Individuals are diagnosed with terminal/chronic conditions on a daily basis globally. Unfortunately, a substantial proportion of the global disease burden of chronic illnesses is recorded within sub-Saharan Africa. Providing or receiving such news can be devastating and may be influenced by cultural preferences and contextual differences. Identifying existing trends and how such news is broken in sub-Saharan Africa will be relevant to identify and inform practice and future research.

This systematic review protocol was developed by following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocol (PRISMA-P), and findings will be reported by following the guidelines and recommendations of PRISMA-2020. CINAHL, Global Health, MEDLINE, PubMed, Scopus, AJOL and APA PsycINFO will be searched for articles. Additional records will be gathered through reference harvesting in Google Scholar search. QualSyst will be used to assess the methodological quality of studies included. Thematic synthesis will be used to analyse and synthesise the findings from the eligible studies.

Due to the fact that systematic reviews focus on accessible and available literature without the direct involvement of human participants, ethical approval will not be sought. The completed review will be submitted to a peer-reviewed journal and may be presented at health conferences. The important findings would be shared with stakeholders and those involved in developing and conducting training for health practitioners, all of whom are involved in breaking bad news.

CRD42025642707.

To assess the prevalence of occupational exposure to hepatitis B and C, examine exposure reporting patterns and identify associated factors among healthcare workers (HCWs) in a military hospital in Ghana.

Analytical cross-sectional study.

A 500-bed tertiary military healthcare facility in Accra, Ghana.

A total of 369 HCWs were selected using stratified random sampling and completed a structured questionnaire. Data were collected through a structured questionnaire administered to 369 respondents. Bivariate and multivariate analyses were conducted using STATA V.17. Proportions, ORs and corresponding 95% CIs were calculated, with a significance level set at 0.05.

Primary outcomes were the prevalence of occupational exposure to bloodborne pathogens (hepatitis B virus (HBV) and hepatitis C virus (HCV)) and the rate of reporting these exposures.

In the 12 months prior to the study, 20.1% of HCWs reported exposure to HBV or HCV. Exposures were more common during weekdays (60.8%) and afternoon shifts (47.3%). Only 37.8% of exposure incidents were reported. Male HCWs were more likely to report exposures than females (OR 82.5, 95% CI 2.5 to 273). Diploma holders were less likely to report compared with degree holders (OR 0, 95% CI 0 to 0.3).

The study demonstrates that HCWs in the military health facility face a significant risk of exposure to bloodborne pathogens, yet under-reporting remains high. Strengthened training, clear reporting systems and supportive workplace policies are urgently needed to address these gaps and safeguard both staff and patient safety.

HIV and tuberculosis (TB) are two of the most devastating disease conditions of public health concern globally. A co-infection of the two diseases poses serious health challenges to patients including mental health problems, ranging from mild to severe, with differing outcomes. This systematic review aims to assess the correlates of HIV-TB co-infection and mental health of adults living in sub-Saharan Africa.

We will conduct comprehensive database and non-database searches for studies (published and unpublished). We will search Google Scholar, PubMed, CINAHL, LILACS, JSTOR, Cochrane Library, SCOPUS, PsycINFO, HINARI and African Journals Online from inception to 31 May 2025, without restriction on language. We will also search the grey literature, including conference proceedings, preprint repositories, databases of dissertations, WHO and governmental databases. In the event where there is a need to contact experts and corresponding authors for further information, the review team will do so to enrich the content of the review. At least three reviewers will independently undertake study selection, data extraction and risk of bias assessment using validated tools. We will resolve discrepancies or disagreements through discussion. We will analyse dichotomous data as risk ratio, OR or proportion and continuous data as mean difference with their SD; all estimates will be presented with their 95% CI. Where applicable, we will determine SD from point estimates and the appropriate denominators assuming a binomial distribution. The magnitude of heterogeneity between the included studies will be assessed quantitatively using the index of heterogeneity (I² statistic). The I² values of 25%, 50% and 75% will be considered to represent low, moderate and significant heterogeneity. The significance of heterogeneity will be determined by the p value of the I² statistic, and a p value of

This systematic review will collate secondary research based on publicly available published and unpublished studies, and no ethical approval is required. However, an eligible study with serious ethical issues will be excluded and the reasons for exclusion documented. The review findings will be shared with key stakeholders, health authorities, agencies involved in the mental health of persons living with HIV-TB (PLHTB) co-infection, social services providers and policy implementers. The findings will be presented at scientific conferences and symposia. The final review report will be in the form of a scientific paper in a high-impact factor peer-reviewed journal.

