The prevalence of mental disorders among intimate partner violence exposed and non-exposed Rwandans: findings from a national cross-sectional survey

Despite mounting evidence indicating an increased risk of long-term mental disorders in Rwanda's general population, little is still known about the national prevalence of mental disorders among victims of intimate partner violence (IPV) in a post-conflict setting. The aim of this study was to compare the prevalence of mental disorders among IPV exposed and non-exposed individuals in Rwanda. This was a cross-sectional study based on secondary data from the 2018 Rwanda Mental Health Survey. The sample consisted 20,381 participants selected nationwide, from 7,124 households (age range: 14-65 years), of which 3,759 Rwandans were exposed to IPV (18.4%) and 16,622 were non-exposed to IPV (81.6%). Participants were screened for IPV exposure and common mental disorders, and data was analyzed using the SPSS version 25 software. The results showed that the rate of any mental disorder was substantially higher in the group exposed to IPV than the non-exposed, at 32.4% and 11.7% respectively. These results highlight that among Rwandans diagnosed with severe mental disorders, participants with a history of IPV exposure present with increased odds of mental disorders prevalence and severity. Therefore, people seeking mental health care should also be screened for their IPV exposure and offered appropriate interventions

Sputum Smear Microscopy: Evaluation of Impact of Training, Microscope Distribution, and Use of External Quality Assessment Guidelines for Resource-Poor Settings

Sputum smear microscopy is the main and often only laboratory technique used for the diagnosis of tuberculosis in resource-poor countries, making quality assurance (QA) of smear microscopy an important activity. We evaluated the effects of a 5-day refresher training course for laboratory technicians and the distribution of new microscopes on the quality of smear microscopy in 13 primary health care laboratories in Kinshasa, Democratic Republic of Congo. The 2002 external QA guidelines for acid-fast bacillus smear microscopy were implemented, and blinded rechecking of the slides was performed before and 9 months after the training course and microscope distribution. We observed that the on-site checklist was highly time-consuming but could be tailored to capture frequent problems. Random blinded rechecking by the lot QA system method decreased the number of slides to be reviewed. Most laboratories needed further investigation for possible unacceptable performance, even according to the least-stringent interpretation. We conclude that the 2002 external QA guidelines are feasible for implementation in resource-poor settings, that the efficiency of external QA can be increased by selecting sample size parameters and interpretation criteria that take into account the local working conditions, and that greater attention should be paid to the provision of timely feedback and correction of the causes of substandard performance at poorly performing laboratories

Partnering to proceed: scaling up adolescent sexual reproductive health programmes in Tanzania. Operational research into the factors that influenced local government uptake and implementation

BACKGROUND: Little is known about how to implement promising small-scale projects to reduce reproductive ill health and HIV vulnerability in young people on a large scale. This evaluation documents and explains how a partnership between a non-governmental organization (NGO) and local government authorities (LGAs) influenced the LGA-led scale-up of an innovative NGO programme in the wider context of a new national multisectoral AIDS strategy. METHODS: Four rounds of semi-structured interviews with 82 key informants, 8 group discussions with 49 district trainers and supervisors (DTS), 8 participatory workshops involving 52 DTS, and participant observations of 80% of LGA-led and 100% of NGO-led meetings were conducted, to ascertain views on project components, flow of communication and decision-making and amount of time DTS utilized undertaking project activities. RESULTS: Despite a successful ten-fold scale-up of intervention activities in three years, full integration into LGA systems did not materialize. LGAs contributed significant human resources but limited finances; the NGO retained control over finances and decision-making and LGAs largely continued to view activities as NGO driven. Embedding of technical assistants (TAs) in the LGAs contributed to capacity building among district implementers, but may paradoxically have hindered project integration, because TAs were unable to effectively transition from an implementing to a facilitating role. Operation of NGO administration and financial mechanisms also hindered integration into district systems. CONCLUSIONS: Sustainable intervention scale-up requires operational, financial and psychological integration into local government mechanisms. This must include substantial time for district systems to try out implementation with only minimal NGO support and modest output targets. It must therefore go beyond the typical three- to four-year project cycles. Scale-up of NGO pilot projects of this nature also need NGOs to be flexible enough to adapt to local government planning cycles and ongoing evaluation is needed to ensure strategies employed to do so really do achieve full intervention integration

