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Abstract Introduction Medical imaging's critical role in diagnosis requires prompt and precise image interpretation. Numerous radiology departments, especially in low‐resourced settings, encounter challenges such as a shortage of radiologists in their operational setup. This study explored the perceptions of radiographers and radiologists from low‐resourced departments in a single country regarding operational challenges and potential solutions in image interpretation. Methods A qualitative approach was utilised, involving heads of departments, senior radiographers, and radiologists with a minimum of 5 years of experience, from three major state referral hospitals. Face‐to‐face, semi‐structured interviews were conducted in November 2022, using an interview guide that included questions on the challenges encountered during image interpretation and the proposed solutions. Data analysis was conducted using Atlas.ti version 9.0, following the four‐step content analysis method. All participants willingly provided consent to participate in the study. Results Ten participants, comprising two radiologists and eight radiographers participated in the study. The research identified three main themes: image interpretation pathways, image interpretation operational challenges and proposed solutions for image interpretation. In addition, a total of 10 subthemes were generated from the three main themes. Conclusion The study revealed critical challenges and the need to explore the formal inclusion of radiographers in image interpretation, as a way to improve efficiency. However, a comprehensive assessment of the image interpretation system, encompassing radiographers' knowledge and competence, is recommended for context‐specific, empirical‐based modifications to enhance service provision.

Abstract Introduction Recently qualified health workers including radiographers struggle with workplace integration. Similarly, in our local context, undocumented complaints were received from the various heads of departments and radiologists regarding recently qualified radiographers' ability to fully assume their professional roles. In light of the complaints, this study sought to explore and describe the lived experiences of recently qualified radiographers from one local University on their readiness to assume their professional roles. Methods A qualitative, descriptive research design with a phenomenological approach was used to conduct the study. Ten (10) diagnostic radiographers who graduated between 2018 and 2020 from the local university were sampled using the snowball sampling technique. Telephonic interviews were conducted using a semi‐structured interview guide. Data were analysed using Tesch's open coding method. Results The findings of this study have shown a combination of positive and negative experiences by recently qualified radiographers. The positive experiences (satisfactory work engagement) emanate from increased confidence and creativity, responsibility consciousness and teamwork. Negative experiences (reality shock and professional role conflict) emanated from excessive workload, patient care impediments, the burden of student supervision and lack of professional trust. Conclusion Though the recently qualified radiographers from our local University experienced some contextual challenges upon assuming their professional roles, they appeared well‐prepared for their clinical roles. Standardised induction and mentorship programmes should be implemented to facilitate the transition process from student to qualified radiographer.

M Grace Duhuze Karera,1,2 Annemarie Wentzel,3,4 MC Sage Ishimwe,2 Jean de Dieu Gatete,1 Ram Jagannathan,5 Margrethe F Horlyck-Romanovsky,1,6 Anne E Sumner1,7 1Section on Ethnicity and Health, Diabetes, Endocrinology, and Obesity Branch, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA; 2Institute of Global Health Equity Research, University of Global Health Equity, Kigali, Rwanda; 3Hypertension in Africa Research Team, North-West University, Potchefstroom, South Africa; 4South African Medical Research Council, Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa; 5Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA; 6Department of Health and Nutrition Sciences, Brooklyn College, City University of New York, New York, NY, USA; 7National Institute of Minority Health and Health Disparities, NIH, Bethesda, MD, USACorrespondence: Anne E Sumner, Building 10, CRC-Rm 6940, Bethesda, MD, 20892-1612, USA, Tel +1 301-402-4240, Email anne.sumner@nih.govAbstract: According to the International Diabetes Federation, sub-Saharan Africa is experiencing the highest anticipate increase in the prevalence of type 2 diabetes (T2D) in the world and has the highest percent of people living with T2D who are undiagnosed. Therefore, diagnosis and treatment need prioritization. However, pharmacological hypoglycemics are often unavailable and bariatric surgery is not an option. Therefore, the ability to induce T2D remission through lifestyle intervention alone (LSI-alone) needs assessment. This scoping review evaluated trials designed to induce T2D remission by LSI-alone. PubMed, Embase, Cochrane, and CINAHL databases were searched for trials designed to induce T2D remission through LSI-alone. Of the 928 identified, 63 duplicates were removed. With abstract review, 727 irrelevant articles were excluded. After full-text review, 112 inappropriate articles were removed. The remaining 26 articles described 16 trials. These trials were published between 1984 and 2021 and were conducted in 10 countries, none of which were in Africa. Remission rates varied across trials. Predictors of remission were 10% weight loss and higher BMI, lower A1C and shorter T2D duration at enrollment. However, LSI-alone regimens for newly diagnosed and established T2D were very different. In newly diagnosed T2D, LSI-alone were relatively low-cost and focused on exercise and dietary counseling with or without calorie restriction (~1500 kcal/d). Presumably due to differences in cost, LSI-alone trials in newly diagnosed T2D had higher enrollments and longer duration. For established T2D trials, the focus was on arduous phased dietary interventions; phase 1: low-calorie meal replacement (< 1000 kcal/day); phase 2: food re-introduction; phase 3: weight maintenance. In short, LSI-alone can induce remission in both newly diagnosed and established T2D. To demonstrate efficacy in Africa, initial trials could focus on newly diagnosed T2D. Insight gained could provide proof of concept and a foundation in Africa on which successful studies of LSI-alone in established T2D could be built.Keywords: hypoglycemics, low-income countries, bariatric surgery, non-communicable diseases

