Agricultural and agri-food systems generate substantial side-streams containing carbohydrates, proteins, lipids, minerals, fibre, and other valuable components that often remain underutilised or discarded. The yellow mealworm, Tenebrio molitor, offers an opportunity to convert selected side-streams into insect biomass and nutrient-rich frass, thereby linking resource recovery with food, feed, and crop production. This narrative review synthesises a practical circular sequence in which side-streams are characterised and screened for safety, formulated as mealworm substrates, converted into insect biomass and frass, processed into food or feed products, and returned to agriculture through frass-based soil and crop applications. The review examines how nutrient balance, moisture, fibre, digestibility, palatability, inclusion level, and contaminants influence larval performance, biomass quality, and product safety. It further evaluates mealworm-derived products and the effects of frass on soil nutrient availability, microbial activity, and crop performance. The central contribution is a connected side-stream-to-crop framework showing how mealworm biomass and frass can be managed as complementary outputs within one circular agricultural pathway. Evidence from Africa, including Kenya, remains limited, highlighting the need for locally validated substrates, safety standards, field evaluation of frass, whole-chain economic assessment, and enabling markets. Read more

The digital revolution has fundamentally transformed childhood experience across the globe. In Ghana, rapid mobile internet penetration, the proliferation of low-cost smartphones, and COVID-19-induced remote learning have dramatically intensified basic school children's exposure to digital screens. Emerging evidence links digital screen addiction (DSA) to significant impairments in children's psychological well-being encompassing emotional, cognitive, social, and behavioural dimensions. Yet, school management responses in Ghanaian basic schools remain underdeveloped and largely uncoordinated. This narrative literature review synthesizes global and sub-Saharan African evidence on digital screen addiction and its psychological well-being consequences among basic school children (ages 5–15), critically examines existing school management frameworks, and proposes a School-Based Digital Wellness Management Framework (SBDWMF) for Ghanaian basic schools. A narrative synthesis approach was employed. Literature was sourced from PubMed, Google Scholar, Scopus, PsycINFO, African Journals Online (AJOL), and grey literature from the WHO, UNESCO, UNICEF, Ghana Education Service (GES), Ghana Health Service (GHS), and the Ministry of Education. Peer-reviewed empirical studies, systematic reviews, meta-analyses, and policy documents published from 2010 to 2024 were included, with a total of 72 sources forming the evidence base. DSA is prevalent among basic school-age children globally, with pooled prevalence estimates ranging from 19% to 38% depending on measurement tools and contexts. Excessive screen exposure is consistently associated with psychological distress, anxiety, depression, attentional difficulties, emotional dysregulation, impaired self-esteem, peer-relationship deficits, and poor academic well-being. In Ghana, contextual risk amplifiers, including parental digital literacy gaps, absent school mental health services, post-COVID normalization of extended screen use, and fragmented policy, compound the psychological burden. School management frameworks in Ghanaian basic schools are largely inadequate to address DSA, with critical deficits in policy, counselling capacity, teacher training, and parental engagement. DSA poses a mounting psychological well-being challenge for Ghanaian basic school children, demanding an urgent, evidence-informed school management response. The proposed six-pillar SBDWMF offers a practical governance architecture for Ghanaian basic school heads, district education officers, and national policymakers to address DSA comprehensively within the school setting. Read more

Although there is a significant gap in universal health coverage (UHC) in Sub-Saharan Africa, it is unclear how much of the region's current health resources could be used to increase service coverage through increased efficiency. An output-oriented variable-returns-to-scale data envelopment analysis (DEA) was estimated at a 2022 benchmark of 46 countries using an unbalanced panel of 48 Sub-Saharan African countries (2000-2023) without imputed values. Smoothed bootstrap bias correction was then applied (1,000 replications) which founded structural correlates using truncated-bootstrap regression, and cross-checked the frontier using scale-efficiency, jackknife, governance-PCA, stochastic-frontier, matched-year, and two-way fixed-effects analyzes. The average UHC service coverage was 40.33. The mean country-specific corrected radial output-expansion potential was 21.8%, and the bias-corrected efficiency was 0.834 as opposed to a traditional 0.889. Efficiency varied not by income (p=0.488) but by financing mode (external 0.884, government 0.863, private/out-of-pocket 0.784; p=0.005). Lower inefficiency was linked to government health spending as a percentage of the government budget (-0.152; 95% bootstrap CI -0.330 to -0.008). The stochastic-frontier cross-check yielded a mean efficiency of 0.858 with significant concordance with DEA rankings (ρ=0.651; p<0.001), and efficiency was stable between matched 2018 and 2022 countries (Wilcoxon p=0.318; Spearman ρ=0.752). In conclusion, the estimated efficiency opportunity is larger after bias correction. Efficient systems are distinguished from inefficient ones by institutional capacity, operating scale, and financing architecture rather than just revenue. UHC service coverage could be increased without solely depending on new funding by lowering point-of-service payments, bolstering domestic pooled financing, enhancing public budget allocation, and investing in health-data systems. Read more

