University of Zambia

Lead (Pb) exposure negatively impacts fertility in both males and females, pregnancy outcomes, and child brain development. We investigated the reproductive and neurological effects of Pb exposure on male and female mice via Pb-contaminated soil for 4 weeks. Breeding was conducted after completion of exposure, in four groups; group 1 consisted of exposed dams and unexposed sires, group 2 consisted of exposed sires and unexposed dams, group 3 consisted of exposed sires and exposed dams and group 4 was the control. Generally, Pb exposure reduced observed conception rates, with a cumulative decrement observed when both males and females are exposed. Gene expression of the testes revealed oxidative stress as the cause of reduced conception rates. Neurological tests: Morris water maze and rotarod were conducted on F1 generation offspring. Maternally and paternally exposed F1 mice performed poorly in the Morris water maze when compared to the control. The severity of the neurological effects was also parent-dependent and sex-dependent. Paternal Pb exposure effects were more pronounced in female offspring. A comparison of gene expression changes of the hippocampus and prefrontal cortex showed paternal Pb-exposure resulted in more prefrontal cortex changes than in the hippocampus, a trend also recorded in the exposed sires. The pronounced effects in female offspring of paternal Pb exposure may suggest that Pb neurological effects may be X-chromosome-linked. Supplementary Information The online version contains supplementary material available at 10.1038/s41598-024-81839-4.

Background Antimicrobial stewardship programs are very essential in addressing the problem of drug-resistant infections. The WHO Access, Watch, and Reserve (AWaRe) classification of antibiotics is essential in monitoring the rational use of antibiotics. Therefore, this study evaluated the awareness of the WHO AWaRe classification of antibiotics among pharmacy professionals in Zambia. Materials and methods This cross-sectional study was conducted among 239 pharmacy professionals practicing in both private and public facilities in Zambia. A questionnaire was used to collect data which was subsequently analyzed using IBM SPSS version 23.0. Results Of the 239 participants, 63% were male and most were pharmacists employed in the public sector. This study found that 58% of the pharmacy professionals were aware of the AWaRe classification of antibiotics. Consequently, only 36% of the participants agreed that they implemented the AWaRe framework of antibiotics in their healthcare facilities. Most of the participants (74%) agreed that implementing the AWaRe tool can promote the rational use of antibiotics and 98% of the participants were willing to learn more about the AWaRe tool through training or meetings. Conclusion This study found a low awareness of the WHO AWaRe classification of antibiotics among pharmacy professionals. Our study further revealed that very few pharmacy professionals agreed that they had implemented the WHO AWaRe tool in their healthcare facilities. Hence, there is a need to strengthen antimicrobial stewardship programs by implementing the AWaRe framework and other recommended guidelines for monitoring the rational use of antibiotics.

Human LULCC is the many driver of environmental changes. Accurate and up-to-date current and predicted information on LULCC is important in land use planning and natural resource management; however, in Zambia, detailed information on LULCC is insufficient. Therefore, this study assessed the dynamics of LULC change (2000–2020) and future projections (2020–2030) for Zambia. The ESA CCI land cover maps, which have been developed from Sentinel-2 images were used in this study. This dataset has a grid spatial resolution of 300 m for the 2000, 2010 and 2020. The 31 ESA CCI Classification were reclassified into ten (10) local Classifications using the r.class module in QGIS 2.18.14. The 2000 and 2010 LULC maps were used to simulate the 2020 LULC scenario using Artificial Neural Network (Multi-layer Perception) algorithms in Modules for Land Use Change Evaluation (MOLUSCE) plugin in QGIS 2.18.14. The 2010 and 2020 maps were used to predict the 2030 LULC classes. The reference 2020 and predicted 2020 LULC maps were used to validate the model. Predicted against observed 2020 LULC map, Kappa (loc) statistic was 0.9869. The 2020 LULC patterns was successfully simulated using ANN-MLP with accuracy level of 95%. LULC classes were predicted for 2030 using the 2010–2020 calibration period. The predicted 2030 LULC types shows an increase in built-up (71.44%) and decrease in cropland (0.73%) with reference to 2020 LULC map. Dense forest (0.19%), grassland (0.85%) and bare land (1.37%) will reduce from 2020–2030. However, seasonally flooded, sparse forest, shrub land, wetland and water body will increase marginally. The largest LULC change is from forest into other LULC types. The insights from this study show that ANN-MLP can be used to predict LULCC, and that the generated information can be employed in land use planning and National Adaptation Plans at regional and national scale.

