Although peridomestic space spraying is commonly applied by national dengue control programmes, there are very few studies evaluating the effectiveness of this intervention. There is no clear evidence for recommending peridomestic space spraying as a single, effective control intervention. Thus, peridomestic space spraying is more likely best applied as part of an integrated vector management strategy. The effectiveness of this intervention should be measured in terms of impact on both adult and immature mosquito populations, as well as on disease transmission.

No abstract

In areas with seasonal malaria transmission, giving antimalarial drugs to preschool children (age < 6 years) as IPTc during the malaria transmission season markedly reduces episodes of clinical malaria, including severe malaria. This benefit occurs even in areas where insecticide treated net usage is high.

No abstract

Rural areas in Africa make up a large proportion of the continent. Since the emergence of COVID-19 on the continent, major attention and responses have been placed on urban areas. Rural areas are typified by certain challenges which may serve as limitations to the provision of resources and tools for COVID-19 responses in these areas. These major challenges include limited access to these areas due to poor road networks which may hamper the possibility of conveying resources and manpower. Shortage of healthcare workforce in these areas, poor health facilities/structures and limited access to COVID-19 diagnostics services may also make containment challenging. It is therefore important that investment should be made in these areas towards providing the necessary tools, resources, and manpower to ensure effective containment of COVID-19 and to alleviate the plight caused by the pandemic in rural Africa. Rural communities in Africa should not be left behind in COVID-19 responses.

Many Sub-Saharan African countries have been known to suffer various challenges which threaten the quality of health services that are offered to the population. With the emergence of COVID-19 outbreak, it is not impossible that access to quality antenatal care services would be further threatened in the region due to the competition for limited health care resources. This paper seeks to highlight the impact of COVID-19 pandemic on antenatal healthcare services in Sub-Saharan Africa. It is imperative for all African countries to put up measures to ensure antenatal care services, which are just as important and needed, are not disrupted due to the urgent need to shift limited resources to contain the COVID-19 pandemic.

* The assumed risk is the m edian control group risk across studies. The corresponding risk (and its 95% CI) is based on the assum ed risk in the com parison group and the relative effect of the intervention (and its 95% CI). CI: Conf idence interval; RR: Risk ratio. GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our conf idence in the estim ate of ef f ect. M oderate quality: Further research is likely to have an im portant im pact on our conf idence in the estim ate of ef f ect and m ay change the estim ate. Low quality: Further research is very likely to have an im portant im pact on our conf idence in the estim ate of ef f ect and is likely to change the estim ate. Very low quality: We are very uncertain about the estim ate. 1 No serious risk of bias: Trials were variable in their risk of bias, but exclusion of the trials at high or unclear risk of selection bias did not change this result. 2 No serious inconsistency: None of the individual trials f ound statistically signif icant ef f ects, and there was no statistical heterogeneity between trials. 3 No serious indirectness: Trials were f rom West Af rica, East Af rica and one f rom India. All were in children with severe m alaria (aged under 15 years), and m ost com pared the standard dose of intram uscular artem ether with the WHO recom m ended dose of intravenous quinine. 4 Downgraded by 1 f or serious im precision: These trials, and the overall m eta-analysis are underpowered to detect a dif f erence or to prove equivalence. 5 Downgraded by 2 f or serious risk of bias: Four of the six trials were at unclear risk of selection bias. When these f our trials are excluded the result becom es non-signif icant. 6 No serious inconsistency: Statistically signif icant dif f erences were only seen in two of the six trials. However, statistical heterogeneity between trials was low and the overall m eta-analysis is statistically signif icant. 7 No serious im precision: The result is statistically signif icant and the overall m eta-analysis is adequately powered to detect this ef f ect. 8 Downgraded by 2 f or very serious im precision: These trials, and the overall m eta-analysis are underpowered to detect a dif f erence or to prove equivalence. The 95% CI is very wide and includes clinically im portant dif f erences and no ef f ect. 9 Downgraded by 1 f or serious inconsistency: The m ean dif f erence in parasite clearance tim e ranged f rom a two hour increase with artem ether to a 15 hour decrease. 10 Downgraded by 1 f or serious risk of bias: Four of the seven trials were at unclear risk of selection bias. When these f our trials are excluded the result becom es non-signif icant.

Although the previous intervention may have contributed to the good knowledge about TB and care-seeking attitudes displayed by respondents in the communities, sustaining active case finding through public-private partnership can go a long way to reduce TB burden, especially in rural communities where healthcare systems are generally weak or inadequate. Adequate funding of TB control activities is critical in eliminating TB as a public health problem, and the private sector participation such as this is a welcome development.