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Abstract We performed a systematic review and meta-analysis of hypertension in people living with human immunodeficiency virus (HIV) in sub-Saharan Africa (SSA). We searched the PubMed, Google Scholar, African Index Medicus, and Embase databases to identify studies published from January 1, 2010, to December 31, 2021. We used a random-effects model to estimate the pooled prevalence of hypertension and mean SBP/DBP level on a sex-specific basis. We included 48 studies reporting data on a pooled sample of 193,843 people living with HIV (PLW-HIV) in SSA. The pooled mean SBP/DBP level was 120 (95% CI 113–128)/77 (95%CI 72–82) mmHg, while the overall pooled prevalence of hypertension was 21.9% (95% CI 19.9–23.9%). Further meta-regression analyses suggested that the prevalence of hypertension was 1.33 times greater in males, 1.23 times greater in individuals receiving antiretroviral therapy (ART) and 1.45 times greater in those individuals with a CD4-count ≥ 200. This meta-analysis of the contemporary pattern of BP levels among PLW-HIV in SSA, suggests that around one in five of such individuals also have hypertension. Given the further context of greater access to ART and subsequently greater longevity, study findings support calls to integrate cardiovascular management into routine HIV care.

Abstract Background Undiagnosed and untreated hypertension is a main driver of cardiovascular disease and disproportionately affects persons living with HIV (PLHIV) in low- and middle-income countries. Across sub-Saharan Africa, guideline application to screen and manage hypertension among PLHIV is inconsistent due to poor service readiness, low health worker motivation, and limited integration of hypertension screening and management within HIV care services. In Mozambique, where the adult HIV prevalence is over 13%, an estimated 39% of adults have hypertension. As the only scaled chronic care service in the county, the HIV treatment platform presents an opportunity to standardize and scale hypertension care services. Low-cost, multi-component systems-level strategies such as the Systems Analysis and Improvement Approach (SAIA) have been found effective at integrating hypertension and HIV services to improve the effectiveness of hypertension care delivery for PLHIV, reduce drop-offs in care, and improve service quality. To build off lessons learned from a recently completed cluster randomized trial (SAIA-HTN) and establish a robust evidence base on the effectiveness of SAIA at scale, we evaluated a scaled-delivery model of SAIA (SCALE SAIA-HTN) using existing district health management structures to facilitate SAIA across six districts of Maputo Province, Mozambique. Methods This study employs a stepped-wedge design with randomization at the district level. The SAIA strategy will be “scaled up” with delivery by district health supervisors (rather than research staff) and will be “scaled out” via expansion to Southern Mozambique, to 18 facilities across six districts in Maputo Province. SCALE SAIA-HTN will be introduced over three, 9-month waves of intensive intervention, where technical support will be provided to facilities and district managers by study team members from the Mozambican National Institute of Health. Our evaluation of SCALE SAIA-HTN will be guided by the RE-AIM framework and will seek to estimate the budget impact from the payer’s perspective. Discussion SAIA packages user-friendly systems engineering tools to support decision-making by frontline health workers and to identify low-cost, contextually relevant improvement strategies. By integrating SAIA delivery into routine management structures, this pragmatic trial will determine an effective strategy for national scale-up and inform program planning. Trial registration ClinicalTrials.gov NCT05002322 (registered 02/15/2023).

BackgroundThere is a paucity of primary data to understand the overall pattern of disease and injuries as well as related health-service utilization in resource-poor countries in Africa.ObjectiveTo generate reliable and robust data describing the pattern of emergency presentations attributable to communicable disease (CD), non-communicable disease (NCD) and injuries in three different regions of Mozambique.MethodsWe undertook a pragmatic, prospective, multicentre surveillance study of individuals (all ages) presenting to the emergency departments of three hospitals in Southern (Maputo), Central (Beira) and Northern (Nampula) Mozambique. During 24-hour surveillance in the seasonally distinct months of April and October 2016/2017, we recorded data on 7,809 participants randomly selected from 39,124 emergency presentations to the three participating hospitals. Applying a pragmatic surveillance protocol, data were prospectively collected on the demography, clinical history, medical profile and treatment of study participants.FindingsA total of 4,021 males and 3,788 (48.5%) females comprising 630 infants (8.1%), 2,070 children (26.5%), 1,009 adolescents (12.9%) and, 4,100 adults (52.5%) were studied. CD was the most common presentation (3,914 cases/50.1%) followed by NCD (1,963/25.1%) and injuries (1,932/24.7%). On an adjusted basis, CD was more prevalent in younger individuals (17.9±17.7 versus 26.6±19.2 years;pInterpretationApplying highly pragmatic surveillance methods suited to the low-resource setting of Mozambique, these unique data provide critical insights into the differential pattern of CD, NCD and injury. Consequently, they highlight specific health priorities across different regions and seasons in Southern Africa.

