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This study investigated non-revenue water (NRW) dynamics in Rwanda from 1 July 2014, to 30 June 2023, utilizing panel data and cross-sectional datasets. It aimed to assess progress towards achieving the government's target of 25% NRW. Through panel data analysis and machine learning models, it examined water supply variations, NRW levels, and associated risks across fiscal years and regions. The observed average NRW of 41.24% underscores the need for targeted interventions to meet the set target. Regional disparities, exemplified by Kigali City's water network's 38.61% average NRW compared to Nyagatare's 55.31%, emphasize the importance of tailored strategies. Machine learning models indicated low and inconsistent progress across networks. Notably, no single water supply managed to meet the target in more than 20% of the 36 quarters studied. Comparison with existing literature highlighted excessive NRW in Rwanda, aligning with global trends. Achieving the 25% NRW target requires region-specific approaches, necessitating infrastructure improvements, leak detection, and capacity building. The positive correlation between water loss risk and household access to improved water sources accentuated the complexity in NRW reduction efforts. This study contributes to understanding NRW dynamics and informs sustainable water management strategies tailored to Rwanda's context. HIGHLIGHTS Need for balancing NRW reduction and access to improved water sources.; NRW is a region-specific issue.; WASAC is progressing slowly in the attainment of the target NRW of 25%.; Need to leverage panel data analysis and machine learning algorithms to understand NRW.; Most instances of 25% NRW or below were uncertain (due to issues of overlaps identified in all NRW classes), thus the need for a specific investigation on them.;

This study in Rwanda offers a comprehensive analysis of water quality, reliability, and cost-effectiveness, departing from previous research by utilizing panel data analysis for a nuanced understanding of spatiotemporal dynamics. Unlike earlier studies focusing on specific aspects, this research adopts a holistic approach, examining factors crucial for water supply, quality, and cost, thus providing an integrated view of Rwanda's water sector. By analyzing data from various sources, including the Water and Sanitation Corporation (WASAC), the study evaluates the reliability, quality, and cost-effectiveness of drinking water. It identifies cost-effective water treatment plants and studies determinants such as production cost, raw water quality, and supply between 2017 and 2022, introducing novel metrics such as performance scores and a drinking water quality index. Despite an increase in lost water, WASAC notably improves water supply, resulting in a higher water access rate by 2022. The study highlights the influence of factors such as performance scores and raw water quality on water supply and quality. It emphasizes continuous monitoring, targeted interventions, and community engagement for sustainable water service delivery. The findings provide actionable insights for policymakers, stakeholders, and practitioners, aiming to enhance water management strategies and improve water access in Rwanda. HIGHLIGHTS Panel data analysis offers nuanced spatiotemporal insights departing from cross-sectional methods.; Holistic approach examines water supply, quality, and cost, unlike prior single-focus studies.; Innovative metrics introduced include performance score and water quality index.; Practical insights help identify cost-effective water treatment plants and key determinants.; Sustainability focus emphasizes continuous monitoring and community engagement.;

Abstract The protection of the replication fork structure under stress conditions is essential for genome maintenance and cancer prevention. A key signaling pathway for fork protection involves TRPV2-mediated Ca2+ release from the ER, which is triggered after the generation of cytosolic DNA and the activation of cGAS/STING. This results in CaMKK2/AMPK activation and subsequent Exo1 phosphorylation, which prevent aberrant fork processing, thereby ensuring genome stability. However, it remains poorly understood how the TRPV2 channel is activated by the presence of cytosolic DNA. Here, through a genome-wide CRISPR-based screen, we identify TRPM8 channel-associated factor 1 (TCAF1) as a key factor promoting TRPV2-mediated Ca2+ release under replication stress or other conditions that activate cGAS/STING. Mechanistically, TCAF1 assists Ca2+ release by facilitating the dissociation of STING from TRPV2, thereby relieving TRPV2 repression. Consistent with this function, TCAF1 is required for fork protection, chromosomal stability, and cell survival after replication stress.

Abstract Background Community and individual participation are crucial for the success of schistosomiasis control. The World Health Organization (WHO) has highlighted the importance of enhanced sanitation, health education, and Mass Drug Administration (MDA) in the fight against schistosomiasis. These approaches rely on the knowledge and practices of the community to be successful; however, where the community knowledge is low and inappropriate, it hinders intervention efforts. Hence, it is essential to identify barriers and misconceptions related to awareness of schistosomiasis, sources of infection, mode of transmission, symptoms, and control measures. Methods This was a mixed-method cross-sectional study involving 1200 pre-school children randomly selected and examined for Schistosoma mansoni infection using the Kato-Katz technique. All parents/guardians of selected children were enrolled for a pre-tested questionnaire survey, while 42 were engaged in focus group discussions (FGDs). The level of knowledge and awareness among parents/guardians about schistosomiasis was evaluated in relation to the infection status of their pre-school children. Results Among pre-school children, the prevalence of intestinal schistosomiasis was 45.1% (95% CI 41.7–48.5). A majority of parents/guardians (85.5%) had heard about schistosomiasis, and this awareness was associated with the participant’s level of education (OR = 0.16, 95% CI 0.08, 0.34). In addition, a positive association was observed between higher educational attainment and knowledge of the causative agent (OR = 0.69, 95% CI 0.49, 0.96). Low education level was significantly associated with limited knowledge of transmission through lake water contact (OR = 0.71, 95% CI 0.52, 0.97) and infection from the lake (OR = 0.33, 95% CI 0.19, 0.57). Notably, parents/guardians who have heard of schistosomiasis could not recognize symptoms of S. mansoni infection, such as abdominal pain (91.8%, 815/888) and blood in the stool (85.1%, 756/888). Surprisingly, 49.8% (442/888) incorrectly identified hematuria (blood in urine), a key sign of S. haematobium, but not S. mansoni, in an endemic area for S. mansoni infection. The majority (82.6%, 734/888) of parents/guardians were unaware that dams are potential infection sites, despite 53.9% (479/888) of their pre-school-aged children testing positive for schistosome infection. Conclusions Despite the high level of awareness of intestinal schistosomiasis in the study area, we identified a low level of knowledge regarding its causes, modes of transmission, signs and symptoms and potential sites of transmission within the community. This study emphasizes the need for targeted educational interventions to address the misconceptions and knowledge gaps surrounding intestinal schistosomiasis through tailored community-based programs.

AbstractGeofence mobile technology can offer significant benefits to all stakeholders in the retail property sector ecosystem. This paper investigated the opportunities and challenges associated with the adoption of geofence mobile technology by retailers in South Africa. The paper adopted a qualitative research approach and interviewed property management professionals who have several years of work experiences in the retail sector in the country. As key stakeholders, retail property managers significantly contribute to the retail environment, especially with the integration of technology. Findings revealed that targeted marketing, shopper engagement and increased sales are opportunities presented by geofencing mobile technology to retailers. These opportunities potentially encourage retailers, and by implication property owners and property portfolio managers, to have management buy in and invest in employees’ skills for the adoption of geofence mobile technology. Additionally, the presence of vendor support and clear and assured data privacy and regulations are needed for the adoption of geofence mobile technology. These results represent a solid attempt to extend knowledge – in terms of research, policy, and practice – of the impact that new technologies have on the retail sector within a developing country, which is ripe for the adoption of geofence technology across its many economic sectors.

Lablab (Lablab purpureus L.) is an important food and livestock feed legume that can also enhance soil fertility. However, its production is limited by insect pests, notably the black bean aphid (Aphis fabae). The present field study was conducted to determine the difference in the contribution of lablab genotypes and natural field margin vegetation (FMV) to the abundance and diversity of natural enemies and the damage, incidence, and abundance of bean aphids. Eighteen lablab genotypes were planted in the presence or absence of FMV in a randomized complete block design experiment replicated four times. Data on aphid abundance, incidence, and severity of damage were collected at four growth stages of the crop. Lablab genotypes significantly influenced aphid incidence, suggesting some level of tolerance to aphid colonization. Findings showed that lablab genotypes were a significant influence on natural enemy species richness with no statistical difference for abundance and natural enemy species diversity. However, the genotypes did not vary significantly in their influence on the number of aphid natural enemies. FMV was associated with low bean aphid damage. Overall, the presence or absence of FMV did not influence the number of natural enemies caught on the crop. This concurs with recent work that shows a similar number of natural enemies with field margin plants but may reflect the reduced number of pest insects. Cropping seasons influenced aphid abundance and damage severity, with the populations developing at the early stages of lablab development and decreasing as the crop advanced. This pattern was similar both in the presence or absence of FMV. The findings of this study highlight the important contribution of crop genotype together with the presence of field margin species in the regulation of aphids and their natural enemies in lablab.