ABSTRACT Objectives The study aimed to assess the predictors of upper limb motor recovery in stroke survivors. Design Pre–posttest study design. Setting Conducted in two centres (First Level Hospital and University Teaching Hospital in Lusaka). Participants Patients living with stroke accessing physiotherapy services at the two public hospitals. A total of 52 patients were recruited at the start of the study, 6 were lost to follow- up and 46 completed the study. Intervention Conventional physiotherapy for 8 weeks (5 September 2022–28 October 2022). Primary outcome Motor function measured using a Fugl- Meyer assessment of the upper extremity. Results Analysis was conducted on 46 participants. A significant difference was observed between the level of motor function at baseline and after 8 weeks of treatment (p=0.0183). At baseline, 50% of participants had mild motor function, which improved after 8 weeks, with 69.6% having mild motor function. Stroke patients with severe motor function impairment at baseline were associated with 0.01 times likelihood of having mild motor function impairment after 8 weeks of physiotherapy treatment (AOR 0.01; 95 % CI 0.00 to 0.16; p=0.002). Conclusion The motor function of stroke patients continues to improve over time. This study demonstrated that initial upper limb motor function impairment could be used as a predictor for upper limb motor function

This paper presents two major advances in parallel assembly sequence planning (PASP) for complex systems, specifically wind turbine gearboxes. The proposed time-cost-quality PASP hybrid model (PASP-TCQ) aims to enhance efficiency, reduce costs, and improve quality by aligning optimisation parameters with real-world demands. This model is designed to optimise complex assembly processes by addressing constraints on time, cost, and quality effectively. Additionally, we introduce a particle swarm-bacteria foraging optimisation (PSBFO) algorithm that integrates the global search capability of particle swarm optimisation (PSO) with the local optimisation strengths of bacteria foraging optimisation (BFO). Integrating PSBFO into PASP-TCQ achieves significant improvements: a 17% reduction in assembly time to 100 hours, a 10% cost reduction to $94,500, and a quality index improvement to 0.93. Statistical tests, including analysis of variance (ANOVA) and tukey’s honest significant difference (HSD), confirmed the PSBFO’s superiority, with significant gains of 8.44 units over BFO and 13.02 units over PSO in objective function values (p < 0.05). Extensive simulations on a 10 MW wind turbine gearbox validate the effectiveness of the PASP-TCQ and PSBFO, demonstrating their potential to enhance efficiency and productivity in industrial assembly operations.

The interaction between basic science epilepsy researchers and clinical epileptologists is a longstanding issue. Efforts to provide opportunities for a dialogue between preclinical and clinical epilepsy professionals are crucial to reduce the knowledge gap between them and improve the translational success of neurobiology‐based research. The International League Against Epilepsy (ILAE) Research and Innovation Task Force circulated a survey to investigate the need for an update on new clinical epilepsy concepts within the basic science community. The 336 respondents included basic scientists (BS), preclinical scientists (PCSs), and/or clinical scientists (CSs). The majority of the 237 BSs/PCSs were engaged in preclinical studies in translational epilepsy research and declared translational research as a priority research interest. Fewer respondents from low‐middle‐income countries than from upper‐middle or high‐income countries (40.7% vs 65%) considered translational research a critical aspect of their research. A broad understanding of both clinical and neurobiological aspects of epilepsy was declared by 48% of BSs/PCSs; 96% of CSs declared a superficial knowledge of neurobiology of epilepsy. Most BSs/PCSs were aware that epilepsy is a complex condition that should be investigated with the help of clinical epileptologists, even though concerns were expressed on the relationship with clinicians. A focused training program on emerging clinical epileptological aspects tailored for BSs/PCSs was recommended by 81% of the participants; the majority of respondents preferred either 1‐ or 2‐week in‐presence tutoring or continuous online training coordinated by ILAE at the regional/national level. The survey also underscored the value of educational programs on neurobiology of epilepsy targeting CSs and low‐middle‐income countries (LMIC) investigators.