Evaluation of the effect of genotype (Romanov breed: n = 26, and F1 crossbreds of Suffolk-Romanov: n = 29), sex (males: n = 37 and females: n = 18) and litter size (singles: n = 6, twins: n = 16, triples: n = 21 and quadruplets: n = 12) on growth and basic carcass quality traits of light lambs was carried out at an organic sheep farm in Kuklík over the years 2007 and 2008. Throughout the experiment the lambs were reared with their mothers, indoors. The weaning of lambs was carried out just before slaughter. The daily feeding ration of the lambs consisted of the mother’s milk (ad libitum) and organic mineral lick (ad libitum), whereas the lambs had free access to the feedstuff of their mothers.The daily feeding ration of the ewes consisted of haylage (2.5 kg/ewe), meadow hay (ad libitum) and organic mineral lick (ad libitum). The genotype (G) and the sex (S) had not a significant effect on growth of lambs in the period from birth till the slaughter. On the other hand the litter size (LS) had a highly significant effect on this trait, whilst the highest daily gain in above-mentioned period was found in singles (157 g). Concerning the carcass traits the G had a significant effect only on carcass dressing percentage while the S had a significant effect only on proportion of kidney. Nevertheless the LS had a significant effect on carcass dressing percentage and the proportions of skin, kidney and kidney fat. In conclusion it can be completed that the fatness scores of all individual carcasses were relatively very low which is important for good realisation of the carcasses on the market.

The aim of the study was the evaluation of the growth of the lambs crossbreeds of Romanov breed (RO), Suffolk (SF) and Charollais (CH) reared on the organic sheep farm in Kuklík. Following genotypes and effects were evaluated: CH × RO: n = 10, RO: n = 37, RO × (SF × RO): n = 12, SF × (SF × RO): n = 11 and SF × RO: n = 64, sex (males: n = 79, females: n = 55), litter size (singles: n = 16, twins: n = 55, triples and multipath (n = 63) and season of rearing of lambs (winter: n = 84, summer: n = 50). The crossbreeds had a significant effect on all live weights (LWs) and daily gains (DGs) under study. The highest DGs in all periods were found in SF × (SF × RO), whilst the DG from birth till 100 days of age (DG 0–100) was in this group 0.213 kg. The lowest DGs in all periods were found in SF × RO, whilst DG 0–100 was in this group 0.181 kg. The sex had not a significant effect on all DGs and LWs. However in all periods were found higher DGs in males. The litter size had a significant effect on all DGs and LWs. The highest DG 0–100 was found in singles, whilst the triples had higher DG 0–100 than twins (0.184 vs 0.176 kg) The season had not a significant effect on live birth weight. On the other hand this factor had a significant effect on all growth parameters. In all periods were found higher DGs in lambs reared in summer, whereas the DG 0–100 in this group of lambs was 0.223 kg.

The main aim of the study was the evaluation of the growth, meatiness and fattiness in vivo in lambs (n = 122) of chosen breeds (CH: Charollais and T: Texel) and crossbreeds (CH x Sf (Suffolk), CH x T, EF (East Friesiane) x CH and EF x T. Whithin the frame of this study were also evaluated the effects of sex (S), litter size (LS), age of the dams (AD) and year of the observation (YO) on aforementioned indicators. The study was carried out on the farm in Kunčice pod Ondřejníkem during the years 2004 and 2005. Within the scope of evaluation of meatiness and fattiness in vivo in lambs the following ultrasound measurement were carried out: area (Am.l.l.t., in cm2) and depth (Dm.l.l.t., in mm) of musculus longissimus lumborum et thoracis (m.l.l.t.) and fat thickness (FT, in mm). Genotype had a significant effect on body weight at birth and on daily gains (DGs) from 30 to 100 days of age and from birth to 100 days of age. Sex had a significant effect on most of body weights under study and on DGs from birth to 30 days of age, from 30 to 70 days of age and from birth to 100 days of age. The LS, AD and YO had a significant effect on most of growth indicators under study. Genotype had a significant effect on Am.l.l.t. at the age of 70 days, Dm.l.l.t. and FT at the age of 100 days. The S had a significant effect on Dm.l.l.t. and Am.l.l.t. at the age of 70 days and on Am.l.l.t. at the age of 100 days. The LS and YO had a significant effect on most of indicators of meatiness and fattiness in vivo under study. On the other hand only the AD had not significant effect on all parameters of meatiness and fattiness.

