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Maintaining a high level of adherence to antiretroviral therapy (ART) is critical to limiting rapid viral replication, drug resistance, and viral transmission. However, ART adherence remains a major challenge in HIV/AIDS treatment success. This systematic review and meta-analysis was aimed to synthesize available evidence on adherence to ART among HIV/AIDS patients in Ghana.This review followed the preferred reporting item for systematic review and meta-analysis (PRISMA) criteria. A comprehensive literature search was done using five online databases (PubMed, Google Scholar, Medline, Africa Index Medicus, and Willey Online Library) from 25th- 30th April 2023 to identify potential studies. In addition, references of related articles were manually searched to further identify relevant studies. Search records were managed in Endnote library where duplicates were removed prior to screening. Studies were eligible for inclusion if they were conducted in Ghana, designed as an observational or experimental study, and explicitly measured adherence to ART, either as a primary or secondary outcome. Studies were excluded if the proportion or prevalence of adherence to ART was not reported.A total number of 126 potential studies were identified from the literature search. Of these, 14 met the inclusion criteria and were included in the Meta-analysis. The studies involved a total number of 4,436 participants. The pooled estimate of adherence to ART was 70% (CI: 58-81%). In subgroup analysis, adolescents and young adults had a lower adherence rate (66%, CI: 46-84%) compared with adults (70%; CI: 58-81%). Publication bias was not observed among studies. The pooled estimate of optimal adherence to ART among HIV patients in Ghana was lower than is recommended (≥95%) to achieve viral suppression. Adherence was lower among young persons living with HIV/AIDS. To achieve the United Nation's Sustainable development goals and the UNAIDS "95-95-95" targets, there is a need to focus on improving adherence interventions among persons living with HIV/AIDS, especially among the younger cohort.

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BACKGROUND: The number of elderly people living with HIV (EPLHIV) has increased significantly as a result of antiretroviral treatment (ART) and this has brought about a variety of psychosocial challenges that have an impact on their quality of life (QoL). Various psychosocial interventions have been tried or implemented in Sub-Saharan Africa (SSA) to improve QoL of EPLHIV. However, there is paucity of data on the types and effectiveness of these interventions. This systematic review, therefore, aims to explore available psychosocial interventions in SSA and their effectiveness in improving the QoL of EPLHIV. METHODS: We will search PubMed, PsycINFO, LILACS, Cochrane Library, Google Scholar, HINARI, Africa Journals Online, Scopus and Web of Science to retrieve publications on psychosocial interventions implemented to improve QoL of EPLHIV from inception of the identified databases to 31st December 2023 without language restrictions. Also, supplementary sources such as conference proceedings, preprint repositories, databases of dissertations, as well as WHO and governmental databases can be explored for additional studies. For unpublished studies, trial registries and experts would be contacted, and reference lists of retrieved papers will be manually searched. Retrieved studies will be deduplicated using Mendeley and exported to Rayyan. At least two reviewers will independently select studies, extract data and assess the quality of the included studies using validated tools. Dichotomous outcomes data will be assessed and reported as odds ratio (OR) or risk ratio (RR) and for continuous outcomes, mean difference (MD) will be used; all reported with their 95% confidence interval (CI). Heterogeneity will be explored graphically by inspecting the overlapping of CIs and assessed quantitatively using the I2 statistic. EXPECTED OUTCOMES: This systematic review will be the first to rigorously identify psychosocial intervention on QoL of EPLHIV in SSA and assess their effectiveness with the aim to provide regional and country- specific data that will inform the selection and implementation of appropriate and socially acceptable policies across countries in SSA. Key findings of the review are expected to contribute critical evidence on availability, types and effectiveness of psychosocial interventions for improving quality of life of vulnerable elderly persons in SSA living with HIV. Furthermore, the review will explore any variation and possible correlates of psychosocial interventions by age, sex, CD4 count (if available), setting and geographic location within SSA that will provide healthcare professionals with reliable evidence, with the ultimate goal of inspiring countries in SSA to adopt innovative interventions to improve HIV care. TRIAL REGISTRATION: Systematic review registration: The systematic review protocol has been registered in the International Prospective Register for Systematic Reviews (PROSPERO), with registration ID CRD42021278218.