Health education is an important component of chronic disease management, yet evidence on its relationship with self-management among patients with hypertension, diabetes mellitus, and hypertension–diabetes comorbidity remains limited in Nigerian tertiary-care settings. This study assessed the association between health education exposure and self-management practices among adults with hypertension, diabetes, and comorbid hypertension and diabetes attending Rivers State University Teaching Hospital (RSUTH), Port Harcourt. A hospital-based cross-sectional analytical study was conducted among 400 adults, comprising 150 with hypertension only, 90 with diabetes only, and 160 with comorbidity. Data were collected using a structured interviewer-administered questionnaire. Health education exposure was assessed according to the number of relevant disease-management topics received during the preceding six months, while self-management was classified as good or poor according to the study scoring criteria. Descriptive statistics, Pearson chi-square tests, linear-by-linear association tests, binary logistic regression, and propensity score matching were performed. Overall, 286 (71.5%) respondents reported health education exposure during the preceding six months. Good self-management was reported by 42 (28.0%) respondents with hypertension only, 25 (27.8%) with diabetes only, and 44 (27.5%) with comorbidity. Higher health education exposure was significantly associated with good self-management in all three disease groups. In adjusted analyses, high exposure remained associated with good self-management among respondents with hypertension only (AOR = 5.56, 95% CI: 1.72–17.98), diabetes only (AOR = 10.12, 95% CI: 1.98–51.72), and comorbidity (AOR = 6.68, 95% CI: 2.12–21.04). Propensity score matching also showed positive adjusted differences in the probability of good self-management between the higher-exposure and low-exposure groups. Because the study was cross-sectional, these estimates indicate association rather than definitive causation. Structured, comprehensive, and continuous health education should be strengthened within routine chronic disease care. Read more

The surge in demand for lithium, driven by the transition to renewable energy sources and the rise of electric vehicles (EVs), underscores its critical role in modern technology. However, the environmental ramifications of lithium mining present significant challenges. This comprehensive review examines the environmental impacts of lithium extraction on ecosystems, water resources, air quality, and local communities, offering a balanced view of its benefits and drawbacks. Despite its crucial role in green technologies, lithium mining has notable environmental costs, including water depletion, habitat destruction, soil erosion, air pollution, and chemical contamination. Water resources are heavily impacted, particularly by brine extraction, which consumes substantial quantities of water, exacerbating local water scarcity in arid regions like Chile's Atacama Desert. In addition, lithium extraction contributes to water pollution through the release of hazardous chemicals. Land degradation, resulting from habitat destruction and soil erosion, further threatens biodiversity and disrupts ecosystems. Air quality is compromised by the release of dust particles and toxic chemicals that poses health risks to mine workers and nearby communities. Moreover, chemical pollution from acid drainage and heavy metal release presents severe environmental and health risks. Socio-economic impacts, including community displacement and conflicts over water resources, are significant. Indigenous communities in the "Lithium Triangle" and other regions face disruptions to their traditional ways of life and livelihoods due to mining activities. Mitigation measures are essential to address environmental and socio-economic impacts of lithium mining. Key strategies include advanced water management, sustainable mining practices, strict regulation, community involvement, enhanced battery recycling, and investing in alternative energy storage materials. Balancing lithium's benefits for renewable energy and EVs with environmental protection requires understanding these impacts and adopting sustainable practices and technological innovations. Read more

