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Highlights political, educational, and teacher education policies in Zimbabwe since independence, noting the effect on teacher education of the expansion in all levels of education. The paper also describes innovations in teacher education which were aggressive actions on the part of educators in Zimbabwe. (SM)

Points out influences on and constraints to planning a social studies curriculum for the 21st century. Proposes a curriculum based on five essential concept clusters and presents a breakdown of these concepts using Zimbabwe themes and issues. Recommends innovations in teacher education to accompany the proposed curriculum. (LS)

Discusses the restructuring of the social studies curriculum after the attainment of political independence in Zimbabwe. Divides the discussion into three levels of curriculum development: primary, secondary, and teacher education. Stresses the Zimbabwean educational aims as the development of self-reliant individuals, the fostering of national unity, patriotism, and national reconstruction. (RW)

Background: Several nontuberculous mycobacteria (NTM) have been isolated from diverse environments such as water, soil, sewage, food and animals. Some of the mycobacteria are now known to be opportunistic pathogens in humans. In this study, we describe the molecular identification of NTM in humans in Zimbabwe. Methods & Materials: Human sputum samples were collected during the national TB survey that was carried out by the Ministry of Health and Child care of Zimbabwe in 2014. The NTM were isolated using Lowensen Jensen (LJ) media and tested for growth in the presence of ParaNitroBenzoic acid and their ability to grow at different temperatures, 25 °C, 37 °C and 45 °C. DNA was extracted and rRNA gene amplified by PCR. Amplicons were sequenced and analyzed using bioinformatics. Species were identified. Results: Out of total of 963 NTM isolates from sputum samples, 81 were analyzed using 16S ribosequencing. Forty isolates (49.4%) were found to belong to Mycobacterium avium complex (MAC) species. The other 41 isolates (50.6%) were identified as M. lentiflavum (6.2%), M. terrae complex (4.9%), M. paraense (4.9%), M. kansasii (3.7%), M. moriokaense (3.7%), M. asiaticum (2.5%), M. novocastrense (2.5%), M. brasiliensis (2.5%), M. elephantis (2.5%), M. paraffinicum (1.2%), M. bohemicum (1.2%), M. manitobense (1.2%), M. intermedium (1.2%), M. tuberculosis complex (1.2%), M. parakoreense (1.2%), M. florentinum (1.2%), M. litorale (1.2%), M. fluoranthenivorans (1.2%), M. sherrisii (1.2%), M. fortuitum (1.2%) andMsepticum (1.2%). Two isolates (2.5%) could not be identified, but were closely related to M. montefiorense and M. phlei respectively. Conclusion: Interestingly, the MAC species were the commonest NTM during the survey. Further studies are necessary to ascertain the true diversity of NTM in Zimbabwe. [ABSTRACT FROM AUTHOR]

Background: Sentinel surveillance for diarrhoea is important to monitor changes in rotavirus epidemiological trends and circulating genotypes among children under 5 years before and after vaccine introduction. The Zimbabwe Ministry of Health and Child Care introduced rotavirus vaccine in national immunization program in May 2014., Methods: Active hospital-based surveillance for diarrhoea was conducted at 3 sentinel sites from 2008 to 2016. Children aged less than 5 years, who presented with acute gastroenteritis as a primary illness and who were admitted to a hospital ward or treated at the emergency unit, were enrolled and had a stool specimen collected and tested for rotavirus by enzyme immunoassay (EIA). Genotyping of positive stools was performed using reverse-transcription polymerase chain reaction and genotyping assays. Pre-vaccine introduction, 10% of all positive stool specimens were genotyped and all adequate positive stools were genotyped post-vaccine introduction., Results: During the pre-vaccine period, a total of 6491 acute gastroenteritis stools were collected, of which 3016 (46%) tested positive for rotavirus and 312 (10%) of the rotavirus positive stools were genotyped. During the post-vaccine period, a total of 3750 acute gastroenteritis stools were collected, of which 937 (25%) tested positive for rotavirus and 784 (84%) were genotyped. During the pre-vaccine introduction the most frequent genotype was G9P[8] (21%) followed by G2P[4] (12%), G1P[8] (6%), G2P[6] (5%), G12P[6] (4%), G9P[6] (3%) and G8P[4] (3%). G1P[8] (30%) was most dominant two years after vaccine introduction followed by G9P[6] (20%), G2P[4] (15%), G9P[8] (11%) and G1P[6] (4%)., Conclusion: The decline in positivity rate is an indication of early vaccine impact. Diversity of circulating strains underscores the importance of continued monitoring and strain surveillance after vaccine introduction., (Copyright © 2018. Published by Elsevier Ltd.)

