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In industry, the monitoring and diagnosis of production processes are crucial issues in ensuring plant reliability, performance and quality. In particular, food processing operations, such as coffee roasting, are subject to numerous risks of failure that can impact on productivity and the quality of the final product. In this context, the main objective of this study was to develop an innovative method for the diagnosis and prognosis of failures in a coffee roasting process. The proposed method differs from standard approaches by using the particle swarm optimization (PSO) algorithm applied to the analysis of signatures of key process variables. This new approach has improved fault detection, with a recognition rate of over 90% for the main types of fault identified, such as heating problems, air obstructions or leaks. In addition to diagnostics, the method has also demonstrated its effectiveness in prognosticating the state of health of the process, with an average error on the prediction of remaining service life reduced to 15%, compared with 35% for fixed-threshold methods. This work has therefore enabled us to develop an innovative method offering superior performance to standard approaches for the diagnosis and prognosis of failures in the roasting process.

Cameroon is a low-and-middle income country (LMIC) with one of the highest incidence and mortality from cervical cancer in Africa. In this Central African country where the prevalence of human immunodeficiency virus (HIV) is high and the screening coverage is low, cervical cancer is the most deadly and the second most common cancer among women. Notwithstanding the growing burden of cervical cancer in Cameroon, most patients - often of lower socioeconomic status - continue to encounter multi-level barriers to timely and adequate care. These include the lack of physical and financial access to healthcare facilities, limited quality pathology, imaging and treatment services, ignorance of disease by the population, shortage of a well-trained oncology workfroce, which result in significant delays in gaining access to screening, diagnosis, treatment and care. This paper presents 3 cases of patients with advanced cervical cancer who had surgery (hysterectomy) as primary treatment, without appropriate post-surgical investigation to further specify disease stage, persistence of residual disease, and need for adjuvant chemoradiation. Pathology services and diagnostic imaging procedures remain scarce and underused in LMIC countries like Cameroon. Healthcare professionals involved in patient care lack adequate knowledge, skills and collaborative strategy to properly navigate these patients. To address these challenges, the health system should be reinforced with adequate infrastructures, sustainable funding should be secured to enhance universal health coverage and promote cancer prevention and control programs, multidisciplinary teams and coordination of care among providers should be improved, and relevant health indicators should be put in place to better monitor the quality of care delivered to patients who are mostly vulnerable and uninformed.

Abstract Background Rhipicephalus (Boophilus) microplus (Canestrini, 1888), the Asian blue tick, is a highly invasive and adaptable ectoparasite. This tick species has successfully established itself in most regions of the world, with movement of cattle being a major driver for its spread. In the recent past, R. microplus ticks have been reported in three districts of Uganda. Information on its spread and distribution are vital in deepening our understanding of the ecological scenarios that lead to tick persistence and in the formulation of control strategies. This is especially important in the cattle-dense districts. Methods We randomly collected tick specimens from 1,461cattle spread across seven cattle dense districts located in the Central, Karamoja and West Nile regions of Uganda from January to September 2020. The ticks were identified using standard morpho-taxonomic keys and the R. microplus tick species identities were confirmed by sequencing of the ITS2 region, 12S rRNA and 16S rRNA genes and phylogenetic analyses. Results Adult ticks (n = 13,019) were collected from 1,461 cattle. Seventeen tick species were identified based on morpho-taxonomic keys and the majority (47.4%; n=6184) of these were R. appendiculatus. In total, 257 R. microplus ticks were found infesting cattle in 18 study sites in the districts of Amudat, Kaabong, Napak (Karamoja region) and Arua (West Nile region). The identity of R. microplus was confirmed using molecular technics. No R. microplus tick was recorded in the districts of Lyantonde and Nakaseke (Central region). Arua district accounted for 82.1% (n=211) of the R. microplus ticks recorded followed by Napak district at 16.3% (n=42), while Amudat and Kaabong districts accounted for 1.5% (n=4). Rhipicephalus microplus and R. decoloratus co-existed in 6 of the 13 study sites in Arua district, while in another 6 study sites, no R. decoloratus was recorded. In the Karamoja region districts R. decoloratus co-existed with R.microplus. Of the total 618 ticks belonging to four species of the subgenus Boophilus recorded in this study, R. decoloratus accounted for 50.04% (n=334), followed by R. microplus at 41.58% (n=257), R. geigyi at 2.75% (n=17) and R. annulatus at 1.61% (n=10). In the districts of Amudat, Kaabong and Napak, R. decoloratus was more dominant (76.1%; n=179) of the three Rhipicephalus (Boophilus) tick species recorded, followed by R. microplus (19.5%; n=46) and R. geigyi (4.2%; n=10). Contrariwise, R. microplus was more dominant (84%; n=211) in Arua district followed by R. decoloratus (10.7%; n=27), R. annulatus (3.9%; n=10) and R. geigyi (1.1%; n=3). Phylogenetic analyses of the ITS2 region, 12S rRNA and 16S rRNA genes revealed subgrouping of the obtained sequences with the previously published R. microplus sequences from other parts of the world. Conclusion Rhipicephalus microplus ticks were found infesting cattle in four districts of Uganda. The inability to find R. decoloratus, an indigenous tick, from six sites in the district of Arua is suggestive of its replacement by R. microplus. Rhipicephalus microplus negatively affects livestock production, and therefore, there is a need to determine its distribution and to deepen the understanding of the ecological factors that lead to its spread and persistence in an area.

Abstract Background Contagious bovine pleuropneumonia [CBPP] is a transboundary animal disease of cattle caused by Mycoplasma mycoides subsp. mycoides [Mmm]. CBPP causes severe economic losses to livestock producers in sub-Saharan Africa mainly due to high mortality, morbidity, reduction in productivity as well as livestock trade restrictions. This study aimed at determining seroprevalence of Mmm in cattle from Karamoja region, north-eastern Uganda; data that are required to design and implement risk based CBPP control program. Methods We randomly collected blood samples from 2,300 cattle spread across Karamoja region. Serum was extracted and screened for antibodies against Mycoplasma mycoides subsp. mycoides [Mmm] using the competitive enzyme linked immunosorbent assay [cELISA]. Results A quarter [25.4%; 95% CI: 23.7–27.3] of the screened cattle [n = 2,300] were sero-positive for Mmm. Amudat and Kaabong districts recorded the lowest [12.3%] and highest [30.7%] Mmm seroprevalence respectively. Increasing age, overnight stay in cattle kraals and location [certain districts, villages, herds and sub counties] of the cattle herds, the factors that promote animal commingling, were the most significant risk factors of seroconversion with Mmm. Conclusion Results from this study indicated a higher seroprevalence of Mmm in Karamoja region cattle herds. This could be due to the increased frequency of CBPP outbreaks in recent years. To be effective, CBPP vaccination programs should target high risk herds along the international borders and other hotspot areas [e.g., parishes or sub counties] where cattle commingling is high.

Abstract Background Stunting among children under 5 years of age remains a worldwide concern, with 148.1 million (22.3%) stunted in 2022. The recent 2019/2020 Rwanda Demographic Health Survey (RDHS) revealed that the prevalence of stunting in Rwanda among under five children was 33.5%. In Rwanda, there is no sufficient evidence on stunting status to guide prioritized interventions at the sector level, the lowest administrative unit for implementing development initiatives. This study aimed to provide reliable estimates of stunting prevalence in Rwanda at the sector level. Methods In this article, Small Area Estimation (SAE) techniques were used to provide sector level estimates of stunting prevalence in children under five in Rwanda. By plugging in relevant significant covariates in the generalized linear mixed model, model-based estimates are produced for all sectors with their corresponding Mean Square Error (MSE). Results The findings showed that, overall, 40 out of 416 sectors had met the national target of having a stunting rate less than or equal to 19%, while 194 sectors were far from meeting this target, having a stunting rate higher than the national prevalence of 33.5% in the year 2020. The majority of the sectors with stunting prevalence that were higher than the national average of 33.5% were found in the Northern Province with 68 sectors out of 89 and in Western Province with 64 sectors out of 96. In contrast, the prevalence of stunting was lower in the City of Kigali where 14 out of 35 sectors had a stunting rate between 0 and 19%, and all sectors were below the national average. This study showed a substantial connection between stunting and factors such as household size, place of residence, the gender of the household head, and access to improved toilet facilities and clean water. Conclusion The results of this study may guide and support informed policy decisions and promote localised and targeted interventions in Rwanda’s most severely affected sectors with a high stunting prevalence in Rwanda.

