Biogas and Solar Energy Use in Rural Institutions in Southern Province, Rwanda

In Rwanda, 85% of primary energy comes from biomass. To alleviate this huge dependence, the Government banks on use of alternative sources of energy prioritising solar energy and biogas in rural areas. This paper analyses the use of the two sources in 45 rural institutions in Southern Province, using data collected through desk study and survey. The research reveals that these sources of energy are known in Rwanda, but very few rural institutions are equipped with such systems. Solar energy and biogas are used for lighting and cooking respectively. Their adoption is still government and NGOs driven. Institutions equipped with such systems experience lack of skilled technicians resulting in poor maintenance and malfunctioning. Lack of funds, little insight on the advantages of using the two sources of energy, and existing financial facilities set up by the government to promote their dissemination are major obstacles to their adoption. Therefore, departments in charge of energy should organise awareness campaign for heads of institutions to inform them on the advantages of using these energy sources. They should also set up and run specific training programmes to avail technicians capable of installing, operating and maintaining solar or biogas power systems.Keywords: Rwanda, Southern province, biogas, solar energy, uses, constraints

Field testing two existing, standardized respiratory severity scores (LIBSS and ReSViNET) in infants presenting with acute respiratory illness to tertiary hospitals in Rwanda - a validation and inter-rater reliability study.

INTRODUCTION: There is a substantial burden of respiratory disease in infants in the sub-Saharan Africa region. Many health care providers (HCPs) that initially receive infants with respiratory distress may not be adequately skilled to differentiate between mild, moderate and severe respiratory symptoms, which may contribute to poor management and outcome. Therefore, respiratory severity scores have the potential to contributing to address this gap. OBJECTIVES: to field-test the use of two existing standardized bronchiolitis severity scores (LIBSS and ReSViNET) in a population of Rwandan infants (1-12 months) presenting with respiratory illnesses to urban, tertiary, pediatric hospitals and to assess the severity of respiratory distress in these infants and the treatments used. METHODS: A cross-sectional, validation study, was conducted in four tertiary hospitals in Rwanda. Infants presenting with difficulty in breathing were included. The LIBSS and ReSViNET scores were independently employed by nurses and residents to assess the severity of disease in each infant. RESULTS: 100 infants were recruited with a mean age of seven months. Infants presented with pneumonia (n = 51), bronchiolitis (n = 36) and other infectious respiratory illnesses (n = 13). Thirty-three infants had severe disease and survival was 94% using nurse applied LIBSS. Regarding inter-rater reliability, the intra-class correlation coefficient (ICC) for LIBSS and ReSViNET between nurses and residents was 0.985 (95% CI: 0.98-0.99) and 0.980 (0.97-0.99). The convergent validity (Pearson's correlation) between LIBSS and ReSViNET for nurses and residents was R = 0.836 (p<0.001) and R = 0.815 (p<0.001). The area under the Receiver Operator Curve (aROC) for admission to PICU or HDU was 0.956 (CI: 0.92-0.99, p<0.001) and 0.880 (CI: 0.80-0.96, p<0.001) for nurse completed LIBSS and ReSViNET respectively. CONCLUSION: LIBSS and ReSViNET were designed for infants with bronchiolitis in resource-rich settings. Both LIBSS and ReSViNET demonstrated good reliability and validity results, in this cohort of patients presenting to tertiary level hospitals. This early data demonstrate that these two scores have the potential to be used in conjunction with clinical reasoning to identify infants at increased risk of clinical deterioration and allow timely admission, treatment escalation and therefore support resource allocation in Rwanda

Assessment of aflatoxin and fumonisin contamination levels in maize and mycotoxins awareness and risk factors in Rwanda