The escalating public debt in African nations has sparked global discussions regarding the sustainability within the region. This concern primarily stems from China's increasing role as a significant financier of African infrastructure projects, raising fears that China might be using debt to gain geopolitical leverage by ensnaring impoverished nations in unmanageable loan agreements. To address this issue, we employ three distinct approaches: a descriptive trend analysis, an examination of the debt-to-GDP ratio, and a modelling approach.For the modelling, we utilize a panel Autoregressive Distributed Lag model to assess the short and long-term relationships between economic growth and specified independent variables, including loans. We choose this model because it allows for panel data analysis encompassing the African countries over a span of 20 years and accounts for potential autocorrelation through the inclusion of lagged terms.Our key findings indicate that, based on the debt-to-GDP ratio, some African countries have sustainable debt levels, while others are at risk of facing financial distress. Furthermore, the results of the Autoregressive Distributed Lag model suggest that Chinese loans contribute to long-term economic growth in the region. Therefore, our study recommends that African governments implement robust debt management strategies to avoid default. Additionally, they should recognize that debt can stimulate economic growth when utilized to enhance infrastructure and production capacity.

Abstract Background The non-pharmaceutical interventions (NPIs) implemented to curb the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) early in the coronavirus disease 2019 (COVID-19) pandemic, substantially disrupted the activity of other respiratory viruses. However, there is limited data from low-and-middle income countries (LMICs) to determine whether these NPIs also impacted the transmission of common enteric viruses. Here, we investigated the changes in the positivity rate of five enteric viruses among hospitalised children who presented with diarrhoea to a referral hospital in coastal Kenya, during COVID-19 pandemic period. Methods A total of 870 stool samples from children under 13 years of age admitted to Kilifi County Hospital between January 2019, and December 2022 were screened for rotavirus group A (RVA), norovirus genogroup II (GII), astrovirus, sapovirus, and adenovirus type F40/41 using real-time reverse-transcription polymerase chain reaction. The proportions positive across the four years were compared using the chi-squared test statistic. Results One or more of the five virus targets were detected in 282 (32.4%) cases. A reduction in the positivity rate of RVA cases was observed from 2019 (12.1%, 95% confidence interval (CI) 8.7–16.2%) to 2020 (1.7%, 95% CI 0.2–6.0%; p

We report a newly emerged SARS-CoV-2 Omicron subvariant FY.4 that has mutations Y451H in spike and P42L in open reading frame 3a proteins. FY.4 emergence coincided with increased SARS-CoV-2 cases in coastal Kenya during April–May 2023. Continued SARS-CoV-2 genomic surveillance is needed to identify new lineages to inform COVID-19 outbreak prevention.

The changes in landscape structure and functioning due to unprecedented human interference are hastening across the globe and it is thus a compelling necessity to preserve and restore our ecosystems. This study aimed to characterize levels of landscape fragmentation, habitat structure, driving forces, and perceptions of the residents on the most preferred reconfiguration approaches. The land use/land cover [LULC] change was first determined by interpreting the 1973, 1986, 1995, 2002, 2014, and 2022 Landsat images using the QGIS 3.26 while the selected landscape fragmentation metrics were analyzed using FRAGSTATS 4.2. Forests, shrubs, and grasslands showed a declining trend, except for agriculture, water, and built-up areas, which depicted high increases for the study periods [1973 to 2022]. The landscape of the study area is characterized as progressively fragmenting as signified by high escalated values of patch number [374 %], edge density [7828 %] between 1986 and 2002, contagion [10.3%], and a declined value of Shannon Diversity Index [SHDI] [-17.42%], Shannon evenness index [SHEI] [-25.8 %] and connectedness [-43.3%]. Considering these results, high losses of forests and grasslands coupled with expansive farmlands and built-up areas have led to unprecedented landscape fragmentation From field surveys and oral interviews, this has not only left streams vulnerable to massive sediment loads but has also triggered annual floods which occur during wet months even though change in onset of rainfall seasons was also reported. The findings call for restoration and integrated and sustainable restoration efforts, especially for the forests, grasslands, and riparian corridors along with sustainable urban planning and community-based sensitization on watershed management.

This case serves as a reminder of the infrequent, yet consequential occurrence of cerebellar degeneration linked to phenytoin usage. Whilst emphasizes the importance of monitoring patients on long-term phenytoin therapy, and it further suggests considering employing bedside imaging tools such as Ultrasound fusion imaging for follow-up of patients at risk of this type of disorder. We present a case study involving a 23-year-old woman who experienced significant neurological impairment resulting in severe cerebellar atrophy while undergoing phenytoin treatment. On cessation of phenytoin, the patient exhibited improvement with enhanced cerebellar function.

Mast cells are essential immune cells involved in the host’s defence against gastrointestinal nematodes. To evade the immune response, parasitic nematodes produce a variety of molecules. Galectin 1, produced by Teladorsagia circumcincta (Tci-gal-1), reduces mast cell degranulation and selectively regulates mediator production and release in an IgE-dependent manner. To uncover the activity of Tci-gal-1, we have examined the effect of the protein on gene expression, protein production, and apoptosis in activated basophilic leukaemia RBL-2H3 cells. Rat RBL-2H3 cells were activated with anti-DNP IgE and DNP-HSA, and then treated with Tci-gal-1. Microarray analysis was used to examine gene expression. The levels of several apoptosis-related molecules and cytokines were determined using antibody arrays and ELISA. Early and late apoptosis was evaluated cytometrically. Degranulation of cells was determined by a β-hexosaminidase release assay. Treatment of activated RBL-2H3 cells with Tci-gal-1 resulted in inhibited apoptosis and decreased degranulation, although we did not detect significant changes in gene expression. The production of pro-apoptotic molecules, receptor for advanced glycation end products (RAGE) and Fas ligand (FasL), and the cytokines IL-9, IL-10, IL-13, TNF-α, and IL-2 was strongly inhibited. Tci-gal-1 modulates apoptosis, degranulation, and production of cytokines by activated RBL-2H3 cells without detectable influence on gene transcription. This parasite protein is crucial for modulation of the protective immune response and the inhibition of chronic inflammation driven by mast cell activity.

Objectives: This study examined the treatment response of mixed vs single-species Plasmodium falciparum infections to artemisinin-based combination therapies (ACTs). Methods: A total of 1211 blood samples collected on days 0, 7, 14, 21, 28, 35, and 42 from 173 individuals enrolled in two randomized ACT efficacy studies were tested for malaria using 18s ribosomal RNA-based real-time polymerase chain reaction. All recurrent parasitemia were characterized for Plasmodium species composition and time to reinfection during 42-day follow-up compared across ACTs. Results: Day 0 samples had 71.1% (116/163) single P. falciparum infections and 28.2% (46/163) coinfections. A total of 54.0% (88/163) of individuals tested positive for Plasmodium at least once between days 7-42. A total of 19.3% (17/88) of individuals with recurrent infections were infected with a different Plasmodium species than observed at day 0, with 76.5% (13/17) of these “hidden” infections appearing after clearing P. falciparum present at day 0. Artesunate-mefloquine (16.4 hours) and dihydroartemisinin-piperaquine (17.6 hours) had increased clearance rates over artemether-lumefantrine (21.0 hours). Dihydroartemisinin-piperaquine exhibited the longest duration of reinfection prophylaxis. Cure rates were comparable across each species composition. Conclusion: No differences in clearance rates were found depending on whether the infection contained species other than P. falciparum. Significantly longer durations of protection were observed for individuals treated with dihydroartemisinin-piperaquine.

Abstract Background The unmet demand for effective malaria transmission-blocking agents targeting the transmissible stages of Plasmodium necessitates intensive discovery efforts. In this study, a bioactive bisbenzylisoquinoline (BBIQ), isoliensinine, from Cissampelos pariera (Menispermaceae) rhizomes was identified and characterized for its anti-malarial activity. Methods Malaria SYBR Green I fluorescence assay was performed to evaluate the in vitro antimalarial activity against D6, Dd2, and F32-ART5 clones, and immediate ex vivo (IEV) susceptibility for 10 freshly collected P. falciparum isolates. To determine the speed- and stage-of-action of isoliensinine, an IC50 speed assay and morphological analyses were performed using synchronized Dd2 asexuals. Gametocytocidal activity against two culture-adapted gametocyte-producing clinical isolates was determined using microscopy readouts, with possible molecular targets and their binding affinities deduced in silico. Results Isoliensinine displayed a potent in vitro gametocytocidal activity at mean IC50 gam values ranging between 0.41 and 0.69 µM for Plasmodium falciparum clinical isolates. The BBIQ compound also inhibited asexual replication at mean IC50 Asexual of 2.17 µM, 2.22 µM, and 2.39 µM for D6, Dd2 and F32-ART5 respectively, targeting the late-trophozoite to schizont transition. Further characterization demonstrated a considerable immediate ex vivo potency against human clinical isolates at a geometric mean IC50 IEV = 1.433 µM (95% CI 0.917–2.242). In silico analyses postulated a probable anti-malarial mechanism of action by high binding affinities for four mitotic division protein kinases; Pfnek1, Pfmap2, Pfclk1, and Pfclk4. Additionally, isoliensinine was predicted to possess an optimal pharmacokinetics profile and drug-likeness properties. Conclusion These findings highlight considerable grounds for further exploration of isoliensinine as an amenable scaffold for malaria transmission-blocking chemistry and target validation.

