IntroductionAnaplastic thyroid carcinoma (ATC) is the most aggressive subtype of thyroid cancer, accounting for 1%–4% of thyroid malignancies, with a median survival of 3–5 months[1]. While ATC typically manifests as a hypoechoic, ill-defined solid mass on ultrasound, predominantly cystic variants are exceedingly rare and often misdiagnosed as benign cystic lesions[2]. We present two pathologically confirmed cases of ATC – one predominantly cystic and one solid – and analyze their sonographic features and diagnostic challenges in conjunction with the literature, offering clinical insights.

A document by Sirak Haylemelekot Gebremesqel. Click on the document to view its contents.

This paper introduces an Improved Pigeon-Inspired Optimization (IPIO) algorithm to solve MTSPs with multiple complex constraints, addressing both single-depot (SDMTSP) and multi-depot (MDMTSP) scenarios. For the first time, the Pigeon-Inspired Optimization (PIO) algorithm is applied to the TSP and MTSP domains, with three novel operators specifically developed to address the unique challenges of these problems: the Probability Heuristic Initialization Operator, the Greedy Crossover Operator, and the Probability Crossover Operator. These operators significantly enhance the worldwide exploration ability of the algorithm and convergence rate while preventing path overlaps and redundancy. To confirm the efficiency of the IPIO algorithm, three widely recognized comparative algorithms—Improved Partheno Genetic Algorithm (IPGA), Particle Swarm Optimization (PSO), and Partheno Genetic Algorithm (PGA)—were implemented, with extensive comparative experiments conducted on multiple benchmark instances. The investigative results demonstrate that the IPIO algorithm is markedly outperformed by the other algorithms in solution quality for large-scale MTSPs while exhibiting exceptional computational efficiency. Furthermore, this paper explores the impact of the number of salespeople and cities on the outcome, emphasizing the importance of optimizing the number of salespeople to enhance algorithm performance. The proposed approach offers new perspectives and methods for addressing TSP and MTSP-related problems.

In a world urgently seeking greener, smarter, and more efficient technologies, halloysite nanotubes (HNTs) have emerged as promising nanomaterials attracting intense scientific and industrial interest. These naturally occurring, eco-friendly clays feature a unique hollow tubular morphology, tunable surface chemistry, and outstanding biocompatibility traits that position them as transformative agents in fields ranging from medicine and environmental remediation to flame retardancy, cosmetics, and catalysis. This review highlights recent advances in HNT synthesis, surface modification, and multifunctional applications, reflecting a 65% surge in related publications between 2015 and 2022. By 2025, biomedical applications alone are expected to comprise 35% of HNT research, underscoring their growing role in drug delivery, wound care, and antimicrobial systems. HNTs are also proving valuable in real-world innovations from antiviral air filtration during the COVID-19 pandemic to AI-assisted material design. Nonetheless, key challenges persist: variability in natural sources, limited scalability of modification techniques, and a lack of long-term clinical validation. This review emphasizes that bridging these gaps through the integration of nanotechnology, artificial intelligence, and sustainable chemistry could unlock the full potential of HNTs advancing them from geological curiosity to cornerstone of next-generation smart materials.

Background: Community engagement is essential for effective epidemic and pandemic preparedness and response. However, existing reviews often focus on conceptual models rather than practical strategies, and few incorporate evidence from the COVID-19 pandemic. To address this gap, this scoping review aims to identify and synthesize strategies used to engage community members during epidemic and pandemic responses in Sub-Saharan Africa. Methods: We conducted a scoping review using the PRISMA-ScR and the methodological framework from Arksey and O’Malley. We searched six databases (EMBASE, PubMed, EBSCO-host, CINAHL, Global Health, Web of Science) and Google Scholar for peer-reviewed literature, and also reviewed gray literature from health ministries and international organisations. A total of 88 documents were included. Data were thematically analysed and mapped using the Gilmore et al. framework for community engagement in infectious disease control. Results: Among the six broad types of engagement identified, social and behavioural communication (SBCC) was the most commonly used strategy across all disease contexts. COVID-19 and Ebola responses emphasized communication and surveillance, while polio and HIV/AIDS response incorporated culturally embedded, locally led approaches. Key enablers included trust, pre-existing networks, and decentralisation; barriers included misinformation, resource constraints, and exclusion of marginalised groups. Most strategies stopped short of full community ownership. Conclusion: Effective community engagement requires tailored, context-specific approaches that go beyond information sharing to foster shared decision-making and local ownership. This review provides a comprehensive synthesis of the strategies for community engagement used in sub-Saharan Africa and highlights the need for more robust implementation research to evaluate the implementation of the strategies and ultimately to support transformative, community-led epidemic response. The protocol for this review was registered in Open Science Framework with registration DOI: [https://doi.org/10.17605/OSF.IO/D478Z](https://doi.org/10.17605/OSF.IO/D478Z)