The aim of the study was evaluated the effect of chosen factors (sex, litter size, year of the study) on the growth of lambs crossbreeds with using Suffolk (Sf) in the sire position. In the mother position there were used following genotypes: Charollais (Ch), Sf 50 Ch, Improved Wallachian (IW) and IW 50 Sf. The evaluation was carried out during two successive years (2004–2005) on the farm Růžďka and involved altogether 141 lambs. The growth of lambs was evaluated in the following crossbreeds: Ch 50 Sf (n = 38), Sf 75 Ch (n = 40), IW 50 Sf (n = 29) and Sf 75 IW (n = 34). All lambs were born indoor in the period from January until the end of first decade of February. Lambs were kept indoor till the end of the study. Genotype had significant effect (P ≤ 0.01) only on birth weight. The highest daily gain (DG) from birth to 100 days of age (201 g) and the highest body weight (BW) at 100 days of age (24.26 kg) were found out in IW 50 Sf. Effect of sex had highly significant effect (P ≤ 0.01) only on birth weight and significant effect (P ≤ 0.05) only on BW at 100 days of age. Litter size was the most important factor that influenced the growth of lambs whereas this factor highly significantly (P ≤ 0.01) influenced all parameters under study excerpt the DG between 70 and 100 days of age. Monitoring year had highly significant effect (P ≤ 0.01) on BW at 100 days of age and on daily gains between 70 and 100 days of age and between birth and 100 days of age.

The evaluation of the effect of somatic cells count on ewe’s milk composition, its properties and on the quality of rennet curd was carried using milk samples obtained from a total 10 ewes F112 crossbreeds of Lacaune (L), East Friesian (EF) and Improved Wallachian (IW), reared on a ecological sheep farm in Valašská Bystřice. All ewes were on the 1st lactation, in good nutritive condition and clinically healthy. The sampling was carried on 47th, 81st, 123rd, 152nd and 189th day of lactation. The analysis involved a total of 50 milk samples, which were categorized into 5 different SCC groups: 1st group (≤ 10 000 SC/ml), 2nd group (11 000–50 000 SC/ml), 3rd group (51 000–100 000 SC/ml), 4th group (101 000–200 000 SC/ml), 5th group (≥ 201 000 SC/ml). Milk composition and milk properties were determined by standard methods. For the evaluation of the quality of rennet curd (class quality) was used following scale: 1st class – very good and hard curd, 2nd class – good curd, 3rd class – bad curd, 4th class – very bad curd, 5th class – no or invisible flocculation of casein. Recorded data were statistically analyzed using the classical least squares method (SAS; PROC GLM variant ss4). The SCC had a significant effect on all components of milk under study. The lowest contents of total solids (TS), fat (F), solids non-fat (SNF), protein (P) and casein (CN) were found in the group with the highest SCC (5th group). On the other hand, the highest contents of all above-mentioned milk components were found in the group with the lowest SCC. The significantly lowest content of lactose (4.42 %) was found in the group with the lowest SCC. The SCC had also significant effect on pH and titrable acidity. However on the other hand SCC had not a significant effect on rennetability and rennet curd quality (RCQ). The highest value of pH was found in the 5th group (the highest SCC). Titrable acidity has decreased from 10.10 °SH to 8.66 °SH depending on growth of SCC. The longest rennetability (257 s) was found in the group with the highest SCC. The best RCQ (class: 1.90) was found in the group where SCC per1 ml of milk ranged from 51 000 to 100 000. On the other hand the worst RCQ (class: 2.28) was found in the group with the lowest SCC.

The aim of our study was to evaluate the effects of chosen factors (crossbreds, sex, litter size, age of ewes and interaction between sex and litter size) on the growth of lambs crossbreds of the breeds Charollais (Ch), Suffolk (Sf) and Improved Valachian (IV). The evaluation was performed in the year 2004 on the farm Růžďka and involved altogether 96 lambs. The growth ability was evaluated at the following crossbreds: Ch x Sf (n = 28), (Ch x Sf) x Sf (n = 28), IV x Sf (n = 21) and (IV x Sf) x Sf (n = 19). All lambs under study were born indoor in January. Lambs were kept indoor till the end of the evaluation. From the evaluation of effects of crossbreds, sex and age of ewes on the live body weights and daily gains of lambs above all result that these factors showed a significant effect only on the live body weight at birth. On the other hand, the factors of litter size and interaction between sex and litter size showed a highly significant (P < 0.01) effect on the live body weights of lambs at birth, at 70 and at 100 days of age as well as on their daily gains within the intervals from birth to 70 and 100 days of age. It can be concluded that the daily gains were highly uniform but relatively low in all crossbreds under the study within the time interval from birth to the age of 100 days, while the non-significantly highest daily gain was recorded in the crossbreds of IV x Sf (211 g). On the other hand the lowest ones were observed in the crossbreds of CH x Sf and (IV x Sf) x Sf (199 g).