Bacterial diseases of the gastrointestinal (GI) tract continue to be a major worldwide cause of human morbidity and mortality. Among various enteric pathogens, Shigella spp. are some of the most common and deadly bacterial pathogens. They are responsible for ~125 million worldwide cases of shigellosis, and ~14,000 deaths annually, the majority in children under the age of 5 and occurring in developing countries. Preventing and treating shigellosis with conventional drugs (e.g., vaccines and antibiotics) has proven to be very difficult. Here, we assessed the safety and tolerability of ShigActive™, a lytic bacteriophage preparation targeting Shigella spp., in a randomized, placebo-controlled, double-blind Phase 1 clinical trial. Ten participants randomized 4:1 received ShigActive™ or placebo co-administered with sodium bicarbonate orally three times daily for 7 days. Solicited and unsolicited adverse events (AEs) were observed for 29 days. Fifty percent of the subjects receiving ShigActive™ reported mild GI-related symptoms, while one participant experienced moderate fatigue. No serious or medically attended AEs occurred through day 90. Additionally, no significant differences in GI-associated inflammatory mediators or fecal microbiome changes were observed between placebo- and ShigActive™-treated subjects, or from a participants’ baseline value. The results of this first-in-human (FIH) randomized, controlled Phase 1 trial of ShigActive™ demonstrate that it is safe and well tolerated when orally administered with no significant differences compared to placebo controls.

Abstract Introduction The African Center for Integrated Laboratory Training (ACILT) in Johannesburg, South Africa offered a laboratory biosafety program to improve laboratory biosafety practices in 22 President’s Emergency Plan for AIDS Relief (PEPFAR) supported countries. This manuscript evaluates the transference of newly gained knowledge and skills to the participants’ place of employment for HIV and TB diagnostic laboratory programs. It also serves as a follow-on to a previously published manuscript that measured training effectiveness for all courses offered at ACILT. Methods ACILT offered 20 Laboratory Biosafety and Infrastructure courses (2008–2014), also referred as biosafety course/course comprising of 14 core laboratory safety elements to 402 participants from 22 countries. In 2015, participants received 22 e-questions divided into four categories: (1) Safety Policies, (2) Management’s Engagement, (3) Safety Programs and (4) Assessments of Safety Practices to determine retrospectively the training effectiveness of biosafety practices in their place of employment 6 months before and after attending their course. We used Kirkpatrick model to assess the transference of knowledge, skills and obstructive factors. Results 20% (81/402) of the participants completed the e-questionnaire. The overall percentage of positive responses indicating implementation of new safety practices increased from 50% to 84%. Improvement occurred in all four categories after attending the course, with the greatest increases in Safety Policies (67–94%) and Safety Programs (43–91%). Creating a safety committee, allocating resources, and establishing a facility safety policy were important drivers for implementing and maintaining laboratory safety practices. In addition, accredited laboratories and countries with national safety regulations or policies had a higher percentage of improvements. The most reported challenges were inadequate funding and lack of management enforcement. Conclusions PEPFAR and other partners’ investments in training institutions, such as ACILT, were effective in building sustainable country ownership to strengthen biosafety practices and were leveraged to combat zoonotic diseases and COVID-19. Although support continues at the national/regional level, a standardized, coordinated and continent-wide sustainable approach to offer a biosafety program-like ACILT is missing. Continuous offerings of biosafety programs similar to ACILT could contribute to sustainable strengthening of laboratory biosafety, QMS and pandemic preparedness.

The low adoption of insurance by potential policyholders in developing countries like Kenya is a cause for concern for insurers, regulators, and other marketing stakeholders. To effectively design targeted marketing strategies to boost insurance adoption, it is crucial to determine the factors that affect insurance uptake among potential policyholders. In this study, the 2021 FinAccess Survey, which interviewed sampled individuals above 16 years in Kenya and machine learning techniques, including Random Forest, XGBoost, and Logistic Regression, were utilized to uncover the factors driving insurance uptake and the reasons for the low adoption of insurance among potential policyholders. Random Forest was the most robust model of the three classifiers based on Kappa score, recall score, F1 score, precision, and area under the operating characteristic curve (approaching 1). The paper explores eight reasons why people currently do not have insurance policies. The results indicated that affordability was the primary driver of uptake with 68.67% of having expressed a desire to possess insurance but are unable to afford it. The highest level of education being the next most significant factor. Cultural and religious beliefs and mistrust of insurance providers were found to have a minimal impact on uptake. These findings imply that offering affordable insurance products and conducting awareness campaigns are critical to increase insurance adoption.

To date, information on Cryptosporidium spp. infection status among people and wild animals living at the wildlife-human interface such as Queen Elizabeth National Park (QENP) is scarce. The aim of this study is to document the molecular detection of Cryptosporidium spp. in wild animals, and people, around QENP in the Kasese District. A total of 308 patients from four health centres and 252 wildlife animals from six species across 13 sampling areas were analysed microscopically and with PCR for Cryptosporidium spp. detection. The parasitological and molecular prevalence of Cryptosporidium spp. in humans was 40% and 53%, respectively; Kasenyi Health Centre recorded the highest percentage of positive stool samples for both tests. Wildlife species had an overall molecular percentage positivity of 30.16%; however, considering individual animal species that were sampled, the Waterbucks had the highest positivity rate, that is, 54.54%. All the samples were confirmed as genus Cryptosporidium with less species discrimination as our PCR target was a short fragment. There is a need to investigate the risk factors that predispose to high Cryptosporidium infection in the study area, especially in Kasenyi. In-depth investigation of the genetic diversity of Cryptosporidium spp. circulating at the human, livestock, and wildlife interface is imperative in devising disease management strategies.

Concrete shells are widespread in civil engineering constructions. Because of the moldability of concrete, special structures such as domes, bridge caissons, buried or raised reservoirs, and arch dams are built with concrete. In this study, we are particularly interested in the variation of the thickness and the resulting strains during a short-term mechanical loading of a concrete ring in its elastic phase. On the one hand, transverse stresses through the thickness are calculated numerically by implementing a particular family of finite elements (four degrees of freedom per summit node) with a two-dimensional shell model, which accounts for thickness variations and transverse distortions. On the other hand, an experimental device was mounted in order to validate numerical predictions.

The article focuses on the influence of differential shrinkage linked by drying at the early-age displacements and strain distribution of a concrete ring specimen. Depending on the gradient of dimension changes through the thickness, tensile stress occurs near the exposed surface where drying is greater and thus results in strain gradients development. An experimental design was carried out on a concrete ring cast in laboratory conditions in order to monitor strains and displacements. Subsequently, a finite element method was used to simulate the ring’s behaviour in drying conditions. The gradient development linked by a non-uniform moisture distribution in the thickness is established by solving the non-linear partial differential drying equation with Mensi’s diffusion law. The stress and displacement analysis was modeled by three nodes curved shell FEM (CSFE-sh) based on strain approximation with the shell theory. Finally, the ring’s behaviour includes both differential shrinkage resulting in the mechanical and physical properties of gradients development in the thickness and the influence of prestressing, in which the tensile creep effects have a great influence. The comparison of experimental results with numerical simulation shows that drying and tensile creep phenomena have the most important influence on the early-age stress development in the walled ring.

The resurgence of what is today referred to as the ‘Anglophone problem/crisis’ has led to several sociocultural, religious, political and linguistic developments which have in no little measure contributed to reshaping the linguistic landscape of Camerooon. Through the Ecolinguistic and Descriptive Statistical Approaches, this investigation delves into the linguistic fallouts and dynamics of the crisis and illustrates how through different linguistic processes like borrowing, neologisms, affixation, blending, clipping, translation and interpretation, etc., English in Cameroon is undergoing indigenisation. This paper demonstrates how the sensitive issue at stake has proffered a propitious breeding ground for the eventual enrichment of the lexical capital of the language. Thus, recurrent patterns in popular usage, viz: ambalander, aluta continua, total ghosting of towns, black cats/vipers/tigers of General Ivo, dipper wearing regime, Bui/Manyu county, royal beggars, Operation Whistle and Pepper Spray, inter alia, constitute new forms of expression as well as old forms that have been accorded novel semantic shades in order to express meaningful thought.

