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BACKGROUND፡ The marked genome plasticity of diarrheagenic Escherichia coli promotes emergence of pathotypes displaying unique phenotypic and genotypic resistance. This study examined phenotypic and genotypic antibiotic resistant diarrheagenic Escherichia coli pathotypes among children in Nairobi City, Kenya.METHODS: In a cross-sectional study, diarrheagenic Escherichia coli pathotypes were isolated from stool samples and their phenotypic and genotypic resistance against eight antimicrobial agents assayed.RESULTS: Diarrheagenic Escherichia coli was detected in 136(36.4%) children. Most of diarrheagenic Escherichia coli that were resistant to ampicillin, ceftriaxone, streptomycin, gentamycin, ciprofloxacin, chloramphenicol, erythromycin and tetracycline, harbored citm, bla CMY, aadA1, aac(3)-IV, qnr, catA, ere(A) and tet(A) corresponding resistant genes.CONCLUSION: Antimicrobial-resistant genes are highly prevalent among phenotypic resistant ETEC pathotypes indicating a possibility of horizontal gene transfer in spreading antibiotic resistant genes among E. coli pathotypes.

Dispute handling may present particular problems for SMEs. The research explored the Alternative Dispute Resolution (ADR) methods used in SMEs and their implications on the performance of SMEs in the construction industry in Zimbabwe. The study revealed that collective bargaining and negotiation are the main ADR methods used in the SMEs while conciliation and arbitration are utilized externally at NEC and the ministry of labour. It was also noted that most SMEs do not have established ADR structures and collective bargaining and negotiation had an impact on employee performance. Collective Bargaining, Conciliation and Adjudication

Purpose The purpose of this paper is to demonstrate the relevance of business intelligence (BI) in businesses in general and tourism firms in particular. BI has been hailed as an innovation that can propel businesses that adopt the system to high productivity and efficiency. This paper confirms that view but further adds that BI also enhances a business’s competitiveness. Design/methodology/approach This paper reviews literature on the use of BI in tourism. Although current literature is largely fragmented, focusing on BI, the tourism industry and the notion of competitiveness separately, this paper makes an attempt to bring the three sub-themes in the same study and highlights their interconnectedness. The study adopts two environmental analysis models to better analyze this matter. First is the environmental analysis model as based on Downes’s modification of Porter’s five forces framework. The second model used is the resource-based view approach to business environmental analysis. Findings This paper affirms that the tourism industry is one of those industries that continue to benefit from the advantages that come with the adoption of a BI system. Literature shows that the tourism industry was one of those that first adopted BI in order to benefit from the benefits that come with its adoption. Such advantages include flexible and user friendly tourists’ data capture, storage, retrieval, processing and analytical capabilities. Research limitations/implications This was a largely literature review-based study. There is, therefore, room for strengthening its findings by conducting field work and mixed methods research for more robust results. Practical implications This study will surely benefit the tourism industry and business in general from its highly favorable conclusions to the benefits that come with the adoption of a BI system. It can also be used as a reference in to the tourism field, especially aggregating important concepts and literature that can help future practical studies. Social implications Society will also benefit from this study in terms of the new knowledge that has been generated. Members of society will then be in a position to demand products and services that are a result of innovation and informed decision making. Originality/value Although this paper is largely based on literature, the conclusions reached are those of the authors. A close assessment of the literature in BI and the tourism industry was done, resulting in the conclusions reached by the authors.

Employee wellness is one of the key and most essential antecedents to employee and organizational performance. Organisational performance heavily depends on the health and wellness of employees and their attitude towards their work. The study explored the relationship between wellness programs and job satisfaction for workers in armed conflict societies. The study focused on one wellness program; that is the establishment of organizational onsite health centers. A quantitative research methodology was employed to carry out the study. A questionnaire was used to solicit data from 50 people who witnessed or directly or indirectly participated in the war of liberation in Zimbabwe and the civil war in Mozambique. Descriptive statistics was used to analyze the collected data. The study established that there is a strong relationship between the establishment of onsite health centers and job satisfaction. All the major services of health clinics such as provision of health services to the injured during the war, provision of counseling services, provision of physical fitness programs and provision of ill-health prevention services showed a strong relationship with job satisfaction. It was recommended that all organizations operating in armed conflict societies should establish health centers within their premises to provide health services to the physically and emotionally injured employees.

