Analysis of Orange Complex Bacteria in the microbiome of whole Saliva in Periodontal Health and Periodontitis Individuals using Next Generation Sequencing Technology

Periodontal disease is a chronic inflammatory condition which is of microbial origin resulting in destruction of the supporting structures of the teeth. While earlier studies focused on a small number of periodontal pathogens, it is now accepted that the whole bacterial community may be important. The application of open-ended methods in bacterial identification has expanded the horizon of understanding of the oral microbiome. AIM OF THE STUDY: The aim of this study is to evaluate the orange complex bacteria in saliva in periodontal health and periodontitis MATERIALS AND METHODS: In this study, Subjects were periodontally evaluated and allocated into two groups as healthy controls (ten subjects) and periodontitis patients (ten subjects).orange complex microbiome was evaluated from periodontally healthy and periodontitis individuals using NGS technology with Illumina sequencing. Amplicons from V3-V4 hypervariable regions of 16S rRNA gene were sequenced. RESULTS: Fusobacterium nucleatum vincentii was present in all the 20 samples examined including periodontal health and disease. There was a statistically significant increase in frequency distribution of Campylobacter gracilis P=0.020 in periodontitis when compared to health. Fusobacterium nucleatum nucleatum (P=0.033), Fusobacterium nucleatum periodonticum (P=0.000), Prevotella intermedia (P=0.011) was present in periodontitis and not in health with a statistically significant difference between the two. Streptococcus constellatus (P=0.474) was present in periodontitis not in health, but without any statistically significant difference. CONCLUSION: Some members of the orange complex seem to be suitable candidates for use as microbial risk markers in periodontal diseases

HIV/AIDS Workplace Policy Implementation in Selected Private Sector Workplaces in Lusaka District: Implementer's Perspective

MASTER IN PUBLIC HEALTHIntroduction: Adult HIV prevalence in Zambia has declined from 16 % (2001-2002) to 13% (2013-2014) but still remains high. The UNAIDS call on eradicating HIV/AIDS by 2030 challenges strengthening multi–sectral response to HIV/AIDS. To understand factors affecting implementation of HIV/AIDS workplace policies, especially in the private sector, it is important to know the extent to which policies exist and experiences on implementation. Methods: A mixed method analysis of availability and implementation of policy using the health policy initiative implementer’s tool was conducted. Data from 128 member companies of the Zambia Federation of Employers was randomly collected through purposively sampled policy implementers. Categorized variables on implementation were analysed using Stata version 12.0: Fishers’ exact test and logistics regression were applied to implementation factors. Concurrently, 28 in-depth interviews on purposively sampled implementers were done. Thematic analysis was used and qualitative results integrated with quantitative findings. Results: Policies were available in 47/128 (36.72%) workplaces. The private sector accounted for 34/47 (72.34%) of all workplaces with policy. Programs were available in 56/128 (43.75%) workplaces. Both policy and programs were found in 46/47 (97.87 %) workplaces. Availability of policy was 2.7 times more likely with the increase in the size of a workplace, P Value=0.0001, (P<0.05). Top management support and having a specific budget for HIV programs were strongly associated with implementation. Management support was 0.253 times more likely in workplaces with policy, P value=0.013, (P<0.05).A specific budget for programs was 0.23 times more likely with policy (P<0.05). Implementation was hindered by reduced funding, lack of time, lack of sensitisation, ill-defined indicators and lack of Monitoring/Evaluation systems. Experiences with implementation, found HIV/AIDS/Stigma and awareness were the most addressed HIV epidemic drivers in workplace programs. Commercial sex workers, GBV, Mother to Child Transmission and Males having sex with males were the least addressed. Onsite VCT and provision of MC, ART were provided through health insurance, government clinics, and subcontracted providers. Conclusion: HIV/AIDS Workplace policies exist in the private sector at a very low proportion but policy translation into programs among workplaces with policies was very high suggesting that workplaces with policies are more likely to translate their policy into a program. Recommendation: Structures for addressing health and safety of employees exist and should be strengthened through sensitisation to include response to HIV/AIDS towards eradicating HIV/AIDS by 2030. The extent to which workplace programs address HIV/AIDS epidemic drivers in Zambia should focus on marginalised populations, gender integration and a wellness approach. Key Words: HIV/AIDS, workplace, policy, programs, implementation

