Rapid assessment for prioritisation of trachoma control at community level in one district of the Kaolack Region, Senegal.

The objective of this study was to use a modified Lot Quality Assurance Sampling methodology to classify communities according to prevalence of active trachoma and to estimate the prevalence of trachoma and trichiasis in Nioro department, Kaolack Region, Senegal. A survey was conducted using two-stage cluster sampling to select 50 children aged 2-5 years in each of 33 clusters. In total 1,648 children were examined for active trachoma. Information on trachoma risk factors was collected through interviews with the mother or the household head of the child. Adults (>40 years) with trichiasis were identified through case finding. Nineteen clusters had a low prevalence of active trachoma in children aged 2-5 years (40%). The prevalence of active trachoma in children aged 2-5 years was 17.4% (95% CI 12.9-21.8%). Multivariate-adjusted predictors of active trachoma were: age, facial cleanliness, hygiene practices and keeping cattle in the household. The prevalence of trichiasis in adults aged over 40 years was 1.77% (95% CI 1.24-2.51), equating to 985 adults (95% CI 765-1250) with trichiasis in Nioro department. In conclusion, a survey using rapid methodology showed that trachoma is a problem of public significance in Nioro department, Senegal

On trial: agricultural biotechnology in Africa

Increasing agricultural productivity and adapting farming to climate change are central to Africa’s development prospects. There are important opportunities to enhance yields and increase resilience through the adoption of improved crop varieties. In some cases, biotechnology, and in particular genetic modification (GM), offers advantages over conventional plant-breeding approaches. Accordingly there are a various projects under way to develop new GM varieties for African farmers, ranging from drought-resistant maize to varieties of cassava, banana, sorghum, cowpea and sweet potato with resistance to pests and disease. In addition to government funds, these projects have also attracted the support of influential donor agencies and philanthropic foundations. However, despite the expenditure of considerable resources, the potential of GM in Africa is not being realized. So far no GM trait developed for African farmers has been put to use. Multiple barriers inhibit the development and adoption of pro-poor GM varieties in Africa. On the demand side, farmers may be reluctant to adopt GM varieties owing to a lack of export opportunities and distrust of the technology among local consumers. Farmers may also be concerned about exploitation by transnational seed companies (despite the fact that development of new GM technologies in Africa is dominated by the public sector). On the supply side, donor funding struggles to match the long timescales of research and development, while incentives among research scientists may be poorly aligned with farmer outcomes. Non-existent, poorly functioning or overly punitive regulatory regimes discourage investment. The most important barriers – such as regulatory constraints, consumer distrust and weak farmer demand – must be understood in the context of wider social and political dynamics surrounding GM, typified by misinformation, polarized public discourse, and dysfunctional and opportunistic politics. The result is most GM projects becoming ‘stuck’ at the field trial stage without ever progressing to release. This ‘convenient deadlock’ of continual field trials allows governments to manage political risks by effectively balancing the demands of pro-GM and anti-GM lobbies – proponents of GM have a pipeline of technologies, while opponents are appeased by the failure of any to gain approval. The disabling socio-political environment for GM development in Africa greatly reduces the efficacy of investment in this technology. This has two important implications. First, technology development needs to be located within a wider project of transformation that engages key actors – most notably politicians, policy-makers and farmers – as stakeholders from the outset, and includes strategies to address multiple demand- and supply-side barriers. Second, successful adoption is more likely in countries with less disabling political conditions, characterized by lower levels of consumer distrust and opposition, genuine farmer demand and demonstrable commitment from government. Focusing efforts and resources on a small number of ‘best bet’ countries will also allow donors and technology providers to support more ambitious, transformational projects led by national governments

An outbreak of acute haemorrhagic conjunctivitis associated with coxsackievirus A24 variant in The Gambia, West Africa.

OBJECTIVE: An outbreak of acute haemorrhagic conjunctivitis occurred in The Gambia, West Africa in 2011. Affected individuals presented with conjunctival haemorrhages, swelling and ocular discharge. In an effort to identify a causative agent of the disease, ocular swabs were taken from patients during the acute and convalescent phases. Total RNA was extracted from all samples and reverse-transcriptase PCR performed using primers specific for all enteroviruses. Resulting amplicons were sequenced and data compared to known sequences using the BLAST algorithm. RESULTS: Forty-eight swabs were included in the analysis. Of these, 21 acute and 9 convalescent swabs (65% of the total) gave positive PCR results. Sequence analysis of the resulting amplicons indicated 99% sequence identity with coxsackievirus A24 variant identified during independent outbreaks of acute haemorrhagic conjunctivitis around the world and suggest the Gambian outbreak was due to this virus

