{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T10:37:28Z","timestamp":1773484648102,"version":"3.50.1"},"reference-count":73,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,3,10]],"date-time":"2024-03-10T00:00:00Z","timestamp":1710028800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Cervical and prostate cancer account for 7.1 and 7.3 deaths per 100,000 people globally in 2022. These rates increased significantly to 17.6 and 17.3 in Africa, respectively, making them the second and third leading cause of cancer deaths in Africa, only surpassed by breast cancer. The human papillomavirus is the prime risk factor for cervical cancer infection. On the other hand, prostate cancer risks include ageing, genetics, race, geography, and family history. However, these factors alone cannot account for the high mortality rate in Africa, which is more than twice the global mortality rate for the two cancers. We searched PubMed, Embase, Scopus, and Web of Science to select relevant articles using keywords related to microorganisms involved in cervical and prostate cancer and the impact of poor healthcare systems on the mortality rates of these two cancers in Africa by carrying out a detailed synopsis of the studies on microbial agents involved and the contributory factors to the deteriorating healthcare system in Africa. It became apparent that the developed countries come first in terms of the prevalence of cervical and prostate cancer. However, more people per capita in Africa die from these cancers as compared to other continents. Also, microbial infections (bacterial or viral), especially sexually transmitted infections, cause inflammation, which triggers the pathogenesis and progression of these cancers among the African population; this has been linked to the region\u2019s deficient health infrastructure, making it difficult for people with microbial infections to access healthcare and hence making infection control and prevention challenging. Taken together, untreated microbial infections, primarily sexually transmitted infections due to the deficient healthcare systems in Africa, are responsible for the high mortality rate of cervical and prostate cancer.<\/jats:p>","DOI":"10.3390\/pathogens13030243","type":"journal-article","created":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T06:05:30Z","timestamp":1710137130000},"page":"243","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Unveiling the Dual Threat: How Microbial Infections and Healthcare Deficiencies Fuel Cervical and Prostate Cancer Deaths in Africa"],"prefix":"10.3390","volume":"13","author":[{"given":"Sofian","family":"Abdul-Nasir","sequence":"first","affiliation":[{"name":"Department of Convergence Medicine, Wonju College of Medicine, Yonsei University, Wonju 26426, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3819-9057","authenticated-orcid":false,"given":"Hyungdon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, Hallym University, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Md. Habibur","family":"Rahman","sequence":"additional","affiliation":[{"name":"Department of Convergence Medicine, Wonju College of Medicine, Yonsei University, Wonju 26426, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7228-8053","authenticated-orcid":false,"given":"Johny","family":"Bajgai","sequence":"additional","affiliation":[{"name":"Department of Convergence Medicine, Wonju College of Medicine, Yonsei University, Wonju 26426, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8748-8122","authenticated-orcid":false,"given":"Kyu-Jae","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Convergence Medicine, Wonju College of Medicine, Yonsei University, Wonju 26426, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9927-9990","authenticated-orcid":false,"given":"Cheol-Su","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Convergence Medicine, Wonju College of Medicine, Yonsei University, Wonju 26426, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3797-8654","authenticated-orcid":false,"given":"Soo-Ki","family":"Kim","sequence":"additional","affiliation":[{"name":"Research Institute of Metabolism and Inflammation, Wonju College of Medicine, Yonsei University, Wonju 26426, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,10]]},"reference":[{"key":"ref_1","unstructured":"WHO (2022). International Agency for Research on Cancer TODAY, WHO. Available online: https:\/\/gco.iarc.who.int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"793","DOI":"10.7326\/0003-4819-118-10-199305150-00007","article-title":"Risk Factors for Prostate Cancer","volume":"118","author":"Pienta","year":"1993","journal-title":"Ann. Intern. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1240","DOI":"10.1053\/j.gastro.2014.01.044","article-title":"Effects of Tenofovir Disoproxil Fumarate in Hepatitis B e Antigen-Positive Patients with Normal Levels of Alanine Aminotransferase and High Levels of Hepatitis B Virus DNA","volume":"146","author":"Chan","year":"2014","journal-title":"Gastroenterology"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Yusuf, K., Sampath, V., and Umar, S. (2023). Bacterial Infections and Cancer: Exploring This Association and Its Implications for Cancer Patients. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24043110"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.ceb.2015.10.002","article-title":"Cell Types of Origin for Prostate Cancer","volume":"37","author":"Lee","year":"2015","journal-title":"Curr. Opin. Cell Biol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3","DOI":"10.7150\/jca.7709","article-title":"Current Approaches, Challenges and Future Directions for Monitoring Treatment Response in Prostate Cancer","volume":"5","author":"Wallace","year":"2014","journal-title":"J. Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"811044","DOI":"10.3389\/fpubh.2022.811044","article-title":"Prostate Cancer Incidence and Mortality: Global Status and Temporal Trends in 89 Countries from 2000 to 2019","volume":"10","author":"Wang","year":"2022","journal-title":"Front. Public Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1007\/s10555-013-9480-2","article-title":"Bone-Targeting Agents in Prostate Cancer","volume":"33","author":"Suzman","year":"2014","journal-title":"Cancer Metastasis Rev."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.15585\/mmwr.mm6941a1","article-title":"Prostate Cancer Incidence and Survival, by Stage and Race\/Ethnicity\u2014United States, 2001\u20132017","volume":"69","author":"Siegel","year":"2020","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Pascale, M., Azinwi, C.N., Marongiu, B., Pesce, G., Stoffel, F., and Roggero, E. (2017). The Outcome of Prostate Cancer Patients Treated with Curative Intent Strongly Depends on Survival after Metastatic Progression. BMC Cancer, 17.","DOI":"10.1186\/s12885-017-3617-6"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1006\/scbi.1998.0075","article-title":"What Causes Prostate Cancer? A Brief Summary of the Epidemiology","volume":"8","author":"Chan","year":"1998","journal-title":"Semin. Cancer Biol."},{"key":"ref_13","unstructured":"(2024, January 24). American Cancer Society Prostate Cancer Risk Factors. Available online: https:\/\/www.cancer.org\/cancer\/types\/prostate-cancer\/causes-risks-prevention\/risk-factors.html."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.1002\/1097-0142(19950401)75:7+<1778::AID-CNCR2820751605>3.0.CO;2-J","article-title":"Does the Racial-ethnic Variation in Prostate Cancer Risk Have a Hormonal Basis?","volume":"75","author":"Ross","year":"1995","journal-title":"Cancer"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1101\/gad.315739.118","article-title":"Genetics and Biology of Prostate Cancer","volume":"32","author":"Wang","year":"2018","journal-title":"Genes. Dev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"560857","DOI":"10.1155\/2013\/560857","article-title":"Global Patterns of Prostate Cancer Incidence, Aggressiveness, and Mortality in Men of African Descent","volume":"2013","author":"Rebbeck","year":"2013","journal-title":"Prostate Cancer"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1001\/jamaoncol.2019.0826","article-title":"Association of Black Race With Prostate Cancer\u2013Specific and Other-Cause Mortality","volume":"5","author":"Dess","year":"2019","journal-title":"JAMA Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1941","DOI":"10.1002\/ijc.31937","article-title":"Estimating the Global Cancer Incidence and Mortality in 2018: GLOBOCAN Sources and Methods","volume":"144","author":"Ferlay","year":"2019","journal-title":"Int. J. Cancer"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"199068","DOI":"10.1016\/j.virusres.2023.199068","article-title":"Elimination of Reserve Cells for Prevention of HPV-Associated Cervical Cancer","volume":"329","author":"Reich","year":"2023","journal-title":"Virus Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2349","DOI":"10.1002\/ijc.27485","article-title":"Human Papillomavirus Types in 115,789 HPV-positive Women: A Meta-analysis from Cervical Infection to Cancer","volume":"131","author":"Guan","year":"2012","journal-title":"Int. J. Cancer"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"167","DOI":"10.2147\/ITT.S273327","article-title":"Therapeutic Vaccines for HPV-Associated Malignancies","volume":"9","author":"Roller","year":"2020","journal-title":"Immunotargets Ther."