Introduction Antimicrobial resistance (AMR) is largely driven by the inappropriate use of antibiotics. This has been attributed to the non-prescription sale of antibiotics in retail drug outlets. Despite the rising number of retail drug outlets in Malawi, the practice of drug dispensing in private pharmacies has not been evaluated. This study therefore assessed the prevalence of non-prescription sales of antibiotics in retail drug outlets in Lilongwe, Malawi. Methods A community-based simulated client cross-sectional study was conducted in Lilongwe, Malawi from December 2023 to February 2024 using mystery shopping. Data were analyzed using IBM SPSS software version 29 using both descriptive and Analytical statistics. We computed simple proportions and conducted a hypotheses test using Chi-Square to test for Significance. Results Antibiotic dispensing practices were surveyed in 51 retail drug outlets comprising 36 retail pharmacies and 15 drugstores. 35.3% (n=18) of the drug outlets had drug dispensing done by pharmacists, 13.7% (n=7) by pharmacy technicians, 21.5% (n=11) by pharmacy assistants and 25.5% (n=15) by drug dispensers who had no pharmacy-related training. The rate of non-prescription sales of antibiotics ranged between 53% for acute diarrhoea and 92% for upper respiratory tract infections. Amoxicillin was the most dispensed antibiotic across all case scenarios. Over 50% of dispensed antibiotics were done upon recommendation of the drug dispensers in the absence of a doctor’s prescription. Furthermore, for all the dispensed antibiotics across all case scenarios, no advice was given for finishing a full course of the antibiotics. Conclusion This study found high rates of over-the-counter dispensing of antibiotics, which call for urgent and comprehensive regulatory measures to control antibiotic consumption in an urban part of Malawi that risks increased AMR. These could range from enacting stringent antibiotic dispensing policies to deploying digital systems to monitor prescription practices and community education on rational antibiotic use.

This study investigated whether silicon applied as a drench to cowpea (Vigna unguiculata L.) could complement mutation-derived resistance to cowpea aphid (Aphis craccivora Koch). Lutembwe is a cowpea variety widely grown in Zambia but is susceptible to aphids. Genotypes LT 3-8-4-1, LT 4-2-4-1 and LT 11-3-3-12 are cowpea mutants derived from Lutembwe using gamma irradiation and have been identified as having partial resistance to cowpea aphid. Silicon accumulation capacity of cowpea genotypes and aphid performance parameters including colony growth, mean relative growth rate and feeding behaviour were assessed. Where silicon was applied to plants significantly higher silicon concentrations were recorded in LT 3-8-4-1, LT 4-2-4-1, LT 11-3-3-12 and Lutembwe genotypes compared to untreated plants. Silicon application on Lutembwe resulted in slower aphid colony growth and lower mean relative growth rates compared to untreated plants. Electrical penetration graph recordings of aphid feeding on silicon-treated Lutembwe plants showed that silicon-derived aphid resistance is mediated by phloem-based resistance factors. Silicon application to LT 3-8-4-1, LT 4-2-4-1 and LT 11-3-3-12, however, did not enhance aphid resistance. This may be due to the partial resistance of mutation-derived genotypes masking any benefits from silicon application to these plants. These results indicate that silicon application or use of mutation-derived genotypes may be effective tools with which to manage aphids on cowpea, but there appears to be little benefit of combining these approaches. This has important implications for developing an integrated pest management framework for cowpea aphid.

In sub-Saharan Africa, children with severe malnutrition (SM) and HIV have substantially worse outcomes than children with SM alone, facing higher mortality risk and impaired nutritional recovery post-hospitalisation. Biological mechanisms underpinning this risk remain incompletely understood. This case-control study nested within the CHAIN cohort in Kenya, Uganda, Malawi, and Burkina Faso examined effect of HIV on six months post-discharge growth among children with SM and those at risk of malnutrition, assessed proteomic signatures associated with HIV in these children, and investigated how these systemic processes impact post-discharge growth in children with SM. Using SomaScanTM assay, 7335 human plasma proteins were quantified. Linear mixed models identified HIV-associated biological processes and their associations with post-discharge growth. Using structural equation modelling, we examined directed paths explaining how HIV influences post-discharge growth. Here, we show that at baseline, HIV is associated with lower anthropometry. Additionally, HIV is associated with protein profiles indicating increased complement activation and decreased insulin-like growth factor signalling and bone mineralisation. HIV indirectly affects post-discharge growth by influencing baseline anthropometry and modulating proteins involved in bone mineralisation and humoral immune responses. These findings suggest specific biological pathways linking HIV to poor growth, offering insights for targeted interventions in this vulnerable population.