Parental Burnout Around the Globe: a 42-Country Study

High levels of stress in the parenting domain can lead to parental burnout, a condition that has severe consequences for both parents and children. It is not yet clear, however, whether parental burnout varies by culture, and if so, why it might do so. In this study, we examined the prevalence of parental burnout in 42 countries (17,409 parents; 71% mothers; M_{age} = 39.20) and showed that the prevalence of parental burnout varies dramatically across countries. Analyses of cultural values revealed that individualistic cultures, in particular, displayed a noticeably higher prevalence and mean level of parental burnout. Indeed, individualism plays a larger role in parental burnout than either economic inequalities across countries, or any other individual and family characteristic examined so far, including the number and age of children and the number of hours spent with them. These results suggest that cultural values in Western countries may put parents under heightened levels of stress

Lipidomics identifies a requirement for peroxisomal function during influenza virus replication

Influenza virus acquires a host-derived lipid envelope during budding, yet a convergent view on the role of host lipid metabolism during infection is lacking. Using a mass spectrometry-based lipidomics approach, we provide a systems-scale perspective on membrane lipid dynamics of infected human lung epithelial cells and purified influenza virions. We reveal enrichment of the minor peroxisome-derived ether-linked phosphatidylcholines relative to bulk ester-linked phosphatidylcholines in virions as a unique pathogenicity-dependent signature for influenza not found in other enveloped viruses. Strikingly, pharmacological and genetic interference with peroxisomal and ether lipid metabolism impaired influenza virus production. Further integration of our lipidomics results with published genomics and proteomics data corroborated altered peroxisomal lipid metabolism as a hallmark of influenza virus infection in vitro and in vivo. Influenza virus may therefore tailor peroxisomal and particularly ether lipid metabolism for efficient replication

Effective monitoring of decentralized forest resources in East Africa

There is no doubt that state control of forest resources in many countries has proved to be ineffective in solving and halting the rate of deforestation. The financial and human resources available to government forest departments are inadequate to carry out the task of policing forested areas without the participation of local communities . However, the success of decentralizing resources to local communities depends on solving three puzzles; the problem of supplying new institutions, the problem of credible commitment and the problem of mutual monitoring. IFRI, studies in Uganda have known that monitoring and rule enforcement is very important for the success of decentralized forest resources (Banana and Gombya- Ssembajjwe 1999). Trying to understand how use-groups and /or communities have monitored their own conformance to their agreements as well as their conformance to the rules in the E. African region is the challenge of this study. The study revealed that an effective monitoring strategy involves having good incentives for the monitors and a mechanism to supervise or monitor the monitors themselves. Where effective was effective, there are few illegal activities, high basal area and the physical and biological condition of the CPR was expected to improve with time

Agroecological integration of shade- and drought-tolerant food/feed crops for year-round productivity in banana-based systems under rain-fed conditions in Central Africa

Yield gaps in banana-based production systems have increased in the past two decades due to declining soil fertility, drought and biotic stresses. Sustainable, environmentally sound and economically viable strategies for intensification in these systems are urgently needed. Agroecological practices, such as the integration of shade- and drought-tolerant crops, nitrogen-fixing and cover crops could potentially improve soil fertility and moisture retention, reduce the weed burden, narrow yield gaps and increase overall plot/farm productivity in these systems. In Malaysia, leguminous crops like Pueraria phaseoloides, Calopogonium caeruleum and Centrosema pubescens are often cultivated as cover crops (to suppress weeds, and reduce moisture loss and soil erosion) in young rubber and oil palm plantations with low shade levels. Even in mature oil palm plantations with less than 30% light intensity, various shade-tolerant crops are grown, e.g., elephant foot yam, turmeric and arrow root. In humid tropical Africa, Colocasia (taro) and Xanthosoma (cocoyam) are reported to tolerate shade conditions and hence often planted under perennial banana/plantain plantations. Drought tolerance is a less common feature of most annual crops grown in the humid tropics. A few root and tuber crops (e.g., cassava, taro, yam and sweetpotato) remain in the field during the dry season in Central Africa and are then harvested according to household needs. This paper also reports on crops (Mucuna, lablab and chickpea) with potential for integration into banana-based systems during the dry season, if planted during the last month of the rainy season. These crops are reported to use the residual soil moisture content for continued growth during the dry season months. The paper concludes with detailed descriptions (from a literature review) on drought- and shade-tolerance characteristics of various crops which have long been integrated in Central African banana-based cropping systems, crops with a more recent cultivation history and crops with potential for system integration

