High case fatality cholera outbreak in Western Kenya, August 2010

Introduction: Cholera is a disease caused by the bacterium Vibrio cholera and has been an important public health problem since its first pandemic in 1817. Kenya has had numerous outbreaks of cholera ever since it was first detected there during 1971. In August 2010 an outbreak of cholera occurred in Kuria West District spreading to the neighboring Migori District. We conducted an investigation in order to determine the magnitude of the problem and institute control measures. Methods: In order to update the line lists we reviewed records in Migori and Kuria district hospitals and conducted active case search in the community between 30th August and 6th September 2010. Data was analyzed using Epi- Info 3.5.2. Results: A total of 114 cases and with 10 deaths (Case Fatality Rate = 9%) were documented. The index case was an 80 years old woman from Mabera Division who had hosted a cultural marriage ceremony a day before the outbreak. The mean age of case patients was 34.5 years (Standard Deviation=23.4) with a range 5 to 80 years. Females accounted for 61.4% of cases; people aged 10-39 years accounted 46.9%, those 40-69 years accounted for 29.2% and those above 70 years accounted for 9.7% of the cases. Sixty percent of deaths occurred among patients aged 50 years and over, case fatality rate was highest in this age group (16.7%) followed by those aged 40-49 years (12.5%), 20-29 years (10%) and 10-19 years (4.8%). The outbreak was confirmed within 2 weeks of onset after one (16.7%) of the six samples taken tested positive for V. cholera (serotype Inaba).Conclusion: High case fatality rate and late laboratory confirmation was noted in this outbreak. There was urgent need to capacity build the districts on cholera case management, outbreak management, and equip the Migori District Hospital laboratory to allow prompt confirmation.Key words: Outbreak, Kuria West, choler

Evaluation of HIV antigen /antibody combination ELISAs for diagnosis of HIV infection in Dar Es Salaam, Tanzania

Introduction: the aim of this study was to evaluate the performance of Enzygnost HIV Integral II antigen/antibody combination ELISAs in orderto formulate HIV ELISA testing algorithms for the Ministry of Health and Social Welfare, Tanzania. Methods: this was a laboratory-based evaluation of Enzygnost HIV Integral II Antibody/ Antigen, Murex HIV antigen/antibody and Vironostika HIV Uniform II antigen/antibody conducted between October 2011 and May 2012. Results: a total of 600 blood samples were included in the evaluation. A total of 209/596 (35.1%) serum samples were confirmed HIV positive. Of these, the prevalence of HIV infection was 2.3% (3/130), 2.3% (3/127), 2.2% (3/139) and 100% (200/200) for VCT clients, ANC attendees, blood donors and CTC patients, respectively. Three hundred and eighty seven (64.9%) were HIV negative samples. Sensitivity was 100% (95% CI; 98.3-100%) for all the three HIV ELISAs. The specificity for the Enzygnost HIV Integral II and Murex was 100% (95% CI; 99.1-100%). The final specificity at repeat testing was 99.5% (95% CI; 98.2-99.9%) for  Vironostika. Enzygnost HIV Integral II detected HIV infection seven days since first bleed.Conclusion: initial testing using either Vironostika or Murex HIV   antigen/antibody combination ELISA followed by testing of reactive samples on the Enzygnost HIV Integral II gave a sensitivity and specificity of 100% with reduced window period. Combination of two HIV antigen/antibody  combination ELISAs can be used as an alternative confirmatory testing  strategy for screening of donated blood at the National and Zonal blood transfusion centres and in lab diagnosis of HIV infection

Effect of Chemically Modified Banana Fibers on the Mechanical Properties of Poly-Dimethyl-Siloxane-Based Composites

The study presents the mechanical properties of polymer-based composites reinforced with chemically modified banana fibers, by alkalization in different concentrations of sodium hydroxide (NaOH). The fiber weight fraction has a great effect on the mechanical properties of the composites. Stiff composites were obtained at 6 wt% fiber fractions with Young’s modulus of 254.00 ±12.70 MPa. Moreover, the yield strength was 35.70 ±1.79 MPa at 6 wt% fiber fractions. However, the ultimate tensile strength (UTS) and toughness of the composites were obtained at 5 wt% fiber fractions. Statistical analyses were used to ascertain the significant different on the mechanical properties of the fibers and composites. The implication of the results is then discussed for potential applications of PDMS-based composites reinforced with chemically modified banana fibers