The recent large outbreaks of Ebola virus disease in West Africa and the Democratic Republic of the Congo have highlighted the need for rapid diagnostic tests to control this disease. In this chapter, the development of immunochromatographic lateral flow assays to detect filovirus nucleoproteins is described as an example of designing rapid diagnostic tests.

IMPACT STATEMENT The study contrasts four manufacturing finance models across the study countries, making three main contributions to literature. Firstly, while extant literature presents statistical and qualitative comparisons between NICs and developing countries for policy learning, comparison of the functional models is rarely addressed, this study attempts to fill this gap. Secondly, while finance literature focuses on generic access to finance by operating firms, this study simultaneously analyses four disaggregations of access to finance, namely, working capital finance, investment finance, domestic private start-up investment and foreign private start-up investment. These distinctions help understand the respective characteristics and interrelationships among firm creation investment, and working capital and investment finance for operating firms. Lastly, the study pioneers a detailed modelling of Zambia’s manufacturing finance, a topic and context for which literature is limited.

According to the World Health Organization (WHO), tobacco use causes over 8 million deaths annually including 1.3 million due to second-hand exposure. Furthermore, data from the Tobacco Atlas show that the tobacco industry continues to target new markets in the WHO African region, one of two regions where absolute numbers of smokers continue to increase. Understanding context contributes to policy formulation and implementation ensuring relevance to a country’s political economy. Focusing on the WHO African region, this scoping review (i) maps the extent of academic research examining contextual factors on the WHO Framework Convention on Tobacco Control (WHO FCTC) national-level implementation, and (ii) reports on contextual factors impacting the WHO FCTC implementation. Using a stepwise structured approach, we conducted a search across four academic databases, yielding 10 342 articles and 42 were selected for full data extraction. Leichter’s four categories of context (situational, structural, cultural and exogenous) and the stages of heuristic policy model guided data extraction. Study findings indicated that situational contextual factors such as the burden of disease or its impact on health can push governments toward policy formulation. Structural contextual factors included political considerations, economic interests, funding, institutional congruence, strength of policy and institutional capacity as important. Cultural contextual factors included the influence of policy entrepreneurs, current social trends and public opinion. Exogenous contextual factors included the WHO FCTC, tobacco industry influence at the national-level and bi-lateral partnerships. Further understanding contextual factors affecting the WHO FCTC national implementation can strengthen policy formulation and align required support with the WHO FCTC Secretariat and other relevant bodies.

Background Rodent-borne orthohantaviruses are the causative agents of hemorrhagic fever with renal syndrome and hantavirus pulmonary syndrome. Apart from the classic rodent-borne hantaviruses, numerous species of hantaviruses have been identified in shrews and bats; however, their antigenicity and pathogenicity are unknown. This study focused on developing a serological method to detect antibodies against bat- and shrew-borne hantaviruses. Methodology/Principal findings Five bat-borne (Brno, Dakrong, Quezon, Robina, and Xuan Song) and 6 shrew-borne (Asama, Altai, Cao Bang, Nova, Seewis, and Thottapalayam) viruses were selected based on the phylogenetic differences in their N proteins. The recombinant N (rN) proteins of these viruses were expressed as antigens in Vero E6 and 293T cell lines using the pCAGGS/MCS vector. Antisera against the Nus-tagged rN fusion proteins of these viruses (mouse anti-Brno, Dakrong, Quezon, Robina, Xuan Song, Asama, Cao Bang, and Nova, while rabbit anti-Altai, Seewis and Thottapalayam) were also generated. Antigenic cross-reactivity was examined in antisera and rN-expressing Vero E6 cells. The rN proteins of almost all the tested viruses, except for the Quezon and Robina viruses, showed independent antigenicity. For serological screening of bat samples, 5 rNs of the bat-borne viruses were expressed together in a single transfection protocol. Similarly, 6 rNs of shrew-borne viruses were expressed. Reactivities of the mixed antigen system were also examined across the singly transfected Vero cell lines to ensure that all antigens were expressed. Using these antigens, bat serum samples collected from Zambia were screened using the indirect immunofluorescence antibody test (IFAT). Selected positive samples were individually tested for the respective antigens by IFAT and western blot assays using rN-expressing 293T cell lysates. Of the 1,764 bat serum samples tested, 11.4% and 17.4% were positive for bat and shrew mixed antigens, respectively. These samples showed positive reactions to the Brno, Dakrong, Quezon, Xuan Son, Robina, Asama, Altai, Cao Bang, or Thottapalayam virus antigens. Conclusions/Significance These observations suggest that the mixed-antigen screening system is useful for serological screening For Orthohantavirus infections and that bats in Zambia are likely exposed to not only bat-borne hantaviruses but also to shrew-borne hantaviruses.