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Causin, R.L., de Freitas, A.J.A., Trovo Hidalgo Filho, C.M., dos Reis, R., Reis, R.M., and Marques, M.M.C. (2021). A Systematic Review of MicroRNAs Involved in Cervical Cancer Progression. Cells, 10.","DOI":"10.3390\/cells10030668"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"S11","DOI":"10.1016\/j.vaccine.2006.05.111","article-title":"The Burden of HPV-Related Cancers","volume":"24","author":"Parkin","year":"2006","journal-title":"Vaccine"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"14064","DOI":"10.1038\/s41598-021-93485-1","article-title":"Mixed and Nonvaccine High Risk HPV Types Are Associated with Higher Mortality in Black Women with Cervical Cancer","volume":"11","author":"Mendoza","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1001\/jama.2023.13174","article-title":"Cervical Cancer Screening","volume":"330","author":"Perkins","year":"2023","journal-title":"JAMA"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1643","DOI":"10.1016\/S1470-2045(20)30524-6","article-title":"Efficacy of the Bivalent HPV Vaccine against HPV 16\/18-Associated Precancer: Long-Term Follow-up Results from the Costa Rica Vaccine Trial","volume":"21","author":"Porras","year":"2020","journal-title":"Lancet Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1007\/s13273-021-00220-y","article-title":"S-Adenosylmethionine Enhances the Inhibitory Effect of Gemcitabine against Pancreatic Cancer Cells via Suppression of the EGFR\/AKT Pathways","volume":"18","author":"Liu","year":"2022","journal-title":"Mol. Cell Toxicol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1186\/s13027-022-00427-1","article-title":"Multiple Pathogens and Prostate Cancer","volume":"17","author":"Lawson","year":"2022","journal-title":"Infect. Agent. Cancer"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1038\/s41568-020-0267-9","article-title":"Prostate Carcinogenesis: Inflammatory Storms","volume":"20","author":"Guo","year":"2020","journal-title":"Nat. Rev. Cancer"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.canep.2014.06.002","article-title":"Sexually Transmitted Infections and Prostate Cancer Risk: A Systematic Review and Meta-Analysis","volume":"38","author":"Caini","year":"2014","journal-title":"Cancer Epidemiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1002\/ijc.2910350105","article-title":"A Prospective Study of Association of Herpes Simplex Virus and Human Papillomavirus Infection with Cervical Neoplasia in Women Exposed to Diethylstilbestrolin Utero","volume":"35","author":"Adam","year":"1985","journal-title":"Int. J. Cancer"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Rokos, T., Holubekova, V., Kolkova, Z., Hornakova, A., Pribulova, T., Kozubik, E., Biringer, K., and Kudela, E. (2022). Is the Physiological Composition of the Vaginal Microbiome Altered in High-Risk HPV Infection of the Uterine Cervix?. Viruses, 14.","DOI":"10.3390\/v14102130"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1038\/nrc3610","article-title":"The Microbiome and Cancer","volume":"13","author":"Schwabe","year":"2013","journal-title":"Nat. Rev. Cancer"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1038\/s41391-018-0041-1","article-title":"The Microbiome in Prostate Inflammation and Prostate Cancer","volume":"21","author":"Porter","year":"2018","journal-title":"Prostate Cancer Prostatic Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/j.currproblcancer.2018.06.003","article-title":"Cervical Cancer Worldwide","volume":"42","author":"Vu","year":"2018","journal-title":"Curr. Probl. Cancer"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1002\/pros.20680","article-title":"A Molecular Analysis of Prokaryotic and Viral DNA Sequences in Prostate Tissue from Patients with Prostate Cancer Indicates the Presence of Multiple and Diverse Microorganisms","volume":"68","author":"Sfanos","year":"2008","journal-title":"Prostate"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1969","DOI":"10.1097\/01.ju.0000158161.15277.78","article-title":"Propionibacterium acnes associated with inflammation in radical prostatectomy specimens: A possible link to cancer evolution?","volume":"173","author":"Cohen","year":"2005","journal-title":"J. Urol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"385","DOI":"10.5114\/aoms.2015.50970","article-title":"Urinary Microbiota in Patients with Prostate Cancer and Benign Prostatic Hyperplasia","volume":"2","author":"Yu","year":"2015","journal-title":"Arch. Med. Sci."