Fibronectin and its effect on immune system activity in infants in the neonatal period

Scientific supervisor: O. Romanju

Dialogue to address the roots of resource competition: Lessons for policy and practice

Conflict management is an intrinsic element of natural resource management, and becomes increasingly important amid growing pressure on natural resources from local uses, as well as from external drivers such as climate change and international investment. If policymakers and practitioners aim to truly improve livelihood resilience and reduce vulnerabilities of poor rural households, issues of resource competition and conflict management cannot be ignored. This synthesis report summarizes outcomes and lessons from three ecoregions: Lake Victoria, with a focus on Uganda; Lake Kariba, with a focus on Zambia; and Tonle Sap Lake in Cambodia. Partners used a common approach to stakeholder engagement and action research that we call “Collaborating for Resilience”. In each region, partners assisted local stakeholders in developing a shared understanding of risks and opportunities, weighing alternative actions, developing action plans, and evaluating and learning from the outcomes. These experiences demonstrate that investing in capacities for conflict management is practical and can contribute to broader improvements in resource governance

Can Sustainable Agriculture Practices Remedy the Negative Effects of Climate Change on Food Security in Zambia?

Some climate change arises from natural factors such as changes in the sun’s intensity, the earth-sun distance and the earth’s orbit around the sun. This natural climate change is slow, small and has been always there. This is termed climate variability. However, it is the increased human activities (notably industrial, agricultural and land use) that are changing the composition of the Earth’s atmosphere at an unprecedented pace.4 The discussions in this report are limited to the agricultural and land use aspects of climate change. The State of Environment in Zambia (2000) also alludes to the fact that climate change refers to any change in classical 30-year climatology regardless of its causes. This sets the minimum timeline within which this study addresses climate change and food security in Zambia.This report was commissioned by the Jesuit Centre for Theological Reflection (JCTR) to inform advocacy and communication on conditions relating to food security and climate change. The study was undertaken during the period that the National Climate Change Response Strategy and its Communication Strategy were being formulated by the Ministry of Tourism, Environment and Natural Resources. As such, this study will in some way, complement their consultation processes

Knowledge of pregnant women regarding prevention of mother-to-child transmission of HIV infection in Gert Sibande District, Mpumalanga Province, South Africa: A qualitative study

Background. Prevention of mother-to-child transmission (PMTCT) of HIV helps in closing the gaps for new HIV infections, thereby contributing to achieving the global targets of an AIDS-free generation. Objective. To explore knowledge regarding PMTCT among pregnant women in Gert Sibande District, Mpumalanga Province, South Africa (SA). Methods. The study was performed in two clinics in Chief Albert Luthuli Municipality, Gert Sibande District. It was a qualitative and descriptive exploratory study involving in-depth, one-on-one interviews with pregnant women regarding their PMTCT knowledge and perspectives. Results. The study findings showed that pregnant women from the two clinics have a good knowledge of PMTCT. However, they were not aware that caesarean section can minimise mother-to-child transmission (MTCT) of HIV infection. Conclusion. PMTCT is important in establishing an HIV-free generation. The study revealed that women had a good understanding of MTCT; nevertheless, additional education is necessary, particularly regarding birthing procedures that minimise the risk of MTCT

Prevalence and risk factors for Betaherpesvirus DNAemia in children >3 weeks and <2 years of age admitted to a large referral hospital in sub-Saharan Africa

Background. Betaherpesviruses are established causes of morbidity and mortality in immunosuppressed patient groups but have been little studied in sub-Saharan Africa, the epicenter of the human immunodeficiency virus (HIV) pandemic. In this region, primary infections with human cytomegalovirus (HCMV) and human herpesvirus type 6 (HHV-6) type 6 are endemic in infancy, but the clinical impact of these infections among pediatric inpatient groups is poorly characterized and assumptive, based largely on data from Western populations. Methods. We used TaqMan polymerase chain reaction to screen sera from a group of 303 pediatric inpatients aged between 3 weeks and 2 years, at the University Teaching Hospital in Lusaka, Zambia. We report the prevalence of DNAemia and viral loads within this patient group, and evaluate possible clinical associations/risk factors for betaherpesvirus infections in these hospitalized children. Results. We detected betaherpesvirus DNAemia in 59.1% (179/303) of children. HCMV was the most prevalent (41.3%), followed by HHV-6B (20.5%), HHV-7 (20.1%), and HHV-6A (0.3%). HIV infection (odds ratio OR], 2.31; 95% confidence interval CI], 1.37-3.90; P = .002), being underweight (OR, 1.82; 95% CI, 1.06-3.12; P = .03), and an admission diagnosis of suspected meningitis (OR, 5.72; 95% CI, 1.07-30.5; P = .041) were independently associated with an increased odds of HCMV DNAemia. Conversely, HHV-6B and HHV-7 DNAemia were not associated with HIV, underweight, or admission diagnosis. Median HCMV viral load was moderately but significantly higher in HIV-infected children. Conclusions. Highly prevalent HCMV DNAemia was independently associated with HIV infection and being underweight across all age groups, and was also associated with meningitis, with previously underappreciated implications for the health and development of African children

Factors contributing to low attendance at mwami family planning clinic.