Hands-on experiments and teacher-based demonstrations are two standard teaching methods in secondary school when teaching chemistry in the laboratory. The available literature on these two teaching methods focuses on students’ academic achievement. Most of this literature reports inconsistent results, and few studies examined teachers’ and students’ behaviours occurring within laboratory setting. Therefore, this study explores five hands-on experiment and five teacher-based demonstrations laboratory sessions to examine students’ and teacher’s behaviours when learning/teaching solutions and titration. Students’ and teachers’ behaviours and the nature of verbal interactions were captured every 2 minutes of the laboratory sessions using the Laboratory Observation Protocol for Undergraduate STEM (LOPUS). The results revealed that students in the hands-on experiment laboratory and their teachers engaged more frequently in interactive behaviours, such as one-on-one dialogue, than their counterparts in the teacher demonstration laboratory. The results also indicated that two types of verbal interactions, including data analysis and calculations, equations and experimental procedures, and equipment/or laboratory techniques, were most frequent in the hands-on and teacher-based demonstration laboratories. However, the hands-on experiment laboratory showed a high percentage of verbal interactions. Therefore, chemistry teachers should prioritise hands-on experiments when teaching chemistry in the laboratory.

Background Infectious disease agents of animal origin, which can cause mild to severe illnesses in humans, are increasingly spilling over into human populations. Southern Africa, particularly Zambia as a regional transport hub, has experienced notable outbreaks of zoonotic pathogens in recent years. This context underscores the importance of research, as numerous studies over the past 33 years have reported various infectious agents with differing zoonotic potential from bats, rodents, and non-human primates (NHPs) in Zambia. However, the data remained unaggregated, hampering comprehensive and organized understanding of these threats. Methods A review spanning January 1990 to December 2022 synthesised data from selected studies conducted in bats, rodents, and NHPs across 14 of Zambia’s 116 districts. Results Among the reported pathogens, viruses predominated (62%, 31/50), followed by parasites (20%, 10/50)), and bacteria (18%, 9/50). Notable pathogens included Ebola virus, Marburg virus, Hantavirus, Zika virus, Human parainfluenza virus-3, Anaplasma phagocytophilum, Borrelia faini, Coxiella burnetii, Trypanosoma brucei rhodesiense, Calodium hepaticum, and Trichinella spiralis. Most identified infectious agents came from short term cross-sectional investigations, thus, the temporal dynamics related to abundance and likelihood of outbreaks remain unknown. Conclusion The findings starkly illuminate significant zoonotic public health threats amidst glaring under-surveillance of zoonoses in humans in Zambia. This critical gap calls urgently for enhanced active, passive and syndromic surveillance activities to identify new diseases and provide evidence-based measures to safeguard public health from emerging infectious risks in Zambia and the Southern African sub-region, considering the country’s position as a regional transport hub.

Introductions The low participation of small-scale farmers in livestock markets in sub-Saharan Africa, including Zambia, is a major inhibitor to private sector investment in the livestock subsector. Despite the immense potential of the livestock industry to bolster the economic development of countries in this region, several socioeconomic, environmental, and cultural factors contribute to this hindrance. Methods This study was conducted in the Western Province of Zambia and adopted a qualitative research approach to understand the challenges and barriers affecting livestock markets among smallholder cattle farmers. In-depth interviews were conducted with 23 key informants and focus group discussions involving key actors in the dairy and beef value chains. Thematic analysis was employed to analyze the gathered data. Results Four themes, including socioeconomic, cultural, market dynamics, and policy and regulatory factors, emerged from this analysis. The sub-themes for socioeconomic factors included access to capital, infrastructure challenges, limited technical knowledge, and inadequate veterinary services. Cultural factors included traditional practices, social norms, and perceptions of livestock, and subthemes for market dynamics included price volatility, lack of market information, and middlemen exploitation. The sub-themes for policy and regulatory factors included policy inconsistencies, land tenure issues, and inadequate government support. Conclusion By identifying and understanding these factors, policymakers and stakeholders can develop effective and sustainable targeted interventions and policies to encourage smallholder cattle farmers’ participation in the livestock sector.

