Cross-sectional study assessing HIV related knowledge, attitudes and behavior in Namibian public sector employees in capital and regional settings

The study objective was to assess the current status of HIV knowledge, attitudes and behavior (KAB) among employees of Namibian ministries. As most HIV campaigning takes place in the capital of Windhoek, an additional aim was to compare Windhoek to four regions (Hardap, Erongo, Oshana, and Caprivi). Between January and March 2011 a cross-sectional survey was conducted in two Namibian ministries, with participants selected randomly from the workforce. Data collection was based on questionnaires. 832 participants were included in the study (51.6% male). Nearly 90% of participants reported to have been tested for HIV before. Knowledge about HIV transmission ranged from 67% to 95% of correct answers, with few differences between the capital and regions. However, a knowledge gap regarding HIV transmission and prevention was seen. In particular, we found significantly lower knowledge regarding transmission from mother-to-child during pregnancy and higher rate of belief in a supernatural role in HIV transmission. In addition, despite many years of HIV prevention activities, a substantial proportion of employees had well-known HIV risk factors including multiple concurrent partnership rates (21%), intergenerational sex (19%), and lower testing rates for men (82% compared to women with 91%)

The relevance of smallholder farming to African agricultural growth and development

Farms less than two hectares constitute most farm holdings in Africa. Most of these farms are operated by rural smallholder farmers who are dependent on agriculture for their economic livelihoods. However, they are constrained by lack of capital assets that would enable them to increase agricultural productivity, food security and income. Despite these challenges, smallholders contribute significantly to the rural economy, and play a significant role in natural resource conservation. Therefore, they represent a critical population to include in poverty reduction efforts. Recent initiatives by African leaders aim to increase public expenditures on agriculture in order to spur economic development, position smallholders to play a significant role in regional growth. To understand the relevance of smallholder farming to Africa’s development agenda, this paper reviews the body of knowledge on smallholder farmers, the constraints and opportunities they face, and their use of practices which embody the tenets of ecological and climate-smart agriculture despite little public investment in this area. This paper recognizes the role of smallholder farmers and concludes that smallholder agriculture will be a driver of economic growth and development in Africa. In order to achieve this, adequate investment should be focused on eliminating the challenges faced by smallholder farmers.Keywords: Smallholder farmers, Sub-Saharan Africa, agricultural development, climate-smart agriculture, green agricultur

A Versatile, Portable Intravital Microscopy Platform for Studying Beta-cell Biology In Vivo

The pancreatic islet is a complex micro-organ containing numerous cell types, including endocrine, immune, and endothelial cells. The communication of these systems is lost upon isolation of the islets, and therefore the pathogenesis of diabetes can only be fully understood by studying this organized, multicellular environment in vivo. We have developed several adaptable tools to create a versatile platform to interrogate β-cell function in vivo. Specifically, we developed β-cell-selective virally-encoded fluorescent protein biosensors that can be rapidly and easily introduced into any mouse. We then coupled the use of these biosensors with intravital microscopy, a powerful tool that can be used to collect cellular and subcellular data from living tissues. Together, these approaches allowed the observation of in vivo β-cell-specific ROS dynamics using the Grx1-roGFP2 biosensor and calcium signaling using the GcAMP6s biosensor. Next, we utilized abdominal imaging windows (AIW) to extend our in vivo observations beyond single-point terminal measurements to collect longitudinal physiological and biosensor data through repeated imaging of the same mice over time. This platform represents a significant advancement in our ability to study β-cell structure and signaling in vivo, and its portability for use in virtually any mouse model will enable meaningful studies of β-cell physiology in the endogenous islet niche

Where there is no psychiatrist: A mental health programme in Sierra Leone

Background. For most low- and middle-income countries, mental health remains a neglected area, despite the recognised burden associated with neuropsychiatric conditions and the inextricable link to other public health priorities. Objectives To describe the results of a free outpatient mental health programme delivered by non specialist health workers in Makeni, Sierra Leone between July 2008 and May 2012. Methods. A nurse and two counsellors completed an 8-week training course focused on the identification and management of seven priority conditions: psychosis, bipolar disorder, depression, mental disorders due to medical conditions, developmental and behavioural disorders, alcohol and drug use disorders and dementia The World Health Organization recommendations on basic mental healthcare packages were followed to establish treatment for each condition. Results. A total of 549 patients was assessed and diagnosed as suffering from psychotic disorders (n=295, 53.7%), manic episodes (n=69, 12.5%), depressive episodes (n=53, 9.6%), drug use disorders (n=182, 33.1%), dementia (n=30, 54%), mental disorders due to medical conditions (n=39, 7.1%), and developmental disorders (n=46, 8.3%). Of these, 417 patients received pharmacological therapy and 70.7% were rated as much or very much improved Of those who could not be offered medication, 934% dropped out of the programme after the first visit. Conclusions. The identification and treatment of mental disorders must be considered an urgent public health priority in low- and middle income countries Trained primary health workers can deliver safe and effective treatment for mental disorders as a feasible alternative to ease the scarcity of mental health specialists in developing countries