Abstract Background Pseudomonas aeruginosa is an opportunistic pathogen that causes a wide range of acute and chronic infections and is frequently associated with healthcare-associated infections. Because of its ability to rapidly acquire resistance to antibiotics, P. aeruginosa infections are difficult to treat. Alternative strategies, such as a vaccine, are needed to prevent infections. We collected a total of 413 P. aeruginosa isolates from the blood and cerebrospinal fluid of patients from 10 countries located on 4 continents during 2005–2017 and characterized these isolates to inform vaccine development efforts. We determined the diversity and distribution of O antigen and flagellin types and antibiotic susceptibility of the invasive P. aeruginosa. We used an antibody-based agglutination assay and PCR for O antigen typing and PCR for flagellin typing. We determined antibiotic susceptibility using the Kirby-Bauer disk diffusion method. Results Of the 413 isolates, 314 (95%) were typed by an antibody-based agglutination assay or PCR (n = 99). Among the 20 serotypes of P. aeruginosa, the most common serotypes were O1, O2, O3, O4, O5, O6, O8, O9, O10 and O11; a vaccine that targets these 10 serotypes would confer protection against more than 80% of invasive P. aeruginosa infections. The most common flagellin type among 386 isolates was FlaB (41%). Resistance to aztreonam (56%) was most common, followed by levofloxacin (42%). We also found that 22% of strains were non-susceptible to meropenem and piperacillin-tazobactam. Ninety-nine (27%) of our collected isolates were resistant to multiple antibiotics. Isolates with FlaA2 flagellin were more commonly multidrug resistant (p = 0.04). Conclusions Vaccines targeting common O antigens and two flagellin antigens, FlaB and FlaA2, would offer an excellent strategy to prevent P. aeruginosa invasive infections.

Universal Health Coverage (UHC) is a global objective aimed at providing equitable access to essential and cost-effective healthcare services, irrespective of individuals' financial circumstances. Despite efforts to promote UHC through health insurance programs, the uptake in Kenya remains low. This study aimed to explore the factors influencing health insurance uptake and offer insights for effective policy development and outreach programs. The study utilized machine learning techniques on data from the 2021 FinAccess Survey. Among the models examined, the Random Forest model demonstrated the highest performance with notable metrics, including a high Kappa score of 0.9273, Recall score of 0.9640, F1 score of 0.9636, and Accuracy of 0.9636. The study identified several crucial predictors of health insurance uptake, ranked in ascending order of importance by the optimal model, including poverty vulnerability, social security usage, income, education, and marital status. The results suggest that affordability is a significant barrier to health insurance uptake. The study highlights the need to address affordability challenges and implement targeted interventions to improve health insurance uptake in Kenya, thereby advancing progress towards achieving Universal Health Coverage (UHC) and ensuring universal access to quality healthcare services.

BackgroundThere is a paucity of data on kidney impairment among older people living with HIV (PLWH). We evaluated kidney function among PLWH age ≥ 60 years on first-line antiretroviral (ARV) therapy during screening for a clinical trial in Kenya.MethodsThe bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) Elderly Study is an open-label, randomized, active-controlled, non-inferiority trial conducted at two sites in Kenya. Potential participants were screened for study entry if they were at least 60 years old, had been on ARVs for at least 24 weeks and had no history of treatment failure. At screening, participants had samples collected for serum creatinine and estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration 2021 equation.ResultsBetween January and April 2022, 714 participants were screened and had creatinine measured. All participants were black, 54.1% were female and the median age was 64 years (range 60 to 87 years). Most participants (666 [93.3%]) were on tenofovir disoproxil fumarate-containing regimens, 711 (99.6%) were on dolutegravir-containing regimens, and only 2 (0.3%) were on a regimen with a ritonavir-boosted protease inhibitor. Most participants (686 [96.6%]) were virally suppressed. Treatment for comorbidities was common, with 175 (24.5%) on treatment for hypertension and 39 (5.5%) on treatment for diabetes mellitus. The median eGFR was 64.7 mL/min/1.73m2, and 289 (40.5%) participants had an eGFR < 60 mL/min/1.73m2. In multivariate analysis, factors associated with lower eGFR were female gender (pConclusionsOur study identified high rates of impaired kidney function among elderly PLHW in Kenya, which highlights the importance of routine assessment of kidney function and the need to address modifiable risk factors, use of appropriate ARVs, and management of kidney disease in this population.

Amidst rising cases of antimicrobial resistance, antimicrobial peptides (AMPs) are regarded as a promising alternative to traditional antibiotics. Even so, poor pharmacokinetic profiles of certain AMPs impede their utility necessitating, a careful assessment of potential AMPs’ absorption, distribution, metabolism, excretion, and toxicity (ADMET) properties during novel lead exploration. Accordingly, the present study utilized ADMET scores to profile seven previously isolated African catfish antimicrobial peptides (ACAPs). After profiling, the peptides were docked against approved bacterial protein targets to gain insight into their possible mode of action. Promising ACAPs were then chemically synthesized, and their antibacterial activity was validated in vitro utilizing the broth dilution method. All seven examined antimicrobial peptides passed the ADMET screening, with two (ACAP-IV and ACAP-V) exhibiting the best ADMET profile scores. The ACAP-V had a higher average binding energy (−8.47 kcal/mol) and average global energy (−70.78 kcal/mol) compared to ACAP-IV (−7.60 kcal/mol and −57.53 kcal/mol), with the potential to penetrate and disrupt bacterial cell membrane (PDB Id: 2w6d). Conversely, ACAP-IV peptide had higher antibacterial activity against E. coli and S. aureus (Minimum Inhibitory Concentration, 520.7 ± 104.3 μg/ml and 1666.7 ± 416.7 μg/ml, respectively) compared to ACAP-V. Collectively, the two antimicrobial peptides (ACAP-IV and ACAP-V) are potential novel leads for the food, cosmetic and pharmaceutical industries. Future research is recommended to optimize the expression of such peptides in biological systems for extended evaluation.

The computation of bent isotropic plates, stretched and/or compressed, is a topic widely explored in the literature from both experimental and numerical point of view. We expose in this work an application of the generalized equations of Finite difference method to that topic. The strength of the proposed method is the ability to reconstruct the approximate solution with respect of eventual discontinuities involved in the investigated function as well as its first and second derivatives, including the right-hand side of the equilibrium equation. It is worth mentioning that by opposition to finite element methods our method needs neither fictitious points nor a special condensation of grid. Well-known benchmarks are used in this work to illustrate the efficiency of our numerical and the high accuracy of calculation as well. A comparison of our results with those available in the literature also shows good agreement.

ABSTRACT In countries where the incidence of typhoid fever is high, fecal material from short-term carriers of Salmonella Typhi contaminates inadequately treated water supplies. As treated water supplies and improved sanitation become available, chronic (mainly gallbladder) carriers of S. Typhi become important. The objective of this study was to develop a method for detection of S. Typhi in bile by quantitative real-time PCR (qPCR) in patients undergoing cholecystectomy. We evaluated sensitivity and specificity of probesets that target oriC, viaB, fliC-d, STY0201, and stoD. We optimized DNA extraction from bile and compared the sensitivity of culture and our qPCR method to detect S. Typhi in bile samples containing various cephalosporins. With the use of an optimized DNA extraction technique, our limit of detection of S. Typhi in spiked human bile samples was 7.4 × 102 CFU/mL. We observed that S. Typhi could be detected by qPCR in samples containing cefazolin, cefotaxime, or ceftriaxone whereas culture could only detect Typhi in samples containing cefazolin but not cefotaxime or ceftriaxone. Our qPCR detection method for S. Typhi in bile should be preferred in areas where antibiotic usage is common. IMPORTANCE New Salmonella Typhi conjugate vaccines have been deployed, which will potentially lead to a fall in incidence rates of typhoid fever in endemic areas. Identification of chronic carriers of S. Typhi will be important as these individuals can be a potential source of transmission to susceptible persons. To address this public health concern, we have developed a novel method to detect S. Typhi in bile using real-time PCR. Our method can be used to identify carriers of S. Typhi among patients undergoing cholecystectomy (gallbladder removal surgery). The sensitivity of our molecular-based assay was superior to culture when performed in the presence of antibiotics commonly used during surgery. Our methodology will complement efforts to eliminate typhoid disease.

Pension plans play a vital role in the economy by impacting savings, consumption, and investment allocation. Despite declining mortality rates and increasing life expectancy, pension enrollment remains low, affecting the long-term financial stability and well-being of populations. To address this issue, this study was conducted to explore the potential of predictive modeling techniques in improving pension participation. The study utilized three tree-based machine learning algorithms and a logistic regression classifier to analyze data from a nationally representative 2019 Kenya FinAccess Household Survey. The results indicated that ensemble tree-based models, particularly the random forest model, were the most effective in predicting pension enrollment. The study identified the key factors that influenced enrollment, such as National Health Insurance Fund (NHIF) usage, monthly income, and bank usage. The findings suggest that collaboration among the NHIF, banks, and pension providers is necessary to increase pension uptake, along with increased financial education for citizens. The study provides valuable insight for promoting and optimizing pension participation.

