The lived experience of depression: a bottom-up review co-written by experts by experience and academics.

We provide here the first bottom-up review of the lived experience of depression, co-written by experts by experience and academics. First-person accounts within and outside the medical field were screened and discussed in collaborative workshops involving numerous individuals with lived experience of depression, family members and carers, representing a global network of organizations. The material was enriched by phenomenologically informed perspectives and shared with all collaborators in a cloud-based system. The subjective world of depression was characterized by an altered experience of emotions and body (feeling overwhelmed by negative emotions, unable to experience positive emotions, stuck in a heavy aching body drained of energy, detached from the mind, the body and the world); an altered experience of the self (losing sense of purpose and existential hope, mismatch between the past and the depressed self, feeling painfully incarcerated, losing control over one's thoughts, losing the capacity to act on the world; feeling numb, empty, non-existent, dead, and dreaming of death as a possible escape route); and an altered experience of time (experiencing an alteration of vital biorhythms, an overwhelming past, a stagnation of the present, and the impossibility of the future). The experience of depression in the social and cultural context was characterized by altered interpersonal experiences (struggling with communication, feeling loneliness and estrangement, perceiving stigma and stereotypes), and varied across different cultures, ethnic or racial minorities, and genders. The subjective perception of recovery varied (feeling contrasting attitudes towards recovery, recognizing recovery as a journey, recognizing one's vulnerability and the need for professional help), as did the experience of receiving pharmacotherapy, psychotherapy, and social as well as physical health interventions. These findings can inform clinical practice, research and education. This journey in the lived experience of depression can also help us to understand the nature of our own emotions and feelings, what is to believe in something, what is to hope, and what is to be a living human being.

Interventions to reduce and prevent childhood obesity in low-income and middle-income countries: a systematic review and meta-analysis.

BACKGROUND: 70% of children with obesity and overweight live in low-income and middle-income countries. Several interventions have been done to reduce the prevalence of childhood obesity and prevent incident cases. Hence, we did a systematic review and meta-analysis to determine the effectiveness of these interventions in reducing and preventing childhood obesity. METHODS: We conducted a search for randomised controlled trials and quantitative non-randomised studies published on MEDLINE, Embase, Web of Science, and PsycINFO databases between Jan 1, 2010, and Nov 1, 2022. We included interventional studies on the prevention and control of obesity in children up to age 12 years in low-income and middle-income countries. Quality appraisal was performed using Cochrane's risk-of-bias tools. We did three-level random-effects meta-analyses and explored the heterogeneity of studies included. We excluded critical risk-of-bias studies from primary analyses. We assessed the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation. FINDINGS: The search generated 12 104 studies, of which eight studies were included involving 5734 children. Six studies were based on obesity prevention, most of which targeted behavioural changes with a focus on counselling and diet, and a significant reduction in BMI was observed (standardised mean difference 2·04 [95% CI 1·01-3·08]; p<0·001). In contrast, only two studies focused on the control of childhood obesity; the overall effect of the interventions in these studies was not significant (p=0·38). The combined studies of prevention and control had a significant overall effect, with study-specific estimates ranging between 0·23 and 3·10, albeit with a high statistical heterogeneity (I2>75%). INTERPRETATION: Preventive interventions, such as behavioural change and diet modification, are more effective than control interventions in reducing and preventing childhood obesity. FUNDING: None.

The reemergence of the human monkeypox: strengthening Africa's epidemic preparedness and response system.

The reemergence of the monkeypox (MPX) virus poses a serious threat to global health security. While the first human case was reported in Democratic Republic of Congo in 1970, a recent outbreak of this disease in May 2022 has gone 'viral,' spreading to most continents and occurring in nonendemic countries. Outside Africa, there have been reports of cases of MPX in countries such as Singapore in May 2019, Israel in September 2018, UK in September 2018, among others which have been traced back to importation of infected wild rodents from Africa. The Centers for Disease Control and Prevention (CDC) recommends that the standard laboratory facility to carry out MPX tests is Biosafety Containment Level (BSL)-2 working standards if the laboratory staff has taken smallpox vaccine within the last 3 years and BSL-3 working standards if the laboratory staff has not taken the smallpox vaccine. However, African countries have a shortage of BSL laboratories. Hence, there is a need to improve the integrated surveillance of the MPX virus, strengthen diagnostic capacity, capacity building of health workforce, public education programs, fund research, and development, among others. Leveraging a 'One Health' approach will offer fresh insight into the human-animal-environment interface and boost the understanding on the possibility and mechanisms of spillback and reverse zoonosis as well as disease severity and risk factors for severe disease as well as its epidemiology in various subpopulations. Not leaving Africa behind in the prevention, diagnosis, and management of MPX is important to stopping the spread and reemergence of this virus.