First report of Rice stripe necrosis virus infecting rice in Sierra Leone

While Rice stripe necrosis virus (RSNV, Benyvirus, Benyviridae) has been reported on rice plants on two continents, little is known about the diversity of this multipartite virus which is transmitted by the plasmodiophorid protist Polymyxa graminis. First identified in 1983 in the Côte d´Ivoire (Fauquet & Thouvenel, 1983), the disease had previously been observed in Sierra Leone without formal identification of the causal agent (Buddenhagen, pers. comm.). Later, the virus was reported in South and Central America (Colombia, Ecuador, Panama and Brazil) causing up to 40% yield losses (Morales et al., 1999). Recently, RSNV was identified for the first time in several African countries including Burkina Faso (Sérémé et al., 2014), Benin (Oludare et al., 2015) and Mali (Decroës et al., 2017) suggesting a re-emergence of the virus in Africa.In 2019, symptoms of leaf-crinkling and stripe necrosis were observed on a rice plant from the Bo District in Sierra Leone (Fig. 1). Leaf samples were analysed by serological and molecular methods to confirm the presence of RSNV in Sierra Leone. RSNV was detected by plate-trapped antibody (PTA)- ELISA using a polyclonal antiserum against RSNV (Fauquet & Thouvenel, 1983).The presence of the virus was confirmed after total RNA extraction using 0.05 g of leaves and the RNeasy Plant Mini Kit (Qiagen) and RT-PCR amplification (10 U/μl M-MLV-reverse transcriptase, Promega; 10 U/μl Dynazyme, Finnzyme) as described previously (Sérémé et al., 2014, Oludare et al., 2015) with primers RSNV1-2901F 5′-TGAATTTGGTGCTCTCTTG-3′ / RSNV1-3827R 5′-TGTGGCGTTTCCAGACCTAAA-3´ and RSNV2-5´ 5´-TATCACTACTGACGAATTCCACCTAC-3´ / RSNV2-1223R 5´-AATCTGCGGCCTGTTTTGTA-3´. Specific amplicons, 926 and 1241 nt in length, were generated corresponding to sequences in the helicase domain and the coat protein (CP) genes on RSNV RNA 1 and RNA 2, respectively. The amplicons were sequenced directly and the sequences deposited in GenBank (Accession Nos. MN750254 and MN750255, respectively).The helicase sequence obtained from the Sierra Leone RSNV isolate showed 1.8-7.3% genetic distance with those from South America (EU099844.3, MG792544, MG792545, MG792546) and only 1.4-2.2% with those from Africa (KP099623, MF115599, MF115600, MF115601, MF115602, MF115603, MK170452, MK170453). The phylogenetic analysis based on the helicase domain included the sequence obtained from the Sierra Leone within a cluster represented by RSNV from South America and West Africa (Fig. 2a). In contrast, the CP sequence from the Sierra Leone RSNV isolate revealed an unexpected genetic differentiation as compared to all the other sequences from South America (5.6%; NC_038774) or Africa (5.2-6.5%; LK023710, MF115604, MF115605, MF115606, MF115607, MF115608, MK170454, MK170455). Interestingly, the CP sequence from Sierra Leone is located at a basal position in the phylogeny (Fig. 2b).To our knowledge, this is the first confirmed report of RSNV in Sierra Leone. Further studies are needed to assess the molecular and biological diversity of RSNV, the spatial distribution and the incidence of this re-emerging rice disease in Africa.Fil: Tucker, M. J.. Sierra Leone Agricultural Research Institute; Sierra LeonaFil: Giovani Celli, Marcos Giovani. Instituto Nacional de Tecnología Agropecuaria. Centro de Investigaciones Agropecuarias. Unidad de Fitopatología y Modelización Agrícola - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Unidad de Fitopatología y Modelización Agrícola; ArgentinaFil: Conteh, A. B.. Sierra Leone Agricultural Research Institute; Sierra LeonaFil: Taylor, D. R.. Sierra Leone Agricultural Research Institute; Sierra LeonaFil: Hebrard, Andrés. Centre National de la Recherche Scientifique. Institut de Recherche pour le Développement; FranciaFil: Poulicard, N.. Centre National de la Recherche Scientifique. Institut de Recherche pour le Développement; Franci

