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Purpose: Population-based prevalence surveys are essential for decision-making on interventions to achieve trachoma elimination as a public health problem. This paper outlines the methodologies of Tropical Data, which supports work to undertake those surveys., Methods: Tropical Data is a consortium of partners that supports health ministries worldwide to conduct globally standardised prevalence surveys that conform to World Health Organization recommendations. Founding principles are health ministry ownership, partnership and collaboration, and quality assurance and quality control at every step of the survey process. Support covers survey planning, survey design, training, electronic data collection and fieldwork, and data management, analysis and dissemination. Methods are adapted to meet local context and needs. Customisations, operational research and integration of other diseases into routine trachoma surveys have also been supported., Results: Between 29 th February 2016 and 24 th April 2023, 3373 trachoma surveys across 50 countries have been supported, resulting in 10,818,502 people being examined for trachoma., Conclusion: This health ministry-led, standardised approach, with support from the start to the end of the survey process, has helped all trachoma elimination stakeholders to know where interventions are needed, where interventions can be stopped, and when elimination as a public health problem has been achieved. Flexibility to meet specific country contexts, adaptation to changes in global guidance and adjustments in response to user feedback have facilitated innovation in evidence-based methodologies, and supported health ministries to strive for global disease control targets.

ABSTRACT Characterization of the groundwater flow systems is important for sustainable water resource management decision-making. We have used vertical profiles of electrical conductivity (EC) and water temperature taken at 2 m intervals during drilling of 109 boreholes, and samples for stable isotope analysis ( δ 18 O, δ 2 H) taken from 47 boreholes to characterize groundwater recharge, flow and discharge. 222 Rn measurements and piezometric evidence were used to complement results from the EC and stable isotopes. The converging evidence shows that groundwater in the study area is characterized by a mix of two different groundwater flow systems: i) the deep groundwater systems are connected to the regional groundwater flow originating from the highlands, outside the surface water basin, ii) the shallow groundwater systems get recharge from local rains. The local recharge zones are located in highly urbanized and industrialized zones posing risk to recharge reduction and pollution. Therefore, attention should be given to protect groundwater resources from contamination and increase groundwater resilience to climate change.

Self-rated physical health (SRPH) has been extensively used to assess health status. In this study, we examine how youth living in the slums of Kampala perceive their physical health and the psychosocial correlates of poor health. Cross-sectional data from the 2014 Kampala Youth Survey (N = 1,134) of youth ages 12-18 years was used to conduct the analyses. Chi-square tests and logistic regression analyses were conducted to determine associations between SRPH, demographic and psychosocial characteristics. Overall, 72% of youth rated their health as 'excellent' or 'good.' Poor SRPH was associated with older age and lower education, but not with sex. Also, orphans (OR = 2.03; 95%CI:1.51-2.72), those who lived on the streets (OR=3.09; 95%CI:2.30-4.15), who did not have electricity (OR = 2.83;95%CI:2.12-3.78), who initiated alcohol use early (OR = 2.08; 95%CI:1.47-2.94), who frequently get drunk (OR = 5.67; 95%CI:2.69-11.96), who were HIV positive (OR = 2.18; 95%CI:1.47-3.23), who had been injured due to their drinking (OR = 2.09; 95%CI:1.44-3.03), who thought about hurting themselves (OR = 2.09; 95%CI:1.60-2.73), and those who often felt lonely (OR = 2.54; 95%CI:1.61-4.02) had higher odds of poor SRPH compared to their peers without these characteristics. Poor SRPH may serve as a marker for multiple health-risk behaviors and severe health disparities among youth in vulnerable and resource-limited settings.