Objective: The potential of NaHCO 3 versus human serum to induce germ tube formation in Candida albicans was investigated., Specimens: A total of 100 isolates were obtained from oral swabs of patients presenting with thrush. Approval for the study was granted by the Joint Research Ethics Committee (JREC/23/08)., Method: Confirmed C. albicans isolates by routine methods were tested for germ tube induction using 5 different concentrations of Tris-maleate buffered NaHCO 3 and Tris-maleate buffer control. Standard control strains included were C. albicans (ATCC 10231) and C. krusei (ATCC 6258). Microculture was done in 20  μ L inoculums on microscope slides for 3 hours at 37°C. The rate of germ tube formation at 10-minute intervals was determined on 100 isolates using the optimum 20 mM Tris-maleate buffered NaHCO 3 concentration. Parallel germ tube formation using human serum was done in test tubes., Results: The optimum concentration of NaHCO 3 in Tris-maleate buffer for germ tube induction was 20 mM for 67% of isolates. Only 21% of isolates formed germ tubes in Tris-maleate buffer control. There was no significant difference in induction between human serum and Tris-maleate buffered NaHCO 3 ., Conclusion: Tris-maleate buffered NaHCO 3 induced germ tube formation in C. albicans isolates at rates similar to human serum.

Background: Several nontuberculous mycobacteria (NTM) were previously isolated from diverse environments such as water, soil, sewage, food and animals. Some of these NTM are now known to be opportunistic pathogens of humans., Objective: The main purpose of the study was to identify NTM isolates stored at the National Microbiology Reference Laboratory (NMRL) and were previously isolated from humans during a national tuberculosis (TB) survey., Methods: Pure NTM cultures already isolated from human sputum samples during the national TB survey were retrieved from the NMRL and used for this study. DNA was extracted from the samples and 16S ribosomal RNA gene amplified by polymerase chain reaction. The amplicons were sequenced and bioinformatics tools were used to identify the NTM species., Results: Out of total of 963 NTM isolates stored at the NMRL, 81 were retrieved for speciation. Forty isolates (49.4%) were found to belong to Mycobacterium avium-intracellulare complex (MAC) species. The other 41 isolates (50.6%) were identified as M. lentiflavum (6.2%), M. terrae complex (4.9%), M. paraense (4.9%), M. kansasii (3.7%), M. moriokaense (3.7%), M. asiaticum (2.5%), M. novocastrense (2.5%), M. brasiliensis (2.5%), M. elephantis (2.5%), M. paraffinicum (1.2%), M. bohemicum (1.2%), M. manitobense (1.2%), M. intermedium (1.2%), M. tuberculosis complex (1.2%), M. parakoreense (1.2%), M. florentinum (1.2%), M. litorale (1.2%), M. fluoranthenivorans (1.2%), M. sherrisii (1.2%), M. fortuitum (1.2%) and M septicum (1.2%). Two isolates (2.5%) could not be identified, but were closely related to M. montefiorense and M. phlei respectively. Interestingly, the MAC species were the commonest NTM during the survey., Conclusion: The study emphasizes the importance of identifying species of NTM in Zimbabwe. Future studies need to ascertain their true diversity and clinical relevance.

Mycobacterium species are naturally found in the environment as well as in domestic animals such as cattle. So far, more than 150 species of Mycobacterium, some of which are pathogenic, have been identified. Laboratory isolation, detection and identification of Mycobacterium species are therefore critical if human and animal infections are to be controlled. The objective of this study was to identify Mycobacterium species isolated in cattle in Zimbabwe using 16S ribosomal RNA gene amplification and sequencing. A total of 134 cow dung samples were collected throughout Zimbabwe and mycobacteria were isolated by culture. Only 49 culture isolates that were found to be acid-fast bacilli positive by Ziehl-Neelsen staining. The 16S rRNA gene was successfully amplified by PCR in 41 (84%) of the samples. There was no amplification in 8 (16%) of the samples. Out of the 41 samples that showed amplification, 26 (63%) had strong PCR bands and were selected for DNA sequencing. Analysis of the DNA sequences showed that 7 (27%) belonged to Mycobacterium neoaurum, 6 (23%) belonged to Mycobacterium fortuitum, 3 (12%) to Mycobacterium goodii, 2 (1%) to Mycobacterium arupense, 2 (1%) to Mycobacterium peregrinum or M. septicum and 1 isolate (0.04%) to Mycobacterium elephantis. There were 5 (19%) isolates that were non-mycobacteria and identified as Gordonia terrae, a close relative of Mycobacterium. The study therefore provided a molecular basis for detection and identification of Mycobacterium species in animals and humans.