Background: The use of skilled birth attendants (SBAs) is still a challenge in low- and middle-income countries, where it contributes significantly to maternal and neonatal morbidity and mortality. While Tanzania has made progress in maternal health, adolescents aged 15–19 remain disproportionately underserved in accessing SBA, which is critical for safe delivery. This study aims to assess the trends and predictors of SBA use among adolescent girls. Methods: This study analyzed nationally representative data from the Tanzania Demographic and Health Surveys (TDHS) conducted in 2004/05, 2010, 2015/16, and 2022. Trends in SBA use among adolescent mothers were assessed, and multivariable modified Poisson regression was used to determine predictors associated with SBA use in the 2022. Results were presented using adjusted prevalence ratio (APR) with a 95% confidence interval. Results: SBA use among adolescent mothers increased from 61.9% in 2004/05 to 85.3% in 2022. Despite this progress, disparities persisted across regions, with Dar es Salaam and Kilimanjaro maintaining near-universal coverage while others lagged. In 2022, adolescents were more likely to use SBA if they lived in urban areas (APR = 1.04), had secondary or higher education (APR = 1.10), came from wealthier households (APR = 1.08), attended four or more antenatal care visits (APR = 1.13), or had a partner with secondary or higher education (APR = 1.15). Rural residence and low educational attainment were associated with reduced SBA use. Conclusion: While SBA coverage among adolescents has improved in Tanzania, structural and social inequalities hinder equitable access. Strengthening adolescent-focused maternal health strategies, including improved ANC coverage, expanded education, and male partner engagement, is essential to address disparities and reduce maternal health risks among adolescent girls.

Heat transfer in rotating systems is crucial for understanding and optimizing the thermal management of machinery and equipment. In such systems, the rotational motion can significantly influence the heat distribution and fluid dynamics, affecting the efficiency and performance of the system. Understanding these effects is essential for designing systems that maintain optimal temperature levels and prevent overheating, especially when dealing with high viscous fluids. Variations in velocity can significantly impact the heat transfer efficiency in a vertical rotating system. Higher fluid velocities generally enhance the heat transfer rate by reducing the thermal boundary layer thickness, allowing for more efficient convection. Conversely, lower velocities may result in a thicker thermal boundary layer, thus decreasing the overall heat transfer efficiency. Present study focused on mathematical modeling of a vertical rotating system based on high viscous fluids with different Reynolds numbers. Pressure variations can significantly influence heat dissipation in a vertical rotating system. Higher pressures tend to enhance the fluid's thermal conductivity, allowing for more efficient heat transfer. Mathematical modeling in heat transfer provides a powerful tool for predicting system behavior and optimizing design. A conceptual mathematical formula developed and solved in MATLAB for heat transfer responses. Fluid with medium Reynolds number with medium pressure and high velocity given better results compare with others.

INTRODUCTION :According to the World Health Organization, one-third of the global population is infected with Mycobacterium tuberculosis . Tuberculosis remains one of the leading causes of death and disability worldwide, accounting for approximately 3 million deaths annually. Among patients with bone and joint tuberculosis, only one-third have a history of pulmonary disease, which makes diagnosis particularly challenging (2). Therefore, early diagnosis is crucial to minimize the risk of bone deformity and improve patient outcomes (3). In this report, we describe a challenging case of musculoskeletal tuberculosis in a patient who presented with prolonged fever and no obvious source identified on clinical examination.This report highlights the rarity of bone tuberculosis and emphasizes that abdominal pain is an uncommon manifestation of the disease

The atmosphere’s interaction with other components at all temporal and spatial scales plays an important role in shaping the climate system. Climate variability and change have direct effects on crop physiology, presenting limited adaptability to climatic variations in temperature, radiation, humidity, drought, incidence of pests and diseases, affecting food availability and access. The factors associated with climate change in agriculture have sparked interest in seeking alternatives to mitigate the adverse effects on crop productivity. In this review, an analysis of the state of the art is carried out to generate new knowledge to address the following questions: Are native germplasms more adaptable to adverse climatic events associated with climate variability and change? What is the difference between climate variability and climate change? What are the potential effects of climate variability and change on agriculture? What is the response of agriculture to climate variability and change, in relation to plant genetic resources as a basis for adaptation of family agriculture? What is the importance of native plant genetic resources and germplasm banks in the face of climate variability and change? This review highlights how climate variability and change are events that are increasingly recurrent and have a greater impact on agricultural production, affecting food autonomy and security.