HIV/AIDS Workplace Policy Implementation in Selected Private Sector Workplaces in Lusaka District: Implementer's Perspective

M. MASTER OF PUBLIC HEALTHIntroduction: Adult HIV prevalence in Zambia has declined from 16 % (2001-2002) to 13% (2013-2014) but still remains high. The UNAIDS call on eradicating HIV/AIDS by 2030 challenges strengthening multi–sectral response to HIV/AIDS. To understand factors affecting implementation of HIV/AIDS workplace policies, especially in the private sector, it is important to know the extent to which policies exist and experiences on implementation. Methods: A mixed method analysis of availability and implementation of policy using the health policy initiative implementer’s tool was conducted. Data from 128 member companies of the Zambia Federation of Employers was randomly collected through purposively sampled policy implementers. Categorized variables on implementation were analysed using Stata version 12.0: Fishers’ exact test and logistics regression were applied to implementation factors. Concurrently, 28 in-depth interviews on purposively sampled implementers were done. Thematic analysis was used and qualitative results integrated with quantitative findings. Results: Policies were available in 47/128 (36.72%) workplaces. The private sector accounted for 34/47 (72.34%) of all workplaces with policy. Programs were available in 56/128 (43.75%) workplaces. Both policy and programs were found in 46/47 (97.87 %) workplaces. Availability of policy was 2.7 times more likely with the increase in the size of a workplace, P Value=0.0001, (P<0.05). Top management support and having a specific budget for HIV programs were strongly associated with implementation. Management support was 0.253 times more likely in workplaces with policy, P value=0.013, (P<0.05).A specific budget for programs was 0.23 times more likely with policy (P<0.05). Implementation was hindered by reduced funding, lack of time, lack of sensitisation, ill-defined indicators and lack of Monitoring/Evaluation systems. Experiences with implementation, found HIV/AIDS/Stigma and awareness were the most addressed HIV epidemic drivers in workplace programs. Commercial sex workers, GBV, Mother to Child Transmission and Males having sex with males were the least addressed. Onsite VCT and provision of MC, ART were provided through health insurance, government clinics, and subcontracted providers. Conclusion: HIV/AIDS Workplace policies exist in the private sector at a very low proportion but policy translation into programs among workplaces with policies was very high suggesting that workplaces with policies are more likely to translate their policy into a program. Recommendation: Structures for addressing health and safety of employees exist and should be strengthened through sensitisation to include response to HIV/AIDS towards eradicating HIV/AIDS by 2030. The extent to which workplace programs address HIV/AIDS epidemic drivers in Zambia should focus on marginalised populations, gender integration and a wellness approach. Key Words: HIV/AIDS, workplace, policy, programs, implementation

Identifying Patients With Vesicovaginal Fistula at High Risk of Urinary Incontinence After Surgery:

To develop a risk score to identify women with vesicovaginal fistula at high risk of residual urinary incontinence after surgical repair

Fertility outcomes following obstetric fistula repair: a prospective cohort study

Abstract Background Obstetric fistula (OF) is a maternal morbidity associated with high rates of stillbirth, amenorrhea, and sexual dysfunction. Limited data exists on the reproductive outcomes of women in the years following a fistula repair. The objective of this study is to describe the fertility outcomes and family planning practices in a population of Malawian women 1–4 years after fistula repair. Methods Women who had enrolled into a clinical database of OF patients and undergone OF repair between January 1, 2012 and July 31, 2014 were recruited and enrolled to complete a home-based survey of their demographic and reproductive health data 1–4 years after their repair. Pregnancy, amenorrhea, and sexual function were described using frequency analysis, and we compared antimüllerian hormone (AMH) concentrations between women with menses or pregnancy with women with amenorrhea or no pregnancy using Wilcoxon rank sum tests. Results Of 297 women with a prior OF repair, 148 had reproductive potential and were included in this analysis. Overall 30 women of these women (21%) became pregnant since their fistula repair, with most pregnancies ending with cesarean delivery. Of the 32 women who were amenorrheic at the time of repair, 25 (78.1%) had resumption of menses. Only 11 (8.6%) of sexually active women reported dyspareunia, and among women who were not trying to conceive, 53.1% were currently using a method of family planning. No significant differences were found in AMH concentrations between those who were pregnant or had menses versus those without pregnancy or menses, respectively. Conclusions In this long-term follow-up study of women after OF repair, many women were able to achieve a pregnancy with a live birth, have normal menses, be sexually active, and access contraception. These achievements will further assist a population of women whose reintegration and restoration of dignity is closely tied to their ability to achieve their reproductive goals. Trial registration ClinicalTrials.gov Identifier: NCT02685878