Single nucleotide polymorphisms (SNPs) in the Plasmodium falciparum multi-drug resistance protein 1 (Pfmrp1) gene have previously been reported to confer resistance to Artemisinin-based Combination Therapies (ACTs) in Southeast Asia. A total of 300 samples collected from six sites between 2008 and 2019 under an ongoing malaria drug sensitivity patterns in Kenya study were evaluated for the presence of SNPs at Pfmrp1 gene codons: H191Y, S437A, I876V, and F1390I using the Agena MassARRAY® platform. Each isolate was further tested against artemisinin (ART), lumefantrine (LU), amodiaquine (AQ), mefloquine (MQ), quinine (QN), and chloroquine (CQ) using malaria the SYBR Green I-based method to determine their in vitro drug sensitivity. Of the samples genotyped, polymorphism at Pfmrp1 codon I876V was the most frequent, with 59.3% (163/275) mutants, followed by F1390I, 7.2% (20/278), H191Y, 4.0% (6/151), and S437A, 3.3% (9/274). A significant decrease in median 50% inhibition concentrations (IC50s) and interquartile range (IQR) was noted; AQ from 2.996 ng/ml [IQR = 2.604-4.747, n = 51] in 2008 to 1.495 ng/ml [IQR = 0.7134-3.318, n = 40] (P

This study focuses on the fabrication and analysis of the mechanical behaviour of unidirectional (UD) glass fibre-reinforced polymer (GFRP) facesheet and polyvinyl chloride (PVC) foam core sandwich structures fabricated by a vacuum-assisted resin infusion method (VARIM). These sandwich structures are commonly used in marine and wind turbine blade applications. To date, relatively little knowledge about the functional behaviour of UD GFRP compared to composites reinforced with bidirectional mats is available for day-to-day applications. The effects of the facesheet orientation, facesheet thickness, and core thickness on the mechanical behaviour of the specimens were examined. The UD fibres were oriented in cross-ply (0/90), angle-ply (+45/−45), and quasi-isotropic orientations. Various mechanical properties such as tensile, flexural, flatwise compression, and edgewise compression tests were examined. Characterization of the tensile properties of the facesheet showed that the cross-ply orientation had a higher strength than the angle-ply and quasi-isotropic orientations. The flexural load-carrying capacity of the cross-ply facesheet orientation was superior to the other orientations. The increase in the core thickness changed the flexural failure mode from face yield and core shear to core indentation. Flatwise compression (FWC) was tested to determine the core characteristics of the sandwich structure, and the peak loads of 4.90, 1.81, and 3.90 kN were obtained for 10-, 15-, and 20 mm core thicknesses, respectively. Edgewise compression (EWC) exhibited stable end crushing for thinner facesheet, whereas thicker facesheet showed core crushing and buckling. When the facesheet thickness was increased from 1.5 mm to 3 mm in the EWC, the buckling load increase ranged from 2.53% to 44.83% for core thicknesses 10-, 15-, and 20 mm, respectively.

Research increasingly involves cross-cultural work with non-English-speaking populations, necessitating translation and cultural validation of research tools. This paper describes the process of translating and criterion validation of the Client Diagnostic Questionnaire (CDQ) for use in a multisite study in Kenya and Uganda. The English CDQ was translated into Swahili, Dholuo (Kenya) and Runyankole/Rukiga (Uganda) by expert translators. The translated documents underwent face validation by a bilingual committee, who resolved unclear statements, agreed on final translations and reviewed back translations to English. A diagnostic interview by a mental health specialist was used for criterion validation, and Kappa statistics assessed the strength of agreement between non-specialist scores and mental health professionals' diagnoses. Achieving semantic equivalence between translations was a challenge. Validation analysis was done with 30 participants at each site (median age 32.3 years (IQR = (26.5, 36.3)); 58 (64.4%) female). The sensitivity was 86.7%, specificity 64.4%, positive predictive value 70.9% and negative predictive value 82.9%. Diagnostic accuracy by the non-specialist was 75.6%. Agreement was substantial for major depressive episode and positive alcohol (past 6 months) and alcohol abuse (past 30 days). Agreement was moderate for other depressive disorders, panic disorder and psychosis screen; fair for generalized anxiety, drug abuse (past 6 months) and Post Traumatic Stress Disorder (PTSD); and poor for drug abuse (past 30 days). Variability of agreement between sites was seen for drug use (past 6 months) and PTSD. Our study successfully adapted the CDQ for use among people living with HIV in East Africa. We established that trained non-specialists can use the CDQ to screen for common mental health and substance use disorders with reasonable accuracy. Its use has the potential to increase case identification, improve linkage to mental healthcare, and improve outcomes. We recommend further studies to establish the psychometric properties of the translated tool.

Background: Corona Virus Disease 2019 (COVID-19), an infection caused by the SARS-CoV-2 virus, has been the largest global pandemic since the turn of the 21st century. With emerging research on this novel virus, studies from the African continent have been few. Corona Virus Disease 2019 has been shown to affect various organs including the lungs, gut, nervous system, and the kidneys. Acute kidney injury (AKI) is an independent risk factor for mortality and increases the health care burden for patients with persistent kidney dysfunction and maintenance dialysis. Sub-Saharan Africa has a high number of poorly controlled chronic illnesses, economic inequalities, and health system strains that may contribute to higher cases of kidney injury in patients with COVID-19 disease. Objectives: The objective of this study was to determine the incidence, associated factors, and outcomes of AKI in patients hospitalized with COVID-19 in Kenya. Methods: This retrospective cohort study included 1366 patients with confirmed COVID-19 illness hospitalized at the Aga Khan University Hospital in Nairobi, Kenya, between April 1, 2020 and October 31, 2021. Data were collected on age, sex, the severity of COVID-19 illness, existing pregnancy and comorbid conditions including human immunodeficiency virus (HIV), diabetes mellitus, hypertension, and functioning kidney transplant patients. Univariate analysis was carried out to determine the association of clinical and demographic factors with AKI. To determine independent associations with AKI incidence, a logistic regression model was used and the relationship was reported as odds ratios (ORs) with a 95% confidence interval (CI). The outcomes of AKI including the in-hospital mortality rate, renal recovery rate at hospital discharge, and the duration of hospital stay were reported and stratified based on the stage of AKI. Results: The median age of study patients was 56 years (interquartile range [IQR] = 45-68 years), with 67% of them being male (914 of 1366). The AKI incidence rate was 21.6% (n = 295). Patients with AKI were older (median age = 64 years vs 54 years; P < .001), majority male (79% of men with AKI vs 63.6% without AKI; P < .001), and likely to have a critical COVID-19 (OR = 8.03, 95% CI = 5.56-11.60; P < .001). Diabetes and hypertension, with an adjusted OR of 1.75 (95% CI = 1.34-2.30; P < .001) and 1.68 (95% CI = 1.27-2.23; P < .001), respectively, were associated with AKI occurrence in COVID-19. Human immunodeficiency virus, pregnancy, and a history of renal transplant were not significantly associated with increased AKI risk in this study. Patients with AKI had significantly higher odds of mortality, and this effect was proportional to the stage of AKI (OR = 11.35, 95% CI = 7.56-17.03; P < .001). 95% of patients with stage 1 AKI had complete renal recovery vs 33% of patients with stage 3 AKI. Of the patients with stage 3 AKI (n = 64), 10 underwent hemodialysis, with 1 recovery in renal function and 3 patients requiring ongoing dialysis after discharge. Conclusions: This study was conducted at a single private tertiary-level health care facility in Kenya and only up to the time of hospital discharge. It is one of the first large studies from sub-Saharan Africa looking at the associated factors and outcomes of AKI in COVID-19 and forms a foundation for further analysis on the long-term consequences of COVID-19 on the kidneys. A major limitation of the study is the lack of baseline pre-admission creatinine values for most patients; thus, the impact of chronic kidney disease/baseline creatinine values on the incidence of AKI could not be established.

IntroductionPopulations of natural enemies of insect pests are declining owing to agricultural intensification and indiscriminate use of pesticides, and this may be exacerbated in agricultural systems that clear all margin plants after the cropping season for other uses such as fodder. Retaining a diversity of non-crop flowering vegetation outside the cropping season may support more resilient and effective natural pest regulation.MethodsWe tested the potential for non-crop vegetation to support natural enemies in fields across two locations after harvesting the primary crops of lablab and maize.ResultsA total of 54 plant species were recorded across the sites in Kenya with 59% of them being annuals and 41% perennials. There was a significant seasonal variation in plant species richness (ANOVA: F1, 16 = 33. 45; P< 0.0001) and diversity (ANOVA: F1, 16 = 7.20; P = 0.0511). While time since harvesting was a significant factor influencing the overall abundance of natural enemies (ANOVA: F2, 1,133 = 8.11; P< 0.0001), they were generally higher in abundance in locations with margin plants or where a diversity of margin plants was observed.DiscussionThese findings demonstrate that flowering plants in agricultural systems offer refuge and alternative food for natural enemies and potentially other beneficial insects between cropping seasons. The conservation of natural enemies between crops may lead to more effective natural pest regulation early in the following crop, thus reducing reliance on insecticides application.

