Luchuo Engelbert Bain

• MD, MPH, MBA, MSc Bioethics PhD
• Head of International Programs at African Population and Health Research Center APHRC

Background Post sexual-based violence (SBV) services are crucial for mitigating SBV-induced consequences. However, these services are reportedly rare and often underutilized, particularly by young women in Sub-Saharan Africa. This study aimed to explore the barriers and facilitators to accessing post-SBV services among young women (18–24 years) att...

Objective: There is evidence of geographical variation in HIV coverage and antiretroviral therapy (ART) adherence, and studies have investigated how the place of residence of people living with HIV (PLWH) influences ART adherence. Where people reside influences their access to health care. Studies on the influence of place of residence on ART adher...

With over 200 million people, 50% of Nigeria's population comprises women of reproductive age (15-49 years), making Sexual Reproductive Health and Rights (SRHR) invaluable in achieving SDGs 3 and 5 on health and well-being and gender equality, respectively. Although Nigeria's reproductive health indices have improved over the past two decades, some...

Background The one health (OH) approach, linking human, animal, and environmental health, relies on effective community engagement (CE), education, stewardship, and effective regional and global partnerships. For real impact, communities should be at the centre of research agenda setting and program implementation. This review aimed at synthesizing...

Background Stillbirth is a devastating and often avoidable adverse pregnancy outcome. Monitoring stillbirth levels and trends—in a comprehensive manner that leaves no one uncounted—is imperative for continuing progress in pregnancy loss reduction. This analysis, completed as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (G...

Objectives: In this study, the trends and current situation of the injury burden as well as attributable burden to injury risk factors at global, regional, and national levels based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 are presented. Study design: To assess the attributable burden of injury risk factors, th...

Background In Sub-Saharan Africa (SSA), there is a noticeable shift from infectious diseases to chronic non-communicable diseases (CNCDs) based on recent studies. However, other studies suggest that social support can significantly improve self-care, increase knowledge of disease symptoms, and ultimately increase overall well-being in patients with...

The current scientific publication architecture and business models are structured to privilege high-impact Western journals. This has been perpetuated in academia and by funding agencies, where a researcher´s value is often measured by the number of publications and where these papers are published. However, the current system renders journals fro...

Background Post-sexual-based violence (SBV) services are imperative when it comes to attenuating SBV-induced consequences. These services are reportedly rare, and often underutilized, most especially by young women in Sub-Saharan Africa. This study aimed to explore the barriers and facilitators in accessing post-SBV services among young women (18–2...

Status disclosure to family and friends among people living with HIV/AIDS (PLWHA) is necessary to ensure social and material support, which are important predictors of quality of life. WeexaminedHIV/AIDSstatus disclosure and its influence on quality of life (QoL) among PLWHAinaGhanaianpopulation. This was ahealth facility-based cross-sectional stud...

Men in sub-Saharan Africa are less likely to accept HIV testing and link to HIV care than women. We conducted a trial to investigate the impact of conditional financial incentives and a decision support application, called EPIC-HIV, on HIV testing and linkage to care. We report the findings of the trial process evaluation to explore whether the int...

Background Accurate assessments of current and future fertility-including overall trends and changing population age structures across countries and regions-are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to i...

This appendix provides detailed information on the methods for the paper “Global fertility in 204 countries and territories, 1950–2021 with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021”

Background Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-base...

Background Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important follow...

Background Global evaluations of the progress towards the WHO End TB Strategy 2020 interim milestones on mortality (35% reduction) and incidence (20% reduction) have not been age specific. We aimed to assess global, regional, and national-level burdens of and trends in tuberculosis and its risk factors across five separate age groups, from 1990 to...

Background Accurate assessments of current and future fertility-including overall trends and changing population age structures across countries and regions-are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to i...

Background: Global evaluations of the progress towards the WHO End TB Strategy 2020 interim milestones on mortality (35% reduction) and incidence (20% reduction) have not been age specific. We aimed to assess global, regional, and national-level burdens of and trends in tuberculosis and its risk factors across five separate age groups, from 1990 to...

Background Globally, the burden of chronic non-communicable diseases is increasing rapidly and approximately one in three of all adults suffer from multiple chronic conditions. Therapeutic communication plays a crucial role in achieving curative, preventive, and promotive goals regarding chronic disease management. We examined therapeutic communica...

Background Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of D...