The objective of the study is to determine the factors contributing to low attendance at Mwami Family Planning Clinic, in order to find solutions to the problem. The literature survey shows that the problems of low attendance at Family Planning Clinics seem to be similar in most countries. A few problems cited in the literature include traditional values, misconception about Family Planning in terms of side effects and emphasis in urban than rural areas. A randomly selected sample of 5O women of child bearing age was selected from clinics - antenatal, family planning and children's. Data was collected in April 1991 using an interview schedule since most of the respondents were of low educational level. In the study infornation from women about number of children they had, who decided on how many children to have, their knowledge about family planning, and reasons for not practicing family planning was established. Some of the major findings in this study were: majority of women were not practicing family planning, and the main reason for not practicing being that they still wanted to have children. The study also found out that these women were using other forms of traditional methods of family planning

The nature of compact radio-loud AGN: a systematic look at the LOFAR AGN population

© 2024 The Author(s). Published by Oxford University Press on behalf of Royal Astronomical Society. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY), https://creativecommons.org/licenses/by/4.0/We investigate the nature of low-luminosity radio-loud active galactic nuclei (RLAGN) selected from the LOFAR Two-metre Sky Survey (LoTSS) first data release (DR1). Using optical, mid-infrared, and radio data, we have conservatively selected 55 radiative AGN candidates from DR1 within the redshift range $0.03$$1-3$ kpc, 42 are compact at the limiting resolution of 0.35 arcsec (taking an upper limit on the projected physical size, this corresponds to less than 1 kpc), and three are undetected. The extended objects display a wide range of radio morphologies: two-jet (5), one-jet (4), and double-lobed (1). We present the radio spectra of all detected radio sources which range from steep to flat/inverted and span the range seen for other compact radio sources such as compact symmetric objects (CSOs), compact steep spectrum (CSS) sources, and gigahertz peaked-spectrum (GPS) sources. Assuming synchrotron self-absorption (SSA) for flat/inverted radio spectrum sources, we predict small physical sizes for compact objects to range between $2-53$ pc. Alternatively, using free-free absorption (FFA) models, we have estimated the free electron column depth for all compact objects, assuming a homogeneous absorber. We find that these objects do not occupy a special position on the power/linear size ($P-D$) diagram but some share a region with radio-quiet quasars (RQQs) and so-called `FR0' sources in terms of radio luminosity and linear size.Peer reviewe

Surveillance of molecular markers for antimalarial resistance in Zambia: Polymorphism of Pfkelch 13, Pfmdr1 and Pfdhfr/Pfdhps genes

Antimalarial resistance is an inevitable feature of control efforts and a key threat to achieving malaria elimination. Plasmodium falciparum, the deadliest of several species causing human malaria, has developed resistance to essentially all antimalarials. This study sought to investigate the prevalence of molecular markers associated with resistance to sulfadoxine-pyrimethamine (SP) and artemether-lumefantrine (AL) in Southern and Western provinces in Zambia. SP is used primarily for intermittent preventive treatment during pregnancy, while AL is the first-line antimalarial for uncomplicated malaria in Zambia. Blood samples were collected from household members of all ages in a cross-sectional survey conducted during peak malaria transmission, April to May of 2017, and amplified by polymerase chain reaction (PCR). Amplicons were then analysed by high-resolution melt following PCR to identify mutations associated with SP resistance in the P. falciparum dihydrofolate reductase (Pfdhfr) and P. falciparum dihydropteroate synthase (Pfdhps) genes and lumefantrine resistance in the P. falciparum multi-drug resistance 1 (Pfmdr1) gene. Finally, artemether resistance was assessed in the P. falciparum Kelch 13 (PfK13) gene using nested PCR followed by amplicon sequencing. The results showed a high frequency of genotypic-resistant Pfdhps A437G (93.2%) and Pfdhfr C59R (86.7%), N51I (80.9%), and S108N (80.8%) of which a high proportion (82.4%) were quadruple mutants (Pfdhfr N51I, C59R, S108N +Pfdhps A437G). Pfmrd1 N86Y, Y186F, and D1246Y - NFD mutant haplotypes were observed in 41.9% of isolates. The high prevalence of quadruple dhps/dhfr mutants indicates strong antifolate drug pressure from SP or other drugs (e.g., co-trimoxazole). Three samples contained PfK13 mutations, two synonymous (T478 and V666) and one non-synonymous (A578S), none of which have been associated with delayed clearance. This suggests that artemisinin remains efficacious in Zambia, however, the moderately high prevalence of approximately 40% Pfmdr1 NFD mutations calls for close monitoring of AL.publishedVersio

Diagnosis of rifampicin-resistant tuberculosis: Discordant results by diagnostic methods.

The performance of the Xpert© MTB/RIF and MTBDRplus assays for the detection of rifampicin resistant Mycobacterium tuberculosis was compared to culture-based drug susceptibility testing in 30 specimens with rifampicin-resistant and rifampicin-indeterminate Xpert MTB/RIF results collected between March 2012 and March 2014. Xpert MTB/RIF and MTBDRplus were 100% sensitive and 100% concordant for rifampicin resistance detection, but 3 of 13 samples (23%) positive for rifampicin resistance on Xpert MTB/RIF and MTBDRplus were negative for rifampicin resistance on mycobacteria growth indicator tube drug susceptibility testing. Specificity was 72% for Xpert MTB/RIF and 80% for MTBDRplus. Positive predictive value for Xpert MTB/RIF for multidrug resistant tuberculosis was 47.8% for new patients and 77.8% for previously treated patients; negative predictive value was 100% for both new and previously treated patients. The discordant rifampicin resistance test results indicate a need to fully characterise circulating rifampicin resistant Mycobacterium tuberculosis strains in Zambia and to inform the development of guidelines for decision-making in relation to diagnosis of drug-resistant tuberculosis

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century