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Europe–Africa collaboration: working together to strengthen health research, implementation, and equitable systems
No full textIn September 2024, key representatives from European Union (EU) directorates and agencies convened to enhance collaboration with Africa in strengthening health research, innovation, and implementation. The meeting focused on bolstering joint efforts to improve health outcomes and support wellbeing across all ages in Africa. Despite progress in addressing infectious diseases, the continent faces a dual burden with the rise of non-communicable diseases and emerging threats such as antimicrobial resistance, climate change, falsified medicines, and pandemic risks. These challenges are exacerbated by fragile health systems, rapid population growth, urbanisation, and limited access to affordable medical interventions.
To address these issues, the EU reaffirmed its commitment to working with the African Union (AU) through strategic frameworks such as the EU Global Health Strategy and the Global Gateway initiative, which prioritise health across the life course, universal health coverage, and pandemic preparedness using a One Health approach. The AU–EU Innovation Agenda further supports this vision by promoting research translation and public health as a shared priority.
Effective implementation requires a comprehensive, end-to-end approach to research and development (R&D), involving coordinated efforts between public and private sectors to build regulatory capacity, trust in medical innovation, and regional manufacturing capabilities. Through a broad range of initiatives spanning the R&D and implementation spectrum, the EU continues to play a pivotal role in supporting global health and development, particularly in advancing solutions for poverty-related diseases in Africa
Impact of cessation of caffeine citrate therapy on intermittent hypoxemia patterns among preterm infants born before 34 weeks
Full text linkIntroduction: Intermittent hypoxemia (IH) is defined as oxygen saturation (SpO2) drop ≥5% from the baseline (set at 90 s preceding the event) to a level less than 90% lasting for ≥5 s. Caffeine citrate, the standard of care for apnea of prematurity, reduces IH events. IH contributes to both short and long-term adverse neurologic outcomes. Standard patient monitors cannot detect IH events due to long averaging times.
Objective: Describe change in patterns of IH events in preterms \u3c 34 weeks before and after cessation of caffeine citrate and factors associated.
Methods: Interrupted time series study design. Data was collected from 1 December 2022 to 30 June 2023. MASIMO RAD-G oximeter was used, and analysis done using Trace software V3028 output was desaturation frequency, duration, and time. Data exported, stored, and analyzed using Excel 2016. Change in slope compared visually in two time periods interrupted at 34 weeks and objective statistical analysis done using the Student-T-test, CI 95% with p-value \u3c 0.05 considered significant.
Results: 49 patients medical records available for secondary analysis. Frequency of IH events increased from 7.94 to 40.94 events/hour (5-fold). IH events of durations lasting between 0 and 10 s, and \u3e20 s decreased by 12.3% and 6.8%, respectively, while those lasting 10–20 s increased by 17%. The mildly severe IH events decreased by nearly half, 46.9% (78.4% to 31.5%), while both the moderately severe and severe IH events increased by 17.4% (18.5%–35.9%), and 26% (6.7% to 32.7%) respectively. The time spent in hypoxemia increased by 2.3 h/week/patient, while the cumulative time in hypoxemia increased by 1.6 h/patient. Preterms exposure to ACS (antenatal corticosteroids) was associated with decrease in IH events.
Conclusion: Caffeine citrate cessation leads to worsening of IH events with increased frequency, duration, severity and cumulative time spent in hypoxemia. Exposure to ACS was associated with decrease in IH events.