Abstract Abnormal-glucose tolerance (Abnl-GT) is due to an imbalance between β-cell function and insulin resistance (IR) and is a major risk factor in cardiovascular disease (CVD). In sub-Saharan Africa, β-cell failure is emerging as an important cause of Abnl-GT (Abnl-GT-β-cell-failure). Visceral adipose tissue (VAT) volume and hyperlipidemia are major contributors to CVD risk when Abnl-GT is due to IR (Abnl-GT-IR). Yet, the CVD profile associated with Abnl-GT-β-cell failure is unknown. Therefore, our goals in 450 African-born Blacks (Male: 65%; Age: 39 ± 10 years; BMI 28 ± 5 kg/m2), living in America were to: (1) determine Abnl-GT prevalence and etiology; (2) assess by Abnl-GT etiology, associations between four understudied subclinical CVD risk factors in Africans: (a) subclinical myocardial damage (high-sensitivity troponin T (hs-cTnT)); (b) neurohormonal regulation (N-terminal pro-Brain-natriuretic peptide (NT-proBNP)); (c) coagulability (fibrinogen); (d) inflammation (high-sensitivity C-reactive protein (hsCRP)), as well as HbA1c, Cholesterol/HDL ratio and VAT. Glucose tolerance status was determined by the OGTT. IR was defined by the threshold at the lowest quartile for the Matsuda Index (≤ 2.97). Abnl-GT-IR required both Abnl-GT and IR. Abnl-GT-β-cell-failure was defined as Abnl-GT without IR. VAT was assessed by CT-scan. For both the Abnl-GT-β-cell-failure and Abnl-GT-IR groups, four multiple regression models were performed for hs-cTnT; NT-proBNP; fibrinogen and hsCRP, as dependent variables, with the remaining three biomarkers and HbA1c, Cholesterol/HDL and VAT as independent variables. Abnl-GT occurred in 38% (170/450). In the Abnl-GT group, β-cell failure occurred in 58% (98/170) and IR in 42% (72/170). VAT and Cholesterol/HDL were significantly lower in Abnl-GT-β-cell-failure group vs the Abnl-GT-IR group (both P < 0.001). In the Abnl-GT-β-cell-failure group: significant associations existed between hscTnT, fibrinogen, hs-CRP, and HbA1c (all P < 0.05), and none with Cholesterol/HDL or VAT. In Abnl-GT-IR: hs-cTnT, fibrinogen and hsCRP significantly associated with Cholesterol/HDL (all P < 0.05) and NT-proBNP inversely related to fibrinogen, hsCRP, HbA1c, Cholesterol/HDL, and VAT (all P < 0.05). The subclinical CVD risk profile differed between Abnl-GT-β-cell failure and Abnl-GT-IR. In Abnl-GT-β-cell failure subclinical CVD risk involved subclinical-myocardial damage, hypercoagulability and increased inflammation, but not hyperlipidemia or visceral adiposity. For Abnl-GT-IR, subclinical CVD risk related to subclinical myocardial damage, neurohormonal dysregulation, inflammation associated with hyperlipidemia and visceral adiposity. ClinicalTrials.gov Identifier: NCT00001853.

