Health Sciences Investigations Journal

Welcome message from the Editor-in-chief 2026

2026-07-10T16:16:29+00:00

Volume 9.1 of the HSI Journal brings together a rich, regionally grounded collection that showcases the breadth and depth of contemporary health sciences research across Africa. This issue spans basic science and translational work, rigorous reviews, applied clinical studies, and innovative technological approaches. From natural product research on wound healing toAI applications in medical education and diagnostic imaging, the manuscripts reflect a shared commitment to improving health outcomes through evidence, context, and collaboration.
Several prominent themes emerge across this issue. Studies on cocoa-based wound healing, a multicentre cardiovascular rehabilitation programme in Yaoundé, and an integrated
physiotherapy approach for brachial plexus injury exemplify translational and clinical innovation. Together, these contributions highlight practical interventions with direct implications for patient care. Women's and maternal health receive focused attention through a scoping review of mental health among young mothers and a multicentre study of polycystic ovary syndrome (PCOS) among infertility patients in Kumasi.

These studies underscore persistent gaps in care and the need for culturally responsive health services. Public trust, ethics, and community engagement are explored in reviews examining hesitancy toward biological sample donation and attitudes toward whole-body donation. Their findings highlight the importance of effective communication, ethical governance, and public engagement in advancing research participation across Ghana and beyond. Digital and diagnostic innovation is another defining theme. The development of a Light-CNN model for chest X-ray interpretation and an investigation into the use of AI in health sciences education in Morocco demonstrate the growing potential of machine learning to enhance both clinical decision-making and professional training.

Unwavering

2026-07-10T11:32:42+00:00

“Unwavering”
Artist's perspective
Unwavering” presents itself as a study in collective resolve rather than individual portraiture. The three female figures are rendered at a monumental scale, towering above the settlement they inhabit. This elevation is symbolic, not heroic in the classical sense, but existential.
They are larger because they carry more than themselves. The composition is unified by forward motion. All three figures move in the same direction, creating a visual rhythm that suggests continuity and shared purpose. There is no hesitation here. The title finds its meaning in posture rather than expression. These women do not announce strength; they embody it. Motherhood appears without sentimentality. The child is integrated into the figure’s stride, an
extension of responsibility rather than an interruption of agency. It is a portrayal of care that coexists with movement, asserting that nurture and progress are not opposing forces. Livelihood is addressed through the figure bearing a tray of fruit. The gesture is modest,almost understated, yet loaded with meaning. Work is presented as dignity, survival as order. The fruits are not decorative; they are currency, sustenance, proof of self reliance. The third figure remains deliberately undefined. This ambiguity is the most compelling aspect of the work. She resists_attach. She resists narrative closure. In doing so, she becomes a vessel for projection. She is potential, identity in flux, the unnamed role women are still stepping into.

Is daily consumption of natural cocoa beverage sufficient to end diabetes?

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Type 2 Diabetes Mellitus (T2DM) is a notable chronic condition globally, and causes substantial perturbation of cellular metabolism in affected individuals.
The geographical distribution of T2DM is not uniform across the continents; the highest burden is observed in low‑ and middle‑income countries, where prevalence is rising very rapidly due to epidemiological transitions, lifestyle changes, and limited access to treatment services. Up till the 1980s, T2DM was predominantly presented by middle aged and older adults. However, the incidence has increased in the subsequent years across all spectrum of age groups, including adolescents and young adults (Perng et al., 2023). An individual is diagnosed with T2DM when the body is unable to produce sufficient insulin or resists the cellular effect of the hormone, leading to persistent hyperglycaemia (fasting blood glucose ≥ 126 mg/dL or glycated haemoglobin ≥ 6.5%). Clinical management of T2DM usually relies on a combination of lifestyle modifications and pharmacological therapy.
A study by Dordoye et al. (2026) reports the wound healing potential of natural cocoa in a rat model induced for T2DM using nicotinamide and Streptozotocin. Cocoa (Theobroma cacao) contains a wide range of bioactive compounds including polyphenols, methylxanthines and plant sterols. Flavanol (a polyphenol) is a strong antioxidant and also contributes to improving cardiovascular health (Tušek et al., 2024). Theobromine is the principal methylxanthine in cocoa, and functions as an inhibitor of phosphodiesterase and an antagonist for adenosine receptor (Martínez‑Pinilla et al., 2015)