Groundwater contamination from petroleum filling station (PFS) activities poses an increasing environmental and public health challenge in rapidly urbanizing regions where groundwater constitutes a major source of domestic water supply. Existing groundwater risk assessment approaches primarily focus on hydrogeological vulnerability or water quality and often overlook the influence of community behavioural factors on human exposure. This study developed and evaluated an Integrated Groundwater Health Risk (IGHR) Decision-Support Model that combines hydrogeological, environmental, and Knowledge Attitude Practice (KAP) indicators to predict groundwater-related health risks in Abeokuta Urban, Ogun State, Nigeria. A mixed-methods approach was adopted, comprising hydrogeological assessment, groundwater quality analysis, household surveys, Geographic Information System (GIS)-based spatial analysis, and statistical modelling, to sample a total of 187 geo-referenced groundwater sources surrounding 19 PFS transects alongside 374 household respondents spatially linked at a 2:1 sampling ratio. Significant spatial variability was observed across physicochemical parameters (pH, EC, TDS, BOD, COD, Cl⁻, NO₃⁻; p < 0.001). Heavy metals (Pb, Cd, Cr, Ni, As, V, Ba) differed significantly across vulnerability classes (p < 0.001), with Lead (29.4%) and Cadmium (33.2%) frequently exceeding WHO drinking water guidelines. Household surveys revealed moderate knowledge (41.9%) and positive attitudes (56.1%) but poor protective practices (37.4%), with regression analysis confirming that attitudinal disposition and education significantly drive water protection practices (R² = 0.285, p < 0.001). The IGHR Decision-Support Model integrated the normalized sub-indices using a weighted additive structure: IGHRI = 0.20(HVRIN) + 0.30(WQIN) + 0.35(HMIN) + 0.15(1 - KAPIN). Using site-wide sub-index mean values HVRIN (0.233), WQIN (0.366), HMIN (0.482), and KAPIN (0.438), the composite index yielded an overall score of 0.4094. The Heavy Metal Index represented the largest weighted contributor (0.1687) to the composite score. Based on equal-interval threshold boundaries (0.401–0.600), the study area is categorized as Moderate Risk, indicating a need for continuous water quality surveillance and targeted community risk communication. Spatial hotspot analysis identified elevated risks down-gradient of PFSs where hydrogeological vulnerability, heavy metal accumulation, and behavioral deficits converged. Model validation against USEPA Non-Carcinogenic Hazard Index scores demonstrated strong spatial predictive accuracy (ROC-AUC = 0.824, p < 0.001). Conclusively, the IGHR model offers a practical spatial decision-support tool for groundwater protection and public health management in petroleum-impacted urban environments. Read more

Background: Postpartum depression (PPD) is a major public health issue affecting maternal and child health globally, particularly in low- and middle-income countries. Despite its high burden, the use of effective coping strategies for managing PPD remains limited. Aim: This study assessed the prevalence of PPD and the coping strategies among women of reproductive age in Ado-Ekiti, Ekiti State. Methods: A descriptive cross-sectional study was conducted among 150 pregnant women with previous childbirth experience in a selected primary Health Centre, Ado-Ekiti, Southwestern Nigeria, using consecutive sampling. Data were collected using a structured questionnaire, the Edinburgh Postnatal Depression Scale (EPDS) developed by Cox et al, and the Ways of Coping Questionnaire developed by Lazarus and Folkway. Data were analyzed using descriptive statistics and interpretive analysis of coping patterns. Results: Participants were predominantly aged 25-29 years (34.9%) and married (76.0%), with most having a tertiary education (78.7%). The mean EPDS score was 16.4 , indicating that a substantial proportion of respondents experienced moderate to severe postpartum depressive symptoms. High prevalence includes self-blame (62.6%), sleep disturbances (60.0%), sadness (60.0%), frequent crying (64.0%), and, notably, self-harm ideation (80.0%), representing a critical clinical concern. Coping strategies were predominantly emotion-focused, with high use of escape-avoidance (54.7%), distancing (52.0%), self-controlling (51.3%), and accepting responsibility (self-blame: 63.3%), showing a reliance on internalized, potentially maladaptive coping mechanisms. However, seeking social support (60.0%) and positive reappraisal (52.0%) reflected some adaptive coping capacity. Conclusion: The study reveals a high burden of postpartum depression alongside a mixed coping profile dominated by maladaptive strategies. The presence of self-harm ideas and avoidance-based coping underscore the need for urgent routine screening, early identification, and integration of mental health services into maternal care. Read more

Routine health data support decision-making only when they are accurate, complete, and available on time. This study examined the use of digital register systems (DHIS2 and eIDSR) and the associated data quality and reporting timeliness at Peripheral Health Units (PHUs) in Nongowa Chiefdom, Kenema District, Sierra Leone. A descriptive cross-sectional survey used a Yamane (1967) sample of 100 health workers from purposively selected PHUs; 96 consented and completed a structured questionnaire (96% response rate), supported by a facility record-review checklist. Data were analyzed descriptively in SPSS. The workforce was experienced and largely trained (95.8%), operating mainly within DHIS2 but entering data monthly rather than at the point of service, with 87.5% still keeping full paper registers. Respondents perceived high accuracy and completeness, driven by validation rules and mandatory fields, and rated timeliness as the strongest dimension. Dominant barriers were unreliable power and connectivity, workload, duplication, staff turnover, and training gaps. The perceived gains remain conditional on infrastructure and workforce stability. Read more

