Lessons learned from operating a pre-commercialisation field-testing platform for innovative non-sewered sanitation in Durban, South Africa

The Engineering Field Testing Platform (EFTP) was designed to provide an opportunity for technology  developers (TDs) to test non-sewered sanitation prototypes in the eThekwini Municipal Area (Durban), South Africa. Between 2017 and 2020, 15 sanitation systems were tested in informal settlements, peri-urban households, and other ‘real world’ settings. This paper illustrates the lessons learned from establishing and managing this testing platform. Costs and timelines for testing are dependent on several factors, including the aims of testing, the development stage of the prototype, whether testing takes place in a community or household setting and if a testing site is shared between prototypes. Timelines were routinely underestimated, particularly for community engagement and commissioning of prototypes to reach steady-state operation. Personnel accounted for more than half of the EFTP’s costs. The presence of the municipality as a platform partner was vital to the success of testing, both for gaining political support and for enabling access to testing sites. It is noted that working in communities, with test sites in public spaces, requires technical and social sensitivity to context. It was important to ensure testing supported future municipal decision-making on service provision, as well as longer-term development within communities. The high number of stakeholders, locally and internationally, raised management challenges common to any large project. However, the EFTP added value to TDs, the eThekwini Municipality, and communities requiring improved sanitation services; this was amplified through the platform approach

Implementing an engineering field testing platform for sustainable non-sewered sanitation prototypes

Researchers globally are developing sanitation solutions that make faecal waste safe, are affordable, do not require external power, water or sewer connections and that recover and reuse water, energy and nutrients. The Engineering Field Testing platform is a collaboration between the Pollution Research Group at the University of KwaZulu-Natal, eThekwini Water and Sanitation and a private company, Khanyisa Projects, which provides a supportive space to test early engineering concepts in a real world environment, while still under the control of technology developers. Local teams of engineers, scientists and social scientists support technology developers through site selection, community engagement, ethical approval, site preparation, installation and commissioning, sampling, testing and feedback and decommissioning. This ensures that locally relevant risks can be identified and mitigated. The concentration of prototypes being tested in a single location allows support resources and expertise to be pooled and increases collaboration to overcome common challenges

Municipal-academic partnerships for innovation in sanitation delivery: a case study in Durban, South Africa

Service delivery for the diverse communities of eThekwini Municipality requires innovative solutions. The partnership between the Pollution Research Group (PRG) at the University of KwaZulu-Natal (UKZN) and eThekwini Water and Sanitation (EWS) began informally in the 1960s and was first formalised in 2006. The Memorandum of Agreement (MoA) between the two organisations included a retainer that allowed greatly flexibility than would have been possible with project-to-project funding. This allows the PRG to act as an in-house research and development team for EWS and gives the PRG access to numerous research sites. The partnership has led to global recognition for progressive policies and innovative service delivery. It has benefited from interdisciplinary research, trust between organisations and individuals that is built on open and transparent communication, and strong leadership. EWS and the PRG are keen to support similar municipal-academic partnerships across Africa to support locally relevant applied sanitation research

Importance of Ethnicity, CYP2B6 and ABCB1 Genotype for Efavirenz Pharmacokinetics and Treatment Outcomes: A Parallel-group Prospective Cohort Study in two sub-Saharan Africa Populations.

We evaluated the importance of ethnicity and pharmacogenetic variations in determining efavirenz pharmacokinetics, auto-induction and immunological outcomes in two African populations. ART naïve HIV patients from Ethiopia (n = 285) and Tanzania (n = 209) were prospectively enrolled in parallel to start efavirenz based HAART. CD4+ cell counts were determined at baseline, 12, 24 and 48 weeks. Plasma and intracellular efavirenz and 8-hydroxyefvairenz concentrations were determined at week 4 and 16. Genotyping for common functional CYP2B6, CYP3A5, ABCB1, UGT2B7 and SLCO1B1 variant alleles were done. Patient country, CYP2B6*6 and ABCB1 c.4036A>G (rs3842A>G) genotype were significant predictors of plasma and intracellular efavirenz concentration. CYP2B6*6 and ABCB1 c.4036A>G (rs3842) genotype were significantly associated with higher plasma efavirenz concentration and their allele frequencies were significantly higher in Tanzanians than Ethiopians. Tanzanians displayed significantly higher efavirenz plasma concentration at week 4 (p<0.0002) and week 16 (p = 0.006) compared to Ethiopians. Efavirenz plasma concentrations remained significantly higher in Tanzanians even after controlling for the effect of CYP2B6*6 and ABCB1 c.4036A>G genotype. Within country analyses indicated a significant decrease in the mean plasma efavirenz concentration by week 16 compared to week 4 in Tanzanians (p = 0.006), whereas no significant differences in plasma concentration over time was observed in Ethiopians (p = 0.84). Intracellular efavirenz concentration and patient country were significant predictors of CD4 gain during HAART. We report substantial differences in efavirenz pharmacokinetics, extent of auto-induction and immunologic recovery between Ethiopian and Tanzanian HIV patients, partly but not solely, due to pharmacogenetic variations. The observed inter-ethnic variations in efavirenz plasma exposure may possibly result in varying clinical treatment outcome or adverse event profiles between populations

Liver Enzyme Abnormalities and Associated Risk Factors in HIV Patients on Efavirenz-Based HAART with or without Tuberculosis Co-Infection in Tanzania.