Background: Radiographers’ role as healthcare workers places them at constant risk for hospital-acquired infections. Practical, evidence-based methods are necessary to reduce the transmission of pathogens to and from patients and healthcare workers. Objectives: The main objectives of this study were to determine knowledge, attitude, and practice levels regarding infection prevention and control (IPC) strategies among radiographers in Windhoek and Oshakati, and measure their relationships with other variables. Methods: A quantitative descriptive design was employed. To assess the knowledge, attitude, and practice levels among radiographers, a self-administered questionnaire was used. Twenty-seven radiographers took part in the study, producing a 68% response rate. Results: The study revealed that the majority of the radiographers showed an appropriate level of overall knowledge and attitude toward infection prevention and control. However, the majority of their practice levels were poor. Pearson rank correlation test revealed that the radiographers’ knowledge was significantly associated with attitudes (P= 0.004; r=0.53) and practices (P=0.03; r=-0.41) with a moderate positive and negative correlation, respectively. Conclusions: In conclusion, the study revealed that radiographers are knowledgeable about IPC strategies, and have good attitudes toward them. However, their practice was poor and inconsistent with the level of knowledge demonstrated. Therefore, it is recommended that healthcare service managers establish efficient and rigorous means of monitoring adherence to IPC strategies and improving practices to reduce incidences of health-acquired infections among radiographers, especially in the age of a pandemic.

The Black Anthropocene, plenary session by Axelle Karera Moderated by Jyoti Mistry on November 17th, 2021 as a part of the PARSE 4th biennial research conference on Violence. It is indeed the case that Anthropos’ imprints on what we might provisionally call “nature” is undeniable. And the degree to which “man’s power” over the earth beckoned massive regimes of techno-ideologies of survival is equally irrefutable. Though discourses of the Anthropocene neither contest geology’s pronouncements nor invest in assessing the politics of its scientific nomenclature, the grounds on which the term continues to carve its discursive trajectories remains tenuous. Here, the accusations range from charges of obscurantism to calling the term a misnomer of catastrophic magnitude – a misnomer that merely revived the hegemonies of brute empiricisms at the expense of a vast range of critical work. These accusations are certainly not far-fetched; and critique’s “alleged” paranoia cannot overstate the punctual resurgence of a scientific rationality pruned for Anthropocenean anxieties. By assessing how and why Anthropocene discourses continue to uncritically endorse a seemingly salvific scientific logic, this talk turns to the figure of blackness in the Anthropocene in order to discern how renewed positivist sensibilities are effectively exculpating a range of violent actors while simultaneously incriminating the most vulnerable communities in our current ecological demise. More than only suggesting that blackness redirects our inquiries into the intimate complicities between destructive ecological violence and the imaginative arts of Anthropocene’s various caregivers, the talks shows that blackness’ ordinary experience of dispossession necessarily complicates matters at hand.⁠

Objectives: The objective of this study was to assess the factors affecting testing behaviours amongst the population in Ondo and Lagos States.Methods: A cross-sectional study involving 704 individuals who were considered eligible for COVID-19 testing in 4 local governments in Lagos (307) and Ondo (397) states in Nigeria, was conducted from April-June 2021. Respondents were selected using simple random sampling. A close-ended questionnaire was administered using a digital survey platform known as SurveyCTO. Data were analyzed using R 4.1.0.Results: In Lagos state, 52.4% were females, 47.2% were males while in Ondo, 55.2% were females, 44.6% were male. Chi-square tests of association revealed that socio demographic factors significantly associated with testing patterns was education level in Lagos, and none in Ondo. Testing behavior associated with testing patterns included awareness of nearby COVID-19 testing centers, internet access, knowledge of preexisting conditions and having another member of the family testing positive at 5% significance level.Conclusion: Knowledge of pre-existing conditions, knowledge of COVID-19 symptoms, and knowing where to go when having symptoms were significantly associated with testing and willingness to test.