Background Morbidity and mortality rates from chronic non-communicable diseases (CNCDs) are increasing globally. In Ghana, CNCDs account for 43% of all deaths. We examined the Health-Related Quality of Life (HRQoL) and associated factors among adults living with CNCDs in the Ho Municipality. Methods This was a health facility-based descriptive cro...

Background: HIV/AIDS is notorious for hindering quality of life (QoL). The availability of care and social support from family and close friends is a significant determinant of the quality of life of people living with HIV/AIDS (PLWHA) in developing countries like Ghana. Only through HIV/AIDS status disclosure can PLWHA access social and material s...

Background In the early months of 2020 as the COVID-19 pandemic took hold in Europe, there was much concern about how the pandemic would impact populations in Africa, both in terms of how the infection would interact with endemic diseases, and also with respect to the capacity for public health response. Initial case finding activities centred on u...

Background Tetanus toxoid vaccination is one of the most effective and protective measures against tetanus deaths among mothers and their newborns. We examined the prevalence and correlates of tetanus toxoid uptake among women in sub-Saharan African (SSA). Materials and methods We analysed pooled data from the Demographic and Health Surveys (DHS)...

Background The development of vaccines for SARS-CoV-2 had a major impact on the COVID-19 pandemic, protecting and vulnerable and dramatically reducing mortality and severe morbidity due to SARS-CoV-2 infection in countries where vaccine coverage was high. African countries faced various challenges in rolling out SARS-CoV-2 vaccination campaigns, wi...

Mentorship in global health is a critical determinant of equitable, sustainable and inclusive improvements in health outcomes globally. Researchers from the Global South face unique global health mentorship challenges. Some of these challenges include: limited opportunities, access to mentorship opportunities, lack of a healthy mentorship culture,...

Over 41 million people die of chronic non-communicable diseases (CNCDs) each year, accounting for 71% of all global deaths. The burden of CNCD is specifically a problem in sub-Saharan Africa (SSA) since CNCDs are largely a leading major cause of mortality in the sub-region. While the disease burden and mortality from chronic non-communicable diseas...

This review explores task shifting and task sharing in sub-Saharan African healthcare to address workforce shortages and cost-effectiveness. Task shifting allocates tasks logically, while task sharing involves more workers taking on specific duties. Challenges include supply chain issues, pay inadequacy and weak supervision. Guidelines and success...

Over 38.4 million people were living with HIV globally in 2021. The HIV continuum includes HIV testing, diagnosis, linkage to combined antiretroviral therapy (cART), and retention in care. An important innovation in the HIV care continuum is HIV self-testing. There is a paucity of evidence regarding the effectiveness of interventions aimed at linki...

The notion of professors and students working together to achieve knowledge and the idea that research should inform teaching is sacrosanct in higher education, but in reality, this has been difficult to maintain as universities have expanded. Moreover, now, there is an increasing separation of personnel into research or teaching roles. The purpose...

Introduction Retention in care is still a significant challenge in the HIV treatment cascade and varies extensively across regions, leading to poor adherence to antiretroviral therapy (ART). Several factors across different socioecological levels, such as health and community-level factors, inhibit ART adherence among people living with HIV (PLWH)...

Background: Communicable disease control has long been a focus of global health policy. There have been substantial reductions in the burden and mortality of communicable diseases among children younger than 5 years, but we know less about this burden in older children and adolescents, and it is unclear whether current programmes and policies rema...

Background Overweight parents are likelier to bear overweight babies, who are likelier to grow into overweight adults. Understanding the shared risks of being overweight between the mother-child dyad is essential for targeted life course interventions. In this study, we aimed to identify such risk factors in Cameroon. Methods We conducted secondar...

Background More than 38.4 million people were living with HIV worldwide in 2021. Sub-Saharan Africa bears two-thirds of the burden, with Nigeria having nearly two million people living with HIV (PLWH). Social support from social networks such as family and friends improve the quality of life, and reduces enacted and perceived stigma, but social sup...

Background Reducing the burden of death due to infection is an urgent global public health priority. Previous studies have estimated the number of deaths associated with drug-resistant infections and sepsis and found that infections remain a leading cause of death globally. Understanding the global burden of common bacterial pathogens (both suscept...

Background Chronic Non-Communicable Diseases (CNCDs) has become a major cause of mortality and disability globally. We explored the coping strategies adopted by CNCD patients and the roles of caregivers in the management of CNCDs in Ghana. Methods This was a qualitative study that adopted an exploratory design. The study was carried out at the Vol...