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s13027-016-0112-7","article-title":"Characterisation of Microbial Communities within Aggressive Prostate Cancer Tissues","volume":"12","author":"Yow","year":"2017","journal-title":"Infect. Agent. Cancer"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2319962","DOI":"10.1080\/21505594.2024.2319962","article-title":"Escherichia coli and HPV16 Coinfection May Contribute to the Development of Cervical Cancer","volume":"15","author":"Zou","year":"2024","journal-title":"Virulence"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1016\/j.ygyno.2021.08.016","article-title":"The Feature of Cervical Microbiota Associated with the Progression of Cervical Cancer among Reproductive Females","volume":"163","author":"Wu","year":"2021","journal-title":"Gynecol. Oncol."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Curty, G., de Carvalho, P.S., and Soares, M.A. (2019). The Role of the Cervicovaginal Microbiome on the Genesis and as a Biomarker of Premalignant Cervical Intraepithelial Neoplasia and Invasive Cervical Cancer. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21010222"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1038\/nrc2090","article-title":"Inflammation in Prostate Carcinogenesis","volume":"7","author":"Platz","year":"2007","journal-title":"Nat. Rev. Cancer"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.2217\/fon.10.95","article-title":"Sexually Transmitted Infections and Risk of Prostate Cancer: Review of Historical and Emerging Hypotheses","volume":"6","author":"Sutcliffe","year":"2010","journal-title":"Future Oncol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Cheng, I., Witte, J.S., Jacobsen, S.J., Haque, R., Quinn, V.P., Quesenberry, C.P., Caan, B.J., and Van Den Eeden, S.K. (2010). Prostatitis, Sexually Transmitted Diseases, and Prostate Cancer: The California Men\u2019s Health Study. PLoS ONE, 5.","DOI":"10.1371\/journal.pone.0008736"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.canep.2015.12.001","article-title":"History of Gonorrhea and Prostate Cancer in a Population-Based Case\u2013Control Study in Mexico","volume":"40","year":"2016","journal-title":"Cancer Epidemiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1159\/000365705","article-title":"Molecular Evidence of Helicobacter Pylori Infection in Prostate Tumors","volume":"8","author":"Ouhtit","year":"2015","journal-title":"Curr. Urol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1186\/s13027-020-00319-2","article-title":"The Human Microbiome and Its Link in Prostate Cancer Risk and Pathogenesis","volume":"15","author":"Katongole","year":"2020","journal-title":"Infect. Agent. Cancer"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1128\/CMR.16.1.1-17.2003","article-title":"Human Papillomavirus and Cervical Cancer","volume":"16","author":"Burd","year":"2003","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Zhou, Z.-W., Long, H.-Z., Cheng, Y., Luo, H.-Y., Wen, D.-D., and Gao, L.-C. (2021). From Microbiome to Inflammation: The Key Drivers of Cervical Cancer. Front. Microbiol., 12.","DOI":"10.3389\/fmicb.2021.767931"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1007\/s13273-022-00278-2","article-title":"FBXO22 Promotes Cell Proliferation and Inhibits Autophagy in HPV-Associated Cervical Cancer by Inactivating the LKB1\/AMPK Pathway","volume":"19","author":"Gao","year":"2023","journal-title":"Mol. Cell Toxicol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1016\/j.ejca.2017.09.023","article-title":"Risk of Early-Onset Prostate Cancer Associated with Occupation in the Nordic Countries","volume":"87","author":"Barry","year":"2017","journal-title":"Eur. J. Cancer"},{"key":"ref_53","unstructured":"WHO IARC Working Group (1995). Human Papillomaviruses. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, International Agency for Research on Cancer."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"87","DOI":"10.3322\/caac.21262","article-title":"Global Cancer Statistics, 2012","volume":"65","author":"Torre","year":"2015","journal-title":"CA Cancer J. Clin."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"53","DOI":"10.5317\/wjog.v2.i3.53","article-title":"Smoking and Genital Human Papilloma Virus Infection in Women Attending Cervical Cancer Screening in Greece","volume":"2","author":"Chatzistamatiou","year":"2013","journal-title":"World J. Obstet. Gynecol."},{"key":"ref_56","first-page":"57","article-title":"Multifactorial Etiology of Cervical Cancer: A Hypothesis","volume":"7","author":"Haverkos","year":"2005","journal-title":"MedGenMed"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"S254","DOI":"10.1093\/carcin\/bgv039","article-title":"Assessing the Carcinogenic Potential of Low-Dose Exposures to Chemical Mixtures in the Environment: The Challenge Ahead","volume":"36","author":"Goodson","year":"2015","journal-title":"Carcinogenesis"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1002\/ijc.1622","article-title":"Burning Wood in the Kitchen Increases the Risk of Cervical Neoplasia in HPV-Infected Women in Honduras","volume":"97","author":"Velema","year":"2002","journal-title":"Int. J. Cancer"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1136\/oemed-2018-105391","article-title":"Usual Adult Occupation and Risk of Prostate Cancer in West African Men: The Ghana Prostate Study","volume":"76","author":"Adler","year":"2019","journal-title":"Occup. Environ. Med."