Mycotoxins are secondary metabolites of fungi that are toxic to humans and animals when consumed in contaminated food and feed. The Rwandan climate conditions like steady temperature and sufficient rainfall favor the growth of fungi leading to high probability of mycotoxins contamination. Mycotoxins get into maize throughout the value chain from the field to processed products. Maize is&nbsp; promoted in Rwanda under the Crop Intensification Program (CIP), for nutrition and food security. The aim of the study was to evaluate mycotoxins (Aflatoxin and fumonisin) levels in maize and assess awareness and factors associated with mycotoxin contamination in Rwanda. Maize samples (227 kg) from season B 2019 were collected in 15 Districts in five provinces of Rwanda after an interview with a representative of the household or cooperative using a structured questionnaire. The samples were analyzed for aflatoxin and&nbsp; fumonisin using Reveal Q+ and AccuScan Gold Reader. From the interview, most of the respondents were not aware about aflatoxin (59.7 %) and 99 % did not know the effect of mycotoxins on human health. The average of aflatoxin contamination in surveyed districts was 6.69±13 μg/kg. In general, 90.4 % of samples scored below the limit of aflatoxin level regulated in East Africa/Kenya regulation standards (10 μg/kg). The levels of aflatoxin ranged between 0 and 100.9 μg/kg. The means aflatoxin levels within districts ranged between 1.36±0.5 μg/kg and 13.75±25 μg/kg. Among 9.6 % of the samples containing aflatoxins above the EU and Kenyan regulations standard limit, 5.7 % were above the US standards of 20 μg/kg. Within clusters, the level of aflatoxin more than 10 μg/kg was 5 %, 7 % and 18 % for stores, household and market samples, respectively. From the study, as mechanical damage of grains, moisture content of grains and the temperature of the store house increased, Aflatoxin level also increased. Fumonisin analyzed in maize ranged from 0 to 2.3 μg/g and only one sample from market showed a slightly higher level of fumonisin than the EU and US limit of 2 μg/g. More effort for aflatoxin mitigation is needed at the market level. Farmers need to be aware and taught how they can improve their agricultural system and more knowledge on mycotoxin control is needed. The results point to appropriate measures to recommend for control ofmycotoxins in Rwanda and awareness creation. Key words: AccuScan, Aflatoxin, Fumonisin, Fungal, Maize, Mycotoxins, Reveal Q+, Rwand

Community mobilization for malaria elimination: application of an open space methodology in Ruhuha sector, Rwanda

Background Despite the significant reduction of malaria transmission in Rwanda, Ruhuha sector is still a highly endemic area for malaria. The objective of this activity was to explore and brainstorm the potential roles of various community stakeholders in malaria elimination. Methods Horizontal participatory approaches such as ‘open space’ have been deployed to explore local priorities, stimulate community contribution to project planning, and to promote local capacity to manage programmes. Two open space meetings were conducted with 62 and 82 participants in years 1 and 2, respectively. Participants included purposively selected community and local organizations’ representatives. Results Malaria was perceived as a health concern by the respondents despite the reported reduction in prevalence from 60 to 20% for cases at the local health centre. Some misconceptions of the cause of malaria and misuse of preventive strategies were noted. Poverty was deemed to be a contributing factor to malaria transmission, with suggestions that improvement of living conditions for poor families might help malaria reduction. Participants expressed willingness to contribute to malaria elimination and underscored the need for constant education, sensitization and mobilization towards malaria control in general. Active diagnosis, preventative strategies and prompt treatment of malaria cases were all mentioned by participants as ways to reduce malaria. Participants suggested that partnership of stakeholders at various levels could speed up programme activities. A community rewards system was deemed important to motivate engaged participants, i.e., community health workers and households. Establishment of malaria clubs in schools settings was also suggested as crucial to speed up community awareness and increase skills towards further malaria reduction. Conclusions This bottom-up approach was found useful in engaging the local community, enabling them to explore issues related to malaria in the area and suggest solutions for sustainable malaria elimination gains