Natural cocoa ingestion promotes wound healing in rats with diabetes by accelerated re-epithelialization and enhanced IGF-1 expression

2026-07-10T16:16:30+00:00

Background: Diabetic wounds (DWs) are difficult to manage due to delayed healing, increasing the risk of infection and limb amputation. Hyperglycemia impairs re-epithelialization and dermal cell proliferation, both key processes in wound closure. The persistent production of
advanced glycation end products (AGEs) further inhibits healing in diabetes. Cocoa is rich in polyphenols, offers antioxidants, antiinflammatory, and anti-glycemic properties that may support DW healing.
Aim: This study investigated the potential of natural cocoa powder in enhancing wound healing in experimentally streptozotocin (STZ)nicotinamide- induced type 2 diabetes mellitus (T2DM) rats.
Methods: T2DM was induced in rats using nicotinamide and STZ. Rats with diabetes were assigned to a cocoa-treated group (DC) and an untreated group (DU); rats without diabetes served as controls (C). Aqueous 2% natural cocoa was administered to the DC group for 6 weeks. Full-thickness dorsal wounds were created, and biopsies were taken on days 0, 3, 7, and 14. Wound contraction, epidermal thickness, and dermal cell counts were assessed histologically. IGF-1 expression was also evaluated via immunohistochemistry.
Conclusion: Cocoa-treated rats showed significantly enhanced wound contraction, thicker epidermis, and higher dermal cell counts. IGF-1 expression markedly increased in DC, compared to the control group.

Artificial intelligence use in Health Sciences Education in Morocco: perception of Educators from selected tertiary health institutions

2026-07-10T16:16:32+00:00

Background: This study explores how health science educators perceive Artificial Intelligence (AI) in the teaching/learning process, specifically looking at their opinions, concerns, and hopes for how it can help students learn better.
Methods: This cross-sectional study occurred in the Marrakech-Safi region of Morocco. A structured, validated questionnaire with 24 questions was used to gather numerical data from n=192 educators at the Faculty of Medicine and Pharmacy, as well as the Higher Institute of Nursing and Health Techniques. The scale reliability was acceptable with a Cronbach's alpha of 0.707.
Results: 50 educators responded to the questionnaire. Descriptive statistics show that while a vast majority (96.0\%) believe AI can improve learning conditions, a high percentage (90.0\%) have never used AI in their teaching practices. A significant positive correlation (rs ≈55) was found between the belief that 'AI will assist me in decision-making' and 'AI will aid in the remediation stage' (p = 0.000412).
Conclusion: Based on the study's results, it is crucial to consider educators' perceptions and the potential outcomes when using AI in health sciences education. Addressing ethical concerns and providing appropriate training are crucial for ensuring successful and equitable AI integration in the curriculum.

The Prevalence, phenotypes and fertility treatment outcomes of polycystic ovary syndrome among infertile women in Ghana: A multi-centre observational study

2026-07-10T16:16:33+00:00

Background: Polyendocrine metabolic ovarian syndrome (PMOS) represents a significant but understudied cause of anovulatory infertility in sub-Saharan Africa (SSA). Regionally, specific data on its prevalence and phenotypic distribution in SSA are scarce, despite its recognized impact on fertility.
Objective: To determine the prevalence and phenotypic distribution of polycystic ovary syndrome (PMOS) among women seeking infertility care in Kumasi, Ghana, and to evaluate dominant follicle selection following ovulation induction.
Methods: In a multi-centre observational study with a cross‑sectional component and nested longitudinal follow‑up, women aged 20–40 years presenting for infertility evaluation at three fertility centres in Kumasi were consecutively screened using the Rotterdam criteria. Women diagnosed with PMOS underwent ovulation induction with clomiphene citrate or letrozole. Dominant follicle selection was monitored via transvaginal ultrasonography. Firth’s penalized logistic regression was used to identify independent predictors of dominant follicle selection, accounting for complete separation and sparse data in BMI and phenotype categories.
Results: Among 1,537 women seeking infertility care, 251 met Rotterdam criteria for PMOS, giving a clinic-based prevalence of 16.3% (95% CI: 14.5–18.2) with Phenotype D being most prevalent (51.8%). Dominant follicle selection occurred in 82.9% (199/240; 95% CI:
78.2–87.7) of women undergoing ovulation induction. Clomiphene citrate and letrozole showed similar follicular response rates in this non‑randomized cohort although letrozole use was limited. Firth’s penalized logistic regression identified Obesity class III (BMI ≥40 kg/m²) as the only BMI category independently associated with dominant follicle selection (aOR = 0.01; 95% CI: 0.00–0.21; p = 0.005). A linear ordinal BMI analysis confirmed that BMI variation significantly reduced the odds of dominant follicle selection (aOR = 0.26; 95% CI: 0.15–0.46; p < 0.001).
Conclusion: PMOS was common among women seeking infertility care in three specialist fertility facilities in Kumasi, Ghana, and phenotype D predominated. Ovulation induction with clomiphene citrate or letrozole was frequently associated with dominant follicle selection, but pregnancy and live‑birth outcomes were not assessed, hence, findings should be interpreted as reflecting an intermediate ovulatory endpoint rather than definitive fertility success. Severe obesity (BMI ≥40 kg/m²) was independently associated with a significantly reduced likelihood of dominant follicle selection, highlighting the clinical importance of weight management in this population and the need for phenotype-informed, weight-sensitive fertility care in the region.