Background: Rubella is a disease of public health significance owing to its adverse effects during pregnancy and on pregnancy outcomes. Women who contract rubella virus during pregnancy may experience complications such as foetal death or give birth to babies born with congenital rubella syndrome. Vaccination against rubella is the most effective and economical approach to control the disease, and to avoid the long term effects and high costs of care for children with congenital rubella syndrome as well as to prevent death from complications. Zimbabwe commenced rubella surveillance in 1999, despite lacking a rubella vaccine in the national Expanded Programme on Immunization, as per the World Health Organization recommendation to establish a surveillance system to estimate the disease burden before introduction of a rubella vaccine. The purpose of this analysis is to describe the disease trends and population demographics of rubella cases that were identified through the Zimbabwe national measles and rubella case-based surveillance system during a 5-year period between 2007 and 2011., Methods: Data from the Zimbabwe National Measles Laboratory for the 5-year study period were analysed for age, sex, district of origin, seasonality, and rubella IgM serostatus., Results: A total of 3428 serum samples from cases of suspected measles in all administrative districts of the country were received by the laboratory during this period. Cases included 51% males and 49% females. Of these, 2999 were tested for measles IgM of which 697 (23.2%) were positive. Of the 2302 measles IgM-negative samples, 865 (37.6%) were rubella IgM-positive. Ninety-eight percent of confirmed rubella cases were children younger than 15 years of age. Most infections occurred during the dry season., Conclusions: The national case-based surveillance revealed the disease burden and trends of rubella in Zimbabwe. These data add to the evidence for introducing rubella-containing vaccine into the national immunization programme.

Objective: We aimed to perform a risk assessment in a rural setting, where drinking water is obtained from both protected and unprotected deep or shallow wells, boreholes and springs. Water is consumed untreated and this poses a risk of acquiring waterborne infections that may cause diarrhea., Methods: The study included 113 study participants who volunteered in Chiweshe rural community (Musarara village) in Mashonaland Central Province in Zimbabwe. There were 34 (30%) males and 79 (70%) females with ages ranging from 2 to 89 years. HIV counseling was carried out at the communal meeting and testing was done at home visits. Stool and drinking water samples were collected from 104 subjects. Routine laboratory methods were used to examine for parasitic infections., Results: Only 29 (25.7%) of participants were confirmed HIV positive using 2 rapid serology tests; eighty-four (74.3%) were negative. Diarrheic stool samples were observed in 17 (16.3%) participants and of these 5 (29.4%) were HIV seropositive. Several parasites were isolated from stool samples: G. duodenalis 6 (5.7%), E. histolytica/dispar 19 (18.2%), C. parvum, 8 (7.6%) and C. cayetanensis 23 (22.1%). Eleven out of 30 (36.6%) water bodies had protozoan parasites: G. duodenalis 2 (6.6%), E. histolytica 4 (13.3%), C. parvum 1 (3.3%), C. cayetanensis 3 (10%), E. coli 1 (3.3%)., Conclusion: The water sources were being used without treatment and were shown to pose a risk for acquiring diarrheagenic protozoan parasites.

Objective: To establish the extent of GBS colonisation, persistence of colonisation in pregnancy and influence of obstetric history in two diverse communities (rural and urban) in Zimbabwe., Design: Cross sectional survey., Setting: Rutsanana Clinic in Highfield, Harare (representing the urban area) and Chitsungo Mission Hospital in Lower Guruve, (representing the rural area)., Subjects: 300 and 100 pregnant women from the urban and rural areas respectively., Main Outcome Measures: GBS colonisation and persistence rates for both urban and rural areas were established, together with pregnancy outcome., Results: Mother colonisation rate was significantly higher in the rural areas (60%) as compared to the urban areas (46%). GBS colonisation persistence was evidently more in rural (48%) that in urban women (12%). Baby colonisation was also more in the rural (23%) that in urban area (5%). In both the rural and urban areas, flu-like illness was a common feature and was equally reported by the subjects. Vaginal discharge requiring treatment, previous stillbirths and previous miscarriages were equally reported in both communities.

Objective: To establish recovery rates of atypical mycobateria from stools of suspected AIDS patients using culture media., Design: Laboratory evaluation of recovery rates, contamination rates, optimum exposure time and optimum concentration of alkali used for decontamination., Setting: The study was conducted in Harare, Zimbabwe at two medical institutions: Beatrice Road Infectious Diseases Hospital (BRIDH) (a tuberculosis referral hospital) and Mashambanzou Care Unit (MCU) (a home-based care centre)., Subjects: A total of 386 stool specimens from suspected AIDS patients from the two health institutions plus 81 stool specimens from clinically healthy patients were collected. The number of patients from MCU was 144 (49 females, 95 males) and 242 from BRIDH (119 males, 123 females)., Main Outcome Measure: The main goals were to determine optimum exposure time and optimum concentration of alkali used in decontamination and to identify the culture medium with the best recovery rates of atypical mycobacteria., Results: Optimum recovery of atypical mycobacteria was achieved on Peizer TB medium after treating stool specimens with 4% sodium hydroxide for 35 minutes. In addition, the use of Kirchner's medium improved isolation rates, although with a slight increase in contamination at levels of 2.9%., Conclusion: A stool specimen can be used to recover atypical mycobacteria in suspected AIDS patients. Recovery is achieved using Peizer TB medium at a concentration of 4%. Varying the exposure time of the stool specimen to the decontaminating alkali and incorporating antifungal agents and antibiotics into the medium, improves recovery of atypical mycobacteria.