Pattern of mtDNA Variation in Three Populations from São Tomé e Príncipe

We have analysed the matrilineal genetic composition of three self-reported ethnic groups from São Tomé e Príncipe (Gulf of Guinea), an African archipelago whose settlement begun in the late fifteenth century. Sequence data from the hypervariable segments I (HVS-I) and II (HVS-II) were obtained for 30 Angolares, 35 Forros and 38 Tongas. The repertory of mtDNA lineages in São Tomé e Príncipe denoted a fully African maternal pool, primarily arisen from a Central/Southwestern substratum. The absence of any lineages of putative European descent means that the European impact at the mitochondrial pool was virtually nil. Angolares showed a clear reduction of mtDNA diversity and a slight genetic differentiation relative to Tongas or Forros, whereas the latter two groups did not present any signs of genetic boundaries between each other. The data obtained here reinforce the depiction of genetic substructuring in São Tomé e Príncipe previously derived from Y-chromosome STRs. In addition, the crossing of mtDNA and Y-STR information led to the inference that the female mediated gene flow within the archipelago was less restricted than the male, a pattern that could be framed in the cultural traditions and socio-historical interactions among the groups

Applying artificial intelligence to determination of legal age of majority from radiographic

Forensic odontologists use biological patterns to estimate chronological age for the judicial system. The age of majority is a legally significant period with a limited set of reliable oral landmarks. Currently, experts rely on the questionable development of third molars to assess whether litigants can be prosecuted as legal adults. Identification of new and novel patterns may illuminate features more dependably indicative of chronological age, which have, until now, remained unseen. Unfortunately, biased perceptions and limited cognitive capacity compromise the ability of researchers to notice new patterns. The present study demonstrates how artificial intelligence can break through identification barriers and generate new estimation modalities. A convolutional neural network was trained with 4003 panoramic-radiographs to sort subjects into 'under-18' and 'over-18' age categories. The resultant architecture identified legal adults with a high predictive accuracy equally balanced between precision, specificity and recall. Moving forward, AI-based methods could improve courtroom efficiency, stand as automated assessment methods and contribute to our understanding of biological ageing.</p

Risk factors associated with multidrug resistant tuberculosis among patients referred to Kibong’oto Infectious Disease Hospital in northern Tanzania

Background: Multidrug resistant tuberculosis (MDR-TB) remains is an important public health problem in developing world. We conducted this study to determine risk factors associated with MDR-TB and drug susceptibility pattern to second line drug among MDR TB patients in Tanzania.Methods: Unmatched case control study was conducted at Kibong’oto Infectious Diseases Hospital in Tanzania in 2014. A case was defined as any patient whose sputum yielded Mycobacterium tuberculosis that were resistance to at least rifampin (RFP) and isoniazid (INH) whereas control was defined as those sensitive to rifampin (RFP) + isoniazid (INH).  One morning sputum sample was collected from each study subject and cultured on Löwenstein-Jensen (LJ) media for M. tuberculosis. Drug susceptibility testing of isolated M. tuberculosis was done for rifampicin, isoniazid, kanamycin and ofloxacin. A semi-structured questionnaire was used to collect socio-demographic and risk factors information for MDR-TB. Results: A total of 102 cases and 102 controls were enrolled. The predominant age group was 31- 40 years, of whom cases and controls accounted for 38 (37.3%) and 35 (34.3%) of the study subjects, respectively. Majority of participants (69% cases and 71% control) were males and self-employed (62.7% cases and 84.4% controls). More than half (52%) and approximately a quarter (24.5%) of cases and control had HIV infection, respectively. About two-thirds of cases (62.7%) were cigarette smokers compared to controls (42.2%). Previous history of TB treatment accounted for approximately three folds in cases (72.5%) and only 24.5% in controls. Risk factors independently associated with MDR-TB were previous history of treatment with first line anti-TB (OR= 3.3, 95% CI 1.7-6.3), smoking (OR=1.9, 95% CI 1.0-3.5), contact with TB case (OR=2.7, 95% CI 1.4-5.1) and history of TB. All MDR TB isolates were sensitive to kanamycin and ofloxacin.Conclusion: MDR-TB among patients referred to Kibong’oto Infectious Diseases Hospital is associated with previous history of TB contact, smoking habit, and contact with TB case. All MDR TB isolates were sensitive to the tested second line drugs, Kanamycin and Ofloxacin

Brucellosis in Terekeka County, Central Equatoria State, Southern Sudan

Objectives: To identify factors associated with Brucellosis in patients attending Terekeka Health Facility, Terekeka County, Central Equatoria State, Southern Sudan and to evaluate the utility of the rapid test kit Euracil®.Design: A facility based case-control study.Setting: Terekeka Health Facility, Terekeka County, Central Equatoria State, Southern Sudan.Subjects: Cases were patients presenting at the Terekeka Health Facility with clinical symptoms suggestive of Brucellosis and tested positive for Brucellosis by rapid antigen test while controls were selected from individuals attending Terekeka Health facility with health problems unrelated to brucellosis or febrile illness.Results: A total of fifty eight cases with clinical symptoms suggestive of and tested positive for Brucellosis by rapid antigen test presented. A total of 116 consented controls were recruited into the study. Males accounted for 52% of the cases and 53% of the controls. The mean age was 31 years for both groups. Cases without formal education were 84% while 40% had no source of income, 20% of the cases and 14% of the controls were cattle keepers while 5% of the cases and 13% of the controls were students. In multivariate analysis there were many factors associated with Brucellosislike consumption of raw meat, living with animals at the same place, raising of goats, farm cleaning contact, eating of aborted and wild animals. Logistic regression revealed two factors associated with the disease; consumption of raw milk (OR=3.9, P-value 0.001, 95% CI 1.6666 - 9.0700) was a risk factor while drinking boiled milk was protective(OR= 0.09, p- value 0.000, 95% CI, 0.1 - 0.2).Conclusions: The main age-groups affected were 20 – 30 years with males being affected more than females. Drinking of raw milk was significantly associated with Brucellosis while drinking boiled milk was protective. There should be active public health education on the benefits of boiling milk before consumption. Further studies to elucidate the extent and epidemiology of brucellosis in humans and animals in Southern Sudan are recommended