Universal Health Coverage (UHC) is considered a strategic component of the Sustainable Development Goals specifically for goal 3 which seeks to ensure healthy lives and promote well-being for all, where all individuals and communities have equal access to key promotive, preventive, curative, and rehabilitative health interventions without financial...

A full grasp of the epidemiological factors promoting transmission is necessary for responding to highly infectious diseases, which involves their control and prevention. With the recent outbreak of Marburg Virus Disease (MVD) in Equatorial Guinea, we saw the need to re-shed some technical light based on our field experiences and published literatu...

Plain English summary Pregnancy increases risk of adverse short- and long-term outcomes for adolescent mothers and their babies. Adolescent pregnancy is significantly high in Zambia. However, the risk factors are varied and in need of further review and research. Using a systematic review process, we identify the trends and factors that influence a...

Integrity and adherence to appropriate ethical standards are important elements of research. These standards are key to protecting research participants´ rights as well as ensuring the reliability and quality of research outputs. Although empirical evidence is scanty, several authors have alluded to the fact that violation of research integrity sta...

For decades now, malaria has been an important public health concern in Africa, which bears the greatest burden for the disease, affecting children and adults alike. Although a few countries (Australia, Brunei, Singapore, and Algeria, among others) have previously eliminated malaria, the World Health Organization (WHO), on June 30, 2021, declared C...

PADRE merits as an organizing framework are P= Preventing avertible outbreaks and/or epidemics, A= Ameliorating emergency response and preparedness abilities, D=Detecting threats early, R=Responding effectively and rapidly, and E=Enhancing the development of unified health security training education program. Lessons learned from health emergencies...

Introduction: meaningful community engagement is increasingly being considered the major determinant of successful research, innovation and intervention uptake. Even though there is available literature recommending community engagement in health research, there are still knowledge gaps in how communities might be best engaged in Sub-Saharan Africa...

Globalization is a reality within major pharmaceutical companies today. With an increase in the depth and scope of biomedical science research, as well as the increasing need to attract, employ and retain the best talent, effective human resource management strategies constitute a core action area for these companies to survive the scientific revol...

People living in rural areas generally experience adverse health outcomes compared to their urban counterparts. They experience a greater burden of non-communicable diseases including: diabetes, hypertension, stroke, kidney disease, and chronic obstructive pulmonary disease (COPD), have limited access to healthcare services, and experience scarcity...

Smartphones with Global Positioning System (GPS) apps offer simple and accurate tools to collect data on human mobility. However, their associated ethical challenges remain to be assessed. We used the Emanuel framework to assess the ethical concerns of using smartphone GPS to record mobility patterns of young adults in rural South Africa for a larg...

Introduction Early identification of persons living with HIV (PLWH) is crucial to institute timely treatment to prevent HIV-related morbidity and mortality. The convenience, flexibility and confidentiality of HIV self-testing enhance the acceptability of HIV testing and early detection of PLWH. However, persons who tested positive after a self-test...

Background Injectable contraceptives are the most popular method of contraception in sub-Saharan Africa (SSA), but their availability in clinical settings has been severely limited, despite the scarcity of health care providers and limited access to health facilities. WHO and USAID have endorsed the community-based distribution of injectable contra...

Background: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods:...

Background: The global burden of lower respiratory infections (LRIs) and corresponding risk factors in children older than 5 years and adults has not been studied as comprehensively as it has been in children younger than 5 years. We assessed the burden and trends of LRIs and risk factors across all age groups by sex, for 204 countries and territor...

Background We sought to examine the levels of awareness, preferences, experiences, and practices of researchers in the health and life sciences regarding research and publication ethics. Methods A questionnaire was deployed on the Google Forms to a global audience. Reminder emails and WhatsApp messages containing a brief description and a link to...

Background In the US, over 52.9 million (21%) adults lived with a mental health illness in 2020, with depression, being one of the commonest of these conditions. The World Health Organization ranks depression as the most important contributor to global disability. As frontline workers who are responsible for taking care of a myriad of patients dail...

Background Injury remains a major concern to public health in the European region. Previous iterations of the Global Burden of Disease (GBD) study showed wide variation in injury death and disability adjusted life year (DALY) rates across Europe, indicating injury inequality gaps between sub-regions and countries. The objectives of this study were...

Background Injury remains a major concern to public health in the European region. Previous iterations of the Global Burden of Disease (GBD) study showed wide variation in injury death and disability adjusted life year (DALY) rates across Europe, indicating injury inequality gaps between sub-regions and countries. The objectives of this study were...

