Spatial variability in penetration resistance of a hardsetting tropical alfisol

Geostatistical techniques were used to analyse the spatial variation of penetration resistance on an experimental plot intended for root studies. Penetration resistance was measured at two soil water conditions. Penetration resistance exhibited spatial structure but the models describing the semivariograms were different for the two soil water conditions. An isotropic linear model provided the best fit for penetration resistance in the dry soil while an isotropic spherical model was used for penetration in the wet soil. A complementary study of the spatial structure of water content also showed a similar trend. Cross-semivariograms were constructed to determine the spatial relationship between penetration resistance and water content. Penetration resistance in the dry soil was negatively correlated with water content. The nugget variances as the percentage of the sill in the wet soil data set suggest that the topsoil was slightly more variable than the subsoil. The spatial scale of variation in penetration resistance of the wet soil was 33 m at 7.5 cm depth and 20–27 m at 15–30 cm depth. Punctual kriging was used to estimate the penetration resistance and water content values. The estimated values are presented as contour maps. The pattern of variation and the underlying possible processes for the variation are discussed. The results suggest that the likely influence of spatial variation of soil properties on crop growth may have to be considered in modelling in order to simulate the real field situation

Tillage methods related to soil and water conservation in south Asia

Research on different tillage systems and their role in soil and water conservation in south Asia is reviewed. Tillage has shown marked influence on soil hydraulic characteristics and to some extent on soil chemical and biological properties particularly organic matter cycling. The importance of conservation tillage in reducing runoff, soil loss and in ensuring sustainable agricultural production in the region is emphasized. The role of other tillage practices, for example contour cultivation, contour bunding, terraces and tied ridging, in increasing the profile water storage is discusse

Basic newborn care and neonatal resuscitation: a multi-country analysis of health system bottlenecks and potential solutions.

BACKGROUND: An estimated two-thirds of the world's 2.7 million newborn deaths could be prevented with quality care at birth and during the postnatal period. Basic Newborn Care (BNC) is part of the solution and includes hygienic birth and newborn care practices including cord care, thermal care, and early and exclusive breastfeeding. Timely provision of resuscitation if needed is also critical to newborn survival. This paper describes health system barriers to BNC and neonatal resuscitation and proposes solutions to scale up evidence-based strategies. METHODS: The maternal and newborn bottleneck analysis tool was applied by 12 countries in Africa and Asia as part of the Every Newborn Action Plan process. Country workshops engaged technical experts to complete the survey tool, which is designed to synthesise and grade health system "bottlenecks" that hinder the scale up of maternal-newborn intervention packages. We used quantitative and qualitative methods to analyse the bottleneck data, combined with literature review, to present priority bottlenecks and actions relevant to different health system building blocks for BNC and neonatal resuscitation. RESULTS: Eleven of the 12 countries provided grading data. Overall, bottlenecks were graded more severely for resuscitation. The most severely graded bottlenecks for BNC were health workforce (8 of 11 countries), health financing (9 out of 11) and service delivery (7 out of 9); and for neonatal resuscitation, workforce (9 out of 10), essential commodities (9 out of 10) and service delivery (8 out of 10). Country teams from Africa graded bottlenecks overall more severely. Improving workforce performance, availability of essential commodities, and well-integrated health service delivery were the key solutions proposed. CONCLUSIONS: BNC was perceived to have the least health system challenges among the seven maternal and newborn intervention packages assessed. Although neonatal resuscitation bottlenecks were graded more severe than for BNC, similarities particularly in the workforce and service delivery building blocks highlight the inextricable link between the two interventions and the need to equip birth attendants with requisite skills and commodities to assess and care for every newborn. Solutions highlighted by country teams include ensuring more investment to improve workforce performance and distribution, especially numbers of skilled birth attendants, incentives for placement in challenging settings, and skills-based training particularly for neonatal resuscitation

The Ability to Look: Management of Breast Disease in the Democratic Republic of the Congo Using Smart Ultrasound Technology

Background: The vast majority of women with breast cancer in sub-Saharan Africa present with advanced stage disease, due primarily to the lack of opportunities for early detection and treatment. As part of a larger effort to increase access to diagnostic and therapeutic services for women's cancers in the Democratic Republic of Congo (DRC), we implemented a curriculum to train the local workforce and a program to build the supportive infrastructure for the diagnosis and treatment of breast cancer at a private sector health facility (Biamba Marie Mutombo Hospital) in Kinshasa. Study design: After onsite trainings in the DRC by a US breast surgeon (RT), Congolese surgeons, general physicians, physician assistants, and nurses used the Phillips Lumify smart-phone ultrasound device to perform and interpret the results of whole breast ultrasound on symptomatic women. Surgeons were trained to perform ultrasound-guided core needle biopsy on those who met the criteria for tissue diagnosis, after which they trained nurses to do the same. Results: Over 3 years, 5,211 patients were identified as having a breast abnormality on clinical breast examination. Ultrasound abnormalities were noted in 1,493 (27%) patients, of which 632 (42%) met the criteria for ultrasound-guided core needle biopsy or fine needle aspiration. Pathology reports were available on 368 (58%) patients who underwent biopsy, of which 164 were malignant and 204 benign. Conclusions: We demonstrated how the “ability to look” using smart technology can be successfully used to augment clinical breast exam and triage patients for biopsy in a resource-constrained African setting