Abstract Background Rhipicephalus microplus, an invasive tick species of Asian origin and the main vector of Babesia species, is considered one of the most widespread ectoparasites of livestock. The tick has spread from its native habitats on translocated livestock to large parts of the tropical world, where it has replaced some of the local populations of Rhipicephalus decoloratus ticks. Although the tick was reported in Uganda 70 years ago, it has not been found in any subsequent surveys. This study was carried out to update the national tick species distribution on livestock in Uganda as a basis for tick and tick-borne disease control, with particular reference to R. microplus. Methods The study was carried out in Kadungulu, Serere district, south-eastern Uganda, which is dominated by small scale livestock producers. All the ticks collected from 240 cattle from six villages were identified microscopically. Five R. microplus specimens were further processed for phylogenetic analysis and species confirmation. Results The predominant tick species found on cattle was Rhipicephalus appendiculatus (86.9 %; n = 16,509). Other species found were Amblyomma variegatum (7.2 %; n = 1377), Rhipicephalus evertsi (2.3 %; n = 434) and R. microplus (3.6 %; n = 687). Phylogenetic analysis of the 12S rRNA, 16S rRNA and ITS2 gene sequences of R. microplus confirmed the morphological identification. Conclusions It is concluded that R. microplus has replaced R. decoloratus in the sampled villages in Kadungulu sub-county, since the latter was not any longer found in this area. There is currently no livestock movement policy in force in Uganda, which could possibly limit the further spread of R. microplus ticks. Future surveys, but also retrospective surveys of museum specimens, will reveal the extent of distribution of R. microplus in Uganda and also for how long this tick has been present on livestock without being noticed.

Abstract Background Lumpy skin disease (LSD) is an infectious viral disease of cattle caused by a Capripoxvirus. LSD has substantial economic implications, with infection resulting in permanent damage to the skin of affected animals which lowers their commercial value. In Uganda, LSD is endemic and cases of the disease are frequently reported to government authorities. This study was undertaken to molecularly characterize lumpy skin disease virus (LSDV) strains that have been circulating in Uganda between 2017 and 2018. Secondly, the study aimed to determine the phylogenetic relatedness of Ugandan LSDV sequences with published sequences, available in GenBank. Results A total of 7 blood samples and 16 skin nodule biopsies were screened for LSDV using PCR to confirm presence of LSDV nucleic acids. PCR positive samples were then characterised by amplifying the GPCR gene. These amplified genes were sequenced and phylogenetic trees were constructed. Out of the 23 samples analysed, 15 were positive for LSDV by PCR (65.2%). The LSDV GPCR sequences analysed contained the unique signatures of LSDV (A11, T12, T34, S99, and P199) which further confirmed their identity. Sequence comparison with vaccine strains revealed a 12 bp deletion unique to Ugandan outbreak strains. Phylogenetic analysis indicated that the LSDV sequences from this study clustered closely with sequences from neighboring East African countries and with LSDV strains from recent outbreaks in Europe. It was noted that the sequence diversity amongst LSDV strains from Africa was higher than diversity from Eurasia. Conclusion The LSDV strains circulating in Uganda were closely related with sequences from neighboring African countries and from Eurasia. Comparison of the GPCR gene showed that outbreak strains differed from vaccine strains. This information is necessary to understand LSDV molecular epidemiology and to contribute knowledge towards the development of control strategies by the Government of Uganda.

The target in this survey is to investigate deformations of laminates shells (DLS), due to asymmetric and axisymmetric loads, including several other loadings using N-T shell equations. We point out here, the contribution of the metric change in thickness for the analysis of static and linear behavior of laminated composite shells. To achieve this objective, we’ve applied N-T’s shells equations on the same monolayer laminate composite shell and derive the law of MBLS. The macrostructure is analyzed under static loads and implemented using low order curved shell finite elements with shifted Lagrange (CSFE-sh). We tested this element on benchmarks found within the literature. The analysis of cylindrical and spherical shells subjected to uniform sinusoidal pressures and asymmetric pressures reveals excellent accuracy compared to others. The results found without any correction factor were compared with those obtained by the analytical method and other finite element models.

Antimicrobial peptides (AMPs) constitute a broad range of bioactive compounds in diverse organisms, including fish. They are effector molecules for the innate immune response, against pathogens, tissue damage and infections. Still, AMPs from African Catfish, Clarias gariepinus, skin mucus are largely unexplored despite their possible therapeutic role in combating antimicrobial resistance. In this study, African Catfish Antimicrobial peptides (ACAPs) were identified from the skin mucus of African Catfish, C. gariepinus. Native peptides were extracted from fish mucus scrapings in 10% acetic acid (v/v) and ultra-filtered using 5 kDa molecular weight cut-off membrane. The extract was purified using C18 Solid-Phase Extraction. The antibacterial activity was determined using the Agar Well Diffusion method and broth-dilution method utilizing Staphylococcus aureus (ATCC 25923) and Escherichia coli (ATCC 25922). Thereafter, Sephadex G-25 gel filtration was further utilized in bio-guided isolation of the most active fractions prior to peptide identification using Orbitrap Fusion Lumos Tribrid Mass Spectrometry. The skin mucus extracted from African Catfish from all the three major lakes of Uganda exhibited antimicrobial activity on E. coli and S. aureus. Lake Albert’s C. gariepinus demonstrated the best activity with the lowest MIC of 2.84 and 0.71 μg/ml on S. aureus and E. coli, respectively. Sephadex G-25 peak I mass spectrometry analysis (Data are available via ProteomeXchange with identifier PXD029193) alongside in silico analysis revealed seven short peptides (11–16 amino acid residues) of high antimicrobial scores (0.561–0.905 units). In addition, these peptides had a low molecular weight (1005.57–1622.05 Da) and had percentage hydrophobicity above 54%. Up to four of these AMPs demonstrated α-helix structure conformation, rendering them amphipathic. The findings of this study indicate that novel AMPs can be sourced from the skin mucus of C. gariepinus. Such AMPs are potential alternatives to the traditional antibiotics and can be of great application to food and pharmaceutical industries; however, further studies are still needed to establish their drug-likeness and safety profiles.

Background: In Rwanda, malaria affects one in six children under five years old. Despite being preventable and treatable, malaria causes substantial morbidity, mortality, and economic burden on the Rwandan government and healthcare donors. Recently, the World Health Organization (WHO) agreed to consider the new malaria vaccine (RTS, S) as an additional prevention strategy. The Global Fund, a healthcare donor, is committed to donating more than fifty million US dollars over four years (2018–2021) to fight malaria in Rwanda. We estimated the potential budget impact of the adoption of RTS, S, into the Global Fund budget (as a case study) for malaria prevention in Rwanda. Methods: We developed a static budget impact model based on clinical, epidemiological, and cost (in US dollars) data from the literature, to assess the financial consequences of adding RTS, S to existing prevention strategies. Cost of treatment and prevention for the first year (without vaccine) was estimated and compared to the total cost after the fifth year (with vaccine). A one-way sensitivity analysis evaluated the robustness of the model. Results: For the 283,931children under 5 years at risk of malaria in Rwanda every year, the expected budget for first year (without vaccine) was $1,328,377.71 and for the fifth year (with vaccine) was $3,837,804, yielding a potential budget impact of $2,509,427. The cost of treating un-prevented malaria for the first year was $736,959 and for the fifth year was $61,413. The annual number of malaria treatments avoided increased from 10,095 children in the first year after introduction of vaccine to 36,701 children at the fifth year. Conclusion: With a potential budget impact of $2,509,427, the introduction of malaria vaccine for children under 5 years by Global Fund in Rwanda may be affordable when compared to the amount spent on treating children with malaria. Given that Malaria causes more harm than most parasitic diseases and disproportionally affects low-income populations, it is ethical to deploy all measures to control or eliminate Malaria, including vaccination.

The outcome of the recent Antibody Mediated Prevention (AMP) trials that tested infusion of the broadly neutralizing antibody (bnAb) VRC01 provides proof of concept for blocking infection from sensitive HIV-1 strains. These results also open up the possibility that triple combinations of bnAbs such as PGT121, PGDM1400, as well as long-lasting LS variants such as VRC07-523 LS, have immunoprophylactic potential. PGT121 and PGDM1400 target the HIV-1 V3 and V2 glycan regions of the gp120 envelope protein, respectively, while VRC07-523LS targets the HIV-1 CD4 binding site. These bnAbs demonstrate neutralization potency and complementary breadth of HIV-1 strain coverage. An important clinical trial outcome is the accurate measurement of in vivo concentrations of passively infused bnAbs to determine effective doses for therapy and/or prevention. Standardization and validation of this testing method is a key element for clinical studies as is the ability to simultaneously detect multiple bnAbs in a specific manner. Here we report the development of a sensitive, specific, accurate, and precise multiplexed microsphere-based assay that simultaneously quantifies the respective physiological concentrations of passively infused bnAbs in human serum to ultimately define the threshold needed for protection from HIV-1 infection.