Abstract Objective: To compare the clinical characteristics and prognostic outcomes of patients with severe H1N1 influenza pneumonia, with and without concurrent infections, while also identifying early warning indicators. Methodology: We included 47 patients diagnosed with severe H1N1 influenza pneumonia, extracted their data from the hospital records and analyzed it. Results: Patients were divided into single infection (n = 17) and co-infection groups (n = 30). The single-infection group exhibited higher proportions of patients with coronary heart disease and acute kidney injury incidence). The co-infection group had elevated Sequential Organ Failure Assessment scores and more severe. Laboratory tests revealed significantly increased C-reactive protein levels and serum galactomannan tests in the co-infection group, with a notable reduction in the B lymphocyte ratio). The 28-day mortality rate was significantly higher in the co-infection group, with a prolonged duration of oxygen therapy. Conclusion: Co-infections with other respiratory pathogens are common in patients with severe H1N1 influenza pneumonia. Compared with single infections, co-infections lead to compromised immune function, extended periods of oxygen therapy, and increased mortality within 28 days. Thus, for patients with severe H1N1 influenza pneumonia, prompt comprehensive examination to confirm potential co-infections is imperative. Keywords: influenza A virus, severe pneumonia, co-infection

MicroRNAs regulate gene expression primarily at the post-translational level and have been increasingly implicated in the pathogenesis of various neurological diseases, indicating an important role in the brain. However, their exact functional roles are often unclear, limiting their potential for clinical applications. MicroRNA-135a-5p has been linked to numerous neurological diseases, synaptic plasticity, and density of dendritic spines. Dendritic spines are small actin-rich protrusions along neuronal dendrites where excitatory synapses are located. Dendritic spine density is regulated by numerous factors, but spine initiation factors and the actin cytoskeleton are central for determining the density and morphology of spines. Here, we elucidated the effects of microRNA-135a-5p mimic or microRNA-135a-5p inhibitor on spine initiation factors expression and actin dynamics using B16F1 melanocytes. Our experiments confirmed the predicted binding of microRNA-135a-5p to spine initiation factor Gas7 but not to the other three tested spine initiation factors. Transfection of the microRNA-135a-5p mimic stabilized actin cytoskeleton observed by live cell imaging and fluorescence recovery of photobleaching approaches. Based on our results, changes are modest but probably suitable for finetuning cellular processes, such as dendritic spine formation or stabilization. The complexity of regulation makes it challenging to create a precise picture of the effects of individual microRNAs.

This study investigates whether electrical stimulation (ES) could mimic traditional exercise in enhancing brain-derived neurotrophic factor (BDNF)-dependent neuroplasticity via muscle-brain communication, specifically through fibronectin type III domain-containing protein 5 (FNDC5)/Irisin pathway. Male Wistar rats received transcutaneous ES targeting the lumbar nerve roots to induce hindlimb muscle contractions for 30 minutes daily over seven consecutive days. Blood and tissue samples were collected for biochemical, histological, and molecular analyses, one day after the final session. Our findings reveal that ES disrupted BDNF signaling in the hippocampus, reducing synaptic protein expression. At the muscular level, ES caused significant damage, particularly in the soleus muscle, accompanied by muscle satellite cell (MuSC) activation, proliferation, and differentiation. Notably, ES increased FNDC5 expression in injured muscles, but this was associated with MuSC activation rather than humoral communication between muscle and brain. Moreover, a positive correlation was observed between the pro-inflammatory state of the injured muscles and hippocampal glucocorticoid receptor activation, as an indicator of stress, which was linked to impaired BDNF signaling. These results suggest two key conclusions: (1) increased FNDC5 expression in damaged muscle fibers primarily reflects local repair mechanisms rather than a beneficial humoral dialogue and (2) ES protocols that induce muscle injury can negatively impact BDNF-dependent plasticity by triggering maladaptive muscle-brain interactions. These findings highlight the importance of optimizing muscle stimulation protocols to minimize muscle damage, particularly when applied to individuals unable to engage in conventional physical activity or suffering from muscle weakness.

