Predicting total body water in infants aged 0.5-24 months and the implications for measuring breast milk intake: a secondary analysis of isotope dilution data.

Background: Total body water (TBW) is commonly used to derive estimates of body composition. The deuterium oxide dose-to-mother (DTM) technique for measuring breast milk intake requires an estimate of infant TBW. The DTM calculation employs a prediction equation for estimating infant TBW from body weight (TBW), but the general validity of this equation is unknown.

The Feasibility and Acceptability of an App-Based Intervention Aimed at Improving Maternal Health Literacy Regarding Infant Play and Development: Mixed Methods Study.

Background: Allowing infants access to unstructured, unrestricted play in their home environment is imperative for increasing healthy movement behaviors and, therefore, developmental outcomes. Interventions should equip mothers to provide opportunities for infant play as early as possible. Evaluating such interventions is necessary to understand the feasibility for scale-up and implementation in specific contexts.

"We don't care because we are not sick": understanding youths perceptions of hypertension in urban South Africa.

Background: The growing burden of cardiovascular disease (CVD) in Sub-Saharan Africa (SSA) is largely driven by hypertension, with risk factors including poor diet, physical inactivity, tobacco use, psychological stress, and limited healthcare access. Early-life exposure to these risks contributes to adverse biological markers that increase hypertension susceptibility in adulthood. This study aimed to explore how young people in Soweto, Johannesburg, perceive hypertension risk, using the Health Belief Model (HBM) to understand their beliefs, attitudes, and barriers to prevention.

Exploring Early Childhood Development Interventions for Building Human Capital in Sub-Saharan Africa: A Scoping Review.

Background: Inequalities in the provision and implementation of early childhood development (ECD) interventions in Sub-Saharan Africa remain a challenge. This scoping review aimed to investigate the types and extent of ECD interventions in this region, using the Nurturing Care framework (NCF).

Methods: This review included randomised controlled trial (RCT) studies related to ECD interventions in Sub-Saharan Africa.

('exercising the mind'): protocol for a mixed methods feasibility and acceptability study of a prototype mental health intervention for adolescents and young people with anxiety and depression.

Background: Approximately one in four adolescents in Sub-Saharan Africa experiences significantly elevated symptoms of anxiety and depression. Those living in resource-constrained communities face heightened risks due to acute distress, trauma, and less responsive health care services. (meaning 'exercising the mind') is an intervention prototype designed for adolescents and young people experiencing common mental health conditions.

Perceptions of preconception health messaging and responsibility: engaging with 'health helpers' in the Healthy Life Trajectories Initiative-South Africa trial.

Premised on the Developmental Origins of Health and Disease theory and on the limited effectiveness of antenatal interventions, interventions in the preconception period are being conducted to potentially improve intergenerational health and non-communicable disease burdens. The Healthy Life Trajectories Initiative (HeLTI) is an international health research consortium primarily investigating the intergenerational effects of behavioural interventions on obesity via a complex four-phase intervention initiated preconceptionally, through pregnancy, and into early childhood. HeLTI, in partnership with the World Health Organization, aims to generate evidence that will shape health policy focused on preconception as part of a life course approach to population health.

Establishing Requirements for Breast Centers in Low- and Middle-Income Countries: A South African Perspective.

Purpose: In South Africa, breast care lacks governance and standardization, necessitating urgent improvements in patient outcomes. Quality improvement initiatives are urgently needed in low- and middle-income countries (LMICs), but requirements for breast centers in lower resource settings remain undefined and must be tailored to local environments. This consensus document outlines the role and requirements of breast centers in LMICs and presents a step-by-step implementation plan.

Development and pilot testing of two behavioural feedback strategies designed to improve maternal self-efficacy.

Background: The aim of this pilot study was to describe the development of, and test the acceptability and feasibility of providing feedback on two behaviours in the context of supportive approaches to improve maternal self-efficacy. We hypothesised that providing individual behavioural feedback to mothers in a socially vulnerable context, when later embedded in supportive intervention approaches, may improve maternal self-efficacy and ultimately promote infant development.

Methods: Feedback was developed following expert consultation with working groups, and included graphical feedback on mother and infant movement behaviours measured using accelerometry, as well as video feedback of mother-infant interactions using first person observation head cameras.

Small for gestational age subgroups have differential morbidity, growth, and neurodevelopment at age 2: the INTERBIO-21 Newborn Study.

Background: Small for gestational age is a complex perinatal syndrome associated with increased neonatal morbidity, mortality, and impaired childhood growth and neurodevelopment. Current classifications rely primarily on birthweight, which does not capture the heterogeneity of the condition nor predict long-term health outcomes. Here we aim to identify and characterize distinct small for gestational age subgroups and assess their neonatal and early childhood health trajectories.

SHBG, testosterone and type 2 diabetes risk in middle-aged African women: exploring the impact of HIV and menopause.

Context: Sex hormone-binding globulin (SHBG) and testosterone are differentially associated with type 2 diabetes (T2D) risk.

Objective: To investigate whether the associations between SHBG, testosterone and T2D risk differ by HIV and menopausal status in Black African women living with (WH) and without HIV (WOH).

Design: Cross-sectional observational.

Adolescent social media use and mental health in sub-Saharan Africa: a scoping review protocol of current research.

Introduction: There is growing public concern and emphasis on the potential negative implications of social media on adolescent mental health and the implementation of social media restrictions, despite limited and mixed evidence that predominantly originates from the Global North. In sub-Saharan Africa (SSA), where adolescent populations are rapidly expanding and adopting technology, research on social media and mental health is limited. This scoping review aims to map and describe the available evidence on social media use and mental health among adolescents in SSA.