Recommendation: Caffeine citrate therapy use beyond 34 weeks is likely to be beneficial especially in the context of LMIC where antenatal steroid is not always administered, and monitoring of preterm babies is suboptimal. Safe cessation of caffeine therapy requires monitoring to detect IH events
A discourse on Madina Fāzila, Virtuous State, in Muslim Thought: An overview of Jalāl-Al-Dīn Muḥammad Davānī’s Aḵlāq-e-Jalālī
Full text linkThis study focuses on Jālāl-al-Dīn Muḥammad Davānī (1426–1502) as an illustrative figure in Muslim political thought, who offered a comprehensive perspective on the characteristics of an ideal Muslim state. Drawing on Davānī’s magnum opus, Akhlaq-e-Jalālī, the study explores his ethical framework for understanding the interrelationship between the individual, the state, and society. This work remained among the most influential writings on Muslim ethics, particularly in the Indian context, and continued to shape Muslim intellectual discourseand educational curricula well into the late 20th century. Its enduring presence highlights its intellectual relevance and its capacity to inspire ongoing debates on Muslim ethics.This paper concentrates on the third section of Akhlaq-e-Jalālī, which addresses fundamental questions concerning politics, governance,statecraft, and the contested notion of the ideal state, Madina Fāzila (the virtuous city/state). Davānī outlines the constitutive elements of such a state by synthesizing Peripatetic rationalism, Illuminationist metaphysics, and Sufi ethics. Central to his political philosophy is the principle of ‘adl (justice)’which he regards as requiring morality to permeate political praxis. This morality, rooted in Islamic values and piety, necessitates ethical behavior at individual, familial, societal levels.Consequently, the core components of Davānī’s virtuous state include morally guided citizens, ethical politics, principled statecraft, and an ideal ruler whose actions are rooted in Islamic morality and who surpasses others in knowledge and understanding. Davānī’s conception of the ideal ruler closely parallels Plato’s philosopher-king, though it is reinterpreted through the framework of Islamic ethical thought. In his vision, the virtuous state is one in which morality and justice are not only interdependent but also mutually reinforcing, working together to promote happiness and well-being at both the individual and societal levels
Childhood adversities and their associations with mental disorders in the world mental health international college student surveys initiative
No full textPurpose: This study investigates associations of childhood adversities (CAs) with lifetime prevalence, 12-month prevalence, and 12-month persistence of mental disorders in a large cross-national sample of university students.
Methods: Data came from epidemiologic surveys carried out by the World Mental Health International College Student (WMH-ICS)Initiative across 18 countries (n=60,719). The web-based surveys screened for lifetime and 12-month prevalence and age-of-onset of common DSM-5 disorders (Major Depressive Disorder, Bipolar I/II Disorder, Generalized Anxiety Disorder, Panic Disorder, Posttraumatic Stress Disorder, Alcohol and Drug Use disorders, Attention-Deficit/Hyperactivity Disorder) and five types of CAs (family dysfunction, emotional abuse, physical abuse, sexual abuse, neglect). Multivariable Poisson regression models estimated associations of CA type, number, and frequency with disorders.
Results: The majority of incoming students reported exposure to at least one CA (64.9%), including 50.0 % family dysfunction, 42.2 % emotional abuse, 21.2 % physical abuse, 18.8 % neglect, and 5.0 % sexual abuse. Lifetime and 12-month disorders were significantly associated with CAs in multivariable models, although associations with disorder persistence were weaker. Population attributable risk proportions of 12-month disorders associated with CAs were in the range of 40.7–61.0 % for anxiety and mood disorders and 13.5–55.2 % for substance use disorders.
Conclusion: Six out of ten university students arrive at university having been exposed to CAs. These students have substantially higher risk of mental disorders than other students, primarily due to associations with lifetime risk rather than persistence. Given the considerable distress and impairment caused by mental disorders, these results underscore the need for primary and secondary prevention efforts
Influence of caregiver knowledge of home asthma management on health outcomes of children in low- and middle-income countries: a systematic review
No full textBackground: Low- and Middle-income Countries (LMICs) bear the highest burden of childhood asthma globally. More than 90 % of asthma-related deaths and 84 % of disability-adjusted life-years associated with childhood asthma occur in LMICs. To reduce the overall burden of childhood asthma in LMICs, concerted efforts have focused on enhancing caregiver knowledge regarding symptom management, adherence to medications, and addressing misconceptions about the disease. The overall impact of these efforts at improving the outcomes in children with asthma in LMICs is mainly unknown.