Buruli ulcer (BU) remains a neglected tropical disease that disproportionately affects populations living in rural communities with frequent exposure to aquatic environments. Despite its debilitating physical, social, and economic consequences, evidence on the health-seeking behaviour of affected individuals remains limited in many endemic areas of Nigeria. This study assessed the health-seeking behaviour of Buruli ulcer patients in rural communities with water bodies in Rivers State, Nigeria, and identified factors associated with poor health-seeking behaviour. The study employed a community-based cross-sectional design among residents of selected rural Local Government Areas with water bodies. A multistage sampling technique was used to select 405 participants, and data were collected using a structured questionnaire adapted from World Health Organization (WHO) Buruli ulcer assessment tools and the WHO Quality of Life (WHOQOL-BREF) instrument. Data were analysed using descriptive statistics and modified Poisson regression, with adjusted prevalence ratios (APR) and 95% confidence intervals (CI) used to identify factors associated with poor health-seeking behaviour. The mean age of the respondents was 38.74 ± 17.20 years. Most respondents were currently unmarried (70.86%), had secondary education (47.04%), lived in households with seven or more members (54.07%), and resided in inland communities (62.47%). Overall, 96.6% of respondents demonstrated poor health-seeking behaviour, while only 3.4% exhibited good health-seeking behaviour. Respondents who were unsure of the distance to their water source were significantly more likely to have poor health-seeking behaviour compared with those living 100–500 m from their water source (APR = 1.16; 95% CI: 1.01–1.34; p = 0.04). Furthermore, respondents who practiced Christianity were significantly less likely to have Buruli ulcer than those practicing Islam (AOR = 0.21; 95% CI: 0.09–0.49; p < 0.001), while civil servants were less likely to have Buruli ulcer than students (AOR = 0.32; 95% CI: 0.10–1.00; p = 0.05). Conversely, respondents with fair knowledge were more likely to have Buruli ulcer than those with good knowledge (AOR = 4.04; 95% CI: 1.07–15.29; p < 0.05). Residence was significantly associated with poor health-seeking behaviour, as respondents living in riverside or swamp areas were less likely (APR = 0.88; 95% CI: 0.79–0.98, p = 0.02) to demonstrate poor health-seeking behaviour than those living inland. Respondents unsure about the distance to their water source were more likely (APR = 1.16; 95% CI: 1.01–1.34, p = 0.04) to have poor health-seeking behaviour than those living 100–500 m from their water source. Additionally, contact with saltwater bodies was associated with an increased likelihood of poor health-seeking behaviour (APR = 1.07; 95% CI: 1.00–1.14, p = 0.05). The study demonstrates that poor health-seeking behaviour remains widespread among Buruli ulcer patients in rural communities of Rivers State, with delayed presentation and reliance on non-formal treatment pathways contributing to the burden of the disease. Strengthening community awareness, improving access to affordable healthcare services, and addressing financial and geographical barriers to care are essential for promoting early diagnosis and treatment of Buruli ulcer in endemic communities. Read more

This study assessed the knowledge, attitude, and perception of mental health nurses toward electroconvulsive therapy in two neuropsychiatric hospitals in South-West, Nigeria. A descriptive cross-sectional design was used to survey 374 mental health nurses working in the Neuropsychiatric Hospital, Aro, Abeokuta, and Federal Neuropsychiatric Hospital, Yaba. Data collected through questionnaires were     analyzed using descriptive statistics. Findings showed that 282(75.3%) of nurses demonstrated high knowledge of ECT Mean = 16.13 (SD = 2.96) , 191(51.0%) had moderate perceptions with Mean = 56.18 (SD = 8.31) and 274(73.2%) reporting favorable attitudes Mean = 27.38 (SD = 4.55).     Knowledge showed a significant positive correlation with perception (r = 0.32, p > 0.05) and attitude (r = 0.39, p > 0.05). Years of work experience were insignificant to attitude (F(193) = 0.98, p < 0.05). The study concluded that nurses demonstrated high knowledge, moderate perception, and positive attitudes toward ECT. These findings provide evidence for continuous training to strengthen the quality of ECT practice in psychiatry. Read more