Rajan Iyer sent me a link to the TEGS 2025 conference in Budapest, Hungary which he chaired (I was unable to attend, and I thank him very much for the link). I saw part of the talk about expansion of the universe and turning the universe inside out. Since I’m a ResearchGate member who couldn’t attend the conference, I’d like to offer some thoughts about why there’s no cosmic expansion (that’s admittedly an extraordinary claim, which is why I’ve supplied extraordinary, but scientific, thoughts). I think the movement of galaxies away from each other is not evidence that the universe is expanding. I believe it means the universe itself is the magnetic monopole physicists are seeking. Let me explain (this 1st section may not seem relevant at first but the ideas of spacetime’s composition become essential when trying to tell how the universe could actually be static at the largest scale). Here are some of the subjects in this article - Universe as magnetic monopole, Building blocks of space-time, Holographic principle, Quantum mechanics only superficially probabilistic, Maths and physics explaining massless gluon, Real and imaginary numbers, Advanced and retarded waves, Mobius strip, Klein bottle, Wick rotation, Aharonov-Bohm effect, Frames of reference, Multiverse-universe unification, Dark matter and dark energy modified, Flat and simply connected cosmos, Model of universe in virtual and augmented reality, Steady State theory and creation of mass, Data swapping and galaxy displacement.

In this article, we introduce a hyper complex algebra based on a binary superposition structure. Each algebraic unit is defined by a pair (f; S) where f ∈ {0; 1} encodes the logical presence of a base component, and S ∈ {-1; 1} encodes a geometric phase or orientation. This framework allows us to define an imaginary product that is both commutative and associative, properties rarely combined in higher-dimensional algebras. We demonstrate the consistency of this product through a binary and superposed formalism. This result provides a solid foundation for representing multi-level logic states, with potential applications in quantum information processing.

Introduction: Neurosurgical 5-aminolevulenic acid (5-ALA) fluorescence-guided surgery (FGS) is evolving from highly subjective approach towards novel systems capable of quantifying the 5-ALA-induced protoporphyrin IX (PpIX) fluorescence. Optical tissue phantoms provide a cost-effective adjunct in obtaining data for the development of FGS systems. Material & Methods: Gelatin phantoms were prepared using variable concentration of PpIX and bovine blood in addition to changing pH level. Intralipid was used as the scatterer. A fluorescence spectrophotometer and novel aspirate tissue monitoring (ATM) device was used to measure the phantoms’ fluorescence emissions. Results: Increasing blood volume fraction (BVF) markedly reduced the PpIX fluorescence. Increments of 0.5% BVF reduced the fluorescence by 55–61% and 51–82% in milder and stronger concentrated phantoms, respectively. Increasing pH (6–8) augmented the fluorescence intensity in the ATM measurements by 50–130%. Conclusion: 5-ALA phantoms can streamline the development of new FGS systems and accelerate the transition from research to clinical practice.

Background: Asthma, a heterogeneous disease with genetic and environmental factors interplay. High dose inhaled corticosteroids recommended for severe asthma. However, global data on medicine use and outcomes is limited Purpose: To identify asthma control predictors in one-year Eastern African cohort Design: Multicounty prospective cohort study design was used in three specialized hospitals. Asthmatic patients were followed for one year with standard treatment of care. The primary outcome was asthma control level and its predictors during follow-up. A generalized linear mixed model was used to determine predictors of asthma control. Result: Of 1521 study participants 1074 (71%) were female. Controller medicines most frequently used were budesonide with formoterol inhalers and fluticasone propionate. During follow-up participants medicines adherence rate were high, medium and low, 69%, 21%, and 10% respectively. Asthma control during follow-up was 68% (95% CI: 66.66, 68.55) representing 47% improvement compared to the baseline. High level of adherence (p<0.001), low dose fluticasone (p<0.001), higher budesonide doses (p<0.001) were associated with increased asthma control. High dose of fluticasone propionate (p<0.001) and low dose budesonide + formoterol (p<0.001) were negatively associated with asthma control. Despite high adherence, 35% of participants failed to control their asthma. Conclusion: The study demonstrated significant improvements in asthma control during follow-up. Study participants who received low dose had six-fold greater odds of having well-controlled asthma. High adherence demonstrated a two-fold asthma controlled compared to low. Implications: Despite improved asthma control over time, one-third of participants remained uncontrolled, underscoring personalized treatment needs. The finding suggests reconsidering corticosteroid doses. Key Words: Asthma, Asthma Control, Eastern Africa, Pharmacotherapy, Predictors