Predicting range shifts of African apes under global change scenarios

Aim: Modelling African great ape distribution has until now focused on current or past conditions, while future scenarios remain scarcely explored. Using an ensemble forecasting approach, we predicted changes in taxon-specific distribution under future scenarios of climate, land use and human populations for (1) areas outside protected areas (PAs) only (assuming complete management effectiveness of PAs), (2) the entire study region and (3) interspecies range overlap. Location: Tropical Africa. Methods: We compiled occurrence data (n = 5,203) on African apes from the IUCN A.P.E.S. database and extracted relevant climate-, habitat- and human-related predictors representing current and future (2050) conditions to predict taxon-specific range change under a best- and a worst-case scenario, using ensemble forecasting. Results The predictive performance of the models varied across taxa. Synergistic interactions between predictors are shaping African ape distribution, particularly human-related variables. On average across taxa, a range decline of 50% is expected outside PAs under the best scenario if no dispersal occurs (61% in worst scenario). Otherwise, an 85% range reduction is predicted to occur across study regions (94% worst). However, range gains are predicted outside PAs if dispersal occurs (52% best, 21% worst), with a slight increase in gains expected across study regions (66% best, 24% worst). Moreover, more than half of range losses and gains are predicted to occur outside PAs where interspecific ranges overlap. Main Conclusions: Massive range decline is expected by 2050, but range gain is uncertain as African apes will not be able to occupy these new areas immediately due to their limited dispersal capacity, migration lag and ecological constraints. Given that most future range changes are predicted outside PAs, Africa's current PA network is likely to be insufficient for preserving suitable habitats and maintaining connected ape populations. Thus, conservation planners urgently need to integrate land use planning and climate change mitigation measures at all decision-making levels both in range countries and abroad

High aboveground carbon stock of African tropical montane forests

Tropical forests store 40–50 per cent of terrestrial vegetation carbon1. However, spatial variations in aboveground live tree biomass carbon (AGC) stocks remain poorly understood, in particular in tropical montane forests2. Owing to climatic and soil changes with increasing elevation3, AGC stocks are lower in tropical montane forests compared with lowland forests2. Here we assemble and analyse a dataset of structurally intact old-growth forests (AfriMont) spanning 44 montane sites in 12 African countries. We find that montane sites in the AfriMont plot network have a mean AGC stock of 149.4 megagrams of carbon per hectare (95% confidence interval 137.1–164.2), which is comparable to lowland forests in the African Tropical Rainforest Observation Network4 and about 70 per cent and 32 per cent higher than averages from plot networks in montane2,5,6 and lowland7 forests in the Neotropics, respectively. Notably, our results are two-thirds higher than the Intergovernmental Panel on Climate Change default values for these forests in Africa8. We find that the low stem density and high abundance of large trees of African lowland forests4 is mirrored in the montane forests sampled. This carbon store is endangered: we estimate that 0.8 million hectares of old-growth African montane forest have been lost since 2000. We provide country-specific montane forest AGC stock estimates modelled from our plot network to help to guide forest conservation and reforestation interventions. Our findings highlight the need for conserving these biodiverse9,10 and carbon-rich ecosystems

High aboveground carbon stock of African tropical montane forests

Tropical forests store 40-50 per cent of terrestrial vegetation carbon(1). However, spatial variations in aboveground live tree biomass carbon (AGC) stocks remain poorly understood, in particular in tropical montane forests(2). Owing to climatic and soil changes with increasing elevation(3), AGC stocks are lower in tropical montane forests compared with lowland forests(2). Here we assemble and analyse a dataset of structurally intact old-growth forests (AfriMont) spanning 44 montane sites in 12 African countries. We find that montane sites in the AfriMont plot network have a mean AGC stock of 149.4 megagrams of carbon per hectare (95% confidence interval 137.1-164.2), which is comparable to lowland forests in the African Tropical Rainforest Observation Network(4) and about 70 per cent and 32 per cent higher than averages from plot networks in montane(2,5,6) and lowland(7) forests in the Neotropics, respectively. Notably, our results are two-thirds higher than the Intergovernmental Panel on Climate Change default values for these forests in Africa(8). We find that the low stem density and high abundance of large trees of African lowland forests(4) is mirrored in the montane forests sampled. This carbon store is endangered: we estimate that 0.8 million hectares of old-growth African montane forest have been lost since 2000. We provide country-specific montane forest AGC stock estimates modelled from our plot network to help to guide forest conservation and reforestation interventions. Our findings highlight the need for conserving these biodiverse(9,10) and carbon-rich ecosystems. The aboveground carbon stock of a montane African forest network is comparable to that of a lowland African forest network and two-thirds higher than default values for these montane forests.Peer reviewe