AbstractThis paper investigates the extent of “greenness” of South African REITs; and whether green investments have any significant effects on the REITs return performance at the aggregate level. It used publicly-accessible green buildings and financial data obtained from the Green Building Council of South Africa’s (GBCSA) website and financial reports of 27 REITs that operate in South Africa, respectively. With only 11 REITs having green buildings in their portfolios, the results show phenomenal growth in the cumulative amount of green Gross Lettable Area (GLA) in under a decade – from a paltry 38,133 square metres of GLA in 2013, to over two million square metres of GLA in 2021. From panel analyses, consistent regression results show that green variables were positive and statistically significant across most of the estimated models. The statistically significant results imply that increased investments in green infrastructures have positive effects on REITs’ return performances. The study has implications for research and practice as far as the investments by REITs in green buildings in South Africa is concerned.

Background There are limited data on the immunogenicity of coronavirus disease 2019 (COVID-19) vaccines in African populations. Here we report the immunogenicity and safety of the ChAdOx1 nCoV-19 (AZD1222) vaccine from a phase 1/2 single-blind, randomised, controlled trial among adults in Kenya conducted as part of the early studies assessing vaccine performance in different geographical settings to inform Emergency Use Authorisation. Methods We recruited and randomly assigned (1:1) 400 healthy adults aged ≥18 years in Kenya to receive ChAdOx1 nCoV-19 or control rabies vaccine, each as a two-dose schedule with a 3-month interval. The co-primary outcomes were safety, and immunogenicity assessed using total IgG enzyme-linked immunosorbent assay (ELISA) against SARS-CoV-2 spike protein 28 days after the second vaccination. Results Between 28th October 2020 and 19th August 2021, 400 participants were enrolled and assigned to receive ChAdOx1 nCoV-19 (n=200) or rabies vaccine (n=200). Local and systemic adverse events were self-limiting and mild or moderate in nature. Three serious adverse events were reported but these were deemed unrelated to vaccination. The geometric mean anti-spike IgG titres 28 days after second dose vaccination were higher in the ChAdOx1 group (2773 ELISA units [EU], 95% CI 2447, 3142) than in the rabies vaccine group (61 EU, 95% CI 45, 81) and persisted over the 12 months follow-up. We did not identify any symptomatic infections or hospital admissions with respiratory illness and so vaccine efficacy against clinically apparent infection could not be measured. Vaccine efficacy against asymptomatic SARS-CoV-2 infection was 38.4% (95% CI -26.8%, 70.1%; p=0.188). Conclusions The safety, immunogenicity and efficacy against asymptomatic infection of ChAdOx1 nCoV-19 among Kenyan adults was similar to that observed elsewhere in the world, but efficacy against symptomatic infection or severe disease could not be measured in this cohort. Pan-African Clinical Trials Registration PACTR202005681895696 (11/05/2020)

Ridge and furrow plastic film mulching (RFM) has improved net primary productivity (NPP) to a high level in semi-arid rainfed agricultural regions. Yet, it is unclear whether there is still a room for further improvement on NPP while stabilizing soil organic carbon through returning previous maize stover pieces. To address this issue, maize stubbles were smashed into pieces and in situ ploughed into 30 cm topsoil at a semi-arid site in northwest China from 2016 to 2017. This was done using the Pioneer 335 maize variety with three treatments (CK, ridge and furrow without mulching; RFM, ridge and furrow with plastic mulching; RFML, 3.49 t ha−1 of maize stover returning in RFM; RFMH, 5.24 t ha−1 of returning in RFM). The results indicated that maize stover returning exhibited similar trend as RFM at early cool seedling stage, raising the topsoil temperature. However, in warm and dry silking stage (2017), both stover returning rates reduced soil temperatures by 1.33 and 0.8 ◦C relative to RFM and CK (P

Abstract Background Hazardous alcohol use among people living with HIV is associated with poor outcomes and increased morbidity and mortality. Understanding the hazardous drinking experiences of people living with HIV is needed to reduce their alcohol use. Methods We conducted 60 interviews among people living with HIV in East Africa with hazardous drinking histories. Interviews and Alcohol Use Disorder Identification Test (AUDIT) scores were conducted 41 – 60 months after their baseline assessment of alcohol use to identify facilitators and barriers to reduced alcohol use over time. Results People living with HIV who stopped or reduced hazardous drinking were primarily motivated by their HIV condition and desire for longevity. Facilitators of reduced drinking included health care workers’ recommendations to reduce drinking (despite little counseling and no referrals) and social support. In those continuing to drink at hazardous levels, barriers to reduced drinking were stress, social environment, alcohol accessibility and alcohol dependency. Conclusions Interventions that capacity-build professional and lay health care workers with the skills and resources to decrease problematic alcohol use, along with alcohol cessation in peer support structures, should be explored.

Tryptophan metabolites, such as 5-hydroxytryptophan (5-HTP), serotonin, and melatonin, hold significant promise as supplements for managing various mood-related disorders, including depression and insomnia. However, their chemical production via chemical synthesis and phytochemical extraction presents drawbacks, such as the generation of toxic byproducts and low yields. In this study, we explore an alternative approach utilizing S. cerevisiae STG S101 for biosynthesis. Through a series of eleven experiments employing different combinations of tryptophan supplementation, Tween 20, and HEPES buffer, we investigated the production of these indolamines. The tryptophan metabolites were analyzed using liquid chromatography with tandem mass spectrometry (LC-MS/MS). Notably, setups replacing peptone in the YPD media with tryptophan (Run 3) and incorporating tryptophan along with 25 mM HEPES buffer (Run 4) demonstrated successful biosynthesis of 5-HTP and serotonin. The highest 5-HTP and serotonin concentrations were 58.9 ± 16.0 mg L−1 and 0.0650 ± 0.00211 mg L−1, respectively. Melatonin concentrations were undetected in all the setups. These findings underscore the potential of using probiotic yeast strains as a safer and conceivably more cost-effective alternative for indolamine synthesis. The utilization of probiotic strains presents a promising avenue, potentially offering scalability, sustainability, reduced environmental impact, and feasibility for large-scale production.

The polyethylene (PE) film mulching as a water conservation technology has been widely used in dryland agriculture, yet the long-term mulching has led to increasing accumulation of secondary pollutants in soils. The decomposition of PE film-sourced pollutants is directly associated with the enrichment of specific bacterial communities. We therefore hypothesized that plant biomass may act as an organic media to mediate the pollutant decomposition via reshaping bacterial communities. To validate this hypothesis, plant biomass (dried maize straw and living clover) was embedded at the underlying surface of PE film, to track the changes in the composition and function of bacterial communities in maize field across two years. The results indicated that both dry crop straw and alive clover massively promoted the α-diversity and abundance of dominant bacteria at plastisphere, relative to bulk soil. Bacterial communities tended to be clustered at plastisphere, forming the bacteria islands to enrich pollutant-degrading bacteria, such as Sphingobacterium, Arthrobacter and Paracoccus. As such, plastisphere bacteria islands substantially enhanced the degradation potential of chloroalkene and benzoate (p

Vincent Kipkorir,1 Isaac Cheruiyot,1 Ibsen Ongidi,1 Fiona K Nyaanga,1 Bridget Neema,1 Elisha Harry Otieno,1 Roger R Baskaran,2 Bahadar S Srichawla,3 Jyotirmoy Biswas,4 Gopal Krishna Dhali,5 Arkadeep Dhali6 1Department of Human Anatomy and Physiology, College of Health Sciences, University of Nairobi, Nairobi, Kenya; 2Department of Critical Care, St. John’s Medical College, Bangalore, India; 3Department of Neurology, UMass Chan Medical School, Worcester, MA, USA; 4Department of General Medicine, College of Medicine and Sagore Dutta Hospital, Kolkata, India; 5Department of Gastroenterology, Institute of Postgraduate Medical Education and Research, Kolkata, India; 6Department of Internal Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UKCorrespondence: Arkadeep Dhali; Roger R Baskaran, Email arkadipdhali@gmail.com; rogerrathna@gmail.comBackground: This systematic review and meta-analysis aims to determine the prevalence of the retrorenal colon (RRC) and its implications in percutaneous nephrolithotomy with the overall objective of promoting the prevention of associated iatrogenic complications.Methods: A systematic search of literature was conducted on the electronic databases PubMed, ScienceDirect, and Hinari to identify studies eligible for inclusion. Search results were screened by title and abstract, and those potentially relevant were evaluated by full text. Studies were deemed eligible for inclusion if they reported clear extractable data regarding the prevalence of the retro-renal colon. A meta-analysis was completed using MetaX1 to calculate the pooled prevalence of the retro-renal colon. Sub-group analysis was performed based on geographical regions from which the studies originated, imaging modality, and patient position.Results: 174 records were screened and a total of 10 records included in the analysis with retrospective cohort studies being the most common study design. A male predominance was seen in most sample sizes that had reported data on gender demographics ranging from 41.5– 62%. The most common imaging modality utilized was computerized tomography (CT) scan followed by ultrasound. The range of the unweighted prevalence of retro-renal colon across all studies that had absolute numbers reported was from 3.5– 25%. One of the studies reported a colonic perforation rate of 0.3% in patients without CT images.Conclusion: The retro-renal colon is a relatively common finding with observed preponderance to females and left lateralization. The presence of RRC increases the likelihood of colon perforations while gaining percutaneous access to the kidney. Pre-procedural imaging can help detect its presence and choose an appropriate route of entry. USG and CT have both been found useful as a modality to pick up RRC.Keywords: colon, nephrolithotomy, retro-renal, urolithiasis