"Watching my family being killed by terrorists made me really depressed": Mental health experiences, challenges and needed support of young internally displaced persons in northern Nigeria.

Background: Over 3.9 million people have been displaced in Nigeria as a result of the over one-decade-long Boko Haram insurgency and about 2.1 million of this population are internally displaced within the country. Young internally displaced persons (IDPs) are at higher risk of mental illness such as depression, anxiety, post-traumatic stress disorder (PTSD) among others, however, there are sparse studies on this population. Therefore, this study explored the mental health experiences, challenges, and needed support for young internally displaced persons in Durumi and New Kuchingoro Internally Displaced Persons Camps in Nigeria. Methods: This qualitative study was conducted among young IDPs in Durumi and New Kuchingoro IDP camps in Northern Nigeria. Fourteen (14) focus group discussions comprising 89 participants and 30 in-depth interviews with 30 participants were conducted with young IDPs. The interviews were in Hausa and Pidgin English, audio-recorded, transcribed, translated into English, and applied thematic analysis was done using MAXQDA Analytics Pro 2020. Results: A total of 89 participants consisting of 47 males and 42 females participated in the FGDs and IDIs. Five key themes emerged from the FGDs and IDI: (1) knowledge about mental health, (2) mental Health Experiences, (3) coping strategies, (4) availability of mental health and other health Support, and (5) needed support. Young IDPs had fair knowledge about mental healthcare. Participants reported their experience before displacement as being peaceful with members of the family together in a good environment while they experienced stress, trauma, shock, sadness, and symptoms of anxiety, depression, and PTSD during and post displacement. Personal coping strategies such as listening to music, engaging in sports, reading books, farming, and other economic activities were reported by participants. Participants reported the absence of structured and specialized mental health support in the IDP camps and solicited mental health, physical health, economic and educational support. Conclusion: Young IDPs had negative experiences that led to symptoms of mental health disorders such as depression, anxiety disorders, PTSD among others with little or no access to quality mental healthcare. Hence, they require specialized and structured mental health support to lead healthy and productive lives. Policy and programs aimed at increasing access to mental health information and services for forced migrants are recommended.

Lessons from the coronavirus disease 2019 (COVID-19) pandemic response in China, Italy, and the U.S.: a guide for Africa and low- and middle-income countries.

Africa can be "left behind" after other advanced continents recover from the coronavirus disease 2019 (COVID-19) pandemic as reflected by the global pandemic of HIV/AIDS. In this paper, we summarize potentially adaptable, effective and innovative strategies from China, Italy, and the U.S. The purpose is to help African countries with weaker healthcare systems better respond to the COVID-19 pandemic. China, being the first to report COVID-19 infection swiftly swung into anti-epidemic actions by the use of innovative risk communication and epidemic containment strategies. Italy and U.S., the next rapidly hit countries after China, however, experienced sustained infections and deaths due to delayed and ineffective response. Many African countries responded poorly to the COVID-19 pandemic as evidenced by the limited capacity for public health surveillance, poor leadership, low education and socioeconomic status, among others. Experience from China, Italy and U.S. suggests that a better response to the COVID-19 pandemic in Africa needs a strong public health leadership, proactive strategies, innovative risk communication about the pandemic, massive tests and isolation, and scaling-up community engagement. Lastly, African countries must collaborate with other countries to facilitate real-time information and experience exchange with other countries to avoid being left behind.

COVID-19: Learning from the HIV/AIDS pandemic response in Africa.