ВЭБ-мононуклеоз у детей в современных условиях

EBV-mononucleosis is a widespread infectious disease, and also it is an urgent problem of the whole world. The purpose of the research was to study the clinical and laboratory features of EBV-mononucleosis in hospitalized children of different ages in modern conditions. Under the supervision were 136 children aged from 1 year to 18 years. All of the patients had typical and mainly (85%) moderate form of the disease, and 15% of them patients had a severe form of the disease. The results: more severe fever and lymphadenopathy were observed in children older than 3 years. Acute tonsillitis was present in all hospitalized children. Adenoiditis and hepatosplenomegaly were greater in the group of patients of a younger age. Hyperfermentemia was determined in more than half of patients, more often in children over 12 years old. In the hemogram leukocytosis and monocytosis were mostly noted. Atypical blood mononuclear cells were detected in 89% of patients. Patients got complex etiopathogenetic therapy.ВЭБ-мононуклеоз является широко распространенным инфекционным заболеванием, а так же актуальной проблемой во всем мире. Цель исследования — изучить клинико-лабораторные особенности ВЭБ-мононуклеоза у госпитализированных детей различного возраста в современных условиях. Под наблюдением находились 136 детей в возрасте от 1 г. до 18 лет. У всех больных диагностирована типичная, преимущественно (85%) среднетяжелая форма заболевания, у 15% пациентов выявлена тяжелая степень болезни. Результаты: более выраженный синдром лихорадки и лимфаденопатии наблюдались у детей в возрасте старше 3 лет. Острый тонзиллит присутствовал у всех госпитализированных. Аденоидит и гепатоспленомегалия были более выраженными у пациентов младшей возрастной группы. Гиперферментемия определялась более чем у половины пациентов, чаще у детей в возрасте старше 12 лет. В гемограмме чаще всего отмечались: лейкоцитоз и моноцитоз. Атипичные мононуклеары в крови были выявлены у 89% пациентов. Пациенты получали комплексную этиопатогенетическую терапию

Design and methods for a quasi-experimental pilot study to evaluate the impact of dual active ingredient insecticide-treated nets on malaria burden in five regions in sub-Saharan Africa

Background Vector control tools have contributed significantly to a reduction in malaria burden since 2000, primarily through insecticidal-treated bed nets (ITNs) and indoor residual spraying. In the face of increasing insecticide resistance in key malaria vector species, global progress in malaria control has stalled. Innovative tools, such as dual active ingredient (dual-AI) ITNs that are effective at killing insecticide-resistant mosquitoes have recently been introduced. However, large-scale uptake has been slow for several reasons, including higher costs and limited evidence on their incremental effectiveness and cost-effectiveness. The present report describes the design of several observational studies aimed to determine the effectiveness and cost-effectiveness of dual-AI ITNs, compared to standard pyrethroid-only ITNs, at reducing malaria transmission across a variety of transmission settings. Methods Observational pilot studies are ongoing in Burkina Faso, Mozambique, Nigeria, and Rwanda, leveraging dual-AI ITN rollouts nested within the 2019 and 2020 mass distribution campaigns in each country. Enhanced surveillance occurring in select study districts include annual cross-sectional surveys during peak transmission seasons, monthly entomological surveillance, passive case detection using routine health facility surveillance systems, and studies on human behaviour and ITN use patterns. Data will compare changes in malaria transmission and disease burden in districts receiving dual-AI ITNs to similar districts receiving standard pyrethroid-only ITNs over three years. The costs of net distribution will be calculated using the provider perspective including financial and economic costs, and a cost-effectiveness analysis will assess incremental cost-effectiveness ratios for Interceptor® G2, Royal Guard®, and piperonyl butoxide ITNs in comparison to standard pyrethroid-only ITNs, based on incidence rate ratios calculated from routine data. Conclusions Evidence of the effectiveness and cost-effectiveness of the dual-AI ITNs from these pilot studies will complement evidence from two contemporary cluster randomized control trials, one in Benin and one in Tanzania, to provide key information to malaria control programmes, policymakers, and donors to help guide decision-making and planning for local malaria control and elimination strategies. Understanding the breadth of contexts where these dual-AI ITNs are most effective and collecting robust information on factors influencing comparative effectiveness could improve uptake and availability and help maximize their impact