Abstract Background Dihydroartemisinin-piperaquine (DHA-PPQ) is an alternative first-line antimalarial to artemether-lumefantrine in Kenya. However, recent reports on the emergence of PPQ resistance in Southeast Asia threaten its continued use in Kenya and Africa. In line with the policy on continued deployment of DHA-PPQ, it is imperative to monitor the susceptibility of Kenyan parasites to PPQ and other antimalarials. Methods Parasite isolates collected between 2008 and 2021 from individuals with naturally acquired P. falciparum infections presenting with uncomplicated malaria were tested for in vitro susceptibility to piperaquine, dihydroartemisinin, lumefantrine, artemether, and chloroquine using the malaria SYBR Green I method. A subset of the 2019–2021 samples was further tested for ex vivo susceptibility to PPQ using piperaquine survival assay (PSA). Each isolate was also characterized for mutations associated with antimalarial resistance in Pfcrt, Pfmdr1, Pfpm2/3, Pfdhfr, and Pfdhps genes using real-time PCR and Agena MassARRAY platform. Associations between phenotype and genotype were also determined. Results The PPQ median IC50 interquartile range (IQR) remained stable during the study period, 32.70 nM (IQR 20.2–45.6) in 2008 and 27.30 nM (IQR 6.9–52.8) in 2021 (P=0.1615). The median ex vivo piperaquine survival rate (IQR) was 0% (0–5.27) at 95% CI. Five isolates had a PSA survival rate of ≥10%, consistent with the range of PPQ-resistant parasites, though they lacked polymorphisms in Pfmdr1 and Plasmepsin genes. Lumefantrine and artemether median IC50s rose significantly to 62.40 nM (IQR 26.9–100.8) (P = 0.0201); 7.00 nM (IQR 2.4–13.4) (P = 0.0021) in 2021 from 26.30 nM (IQR 5.1–64.3); and 2.70 nM (IQR 1.3–10.4) in 2008, respectively. Conversely, chloroquine median IC50s decreased significantly to 10.30 nM (IQR 7.2–20.9) in 2021 from 15.30 nM (IQR 7.6–30.4) in 2008, coinciding with a decline in the prevalence of Pfcrt 76T allele over time (P = 0.0357). The proportions of piperaquine-resistant markers including Pfpm2/3 and Pfmdr1 did not vary significantly. A significant association was observed between PPQ IC50 and Pfcrt K76T allele (P=0.0026). Conclusions Circulating Kenyan parasites have remained sensitive to PPQ and other antimalarials, though the response to artemether (ART) and lumefantrine (LM) is declining. This study forms a baseline for continued surveillance of current antimalarials for timely detection of resistance.

Abstract This study presents the real-time energy consumption of a container ship’s generator engine on two round-trips from the West Coast of the US to the East Asian ports and analyzes the ship’s PM10, PM2.5, NOx, SOx, CO, and HC emissions, shore power usage, and factors affecting energy consumption. The average total energy consumption and air emissions for the two round trips were 1.72 GWh and 42.1 tons, respectively. The transpacific crossing segment had the highest average energy consumption (2848 ± 361 kWh) and pollutant emission rate (78.9 ± 10.0 kg h−1). On the other hand, the West Coast of the US had the least energy consumption due to shore power adoption. Furthermore, switching from heavy fuel oil (HFO) to ultra-low-sulfur fuel oil (ULSFO) greatly reduced the emissions of PM and SOx by > 96% and NOx by 17.0%. However, CO and HC increased by 16.9% and 36.1%, respectively, implying incomplete combustion. In addition, the energy consumption was influenced by the number of reefers and wind. Therefore, this study recommends further research on energy-efficient reefers, generator engine optimization, and shore power adoption to reduce emissions from container ships.

Abstract Background The ABO blood groups consist of A, B, and H carbohydrate antigens, which regulate protein activities during malaria infection in humans. Understanding the interplay between the malaria parasite and blood group antigens is essential in understanding new interventions to reduce the global burden of malaria. This study assessed the burden of malaria infection among individuals with varying blood groups seeking treatment at selected hospitals in Kenya. Methods A total of 366 samples from an ongoing malaria surveillance study were diagnosed for malaria by microscopy and further typed for blood group using ABO blood grouping. Age and sex were recorded in a data sheet, and analysed using R software version 4. Groups’ proportions (blood group, malaria infection, age and sex) were compared using Pearson’s Chi-square and Fischer exact tests. Wilcoxon and Kruskal-Wallis tests were performed and P-value 18 years n = 61 (19.43%)). Malaria prevalence was higher among females than males, 54.46% and 45.54%, respectively. Kisumu enrolled the highest number 109 (35%)) of malaria cases, Kombewa 108 (35%), Malindi 32 (10%), Kisii 28 (9%), Marigat 23 (7%), and Kericho 12 (4%). Blood group O+ was the most prevalent among the enrolled individuals (46.50%), A+ (27.71%), B+ (21.02%) and AB+ (4.78%) respectively. Compared to blood group O+, blood group B+ individuals were (14%) were more likely to habour Plasmodium falciparum infection as opposed to A+ and AB+ individuals, that were 7% and 20%, respectively,. Those living in malaria-endemic zones presented with higher parasite densities compared to those living in malaria-epidemic (p = 0.0061). Individuals bearing B + blood group are more likely to habour high parasitaemia compared to O + blood group bearers (OR = 4.47, CI = 1.53–13.05, p = 0.006). Conclusion Individuals of blood group B harbour high parasitaemia compared with the blood group O, Additionally, blood group A and B present with symptoms at lower parasitaemia than blood group O. Regardles of malaria transmission zones, individuals from endemic zones showed up with high parasitaemia and among them were more individuals of blood groups A and B than individuals of blood group O. Implying that these individuals were more at risk and require additional attention and effective case management. Garphical Abstract

The need of developing systems that address traffic matters such as traffic control and accidents has led to the development of a number of techniques, methods and tools to address road usability issues. Many automated models have been proposed and applied in different scenarios such as road oddities. Despite of the advantages of these models the major problem of road accidents continue to pose problem globally. This has created the need to come up with more user-effective approaches to address road accidents. Main objective of this research therefore is to identify and address the gap in Location Based Services (LBS). A model that combines RFID and GPS technology to provide Location Based Services via audio alerts to drivers as they approach black spots is presented. The model provides location based services to drivers as they approach black spots causing them to adjust their driving accordingly (i.e. speeding, overtaking). Since LBS technologies have different limitations, most researchers have focused on addressing accuracy limitation by proposing hybrid technologies. Accuracy requirement varies depending on application area. The analysis of the different technologies revealed that in vehicle transportation medium accuracy is effective. This research focused on availability aspect which is a key requirement in LBS. To achieve this a model made up of RFID & GPS is formulated. Higher availability of significant alerts at black spots is registered through simulation as compared to alerts when the technologies are applied separately. Black spot accidents are therefore managed due to safer driving around black spots. This can lead to reduction in exposure to accidents, likelihood of occurrence and impact in the event of an incident. Usability metrics is used to determine effectiveness of the model.

Abstract Displacements from developmental-related projects such as dams, conservancies, and geothermals displace 15–20 million people annually, necessitating the relocation of project-affected persons (PAPs). Most resettlement action plans (RAPs) fail in resettling the PAPs fully, causing loss of livelihoods and impoverishment. In 2014, Kenya Electricity Generating Company Limited (KenGen) displaced 155 Maasai pastoral households to create space for the expansion of existing geothermal electricity generation plants at Olkaria. The PAPs were relocated into a newly created area called RAPland village. The study aimed at answering the question: how did displacement and relocation affect livestock production and performance of the resettled pastoralists. Data on livestock population structures and cattle herd structures and performance (age at first calving, calving interval, lactation length, and milk yields) before and after the relocation were collected by a survey of 105 household heads of the intended census of 155. Data collected were summarised using Excel and analysed with Statistical Package for Social Sciences (SPSS). Results showed that daily milk yield per cow decreased from a mean of 3.8 ± 0.19 to 2.38 ± 0.19 l, while total livestock populations reduced from 8383 to 3124 tropical livestock units (TLU) after the relocation. The mean livestock holding per household (TLU) before the relocation was 75.7 ± 8.83, 15.5 ± 1.78, 5.83 ± 0.67, 1.46 ± 0.22, and 0.14 ± 0.02; this decreased after the relocation to 26.4 ± 8.3, 4.62 ± 1.7, 2.5 ± 0.63, 0.34 ± 0.21, and 0.3 ± 0.02 for cattle, sheep, goats, donkeys, and poultry, respectively. Young cattle proportions reduced from 27.6 to 20%, while that of cows increased from 51.7 to 60% after resettlement. Relocation affected livestock production and performances through reduced daily milk yield and livestock populations, thus reducing pastoralists’ resilience for food, nutritional security, and coping with catastrophes. As such, future displacement and resettlement programmes involving pastoral communities should address grazing needs and pastoral resilience to avoid impoverishment.