Effective monitoring of decentralized forest resources in East Africa

There is no doubt that state control of forest resources in many countries has proved to be ineffective in solving and halting the rate of deforestation. The financial and human resources available to government forest departments are inadequate to carry out the task of policing forested areas without the participation of local communities . However, the success of decentralizing resources to local communities depends on solving three puzzles; the problem of supplying new institutions, the problem of credible commitment and the problem of mutual monitoring. IFRI, studies in Uganda have known that monitoring and rule enforcement is very important for the success of decentralized forest resources (Banana and Gombya- Ssembajjwe 1999). Trying to understand how use-groups and /or communities have monitored their own conformance to their agreements as well as their conformance to the rules in the E. African region is the challenge of this study. The study revealed that an effective monitoring strategy involves having good incentives for the monitors and a mechanism to supervise or monitor the monitors themselves. Where effective was effective, there are few illegal activities, high basal area and the physical and biological condition of the CPR was expected to improve with time

Vaginal practices among women at high risk of HIV infection in Uganda and Tanzania: recorded behaviour from a daily pictorial diary.

BACKGROUND: Intravaginal practices (IVP) are highly prevalent in sub-Saharan African and have been implicated as risk factors for HIV acquisition. However, types of IVP vary between populations, and detailed information on IVP among women at risk for HIV in different populations is needed. We investigated IVP among women who practice transactional sex in two populations: semi-urban, facility workers in Tanzania who engage in opportunistic sex work; and urban, self-identified sex workers and bar workers in Uganda. The aim of the study was to describe and compare IVP using a daily pictorial diary. METHODOLOGY/PRINCIPAL FINDINGS: Two hundred women were recruited from a HIV prevention intervention feasibility study in Kampala, Uganda and in North-West Tanzania. Women were given diaries to record IVP daily for six weeks. Baseline data showed that Ugandan participants had more lifetime partners and transactional sex than Tanzanian participants. Results from the diary showed that 96% of Tanzanian participants and 100% of Ugandan participants reported intravaginal cleansing during the six week study period. The most common types of cleansing were with water only or water and soap. In both countries, intravaginal insertion (e.g. with herbs) was less common than cleansing, but insertion was practiced by more participants in Uganda (46%) than in Tanzania (10%). In Uganda, participants also reported more frequent sex, and more insertion related to sex. In both populations, cleansing was more often reported on days with reported sex and during menstruation, and in Uganda, when participants experienced vaginal discomfort. Participants were more likely to cleanse after sex if they reported no condom use. CONCLUSIONS: While intravaginal cleansing was commonly practiced in both cohorts, there was higher frequency of cleansing and insertion in Uganda. Differences in IVP were likely to reflect differences in sexual behaviour between populations, and may warrant different approaches to interventions targeting IVP. Vaginal practices among women at high risk in Uganda and Tanzania: recorded behaviour from a daily pictorial diary

Sputum smear microscopy: evaluation of impact of training, microscope distribution, and use of external quality assessment guidelines for resource-poor settings

Sputum smear microscopy is the main and often only laboratory technique used for the diagnosis of tuberculosis in resource-poor countries, making quality assurance (QA) of smear microscopy an important activity. We evaluated the effects of a 5-day refresher training course for laboratory technicians and the distribution of new microscopes on the quality of smear microscopy in 13 primary health care laboratories in Kinshasa, Democratic Republic of Congo. The 2002 external QA guidelines for acid-fast bacillus smear microscopy were implemented, and blinded rechecking of the slides was performed before and 9 months after the training course and microscope distribution. We observed that the on-site checklist was highly time-consuming but could be tailored to capture frequent problems. Random blinded rechecking by the lot QA system method decreased the number of slides to be reviewed. Most laboratories needed further investigation for possible unacceptable performance, even according to the least-stringent interpretation. We conclude that the 2002 external QA guidelines are feasible for implementation in resource-poor settings, that the efficiency of external QA can be increased by selecting sample size parameters and interpretation criteria that take into account the local working conditions, and that greater attention should be paid to the provision of timely feedback and correction of the causes of substandard performance at poorly performing laboratories