Sex of household head and women's willingness to accept malaria vaccine for children under five years in Ghana

2026-07-10T16:16:34+00:00

Background: The malaria vaccine is effective in reducing the burden of malaria among children under five.
Objective: This study examined the influence of the sex of the household head on Ghanaian women of reproductive age’s willingness to accept malaria vaccine.
Methods: This study analysed data from the 2019 Ghana Malaria Indicator Survey. It included 730 (weighted) women of reproductive age with no exposure to the GoodLife Campaign. The outcome variable of interest was a willingness to accept the malaria vaccine for children. The data were analysed using descriptive statistics and multivariable logistic regression with the aid of Stata/SE version 17.
Results: The majority (59.8%) of the participants were from male-headed households. The results showed that 36% of women had heard about the malaria vaccine, and 88% were willing to accept it. Women in female-headed households (AOR = 2.01, 95% CI: 1.03 - 3.91), those who professed traditional religion (AOR = 7.52, 95% CI: 1.13 - 49.77), those who knew that malaria is covered by NHIS (AOR = 2.49, 95% CI: 1.44-4.31), and those residing in the Ashanti region (AOR = 9.41, 95% CI: 1.64 - 53.98) were more willing to accept the malaria vaccine.
Conclusion: This study demonstrated that women with female household heads were more willing to accept the malaria vaccine than those with male-headed households. Going forward, interventions geared towards increasing willingness to accept malaria vaccine among women with no exposure to malaria campaigns would have to prioritise women living in male-headed households.

Outcome of a supervised cardiovascular rehabilitation programme on muscle strength, symptoms, and functional capacity in patients with stable chronic heart failure: A multicentre longitudinal study in Yaoundé, Cameroon

2026-07-10T16:16:35+00:00

Background: Peripheral muscle weakness contributes significantly to exercise intolerance in chronic heart failure (CHF).
Objective: This study evaluated the impact of a supervised cardiovascular rehabilitation (CVR) program on segmental muscle strength, symptoms, and functional capacity in stable CHF patients in Yaoundé, Cameroon.
Methods: In this multicentre longitudinal study, adults aged ≥18 years with stable CHF (NYHA class I-III) underwent a standardised outpatient CVR program targeting 18 sessions (3 sessions/week over 6–7 weeks on average; minimum 15 sessions; median 18, range 15–20).
The program comprised aerobic exercise (treadmill/cycling at 50 – 75% heart rate reserve) interspersed with segmental resistance training (body weight/light loads, 10 – 15 repetitions × 2–3 sets for major muscle groups), warm-up, cool-down, and therapeutic education. Baseline data were retrospectively extracted from program intake records; post-intervention assessments were prospectively conducted within one week of completion. The primary outcome was lower-limb muscle strength (handheld dynamometry: quadriceps). Secondary outcomes included symptoms (dyspnoea, palpitations), body weight, Duke Activity Status Index (DASI), six-minute walk test (6MWT) distance, and peak metabolic equivalents/estimated VO₂max (cycle ergometer). Pre–post changes were analysed with Wilcoxon signed-rank tests (p <0.05).
Results: The cohort (median age 56 years; 54% female; 70% preserved ejection fraction) showed significant improvements post-CVR. Lower limb strength increased dramatically (median 0.0 to 10.0 kgf, p < 0.001). Symptoms reduced markedly (dyspnoea: 22% to 2%, p = 0.037, palpitations: 16% to 2%, p < 0.001). Functional capacity improved robustly: 6MWT +100 m (400 to 500 m, p < 0.001), DASI score +26.25 (24.45 to 50.70, p < 0.001), peak METs +3.37 (p < 0.001), estimated VO₂max +11.72 ml/kg/min (p < 0.001). A modest weight loss of -1.5kg occurred (p = 0.001). No adverse events were reported.
Conclusion: A supervised CVR program with combined aerobic and resistance training significantly enhanced lower limb strength, reduced symptoms, and improved functional capacity in stable CHF patients in a resource-limited setting. These findings support CVR implementation to optimise outcomes in sub-Saharan Africa.