Abstract Background Lumpy skin disease (LSD) is a transboundary cattle disease caused by a Capripoxvirus of the family Poxviridae. In Uganda, documented information on the epidemiology of the disease is rare and there is no nationwide control plan, yet LSD is endemic. This study set out to investigate the seroprevalence of lumpy skin disease and determine the risk factors for LSD seropositivity, by carrying out a cross-sectional study in 21 districts of Uganda. Results A total of 2,263 sera samples were collected from 65 cattle herds and an indirect ELISA was used to screen for lumpy skin disease virus (LSDV) antibodies. We used univariable and multivariable mixed effect logistic regression models to identify risk factors for LSD seropositivity. The overall animal and herd-level seroprevalences were 8.7% (95% CI: 7.0–9.3) and 72.3% (95% CI: 70.0–80.3), respectively. Animal-level seroprevalence in Central region (OR = 2.13, p = 0.05, 95% CI: 1.10–4.64) was significantly different from the Northern region (Reference) and Western region (OR = 0.84, p = 0.66, 95% CI: 0.39–1.81). Management type, sex, age, mean annual precipitation > 1000 mm, and drinking from communal water sources were statistically significant risk factors for occurrence of anti-LSDV antibodies in cattle. Breed, region, herd size, contact with buffalo and other wildlife and introduction of new cattle did not have a statistically significant association with being positive for LSDV. Conclusion We report a high herd-level LSDV seroprevalence in Uganda with a moderate animal-level seroprevalence. Cattle with the highest risk of LSD infection in Uganda are those in fenced farms, females > 25 months old, in an area with a mean annual rainfall > 1000 mm, and drinking from a communal water source.

This paper examined farmers' perceptions, constraints and preferences for improved Bambara groundnut varieties among smallholders in Ghana. Using data from 113 randomly selected farmers from the Nkoranza and Wenchi Municipalities, A 5-point Likert was used to examine farmers' perception on improved Bambara groundnut varieties. The Kendall's Coefficient of concordance was used to rank key constraints in Bambara groundnut production. Factors influencing farmers' preference for major categories of attributes of Bambara groundnut was examined using the multinomial logit model. The results revealed that, farmers strongly agree that Bambara groundnut is disease tolerant, able grow on poor soils, can grow with minimal fertilizer, fixes nitrogen, high in nutrients such as carbohydrates, protein, calcium, potassium and fibre. Conversely, farmers disagreed to the crop having high tolerance to waterlogging and sufficient amounts of fat. The most important constraint to Bambara groundnut production include inadequate capital and lack of access to improved varieties. Furthermore, the key attributes farmers desired in an improved Bambara variety were, ease to harvest mechanically, drought tolerance, disease tolerance, tolerance to waterlogging, ability to fix nitrogen, high yields, early maturing and ease of cooking. The white and dark coloured beans were preferred. Factors influencing farmers' preference for seed colour, nutritional and agronomic attributes to plant orientation attributes of an improved Bambara variety were sex, education, years of Bambara cultivation, off-farm income, FBO membership and household size. Careful considerations needs to be given to these desired attributes and factors in the development of improved Bambara varieties for increased adoption and enhanced food security in Ghana.

Antimicrobial resistance remains a great threat to global health. In response to the World Health Organizations’ global call for action, nature has been explored for novel and safe antimicrobial candidates. To date, fish have gained recognition as potential source of safe, broad spectrum and effective antimicrobial therapeutics. The use of computational methods to design antimicrobial candidates of industrial application has however, been lagging behind. To fill the gap and contribute to the current fish-derived antimicrobial peptide repertoire, this study used Support Vector Machines algorithm to fish out fish-antimicrobial peptide-motif candidates encrypted in 127 peptides submitted at the Antimicrobial Peptide Database (APD3), steered by their physico-chemical characteristics (i.e., positive net charge, hydrophobicity, stability, molecular weight and sequence length). The best two novel antimicrobial peptide-motifs (A15_B, A15_E) with the lowest instability index (−28.25, −22.49, respectively) and highest isoelectric point (pI) index (10.48 for each) were selected for further analysis. Their 3D structures were predicted using I-TASSER and PEP-FOLD servers while ProSA, PROCHECK, and ANOLEA were used to validate them. The models predicted by I-TASSER were found to be better than those predicted by PEP-FOLD upon validation. Two I-TASSER models with the lowest c-score of −0.10 and −0.30 for A15_B and A15_E peptide-motifs, respectively, were selected for docking against known bacterial-antimicrobial target-proteins retrieved from protein databank (PDB). Carbapenam-3-carboxylate synthase (PDB ID; 4oj8) yielded the lowest docking energy (−8.80 and −7.80 Kcal/mol) against motif A15_B and A15_E, respectively, using AutoDock VINA. Further, in addition to Carbapenam-3-carboxylate synthase, these peptides (A15_B and A15_E) were found to as well bind to membrane protein (PDB ID: 1by3) and Carbapenem synthetase (PDB: 1q15) when ClusPro and HPEPDOCK tools were used. The membrane protein yielded docking energy scores (DES): −290.094, −270.751; coefficient weight (CW): −763.6, 763.3 for A15_B and A15_E) whereas, Carbapenem synthetase (PDB: 1q15) had a DES of −236.802, −262.75 and a CW of −819.7, −829.7 for peptides A15_B and A15_E, respectively. Motif A15_B of amino acid positions 2–19 in Pleurocidin exhibited the strongest in silico antimicrobial potentials. This segment could be a good biological candidate of great application in pharmaceutical industries as an antimicrobial drug candidate.

Changes in soil nutrition caused by appropriate fertilization lead to an overall improvement in crop productivity. It is unknown whether different soil amendments could increase growth and yield of improved sweet potato varieties released by CSIR-Crops Research Institute in different agro-ecological environments in Ghana. The aim of the study was to assess the performance of four varieties of sweetpotato under different soil amendments in two different agroecological zones. Field experiments were conducted at CSIR-Crops Research Institute (CSIR-CRI) research fields at Fumesua and Ejura located in the deciduous forest zone and forest-savanna transition zone of Ghana respectively. The experiment design was 4 × 4 factorial in RCBD with three replications. The treatments were four varieties of sweet potato (Ligri, Bohye, Dadanyuie and Apomuden) and four fertilizer treatments (T1:200 kg NP2O5K2O/ha 15-15-15, T2: 200 kg NP2O5K2O /ha 15-15-15 + 50 kg K2O/ha, T3:200 kg NP2O5K2O /ha 15-15-15 + 100 kg K2O/ha and T4: Control). Fertilizer rates applied did not have any significant influence on growth and yield parameters evaluated. There were significant variety × location interactions (P < 0.05) effect of chlorophyll content, vine and petiole length in most cases. The significant interaction between variety and location for most growth parameters suggests that location can affect the performance of the varieties. On average, Apomuden variety increased chlorophyll content by 19.7 % and 26.3 % compared with Bohye and Dadanyuie respectively. This translated into improved yield and yield components. There were significant interactions (P < 0.05) between variety and location in root yield and harvest index. Apomuden in Ejura had significantly (P < 0.05) increased root yield by 95.2 %, 179.3% and 20.0% relative to Bohye, Dadanyuie and Ligri respectively. Based on these results, Apomuden planted in Ejura appears to have a potential for improve yield.

Klebsiella pneumoniae is a common cause of sepsis and is particularly associated with healthcare-associated infections. New strategies are needed to prevent or treat infections due to the emergence of multi-drug resistant K. pneumoniae. The goal of this study was to determine the diversity and distribution of O (lipopolysaccharide) and K (capsular polysaccharide) antigens on a large (>500) global collection of K. pneumoniae strains isolated from blood to inform vaccine development efforts. A total of 645 K. pneumoniae isolates were collected from the blood of patients in 13 countries during 2005–2017. Antibiotic susceptibility was determined using the Kirby-Bauer disk diffusion method. O antigen types including the presence of modified O galactan types were determined by PCR. K types were determined by multiplex PCR and wzi capsular typing. Sequence types of isolates were determined by multilocus sequence typing (MLST) targeting seven housekeeping genes. Among 591 isolates tested for antimicrobial resistance, we observed that 19.3% of isolates were non-susceptible to carbapenems and 62.1% of isolates were multidrug resistant (from as low as 16% in Sweden to 94% in Pakistan). Among 645 isolates, four serotypes, O1, O2, O3, and O5, accounted for 90.1% of K. pneumoniae strains. Serotype O1 was associated with multidrug resistance. Fifty percent of 199 tested O1 and O2 strains were gmlABC-positive, indicating the presence of the modified polysaccharide subunit D-galactan III. The most common K type was K2 by both multiplex PCR and wzi capsular typing. Of 39 strains tested by MLST, 36 strains were assigned to 26 known sequence types of which ST14, ST25, and ST258 were the most common. Given the limited number of O antigen types, diverse K antigen types and the high multidrug resistance, we believe that an O antigen-based vaccine would offer an excellent prophylactic strategy to prevent K. pneumoniae invasive infection.