Research question: How does caregivers\u27 knowledge of home asthma management influence the health outcomes of children in LMICs? Methods PRISMA guided this systematic review. PubMed, Web of Science, and CINAHL databases were searched for original studies published between January 2014 and May 2025. Retrieved articles were imported into Covidence (https://www.covidence.org) for management. At least two researchers independently screened articles during each phase of the review. Study quality assessment tools were used to assess the quality of studies.
Results: The search yielded 1425 articles, of which 24 met the inclusion criteria. Caregivers\u27 knowledge of asthma was associated with favorable childhood asthma outcomes. More specifically, caregivers with better knowledge about the disease reported better symptom management, adherence to medication instructions, correct inhaler use technique, reduced hospital visits, and fewer rehospitalizations.
Conclusion: Good caregiver knowledge results in improved outcomes in children with asthma in LMICs.
Practice implications: Developing strategies that enhance caregivers\u27 knowledge has the potential to reduce the burden of childhood asthma in resource-limited settings
Mechanisms of interventions targeting modifiable factors for dementia risk reduction
Full text linkThe global prevalence of dementia is increasing. With no widely available and accessible treatments to halt or reverse the progression of dementia, exploring preventative strategies is critical. Lifestyle-based interventions show promise in preventing or delaying dementia onset. However, understanding the complex and multifactorial mechanisms underlying dementia, and how interventions target these pathways, is essential for developing personalized and effective strategies. In this review, we examined the current evidence of the mediating pathways in dementia risk reduction. We focused on mechanisms investigated in single-domain interventions on physical exercise, cognitive training, diet, metabolic/cardiovascular or psycho-social risk factors in line with those combined in the landmark FINGER trial. Additionally, we synthesized existing literature on mechanisms of action in multimodal interventions combining multiple lifestyle changes. Most evidence was identified in relation to neuroimaging biomarkers with positive effects for all intervention components. The evidence among fluid biomarkers of Alzheimer’s disease and related disorders (ADRD) (amyloid-beta peptide (Aβ), tau and neuroflament light chain (Nf)) vascular markers, inflammatory markers, and neurotrophies were less conclusive, though physical exercise consistently appeared to impact several of these pathways. The findings of this review underscore the potential of lifestyle-based interventions in modulating several different types of pathophysiological pathways associated with dementia. As the number of dementia cases reach epidemic proportions, a multifaceted approach is needed. We propose that the next critical step in dementia prevention/risk reduction is to refine existing intervention tools and develop an adaptive platform that integrates different lifestyle interventions tailored to individual risk profiles and needs. Understanding the underlying mechanisms and biomarkers related to modifiable risk factors will be instrumental to optimizing these intervention
The impact of undernutrition and overnutrition on early brain development
No full textIn this review, we explore the effects of malnutrition on childhood neurodevelopment. Early brain development is highly sensitive to nutritional status. Both undernutrition and overnutrition can disrupt critical neurodevelopmental processes, affecting cognition, emotional regulation, and long-term mental health. Nutrient deficiencies, such as iron, iodine, folate, and vitamin B12, have been linked to impaired brain growth and function. Similarly, excessive caloric intake can also negatively impact brain development as it may contribute to neuroinflammation and altered neurocircuitry. The effects are most pronounced during prenatal life and early childhood, with lasting consequences on academic performance, behavior, and productivity. In addition to health-related outcomes, undernutrition and overnutrition can also have significant social and financial repercussions for individuals and their communities. This review synthesizes current insights on the relationship between nutrition and brain development, explores specific nutrient effects, and highlights the role of public health interventions. Addressing both undernutrition and overnutrition through early and targeted action is essential for optimizing neurodevelopment and reducing the long-term societal burden of cognitive and mental health disorders. Continuous monitoring of both existing and emerging nutritional deficiencies is necessary, particularly in marginalized communities and low- and middle-income regions, where the risk of undernutrition remains high