25 research outputs found
The impacts of anthropogenic fires in West African savanna woodlands and parklands: the case of the Guinea savanna, Ghana
Fire is recognised as an important factor influencing the structure and function of tropical savannas. Despite the extensive studies conducted on the effects of fire on global savannas, there are relatively few studies focusing on fire-assisted land use practices in the agroforestry parkland of the Sudano-Guinean savannas of West Africa. The region experiences recurrent fires in the dry season which begins from November to April. The fires are anthropogenic and are mainly caused through rural livelihoods and cultural practices such as farming - to remove debris from crop fields and to improve soil fertility and hunting to flush out animals, among other reasons. This study therefore sought to: 1. contribute to the understanding of fire-assisted traditional land use practices, people’s knowledge and perceptions of fire use and fire regime: 2. analyse the effects of fire on vegetation, and 3. determine the effects of fire on soils in the Guinea savanna woodlands and parklands of Ghana. Study sites (burnt and unburnt land use types) were selected based on five-year daily fire counts (2013-2017) data, obtained from the Earth Observation Research and Innovation Centre (EORIC), Ghana in collaboration with the Council for Scientific and Industrial Research (CSIR) Meraka Institute, South Africa. Fire densities were calculated for the 18 districts in the Guinea savanna (Northern Region of Ghana). The districts were stratified into low, medium and high fire frequency areas. The East Gonja district recorded the highest fire density (1.0 fires km-2) while Tamale recorded the lowest fire density (0.3 fires km-2). Of the eighteen districts, six districts were purposively selected and ten communities sampled. Firstly, I investigated the frequency of fire use and control, perceptions of fire regime for selected livelihood and socio-cultural activities in the six districts. The majority of respondents (83%) across the study districts indicated that they used fire once a year for at least one of the following activities: land preparation, weed/grass/pest control, burning stubble after harvest, bush clearing around homesteads, firebreaks, charcoal burning and hunting. The study showed the highest frequency of fire use in the dry season was for land preparation for cropping. However, less than a fifth of the respondents (17%) indicated that they did not use fire for any of the above activities. The results of a multiple regression predicted fire activities in the dry season from gender, age, level of education, occupation and household size. Secondly, the study examined how fire influenced the population structure and abundance of two economically important woody species Vitellaria paradoxa C. F. Gaertn. (Shea tree) and Anogeissus leiocarpa (DC.) Guill. & Perr. (African Birch) in burnt and unburnt land-use types. Stand basal area, mean densities of juveniles and adult trees and Simpson’s index of dominance were determined. Eight diameter size classes of each species were analysed by comparing their observed distributions to a three-parameter Weibull distribution across the land use types. A total of 3,366 individuals of A. leiocarpa (n = 1,846) and V. paradoxa (n = 1,520) were enumerated. The highest total basal area of Anogeissus leiocarpa (16.9 m2/ha) was estimated in sacred groves whereas Vitellaria. paradoxa (20.6 m2 /ha) was found in unburnt woodland. The highest mean densities of A. leiocarpa (22.7±29.7 stems/ha) and V. paradoxa (15.3±2.2 stems/ha) were found in sacred in groves. Anogeissus leiocarpa was, however, absent in fallows and burnt crop fields. A somewhat inverse J-shaped distribution was found in sacred groves for both species. Thirdly, the study compared species composition in early burnt, late burnt and unburnt plots in a protected area where fire was regulated. Vitellaria paradoxa C. F. Gaertn., Terminalia avicennioides Guill. & Perr., Combretum adenogonium Steud. ex A. Rich. and Combretum molle R. Br. Ex. G. Don. were the most common and abundant in all treatments. Late burnt and unburnt plots recorded the lowest diversity amongst the three treatments. Unburnt plots had higher tree density than burnt plots. A Detrended Canonical Analysis showed a changing trend, indicating a moderately strong positive association between burning time and species composition. The first and second axes contributed 53% and 12% variation, respectively. Most of the species found in axis one had fairly strong positive association to early and late burnt treatment than unburnt treatments. Finally, the effects of fire on soil properties in burnt and unburnt crop fields and woodland in the ten communities were also investigated. A total of 151 composite samples in selected burnt and unburnt land use types (burnt crop field n=20; unburnt crop field n=27; burnt woodland n=53, unburnt woodland n=51) were analysed. The variables analysed were pH, soil organic carbon (SOC), total nitrogen (TN), available phosphorous (P), Exchangeable bases - potassium (K), magnesium (Mg), calcium (Ca), cation exchange and soil texture. Total N, SOC, pH and Ca differed significantly