Microservices architecture promises scalability and team autonomy, but it introduces significant complexity that many teams underestimate. Drawing on hard-won experience modernizing platforms across fintech, healthcare, crypto, and SaaS domains, this article critically dissects the myths and realities of microservices adoption. It surfaces the hidden operational, cultural, and architectural costs often ignored by the hype and highlights scenarios where microservices deliver value—and where they don’t. Through a practitioner-informed lens, it presents a decision-making matrix, architectural risk indicators, and evidence-based success criteria to guide technology leaders in choosing the right architecture for their stage of growth. This article draws on qualitative analysis from over a decade of architecture leadership across multiple domains and incorporates two case studies with measured engineering outcomes. It includes a comparative decision matrix (Tables [1](#tbl-cap-0001)–[4](#tbl-cap-0004)) and a practical readiness evaluation framework (Figure 1: READI) to guide architectural strategy. This article is designed to help busy CTOs, VPEs, and engineering leaders clearly assess the magnitude of architectural differences and make informed tradeoff decisions before committing to microservices and issuing top-down directives—decisions that teams may be reluctant to challenge.

Primary auditory cortical neurons show sensitivity to deviations in streams of sound tokens forming the basis of mismatch negativity. Models based on synaptic depression can explain the above phenomenon. However, such models can only explain selectivity towards oddball tones, based on the tonotopic arrangement of the auditory pathway. In the present study, we have used an oddball presentation of stimuli with different spectral contents to study the selectivity towards deviations in specific spectral shape of auditory stimuli. We used the metric of auditory contrast as a measure of the spectral shape. With single-unit in-vivo electrophysiology in the primary auditory cortex of adult mice, we found selectivity shown by the neurons towards specific spectral shapes of relatively high or low contrast value. The above selectivity was further dependent on the spectral context or spectral shape of the preceding stimulus tokens. Functional connectivity estimated using pairwise noise-correlations revealed differential connectivity within the local circuitry shown by neurons preferring spectral shapes of different contrast values in different contexts. Furthermore, using Jaccard index we found a high degree of heterogeneity among populations which prefer spectral shapes with low-contrast value. Using 2-photon Ca2+ imaging we investigated the role of two inhibitory interneuron types the Parvalbumin-expressing (PV) and the Somatostatin-expressing (SOM) in the selectivity for spectral shapes with different auditory contrast at different contexts. We found selective inhibitory subnetworks with specific excitatory neurons playing an important role in encoding for the spectral shape and context information in the auditory stimuli.

Objectives: Over 15,000 children in the United States are diagnosed with cancer annually, with many treatments impacting future fertility. Despite increased knowledge and availability of fertility preservation interventions, individual- and systems-level barriers may affect their implementation and completion. We sought to determine associations between sociodemographic factors and rates of referral for and completion of fertility preservation interventions in pediatric hematology/oncology patients at increased risk for future gonadal failure/infertility. Methods: This single center, retrospective cohort study included children aged 0-18 who were treated at the University of Chicago between 2018-2023, all at high levels of increased risk for future gonadal failure/infertility as per the Pediatric Initiative Network Risk Stratification System. Sociodemographic (sex, pubertal status, race/ethnicity, primary language) and systems-level (insurance status, “in house” versus “outside” referral) variables were collected via electronic medical records. “Social vulnerability” was calculated using the CDC/ATSDR Social Vulnerability Index. Fertility preservation referral was defined as documented discussions about fertility risks and preservation strategies, while completion included documentation of procedures. We compared rates of fertility preservation referral and completion, as well as time to referral and completion, using Chi-squared tests and t-tests. Results: 143 participants were included for analysis (62% male, 39% white, 21% Hispanic/Latine, mean age 9.1±7.1 years). 87 (61%) of participants received fertility preservation referrals, and 47 (54%) completed a procedure. No associations were observed between sociodemographic or systems-level factors and rates of referral or completion. Males had a longer time to referral from diagnosis compared to females (p=0.01). Non-white participants experienced longer times from diagnosis to referral (p=0.03) and completion (p=0.04) compared to white participants. Conclusions: Fertility preservation referral and completion rates in pediatric patients remain suboptimal. Sociodemographic and systems-level factors may be less influential than previously thought, indicating the need for further research to understand and address factors affecting fertility preservation rates.