The longitudinal study assessed the effectiveness of hermetic storage technology in limiting aflatoxin exposure among women aged 15-45 years and children under five years of age from households in selected smallholder farming areas of Zimbabwe. Exposure levels were determined by measuring aflatoxin M1 (AFM1) in urine samples from women and children every three months during the 2015/2016 storage season for nine months. After extraction and immunoaffinity column clean up, AFM1 was determined by high performance liquid chromatography. Generally, the proportion of AFM1 positive urine samples from women increased throughout the grain storage season from 5.4% (n=23) (geometric mean (GM) 1.62 μg/l) at harvest to 75% (n=315) (GM 48.35 μg/l) nine months later (range 1 positive samples increased from 2.2% (n=4) (GM 0.78 μg/l) at harvest to 72.5% (n=98) (GM 22.81 μg/l) nine months later (range 1 was significantly higher in samples from participants using conventional storage (GM 62.28 μg/l; range 1 concentrations in urine samples from participants consuming grain from metal silos and hermetic bags (P>0.05) hence the two technologies are equally effective in limiting exposure to aflatoxins in humans. The study concluded that aflatoxin exposure levels among women and children from small-holder farming areas increase throughout the postharvest season and the use of hermetic storage technology resulted in up to 33.2% decrease in frequency of detection and 48.7% decrease in levels of AFM1 compared to conventional storage technologies. Thus hermetic grain storage can be an effective technology recommended for limiting aflatoxin exposure in smallholder farming populations.

The longitudinal study assessed the effectiveness of hermetic storage technology in limiting aflatoxin exposure among women aged 15-45 years and children under five years of age from households in ...

Smallholder farmers in sub‐Saharan Africa recurrently face situations of complex and dynamic decision trade‐offs. Short‐term‐oriented activities such as fertilizer application help to cover immediate food needs but compromise on future food production. Long‐term‐oriented production activities such as building up soil fertility are important systemic leverage points; however, they compromise on today's harvests. This article uses a semicomputerized observational experiment in Zambia to investigate farm management decision making with conflicting production objectives in a dynamic context. The results reveal that, overall, Zambian smallholder farmers have a strong and significant preference for short‐term‐oriented production activities, which leads to a suboptimal performance in production in the long term. A mind shift towards more long‐term‐oriented production activities is required to sustainably increase food production. Our findings point at two things in this regard: First, we identify decision rules that successful performers have applied and that should be the basis for capacity building strategies. Second, we indicate that our approach itself contributed to recognition of the importance of a longer term perspective. acceptedVersion

Sir, Paraneoplastic syndromes are contemporaneous with various malignant tumors. Leser–Trélat syndrome is a paraneoplastic syndrome associated with certain cancers, notably, breast, lung, kidney, hepato-digestive, melanoma, and lymphoma [1]. The pathogenesis of Leser–Trélat syndrome remains unknown. Exceptional observations associate Leser–Trélat with bladder carcinoma [2]. Herein, we report Leser–Trélat syndrome in a 75-year-old black patient with bladder carcinoma. The aim of this work is to report an unusual association. The patient was a 75-year-old male, a non-smoker, with no previous history, admitted to the urology department of the Brazzaville Hospital for bladder carcinoma. The tumor suspected on ultrasound was documented by anatomopathological examination. The incidental discovery of a rash of diffuse pigmented papules located preferentially on the trunk, consisting of lesions of variable size, measuring from 3 to 1 cm, with a soft or firm consistency and irregular surface (Fig. 1). These lesions were suggestive of seborrheic keratoses.

There has been a significant increase in the number of women entrepreneurs in various sectors of the economy throughout the world. Some women entrepreneurs registered some success stories, while others dismally failed and ended up poorer than they were before they started their businesses. The main purpose of this study was to establish the successes, failures and survival strategies of women entrepreneurs in Masvingo city, Zimbabwe. A qualitative research methodology was employed to carry out the study. Face-to-face semi-structured interviews were conducted on 40 (forty) participants who were selected by using the snowball sampling technique. Thematic data analysis approach was utilized to analyse the collected data. It was found that despite some registered failures and challenges like failing to retain staff, failing to raise adequate capital, and failing to access advanced technology, a significant number of women entrepreneurs were generally successful in launching, maintaining and growing their businesses. The strategies which women entrepreneurs employed to survive, included among others, buying raw materials or goods for resale in bulk to enjoy the economies of scale; pegging prices and selling their products in United States Dollars (USD); pegging prices in USD and selling products at the prevailing Zimbabwean Dollar exchange rate; or hiring competent staff to ensure that workers were appropriately motivated. It was recommended that women entrepreneurs should continuously scan the macro- and micro-environments to identify new opportunities as well as emerging business threats.

