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Background: Snakebite envenoming (SBE) is a potentially life-threatening event that can lead to severe physical, mental, and economic hardships, particularly in under-resourced regions like sub-Saharan Africa. In Rwanda, there have been no epidemiological assessments of SBE to guide the Ministry of Health in its efforts to reduce the burden. This study had two main objectives: first, to estimate the incidence of snakebites across districts, and second, to describe formal versus informal healthcare seeking behaviors among snakebite victims in Eastern Province, Rwanda in 2020. Methodology: This cross-sectional study utilized a cluster sampling approach, involving Community Health Workers (CHWs) who recorded snakebite cases across seven districts. The descriptive analysis considered sampling weights, and healthcare seeking behavior was assessed based on the type of care sought as the first point of treatment. Findings: The study surveyed 390,546 individuals across 763 villages and estimated a provincial annual incidence rate of 4.3 cases per 1,000 individuals. Incidence estimates ranged from 1.1 cases per 1,000 in Nyagatare to 9.1 cases per 1,000 individuals in Bugesera and Ngoma districts. Among the 2,545 cases recorded by CHWs, three resulted in deaths. Regarding healthcare-seeking behavior, 13% of snakebite victims (143 out of 1,098) initially consulted formal care providers (CHWs, health post/center, or hospital), while 87% sought informal care (family/friends, pharmacist, or traditional healer). Approximately half of the victims (583, 53.1%) reported severe symptoms. Unsafe practices included skin cutting/burning, tourniquet application, use of black stones, and venom extraction; only 24 cases (2.2%) received anti-venom. Conclusions: This large-scale community-based assessment highlights variations in snakebite incidence between districts and confirms frequent involvement of traditional healers in management. Improving access to anti-venom and community education on the risks of ineffective practices, along with timely use of formal healthcare, are crucial. Collaboration between healthcare providers, traditional healers, community leaders, and policymakers is essential to implement targeted interventions for enhancing snakebite prevention and management strategies. Author summary: Snakebites can be life-threatening, especially in places like sub-Saharan Africa. In Rwanda, there haven't been any studies to understand how many snakebites happen and where they happen. This study wanted to find out two main things: first, how many snakebites happened in different parts of the Eastern Province of Rwanda in 2020, and second, where people who got bitten by snakes went for help—to doctors or traditional healers. The study involved 390,546 people across 763 villages. It found that each year, about 4.3 out of 1,000 people in the province get bitten by snakes, but the numbers vary in different areas. Surprisingly, only 13% of the victims initially consulted formal healthcare providers like community health workers, health centers, or hospitals. In contrast, a larger group, 87%, sought informal care from family, friends, pharmacists, or traditional healers first. About half of the people bitten by snakes experienced severe symptoms. Unfortunately, many people used unsafe methods to treat snakebites, like cutting or burning the skin, tying a tight band around the bitten area, using black stones, or trying to suck out the venom. Only a very small number of cases, just 24 out of all 1,098 victims, received anti-venom. The study suggests we need to make sure anti-venom is easier to get and teach communities about the risks of unsafe practices and why it's important to get formal healthcare quickly. It's important for doctors, traditional healers, community leaders, and government officials to work together to make sure people get safe and appropriate treatment and learn how to prevent snakebites. [ABSTRACT FROM AUTHOR]

Through Facebook and Twitter, users now have communities always already available. The dynamic nature of these sites, constantly updating, changing, and shifting, allows for a rich exploration of the nature of self and community. This paper examines such interactions within the "Parlour rooms" of social networks, using Kenneth Burke's theories on identity as a framework. These platforms offer opportunities for writing teachers to explore rhetorical concepts, develop students' critical literacy skills, and foster collaborative learning. Considered in the context of computer-mediated communications, Burke's theories expand traditional notions of the rhetorical concept kairos and, as Cynthia Sheard (1993) notes, enrich our notions of what it means to be spatially, temporally, and rhetorically situated as writers and readers in these digital mediums. [ABSTRACT FROM AUTHOR]

Pasteurization of milk ensures safety for human consumption by reducing the number of viable pathogenic bacteria. Although the public health benefits of pasteurization are well established, pro-raw milk advocate organizations continue to promote raw milk as "nature's perfect food." Advocacy groups' claims include statements that pasteurization destroys important vitamins and that raw milk consumption can prevent and treat allergies, cancer, and lactose intolerance. A systematic review and meta-analysis was completed to summarize available evidence for these selected claims. Forty studies assessing the effects of pasteurization on vitamin levels were found. Qualitatively, vitamins B12 and E decreased following pasteurization, and vitamin A increased. Random effects meta-analysis revealed no significant effect of pasteurization on vitamin B6 concentrations (standardized mean difference [SMD], -2.66; 95% confidence interval [CI], -5.40, 0.8; P = 0.06) but a decrease in concentrations of vitamins B l (SMD, -1.77; 95% CI, -2.57, -0.96; P < 0.001), B2 (SMD, -0.41; 95% CI, -0.81, -0.01; P < 0.05), C (SMD, -2.13; 95% CI, -3.52, -0.74; P < 0.01), and folate (SMD, -11.99; 95% CI, 20.95, -3.03: P < 0.01). The effect of pasteurization on milk's nutritive value was minimal because many of these vitamins are naturally found in relatively low levels. However, milk is an important dietary source of vitamin B2, and the impact of heat treatment should be further considered. Raw milk consumption may have a protective association with allergy development (six studies), although this relationship may be potentially confounded by other farming-related factors. Raw milk consumption was not associated with cancer (two studies) or lactose intolerance (one study). Overall, these findings should be interpreted with caution given the poor quality of reported methodology in many of the included studies. [ABSTRACT FROM AUTHOR]

In Vietnam, pigs and poultry are predominantly produced by small-scale farmers, creating challenges for zoonotic disease management. The objective of this study was to characterize practices related to livestock and manure management and to measure association with 3 self-reported health symptoms (coughing, fever, and diarrhea/nausea/vomiting) in a region currently undergoing health transitions. We analyzed cross-sectional survey data collected from a subset (N = 5520) of the Chi Linh Health and Demographic Surveillance System cohort in Chi Linh district, Vietnam. Bivariate analyses indicated that female gender was a significant risk factor for all 3 health symptoms, whereas age (≥60 years), suburban living, low education level, and household wealth were risk factors for 2 symptoms. Overall, we found no indication that biogas production or exposure to livestock and manure adversely affected human health. Efforts to control zoonotic disease transmission should prioritize utilization of veterinarians, enhanced farm biosecurity, and improvements to commune drinking water/wastewater infrastructure.