Pancreatic beta cell autophagy is impaired in type 1 diabetes

Aims/hypothesis Pancreatic beta cells are subjected to exogenous damaging factors such as proinflammatory cytokines or excess glucose that can cause accumulation of damage-inducing reactive oxygen species during the pathogenesis of diabetes. We and others have shown that beta cell autophagy can reduce reactive oxygen species to protect against apoptosis. While impaired islet autophagy has been demonstrated in human type 2 diabetes, it is unknown if islet autophagy is perturbed in the pathogenesis of type 1 diabetes. We hypothesised that beta cell autophagy is dysfunctional in type 1 diabetes, and that there is a progressive loss during early diabetes development. Methods Pancreases were collected from chloroquine-injected and non-injected non-obese diabetes-resistant (NOR) and non-obese diabetic (NOD) mice. Age- and BMI-matched pancreas tissue sections from human organ donors (N = 34) were obtained from the Network for Pancreatic Organ Donors with Diabetes (nPOD). Tissue sections were stained with antibodies against proinsulin or insulin (beta cell markers), microtubule-associated protein 1 light chain 3 A/B (LC3A/B; autophagosome marker), lysosomal-associated membrane protein 1 (LAMP1; lysosome marker) and p62 (autophagy adaptor). Images collected on a scanning laser confocal microscope were analysed with CellProfiler and ImageJ. Secondary lysosomes and telolysosomes were assessed in electron micrographs of human pancreatic tissue sections (n = 12), and energy dispersive x-ray analysis was performed to assess distribution of elements (n = 5). Results We observed increased autophagosome numbers in islets of diabetic NOD mice (p = 0.008) and increased p62 in islets of both non-diabetic and diabetic NOD mice (p < 0.001) vs NOR mice. There was also a reduction in LC3-LAMP1 colocalisation in islets of diabetic NOD mice compared with both non-diabetic NOD (p < 0.001) and NOR mice (p < 0.001). Chloroquine elicited accumulation of autophagosomes in the islets of NOR (p = 0.003) and non-diabetic NOD mice (p < 0.001), but not in islets of diabetic NOD mice; and stimulated accumulation of p62 in NOR (p < 0.001), but not in NOD mice. We observed reduced LC3-LAMP1 colocalisation (p < 0.001) in residual beta cells of human donors with type 1 diabetes vs non-diabetic participants. We also observed reduced colocalisation of proinsulin with LAMP1 in donors with type 1 diabetes (p < 0.001). Electron microscopy also revealed accumulation of telolysosomes with nitrogen-dense rings in beta cells of autoantibody-positive donors (p = 0.002). Conclusions/interpretation We provide evidence of islet macroautophagy/crinophagy impairment in human type 1 diabetes. We also document accumulation of telolysosomes with peripheral nitrogen in beta cells of autoantibody-positive donors, demonstrating altered lysosome content that may be associated with lysosome dysfunction before clinical hyperglycaemia. Similar macroautophagy impairments are present in the NOD mouse model of type 1 diabetes

Mobile health (mHealth) approaches and lessons for increased performance and retention of community health workers in low- and middle-income countries: a review.

BACKGROUND: Mobile health (mHealth) describes the use of portable electronic devices with software applications to provide health services and manage patient information. With approximately 5 billion mobile phone users globally, opportunities for mobile technologies to play a formal role in health services, particularly in low- and middle-income countries, are increasingly being recognized. mHealth can also support the performance of health care workers by the dissemination of clinical updates, learning materials, and reminders, particularly in underserved rural locations in low- and middle-income countries where community health workers deliver integrated community case management to children sick with diarrhea, pneumonia, and malaria. OBJECTIVE: Our aim was to conduct a thematic review of how mHealth projects have approached the intersection of cellular technology and public health in low- and middle-income countries and identify the promising practices and experiences learned, as well as novel and innovative approaches of how mHealth can support community health workers. METHODS: In this review, 6 themes of mHealth initiatives were examined using information from peer-reviewed journals, websites, and key reports. Primary mHealth technologies reviewed included mobile phones, personal digital assistants (PDAs) and smartphones, patient monitoring devices, and mobile telemedicine devices. We examined how these tools could be used for education and awareness, data access, and for strengthening health information systems. We also considered how mHealth may support patient monitoring, clinical decision making, and tracking of drugs and supplies. Lessons from mHealth trials and studies were summarized, focusing on low- and middle-income countries and community health workers. RESULTS: The review revealed that there are very few formal outcome evaluations of mHealth in low-income countries. Although there is vast documentation of project process evaluations, there are few studies demonstrating an impact on clinical outcomes. There is also a lack of mHealth applications and services operating at scale in low- and middle-income countries. The most commonly documented use of mHealth was 1-way text-message and phone reminders to encourage follow-up appointments, healthy behaviors, and data gathering. Innovative mHealth applications for community health workers include the use of mobile phones as job aides, clinical decision support tools, and for data submission and instant feedback on performance. CONCLUSIONS: With partnerships forming between governments, technologists, non-governmental organizations, academia, and industry, there is great potential to improve health services delivery by using mHealth in low- and middle-income countries. As with many other health improvement projects, a key challenge is moving mHealth approaches from pilot projects to national scalable programs while properly engaging health workers and communities in the process. By harnessing the increasing presence of mobile phones among diverse populations, there is promising evidence to suggest that mHealth can be used to deliver increased and enhanced health care services to individuals and communities, while helping to strengthen health systems