Maintaining the quality of breathing air in urban and industrial areas is one of the biggest challenges faced by humanity in the modern era. Diesel engines, as one of the main providers of energy supply for modern equipment and transport, are also unfortunately contributing highly to the deterioration of air quality. A recent research path on the limitation of diesel engine emissions is the use of alternative fuel from vegetable or animal fats or oil called biodiesel. Although the use of biodiesel has proven its efficiency in reducing emissions, it remains a problem to maintain the engine’s efficiency when shifting to biodiesel, especially due to its injection and atomization properties; most of the recent research focused on improving biodiesel fuel quality by blending it with traditional diesel fuel, but few works can be found on the regulation or control of diesel engine process when shifting to 100% biodiesel fuel (B100). This work proposes a fuel control strategy and methodology based on diesel engine operating data obtained from an experimentally designed rate of injection model (ROI) at different injection pressures and a jet and spray droplet distribution validated a two-zone model. Results show that B100 gives a higher amount of about 8% of injected fuel, a longer jet penetration of about 20 mm higher at 100 MPa injection pressure, a wider cone angle, and about a 40% increase of coarseness of the jet distribution. The experimental and numerical-based control strategy provides interacting relationships between B100 properties and specific engine features where actions shall be made to keep the engine’s efficiency when the shift is made; meanwhile, the algorithm provides a hierarchical step-by-step correcting procedure taking into account the possible degradation that could occur from the use of B100 in diesel engines.

Abstract Background Giant ovarian cysts are tumours of the ovary presenting with diameters greater than 10 cm. Giant ovarian cysts have become rare in recent days as they are diagnosed and managed early due to the availability of good imaging modalities. The aim of this case report is to show how a huge cystic ovarian mass can mislead the diagnosis of ascites in a postmenopausal woman. Factors associated with late presentation of giant ovarian cysts in sub-Saharan Africa have also been discussed. Case presentation We present the case of a 65-year-old grand multiparous woman who was referred to our centre with a grossly distended abdomen misdiagnosed as a massive ascites. Abdominopelvic ultrasound scan revealed a right giant multiloculated ovarian cyst. She benefited from a cystectomy with an uneventful postoperative stay. Histopathology revealed mucinous cystadenoma. Conclusion Large cystic ovarian tumours can present masquerading as massive ascites and misleading diagnosis as in this case report. We report this case to increase the suspicion index of a large ovarian cyst in all women presenting with massive ascites.

The role of insurance in financial inclusion and economic growth, in general, is immense and is increasingly being recognized. However, low uptake impedes the growth of the sector, hence the need for a model that robustly predicts insurance uptake among potential clients. This study undertook a two phase comparison of machine learning classifiers. Phase I had eight machine learning models compared for their performance in predicting the insurance uptake using 2016 Kenya FinAccessHousehold Survey data. Taking Phase I as a base in Phase II, random forest and XGBoost were compared with four deep learning classifiers using 2019 Kenya FinAccess Household Survey data. The random forest model trained on oversampled data showed the highest F1-score, accuracy, and precision. The area under the receiver operating characteristic curve was furthermore highest for random forest; hence, it could be construed as the most robust model for predicting the insurance uptake. Finally, the most important features in predicting insurance uptake as extracted from the random forest model were income, bank usage, and ability and willingness to support others. Hence, there is a need for a design and distribution of low income based products, and bancassurance could be said to be a plausible channel for the distribution of insurance products.

Ticks are arthropod vectors of pathogens of both Veterinary and Public health importance. Acaricide application, which is currently the mainstay of tick control, is hampered by high cost, the need for regular application and a selection of multi-acaricide resistant tick populations. In light of this, future tick control approaches are poised to rely on the integration of rational acaricide application and other methods, such as vaccination. To contribute to systematic research-guided efforts to produce anti-tick vaccines, we carried out an in-silico analysis of tick aquaporin-1 (AQP1) protein in order to identify tick-specific AQP1 peptide motifs that can be used in future peptide anti-tick vaccine development. We carried out multiple sequence alignment (MSA), motif analysis, homology modeling, and structural analysis to identify tick-specific AQP1 peptide motifs. BepiPred, Chou and Fasman-Turn, Karplus and Schulz Flexibility, and Parker-Hydrophilicity prediction models were used to predict these motifs' potential to induce B cell mediated immune responses. The tick AQP1 (GenBankID: QDO67142.1) protein was largely similar to the bovine AQP1 (PDB:1J4N) (23 % sequence similarity; Structural superimposition of the homology model and 14JN homotetramers gave an RMSD = 3.269 while superimposition of a single chain gave an RMSD = 1.475). Tick and bovine AQP1 transmembrane domains were largely similar while their extracellular and cytoplasmic domain loops showed variation. Two tick-specific AQP1 peptide motifs; M7 (residues 106–125, p = 5.4e-25), and M8 (residues 85–104, p = 3.3e-24) were identified. These two motifs are located on the extra-cellular AQP1 domain. Motifs; M7 and M8 showed the highest Parker-Hydrophilicity prediction immunogenicity scores of 1.784 and 1.536, respectively. These two motifs can be a good starting point for the development of potential tick AQP1 peptide-based anti-tick vaccines. Further analyses such as molecular dynamics, in vitro assays, and in vivo immunization assays are required to validate these findings.

This paper describes an assessment of the patterns of peste des petits ruminants virus circulation in the Karamoja subregion of Uganda conducted to identify the communities that maintain the virus and inform the development of a targeted vaccination strategy. Participatory epidemiological methods were used to develop an operational hypothesis for the patterns of PPR in Karamoja that was subsequently validated through outbreak investigation and genomics. The participatory epidemiological assessment included risk mapping with livestock owners, community animal health workers and veterinarians and indicated there were two critical foci of virus transmission on the Uganda-Kenya border. One was located in two adjacent subcounties of Kotido and Kaabong Districts in northern Karamoja and the other in Loroo subcounty of Amudat District in southern Karamoja. Participants reported that these were locations where outbreaks were usually first observed in Karamoja and subsequently spread to other areas. Following the participatory assessment, surveillance activities were implemented across the Karamoja subregion in 2018. Three outbreak were detected, investigated and sampled. Two outbreaks were located in the northern and one on the southern focus of transmission. No Outbreaks were diagnosed in Karamoja outside of these foci during 2018. Genomics indicated different clusters of viruses were associated with the northern and southern foci that were more closely related to other East African isolates than to each other. This indicates these are two separate systems of virus circulation which should be explicitly addressed in eradication as separate cross-border systems that require integrated cross-border interventions.

INTRODUCTION: Access to free diagnoses and treatments has been shown to be a major determinant in malaria control. The Cameroon government launched in 2011 and 2014 the exemption of the under-fives' simple and severe malaria treatment policy to increase access to health care and reduce inequality, so as to reduce the mortality related to malaria among the under-fives. This study assessed the effect of providing free malaria treatment in the Buea Health district. METHODS: This retrospective and cross sectional study was carried out in the Buea health district. Aggregated monthly data from (2008-2010) before and (2012-2014) after the implementation of free malaria treatment was compared, to assess the attributable outcomes of free treatment. A semi-structure questionnaire was also used to assess barriers faced in providing free malaria treatment services by health care workers. Data was collected using a semi-structure questionnaire and a data review summary sheet. The Data was analysed using Epi-Info 7, Excel and SPSS (Statistical Package for the Social Sciences) version 20.0 for Windows. All statistical tests were performed at 95% confidence interval (significance level of 0.05). RESULTS: Increase utilisation of health care; as general and malaria related consultations (by 5.7% (p=0.001) witnessed an increase after the implementation of free malaria treatment services. Severe malaria hospitalisation also increased, indicating that most caregivers used the health facility when complications had already set in, which could have led to no significant reduction in mortality due to malaria among under-five children (4.4%, p=0.533). CONCLUSION: Utilisation of health care increased; as consultation and morbidity rate increased after the implementation of free malaria treatment services. Communication strategy should therefore be strengthened so as to better disseminate information, so as to enhance the effectiveness of the program. There is the need to make a large-scale study to assess the impact of subsidized malaria treatment.

African swine fever (ASF) is an infectious transboundary disease of domestic pigs and wild swine and is currently the most serious constraint to piggery in Uganda. The causative agent of ASF is a large double-stranded linear DNA virus with a complex structure. There are twenty-four ASFV genotypes described to date; however, in Uganda, only genotypes IX and X have been previously described. Inadequate ASF outbreak investigation has contributed to the delayed establishment of effective interventions to aid the control of ASF. Continuous virus characterization enhances the understanding of ASF epidemiology in terms of viral genome variations, extent, severity, and the potential source of the viruses responsible for outbreaks. We collected samples from pigs that had died of a hemorrhagic disease indicative of ASF. DNA was extracted from all samples and screened with the OIE recommended diagnostic PCR for ASF. Partial B646L (p72), full-length E183L (p54) genes, and CVR region of the P72 gene were amplified, purified, and sequenced. Web-based BLAST and MEGA X software were used for sequence analysis. ASF was confirmed in 10 of the 15 suspected pig samples. Phylogenetic analysis confirmed circulation of genotype IX by both full-length E183 (p54) and partial B646L (p72) gene sequencing. Intragenotypic resolution of the CVR region revealed major deletions in the virus genome, in some isolates of this study. The marked reduction in the number of tetrameric tandem repeats in some isolates of this study could potentially play a role in influencing the virulence of this particular genotype IX in Uganda.

