheme continues with an Iranian paper on the "Association of Rs61764370 polymorphism within let-7 microRNA-binding site with lung cancer 34 ".

Now to sickle cell anaemia and leukaemia:
Nigerian authors 35 report a case series on "Acute leukaemia in sickle cell disease patients in a tertiary health facility." We end this section with a paper on: "Telepathological evaluation of paediatric histological specimens in support of a hospital in Tanzania" 36 . Quite appropriate because resources and capacity are limited but not innovation! Now to diabetes mellitus: From Kenya and the USA we have a description of "a quality improvement project to improve diabetes self-management and patient satisfaction in a low-resourced central Kenyan hospital" 37 Saudi scientists 38 describe how "weight reduction ameliorates inflammatory cytokines, adipocytokines and endothelial dysfunction biomarkers among patients with type 2 diabetes." And from Morocco 39 we a paper on: "anti-GAD and anti-IA2 autoantibodies by ELISA test in a series of Moroccan paediatric patients with type 1 diabetes." Tackling a social angle of diabetes, a paper from South Africa 40 documents "socio-demographic and modifiable risk factors of diabetes and hypertension among resource constrained patients from rural areas in Mdantsane Township." While Ghanain rsearchers 41 write for us on "adherence to drug therapy among hypertensive patients attending two district hospitals," Chinese workers 42 describe the "association of apoE gene polymorphisms with lipid metabolism in renal diseases." The paper on "Nephroprotective effect of methanol extract of Moringa oleifera leaves on acute kidney injury induced by ischemia-reperfusion in rats" 43 epitomises ethnopharmacological studies; and ends this section on NCDs.
But perhaps studies on alcohol use are more needed than ever before given the pandemic of substance abuse on our continent. Hence a systematic review on "effective school-based preventive interventions for alcohol use in Africa" 44 is timely. Still with the alcohol theme, work from Uganda 45 reports on "physical activity participation is associated with higher quality of life scores in men with alcohol use disorders".
And now to more mental health papers: They are on "depression among medical students in Alexandria, ii African Health Sciences Vol 20 Issue 3, September, 2020 Egypt;" 46 "the relationship between life events with psychosocial competence of students in selected secondary schools in Northern and Central Uganda;" 47 and one on "test-retest reliability and correlates of the Simple Physical Activity Questionnaire in Ugandan out-patients with psychosis". 48 We have several papers on GIT disorders, such as "Peptic ulcer disease in Port Harcourt metropolis, Nigeria" 49 ; and "evaluating IL-23/IL-17 axis in adult patients with gastritis" 50 ; and "clinical predictors and outcome of bowel resection in paediatric intussusception." 51 Outlier? No. Look at this one on "factors associated with discrepancies between poor dyspnea perception and abnormal lung function in 65 asthmatic patients." 52 What about this one on "household and individual risk factors of anaemia among under-5 children in Lesotho." 53 ? Maybe a touch many others would call the icing on the cake: "Improving healthcare: a guide to roll-out best practices; 54 and end with "Magnetic resonance imaging in chronic headache: our experiences and perspectives." 55 A very rich selection, as we struggle to push African publishing to greater heights!