To investigate the timing, incidence, clinical presentation, pharmacokinetics and pharmacogenetic predictors for antiretroviral and anti-tuberculosis drug induced liver injury (DILI) in HIV patients with or without TB co-infection. A total of 473 treatment naïve HIV patients (253 HIV only and 220 with HIV-TB co-infection) were enrolled prospectively. Plasma efavirenz concentration and CYP2B6*6, CYP3A5*3, *6 and *7, ABCB1 3435C/T and SLCO1B1 genotypes were determined. Demographic, clinical and laboratory data were collected at baseline and up to 48 weeks of antiretroviral therapy. DILI case definition was according to Council for International Organizations of Medical Sciences (CIOMS). Incidence of DILI and identification of predictors was evaluated using Cox Proportional Hazards Model. The overall incidence of DILI was 7.8% (8.3 per 1000 person-week), being non-significantly higher among patients receiving concomitant anti-TB and HAART (10.0%, 10.7 per 1000 person-week) than those receiving HAART alone (5.9%, 6.3 per 1000 person-week). Frequency of CYP2B6*6 allele (p = 0.03) and CYP2B6*6/*6 genotype (p = 0.06) was significantly higher in patients with DILI than those without. Multivariate cox regression model indicated that CYP2B6*6/*6 genotype and anti-HCV IgG antibody positive as significant predictors of DILI. Median time to DILI was 2 weeks after HAART initiation and no DILI onset was observed after 12 weeks. No severe DILI was seen and the gain in CD4 was similar in patients with or without DILI. Antiretroviral and anti-tuberculosis DILI does occur in our setting, presenting early following HAART initiation. DILI seen is mild, transient and may not require treatment interruption. There is good tolerance to HAART and anti-TB with similar immunological outcomes. Genetic make-up mainly CYP2B6 genotype influences the development of efavirenz based HAART liver injury in Tanzanians

The 1.28 GHz MeerKAT DEEP2 Image

We present the confusion-limited 1.28 GHz MeerKAT DEEP2 image covering one qb » ¢ 68 FWHM primarybeam area with θ = 7 6 FWHM resolution and s = m - n 0.55 0.01 Jy beam 1 rms noise. Its J2000 center position α = 04h 13m 26 4, δ = −80° 00′ 00″ was selected to minimize artifacts caused by bright sources. We introduce the new 64-element MeerKAT array and describe commissioning observations to measure the primary-beam attenuation pattern, estimate telescope pointing errors, and pinpoint (u, v) coordinate errors caused by offsets in frequency or time. We constructed a 1.4 GHz differential source count by combining a power-law count fit to the DEEP2 confusion P(D) distribution from 0.25 to 10 μJy with counts of individual DEEP2 sources between 10 μJy and 2.5 mJy. Most sources fainter than S ∼ 100 μJy are distant star-forming galaxies (SFGs) obeying the far-IR/ radio correlation, and sources stronger than 0.25 μJy account for ∼93% of the radio background produced by SFGs. For the first time, the DEEP2 source count has reached the depth needed to reveal the majority of the star formation history of the universe. A pure luminosity evolution of the 1.4 GHz local luminosity function consistent with the Madau & Dickinson model for the evolution of SFGs based on UV and infrared data underpredicts our 1.4 GHz source count in the range -5 log Jy 4 [ ( )] S

Lessons learned from operating a pre-commercialisation field-testing platform for innovative non-sewered sanitation in Durban, South Africa

The Engineering Field Testing Platform (EFTP) was designed to provide an opportunity for technology developers (TDs) to test non-sewered sanitation prototypes in the eThekwini Municipal Area (Durban), South Africa. Between 2017 and 2020, 15&nbsp;sanitation systems were tested in informal settlements, peri-urban households, and other ‘real world’ settings. This paper illustrates the lessons learned from establishing and managing this testing platform. Costs and timelines for testing are dependent on several factors, including the aims of testing, the development stage of the prototype, whether testing takes place in a community or household setting and if a testing site is shared between prototypes. Timelines were routinely underestimated, particularly for community engagement and commissioning of prototypes to reach steady-state operation. Personnel accounted for more than half of the EFTP’s costs. The presence of the municipality as a platform partner was vital to the success of testing, both for gaining political support and for enabling access to testing sites. It is noted that working in communities, with test sites in public spaces, requires technical and social sensitivity to context. It was important to ensure testing supported future municipal decision-making on service provision, as well as longer-term development within communities. The high number of stakeholders, locally and internationally, raised management challenges common to any large project. However, the EFTP added value to TDs, the eThekwini Municipality, and communities requiring improved sanitation services; this was amplified through the platform approach