Two field experiments were conducted at Ellembelle and Jomoro districts in the Western region of Ghana where rubber cultivation is a predominant farming activity. The objective of the study was to assess the effect of rubber and plantain intercropping systems on selected soil properties. The experiment was arranged in a randomized complete block design (RCBD) with 3 replications. The treatments were the sole crop rubber (R), sole crop plantain (P) and three intercrop systems comprising an additive series of plantain: one row of plantain to one row of rubber (PR), two rows of plantain to one row of rubber (PPR) and three rows of plantain to one row of rubber (PPPR). Generally, agroforestry systems improved the soil hydraulic properties considerably, with the highest cumulative infiltration rates of 5.16 and 8.68 cm/min observed under the PPPR systems at the Ellembelle and Jomoro sites, respectively. Microbial biomass C (Cmic), N (Nmic) and P (Pmic) was significantly improved (P < 0.05) under the agroforestry than the monocrop systems. The Cmic, Nmic and Pmic values were highest under the PPPR system at both Ellembelle (Cmic, = 139.9 mg/kg; Nmic = 36.26 mg/kg and Pmic = 87.6 mg/kg) and Jomoro (Cmic = 78.7 mg/kg; Nmic = 80.3 mg/kg and Pmic = 3.45 mg/kg) sites.

BACKGROUND:Live, attenuated viral vectors that express HIV-1 antigens are being investigated as an approach to generating durable immune responses against HIV-1 in humans. We recently developed a replication-competent, highly attenuated Ad26 vector that expresses mosaic HIV-1 Env (rcAd26.MOS1.HIV-Env, "rcAd26"). Here we present the results of a first-in-human, placebo-controlled clinical trial to test the safety, immunogenicity and mucosal shedding of rcAd26 given orally. METHODS:Healthy adults were randomly assigned to receive a single oral dose of vaccine or placebo at 5:1 ratio in a dosage escalation of 10^8 to 10^11 rcAd26 VP (nominal doses) at University of Rochester Medical Center, Rochester, NY, USA. Participants were isolated and monitored for reactogenicity for 10 days post-vaccination, and adverse events were recorded up to day 112. Rectal and oropharyngeal secretions were evaluated for shedding of the vaccine. Humoral and cellular immune responses were measured. Household contacts were monitored for secondary vaccine transmission. RESULTS:We enrolled 22 participants and 11 household contacts between February 7 and June 24, 2015. 18 participants received one dose of HIV-1 vaccine and 4 participants received placebo. The vaccine caused only mild to moderate adverse events. No vaccine-related SAEs were observed. No infectious rcAd26 viral particles were detected in rectal or oropharyngeal secretions from any participant. Env-specific ELISA and ELISPOT responses were undetectable. No household contacts developed vaccine-induced HIV-1 seropositivity or vaccine-associated illness. CONCLUSIONS:The highly attenuated rcAd26.MOS1.HIV-Env vaccine was well tolerated up to 10^11 VP in healthy, HIV-1-uninfected adults, though the single dose was poorly immunogenic suggesting the replicative capacity of the vector was too attenuated. There was no evidence of shedding of infectious virus or secondary vaccine transmission following the isolation period. These data suggest the use of less attenuated viral vectors in future studies of live, oral HIV-1 vaccines. TRIAL REGISTRATION:ClinicalTrials.gov NCT02366013.

The natural phototransformation of organic pollutants in the environment depends on several water constituents, including inorganic ions, humic substances, and pH. However, the literature information concerning the influence of various water components on the amount of phototransformation and their impact on the development of various transformation products (TPs) is minimal. This study investigated the phototransformation of ofloxacin (OFL), a fluoroquinolone antibiotic, in the presence of various water components such as cations (K + , Na + , Ca 2+ , NH 4 + , Mg 2+ ), anions (NO 3 - , SO 4 2- , HCO 3 - , CO 3 2- , PO 4 3- ), pH, and humic substances when exposed to natural sunlight. The study reveals that neutral pH levels (0.39374 min⁻ 1 ) enhance the phototransformation of OFL in aquatic environments. Carbonate, among anions, shows the highest rate constant (2.89966 min⁻ 1 ), significantly influencing OFL phototransformation, while all anions exhibit a notable impact. In aquatic environments, indirect phototransformation of OFL, driven by increased reactive oxygen species, expedites light-induced reactions, potentially enhancing OFL phototransformation. A clear difference was visible in the type of transformation products (TPs) formed during direct and indirect photolysis. The impact of indirect photolysis in the product profile was evaluated by examining the unique properties of TPs in direct and indirect photolysis. The primary transformation products were generated by oxidation and cleavage processes directed towards the ofloxacin piperazinyl, oxazine, and carboxyl groups. The toxicity assessment of TPs derived from OFL revealed that among the 26 identified TPs, TP3 (demethylated product), TP7 and TP8 (decarboxylated products), and TP15 (piperazine ring cleaved product) could potentially have some toxicological effects. These findings suggest that the phototransformation of OFL in the presence of various water components is necessary when assessing this antibiotic's environmental fate., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Background: Pregnant women in sub-Saharan Africa (SSA) experience the highest levels of maternal mortality and stillbirths due to predominantly avoidable causes. Antenatal care (ANC) can prevent, detect, alleviate, or manage these causes. While eight ANC contacts are now recommended, coverage of the previous minimum of four visits (ANC4+) remains low and inequitable in SSA., Methods: We modelled ANC4+ coverage and likelihood of attaining district-level target coverage of 70% across three equity stratifiers (household wealth, maternal education, and travel time to the nearest health facility) based on data from malaria indicator surveys in Kenya (2020), Uganda (2018/19) and Tanzania (2017). Geostatistical models were fitted to predict ANC4+ coverage and compute exceedance probability for target coverage. The number of pregnant women without ANC4+ were computed. Prediction was at 3 km spatial resolution and aggregated at national and district -level for sub-national planning., Results: About six in ten women reported ANC4+ visits, meaning that approximately 3 million women in the three countries had  20,000 women having

Subnational projections of under-5 mortality (U5M) have increasingly become an essential planning tool to support Sustainable Development Goals (SDGs) agenda and strategies for improving child survival. To support child health policy, planning, and tracking child development goals in Kenya, we projected U5M at units of health decision making. County-specific annual U5M were estimated using a multivariable Bayesian space-time hierarchical model based on intervention coverage from four alternate intervention scale-up scenarios assuming 1) the highest subnational intervention coverage in 2014, 2) projected coverage based on the fastest county-specific rate of change observed in the period between 2003-2014 for each intervention, 3) the projected national coverage based on 2003-2014 trends and 4) the country-specific targets of intervention coverage relative to business as usual (BAU) scenario. We compared the percentage change in U5M based on the four scale-up scenarios relative to BAU and examined the likelihood of reaching SDG 3.2 target of at least 25 deaths/1,000 livebirths by 2022 and 2025. Projections based on 10 factors assuming BAU, showed marginal reductions in U5M across counties with all the counties except Mandera county not achieving the SDG 3.2 target by 2025. Further, substantial reductions in U5M would be achieved based on the various intervention scale-up scenarios, with 63.8% (30), 74.5% (35), 46.8% (22) and 61.7% (29) counties achieving SDG target for scenarios 1,2,3 and 4 respectively by 2025. Scenario 2 yielded the highest reductions of U5M with individual scale-up of access to improved water, recommended treatment of fever and accelerated HIV prevalence reduction showing considerable impact on U5M reduction (≥ 20%) relative to BAU. Our results indicate that sustaining an ambitious intervention scale-up strategy matching the fastest rate observed between 2003-2014 would substantially reduce U5M in Kenya. However, despite this ambitious scale-up scenario, 25% (12 of 47) of the Kenya's counties would still not achieve SDG 3.2 target by 2025., Competing Interests: The authors declare that they have no competing interests., (Copyright: © 2022 Joseph et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: During the millennium development goals period, reduction in under-five mortality (U5M) and increases in child health intervention coverage were characterised by sub-national disparities and inequities across Kenya. The contribution of changing risk factors and intervention coverage on the sub-national changes in U5M remains poorly defined., Methods: Sub-national county-level data on U5M and 43 factors known to be associated with U5M spanning 1993 and 2014 were assembled. Using a Bayesian ecological mixed-effects regression model, the relationships between U5M and significant intervention and infection risk ecological factors were quantified across 47 sub-national counties. The coefficients generated were used within a counterfactual framework to estimate U5M and under-five deaths averted (U5-DA) for every county and year (1993-2014) associated with changes in the coverage of interventions and disease infection prevalence relative to 1993., Results: Nationally, the stagnation and increase in U5M in the 1990s were associated with rising human immunodeficiency virus (HIV) prevalence and reduced maternal autonomy while improvements after 2006 were associated with a decline in the prevalence of HIV and malaria, increase in access to better sanitation, fever treatment-seeking rates and maternal autonomy. Reduced stunting and increased coverage of early breastfeeding and institutional deliveries were associated with a smaller number of U5-DA compared to other factors while a reduction in high parity and fully immunised children were associated with under-five lives lost. Most of the U5-DA occurred after 2006 and varied spatially across counties. The highest number of U5-DA was recorded in western and coastal Kenya while northern Kenya recorded a lower number of U5-DA than western. Central Kenya had the lowest U5-DA. The deaths averted across the different regions were associated with a unique set of factors., Conclusion: Contributions of interventions and risk factors to changing U5M vary sub-nationally. This has important implications for targeting future interventions within decentralised health systems such as those operated in Kenya. Targeting specific factors where U5M has been high and intervention coverage poor would lead to the highest likelihood of sub-national attainment of sustainable development goal (SDG) 3.2 on U5M in Kenya.