Objective: To compare the in-vitro sensitivity of meropenem with imipenem and other antibiotics against clinically significant bacteria., Design: A longitudinal survey., Setting: Department of Medical Microbiology, in a tertiary care university hospital., Subjects: Specimens obtained from patients attending various clinics at tertiary care and teaching hospital in Harare. Those submitted to the Public Health Bacteriology Laboratory were analysed., Main Outcome Measures: Rates of resistance or susceptibility of the various bacteria to the antibiotics employed in the study., Results: There was excellent in-vitro bacterial activity of meropenem against virtually all clinically significant Gram positive and Gram negative isolates when compared with other antibiotics such as imipenem, ciprofloxacin, gentamicin, penicillin, ampicillin, fusidic acid, tetracyclines, erythromycin and clindamycin (p < 0.5). All isolates of Streptococcus pyogenes, Pseudomonas aeruginosa, Enterobacteriaceae, Neisseria meningitidis were susceptible to meropenem. Meropenem showed 99% overall in-vitro sensitivity against Gram positive and Gram negative bacteria. About 80% of staphylococci were resistant to penicillin whereas at least 20-25% of S. aureus, coagulase negative staphylococci, S. pyogenes showed resistance to ampicillin, erythromycin, gentamicin, tetracycline and clindamycin., Conclusion: Meropenem is not included in the list of routinely tested antibiotics in our laboratory, a major tertiary laboratory in the country. As a result of the ultra-broad spectrum of activity, we recommend its inclusion in our routine antibiotic sensitivity testing and observe that there is a great potential for meropenem in the treatment of infections caused by several genera of bacteria in our environment.

The in-vitro activity of piperacillin/tazobactum which is not among the routinely tested antibiotic at the Public Health Bacteriology Laboratory, Parirenyatwa Hospital, Harare, Zimbabwe was evaluated for its activity against bacterial pathogens using the Kirby-Bauer disk diffusion method. Piperacillin/tazobactum showed superior in-vitro activity against both gram positive and gram negative bacteria when compared with routinely tested antibiotics such as gentamicin, erythromycin, tetracycline, penicillin, chloramphenicol, fusidic acid and clindamycin and the difference was statistically significant (p < 0.05). Ciprofloxacin showed in-vitro activity comparable to that of tazobactam/piperacillin. Specifically, 96% of gram positive isolates (comprising Streptococcus pyogenes, Staphylococcus aureus, coagulase negative staphylococci and Streptococcus pneumoniae were sensitive to piperacillin/tazobactam. For gram negative organisms, 98% of Haemophilus influenzae Shigella spp, Klebsiella spp were also sensitive to the combination. The broad spectrum of activity of piperacillin/tazobactam shows that the potential of the drug combination for the treatment of infections caused by diverse microorganisms should not be underestimated. We recommend its inclusion in routine antibiotic sensitivity testing in our hospital.

The ability of human monocytes to phagocytize and respond to infection by Mycobacterium fortuitum was tested using the method of Crowle and May. The monocytes were obtained from heparinized donor blood samples and separated from lymphocytes by adherence to plastic surfaces. M. fortuitum infection was performed immediately. Intracellular viability was indicated by colony forming units (CFU) done at 2 hour intervals. Monocytes were found to cause a rapid reduction in CFU during the first 2 hours of incubation. The rate of killing of M. fortuitum decreased thereafter but continued for the entire 8-hour study period. In parallel tests, ciprofloxacin and ofloxacin were added to the culture medium. Increased intracellular killing was observed with drug concentrations above 2 x MIC in both cases. Ofloxacin showed better antimycobacterial effects than ciprofloxacin.

Twenty-two strains of Coccidioides immitis were tested for the ability to hydrolyse elastin. Screening assays with Czapek's or Tryptic Soy Agar supplemented with 0.5% elastin demonstrated that 21 strains (95%) were elastolytic. In broth cultures, elastase activity was induced by incorporation of insoluble elastin into the medium and induction was suppressed by supplementation with yeast extract. C. immitis appears to be unique amongst dimorphic fungal pathogens in its digestion of elastin.