Abstract Background Heat tolerance is a trait of economic importance in the context of warm climates and the effects of global warming on livestock production, reproduction, health, and well-being. This study investigated the improvement in prediction accuracy for heat tolerance when selected sets of sequence variants from a large genome-wide association study (GWAS) were combined with a standard 50k single nucleotide polymorphism (SNP) panel used by the dairy industry. Methods Over 40,000 dairy cattle with genotype and phenotype data were analysed. The phenotypes used to measure an individual’s heat tolerance were defined as the rate of decline in milk production traits with rising temperature and humidity. We used Holstein and Jersey cows to select sequence variants linked to heat tolerance. The prioritised sequence variants were the most significant SNPs passing a GWAS p-value threshold selected based on sliding 100-kb windows along each chromosome. We used a bull reference set to develop the genomic prediction equations, which were then validated in an independent set of Holstein, Jersey, and crossbred cows. Prediction analyses were performed using the BayesR, BayesRC, and GBLUP methods. Results The accuracy of genomic prediction for heat tolerance improved by up to 0.07, 0.05, and 0.10 units in Holstein, Jersey, and crossbred cows, respectively, when sets of selected sequence markers from Holstein cows were added to the 50k SNP panel. However, in some scenarios, the prediction accuracy decreased unexpectedly with the largest drop of − 0.10 units for the heat tolerance fat yield trait observed in Jersey cows when 50k plus pre-selected SNPs from Holstein cows were used. Using pre-selected SNPs discovered on a combined set of Holstein and Jersey cows generally improved the accuracy, especially in the Jersey validation. In addition, combining Holstein and Jersey bulls in the reference set generally improved prediction accuracy in most scenarios compared to using only Holstein bulls as the reference set. Conclusions Informative sequence markers can be prioritised to improve the genomic prediction of heat tolerance in different breeds. In addition to providing biological insight, these variants could also have a direct application for developing customized SNP arrays or can be used via imputation in current industry SNP panels.

Parasitic nematodes and their products are promising candidates for therapeutics against inflammatory bowel diseases (IBD). Two species of nematodes, the hookworm Necator americanus and the whipworm Trichuis suis, are being used in clinical treatment trials of IBD referred to as “helminth therapy”. Heligmosomoides polygyrus is a well-known model for human hookworm infections. Excretory–secretory (ES) products of H. polygyrus L4 stage that developed during colitis show a different immunomodulatory effect compared to the ES of H. polgyrus from healthy mice. The aim of the study was to evaluate excretory–secretory proteins produced by H. polygyrus L4 stage males and females that developed in the colitic milieu. Mass spectrometry was used to identify proteins. Blast2GO was used to investigate the functions of the discovered proteins. A total of 387 proteins were identified in the ES of H. polygyrus L4 males (HpC males), and 330 proteins were identified in the ES of L4 females that developed in the colitic milieu (HpC females). In contrast, only 200 proteins were identified in the ES of L4 males (Hp males) and 218 in the ES of L4 females (Hp females) that developed in control conditions. Most of the proteins (123) were detected in all groups. Unique proteins identified in the ES of HpC females included annexin, lysozyme-2, apyrase, and galectin. Venom allergen/Ancylostoma-secreted protein-like, transthyretin-like family proteins, and galectins were found in the secretome of HpC males but not in the secretome of control males. These molecules may be responsible for the therapeutic effects of nematodes in DSS-induced colitis.

Background: Duplication of the femoral vein is an important anatomical variation of the venous anatomy which has been shown to have an impact on the diagnosis of deep venous thrombosis by compression ultrasonography. The presence of duplication may result in false negative findings while evaluating for deep venous thrombosis, with serious consequences such as pulmonary embolism and death. This metaanalysis aims to determine the pooled prevalence of duplicated femoral veins. Methods: A systematic search was conducted through the major databases PubMed, Hinari, Embase and Medline to identify studies eligible for inclusion. Appropriate data were extracted and pooled into a random-effects metaanalysis using MetaXL software. The primary and secondary outcomes of the study included the pooled prevalence of duplicated femoral veins and the prevalence of bilaterally duplicated femoral veins, respectively. Results: A total of 11 studies (n = 3,682 limbs) were included. The overall pooled prevalence of duplicated femoral veins was 19.7% (95% CI 11–30). There was a significant difference in prevalence between cadaveric studies (2%, 95% CI 1–4) and imaging studies (25%, 95% CI 17–34). Conclusion: Duplication of the femoral vein is a common variation in the lower limbs. Routine watch-out should be practiced especially when performing lower limb Doppler studies in cases of deep venous thrombosis in order to avoid misdiagnosis and improve diagnostic accuracy.

Background: The COVID-19 pandemic relies on real-time polymerase chain reaction (qRT-PCR) for the detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), to facilitate roll-out of patient care and infection control measures. There are several qRT-PCR assays with little evidence on their comparability. We report alterations to the developers’ recommendations to sustain the testing capability in a resource-limited setting. Methods: We used a SARS-CoV-2 positive control RNA sample to generate several 10-fold dilution series that were used for optimization and comparison of the performance of the four qRT-PCR assays: i) Charité Berlin primer-probe set, ii) European Virus Archive – GLOBAL (EVAg) primer-probe set, iii) DAAN premixed commercial kit and iv) Beijing Genomics Institute (BGI) premixed commercial kit. We adjusted the manufacturer- and protocol-recommended reaction component volumes for these assays and assessed the impact on cycle threshold (Ct) values. Results: The Berlin and EVAg E gene and RdRp assays reported mean Ct values within range of each other across the different titrations and with less than 5% difference. The DAAN premixed kit produced comparable Ct values across the titrations, while the BGI kit improved in performance following a reduction of the reaction components. Conclusion: We achieved a 2.6-fold and 4-fold increase in the number of tests per kit for the commercial kits and the primer-probe sets, respectively. All the assays had optimal performance when the primers and probes were used at 0.375X, except for the Berlin N gene assay. The DAAN kit was a reliable assay for primary screening of SARS-CoV-2 whereas the BGI kit’s performance was dependent on the volumes and concentrations of both the reaction buffer and enzyme mix. Our recommendation for SARS-CoV-2 diagnostic testing in resource-limited settings is to optimize the assays available to establish the lowest volume and suitable concentration of reagents required to produce valid results.

Laboratory diagnosis plays a critical role in the containment of a pandemic. Strong laboratory quality management systems (QMS) are essential for laboratory diagnostic services. However, low laboratory capacities in resource-limited countries has made the maintenance of laboratory quality assurance, especially during a pandemic, a daunting task. In this paper, we describe our experience of how we went about providing diagnostic testing services for SARS-CoV-2 through laboratory reorganization, redefining of the laboratory workflow, and training and development of COVID-19 documented procedures, all while maintaining the quality assurance processes during the COVID-19 pandemic at the Kenya Medical Research Institute (KEMRI) Wellcome Trust Research Programme (KWTRP) laboratory. The KWTRP laboratory managed to respond to the COVID-19 outbreak in Kenya by providing diagnostic testing for the coastal region of the country, while maintaining its research standard quality assurance processes. A COVID-19 team comprising of seven sub-teams with assigned specific responsibilities and an organizational chart with established reporting lines were developed. Additionally, a total of four training sessions were conducted for county Rapid Response Teams (RRTs) and laboratory personnel. A total of 11 documented procedures were developed to support the COVID-19 testing processes, with three for the pre-analytical phases, seven for the analytical phase, and one for the post-analytical phase. With the workflow re-organization, the development of appropriate standard operating procedures, and training, research laboratories can effectively respond to pandemic outbreaks while maintaining research standard QMS procedures.

Dolichos (Lablab purpureus L.) is a drought tolerant legume used as food/feed and im- provement of soil fertility. The production of dolichos in Kenya, Nakuru County is however limited by insect pests like bean aphids, pod borers and whiteflies. Field stud- ies were conducted to determine the effect of cropping systems (dolichos monocrop and maize-dolichos intercrop) and field margin vegetation on bean aphids and their natural enemies. The experiment was conducted in Njoro (high field margin vegetation) and Ron- gai (low field margin vegetation) during May–December 2019 and March−November 2020 cropping seasons. Bean aphid percent incidence, severity of damage and abundance was assessed at seedling, early vegetative, late vegetative and flowering dolichos growth stages. The populations of natural enemies in the plots and field margin vegetation were monitored using pan traps and sweep nets. Species diversity and composition of the field margin ve-getation was determined using a quadrat. Results showed that location and cropping system had significant effects on bean aphid infestations. A high bean aphid incidence (38.13%) was observed in Njoro compared to Rongai (31.10%). Dolichos monocrop had significantly higher bean aphid infestation (51.63%) than the maize-dolichos intercrop system (24.62%). A highly diverse Shannon-weaver index was observed in Rongai (1.90) compared to Njoro (1.67). Dolichos monocrop had a more diverse Shannon-weaver index (1.8) than the maize- dolichos intercrop system (1.7). Rongai had the most abundant annual and perennial field margin vegetation species. The field margin species richness and diversity were higher in Rongai (81%) than in Njoro (54%). The findings of this study have demonstrated that a maize-dolichos intercrop in Rongai can reduce bean aphid damage in dolichos.