across the burnt and unburnt land-use types. A principal component analysis showed a stronger association and more positive gradient in woodlands than in crop fields. Total N showed a positive association with SOC, whereas silt showed a negative association to sand and clay. Traditional knowledge and perceptions of users of savanna agroforestry parklands can inform the formulation of local by-laws for community fire management as well as national policy regulation on fire use in the savanna through the interlinked analysis of social and ecological systems as have been elucidated in this study. The results on vegetation assessment revealed that fire practices and land uses influenced size class distribution of the two study species as well as the densities of woody species in traditional crop fields and the National Park. The unstable populations observed in most land uses and the absence of A. leiocarpa in crop fields and fallows call for education and policy actions on the use of fire in parklands of West Africa. Furthermore, fires positively influenced some soil properties in both woodlands and crop fields confirming one of the emphasised reasons why rural subsistence farmers use fire. As an environmental management decision and land use policy intervention, early dry season burning could be an option to curbing the indiscriminate and unplanned fire use. Also, the protection of trees on farm lands could check the unstable population structure of economically important woody species leading to the different structures that deviated from the recommended reverse J-shaped distribution curve observed in these agroforestry parklands. The management of socio-ecological systems such as the agroforestry parklands of West Africa require a holistic understanding of the complexity of the different resource systems, units and actors involved for sustainable management of these natural resources.Thesis (PhD) -- Faculty of Science, Environmental Science, 202
Keeping Products of Higher Educational Institutions (HEIs) of Relevance to the Industry: A Reason to Stay in Touch with Alumni
This paper aims to show how important it is for Higher Educational Institutions (HEIs) to be involved in the Continuous Professional Development (CPD) of alumni. The authors provide a model to show the value added to the product by CPD. This paper proposes ways in which institutions can make the best of the relationship with the student at each level proposed in the model. The major findings were that HEIs should get involved in CPD for its Alumni and CPD provides increased value to products of HEIs. Implications were that HEIs have a role to play in the CPD of their Alumni. This is the first study to introduce the Value- Adding CPD Knowledge Cycle Model. Keywords: HEI, Products, CPD, Students, Graduates, Alumn
Intermittent Screening and Treatment versus Intermittent Preventive Treatment of Malaria in Pregnancy: Provider Knowledge and Acceptability
Malaria in pregnancy (MiP) is associated with increased risks of maternal and foetal complications. The WHO recommends a package of interventions including intermittent preventive treatment (IPT) with sulphadoxine-pyrimethamine (SP), insecticide-treated nets and effective case management. However, with increasing SP resistance, the effectiveness of SP-IPT has been questioned. Intermittent screening and treatment (IST) has recently been shown in Ghana to be as efficacious as SP-IPT. This study investigates two important requirements for effective delivery of IST and SP-IPT: antenatal care (ANC) provider knowledge, and acceptance of the different strategies. Structured interviews with 134 ANC providers at 67 public health facilities in Ashanti Region, Ghana collected information on knowledge of the risks and preventative and curative interventions against MiP. Composite indicators of knowledge of SP-IPT, and case management of MiP were developed. Log binomial regression of predictors of provider knowledge was explored. Qualitative data were collected through in-depth interviews with fourteen ANC providers with some knowledge of IST to gain an indication of the factors influencing acceptance of the IST approach. 88.1% of providers knew all elements of the SP-IPT policy, compared to 20.1% and 41.8% who knew the treatment policy for malaria in the first or second/third trimesters, respectively. Workshop attendance was a univariate predictor of each knowledge indicator. Qualitative findings suggest preference for prevention over cure, and increased workload may be barriers to IST implementation. However, a change in strategy in the face of SP resistance is likely to be supported; health of pregnant women is a strong motivation for ANC provider practice. If IST was to be introduced as part of routine ANC activities, attention would need to be given to improving the knowledge and practices of ANC staff in relation to appropriate treatment of MiP. Health worker support for any MiP intervention delivered through ANC clinics is critical
Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis
BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London
Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study
Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world.
Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231.
Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001).
Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication
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The bii4africa dataset of faunal and floral population intactness estimates across Africa’s major land uses
Sub-Saharan Africa is under-represented in global biodiversity datasets, particularly regarding the impact of land use on species’ population abundances. Drawing on recent advances in expert elicitation to ensure data consistency, 200 experts were convened using a modified-Delphi process to estimate ‘intactness scores’: the remaining proportion of an ‘intact’ reference population of a species group in a particular land use, on a scale from 0 (no remaining individuals) to 1 (same abundance as the reference) and, in rare cases, to 2 (populations that thrive in human-modified landscapes). The resulting bii4africa dataset contains intactness scores representing terrestrial vertebrates (tetrapods: ±5,400 amphibians, reptiles, birds, mammals) and vascular plants (±45,000 forbs, graminoids, trees, shrubs) in sub-Saharan Africa across the region’s major land uses (urban, cropland, rangeland, plantation, protected, etc.) and intensities (e.g., large-scale vs smallholder cropland). This dataset was co-produced as part of the Biodiversity Intactness Index for Africa Project. Additional uses include assessing ecosystem condition; rectifying geographic/ taxonomic biases in global biodiversity indicators and maps; and informing the Red List of Ecosystems
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
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
Fire use practices, knowledge and perceptions in a West African savanna parkland.
Understanding people's practices, knowledge and perceptions of the use of fire and fire regimes can inform fire management plans that could contribute to savanna conservation and sustainable management. We investigated the frequency of fire use, control and perceptions of fire regimes for selected livelihood and socio-cultural activities in six districts in the Guinea savanna of Ghana. The six districts were selected to have a good representation of fire prone areas in the region based on fire frequency data obtained from the CSIR Meraka Institute, South Africa. A multiple regression analysis showed that people's use of fire for the selected socio-cultural activities from district, occupation, gender, age and ethnic group significantly predicted fire use for the activities R2 = 0.043, F (5,498) = 5.43, p < 0.000. Age and occupation added significantly to the use of fire. The study revealed that the majority of respondents (83%) across the study districts used fire once a year for at least one of the following activities: land preparation, weed/pest control, burning postharvest stubble, bush clearing around homesteads, firebreaks, charcoal burning and hunting. The study also showed a higher frequency of fire use for land preparation for cropping than for the other activities. Less than a fifth of the respondents (17%) indicated that they do not use fire for any of the selected activities. The majority of respondents (65%) mentioned that they controlled their use of fire to prevent destruction to property or injuring humans. The study revealed a higher frequency of fire use in the dry season for land preparation for cropping. However, respondents rated season of burning as the most important attribute, with little attention to the other attributes of a fire regime, contrary to what is theoretically recognized. Understanding traditional fire use practices in terms of how to regulate the mix of frequency, intensity/severity, season, size and type of fire for these and other socio-cultural purposes could help to mitigate and/or manage bushfires in West African savannas and enhance savanna conservation and management. Hence, the need to better understand people's knowledge and perceptions of fire regimes in fire assisted socio-cultural practices in West Africa