Background: To improve child survival, it is necessary to describe and understand the spatial and temporal variation of factors associated with child survival beyond national aggregates, anchored at decentralised health planning units. Therefore, we aimed to provide subnational estimates of factors associated with child survival while elucidating areas of progress, stagnation and decline in Kenya., Methods: Twenty household surveys and three population censuses conducted since 1989 were assembled and spatially aligned to 47 subnational Kenyan county boundaries. Bayesian spatio-temporal Gaussian process regression models accounting for inadequate sample size and spatio-temporal relatedness were fitted for 43 factors at county level between 1993 and 2014., Results: Nationally, the coverage and prevalence were highly variable with 38 factors recording an improvement. The absolute percentage change (1993-2014) was heterogeneous ranging between 1% and 898%. At the county level, the estimates varied across space and over time with a majority showing improvements after 2008 which was preceded by a period of deterioration (late-1990 to early-2000). Counties in Northern Kenya were consistently observed to have lower coverage of interventions and remained disadvantaged in 2014 while areas around Central Kenya had and historically have had higher coverage across all intervention domains. Most factors in Western and South-East Kenya recorded moderate intervention coverage although having a high infection prevalence of both HIV and malaria., Conclusion: The heterogeneous estimates necessitates prioritisation of the marginalised counties to achieve health equity and improve child survival uniformly across the country. Efforts are required to narrow the gap between counties across all the drivers of child survival. The generated estimates will facilitate improved benchmarking and establish a baseline for monitoring child development goals at subnational level., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.)

Background and Purpose: Pregnancy as a hemorrhage risk factor in women with cavernous malformations (CMs) is controversial. We describe prospective hemorrhage risk in women who become pregnant after an established CM diagnosis., Methods: Beginning in 2015, we recruited consecutive patients with radiologically confirmed CM of the brain or spinal cord to participate in a prospective registry. Participants underwent a baseline and annual medical record review, imaging review, and annual surveys to ascertain pregnancies, deliveries, and neurological complications. We collected prospective hemorrhage data on reproductive age women. We calculated prospective hemorrhage rates on childbearing age patients based on the number of hemorrhages occurring post-CM diagnosis during pregnancy and nonpregnancy, divided by the years of follow-up and censored at last follow-up, age 46, or surgery in sporadic-form CM. The hemorrhage rates were compared and the 95% CI presented with a P value of <0.05., Results: Of 160 women, 90 presented with CM under the age of 46 (average age 31.6 years; 25.6% familial form; 46.7% with hemorrhage; 24.4% brain stem location). These 90 patients had 136 pregnancies before CM diagnosis; 36 pregnancies occurred at or after the diagnosis of CM. Four patients had a hemorrhage while pregnant or postpartum leading to the first CM diagnosis. During 402.6 years of follow-up while not pregnant, 42 hemorrhages occurred prospectively yielding a 10.4% per year (95% CI, 7.5-14.0) risk of hemorrhage while not pregnant. No hemorrhages occurred during 32 prospective pregnancies (26 live births including 1 twinset and 7 nonviable fetuses) after CM diagnosis during 26.9 years of pregnancy time yielding a rate of 0% per year (95% CI, 0-13.6). We found no statistical difference in the rates of hemorrhage during pregnant and nonpregnant time ( P =0.09). No hemorrhage occurred during delivery., Conclusions: Our prospective data suggest that pregnancy does not increase the risk of hemorrhage in women with a known brain or spinal cord CM and that vaginal delivery is safe in appropriate candidates.

Background: Poor access to immunisation services remains a major barrier to achieving equity and expanding vaccination coverage in many sub-Saharan African countries. In Kenya, the extent to which spatial access affects immunisation coverage is not well understood. The aim of this study was to quantify spatial accessibility to immunising health facilities and determine its influence on immunisation uptake in Kenya while controlling for potential confounders., Methods: Spatial databases of immunising facilities, road network, land use and elevation were used within a cost friction algorithim to estimate the travel time to immunising health facilities. Two travel scenarios were evaluated; (1) Walking only and (2) Optimistic scenario combining walking and motorized transport. Mean travel time to health facilities and proportions of the total population living within 1-h to the nearest immunising health facility were computed. Data from a nationally representative cross-sectional survey (KDHS 2014), was used to estimate the effect of mean travel time at survey cluster units for both fully immunised status and third dose of diphtheria-tetanus-pertussis (DPT3) vaccine using multi-level logistic regression models., Results: Nationally, the mean travel time to immunising health facilities was 63 and 40 min using the walking and the optimistic travel scenarios respectively. Seventy five percent of the total population were within one-hour of walking to an immunising health facility while 93% were within one-hour considering the optimistic scenario. There were substantial variations across the country with 62%(29/47) and 34%(16/47) of the counties with < 90% of the population within one-hour from an immunising health facility using scenarios 1 and 2 respectively. Travel times > 1-h were significantly associated with low immunisation coverage in the univariate analysis for both fully immunised status and DPT3 vaccine. Children living more than 2-h were significantly less likely to be fully immunised [AOR:0.56(0.33-0.94) and receive DPT3 [AOR:0.51(0.21-0.92) after controlling for household wealth, mother's highest education level, parity and urban/rural residence., Conclusion: Travel time to immunising health facilities is a barrier to uptake of childhood vaccines in regions with suboptimal accessibility (> 2-h). Strategies that address access barriers in the hardest to reach communities are needed to enhance equitable access to immunisation services in Kenya.

Background: Response to the coronavirus disease 2019 (COVID-19) pandemic calls for precision public health reflecting our improved understanding of who is the most vulnerable and their geographical location. We created three vulnerability indices to identify areas and people who require greater support while elucidating health inequities to inform emergency response in Kenya., Methods: Geospatial indicators were assembled to create three vulnerability indices; Social VulnerabilityIndex (SVI), Epidemiological Vulnerability Index (EVI) and a composite of the two, that is, Social Epidemiological Vulnerability Index (SEVI) resolved at 295 subcounties in Kenya. SVI included 19 indicators that affect the spread of disease; socioeconomic deprivation, access to services and population dynamics, whereas EVI comprised 5 indicators describing comorbidities associated with COVID-19 severe disease progression. The indicators were scaled to a common measurement scale, spatially overlaid via arithmetic mean and equally weighted. The indices were classified into seven classes, 1-2 denoted low vulnerability and 6-7, high vulnerability. The population within vulnerabilities classes was quantified., Results: The spatial variation of each index was heterogeneous across Kenya. Forty-nine northwestern and partly eastern subcounties (6.9 million people) were highly vulnerable, whereas 58 subcounties (9.7 million people) in western and central Kenya were the least vulnerable for SVI. For EVI, 48 subcounties (7.2 million people) in central and the adjacent areas and 81 subcounties (13.2 million people) in northern Kenya were the most and least vulnerable, respectively. Overall (SEVI), 46 subcounties (7.0 million people) around central and southeastern were more vulnerable, whereas 81 subcounties (14.4 million people) were least vulnerable., Conclusion: The vulnerability indices created are tools relevant to the county, national government and stakeholders for prioritisation and improved planning. The heterogeneous nature of the vulnerability indices underpins the need for targeted and prioritised actions based on the needs across the subcounties., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ.)