BackgroundEmerging data suggests that in sub-Saharan Africa β-cell-failure in the absence of obesity is a frequent cause of type 2 diabetes (diabetes). Traditional diabetes risk scores assume that obesity-linked insulin resistance is the primary cause of diabetes. Hence, it is unknown whether diabetes risk scores detect undiagnosed diabetes when the cause is β-cell-failure.AimsIn 528 African-born Blacks living in the United States [age 38 ± 10 (Mean ± SE); 64% male; BMI 28 ± 5 kg/m2] we determined the: (1) prevalence of previously undiagnosed diabetes, (2) prevalence of diabetes due to β-cell-failure vs. insulin resistance; and (3) the ability of six diabetes risk scores [Cambridge, Finnish Diabetes Risk Score (FINDRISC), Kuwaiti, Omani, Rotterdam, and SUNSET] to detect previously undiagnosed diabetes due to either β-cell-failure or insulin resistance.MethodsDiabetes was diagnosed by glucose criteria of the OGTT and/or HbA1c ≥ 6.5%. Insulin resistance was defined by the lowest quartile of the Matsuda index (≤ 2.04). Diabetes due to β-cell-failure required diagnosis of diabetes in the absence of insulin resistance. Demographics, body mass index (BMI), waist circumference, visceral adipose tissue (VAT), family medical history, smoking status, blood pressure, antihypertensive medication, and blood lipid profiles were obtained. Area under the Receiver Operator Characteristics Curve (AROC) estimated sensitivity and specificity of each continuous score. AROC criteria were: Outstanding: >0.90; Excellent: 0.80–0.89; Acceptable: 0.70–0.79; Poor: 0.50–0.69; and No Discrimination: 0.50.ResultsPrevalence of diabetes was 9% (46/528). Of the diabetes cases, β-cell-failure occurred in 43% (20/46) and insulin resistance in 57% (26/46). The β-cell-failure group had lower BMI (27 ± 4 vs. 31 ± 5 kg/m2P < 0.001), lower waist circumference (91 ± 10 vs. 101 ± 10cm P < 0.001) and lower VAT (119 ± 65 vs. 183 ± 63 cm3, P < 0.001). Scores had indiscriminate or poor detection of diabetes due to β-cell-failure (FINDRISC AROC = 0.49 to Cambridge AROC = 0.62). Scores showed poor to excellent detection of diabetes due to insulin resistance, (Cambridge AROC = 0.69, to Kuwaiti AROC = 0.81).ConclusionsAt a prevalence of 43%, β-cell-failure accounted for nearly half of the cases of diabetes. All six diabetes risk scores failed to detect previously undiagnosed diabetes due to β-cell-failure while effectively identifying diabetes when the etiology was insulin resistance. Diabetes risk scores which correctly classify diabetes due to β-cell-failure are urgently needed.

Background. All newborn infants are required to undergo the Apgar score/assessment immediately after birth and again at five minutes. This vital examination is performed to determine how well the infant is adjusting to the birthing process and the outside environment. Some newborns may have a normal Apgar score, while others may have a low score. The purpose of this study was to identify factors associated with low Apgar scores among newborns at an intermediate hospital in Northern Namibia. Objective. To identify maternal factors associated with an immediate low Apgar score in newborns at an intermediate hospital in Northern Namibia and to examine the association between maternal factors and an immediate low Apgar score. Quantitative, retrospective, descriptive research methodology was employed. A document review checklist was utilized to collect data at Onandjokwe Intermediate Hospital between August 2020 and October 2020. Results. Gravidity (p0.021), parity (p0.029), haemoglobin after the first ante-natal care visit (p0.011), antepartum haemorrhage (APH) (p0.004), membrane status (p0.000), duration of labour (p0.000), type of delivery (p0.000), and caesarean section type and indication (p0.000) were found to be associated with an immediate low Apgar score. Conclusions: The study identified maternal factors that influence an infant’s initial low Apgar score. Strengthen maternal health education regarding gravidity and parity, diet, and recognizing danger signs during pregnancy. In addition, strict monitoring of patients with a partograph, cardiotocography, accurate record keeping, and prompt referral of patients with risk factors is strongly advised.