Cowpea (Vigna unguiculata L. Walp) grain is an important source of protein for smallholder farmers in developing countries. However, cowpea grains are highly susceptible to bruchid attack, resulting in high quantitative and qualitative postharvest losses (PHLs). We evaluated the performance of five different hermetic bag brands for cowpea grain storage in two contrasting agro-ecological zones of Zimbabwe (Guruve and Mbire districts) for an 8-month storage period during the 2017/18 and 2018/19 storage seasons. The hermetic bag treatments evaluated included: GrainPro Super Grain bags (SGB) IVR™; PICS bags; AgroZ® Ordinary bags; AgroZ® Plus bags; ZeroFly® hermetic bags. These were compared to untreated grain in a polypropylene bag (negative control) and Actellic Gold Dust® (positive chemical control). All treatments were housed in farmers’ stores and were subjected to natural insect infestation. Hermetic bag treatments were significantly superior (p< 0.001) to non-hermetic storage in limiting grain damage, weight loss and insect population development during storage. However, rodent control is recommended, as rodent attack rendered some hermetic bags less effective. Actellic Gold Dust® was as effective as the hermetic bags. Callosobruchus rhodesianus (Pic.) populations increased within eight weeks of storage commencement, causing high damage and losses in both quality and quantity, with highest losses recorded in the untreated control. Cowpea grain stored in Mbire district sustained significantly higher insect population and damage than Guruve district which is ascribed to differences in environmental conditions. The parasitic wasp, Dinarmus basalis (Rondani) was suppressed by Actellic Gold Dust® and all hermetic treatments. All the hermetic bag brands tested are recommended for smallholder farmer use in reducing PHLs while enhancing environmental and worker safety, and food and nutrition security.

Aim: Determine the prevalence of enteric bacterial pathogens and their antimicrobial resistance among diarrheic children in Nairobi City, Kenya. Background: Regardless of enteric bacterial pathogens being a major cause of gastroenteritis in children, their occurrence and antimicrobial resistance patterns reveals regional spatial and temporal variation. Methods: In a cross-sectional study, a total of 374 children below five years presenting with diarrhea at Mbagathi County Hospital were recruited. Stool microbiology test was used to detect enteric bacterial infection. Antimicrobial resistance was determined using the disk diffusion method. Results: Diarrheagenic E. coli (36.4%) was the leading species followed by Shigella (3.2%), Salmonella (2.4%), Campylobacter (1.6%), Yersinia (1.3%) and Aeromonas (1.1%) species. Escherichia coli pathotyping revealed that 20.9%, 4.0%, 10.2% and 0.5% of the study participants were infected with enteroaggregative E. coli (EAEC), enteropathogenic E. coli (EPEC), enterotoxigenic E. coli (ETEC) and enteroinvasive E. coli (EIEC) pure isolates while the prevalence of mixed pathotype infections was 0.3% for EAEC/EPEC/ETEC and 0.5% for EAEC/ETEC. Shigella sero-grouping revealed that 0.5%, 0.3%, 1.9%, and 0.5% were infected with Shigella boydii, Shigella dysentriae, Shigella flexneri and Shigella sonnei pure isolates. Shigella species and E. coli co-infection was detected in 2.4% of the children, specifically, 1.1% for EAEC/Shigella boydii, 0.5% for EAEC/Shigella dysentriae and 0.3% in each case of EAEC/Shigella sonnei, EPEC/Shigella flexneri and ETEC/Shigella flexneri co-infections. Most of the isolates were resistant to commonly prescribed antibiotics. Conclusion: There was a high prevalence of enteric bacterial pathogens and co-infection alters epidemiological dynamics of bacterial diarrhea in children. Continuous antibiotic resistance surveillance is justified because the pathogens were highly resistant to commonly prescribed antimicrobials.