Background: Calcium channel blockers (CCBs) are commonly used to treat conditions such as arterial hypertension and supraventricular dysrhythmias. Poisoning from these drugs can lead to severe morbidity and mortality. We aimed to determine the utility of extracorporeal treatments (ECTRs) in the management of CCB poisoning., Methods: We conducted systematic reviews of the literature, screened studies, extracted data, summarized findings, and formulated recommendations following published EXTRIP methods., Results: A total of 83 publications (6 in vitro and 1 animal experiments, 55 case reports or case series, 19 pharmacokinetic studies, 1 cohort study and 1 systematic review) met inclusion criteria regarding the effect of ECTR. Toxicokinetic or pharmacokinetic data were available on 210 patients (including 32 for amlodipine, 20 for diltiazem, and 52 for verapamil). Regardless of the ECTR used, amlodipine, bepridil, diltiazem, felodipine, isradipine, mibefradil, nifedipine, nisoldipine, and verapamil were considered not dialyzable, with variable levels of evidence, while no dialyzability grading was possible for nicardipine and nitrendipine. Data were available for clinical analysis on 78 CCB poisoned patients (including 32 patients for amlodipine, 16 for diltiazem, and 23 for verapamil). Standard care (including high dose insulin euglycemic therapy) was not systematically administered. Clinical data did not suggest an improvement in outcomes with ECTR. Consequently, the EXTRIP workgroup recommends against using ECTR in addition to standard care for patients severely poisoned with either amlodipine, diltiazem or verapamil (strong recommendations, very low quality of the evidence (1D)). There were insufficient clinical data to draft recommendation for other CCBs, although the workgroup acknowledged the low dialyzability from, and lack of biological plausibility for, ECTR., Conclusions: Both dialyzability and clinical data do not support a clinical benefit from ECTRs for CCB poisoning. The EXTRIP workgroup recommends against using extracorporeal methods to enhance the elimination of amlodipine, diltiazem, and verapamil in patients with severe poisoning.

Despite recent focus on health systems strengthening, few studies report large-scale efforts to improve hospital management capacity in low-income countries, a central component of improving health care delivery. We sought to assess the contributions of a systems-based approach, the Ethiopian Hospital Management Initiative (EHMI), which established hospital chief executive officers (CEOs) trained through a Masters of Healthcare and Hospital Administration (MHA) degree programme in Ethiopia. We conducted a pre-post study of 24 hospitals that are managed by CEOs in the MHA programme. We measured changes in hospital functioning based on adherence to a set of 86 hospital performance standards across 12 management domains published in the Standards for Hospital Management in Ethiopia. We found that adherence to hospital performance standards increased significantly during the one-year follow-up (27% compared with 51% of standards met at baseline and follow-up, respectively; P-value < 0.001); overall improvement was driven by improvement in seven of the 12 management domains. The EHMI is an example of health systems strengthening with focus on building hospital management capacity. Early evidence suggests that the establishment of hospital CEOs and MHA training to equip them with management skills may promote scalable improvements in health facility functioning.

The isotope balance approach, which used (18)O content of waters, has been used as an independent tool to estimate inflow to Lake Tana of surface water flows from ungauged catchment of Lake Tana (50% of the total area) and evaporative water loss in the vast plains adjoining the lake. Sensitivity analysis has been conducted to investigate the effects of changes in the input parameters on the estimated flux. Surface water inflow from ungauged catchment is determined to be in the order of 1.698×10(9) m(3)a(-1). Unaccounted water loss from the lake has been estimated at 454×10(6) m(3)a(-1) (equivalent to 5% of the total via surface water). Since the lake is water tight to groundwater outflow, the major error introduced into the water balance computation is related to evaporative water loss in water from the flood plains. If drained, the water which is lost to evaporation can be used as an additional water resource for socio-economic development in the region (tourism, agriculture, hydropower, and navigation). Hydrological processes taking place in the vast flood plains of Lake Tana (origin of salinity, groundwater surface water interaction, origin of flood plain waters) have been investigated using isotopes of water and geochemistry as tracers. The salinity of shallow groundwaters in the flood plains is related to dissolution of salts accumulated in sediments covering former evaporation pools and migration of trace salt during recharge. The waters in the flood plains originate from local rainfall and river overflows and the effect of backwater flow from the lake is excluded. Minimum linkage exists between the surface waters in the flood plains and shallow groundwaters in alluvio lacustrine sediments suggesting the disappearance of flood waters following the rainy season, which is related to complete evaporation or drainage than seepage to the subsurface. There is no groundwater outflow from the lake. Inflow of groundwater cannot be ruled out. Discharge of groundwater to the lake is presumed to take place along rocky bottom in southern sector from Quaternary volcanics covering the southern sector of the catchment.