Keluhan pendengaran, menurut banyak penelitian telah dinyatakan berkorelasi positif dengan kehilangan pendengaran. Kehilangan pendengaran merupakan penyebab kecacatan keempat tertinggi di dunia dan dapat disebabkan oleh paparan kebisingan di tempat kerja. Banyak penelitian mengungkapkan bahwa salah satu sektor pekerjaan dengan tingkat kebisingan tinggi di area kerjanya adalah pengolahan kayu. WHO merekomendasikan adanya tindakan identifikasi gangguan pendengaran beserta penyebabnya, dan menerapkan tindakan pencegahan untuk membatasi dampak merugikan yang ditimbulkan oleh paparan kebisingan. Tujuan dari penelitian ini adalah untuk menggambarkan keluhan pendengaran yang dialami pekerja dan memetakan intensitas kebisingan di tempat kerja industri penggergajian kayu UD. Mayoa Jember guna menentukan jenis alat pelindung telingan / pendengaran yang dibutuhkan oleh pekerja. Penelitian ini merupakan penelitian deskriptif. Data yang digunakan dalam penelitian ini merupakan data primer yang didapatkan melalui wawancara dan observasi. Wawancara dilakukan kepada seluruh pekerja yang berjumlah 32 orang. Observasi dilakukan dengan melakukan pengukuran intensitas kebisingan pada 139 titik pengukuran yang tersebar di seluruh area kerja. Pengolahan data untuk pembuatan peta sebaran kebisingan dilakukan dengan bantuan aplikasi Surfer ver.16. Hasil penelitian menunjukkan bahwa sebagian besar responden mengalami keluhan pendengaran pada level yang tidak mengganggu aktifitas. Pemetaan intensitas kebisingan menunjukkan bahwa kebisingan yang terjadi pada saat jam kerja berkisar antara 73,8 – 105,2 dBA dan luas area dengan tingkat kebisingan di atas NAB adalah sekitar 500 m2. Intensitas pada saat jam istirahat berkisar antara 68,2 – 101,0 dBA dengan luas area dengan tingkat kebisingan di atas NAB adalah kurang dari 30 m2. APT yang direkomendasikan untuk tingkat kebisingan 86 - 95 dBA adalah sumbat telinga, untuk kebisingan 96 – 100 dBA adalah sumbat telinga/penutup telinga, sedangkan untuk kebisingan lebih dari 100 dBA adalah perlindungan ganda yakni sumbat telinga dan penutup telinga. Saran yang dapat diberikan kepada pengurus usaha adalah untuk melakuan redesain jam kerja atau melakukan rotasi kerja.

Provinsi Jawa Timur memiliki prevalensi hipertensi yang lebih tinggi (36.8%) dibandingkan dengan prevalensi nasional (34.1%) pada tahun 2018. Profil Kesehatan Kabupaten Jember (2016) menunjukkan bahwa jumlah penderita hipertensi primer pada usia lanjut yang ditangani puskesmas di Kabupaten Jember sebanyak 59.736 kasus sedangkan prevalensi hipertensi pada lanjut usia di kecamatan Ledokombo Kabupaten Jember sebesar 41,88 %. Kejadian hipertensi ini akan terus meningkat apabila tidak dicarikan solusi yang tepat dalam penanganannya. Padahal akan timbul beberapa dampak negatif bagi penderita hipertensi terutama lansia salah satunya timbulnya komplikasi yang berujung kepada kematian. Metode edukasi tricky card game dapat dijadikan sebagai solusi dalam mengatasi permasalahan tersebut. Desain penelitian ini adalah intervensi menggunakan metode tricky card game. Metode edukasi tricky card game ini meliputi empat kegiatan inti antara lain penyuluhan yang interaktif, permainan yang edukatif, pemberian buku panduan hidup sehat bebas hipertensi dan konsultasi serta pengukuran tekanan darah. Responden dalam penelitian ini adalah seluruh anggota sekolah eyang – eyang di Kecamatan Ledokombo Kabupaten Jember. Intervensi dilakukan selama satu bulan. Hasil dari intervensi menunjukkan terdapat peningkatan pengetahuan lansia terhadap pencegahan hipertensi (p value < 0.05). Terjadi peningkatan jumlah lansia yang memiliki nilai tes ≥ 70 pada sebelum (33.33%) dan sesudah (60%) intervensi. Selain itu, terjadi penurunan tekanan darah baik sistolik maupun diastolik dari lansia sebelum dan sesudah intervensi (p value < 0.05). Jumlah lansia yang mengalami penurunan tekanan darah sistolik sebesar 66.67% dan distolik (33.3%). Dengan demikian, metode edukasi tricky card game dapat dijadikan sebagai salah satu upaya untuk pencegahan hipertensi pada lansia.