Background Injury remains a major concern to public health in the European region. Previous iterations of the Global Burden of Disease (GBD) study showed wide variation in injury death and disability adjusted life year (DALY) rates across Europe, indicating injury inequality gaps between sub-regions and countries. The objectives of this study were...

Introduction: Meaningful community engagement (CE) is increasingly being considered the major determinant of successful research, innovation and intervention uptake. Community leaders, policy makers and funders have expressed the need to engage communities in research. CE in research empowers the host community to participate in addressing its own...

Background: Improving maternal health and achieving universal health coverage (UHC) are important expectations in the global Sustainable Development Goals (SDGs) agenda. While health insurance has been shown as effective in the utilisation of maternal healthcare, there is a paucity of literature on this relationship in sub-Saharan Africa (SSA). We...

Background: Injectable contraceptives are the most popular method of contraception in Sub-Saharan Africa (SSA), but their availability in clinical settings has been severely limited, despite scarcity of health care providers and limited access to health facilities. WHO and USAID has endorsed community-based distribution of injectable contraceptives...

Abstract Background Maternal health constitutes high priority agenda for governments across the world. Despite efforts by various governments in sub-Saharan Africa (SSA), the sub-region still records very high maternal mortality cases. Meanwhile, adequate utilization of maternal healthcare (antenatal care [ANC], skilled birth attendance [SBA], and...

The projected worst-case scenario with no interventions was that Africa could see 3.3 million deaths and 1.2 billion infections as of mid-November 2020. The place of African traditional medicine in this pandemic has been central but yet underreported and almost not carefully systematically researched as expected. The reality presented by lack of in...

Sub-Saharan Africa (SSA) has made major progress in improving access to health care over the past three decades. Despite efforts made toward achieving universal health coverage, the health systems of countries in the sub-region are inundated by a myriad of challenges that have become more virulent amid the COVID-19 pandemic. This paper discusses th...

A raft of recent commentaries has called for the “decolonization of Global Health.” “Global Health” commentators concerned with medical education, practice, research and governance would appear to agree that the status quo is grossly inequitable. They suggest that embedded power asymmetries rooted in the colonial past persist and that they are a ma...

Malaria, human immune deficiency virus (HIV) and tuberculosis (TB) are leading causes of death and public health threat to millions in Democratic Republic of Congo (DRC). The DRC is the second most malaria affected sub-Saharan African country after Nigeria, with malaria being the leading cause of death in children under 5 years (Lechthaler et al.,...

Background Disability and mortality burden of non-communicable diseases (NCDs) have risen worldwide; however, the NCD burden among adolescents remains poorly described in the EU. Methods Estimates were retrieved from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Causes of NCDs were analysed at three different levels o...

Objective We examined the national prevalence as well as the individual and contextual factors associated with maternal healthcare utilisation in Mali. Setting The study was conducted in Mali. Participants We analysed data on 6335 women aged 15–49 years from Mali’s 2018 Demographic and Health Survey. Outcome variable Maternal healthcare utilisat...

Child health services remain one of the most cost-effective strategies in reducing child mortality which is still disturbingly high in Sub-Saharan Africa (SSA). Efforts by governments and other stakeholders in response to the COVID-19 pandemic have inadvertently disrupted the provision of other essential health services including those focusing on...

Background: Injury remains a major concern to public health in the European region, particularly among adults younger than 49 years. Previous iterations of the Global Burden of Disease (GBD) study showed wide variation in injury death and disability adjusted life year (DALY) rates across Europe, indicating injury inequality gaps between sub-regions...

Background Emergency contraception (EC) is a method used to avoid pregnancy after unprotected sexual intercourse. Emergency contraceptives can reduce the risk of unintended pregnancy by up to over 95% when taken within 72 h of sexual intercourse. EC is helpful to women who have experienced method failure, incorrect use of contraceptives, raped or h...

Responding to highly infectious diseases relies on a thorough understanding of transmission epidemiology. With the recent outbreak of Marburg Virus Disease (MVD) in Guinea, we saw the need to shed some technical light based on published literature and our field experiences. We reviewed 14 previous MVD outbreaks globally. Coupled with core one - hea...

Pericardial effusion complicated by cardiac tamponade is a medical emergency. Large pericardial effusion and tamponade are rare in childhood. Tuberculosis remains a major cause of pericardial effusion in endemic areas. A 16-year-old adolescent with no significant past history was admitted to the medical unit of the Buea Regional hospital in the Sou...