Abstract While understanding the genetic basis of heat tolerance is crucial in the context of global warming’s effect on humans, livestock, and wildlife, the specific genetic variants and biological features that confer thermotolerance in animals are still not well characterized. We used dairy cows as a model to study heat tolerance because they are lactating, and therefore often prone to thermal stress. The data comprised almost 0.5 million milk records (milk, fat, and proteins) of 29,107 Australian Holsteins, each having around 15 million imputed sequence variants. Dairy animals often reduce their milk production when temperature and humidity rise; thus, the phenotypes used to measure an individual’s heat tolerance were defined as the rate of milk production decline (slope traits) with a rising temperature–humidity index. With these slope traits, we performed a genome-wide association study (GWAS) using different approaches, including conditional analyses, to correct for the relationship between heat tolerance and level of milk production. The results revealed multiple novel loci for heat tolerance, including 61 potential functional variants at sites highly conserved across 100 vertebrate species. Moreover, it was interesting that specific candidate variants and genes are related to the neuronal system (ITPR1, ITPR2, and GRIA4) and neuroactive ligand–receptor interaction functions for heat tolerance (NPFFR2, CALCR, and GHR), providing a novel insight that can help to develop genetic and management approaches to combat heat stress.

Over the last decades, increased emission of greenhouse gases has led to hot weather extremes, heavy precipitation and worsening of agricultural and ecological droughts. Although Africa’s contribution to climate change is minimal, the continent is especially vulnerable to its effects. This report aims to describe the effect of climate change leading to drought in Kilifi County, Kenya, and the communities’ experiences of this effect on food availability. During their community rotation, residents from a university in Nairobi, Kenya, evaluated changes in weather patterns and nutrition indicators in Kilifi County and conducted focus group discussions (FGDs) with community members and health care stakeholders to explore challenges in access to adequate nutrition and possible local solutions. Kilifi County has one of the highest rates of undernutrition in Kenya, with one in five under-5 children being underweight. County data showed that rainfall in the last 4 years has become increasingly unpredictable, resulting in reduced household milk production, one of the indicators of nutrition security. Three major themes emerged from the FGDs: lack of food variety, collapse of drought mitigating projects and increasing poverty levels. Possible solutions to these problems include promoting alternatives to the current diet that are culturally sensitive and adaptable to recent climate changes, ensuring continuity of agricultural and financial support projects and improved local leadership and governance.

The impact of pre-existing immunity on the efficacy of artemisinin combination therapy is largely unknown. We performed in-depth profiling of serological responses in a therapeutic efficacy study [comparing artesunate-mefloquine (ASMQ) and artemether-lumefantrine (AL)] using a proteomic microarray. Responses to over 200 Plasmodium antigens were significantly associated with ASMQ treatment outcome but not AL. We used machine learning to develop predictive models of treatment outcome based on the immunoprofile data. The models predict treatment outcome for ASMQ with high (72–85%) accuracy, but could not predict treatment outcome for AL. This divergent treatment outcome suggests that humoral immunity may synergize with the longer mefloquine half-life to provide a prophylactic effect at 28–42 days post-treatment, which was further supported by simulated pharmacokinetic profiling. Our computational approach and modeling revealed the synergistic effect of pre-existing immunity in patients with drug combination that has an extended efficacy on providing long term treatment efficacy of ASMQ.

Purpose- The paper examines the relationship between strategic direction, core competencies, and firm competitiveness among manufacturing firms in Uganda. Design/Methodology- This study collected quantitative data from 410 manufacturing firms using self-administered questionnaires, while qualitative data was collected from 10 manufacturing firms using an interview guide. Quantitative data were augmented by qualitative methods, allowing us to comprehend the phenomenon under study completely. To study the nature of reality, an explanatory cross-sectional survey was employed. While the content analysis was used to investigate qualitative data, regression analysis was used to evaluate hypotheses. Findings- According to the research, a firm's competitiveness improves when its executives concentrate on their capabilities. The findings validated the theoretical foundations of the resource-based viewpoint. Practical Implications- As a result of the findings, manufacturing firms may increase strategic leadership's influence on competitiveness by ensuring that workers have proper directions and that the core competencies are identified and leveraged to ensure efficiency and effectiveness in operations. The findings may assist CEOs and policymakers design strategies and policies to increase the level of competitiveness of their firms.

Background: Knowledge of vascular anatomy and its possible variations is essential for performing embolization or revascularization procedures and complex surgery in the pelvis. The obturator artery (OA) is a branch of the anterior division of the internal iliac artery (IIA), and it has the highest frequency of variation among branches of the internal iliac artery. Possible anomalies of the origin of the obturator artery (OA) should be known when performing pelvic and groin surgery, where its control or ligation may be required. The purpose of this systematic review and meta-analysis, based on Sanudo’s classification, is to analyze the origin of the obturator artery (OA) and its variants. Methods: Thirteen articles published between 1952 and 2020 were included. Results: The obturator artery (OA) was present in almost all cases (99.8%): the pooled prevalence estimate for the origin from the IIA axis was 77.7% (95% CI 71.8–83.1%) vs. 22.3% (95% CI 16.9–28.2%) for the origin from EIA axis. In most cases, the obturator artery (OA) originated from the anterior division trunk of the internal iliac artery (IIA) (61.6%). Conclusions: Performing preoperative radiological examination to determine the pelvic vascular pattern and having the awareness to evaluate possible changes in the obturator artery can reduce the risk of iatrogenic injury and complications.

Abstract Background Eclampsia, considered as serious complication of preeclampsia, remains a life-threatening condition among pregnant women. It accounts for 12% of maternal deaths and 16–31% of perinatal deaths worldwide. Most deaths from eclampsia occurred in resource-limited settings of sub-Saharan Africa. This study was performed to determine the optimum mode of delivery, as well as factors associated with the mode of delivery, in women admitted with eclampsia at Riley Mother and Baby Hospital. Methods This was a hospital-based longitudinal case-series study conducted at the largest and busiest obstetric unit of the tertiary hospital of western Kenya. Maternal and perinatal variables, such as age, parity, medications, initiation of labour, mode of delivery, admission to the intensive care unit, admission to the newborn care unit, organ injuries, and mortality, were analysed using the Statistical Package for the Social Sciences software version 20.0. Quantitative data were described using frequencies and percentages. The significance of the obtained results was judged at the 5% level. The chi-square test was used for categorical variables, and Fisher’s exact test or the Monte Carlo correction was used for correction of the chi-square test when more than 20% of the cells had an expected count of less than 5. Results During the study period, 53 patients diagnosed with eclampsia were treated and followed up to 6 weeks postpartum. There was zero maternal mortality; however, perinatal mortality was reported in 9.4%. Parity was statistically associated with an increased odds of adverse perinatal outcomes (p = 0.004, OR = 9.1, 95% CI = 2.0–40.8) and caesarean delivery (p = 0.020, OR = 4.7, 95% CI = 1.3–17.1). In addition, the induction of labour decreased the risk of adverse outcomes (p = 0.232, OR = 0.3, 95% CI = 0.1–2.0). Conclusion There is no benefit of emergency caesarean section for women with eclampsia. This study showed that induction of labour and vaginal delivery can be successfully achieved in pregnant women with eclampsia. Maternal and perinatal mortality from eclampsia can be prevented through prompt and effective care.

Provision of the bed net in Sub-Saharan Africa has substantially resulted in the decrease in malaria incidences in the region. However, malaria still ravages these regions causing significant deaths. This situation has been attributed to socio-economic inequalities that reduce access to the net, failure to seek treatment, and poor antimalarial drug use. Information about these factors in malaria control in Western Kenya highlands is not clearly documented. This study sought to find out bed net availability and use, treatment-seeking, and antimalarial drug use behavior in two rural communities. The study was a qualitative-quantitative baseline cross-sectional survey carried out in two rural villages in Western Kenya highlands in November – December 2018. Focus group discussion, a semi-structured questionnaire, and in-depth interviews were conducted in 736 households to determine: socio-demographic characteristics; bed net availability and use; action taken when sick with malaria, and antimalarial drug usage. Socio-demographic characteristics and the responses of the participants were expressed as percentages. Dependent and independent variables were cross-tabulated for calculation of OR and association was tested using Pearson Chi-square at 95% CI and a p ≤ 0.05 was considered significant. Ninety-three percent of the respondents had used the net the previous night, females (56.50%) constituted the majority of respondents, going to health facility (84.26%) was the preferred action taken when a person had malaria, Artemether Lumefantrine (90.19%), and a pain killer was the most cited drug, 22.96% of the responders reported to have failed to complete antimalarial dose saying that they had recovered from the malaria bout and 9.80% reported to re-use the remaining part of the dosage. This was the first study in mining and sugarcane growing communities in Western Kenya Highlands that has shown that there was no association between socio-demographic parameters and bed net use, action taken when having malaria, and adherence to drug use. The two rural communities have the bed net and know its use. They have good knowledge of malaria and seek treatment whenever they saw malaria signs. The study also reported that the action the sick person took when they had a malaria bout, the drug they got from the health facility, or failure to complete an AL dosage regimen was not associated with socio-demographic characteristics of the responder. These findings raise the need for further qualitative studies in other settings to accept or deny that there was no association between socio-demographics and action taken when hit with malaria bout, the drug used, and failure to complete drug dosage.