The discovery of plastics as useful materials for human existence, providing comfort and ease has now turned into a menace in the society and a pain in the neck as plastics have also become co-habitat of the human ecosystem. Plastics were made by men, but plastics now live way longer than the men who gave them the privilege of existence. Since these colonies of materials cannot be eradicated, it is very pertinent to discover possible ways of useful diversion through recycling by converting plastic bottle waste into useful raw materials for other sectors of the economy. This paper has stirred the pool of relevant literature to extract some of the innovative efforts that have been deployed into redirecting the potential of plastic waste into useful applications like engineering and building construction, horticulture in agriculture, and the most advanced application is the 3D printing using plastics as filaments. Following the trend of technology, 3D printing is a grey area of plastic recycling, it is quite expensive however, it worth exploring.

Quality improvement and quality assurance in healthcare settings depend to a great degree on interpersonal relationships that enable effective communication and understanding between individuals. Poor interpersonal relationships between health professionals, patients or groups are considered detrimental to the achievement and sharing of common goals. This paper explored the experiences of managers and health professionals regarding the quality of health care delivery at the Ministry of Health and Social Services (MoHSS) in Namibia, using interviews and focus group discussions. The findings indicated negative attitudes by health professionals towards patients; poor communication among health professionals; lack of motivation and team work as well as resistance to change. It was concluded that most of the problems at MoHSS health care facilities are due to the lack of strong interpersonal relationships, either between patients and health professionals or between health professionals and management. The researchers recommend future research to document the views and experiences of private health providers and patients.

The first case of COVID-19 in Nigeria was recorded on February 27, 2020, being an imported case by an Italian expatriate, to the country. Since then, there has been steady increase in the number of cases. However, the number of cases in Nigeria is low in comparison to cases reported by other countries with similar large populations, despite the poor health system prevailing in the country. This has been mainly attributed to the low testing capacity in Nigeria among other factors. Therefore, there is a need for innovative ways to increase the number of persons testing for COVID-19. The aim of the study was to pilot a nasopharyngeal swab self-sample collection model that would help increase COVID-19 testing while ensuring minimal person-to-person contact being experienced at the testing center. 216 participants took part in this study which was carried out at the Nigerian Institute of Medical Research between June and July 2020. Amongst the 216 participants, 174 tested negatives for both self-collected samples and samples collected by Professionals, 30 tested positive for both arms, with discrepancies occurring in 6 samples where the self-collected samples were positive while the ones collected by the professionals were negative. The same occurred in another set of 6 samples with the self-collected samples being negative and the professional—collected sample coming out positive, with a sensitivity of 83.3% and a specificity of 96.7%. The results of the interrater analysis are Kappa = 0.800 (95% CI, 0.690 to 0.910) which implies an outstanding agreement between the two COVID-19 sampling methods. Furthermore, since p< 0.001 Kappa (k) coefficient is statistically different from zero, our findings have shown that self-collected samples can be reliable in the diagnosis of COVID-19.

The first case of COVID-19 in Nigeria was recorded on February 27, 2020, being an imported case by an Italian expatriate, to the country. Since then, there has been steady increase in the number of cases. However, the number of cases in Nigeria is low in comparison to cases reported by other countries with similar large populations, despite the poor health system prevailing in the country. This has been mainly attributed to the low testing capacity in Nigeria among other factors. Therefore, there is a need for innovative ways to increase the number of persons testing for COVID-19. The aim of the study was to pilot a nasopharyngeal swab self-sample collection model that would help increase COVID-19 testing while ensuring minimal person-to-person contact being experienced at the testing center. 216 participants took part in this study which was carried out at the Nigerian Institute of Medical Research between June and July 2020. Amongst the 216 participants, 174 tested negatives for both self-collected samples and samples collected by Professionals, 30 tested positive for both arms, with discrepancies occurring in 6 samples where the self-collected samples were positive while the ones collected by the professionals were negative. The same occurred in another set of 6 samples with the self-collected samples being negative and the professional-collected sample coming out positive, with a sensitivity of 83.3% and a specificity of 96.7%. The results of the interrater analysis are Kappa = 0.800 (95% CI, 0.690 to 0.910) which implies an outstanding agreement between the two COVID-19 sampling methods. Furthermore, since p< 0.001 Kappa (k) coefficient is statistically different from zero, our findings have shown that self-collected samples can be reliable in the diagnosis of COVID-19.