Multi-centre point-prevalence survey of hospital-acquired infections in Ghana

Background: There is a paucity of data describing hospital-acquired infections (HAIs) in Africa. Objective: To describe the prevalence and distribution of HAIs in acute care hospitals in Ghana. Methods: Between September and December 2016, point-prevalence surveys were conducted in participating hospitals using protocols of the European Centre for Disease Prevention and Control. Medical records of eligible inpatients at or before 8am on the survey date were reviewed to identify HAIs present at the time of the survey. Findings: Ten hospitals were surveyed, representing 32.9% of all acute care beds in government hospitals. Of 2107 inpatients surveyed, 184 HAIs were identified among 172 patients, corresponding to an overall prevalence of 8.2%. The prevalence values in hospitals ranged from 3.5% to 14.4%, with higher proportions of infections in secondary and tertiary care facilities. The most common HAIs were surgical site infections (32.6%), bloodstream infections (19.5%), urinary tract infections (18.5%) and respiratory tract infections (16.3%). Device-associated infections accounted for 7.1% of HAIs. For 12.5% of HAIs, a micro-organism was reported; the most commonly isolated micro-organism was Escherichia coli. Approximately 61% of all patients surveyed were on antibiotics; 89.5% of patients with an HAI received at least one antimicrobial agent on the survey date. The strongest independent predictors for HAI were the presence of an invasive device before onset of infection and duration of hospital stay. Conclusion: A low HAI burden was found compared with findings from other low- and middle-income countries

Analysis of drug resistance among difficult-to-treat tuberculosis patients in Ghana identifies several pre-XDR TB cases

BACKGROUND: Resistance to tuberculosis (TB) drugs has become a major threat to global control efforts. Early case detection and drug susceptibility profiling of the infecting bacteria are essential for appropriate case management. The objective of this study was to determine the drug susceptibility profiles of difficult-to-treat (DTT) TB patients in Ghana. METHODS: Sputum samples obtained from DTT-TB cases from health facilities across Ghana were processed for rapid diagnosis and detection of drug resistance using the Genotype MTBDRplus and Genotype MTBDRsl.v2 from Hain Life science. RESULTS: A total of 298 (90%) out of 331 sputum samples processed gave interpretable bands out of which 175 (58.7%) were resistant to at least one drug (ANY(r)); 16.8% (50/298) were isoniazid-mono-resistant (INH(r)), 16.8% (50/298) were rifampicin-mono-resistant (RIF(r)), and 25.2% (75/298) were MDR. 24 (13.7%) of the ANY(r) were additionally resistant to at least one second line drug: 7.4% (2 RIF(r), 1 INH(r), and 10 MDR samples) resistant to only FQs and 2.3% (2 RIF(r), 1 INH(r), and 1 MDR samples) resistant to AMG drugs kanamycin (KAN), amikacin (AMK), capreomycin (CAP), and viomycin (VIO). Additionally, there were 4.0% (5 RIF(r) and 2 MDR samples) resistant to both FQs and AMGs. 81 (65.6%) out of 125 INH-resistant samples including INH(r) and MDR had katG-mutations (MT) whereas 15 (12%) had inhApro-MT. The remaining 28 (22.4%) had both katG and inhA MT. All the 19 FQ-resistant samples were gyrA mutants whereas the 10 AMGs were rrs (3), eis (3) as well as rrs, and eis co-mutants (4). Except for the seven pre-XDR samples, no sample had eis MT. CONCLUSION: The detection of several pre-XDR TB cases in Ghana calls for intensified drug resistance surveillance and monitoring of TB patients to, respectively, ensure early diagnosis and treatment compliance

Soil management options to reduce runoff and erosion on a hardsetting Alfisol in the semi-arid tropics

Improved farming systems are needed to enhance productivity and reduce degradation on hardsetting Alfisols in the semi-arid tropics. A long-term experiment was started in July 1988 at ICRISAT, Hyderabad, India, to evaluate practices to improve infiltration and reduce erosion by stimulating biological activity and protecting soil in the rainy season. This paper outlines the rationale for the experiment, describes it, and summarises early results. Fifteen treatments in a randomised block design were applied to plots 28.5 m long by 5 m wide on a 2% slope. Nine annual treatments made up a factorial sub-set: tillage by tined implement to three depths (0, 10 and 20 cm) combined with three mulch treatments (no mulch, farmyard manure (FYM) at 15 t ha−1, and rice straw at 5 t ha−1). Pearl millet (Pennisetum glaucum) was sown in the factorial sub-set in July 1988. Six perennial species ley treatments (combinations of perennial pigeonpea (Cajanus cajan), verano stylo (Stylosanthes hamata), and buffel grass (Cenchrus ciliaris)) completed the randomised block design. All treatments were replicated three times making 45 plots in total. Plots were instrumented to measure runoff and soil loss. Millet straw yield was reduced by tillage to 20 cm and grain yield was significantly reduced by tillage to both 10 and 20 cm. Mulches had no effect on millet straw yield but FYM significantly increased millet grain yield. The proportion of rainfall running off plots ranged from 15.8 to 39.1%. Perennial species treatments tended to have higher runoff than treatments under millet, but this was not consistent as zero tillage without mulch, and tillage to 10 cm either with mulch or with FYM mulch, also had relatively high runoff. Rice straw mulch significantly reduced runoff by comparison with FYM and no mulch. Soil was lost mainly as suspended load, indicating that raindrop detachment was the main erosion process. Effects of perennial species were variable and probably reflected the degree of surface protection provided in this establishment phase. Tillage significantly increased suspended load concentration in the first major runoff event but not in an event later in the season. Rice straw mulch significantly reduced bed load concentration in the first event and reduced suspended load in the later event. The ability of straw mulch to reduce runoff volume and sediment concentration suggests mulch-based systems may be able to contribute to sustainability of farming systems in the semi-arid tropics. The lack of beneficial effects from tillage suggests a limited role for tillage-based systems. Results from subsequent years are needed to form definite conclusions and to show effects of slower biologically-induced changes in the soil