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BACKGROUND: The use of modern contraceptives (MC) in most African countries has been low despite the high fertility rate and unmet need for family planning. This study sought to determine the coverage and determinants of modern contraceptive use among women of reproductive age (15-49 years) in sub-Saharan Africa (SSA). METHODS: Data for the study were obtained from the Demographic and Health Surveys (DHS) conducted between 1995-2020 across 37 SSA countries. Women of reproductive age (15-49 years) was the unit of analysis. Analysis of data was done using STATA version 16 for windows. A bivariate Rao Scott's Chi-square test of independence was done to determine factors associated with the use of modern contraceptives. Factors that showed significance (p < 0.05) were included in a multilevel logistic regression to determine significant predictors of modern contraceptives. Clustering, stratification and sample weighting were accounted for in the analyses. RESULTS: The overall prevalence of the use of MC was found to be 22.0%. This ranged from 3.5% in the Central Africa Republic to 49.7% in Namibia. The most common type of MC used were injections (39.4%), condoms (17.5%) and implants (26.5%). Women were less likely to use modern contraceptive if they: had no education (aOR = 0.4, 95% CI 0.38-0.44), had no children (aOR = 0.27-0.42), not told of family planning at a health facility (aOR = 0.69, 95% CI 0.67-0.71), not heard of family planning in the media (aOR = 0.77, 95% CI 0.74-0.79) and being poor (aOR = 0.76, 95% CI 0.73-0.79). On the other hand, women were more likely to use modern contraceptive if they were between the age of 35-39 years (aOR = 1.69, 95% CI 0.73-0.79), married (aOR = 2.66, 95% CI 2.50-2.83), had seven or more children (aOR = 1.27, 95% CI 1.17-0.38), had knowledge of any method of contraceptives (aOR = 303.8, 95% CI 89.9-1027.5) and when field worker visited and talked about family planning (aOR = 1.53, 95% CI 1.39-0.68). CONCLUSION: The study showed a low prevalence of modern contraceptive use in sub-Saharan Africa. Findings from the study highlight the need to provide education to women to increase uptake of modern contraceptive and also re-enforce contraceptive interventions to improve women's health and well-being.

The use of modern contraceptives (MC) to protect against sexually transmitted diseases, unwanted pregnancy and mortality as a result of unsafe abortion is low in many African countries. This study sought to determine the coverage and factors associated with the use of MC among women of child-bearing age in sub-Saharan Africa (SSA). Data for the study were obtained from the Demographic and Health Surveys (DHS) conducted in 37 SSA countries. Interpretation of the data focussed on women of children bearing age (15­49 years). The overall prevalence of the use of MC was found to be 22.0%. This ranged from 3.5% in the Central Africa Republic to 49.7% in Namibia. The most common type of MC used were injections (39.4%), condoms (17.5%) and implants (26.5%). Women were less likely to use MC if they had no education, no children, were not told of family planning at a health facility, had not heard of family planning on the Television, radio, newspaper and were poor. On the other hand, women who were between 35­39 years, were married, had seven or more children, had knowledge of any method of contraceptives and had a field worker visited and talked about family planning were more likely to use modern contraceptives. The study showed a low prevalence of MC use in sub-Saharan Africa. The results from the study is important and emphasize the need to provide education to women of child-bearing age to increase uptake of MC to reduce mortality and improve on women's health and well-being.

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BACKGROUND: Sickle cell disease (SCD) is a chronic genetic blood disorder common among people of African descent, which places nutritional burden among affected individuals. The aim of the study was to determine the dietary intake and nutritional status of children with SCD. METHOD: This was a cross sectional study that involved 120 children with SCD aged 3-12 years at the paediatric outpatient department of Princess Marie Louise Hospital (PML) in Accra. A semi-structured questionnaire was used to take information on participant's demographic characteristics and clinical data were obtained from their medical records. Dietary data were obtained using 24-h dietary recall and food frequency questionnaire. Height and weight were measured for participants and their haemoglobin levels were determined to assess their anaemia status. RESULTS: Intakes of participants were below recommendations for most nutrients, particularly for calcium and antioxidant vitamins (vitamin C and E). Adequacy of nutrient intake declined with age and children with genotype HbSS had a lower tendency to meet dietary recommendations (aOR = 0.45, 95% CI: 0.18, 1.10; p = 0.084). More than a third of the study children (38%) were malnourished, with older children having a tendency to be malnourished compared to the younger ones. Children with the SS genotype were more likely to be stunted (aOR = 3.48, 95% CI: 1.10, 11.01), compared to other genotypes. CONCLUSION: Malnutrition is prevalent among children with SCD and hence there is the need to develop comprehensive management coupling nutritional therapy to medical care to improve their nutritional status. Nutritional management should focus much on calcium-rich foods and antioxidants nutrients particularly vitamin C and E to reduce rapid erythrocyte haemolysis and chronic anaemia.

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Sickle cell disease (SCD) is one of the common inherited blood disorders in humans and has been associated with decreased dietary intake which results in poor nutritional status and impaired growth. Nutrition is one of the most important but often forgotten aspect of care of patients with chronic disorders and there have been emerging concern in literature on increased nutritional needs of SCD patients. This paper sought to review the available literature on the roles of individual nutrients in the pathophysiology and management of SCD among children. Children with SCD have been shown to exhibit suboptimal status with respect to both macronutrients and micronutrients. Thus, nutrition could play an important role in the management of SCD. However, there is paucity of evidence coming from trials with large sample sizes to support the suggestion that supplementation with various nutrients that have been considered in this review will be helpful.

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