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1007\/s13273-022-00306-1","article-title":"Occupational Exposure to Mixtures and Toxic Pathways Prediction for Workers\u2019 Health","volume":"19","author":"Rim","year":"2023","journal-title":"Mol. Cell Toxicol."},{"key":"ref_61","first-page":"10","article-title":"Exploring the Challenges with Infection Control Practices among Managers in Intensive Care Units in South Africa","volume":"34","author":"Mahomed","year":"2018","journal-title":"S. Afr. J. Crit. Care"},{"key":"ref_62","unstructured":"Center for Disease Dynamics, Economics & Policy (2011). Infection Control Challenges in Public Hospitals in Kenya, Center for Disease Dynamics, Economics & Policy."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Samuel, S.O., Kayode, O.O., Musa, O.I., Nwigwe, G.C., Aboderin, A.O., Salami, T.A.T., and Taiwo, S.S. (2010). Nosocomial Infections and the Challenges of Control in Developing Countries. Afr. J. Clin. Exp. Microbiol., 11.","DOI":"10.4314\/ajcem.v11i2.53916"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1057\/s41271-018-0136-x","article-title":"Energy Poverty in Healthcare Facilities: A \u201cSilent Barrier\u201d to Improved Healthcare in Sub-Saharan Africa","volume":"39","author":"Ouedraogo","year":"2018","journal-title":"J. Public. Health Policy"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"395","DOI":"10.2147\/IJGM.S223882","article-title":"Identifying Key Challenges Facing Healthcare Systems In Africa And Potential Solutions","volume":"12","author":"Oleribe","year":"2019","journal-title":"Int. J. Gen. Med."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1158\/1055-9965.EPI-20-1005","article-title":"Rising Prostate Cancer Incidence in Sub-Saharan Africa: A Trend Analysis of Data from the African Cancer Registry Network","volume":"30","author":"Seraphin","year":"2021","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"650117","DOI":"10.3389\/fonc.2021.650117","article-title":"Cancer in Africa: The Untold Story","volume":"11","author":"Hamdi","year":"2021","journal-title":"Front. Oncol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/inthealth\/ihx046","article-title":"Social Health Insurance Schemes in Africa Leave out the Poor","volume":"10","author":"Fenny","year":"2018","journal-title":"Int. Health"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"e004712","DOI":"10.1136\/bmjgh-2020-004712","article-title":"Examining the Level and Inequality in Health Insurance Coverage in 36 Sub-Saharan African Countries","volume":"6","author":"Barasa","year":"2021","journal-title":"BMJ Glob. Health"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1093\/heapol\/czac104","article-title":"Barriers to Cervical Cancer and Breast Cancer Screening Uptake in Low- and Middle-Income Countries: A Systematic Review","volume":"38","author":"Srinath","year":"2023","journal-title":"Health Policy Plan."},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Guimar\u00e3es, Y.M., Godoy, L.R., Longatto-Filho, A., and Reis, R. (2022). dos Management of Early-Stage Cervical Cancer: A Literature Review. Cancers, 14.","DOI":"10.3390\/cancers14030575"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1851346","DOI":"10.1080\/26410397.2020.1851346","article-title":"Comprehensive Sexuality Education in Sub-Saharan Africa: Adaptation and Implementation Challenges in Universal Access for Children and Adolescents","volume":"28","author":"Wangamati","year":"2020","journal-title":"Sex. Reprod. Health Matters"},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Crocetto, F., Arcaniolo, D., Napolitano, L., Barone, B., La Rocca, R., Capece, M., Caputo, V.F., Imbimbo, C., De Sio, M., and Calace, F.P. (2021). Impact of Sexual Activity on the Risk of Male Genital Tumors: A Systematic Review of the Literature. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18168500"}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/13\/3\/243\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:11:35Z","timestamp":1760105495000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/13\/3\/243"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,10]]},"references-count":73,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,3]]}},"alternative-id":["pathogens13030243"],"URL":"https:\/\/doi.org\/10.3390\/pathogens13030243","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,10]]}}}