Taking technologies to a greater scale

Open Access ChapterThis chapter presents a definition of 'scaling' and outlines the key elements for success based on the experiences gained from Africa RISING research and dissemination in East and Southern Africa (ESA). Three examples are presented: (a) research and development partnerships; (b) community based scaling through seed systems; and (c) outdoor advertising for orange-fleshed sweet potato. It presents experiences and lessons learned from using these approaches to transfer and scale the technologies

Chronic kidney disease (CKD) and associated risk in rural South Africa: a population-based cohort study.

BACKGROUND: In Africa, true prevalence of chronic kidney disease (CKD) is unknown, and associated clinical and genetic risk factors remain understudied. This population-based cohort study aimed to investigate CKD prevalence and associated risk factors in rural South Africa. METHODS: A total 2021 adults aged 20-79 years were recruited between 2017-2018 from the Agincourt Health and Socio-Demographic Surveillance System in Bushbuckridge, Mpumalanga, South Africa. The following were collected: sociodemographic, anthropometric, and clinical data; venous blood samples for creatinine, hepatitis B serology; DNA extraction; spot urine samples for dipstick testing and urine albumin: creatinine ratio (UACR) measurement. Point-of-care screening determined prevalent HIV infection, diabetes, and hypercholesterolemia. DNA was used to test for apolipoprotein L1 (APOL1) kidney risk variants. Kidney Disease Improving Global Outcomes (KDIGO) criteria were used to diagnose CKD as low eGFR (<60mL/min/1.73m2) and /or albuminuria (UACR ≥ 3.0mg/mmol) confirmed with follow up screening after at least three months. eGFR was calculated using the CKD-EPI(creatinine) equation 2009 with no ethnicity adjustment. Multivariable logistic regression was used to model CKD risk. RESULTS: The WHO age-adjusted population prevalence of CKD was 6.7% (95% CI 5.4 - 7.9), mostly from persistent albuminuria. In the fully adjusted model, APOL1 high-risk genotypes (OR 2.1; 95% CI 1.3 - 3.4); HIV infection (OR 1.8; 1.1 - 2.8); hypertension (OR 2.8; 95% CI 1.8 - 4.3), and diabetes (OR 4.1; 95% CI 2.0 - 8.4) were risk factors. There was no association with age, sex, level of education, obesity, hypercholesterolemia, or hepatitis B infection. Sensitivity analyses showed that CKD risk factor associations were driven by persistent albuminuria, and not low eGFR. One third of those with CKD did not have any of these risk factors. CONCLUSIONS: In rural South Africa, CKD is prevalent, dominated by persistent albuminuria, and associated with APOL1 high-risk genotypes, hypertension, diabetes, and HIV infection

Chronic kidney disease (CKD) and associated risk in rural South Africa: a population-based cohort study.

Background: In Africa, true prevalence of chronic kidney disease (CKD) is unknown, and associated clinical and genetic risk factors remain understudied. This population-based cohort study aimed to investigate CKD prevalence and associated risk factors in rural South Africa. Methods: A total 2021 adults aged 20-79 years were recruited between 2017-2018 from the Agincourt Health and Socio-Demographic Surveillance System in Bushbuckridge, Mpumalanga, South Africa. The following were collected: sociodemographic, anthropometric, and clinical data; venous blood samples for creatinine, hepatitis B serology; DNA extraction; spot urine samples for dipstick testing and urine albumin: creatinine ratio (UACR) measurement. Point-of-care screening determined prevalent HIV infection, diabetes, and hypercholesterolemia. DNA was used to test for apolipoprotein L1 (APOL1) kidney risk variants. Kidney Disease Improving Global Outcomes (KDIGO) criteria were used to diagnose CKD as low eGFR (<60mL/min/1.73m2) and /or albuminuria (UACR ≥ 3.0mg/mmol) confirmed with follow up screening after at least three months. eGFR was calculated using the CKD-EPI(creatinine) equation 2009 with no ethnicity adjustment. Multivariable logistic regression was used to model CKD risk. Results: The WHO age-adjusted population prevalence of CKD was 6.7% (95% CI 5.4 - 7.9), mostly from persistent albuminuria. In the fully adjusted model, APOL1 high-risk genotypes (OR 2.1; 95% CI 1.3 - 3.4); HIV infection (OR 1.8; 1.1 - 2.8); hypertension (OR 2.8; 95% CI 1.8 - 4.3), and diabetes (OR 4.1; 95% CI 2.0 - 8.4) were risk factors. There was no association with age, sex, level of education, obesity, hypercholesterolemia, or hepatitis B infection. Sensitivity analyses showed that CKD risk factor associations were driven by persistent albuminuria, and not low eGFR. One third of those with CKD did not have any of these risk factors. Conclusions: In rural South Africa, CKD is prevalent, dominated by persistent albuminuria, and associated with APOL1 high-risk genotypes, hypertension, diabetes, and HIV infection

A comparative study of flooding on food security of urban and rural households in Blantyre City and Chikwawa, Malawi

The impacts of climate-related risks on rural-urban linkages and the food systems on which urban settlements depend are poorly understood. This study analysed i) the climate trends for Blantyre City and rural Chikwawa district in Malawi, ii) the sources of foods typically consumed in these locations, iii) the implications of flooding following Tropical Cyclone Idai on urban and rural households interconnected agri-food systems and food security. Although floods were reported to cause both positive and negative effects on food production, food flows between rural and urban areas, and household food security; the negative effects (i.e., destruction of crops, homes and transport routes; higher food prices) outweighed the positive. In both rural and urban areas, poorer households were disproportionately affected resulting in reduced dietary diversity and food intake, shifts to consumption of cheaper foods, and requests for emergency food donations. Given the rapid rate of urbanisation, better understanding of food security amongst urban households is required. Following extreme events such as flooding, special attention needs to be directed to assessing and addressing food availability, access and consumption challenges in both urban and rural areas reliant on interconnected agricultural and food flows, and particularly in poor households

Procedures for the evaluation of sweetpotato trials. Manual.

Breeding programs involve large investments of time and money, but can pay very large returns on investment in the form of improved varieties that benefit farmers, societies and the environment. International breeding efforts involving multiple partners and targeting regionally important constraints have great potential for efficiently and rapidly achieving impact. Standardised information on the performance of progenies and selected clones across environments assists breeders to efficiently make decisions about selection and variety releases. Standardised methods also facilitate the reporting of breeding program results to the agencies that support us. This manual of procedures for the evaluation and analysis of sweetpotato trials provides standard methods for partners in CIP’s global breeding efforts