Light-CNN Optimization for chest x-ray classification in establishing diagnoses in pneumonia cases

2026-07-10T16:16:37+00:00

Background: Pneumonia remains a leading cause of mortality worldwide, with chest X-ray serving as the primary diagnostic tool. However, manual interpretation is subject to inter-observer variability, and existing deep learning models often require substantial computational resources that limit deployment in resource-constrained clinical environments.
Objective: This study aimed to develop LightCNN, a novel lightweight convolutional neural network that integrates depthwise separable convolution, inverted residual blocks, channel shuffle mechanism, and lightweight attention for efficient and accurate pneumonia classification from chest X-ray images.
Methods: LightCNN was designed with seven progressive feature extraction stages that incorporate the four aforementioned optimization techniques. The model was trained and evaluated on the publicly available Chest X-Ray Images (Pneumonia) dataset from Kaggle, comprising 5,856 images stratified into training (70%), validation (15%), and test (15%) subsets with patient-level splitting to prevent data leakage.
Preprocessing included CLAHE contrast enhancement, normalization, and data augmentation. Training employed the AdamW optimizer with cosine annealing scheduling and class-weighted cross-entropy loss over 50 epochs. The performance of LightCNN was benchmarked against three baseline models — MobileNetV2 (2.23 M parameters), ResNet-18 (11.18 M parameters), and EfficientNet-B0 (4.01 M parameters) — using identical preprocessing and training protocols. Evaluation metrics included accuracy, precision, recall, F1-score, AUC-ROC, parameter count, model size, and inference time.
Results: LightCNN achieved 95.56% accuracy, 0.9556 recall, 0.9584 precision, 0.9562 F1-score, and 0.9875 AUC-ROC on the test set, outperforming all baseline models. The model contains 2.52 million parameters (9.63 MB), representing a 77.4% reduction compared to ResNet-18, with an inference time of 0.25 ms per image — approximately four times faster than the nearest competitor. Ablation study results confirmed that each architectural component contributed incrementally to overall performance; depthwise separable convolution provided the largest efficiency gain, and inverted residual blocks contributed the most substantial accuracy improvement.
Conclusion: LightCNN demonstrates that systematic integration of lightweight architectural techniques can achieve clinically relevant diagnostic performance with minimal computational overhead, supporting its potential deployment in mobile and edge computing scenarios for point-of-care pneumonia diagnosis.

Sensitivity Profile of B-Scan for Retinal Detachment in Diabetic Retinopathy: a Systematic Review

2026-07-10T16:16:38+00:00

Background: Retinal detachment is an ocular complication of proliferative diabetic retinopathy (PDR), a leading cause of blindness and visual impairment globally. It can occur as a consequence of tractional forces due to fibrovascular proliferation or because of a combination of tractional and rhegmatogenous causes. It needs to be detected early and corrected to allow prompt intervention and favorable visual
outcomes.
Objective: To assess the diagnostic validity of B-scan ultrasonography in identifying retinal detachment in diabetic retinopathy patients with media opacities where optical coherence tomography (OCT) is suboptimal.
Methods: A systematic review of peer-reviewed articles published within the last decade was undertaken using PubMed, Scopus, Web of Science, and Google Scholar. Included studies evaluated the diagnostic utility of B-scan ultrasonography for the diagnosis of retinal detachment in diabetic retinopathy with comparison to other imaging techniques. Studies addressing media opacities only were considered.
Results: B-scan ultrasound repeatedly demonstrated excellent sensitivity (>90%) in the detection of retinal detachment despite the presence of dense cataract or vitreous hemorrhage. It was however not able to consistently distinguish between tractional and rhegmatogenous detachment.
Conclusion: B-scan ultrasound is still a very sensitive, cost-effective, and generalizable imaging modality for the detection of retinal detachment in diabetic retinopathy where OCT or fundoscopy is not an option. Additional imaging will still be necessary for accurate classification of detachment type.