Mangrove forests occupy approximately not more than 1% of the world's forested land, according to experts. These important ecosystems are currently being lost at an alarming rate. Aquaculture, urban development, agriculture, and industrial development have been observed to be the major causes of these mangrove losses. Mangroves are an important source of ecosystem goods and services, among which are carbon sequestration, providing breeding and nursery grounds for several species of flora and fauna, materials, medicines, and climate change impact protection. Carbon dioxide capturing and sequestration is a system of man-made processes to reduce carbon dioxide emissions from utilities which use coal and gas. Mangroves can actually do this as natural carbon capture and sequestration (CCS) agents for mankind.

Gastrointestinal endoscopy (GIE) is not routinely accessible in many parts of rural Africa. As surgical training expands and technology progresses, the capacity to deliver endoscopic care to patients improves. We aimed to describe the current burden of gastrointestinal (GI) disease undergoing GIE by examining the experience of surgical training related to GIE.A retrospective review was conducted on GIE procedures performed by trainees with complete case logs during 5-year general surgery training at Pan-African Academy of Christian Surgeons (PAACS) sites. Cases were classified according to diagnosis and/or indication, anatomic location, intervention, adverse events, and outcomes. Comparisons were performed by institutional location and case volumes. Analysis was performed for trainee self-reported autonomy by post-graduate year and case volume experience.Twenty trainees performed a total of 2181 endoscopic procedures. More upper endoscopies (N = 1,853) were performed than lower endoscopies (N = 325). Of all procedures, 546 (26.7%) involved a cancer or mass, 267 (12.2%) involved a report of blood loss, and 452 (20.7%) reported pain as a component of the diagnosis. Interventions beyond biopsy were reported in 555 (25%) procedures. Esophageal indications predominated the upper endoscopies, particularly esophageal cancer. Trainees in high-volume centers and in East Africa performed more interventional endoscopy and procedures focused on esophageal cancer. Procedure logs documented adverse events in 39 cases (1.8% of all procedures), including 16 patients (0.8%) who died within 30 days of the procedure. Self-reported autonomy improved with both increased endoscopy experience and post-graduate year.GIE is an appropriate component of general surgery residency training in Africa, and adequate training can be provided, particularly in upper GI endoscopy, and includes a wide variety of endoscopic therapeutic interventions.

Introduction: Recommended child-feeding practices such as exclusive breastfeeding for six months, prolonged breastfeeding and adequate complementary feeding have been proven to reduce prevalence of malnutrition. Declining socioeconomic environment may be putting children from urban poor families at risk of malnutrition due to poor feeding practices and increased risk of morbidity. Objective: The aim of this cross-sectional study was to assess child feeding practices and morbidity prevalence among Harare urban families living in low socieconomic districts. Methods: A health facility based cross sectional study was conducted in Harare in five clinics serving low socio economic communities from July to August 2012. A structured interviewer-administered questionnaire assessing WHO indicators for infant and young child feeding (IYCF) was used to interview primary caregivers on child-feeding practices. Secondary outcomes assessed was prevalence of diarrhea, influenza, malaria, measles, fever, and cough. Data were analysed using vSPSS-21 statistical software. Results: A total of 218 infant and caregiver pairs attending growth monitoring at the clinics were enrolled in the study. Seventy-five percent of the children were below two years of age. There was a high prevalence of early introduction of complementary foods (81.4% before 6 months of age). About half (49.2%) of the infants had 4 or more meals per day. A significant proportion (74.4%) had been weaned onto family meals. Fifty-three (24%) of the children had been sick with diarrhea, 59% influenza , 1% malaria , 1% measles, 23% fever and 53% with a cough during the 1 month recall period. Conclusion: There is a high prevalence of inadequate infant feeding practices and morbidity in low resource communities in Harare. There is need to design child-feeding interventions for the urban community targeting all family members involved in decision-making.

