The recent Ebola outbreak in west Africa has affected countries deeply in need of foreign aid.1 People desperately need correct information on how to prevent and treat Ebola. Despite the poverty, the increasing spread of computers, tablets, and smartphones in the region creates an opportunity for the rapid dissemination of information through the internet and social media, but there is no guarantee that this information is correct. After reports that misinformation spread by text messages led to deaths, 2 3 we checked the quality of Ebola related information on Twitter.We used the Twitter search engine to collect all tweets in English with the terms "Ebola" and "prevention" or "cure" from Guinea, Liberia, and Nigeria during 1 to 7 September 2014. We grouped them into medically correct information, medical misinformation, and other (including tweets of a spiritual nature). Most tweets and retweets contained misinformation, and misinformation had a much larger potential reach than correct information (table⇓).The most common misinformation was that Ebola might be cured by the plant ewedu or by blood transfusion (unqualified-not just from Ebola survivors). Drinking and washing in salty water were also mentioned. Among these tweets, 248 (44%) were retweeted at least once; 95 of these contained scientifically correct information (38.3%), whereas 146 contained medical misinformation (58.9%; P<0.001). Two of these tweets-"Take ewedu daily to prevent and cure Ebola LUTH doctor urges Nigerians" and "Herbal healers' claim to cure Ebola false"-were retweeted 23 and 24 times, respectively.While most erroneous tweets were left undisputed, in some cases they were corrected by a Nigerian government agency and this correction spread on Twitter three days later. Public health and government agencies in west Africa should use Twitter to spread correct information and amend misinformation on how to deal with this emergency.

Objective To review misinformation related to coronavirus disease 2019 (COVID-19) on social media during the first phase of the pandemic and to discuss ways of countering misinformation. Methods We searched PubMed®, Scopus, Embase®, PsycInfo and Google Scholar databases on 5 May 2020 and 1 June 2020 for publications related to COVID-19 and social media which dealt with misinformation and which were primary empirical studies. We followed the preferred reporting items for systematic reviews and meta-analyses and the guidelines for using a measurement tool to assess systematic reviews. Evidence quality and the risk of bias of included studies were classified using the grading of recommendations assessment, development and evaluation approach. The review is registered in the international prospective register of systematic reviews (PROSPERO; CRD42020182154). Findings We identified 22 studies for inclusion in the qualitative synthesis. The proportion of COVID-19 misinformation on social media ranged from 0.2% (413/212 846) to 28.8% (194/673) of posts. Of the 22 studies, 11 did not categorize the type of COVID-19-related misinformation, nine described specific misinformation myths and two reported sarcasm or humour related to COVID-19. Only four studies addressed the possible consequences of COVID-19-related misinformation: all reported that it led to fear or panic. Conclusion Social media play an increasingly important role in spreading both accurate information and misinformation. The findings of this review may help health-care organizations prepare their responses to subsequent phases in the COVID–19 infodemic and to future infodemics in general.

BackgroundWorldwide, about 287 000 women die each year from mostly preventable complications related to pregnancy and childbirth. A disproportionately high number of these deaths occur in sub-Saharan Africa. The Abiye (‘Safe Motherhood’) project in the Ifedore Local Government Area (LGA) of Ondo-State of Nigeria aimed at improving facility utilization and maternal health through the use of cell phones and generally improved health care services for pregnant women, including Health Rangers, renovated Health Centres, and improved means of transportation.MethodsA one-year sample of retrospective data was collected from hospital records and patients’ case files from Ifedore (the project area) and Idanre (control area) and was analyzed to determine healthcare facility utilization rates in each location. Semi-structured questionnaires were used to generate supplemental data.ResultsThe total facility utilization rate of pregnant women was significantly higher in Ifedore than in Idanre. The facility utilization rate of the primary health care centres was significantly higher in Ifedore than in Idanre. The number of recorded cases of the five major causes of maternal death in the two LGAs was not significantly different, possibly because the project was new.ConclusionsGiving cell phones to pregnant women and generally improving services could increase their utilization of the primary healthcare system.

Highlights  Liver cancer rates are increasing in Western countries, possibly due to increases in obesity, diabetes, and physical inactivity.  Previous evidence was not convincing to support an effect of physical activity on liver cancer.  We found that physical activity reduced the risk of hepatocellular carcinoma by about 45%.

Background Electronic health (eHealth) services may help people obtain information and manage their health, and they are gaining attention as technology improves, and as traditional health services are placed under increasing strain. We present findings from the first representative, large-scale, population-based study of eHealth use in Norway. Objective The objectives of this study were to examine the use of eHealth in a population above 40 years of age, the predictors of eHealth use, and the predictors of taking action following the use of these eHealth services. Methods Data were collected through a questionnaire given to participants in the seventh survey of the Tromsø Study (Tromsø 7). The study involved a representative sample of the Norwegian population aged above 40 years old. A subset of the more extensive questionnaire was explicitly related to eHealth use. Data were analyzed using logistic regression analyses. Results Approximately half (52.7%; 9752/18,497) of the respondents had used some form of eHealth services during the last year. About 58% (5624/9698) of the participants who had responded to a question about taking some type of action based on information gained from using eHealth services had done so. The variables of being a woman (OR 1.58; 95% CI 1.47-1.68), of younger age (40-49 year age group: OR 4.28, 95% CI 3.63-5.04), with a higher education (tertiary/long: OR 3.77, 95% CI 3.40-4.19), and a higher income (>1 million kr [US $100,000]: OR 2.19, 95% CI 1.77-2.70) all positively predicted the use of eHealth services. Not living with a spouse (OR 1.14, 95% CI 1.04-1.25), having seen a general practitioner (GP) in the last year (OR 1.66, 95% CI 1.53-1.80), and having had some disease (such as heart disease, cancer, asthma, etc; OR 1.29, 95% CI 1.18-1.41) also positively predicted eHealth use. Self-rated health status did not significantly influence eHealth use. Taking some action following eHealth use was predicted with the variables of being a woman (OR 1.16, 95% CI 1.07-1.27), being younger (40-49 year age group: OR 1.72, 95% CI 1.34-2.22), having a higher education (tertiary/long: OR 1.65, 95% CI 1.42-1.92), having seen a GP in the last year (OR 1.58, 95% CI 1.41-1.77), and having ever had a disease (such as heart disease, cancer or asthma; OR 1.26, 95% CI 1.14-1.39). Conclusions eHealth appears to be an essential supplement to traditional health services for those aged above 40 years old, and especially so for the more resourceful. Being a woman, being younger, having higher education, having had a disease, and having seen a GP in the last year all positively predicted using the internet to get health information and taking some action based on this information.