How Worried Are You about Food Fraud? A Preliminary Multi-Country Study among Consumers in Selected Sub-Saharan African Countries

Food fraud is an old, recurring, and global threat to public health. It poses a serious threat to food security in sub-Saharan Africa (SSA). Despite the prevalence of food fraud in SSA, little is known about how food fraud is viewed by consumers. This study aims to provide an overview of consumers’ concerns about food fraud in SSA. A multi-country survey was conducted in October 2022–31 January 2023, and 838 valid responses were returned. To reduce the large and correlated dataset, Principal Component Analysis (PCA) was used. Five components were derived from PCA: (i) Staple foods; (ii) Premium food and drink products; (iii) Trust in reliable sources; (iv) Trust in less reliable sources; and (v) Trust in food vendors. The findings revealed Ghanaian (mean rank = 509.47) and Nigerian (mean rank = 454.82) consumers tended to score higher on the measure of food fraud concern suggesting that they were less confident in the safety and quality of the food they consume. Demographic characteristics including age, number of children, personal and family experience of food fraud and PCA components such as ‘Staple foods’, ‘Trust in reliable sources’, and ‘Trust in food vendors’ significantly predicted the model. This is the first preliminary study to provide empirical findings on consumers’ concerns about food fraud in SSA. Practical and policy recommendations for the region are suggested. This includes (i) modelling the AfriFoodinTegrity in West Africa across other major regions such as Central, East, and Southern Africa; (ii) establish a regional sub-Saharan Africa Rapid Alert System for Food and Feed (SSA-RASFF) platform; and (iii) food safety and food fraud reports could be incorporated into SSA-RASFF portal for information sharing

HIV/AIDS Workplace Policy Implementation in Selected Private Sector Workplaces in Lusaka District: Implementer's Perspective

M. MASTER OF PUBLIC HEALTHIntroduction: Adult HIV prevalence in Zambia has declined from 16 % (2001-2002) to 13% (2013-2014) but still remains high. The UNAIDS call on eradicating HIV/AIDS by 2030 challenges strengthening multi–sectral response to HIV/AIDS. To understand factors affecting implementation of HIV/AIDS workplace policies, especially in the private sector, it is important to know the extent to which policies exist and experiences on implementation. Methods: A mixed method analysis of availability and implementation of policy using the health policy initiative implementer’s tool was conducted. Data from 128 member companies of the Zambia Federation of Employers was randomly collected through purposively sampled policy implementers. Categorized variables on implementation were analysed using Stata version 12.0: Fishers’ exact test and logistics regression were applied to implementation factors. Concurrently, 28 in-depth interviews on purposively sampled implementers were done. Thematic analysis was used and qualitative results integrated with quantitative findings. Results: Policies were available in 47/128 (36.72%) workplaces. The private sector accounted for 34/47 (72.34%) of all workplaces with policy. Programs were available in 56/128 (43.75%) workplaces. Both policy and programs were found in 46/47 (97.87 %) workplaces. Availability of policy was 2.7 times more likely with the increase in the size of a workplace, P Value=0.0001, (P<0.05). Top management support and having a specific budget for HIV programs were strongly associated with implementation. Management support was 0.253 times more likely in workplaces with policy, P value=0.013, (P<0.05).A specific budget for programs was 0.23 times more likely with policy (P<0.05). Implementation was hindered by reduced funding, lack of time, lack of sensitisation, ill-defined indicators and lack of Monitoring/Evaluation systems. Experiences with implementation, found HIV/AIDS/Stigma and awareness were the most addressed HIV epidemic drivers in workplace programs. Commercial sex workers, GBV, Mother to Child Transmission and Males having sex with males were the least addressed. Onsite VCT and provision of MC, ART were provided through health insurance, government clinics, and subcontracted providers. Conclusion: HIV/AIDS Workplace policies exist in the private sector at a very low proportion but policy translation into programs among workplaces with policies was very high suggesting that workplaces with policies are more likely to translate their policy into a program. Recommendation: Structures for addressing health and safety of employees exist and should be strengthened through sensitisation to include response to HIV/AIDS towards eradicating HIV/AIDS by 2030. The extent to which workplace programs address HIV/AIDS epidemic drivers in Zambia should focus on marginalised populations, gender integration and a wellness approach. Key Words: HIV/AIDS, workplace, policy, programs, implementation