CRD42024572331.

Poor menstrual health and unmet menstrual needs influence several aspects of adolescent girls’ lives, including their educational outcomes. However, evidence on menstrual health needs and educational outcomes among these vulnerable girls living in countries across sub-Saharan Africa (SSA) is fragmented and inconclusive. The systematic review aims to explore the association between menstrual health needs and educational outcomes among adolescent girls (10–19 years) living in SSA.

Studies (published and unpublished) will be identified from relevant electronic databases including PubMed, CINAHL, ScienceDirect, Google Scholar and LILACS without language restriction from January 2012 to December 2024. A comprehensive set of search terms and their alternate terms, together with the names of countries in sub-Saharan Africa, will be used for running the searches. We will also search Scopus, Web of Science, African Index Medicus, HINARI, African Journals Online, Academic Search Premier, MedRXIV, ProQuest, EBSCO Open Dissertations and reference lists of relevant studies. We will contact experts, identified through authorship of key publications in menstrual health research and recommendations from established research networks, for potentially relevant unpublished studies. All retrieved articles from the electronic databases and grey literature will be collated and deduplicated using Endnote and exported to Rayyan QCRI. The pre-defined eligibility criteria will be followed to screen papers for inclusion in the review. The flow of studies will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram. Given the anticipated volume of literature to be reviewed, at least two reviewers will independently select studies, extract data and assess the quality of the included studies for risk of bias using the Robbins-E risk of bias assessment tool. Any disagreements will be resolved through discussion between the reviewers. The Joanna Briggs Institute’s Sumari Software will be used for citation management. Binary outcomes will be estimated using pooled proportions (for non-comparative studies) and odds ratio (OR) or risk ratio (RR) (for comparative studies), reported with their 95% CIs. The mean difference (MD) will be used for reporting continuous outcomes with their 95% CIs. In the case where different instruments have been used to report means, we will employ standardised mean difference (SMD). Heterogeneity will be assessed graphically for overlapping CIs and statistically using the I² statistic, and if heterogeneity is detected to be high (>50%), subgroup analysis will be performed to assess the impact of such variation.

While ethical approval is not required for the systematic review methodology itself, appropriate data sharing agreements and confidentiality protocols will be followed when collecting unpublished data from experts. The findings from this review will be published in a peer-reviewed journal and presented at relevant conferences. Also, the findings will be communicated to local stakeholders (eg, adolescent girls, parents/guardians, school authorities) in appropriate formats and languages to support translation into policy and practice to improve menstrual health and hygiene and education for adolescent girls in sub-Saharan Africa.

CRD42024565296.

Breast cancer is a global concern, especially for women of African descent, with rising cases in Ghana. While awareness and diagnostic screening have improved, studies in Ghana and many African countries have prioritised breast self-examinations, with limited focus on mammography.

Our study explores beliefs and attitudes towards mammography screening among mothers at Teshie Community in Ghana.

The study methodology was qualitative and an exploratory design was used. Convenience sampling was used to select 30 participants until saturation was reached. Indepth, one-on-one interviews were conducted with a semistructured interview guide with probes until saturation was reached. Then data were audiotaped audiotaped, transcribed and coded. Content analysis was done to generate themes and subthemes.

Most participants, 93%, had not undergone mammography screening. Only two individuals (7%) had experienced mammography screening. The study identified two major themes: beliefs and perceptions regarding mammography, and attitudes towards mammography screening. Participants generally displayed limited knowledge of mammography screening, along with mixed attitudes and varying degrees of motivation. Notably, many participants enjoyed strong spousal support for mammography screening.

It was recommended that nurses should create awareness of mammography to increase the knowledge of women and the general population about mammography, as this is believed to increase the uptake of mammography screening.