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Objective: Our objective was to assess clinical governance and the quality of health services in public primary health facilities in three councils of Arusha Region. Participants: We conducted a study involving 270 clients from 19 primary health facilities in three councils in Arusha Region. Methods: We conducted a cross-sectional study. The clients were selected using multistage-cluster sampling. Data were collected using exit interview and observation. A descriptive statistical method was used to analyse data. Results: We found that health facilities had the key policies and structures for quality improvement and limited governance for quality of health services. In total,109(43%) of the clients reported receiving all the prescribed medicines and 230 (85%) of the clients had a positive experience with care processes. Also, 181(72%) of the clients were satisfied with the health services and 230 (85%) of clients had confidence and trust in public primary health facilities. Conclusion: This research has generated valuable evidence on governance and the quality of health services offered in public primary health facilities in three councils of the Arusha Region. Our research has indicated that: facilities had limited governance for quality of health services and clients had limited access to essential medicines; the majority of clients had a positive experience with the processes of health care; the majority of clients were satisfied with health services offered and had confidence and trust in public primary health facilities. The empirical evidence of this study should inform quality improvement efforts in the studied councils and Tanzania. [ABSTRACT FROM AUTHOR]

In May 2011 in Turkana County, north-western Kenya, tissue samples were collected from goats suspected of having died of peste des petits ruminant ( PPR) disease, an acute viral disease of small ruminants. The samples were processed and tested by reverse transcriptase PCR for the presence of PPR viral RNA. The positive samples were sequenced and identified as belonging to peste des petits ruminants virus ( PPRV) lineage III. Full-genome analysis of one of the positive samples revealed that the virus causing disease in Kenya in 2011 was 95.7% identical to the full genome of a virus isolated in Uganda in 2012 and that a segment of the viral fusion gene was 100% identical to that of a virus circulating in Tanzania in 2013. These data strongly indicate transboundary movement of lineage III viruses between Eastern Africa countries and have significant implications for surveillance and control of this important disease as it moves southwards in Africa. [ABSTRACT FROM AUTHOR]

Background Context: Ossification of the posterior longitudinal ligament (OPLL) is a progressive, debilitating disease most commonly affecting the cervical spine. When compared to other degenerative pathologies, OPLL procedures carry a significantly higher risk of complications owing to increased case complexity and technical difficulties. Most previous studies have focused on functional outcomes and few have reported on risk factors for postoperative complications in OPLL patients., Purpose: To identify clinical and radiological risk factors of surgical complications following treatment for cervical OPLL STUDY DESIGN: Retrospective review PATIENT SAMPLE: One hundred thirty-one patients with cervical myelopathy secondary to OPLL who underwent surgical decompression with complete 2-year follow-up., Outcome Measures: Surgical and medical postoperative complications were analyzed. Revision surgery rates and mortality rates were recorded., Methods: Clinical, surgical, and radiological characteristics were collected for each patient. Complications within 30 days were identified. Univariate and multivariate analysis were performed to identify risk factors for surgical complications., Results: There were 39 (29.8%) surgical complications in the cohort, which included C5 palsy (7.6%), dural tear (3.1%), surgical site infection (3.1%), and epidural hematoma (1.5%). 2-year revision and mortality rates were 4.6% and 2.3%, respectively. Univariate analysis revealed that blood loss ≥750mL (OR 3.42, p=0.028), operative duration ≥5.5 hours (OR 3.16, p=0.008), hill-type OPLL (OR 3.08, p=0.011), K-line (-) OPLL (OR 5.39, p<0.001), and presence of a double-layer sign (OR 3.79, p=0.002) were significant risk factors. In multivariate analysis, only hill-type OPLL (OR 2.61, p=0.048) and K-line (-) OPLL (OR 2.98, p=0.031) were found to be significant. Patients with both hill-type and K-line (-) OPLL had a 3.5 times risk of developing surgical complications (p=0.009)., Conclusions: Patients with OPLL have a higher risk of perioperative surgical complications if they had a hill-shaped OPLL and K-line (-) OPLL on preoperative imaging studies. To the best of the authors' knowledge, this study is the first to link hill-type and K-line (-) OPLL morphology as risk factors for perioperative surgical complications., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Invasion specificity of Eimeria stiedai sporozoites in cultured cells was examined. Intracellular sporozoites were observed in hepatobiliary epithelial cells, as early as 3 hours post inoculation (p.i.) but the infection rate was monitored for 6 hours. No intracellular parasites were found in rabbit parenchymal hepatocytes and rabbit kidney cells, even on prolonged culturing. In the hepatobiliary epithelial cells inoculated with fixed sporozoites, no intracellular parasite were found. Sporozoites attached on the cell surface of the hepatobiliary epithelial cells fixed with paraformaldehyde but did not penetrate. The carbohydrates present on Eimeria stiedai sporozoites and their functional role in the process of invasion of host cells were also examined. Lectin binding sites on the surface of sporozoites were detected by means of peroxidase-conjugated lectins. Sporozoites showed specific binding with UEA-I and PNA lectins, which bind L-fucose and D-galactose, respectively. Exposure of sporozoites to 100 microg/ml UEA-I significantly reduced their ability to invade primary rabbit hepatobiliary epithelial cells, but similar treatment with PNA had no such effect. Preincubation of these cells in Dulbecco's minimum essential medium containing 10% fetal bovine serum and 1% L-fucose suppressed the invasion activity of the sporozoites, but preincubation of the sporozoites in the same medium without L-fucose had no effect on cell penetration. D-galactose added to the medium had no effect on the invasion activity of sporozoites. These results indicate that L-fucose residues on E. stiedai sporozoites and L-fucose binding sites on host cells both are associated with recognition and/or invasion process.