Introduction: Recommended child-feeding practices such as exclusive breastfeeding for six months, prolonged breastfeeding and adequate complementary feeding have been proven to reduce prevalence of malnutrition. Declining socioeconomic environment may be putting children from urban poor families at risk of malnutrition due to poor feeding practices and increased risk of morbidity. Objective: The aim of this cross-sectional study was to assess child feeding practices and morbidity prevalence among Harare urban families living in low socieconomic districts. Methods: A health facility based cross sectional study was conducted in Harare in five clinics serving low socio economic communities from July to August 2012. A structured interviewer-administered questionnaire assessing WHO indicators for infant and young child feeding (IYCF) was used to interview primary caregivers on child-feeding practices. Secondary outcomes assessed was prevalence of diarrhea, influenza, malaria, measles, fever, and cough . Data were analysed using vSPSS-21 statistical software. Results: A total of 218 infant and caregiver pairs attending growth monitoring at the clinics were enrolled in the study. Seventy-five percent of the children were below two years of age. There was a high prevalence of early introduction of complementary foods (81.4% before 6 months of age). About half (49.2%) of the infants had 4 or more meals per day. A significant proportion (74.4%) had been weaned onto family meals. Fifty-three (24%) of the children had been sick with diarrhea, 59% influenza , 1% malaria , 1% measles, 23% fever and 53% with a cough during the 1 month recall period. Conclusion: There is a high prevalence of inadequate infant feeding practices and morbidity in low resource communities in Harare. There is need to design child-feeding interventions for the urban community targeting all family members involved in decision-making.

The study assesses the effectiveness of collective bargaining in resolving conflicts between employers and employees in the retail industry. The study shows that collective bargaining is a valuable dispute resolution device in the retail industry. It gives an opportunity to employers and employees to discuss their concerns pertaining to issues of work thereby preventing and resolving disputes amicably. Collective bargaining creates a platform for effective communication, negotiations in good faith, impart knowledge of rights as outlined in the Labour Act Chapter 28:01 and make organisations follow through the collective bargaining agreement (CBA). The study proposes that organisations should ensure that collective bargaining adheres and implements all the CBAs.

Ethnopharmacological relevance In Guinea, medicinal plants play an important role in the management of infectious diseases including urinary disorders, skin diseases and oral diseases. This study was carried out to collect medicinal plant species employed for the treatment of these diseases and to investigate their antimicrobial potential. Materials and methods Based on an ethnobotanical investigation carried out in three Guinean regions, 74 traditional healers and 28 herbalists were interviewed and medicinal plants were collected. The most quoted plant species were evaluated for their antimicrobial activities against Staphylococcus aureus, Escherichia coli, Candida albicans, and in addition against Plasmodium falciparum. Results A total of 112 plant species belonging to 102 genera distributed over 42 botanical families were inventoried. Among the selected plant species, promising activities against C. albicans were obtained for the methanolic extracts of the stem bark of Terminalia albida (IC50 1.2 μg/ml), the leaves of Tetracera alnifolia (IC50 1.6 μg/ml) and the root bark of Swartzia madagascariensis (IC50 7.8 μg/ml). The highest activity against S. aureus was obtained for the dichloromethane extracts of the leaves of Pavetta crassipes (IC50 8.5 μg/ml) and the root of Swartzia madagascariensis (IC50 12.8 μg/ml). Twenty one extracts, obtained from twelve plant species, were strongly active against Plasmodium falciparum, including the dichloromethane extracts of the root and stem bark of Terminalia albida root (IC50 0.6 and 0.8 μg/ml), the leaves of Landolphia heudelotii (IC50 0.5 μg/ml), the stem bark of Combretum paniculatum (IC50 0.4 μg/ml) and the leaves of Gardenia ternifolia (IC50 1.3 μg/ml). Conclusion The present study provides a comprehensive overview of medicinal plants employed by Guinean traditional healers for the treatment of various microbial diseases, including urinary disorders, skin diseases and oral diseases. Some of the studied plant species showed promising antimicrobial activity and could be considered as a potential source for the development of new antifungal and/or antimalarial agents.