Strengthening the paediatric clinical trial ecosystem to better inform policy and programmes.

The first WHO Global Clinical Trials Forum was convened in November, 2023 to develop a shared vision of an effective global clinical trial infrastructure. The Paediatric Clinical Trials Working Group was formed to provide perspectives, identify challenges, and propose solutions to strengthen the paediatric clinical trials ecosystem. Participants represented paediatric disciplines, including infectious diseases, nutrition, neonatology, pharmacology, oncology, neurodevelopment, public health, and policy.

Prospective harmonisation of four international randomised controlled trials in Canada, China, India and South Africa: the Healthy Life Trajectories Initiative.

Objectives: The Healthy Life Trajectories Initiative (HeLTI) is an international multistudy consortium that supports the development and integration of four randomised controlled trials (RCTs) conducted in South Africa, India, China and Canada. HeLTI aims to evaluate interventions to improve the health and well-being of mothers and children, starting from preconception through pregnancy and early childhood until age 5 years. This paper describes the process by which we prospectively harmonised the participating studies and provides a descriptive analysis of the study-specific harmonisation potential.

Incident type 2 diabetes and its risk factors in men and women aged 40-60 years from four sub-Saharan African countries: results from the AWI-Gen study.

Background: The incidence of type 2 diabetes in sub-Saharan Africa is expected to increase, but few longitudinal studies have characterised its risk factors. This study aimed to determine the incidence of type 2 diabetes over 33 481 person-years and identify its principal risk factors in middle-aged adults (ie, those aged 40-60 years) from four sub-Saharan African countries.

Methods: Longitudinal data were available from 6553 participants aged 40-60 years at baseline from study centres in South Africa, Kenya, Ghana, and Burkina Faso.

Self-reported hypertension prevalence, risk factors, and knowledge among South Africans aged 24 to 40 years old.

Although hypertension is a significant public health burden in South Africa (SA), less is known about its prevalence, risk factors, and possible preventative strategies among young adults. We assessed the prevalence, possible risk factors, and knowledge associated with self-reported hypertension among young adults from SA. A cross-sectional online survey was conducted among 1000 young South African adults (24-40 years; 51.

A survey of perceptions and behavioural responses towards the COVID-19 pandemic in South Africa.

Background:  The South African response to the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus was swift and assertive, although it came with economic and social costs. An understanding of the pandemic experiences of different population groups is integral to enhancing disease control.

Aim:  The aim of this study was to identify behavioural responses and public perceptions relating to the coronavirus disease 2019 (COVID-19) pandemic.

Retention in the trial in Soweto, South Africa: a qualitative analysis using self-determination theory.

Introduction: There is limited research on applying theory to retention in complex intervention trials. To address this gap, this study aimed to qualitatively examine retention in the randomised controlled trial, from the perspective of trial participants and staff, through the lens of self-determination theory (SDT). The trial is part of the Healthy Life Trajectories Initiative in Soweto, South Africa, with young women.

Obesity phenotypes and dyslipidemia in adults from four African countries: An H3Africa AWI-Gen study.

Introduction: The contribution of obesity phenotypes to dyslipidaemia in middle-aged adults from four sub-Saharan African (SSA) countries at different stages of the epidemiological transition has not been reported. We characterized lipid levels and investigated their relation with the growing burden of obesity in SSA countries.

Methods: A cross-sectional study was conducted in Burkina Faso, Ghana, Kenya and South Africa.

Adolescent mental health in sub-Saharan Africa: crisis? What crisis? Solution? What solution?

Addressing adolescent mental health care across sub-Saharan Africa faces numerous challenges, including underfunded public health systems, a shortage of mental health professionals, barriers to access, and pervasive stigma. Untreated adolescents often experience worsening symptoms, academic and social difficulties, physical health risks, and engage in risky behaviours. Early detection and appropriate treatment of common mental health conditions can support adolescents in developing robust social and emotional foundations and enhancing their mental well-being.

Associations between skeletal muscle mass and elevated blood pressure are independent of body fat: a cross-sectional study in young adult women of African ancestry.

Although research on the relationship between lean body mass and blood pressure (BP) has been inconsistent, most studies reported that measures of lean body mass are associated with a higher risk of hypertension. We explored relationships between body composition (fat and skeletal muscle mass) and BP in 1162 young adult African women. Dual-energy X-ray absorptiometry-derived measures of whole-body, central and arm fat mass were associated with higher systolic and diastolic BP, while leg fat percentage was associated with lower systolic and diastolic BP.

Sex hormone-binding globulin, testosterone and type 2 diabetes risk in middle-aged African women: exploring the impact of HIV and menopause.

Objectives: Sex hormone-binding globulin (SHBG) and testosterone are differentially associated with type 2 diabetes (T2D) risk. We investigated whether these associations differ by HIV and menopausal status in Black South African women living with (WLWH) and without HIV (WLWOH).

Design: Cross-sectional observational.

"You go an extra mile": a qualitative study of community health worker perspectives in a health promotion intervention in urban South Africa.

Background: As part of the Healthy Life Trajectories Initiative in South Africa, the Bukhali health promotion intervention is being implemented by community health workers (CHW's) with young women in urban Soweto. The perspectives of these CHW's have not been fully explored.

Methods: A qualitative study was conducted to describe CHW's perspectives and experiences of delivering the Bukhali intervention.

Alleviating the public health burden of hypertension: debating precision prevention as a possible solution.

Hypertension is a major global health concern, with deaths attributed to the condition expected to increase to 1.57 million by 2034, particularly affecting low-and-middle-income countries such as those within sub-Saharan Africa. Non-communicable diseases, with hypertension as a core contributor, account for 74.