In Zambia, efforts to produce a tobacco control policy have stalled for over a decade, and the country is not yet close to developing one. Limited studies have explored the dynamics in this policy process and how they affect the attainment of policy goals and outcomes. This study explored how collaborative dynamics within tobacco control policy development shaped shared motivation among stakeholders in Zambia. The study used a qualitative case study design that adopted a collaborative governance lens, comprising an in-depth exploration of the tobacco control policy working group meetings and their internal collaborative dynamics. The integrative framework for collaborative governance, which identifies mutual trust, mutual understanding, internal legitimacy and shared commitment as key elements of shared motivation, was adapted for this study. Data were collected from 27 key informants and analysed using thematic analysis. Several collaborative dynamics thwarted mutual trust among tobacco control stakeholders, including concerns about associated loyalties, fear of a ban on tobacco production, silo-mentality and lack of comprehensive dialogue. All stakeholders agreed that the limited sharing of information on tobacco control and the lack of reliable local evidence on the tobacco burden hindered mutual understanding. Diverse factors hampered internal legitimacy, including sector representatives’ lack of authority and the perceived lack of contextualization of the proposed policy content. Acknowledgement of the need for multisectoral action, lack of political will from other sectors and limited local allocation of funds to the process were some of the factors that shaped shared commitment. To accelerate the development of tobacco control policies in Zambia and elsewhere, policymakers must adopt strategies founded on shared motivation that deliberately create opportunities for open discourse and respectful interactions, promote a cultural shift towards collaborative information sharing and address unequal power relations to enable shaping of appropriate tobacco control actions in respective sectors.

The published history of Zambian pre-colonial era is more prominent on how male leaders succeeded or failed in administrative roles than it is on their female counterparts. Recent attempts aimed at investigating women’s space in Zambian political history have been restricted to colonial and post-colonial eras. This tendency robs contemporary women aspiring for leadership roles of credible and insightful role models. This chapter, therefore, sought to document the seventeenth century female diplomat and traditional leader, Mwenya Mukulu’s life experiences to argue that women did not only exist in pre-colonial era but also presided as leaders over the political, religious and spiritual affairs of their respective pre-colonial communities in Northern Rhodesia, now Zambia. The chapter argues that the Lungu, Azamba, and Sao people of present day Mbala and Mpulungu Districts in Northern Province of Zambia benefited from the trajectory life experiences of Mwenya Mukulu. Though not much has been documented about her in the history of the country, Mwenya’s leadership skills played a pivotal role in the governance, religious and spiritual wellbeing of the aforesaid people and others in her control. In order to document Mwenya’s life experiences appropriately, a phenomenological qualitative approach was used. Information was gathered through desk review and an interview carried out with one purposively selected and willing participant from the Lungu chiefdom influenced by Mwenya’s leadership style. The findings were analysed qualitatively according to emerging themes. A study on Mwenya Mukulu was long overdue but worth it, as it might supplement current and scanty literature on matriarchy and its contribution to pre-colonial leadership, which has for a long time been highly patriarchal.

Background: Although Helicobacter pylori infection (H. pylori) prevalence in Africa has declined in the last decade, it remains concerningly high. H. pylori is asymptomatic in the majority of patients but is associated with significant morbidity and mortality in 10%-20%. Materials and Methods: We conducted an online survey of 21 African countries, with the link distributed to members of the African Helicobacter Microbiota Study Group. The survey was completed by 562 respondents; the majority were from Nigeria (27.2%), South Africa (18.1%), Tanzania (17.6%), Egypt (16.9%), and Cameroon (14.2%). Results: The most common reason for H. pylori testing was dyspepsia in 83.9% of the cases. Abnormal findings at gastroscopy (62.3%) and heartburn (61.7%) were also common indications. Stool antigen testing and histological examination of gastric biopsies using Giemsa were the two most used methods for H. pylori testing at 62.3% and 50.3%, respectively. Most respondents reported the use of standard clarithromycin-based triple therapy as first-line treatment for H. pylori infection. Conclusion: This survey has demonstrated the diversity of practice and resource availability within the African continent. Several international guidelines exist on the management of H. pylori, but little data is available in Africa on how this condition is managed in every day clinical practice. There is an urgent need to formulate evidence-based and locally relevant practice guidelines on the African continent. In this context, the African Helicobacter and Microbiota study group was formed to coordinate efforts across the continent on H. pylori research to provide guidance on its management. This paper, therefore, aimed to