About 74.9 million persons were infected during the human immunodeficiency virus/acquired immunodeficiency syndrome HIV/AIDS global pandemic with nearly half of them succumbing to the disease. In 2018 alone, Africa recorded over 400,000 AIDS-related deaths which is more than half of the global total. This reflects years of inequality in the global pandemic response. Also, the international response to AIDS in the early years was very slow, with a global programme only developed 6 years into the pandemic. Many African countries still lack pandemic preparedness plans to handle a global pandemic. Thus, this paper highlights the important lessons that can be learnt from the response to the AIDS pandemic and recommends how they can be applied during the coronavirus disease 2019 (COVID-19) pandemic. Some of the important lessons include: HIV reversed the previous success recorded in health systems of developing countries; the antiretroviral drug development process was prolonged and required long term commitment; and primary healthcare was crucial in preventing and controlling the disease. These lessons can be utilised in the fight against COVID-19 pandemic. It is recommended that: there should be solidarity among the nations of the world to fight COVID-19; health authorities should be proactive in curbing misinformation; and interventions should prioritise human rights and focus on vulnerable communities. HIV treatment services should not be discontinued as it is still an ongoing pandemic. A balance needs to be achieved in combating both pandemics as discontinuation of HIV treatment during the coronavirus pandemic could result in more than 500,000 deaths.

Global fund: Analyzing 10 Years of bridging health inequalities.

The Global Fund is a non-profit organization founded by Bill Gates, Melinda Gates, Kofi Annan, Amir Attaran, and Jeffrey Sachs on the 28th January, 2002. Each year, about US$ 4 billion is invested to support programs and organizations led by local experts in various communities towards developing strategies and ways in which these three (HIV/AIDS, Malaria and Tuberculosis) diseases could be fought. The Global Fund has supported various innovative strategies used in tackling these infectious diseases. It is also worthy of note that 38 million lives have been saved through the Global Funds Partnership resulting in a 50% decline in mortality rate caused by tuberculosis, AIDS and Malaria in these reached countries. However, the Global Fund is not without its challenges as there has been lack of fund commitment from the G8 countries who instituted the idea in the first place. Another limitation being experienced is the poor risk management that has resulted in discrepancies of over US$4 million discovered in the Global Fund grants received by Nigeria as of 2016. This study discusses the current state of the Global Fund and suggests recommendations to policymakers that could be instrumental in strengthening health systems and achieving increased impact.

Head and neck cancer awareness: a survey of young people in international communities.

INTRODUCTION: Head and neck cancer (HNC) is killing young people yearly. The knowledge of HNC risk factors and its symptoms among this population group may go a long way in HNC prevention among them. This study aims to: determine the level of awareness of HNC; determine the prevalence of HNC risk factors; and explore the knowledge of HNC risk factors, HNC symptoms, as well as family history of HNC among youth in the international communities (with focus on the Canadian and Nigerian youth). METHODS: A sample of 801 youth were surveyed using an e-questionnaire. The questionnaire obtained information from each participant about their: socio-demographic information; knowledge of HNC, its risk factors, and its manifestations; and family history of HNC. Data obtained from the participants were analyzed using the Statistical Analysis Software (SAS Version 9.4 for Windows). RESULTS: The majority (73%) of the surveyed youth (n=801) were residing in Nigeria, seven-tenths of them were between the age 18 and 24 years, and 53% were females. Less than 10% had a history of smoking, 7% were active smokers, and 24% had history of oral sex (of which 57% (108/109) of them had a lifetime history of more than one oral sexual partner). Around half (51%) of the participants had never heard of HNC before. Only 4% knew of a family member who had suffered/is suffering from HNC. Half of the participants were not sure whether HNC can manifest without initial complaint, pain, or symptoms. Only 9% of the participants erroneously believed that HNC is a contagious disease. Comparative analyses among subgroups revealed that a higher proportion of those participants who were: from Canada; young adults; and males generally knew about HNC when compared with the proportions recorded among those in the adolescents; females, and Nigerian participants' categories. Lastly, 76% of the participants showed interest in knowing more about HNC. CONCLUSION: The majority of the surveyed youth demonstrated poor knowledge of HNC. Also, a significant proportion of them are at risk of developing HNC disease in future, if they keep indulging in HNC risky behaviors. There exists the need to conduct community health education programs on HNC among youth in these surveyed communities.