Maize is susceptible to many mycotoxigenic fungi and mycotoxins, being prone to Fusarium spp. infection and subsequent mycotoxin contamination. Fumonisin B1 (FB1) is the predominant mycotoxin in Zimbabwean subsistence-grown maize and results of mycotoxin analyses indicated FB1 to be significantly higher compared to other mycotoxins. To fully elucidate maize agronomic practices influencing FB1 contamination of maize produced by Zimbabwean subsistence farming populations, an investigative field survey was conducted in the selected provinces of Mashonaland West and Manicaland. Agronomic data and associated climatic data were collected during the 2014/2015 agricultural season. A total of 158 maize samples were collected from households’ harvest, three months and six months post-harvest. Analysis and quantification of mycotoxin contamination in the maize samples was performed using a validated multi-mycotoxin analysis method with a scope of 23 mycotoxins. Maize was mainly contaminated by FB1. There was low mycotoxin co-occurrence in Zimbabwean maize, which was typically of Fusarium toxins. FB1 occurred in 23, 47 and 47% of samples at harvest, three and six months post-harvest, respectively. The corresponding means of positive samples were 609, 597 and 289 μg/kg, respectively. Regarding fumonisins, the choice of seed and fertiliser application were significant in modulating FB1 contamination. There was no significant difference in mean FB1 contamination during post-harvest maize storage. Daily temperatures were key factors influencing FB1 incidence and levels. High temperatures were associated with high FB1 contamination particularly at the flowering stage of maize. Rainfall was positively correlated with FB1 contamination. Good agricultural practices attributed to low FB1 contamination in maize pre-harvest. Post-harvest practices such as preserving seed integrity by preventing pest infestation using grain protection chemicals are important in achieving lower mycotoxin contamination and in particular, FB1, in maize grain.

There is limited empirical evidence on the efficacy of hermetic storage containers in reducing mycotoxin occurrence in stored maize grain under smallholder field conditions. Levels of aflatoxin B1 (AFB1) and fumonisin B1 (FB1) in maize samples collected from hermetic metal silos (148), hermetic grain bags (121) and conventional stores (179) during 2015 and 2016 storage seasons in two rural districts of Zimbabwe were assessed. AFB1 was determined using high performance liquid chromatography with post-column derivatisation and fluorescence detection, whilst FB1 was determined using direct competitive ELISA. All maize samples collected at harvest in 2015 and 2016 seasons contained FB1 at levels ranging from 10 to 462 μg/kg and 13 to 537 μg/kg, respectively. Use of hermetic containers did not seem to have any effect on the development of FB1 in stored maize grain, as there was no significant difference (P>0.05) in the increase of FB1 contamination in hermetic and conventional stores. Prior to storage, the levels of AFB1 in the maize ranged from below the limit of quantitation (LOQ) to 25.0 μg/kg, whilst levels during storage ranged from 1 in maize stored in hermetic containers, was significantly (P1 and subsequent human exposure to these toxins. Therefore, hermetic storage containers are recommended to smallholder maize producers for safe and effective limitation of AFB1 contamination during storage and hence reduce exposure among consumers.

AIM To determine the cultural competency training, knowledge and attitudes of health professionals about Aboriginal and Torres Strait Islander (hereafter referred to as Aboriginal) health-care delivery. METHODS Survey of medical (n = 200), nursing (n = 200) and other health professionals (n = 210) working in two tertiary paediatric hospitals in December 2013. The main outcome measures were training in Aboriginal health-care delivery, knowledge of Aboriginal health and services, attitudes to identification of Aboriginal patients and suggested ways to improve health-care delivery to Aboriginal patients. RESULTS We received responses from 286 of 572 (50.0%) staff with valid emails: 75 medical, 88 nursing and 123 other health professionals. A minority reported receiving specific Aboriginal health training (126/286, 44.8%) and Aboriginal cultural competency training (106/286, 37.1%). Medical staff were less likely than others to report Aboriginal health-care training (P = 0.01), cultural competency training (P < 0.001) and that their training equipped them to manage Aboriginal patients (P = 0.04). Few medical staff reported a good/very good knowledge of the services provided by the Aboriginal Community Controlled Health Services (20.0%), the Federal Government Closing the Gap initiative (14.7%) or the Royal Australasian College of Physicians' Reconciliation Action Plan (8.0%). Only 62 of 286 (21.7%) staff agreed that they usually asked patients/parents whether they identified as Aboriginal. Although 256 of 286 (89.5%) agreed that Aboriginal staff were an important resource, only 125 of 286 (43.7%) had referred Aboriginal patients to one. CONCLUSION The opportunities we have identified to improve health-care delivery to Aboriginal patients include: increasing Aboriginal cultural competency training, correct identification of Aboriginal patients, referring Aboriginal patients to Aboriginal health-care services and increased awareness of Aboriginal Community Controlled Health Services.