Clustering in 18O - absolute determination of branching ratios via high-resolution particle spectroscopy

The determination of absolute branching ratios for high-energy states in light nuclei is an important and useful tool for probing the underlying nuclear structure of individual resonances: for example, in establishing the tendency of an excited state towards α -cluster structure. Difficulty arises in measuring these branching ratios due to similarities in available decay channels, such as ( 18 O, n ) and ( 18 O, 2 n ), as well as differences in geometric efficiencies due to population of bound excited levels in daughter nuclei. Methods are presented using Monte Carlo techniques to overcome these issues

Students’ perceptions on their use of an EHR: pilot questionnaire study

Introduction Many clinical education programmes have not incorporated the use of the electronic health record (EHR) into their curriculum. It is important to incorporate technologies that will be used in real-world settings to better prepare students for clinical practice. Objectives To undertake a review of literature to identify a training evaluation framework; to conduct a self-completion survey, pretraining and post-training, to determine students’ perceptions on the benefit of using EHR training system. Setting Nursing School, University, North West England, UK; University Ethic Committee Approval Received. Participants Registered nurses undertaking a validated return to practice course; 24 participants for the first cohort who completed pretraining questionnaire and 23 for the second post-training cohort. Results The statistical results show that the students perceived that the training improved their capability in employing digital systems with statistically significant difference in the assessed preproficiency and post proficiency in the use of digital clinical systems (premedians and post medians are 2 and 5 on 10-point Likert scale, p=0.041). There was also an indication of an improvement in the knowledge of EHR systems although not statistically significant. Most students perceived it increased their knowledge on digital systems. Conclusion Students perceived an increase in proficiency with the EHR. There was evidence of improvement in confidence in the use of the EHR, but this confidence would be enhanced by additional use of the system. Some desire to increase confidence further and to develop knowledge of digital systems was expressed

Racism and the Political Economy of COVID-19: Will We Continue to Resurrect the Past?

COVID-19 is not spreading over a level playing field; structural racism is embedded within the fabric of American culture, infrastructure investments, and public policy, and fundamentally drives inequities. The same racism that has driven the systematic dismantling of the American social safety-net has also created the policy recipe for American structural vulnerability to the impacts of this and other pandemics. The Bronx provides an important case study for investigating the historical roots of structural inequities showcased by this pandemic; current lived experiences of Bronx residents are rooted in the racialized dismantling of New York City’s public infrastructure and systematic disinvestment. The story of the Bronx is repeating itself, only this time with a novel virus. In order to address the root causes of inequities in cases and deaths due to COVID-19, we need to focus not just on restarting the economy, but on reimagining the economy, divesting of systems rooted in racism and the devaluation of Black and Brown lives

Detection, quantification and genotyping of Herpes Simplex Virus in cervicovaginal secretions by real-time PCR: a cross sectional survey

BACKGROUND: Herpes Simplex Virus (HSV) Genital Ulcer Disease (GUD) is an important public health problem, whose interaction with HIV results in mutually enhancing epidemics. Conventional methods for detecting HSV tend to be slow and insensitive. We designed a rapid PCR-based assay to quantify and type HSV in cervicovaginal lavage (CVL) fluid of subjects attending a Genito-Urinary Medicine (GUM) clinic. Vaginal swabs, CVL fluid and venous blood were collected. Quantitative detection of HSV was conducted using real time PCR with HSV specific primers and SYBR Green I. Fluorogenic TaqMan Minor Groove Binder (MGB) probes designed around a single base mismatch in the HSV DNA polymerase I gene were used to type HSV in a separate reaction. The Kalon test was used to detect anti-HSV-2 IgG antibodies in serum. Testing for HIV, other Sexually Transmitted Infections (STI) and related infections was based on standard clinical and laboratory methods. RESULTS: Seventy consecutive GUM clinic attendees were studied. Twenty-seven subjects (39%) had detectable HSV DNA in CVL fluid; HSV-2 alone was detected in 19 (70%) subjects, HSV-1 alone was detected in 4 (15%) subjects and both HSV types were detected in 4 (15%) subjects. Eleven out of 27 subjects (41%) with anti-HSV-2 IgG had detectable HSV-2 DNA in CVL fluid. Seven subjects (10%) were HIV-positive. Three of seven (43%) HIV-infected subjects and two of five subjects with GUD (40%) were secreting HSV-2. None of the subjects in whom HSV-1 was detected had GUD. CONCLUSION: Quantitative real-time PCR and Taqman MGB probes specific for HSV-1 or -2 were used to develop an assay for quantification and typing of HSV. The majority of subjects in which HSV was detected had low levels of CVL fluid HSV, with no detectable HSV-2 antibodies and were asymptomatic