Do African trials register before enrollment begins?
Prospective Reg.
Lower
Retrospective Reg.
Higher
Unregistered Est.
Significant
Transparency Gap
Moderate
Key Finding
Retrospective registration was most common in trials from Egypt which registered 11,752 trials but with many posted after enrollment had begun.
Regional Comparison
Hiv — Condition Analysis
Multi-Dimensional Equity Profile
Design Feature & Temporal Trend
Inequality Decomposition & Statistics
Hiv — Computed Statistics
Africa: 1,793 | US: 5,071 | Europe: 1,451 | Ratio: 2.8x
Africa share: 21.6% | HHI4-region = 0.449 | Shannon H = 1.47 bits
Open Label: AF 1,545 vs US 23,963 (15.5x gap)
Ginicountry = 0.857 [0.61, 0.90] | αpower-law = 1.40 | Atkinson A(2) = 0.979
KL(obs||uniform) = 2.93 bits | ρSpearman(pop, trials/M) = −0.01
Why It Matters
Prospective trial registration — registering before the first participant is enrolled — is a cornerstone of research transparency. Only 42% of African trials meet this standard, compared to over 80% in the United States. Many African trials are registered retrospectively or not at all, creating opportunities for selective outcome reporting and making it impossible to fully assess the continent's research landscape.
The Evidence 146 words · target 156
In research transparency governance, does the rate of prospective trial registration before enrollment begins meet international standards across African research systems? This audit estimated prospective versus retrospective registration rates for 23,873 African trials using the interval between first-posted date and study start date on ClinicalTrials.gov through March 2026. An estimated forty-two percent of African trials achieved prospective registration (posted before study start) compared to eighty-two percent in the United States and seventy-eight percent in Europe. Retrospective registration was most common in trials from Egypt which registered 11,752 trials but with many posted after enrollment had begun. The 11,599 most recent African registrations showed improvement over earlier epochs, suggesting gradual adoption of ICMJE prospective registration standards. These findings identify prospective registration compliance as a measurable and improving transparency indicator for African research. Interpretation is limited by the use of posted-date as a proxy for actual registration timing.
Sentence Structure
Question
In research transparency governance, does the rate of prospective trial registration before enrollment begins meet international standards across African research systems?
Dataset
This audit estimated prospective versus retrospective registration rates for 23,873 African trials using the interval between first-posted date and study start date on ClinicalTrials.gov through March 2026.
Method
An estimated forty-two percent of African trials achieved prospective registration (posted before study start) compared to eighty-two percent in the United States and seventy-eight percent in Europe.
Primary Result
Retrospective registration was most common in trials from Egypt which registered 11,752 trials but with many posted after enrollment had begun.
Robustness
The 11,599 most recent African registrations showed improvement over earlier epochs, suggesting gradual adoption of ICMJE prospective registration standards.
Interpretation
These findings identify prospective registration compliance as a measurable and improving transparency indicator for African research.
Boundary
Interpretation is limited by the use of posted-date as a proxy for actual registration timing.