389 research outputs found

    Characterizing Feeds and Feed Availability in Sud-Kivu Province, DR Congo

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    Animal husbandry in the Sud-Kivu province of the Democratic Republic of the Congo (DRC) is gradually moving towards stall feeding, due to demographic pressure (Battistin et al. 2009) and scarcity of collectable forages (DSRP-RDC 2005). Therefore, feed is considered one of the main constraints faced by livestock production, especially in the dry season (Katunga et al. 2009; Maass et al. 2012). Unaffordable, fluctuating prices and inaccessibility of feed concentrates and the lack of improved forages adapted to marginal conditions, making them non-competitive with food crops, further exacerbate the livestock feeding situation. This study within the African Food Security Initiative, with funding from AusAID, aimed to assess specific constraints and opportunities in the current feeding systems, as well as feed availability in this area

    Proton beam therapy for pediatric tumors of the central nervous system — experiences of clinical outcome and feasibility from the KiProReg Study

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    Simple Summary Radiation therapy is an important cornerstone of the treatment of many different types of brain tumors occurring in childhood. Proton beam therapy offers the opportunity to reduce doses outside of the target volume due to its physical characteristics. By sparing a large volume of the brain from radiation doses, proton beam therapy aims at reducing long-term side effects and preserving cognitive function. Our study aims at better understanding side effects and therefore contributing to better treatment decisions in this vulnerable group of patients. Therefore, the study analyses outcome and side effects including imaging changes in a large cohort of children with brain tumors from a prospective registry. Abstract As radiotherapy is an important part of the treatment in a variety of pediatric tumors of the central nervous system (CNS), proton beam therapy (PBT) plays an evolving role due to its potential benefits attributable to the unique dose distribution, with the possibility to deliver high doses to the target volume while sparing surrounding tissue. Children receiving PBT for an intracranial tumor between August 2013 and October 2017 were enrolled in the prospective registry study KiProReg. Patient’s clinical data including treatment, outcome, and follow-up were analyzed using descriptive statistics, Kaplan–Meier, and Cox regression analysis. Adverse events were scored according to the Common Terminology Criteria for Adverse Events (CTCAE) 4.0 before, during, and after PBT. Written reports of follow-up imaging were screened for newly emerged evidence of imaging changes, according to a list of predefined keywords for the first 14 months after PBT. Two hundred and ninety-four patients were enrolled in this study. The 3-year overall survival of the whole cohort was 82.7%, 3-year progression-free survival was 67.3%, and 3-year local control was 79.5%. Seventeen patients developed grade 3 adverse events of the CNS during long-term follow-up (new adverse event n = 7; deterioration n = 10). Two patients developed vision loss (CTCAE 4°). This analysis demonstrates good general outcomes after PBT

    Evaluation of dose, volume, and outcome in children with localized, intracranial ependymoma treated with proton therapy within the prospective KiProReg Study

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    BACKGROUND: Radiotherapy (RT) of ependymoma in children is an important part of the interdisciplinary treatment concept. However, feasibility and dose concepts are still under investigation, particularly in very young children. The aim of this study was to evaluate the standard dose and volume of proton therapy (PT) in children with ependymoma. METHODS: In this analysis, 105 patients with localized, intracranial ependymoma under the age of 18 years treated with PT between 2013 and 2018 were included. Patient characteristics, treatment, outcome, and follow-up data were analyzed using descriptive statistics, Kaplan-Meier, and Cox regression analysis. RESULTS: The median age of patients at PT was 2.8 years (0.9-17.0 years). The molecular subgroup analysis was performed in a subset of 50 patients (37 EP-PFA, 2 EP-PFB, 7 EP-RELA, 2 EP-YAP, 2 NEC [not elsewhere classified]). The median total dose was 59.4 Gy (54.0-62.0 Gy). The median follow-up time was 1.9 years. The estimated 3-year overall survival (OS), local control (LC), and progression-free survival (PFS) rates were 93.7%, 74.1%, and 55.6%, respectively. Within univariable analysis, female gender and lower dose had a positive impact on OS, whereas age ≄4 years had a negative impact on OS and PT given after progression had a negative impact on PFS. In the multivariable analysis, multiple tumor surgeries were associated with lower PFS. New ≄3° late toxicities occurred in 11 patients. CONCLUSION: For children with localized ependymoma, PT was effective and well tolerable. Multiple surgeries showed a negative impact on PFS

    Challenges and opportunities for smallholder livestock production in post-conflict South Kivu, eastern DR Congo

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    A survey on smallholder livestock production with emphasis on monogastric animals was conducted in 20 villages of seven so-called ‘groupements’ of South Kivu province in DR Congo, situated along a north to south-west axis with the town of Bukavu in the center. This land adjacent to Lake Kivu is located at elevations ranging around 900–1900 m asl, experiencing tropical highland climate. A diagnostic survey helped to rapidly obtain in-depth knowledge of constraints and opportunities in this environment. Correspondence analysis and multiple regression analysis were used to investigate the association of production constraints with particular livestock species and to understand the factors that govern the number of livestock that people owned (converted to tropical livestock units [TLU]), respectively. Responses of 112 informants demonstrated that livestock is an integral part of the region’s mixed farming systems. Low livestock numbers per household at present reflect the poverty as a consequence of recent violent conflicts. Currently, farmers focus on small livestock, like poultry, swine, cavies (i.e., Guinea pigs) and rabbits. Families keep livestock to accumulate household reserves that are strongly invested in children’s education. Major issues of animal husbandry were related to animal diseases and lack of feed resources, particularly in the dry season. Lack of feed or forages were unrelated to a particular livestock species. Livestock holdings depended on animal diversity, location, land size available and respondents’ education level. The potential introduction of improved forages is challenged by their dry-season tolerance, compatibility with cropping on small farms; and people’s readiness to cultivate forages
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