Spatial variation in leopard (Panthera pardus) site use across a gradient of anthropogenic pressure in Tanzania's Ruaha landscape

Understanding large carnivore occurrence patterns in anthropogenic landscapes adjacent to protected areas is central to developing actions for species conservation in an increasingly human-dominated world. Among large carnivores, leopards (Panthera pardus) are the most widely distributed felid. Leopards occupying anthropogenic landscapes frequently come into conflict with humans, which often results in leopard mortality. Leopards’ use of anthropogenic landscapes, and their frequent involvement with conflict, make them an insightful species for understanding the determinants of carnivore occurrence across human-dominated habitats. We evaluated the spatial variation in leopard site use across a multiple-use landscape in Tanzania’s Ruaha landscape. Our study region encompassed i) Ruaha National Park, where human activities were restricted and sport hunting was prohibited; ii) the Pawaga-Idodi Wildlife Management Area, where wildlife sport hunting, wildlife poaching, and illegal pastoralism all occurred at relatively low levels; and iii) surrounding village lands where carnivores and other wildlife were frequently exposed to human-carnivore conflict related-killings and agricultural habitat conversion and development. We investigated leopard occurrence across the study region via an extensive camera trapping network. We estimated site use as a function of environmental (i.e. habitat and anthropogenic) variables using occupancy models within a Bayesian framework. We observed a steady decline in leopard site use with downgrading protected area status from the national park to the Wildlife Management Area and village lands. Our findings suggest that human-related activities such as increased livestock presence and proximity to human households exerted stronger influence than prey availability on leopard site use, and were the major limiting factors of leopard distribution across the gradient of human pressure, especially in the village lands outside Ruaha National Park. Overall, our study provides valuable information about the determinants of spatial distribution of leopards in human-dominated landscapes that can help inform conservation strategies in the borderlands adjacent to protected areas

Harmless or Threatening? Interpreting the Results of Molecular Diagnosis in the Context of Virus-Host Relationships

Molecular methods, established in the 1980s, expanded and delivered tools for the detection of vestigial quantities of nucleic acids in biological samples. Nucleotide sequencing of these molecules reveals the identity of the organism it belongs to. However, the implications of such detection are often misinterpreted as pathogenic, even in the absence of corroborating clinical evidence. This is particularly significant in the field of virology where the concepts of commensalism, and other benign or neutral relationships, are still very new. In this manuscript, we review some fundamental microbiological concepts including commensalism, mutualism, pathogenicity, and infection, giving special emphasis to their application in virology, in order to clarify the difference between detection and infection. We also propose a system for the correct attribution of terminology in this context.info:eu-repo/semantics/publishedVersio

Training in women soccer players: A systematic review on training load monitoring

ObjectiveThe present systematic review aimed to provide an overview of training load (TL), along with their responses, monitoring during training sessions in highly trained and elite adult women soccer players.Data sourceElectronic databases searches (PubMed, Scopus, Web of Science and Ebsco) for relevant studies published in peer-reviewed journals were conducted, and eligibility criteria were based on the PICOS model in accordance with PRISMA guidelines.Study selectionStudies were considered as follows: (a) highly trained and elite adult (&gt;18 years) women’s soccer players; (b) continuous (minimum 1-week duration) TL monitoring in the context of the team routine; (c) TL collected from entire training session. Methodological qualitative assessments and risk of bias criteria were used for judging the studies.Data extractionA total of 1,163 studies were identified, and 16 were included. The selected studies were fully screened to extract the population characteristics; the number of players; a type of study design; region where the study was performed; the main findings.Data synthesisAccumulated external TL (ETL) during the pre-season was positively correlated to enhanced adaptations in intermittent exercise capacity. Daily ETL was negatively correlated to next-day self-reported fatigue and muscle soreness. Daily internal TL (ITL) was negatively correlated to post-session sleep duration and sleep efficiency. One study showed that higher accumulated player load and total distance were associated with injury.ConclusionInformation about TL during training sessions in women soccer players is very sparse, and it is currently very difficult to consider evidence-based practices for training sessions in highly trained and elite adult women soccer players. Moreover, the dose–response relationships between TL and training outcome (e.g., fatigue, training adaptations and injuries) need to be further explored to understand the optimal training stimulus to enhance performance outcomes while preserving player health