Background: A number of countries have adopted sugar-sweetened beverage taxes to prevent non-communicable diseases but there is variance in the structures and rates of the taxes. As interventions, sugar-sweetened beverage taxes could be cost-effective but must be compliant with existing legal and taxation systems. Objectives: To assess the legal feasibility of introducing or strengthening taxation laws related to sugar-sweetened beverages, for prevention of non-communicable diseases in seven countries: Botswana, Kenya, Namibia, Rwanda, Tanzania, Uganda and Zambia. Methods: We assessed the legal feasibility of adopting four types of sugar-sweetened beverage tax formulations in each of the seven countries, using the novel FELIP framework. We conducted a desk-based review of the legal system related to sugar-sweetened beverage taxation and assessed the barriers to, and facilitators and legal feasibility of, introducing each of the selected formulations by considering the existing laws, laws related to impacted sectors, legal infrastructure, and processes involved in adopting laws. Results: Six countries had legal mandates to prevent non-communicable diseases and protect the health of citizens. As of 2019, all countries had excise tax legislation. Five countries levied excise taxes on all soft drinks, but most did not exclusively target sugar-sweetened beverages, and taxation rates were well below the World Health Organization’s recommended 20%. In Uganda and Kenya, agricultural or HIV-related levies offered alternative mechanisms to disincentivise consumption of sugar-sweetened beverages without the introduction of new taxes. Nutrition-labelling laws in all countries made it feasible to adopt taxes linked to the sugar content of beverages, but there were lacunas in existing infrastructure for more sophisticated taxation structures. Conclusion: Sugar-sweetened beverage taxes are legally feasible in all seven countries Existing laws provide a means to implement taxes as a public health intervention.

Background: Nutrition-related non-communicable diseases contribute to approximately half of the premature deaths in Namibia. Westernisation and urbanisation of communities have resulted in changing dietary patterns that see people eating more refined and high sugar content foods that are a risk for nutrition-related non-communicable diseases. Sugar-sweetened beverage taxation has been found to influence consumer purchasing behaviour and to raise revenue for health-promoting activity in other low- and middle-income countries. Objectives: To analyse Namibia’s non-communicable diseases prevention policy landscape and assess the readiness of the Government to adopt sugar-sweetened beverage taxation policies for public health. Methods: Government policy documents relating to nutrition-related non-communicable diseases were analysed, utilising predetermined variables based on policy theory. Thirteen key informant interviews were conducted with stakeholders from Government, non-governmental organisations and academic institutions. Data sets were analysed utilising Kingdon’s analytical theory for agenda setting. Results: Nutrition-related non-communicable diseases are an increasing problem that requires immediate action. Diet and lifestyle are recognised as major contributors to non-communicable diseases. The Government has adopted a multisectoral approach to the control and prevention of non-communicable diseases in Namibia. A sugar-sweetened beverage tax is envisaged in policy, but there is no progress towards its enactment. At the highest level of Government, the Ministry of Finance has ruled out immediate action towards sugar-sweetened beverage taxation. There is little publicly available information about the Namibian beverages industry, but it is closely tied to the South African drinking industry and is influenced by policy action in that country. Conclusion: The Government of Namibia has taken positive steps and the policy environment is friendly towards an SSB tax. The proximity of trade and the competitive nature of the Namibian drinks industry with South Africa suggest that a regional perspective to advocacy would be of value.

Abstract Background Severe malaria is a medical emergency associated with high mortality. Adequate treatment requires initial parenteral therapy for fast parasite clearance followed by longer acting oral antimalarial drugs for cure and prevention of recrudescence. Methods In a randomized controlled clinical trial, we evaluated the 42-day parasitological outcomes of severe malaria treatment with intravenous artesunate (AS) or intravenous quinine (QNN) followed by oral artemisinin based combination therapy (ACT) in children living in a high malaria transmission setting in Eastern Uganda. Results We enrolled 300 participants and all were included in the intention to treat analysis. Baseline characteristics were similar across treatment arms. The median and interquartile range for number of days from baseline to parasite clearance was significantly lower among participants who received intravenous AS (2 (1–2) vs 3 (2–3), P