Globalisation, structural adjustment and small and micro-sized enterprises in Malawi

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

The role of gender based violence in HIV transmission among women in Lusaka, Zambia

Thesis (MPhil)--Stellenbosch University, 2013.ENGLISH ABSTRACT: Introduction: Gender based violence has been associated with risky sexual behaviours such as low condom use multiple and concurrent sexual partnering with low levels of HIV self-risk perception. Study Design: The study was a survey conducted at the Young Women Christian Association in Lusaka. Data was collected from 50 study participants aged between 18 and 49 who were self-reporting Gender Based Violence by a regular intimate partner or husband through interviewer administered questionnaires by simple random sampling. Individual knowledge was collected on HIV/AIDS, Gender based violence, sexual practices, attitudes towards condoms use and HIV/AIDS and personal experience with gender based violence as well as Marriages and Cohabiting relations. Findings: The study found high levels of awareness and knowledge on Gender Based violence (98%) and HIV transmission (76- 98%) respectively. The study found that 90% of females interviewed thought Gender based violence in Zambia was a serious problem with 92 % saying men who beat their wives were breaking the law. Frequency of GBV experienced by an intimate partner in the last 12 months found10% indicated having beaten 1 time , 16% beaten 2 times, 6% being beaten 3 times and 68% being beaten more than 4 times in the past. The study further found that only 40% of participants had knowledge of the Anti-Gender Based Violence Act No. 1 of 2011. Conclusions: The study concluded that there were high knowledge levels of HIV and high awareness of gender based violence among the females in the study. Gender Based Violence increases vulnerability of women to risk HIV infection by reducing ability to negotiate safe sex. Condom utilisations among women who experienced intimate partner violence were low while multiple sexual partnerships were prevalent. Self-risk perception to HIV infection of women in intimate partner relationships increased when association to GBV was made.AFRIKAANSE OPSOMMING: Impleading: Geslagsgebaseerde geweld is wat verband hou met riskante seksuele gedrag soos lae kondoom gebruik veelvuldige en gelyktydige seksuele vennootskap met lae vlakke van MIV-self-risiko persepsie. Studie-ontwerp: Die studie was 'n opname by die Jong Vroue Christelike Vereniging in Lusaka. Data is ingesamel van 50 studie-deelnemers tussen die ouderdomme van 18 en 49 wat self-rapportering geslagsgebaseerde geweld deur 'n gereelde intieme vennoot of man deur onderhoudvoerder vraelyste deur eenvoudige ewekansige steekproefneming. Individuele kennis versamel oor MIV / VIGS, geslagsgebaseerde geweld, seksuele praktyke, houdings teenoor kondome gebruik en MIV / VIGS en persoonlike ervaring met gender-gebaseerde geweld sowel as Huwelike en WOON verhoudings. Bevindinge: Die studie het gevind dat hoë vlakke van bewustheid en kennis oor geslagsgebaseerde geweld (98%) en MIV-oordrag (76 - 98%) onderskeidelik. Die studie het bevind dat 90% van die vroue ondervra gedink Geslag gebaseerde geweld in Zambië was 'n ernstige probleem met die 92% sê mans wat hul vroue slaan die wet breek. Frekwensie van GBV ervaar deur 'n intieme vennoot in die laaste 12 maande found10% aangedui geklits 1 keer, 16% geklop 2 keer, 6% geslaan 3 keer en 68% meer as 4 keer geslaan in die verlede. Die studie het verder bevind dat slegs 40% van die deelnemers het kennis van die Anti-geslagsgebaseerde geweld Wet No 1 van 2011. Gevolgtrekkings: Die studie het tot die gevolgtrekking gekom dat daar hoë vlak van kennis van MIV en hoë bewustheid van geslagsgebaseerde geweld onder die vroue in die studie. Kondoom aanwendings onder vroue wat intieme maat geweld ervaar laag was terwyl verskeie seksuele vennootskappe teenwoordig was. Self-risiko persepsie tot MIV-infeksie van vroue in intieme verhoudings met vennote verhoog wanneer assosiasie te GBV gemaak