Heat tolerance is the ability of an animal to maintain production and reproduction levels under hot and humid conditions and is now a trait of economic relevance in dairy systems worldwide because of an escalating warming climate. The Australian dairy population is one of the excellent study models for enhancing our understanding of the biology of heat tolerance because they are predominantly kept outdoors on pastures where they experience direct effects of weather elements (e.g., solar radiation). In this article, we focus on evidence from recent studies in Australia that leveraged large a dataset [∼40,000 animals with phenotypes and 15 million whole-genome sequence variants] to elucidate the genetic basis of thermal stress as a critical part of the strategy to breed cattle adapted to warmer environments. Genotype-by-environment interaction (i.e., G × E) due to temperature and humidity variation is increasing, meaning animals are becoming less adapted (i.e., more sensitive) to changing environments. There are opportunities to reverse this trend and accelerate adaptation to warming climate by 1) selecting robust or heat-resilient animals and 2) including resilience indicators in breeding goals. Candidate causal variants related to the nervous system and metabolic functions are relevant for heat tolerance and, therefore, key for improving this trait. This could include adding these variants in the custom SNP panels used for routine genomic evaluations or as the basis to design specific agonist or antagonist compounds for lowering core body temperature under heat stress conditions. Indeed, it was encouraging to see that adding prioritized functionally relevant variants into the 50k SNP panel (i.e., the industry panel used for genomic evaluation in Australia) increased the prediction accuracy of heat tolerance by up to 10% units. This gain in accuracy is critical because genetic improvement has a linear relationship with prediction accuracy. Overall, while this article used data mainly from Australia, this could benefit other countries that aim to develop breeding values for heat tolerance, considering that the warming climate is becoming a topical issue worldwide.

Soil amendment with beneficial microorganisms is gaining popularity among farmers to alleviate the decline of soil fertility and to increase food production and maintain environmental quality. However, farm management greatly influence soil microbial abundance and function, which overly affects crop growth and development. In this work, greenhouse experiments involving soybeans were conducted to evaluate the effects of bradyrhizobia and arbuscular mycorrhizal fungi (AMF) dual inoculation on nodulation, AMF root colonization, growth and nutrient acquisition under contrasting farming systems. The experimental treatments were AMF and/or bradyrhizobia inoculation and dual inoculation on SC squire soybean variety. The exotic AMF inoculants used were Funneliformis mosseae (BEG 12) and Rhizophagus irregularis (BEG 44) while bacteria were commercial Bradyrhizobium japonicum (USDA110) and native bradyrhizobia isolates. Experiments with soil samples from organic and conventional farms were set out using a completely randomized design with three replicates. The results demonstrated that bradyrhizobia and AMF dual inoculation consistently and significantly enhanced soybean nodule dry weight (NDW), shoot dry weight (SDW) and AMF root colonization compared with individual bradyrhizobia, AMF and non-inoculated control. Moreover, organic soil significantly (p = 0.001) increased soybean SDW, NDW and AMF root colonization compared to conventional soil. Remarkably, shoot nutrients content differed in organic and conventional farming where, shoot nitrogen, phosphorus, potassium and organic carbon were higher in organic farming than the latter. Among individual inoculants, Rhizophagus irregularis out-performed Funneliformis mosseae, while commercial Bradyrhizobium japonicum showed higher performance than native bradyrhizobia. Our results demonstrated the importance of organic farming, AMF and bradyrhizobia dual inoculation in enhancing soybean growth and nutrient acquisition. However, field trials should be assessed to determine the good performance of bradyrhizobia and AMF dual inoculation in organic farming before being popularized and adopted by farmers as a sustainable agronomical management strategy to increase soil fertility and food productivity.

Abstract Background Excretory-secretory (ES) products are crucial in maintaining helminths in the host. Consequently, the proteins of ES are potential vaccine molecules and potential therapeutic agents for autoimmune diseases. Heligmosomoides polygyrus bakeri, a gastrointestinal parasite of mice, is a model of hookworm infection in humans. ES produced by both sexes of H. polygyrus bakeri L4 stage cultured separately shows different immunomodulatory properties than ES obtained when both sexes are cultured together. Accordingly, the objective of this study was to identify and compare the excretory-secretory molecules from single-sex and mixed cultures. Methods The composition of ES of male and female L4 stage nematodes in the presence (cultured together) or absence (cultured alone) of the opposite sex was examined. Proteins were identified using mass spectrometry. The functions of identified proteins were explored with Blast2GO. Results A total of 258 proteins derived from mixed larval culture in the presence of sex pheromones were identified, 160 proteins from pure female cultures and 172 from pure male cultures. Exposure of nematodes to the sex pheromones results in abundant production of proteins with immunomodulatory properties such as Val proteins, acetylcholinesterases, TGF-β mimic 9 and HpARI. Proteins found only in ES from mixed larval cultures were TGF-β mimics 6 and 7 as well as galectin. Conclusions The presence of the opposite sex strongly influences the composition of ES products, probably by chemical (pheromone) communication between individuals. However, examination of the composition of ES from various conditions gives an opportunity for searching for new potentially therapeutic compounds and anthelminthics as well as components of vaccines. Manipulation of the nematode environment might be important for the studies on the immunomodulatory potential of nematodes.

Abstract Background Chikungunya fever (CHIKF) was first described in Tanzania in 1952. Several epidemics including East Africa have occurred, but there are no descriptions of longitudinal surveillance of endemic disease. Here, we estimate the incidence of CHIKF in coastal Kenya and describe the associated viral phylogeny. Methods We monitored acute febrile illnesses among 3500 children visiting two primary healthcare facilities in coastal Kenya over a 5-year period (2014–2018). Episodes were linked to a demographic surveillance system and blood samples obtained. Cross-sectional sampling in a community survey of a different group of 435 asymptomatic children in the same study location was done in 2016. Reverse-transcriptase PCR was used for chikungunya virus (CHIKV) screening, and viral genomes sequenced for phylogenetic analyses. Results We found CHIKF to be endemic in this setting, associated with 12.7% (95% CI 11.60, 13.80) of all febrile presentations to primary healthcare. The prevalence of CHIKV infections among asymptomatic children in the community survey was 0.7% (95% CI 0.22, 2.12). CHIKF incidence among children

Gully erosion is the most intensive type of water erosion and it leads to land degradation across the world. Therefore, analyzing the spatial occurrence of this phenomenon is crucial for land management. The objective of this research was to predict gully erosion susceptibility in the Kakia-Esamburmbur catchment in Narok, Kenya, which is badly affected by gully erosion. GIS and ensemble techniques using weight of evidence (WoE) and logistic regression (LR) models were used to map the susceptibility to gully erosion. First, 130 gullies were detected in the study area and portioned out 70:30 for training and validation, respectively. Nine gully erosion conditioning factors were selected as predictors. The relationships between the gully locations and the factors were identified and quantified using WoE, LR and WoE–LR ensemble models. The results show that land use/cover, distance to road, sediment transport index (STI) and topographic wetness index (TWI) are the factors that have the most influence on gully occurrence in the catchment. Additionally, the WoE–LR model performed better than the WoE and LR models, producing an AUC value of 0.88, which was higher than that of the WoE model, 0.62 and the LR model, 0.63. Therefore, the WoE–LR ensemble model is useful in gully erosion susceptibility mapping and is of help to decision makers in land-use planning.

A key obstacle to advocacy efforts to promote legal and policy reforms that ensure women's and girls' access to comprehensive abortion care (CAC) is the lack of relevant and timely evidence. This commentary outlines a research agenda-setting initiative that identified research priorities to support evidence-informed policy and advocacy for CAC access in sub-Saharan Africa (SSA). It involved three phases: 1) a landscape analysis; 2) research agenda co-creation with stakeholders, and 3) a validation exercise on research priorities. Overall, the priority evidence needs included 1) estimating the incidence and magnitude of unsafe abortion and related costs; 2) examining the role of abortion laws and policies in facilitating or inhibiting access to CAC; 3) developing and documenting successful approaches for addressing societal barriers to the provision of CAC, and fostering a more inclusive and liberal abortion environment, and 4) documenting practice-based evidence on the provision of legal abortion services as well as for advocating for CAC. Various stakeholders, including researchers, policymakers, civil society organizations, and funding agencies, will find the agenda useful as they engage, at different levels, for the full domestication and implementation of forward-looking commitments on access to CAC in SSA.