Neuroblastoma is the most common solid extracranial tumor in children, and congenital forms account for 5% of all neuroblastoma cases. Diagnosis in utero is very rare, and their evolution leading to premature delivery for urgent treatment is exceptional. In some of these cases, chemotherapy is required after birth, in the face of tumor progression that threatens functional (dumbbell neuroblastoma), or even vital prognosis (stage 4S). However, the optimal doses of chemotherapy in premature newborns are not known. In this article, we review the management of six patients treated in French pediatric oncology centers, in order to analyze the treatment modalities, and report on their tolerance as well as the outcome of these newborns.

The management of childhood cancers requires central venous access, with totally implantable Ports commonly used. Many pediatric patients remain active—even during chemotherapy—and engage in sports and dynamic activities, raising concerns about the potential consequences of accidental thoracic traumas involving the Port or nearby tissues. To explore this, we conducted in silico computational crash testing simulating the impact of a soccer ball striking the chest over the Port reservoir, analyzing mechanical interactions between the device and surrounding anatomical tissues under external load. We could provide evidence of potential tissue injury in realistic scenarios to inform patient counselling.

Background: Pediatric cancer remains a significant cause of morbidity and mortality in low- and middle-income countries. In Peru, structural barriers limit timely diagnosis, comprehensive treatment, and proper epidemiological registration. Methods: A retrospective, observational, and descriptive study based on the 2024 institutional cancer registry from the Instituto Nacional de Salud del Niño (INSN) using the national epidemiological surveillance guideline (NTS No. 199-MINSA/CDC-2023). Results: 175 cases of pediatric cancer were registered, of which 121 (69.1%) were malignant. Most patients came from Lima (56.2%). The most affected age group was 5–9 years (34.7%). The average diagnostic delay was 69 days. Histological confirmation was achieved in 97.7% of cases. Ten children died (8%), and 87.3% were referred to INEN for treatment. Conclusions: Peru faces critical delays in childhood cancer diagnosis and inequities in access to care. National reforms are needed to decentralize services, improve early detection, and ensure integrated oncologic treatment.

Introduction: Concerns about water scarcity have driven research initiatives that incorporate educational techniques. Objective: To bibliometrically identify scientific publications related to water use mediated by educational techniques. Methodology: Exploratory-descriptive and quantitative, conducted through a bibliometric review. Data were collected from the Web of Science database, applying bibliometric laws. Biblioshiny software was used for data representation. Results: 4,816 articles were retrieved from 1,041 sources, authored by 14,500 researchers. There was a predominance of publications in Chinese. Only 17 authors published individually. Two journals accounted for over 100 publications in the period analyzed. Ten publications were selected and ranked using the InOrdinatio equation. The most frequent keywords were: water, performance, and efficiency. A bibliographic portfolio was constructed using the InOrdinatio. Conclusions: The findings reveal a growing trend in technologies related to water use. The data point to existing gaps and opportunities for the development of future research in this area.

Objective: To estimate the pooled prevalence and identify determinants of Rhesus isoimmunization among pregnant women in African hospitals. Methods: We conducted a systematic review following PRISMA guidelines, searching PubMed, SCOPUS, Web of Science, Lens.org, and Google Scholar for observational studies (2010–May 2025) on Rhesus isoimmunization in African hospital settings. The PICO framework guided the research question (Population: pregnant women; Intervention: none; Comparison: subgroups; Outcome: prevalence and determinants). Data were extracted using a standardized form, and study quality was assessed with the Joanna Briggs Institute checklist. A random-effects model with logit transformation pooled prevalence estimates. Heterogeneity was evaluated using I 2 and Cochran’s Q, and publication bias was assessed via Fail-Safe N, Kendall’s Tau, Egger’s regression, and funnel plots. Results: Nine studies (n=28,188 women) from Nigeria, Ethiopia, Uganda, and DR Congo showed a pooled prevalence of 2.93% (95% CI: 1.58%–5.36%), with high heterogeneity (I 2=85.12%, Q=48.320, p<0.001). Regional prevalence ranged from 0.31% (DR Congo) to 7.04% (Ethiopia). Key determinants included previous pregnancies, abortions, stillbirths, blood transfusions, and lack of anti-D prophylaxis. No publication bias was detected (Fail-Safe N=2,581, Egger’s p=0.672). Conclusions: Rhesus isoimmunization affects ~2.93% of pregnant women in African hospitals, posing a significant risk of hemolytic disease of the fetus and newborn. Routine Rhesus screening, accessible anti-D prophylaxis, and policy reforms are critical to reduce maternal and neonatal morbidity.