Experiences influencing the mental health of young mothers in West Africa: a scoping review

2026-07-10T16:16:39+00:00

Background: Globally, West Africa has one of the highest levels of adolescent childbearing. This review explores peer-reviewed empirical literature to identify what is known about the experiences influencing the mental health of young mothers in West Africa.
Methods: A search was conducted across six databases, covering the period January 2010 to August 2025. Additional articles were identified through knowledge of the authoring team and manual searching of websites. Peer-reviewed articles were included if they reported empirical research, included mothers aged 19 years and younger at the time of birth in their sample, were studies that reported on the experiences of young mothers and linked these to young mothers’ mental health, reported research conducted in a West African country and were published in the English language. Overall, 21 studies were included in this review, 12 identified via the database search and nine via the other methods described. The findings of the included studies were analysed using thematic analysis.
Results: Most articles (n=15) reported on research conducted in Ghana, five reported on research conducted in Nigeria and one research study was conducted in The Gambia. The included articles found that young mothers’ experiences of stigma and discrimination, partner, family and social support, financial and health challenges, difficulties with childcare, young mothers’ faith and their hopes for the future influence their mental health.
Conclusion: This scoping review highlights a complex mix of cultural, psychological, and social influences on young mothers’ mental health in West Africa.

Understanding and Addressing Sample Collection Hesitancy in Biomedical Research in Ghana

2026-07-10T16:16:40+00:00

Background: Human biological specimens are essential for biomedical research, driving advancements in disease understanding, biomarker discovery, and the development of diagnostics, vaccines, and therapies. In Ghana, reports and experiential accounts from researchers indicate increasing hesitancy toward providing biological samples, leading to high refusal rates and participant attrition that threaten the validity and representativeness of scientific studies.
Objective: This study aims to identify and analyze the drivers of biological sample hesitancy in Ghana and West Africa, and to develop an evidence-based operational checklist for researchers to improve participant recruitment, retention, and community trust in biomedical research.
Methods: We conducted a narrative review of peer-reviewed and grey literature on biological sample hesitancy in Ghana and West Africa. We searched PubMed, Google Scholar, and African Journals Online (AJOL) between October and November 2024 for publications from 2000 to 2024 using terms including biospecimen, sample refusal, research participation, hesitancy, informed consent, Ghana, and Africa. Of 127 records initially identified, 89 were screened, and 46 studies (38 peer-reviewed articles and 8 grey literature reports) met inclusion criteria. Studies were appraised using adapted CASP and Newcastle-Ottawa criteria.
Results: Hesitancy is influenced by deep-rooted mistrust stemming from historical unethical research, ethical concerns, cultural and religious beliefs, language barriers, limited research literacy, and tribal influences. Sample type and research context significantly affect acceptability, with blood samples evoking the greatest concern. Consequences extend beyond individual refusal, contributing to selection bias, underrepresentation of populations, delayed innovation, and compromised public health interventions.
Conclusion: Addressing hesitancy requires multifaceted approaches, including trust-building initiatives, culturally sensitive education, transparent communication, community engagement, and operationalized benefit-sharing mechanisms. We provide an evidence-based operational checklist to guide researchers in implementing sustainable strategies that prioritize participant rights and foster long-term community partnerships.

Integrated physiotherapy through electrical stimulation and biofeedback for complex middle–lower trunk brachial plexus injury- A case report

2026-07-10T16:16:42+00:00

This case study presents the rehabilitation management and follow-up recovery of a 63-year-old female patient who sustained a fall resulting in neurological deficits. The injury led to wrist drop and weakness of the interossei muscles, contributing to the development of claw hand deformity. The clinical presentation suggested involvement of the middle and lower brachial plexus, significantly impairing her hand function
and quality of life. Electrical stimulation, biofeedback training, and a structured strengthening programme were implemented to reinforce the weakened hand and wrist musculature to ensure overall dexterity. This case study highlights the efficacy of a personalised rehabilitation approach in managing rare middle and lower brachial plexus injuries.