Improved Malaria Case Management through the Implementation of a Health Facility-Based Sentinel Site Surveillance System in Uganda

Heath facility-based sentinel site surveillance has been proposed as a means of monitoring trends in malaria morbidity but may also provide an opportunity to improve malaria case management. Here we described the impact of a sentinel site malaria surveillance system on promoting laboratory testing and rational antimalarial drug use.Sentinel site malaria surveillance was established at six health facilities in Uganda between September 2006 and January 2007. Data were collected from all patients presenting to the outpatient departments including demographics, laboratory results, diagnoses, and treatments prescribed. Between the start of surveillance and March 2010, a total 424,701 patients were seen of which 229,375 (54%) were suspected of having malaria. Comparing the first three months with the last three months of surveillance, the proportion of patients with suspected malaria who underwent diagnostic testing increased from 39% to 97% (p<0.001). The proportion of patients with an appropriate decision to prescribe antimalarial therapy (positive test result prescribed, negative test result not prescribed) increased from 64% to 95% (p<0.001). The proportion of patients appropriately prescribed antimalarial therapy who were prescribed the recommended first-line regimen artemether-lumefantrine increased from 48% to 69% (p<0.001).The establishment of a sentinel site malaria surveillance system in Uganda achieved almost universal utilization of diagnostic testing in patients with suspected malaria and appropriate decisions to prescribed antimalarial based on test results. Less success was achieved in promoting prescribing practice for the recommended first-line therapy. This system could provide a model for improving malaria case management in other health facilities in Africa

Contributions of organic matter, clay and silt to the effective CEC of soils of different land use history

This study examined the contributions of organic matter (OM), clay and silt to the effective cation exchange capacity (ECEC) of soils of different land use history, in order to determine the influence of land use on the contributions of the various fractions to the ECEC of the soils. The land use types examined were sole cassava (C), sole pigeon pea (P), mixed cropping of cassava and pigeon pea (C + P), natural fallow land (FA) and forestland (FO). The results showed that in FA and FO, the OM fraction contributed more to the ECEC compared to the other fractions. The contribution of clay was more visible in the legume-based cropping systems, while that of silt was more pronounced in C. The average contribution of OM to ECEC was 54%, while that of silt and clay were 26% and 20%, respectively. Thus the OM fraction gave better predictions of ECEC than the particle size fractions in an Alfisol of southeastern Nigeria. The low contribution of clay to ECEC recorded in this study may be due to low activity clay dominant in the clay mineralogy of the soil

Fluctuations in the Characteristics of an Important Short Tropical Season, `August Break' in Eastern Nigeria

Available rainfall and relative humidity data (18 years), maximum and minimum temperature (14 years), sunshine hours (13 years) and evapotranspiration (Eight years) from the University of Nigeria, Nsukka meteorological station were analyzed in this study. The objectives were to obtain the probability of occurrence of `August Break' and assess relationships and fluctuations in the characteristics of `August Break' dry spell in the area. The study revealed that `August Break' could occur in the months of June (probability = 0.25), July (probability = 0.31) and August (probability = 0.44). In terms of the absolute values of the mean monthly rainfall and number of rain days as well as moisture balance and relative humidity, June is the driest month followed by July then August. Thus, the adoption of the term `August Break' could have been drawn from the observed frequency of occurrence rather than the overall moisture balance. The mean monthly rainfall data from `August Break' months significantly (P = 0.05) correlated with those of the months of July, August and December while the mean relative humidity in August significantly (P=0.05) correlated with those of May, September and October. The mean relative humidity of May also significantly correlated with that of July. The implications of the fluctuations in the characteristics of this dry spell on agricultural and outdoor activities in the area are discussed. Key words: August break, occurrence, fluctuation, Nigeria Rsum Au cours de la prsente tude, des donnes disponibles sur les prcipitations pluviomtriques et l'humidit relative (18 ans), les tempratures maximales et minimales (14 ans), les heures d'ensoleillement (13 ans) et l'vapotranspiration (8 ans) obtenues de Nsukka, une station mtorologique de l'universit du Nigeria, ont fait objet d'analyse. Les objectifs taient d'obtenir la probabilit de l'incidence de l'intermittence du mois d'aot et valuer les rapports et les fluctuations dans les caractristiques de la priode sche d'aot dans la rgion. L'tude a indiqu que dans cette rgion, l'intermittence du mois d'aot pourrait mme se produire en juin (P = 0,25), en juillet (P = 0,31) et en aot (P = 0,44). En termes de valeurs absolues des prcipitations moyennes mensuelles et du nombre de jours pluvieux, de l'humidit totale et l'humidit relative, juin se prsente comme le mois le plus sec suivi des mois de juillet et enfin d'aot. Ainsi l'adoption du terme intermittence du mois d'aot `pourrait avoir t tire plutt de la frquence observe de l'incidence que de la balance hydrique totale. Les donnes sur les prcipitations mensuelles moyennes des mois d'aot ont corrl de manire significative (P = 0,05) avec celles des mois de juillet, d'aot et de dcembre, tandis que l'humidit relative moyenne du mois d'aot corrlait de manire significative (P=0,05) avec celle de mai, septembre et d'octobre. De mme l'humidit relative moyenne de mai a sensiblement corrl avec celle de juillet. Les effets des fluctuations de ces indicateurs au cours de cette priode sche sur les activits agricoles et autres activits diverses dans la rgion sont discutes. Mots cls: intermittence du mois d'aot, incidence, fluctuation, Nigeria (Discovery and innovation: 14(1-2): 92-101

The contibutions of soil properties to cassava yield parameters in Sub-Saharan Africa

The Collaborative Study of Cassava in Africa (COSCA) undertook cassava yield and soil fertility surveys in sub-Saharan Africa in 1991 with the objectives of obtaining average yields from farmers' fields and determining factors which could account for the yield differences across the various climate, altitude, population density and market access zones - the site selection factors considered in the study. In this analysis, the contributions of various soil properties determined from the fields were also obtained and evaluated. The cassava yield parameters considered were fresh root and shoot weight, harvest index and cassava stand density. The interaction between the site selection factors had a greater significant effect on the yield parameters than the individual factors. Whereas the effect of climate was not significant (P = 0.1), both climate x market access and population x market access interactions were highly significant (P &#61603; 0.01) on root yield. The overall mean root yield was estimated as 13.1 t/ha. It was highest in the subhumid followed by nonhumid and lowland humid zones, and least in the highland humid zone. It was significantly (P &#61603; 0.05) higher (13.6 t/ha) in the low altitude zones than in the mid (8.5 t/ha) altitude zones. The results of stepwise regression analysis showed that the total contribution of soil variables to root yield variations ranged from about 30% for the entire sub-region through 32% in the lowland and about 40% in nonhumid zones to more than 45% in the highland humid zones. The contribution of total sulphur to the total variations in root yield was consistently high in both the sub-region and across the climate zones compared to other soil variables evaluated. The overall contributions of the soil variables to shoot yield, harvest index and stand density were approximately 35%, 30% and 50%, respectively. Though the contributions of the soil properties to cassava performance confirmed that other factors are also important in cassava production, the significant roles of individual soil variables both in the sub-region and across the climate zones have been established. Keywords: cassava, soil properties, regression, subSaharan Africa> Agro-Science Vol. 6 (1) 2007: pp. 1-1