Comparison of Reliability of Rapid Diagonostic Test to Microscopy in the Diagnosis of Malaria at Gulu Regional Referral Hospital

Background: Malaria is one of the leading causes of mortality in sub-Saharan Africa and continues to be  a threat to life. Everyday 320 people die due to malaria in Uganda. Statistics from the ministry of health  show that of all outpatient visits at health Centres, malaria represents 25 - 40 % with 9 - 14 % in  in-patient. Microscopy remains the main stay for malaria diagnosis. Nevertheless it is slow and needs a  lot of experience and expertise, consequently there is need to use a faster method but retaining the  precision of the microscope.Objective: To determine the reliability of the rapid diagnostic test in comparison to microscopy in the  diagnosis of malaria thereafter improve the management of malaria.Design: An experimental study.Setting: Gulu Regional Referral Hospital laboratories.Subjects: The study was experimental; using 250 malarial suspected participants with fever .The malaria rapid diagnostic method and microscopy of the stained malarial slides were the methods used.Results: Of the 250 samples, 214 were found to be negative using microscopy and 208 using Rapid  Diagnostic Test suggesting over suspicion of malaria. Microscopy had a sensitivity of 85.7%, specificity of 94.7% and Negative predictive value (NPV) of 97.2%.Conclusion: RDTs can be used to quickly confirm the clinical diagnosis of malaria to reduce irrational use of anti-malarials when microscopy is not available before initiating treatment to avoid irrational use of drugs. However due to the cost, microscopy still remains the gold standard method for the diagnosis of Malaria

EVALUATION OF SCHISTOSOMA MANSONI MORBIDITY ONE YEAR AFTER PRAZIQUANTEL TREATMENT IN RHINO CAMP AND OBONGI IN WEST NILE, UGANDA

An evaluation study on reversibility of Schistosoma mansoni induced periportal fibrosis (PF) morbidity following treatment with praziquantel, 40mg/kg body weight after one year, was carried out in Rhino Camp and Obongi all are West Nile districts in northern Uganda. To assess the reversibility of Schistosoma (S) mansoni induced PFs morbidity following treatment with praziquantel, 40mg/kg body weight after one year. The design was a Prospective cohorts study; and the setting was a busy canoe landing sites along Albert Nile in Schistosoma (S) mansoni hyperendemic areas of Rhino Camp and Obongi fishing village were selected for the study. Previously in 2005, 1562 people including fishermen and women, school pupils, teachers, and civil servants were studied in both fishing villages for S. mansoni using Kato/Katz stool smear method. Abdominal ultrasonography and sonomorphological abnormalities of periportal fibrosis were performed with Aloka portable ultrasound machine (Hellige, Freiburg, Germany) fitted with a convex probe of 3.5 mega Hertz was also performed in the field clinic on all patients who had S. mansoni eggs in their faeces. The sonomorphological abnormalities of periportal fibrosis were categorised and organomorphometry of liver and spleen was done. One thousand two hundred and seventy three 1273 (81.5%) patients in Rhino Camp and Obongi fishing villages were found to be excreting from 100 to ≥ 500 eggs per gram (epg) of faeces of S. mansoni eggs. Two hundred and eighty nine (18.5%) did not have eggs of S.mansoni in their faeces. All the 1273 patients secreting eggs of S.mansoni in their stool in Rhino Camp and Obongi fishing villages had abdominal ultrasonography and sonomorphological abnormalities of periportal fibrosis. Eight hundred and forty 840 (66%) although excreted S. mansoni eggs in their stool had Pf (0); Pf grade (I), n=259 (20.3%); Pf grade (II) n =147 (11.5%); and Pf grade (III) n=27 (2.1%) were observed

Detection of Cryptococcus neoformans in Cerebrospinal Fluid from Meningitis Patients Associated with HIV/AIDS in Uganda

The significance of Cryptococcus var. neoformans meningitis fatality in human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) patients was confirmed in ten cerebrospinal fluids (CSFs) from Entebbe hospitals in Uganda. All ten CSF specimens were turbid, but on centrifugation, their supernatants were clear and colourless. The protein content of the specimens ranged from 20 to 50mg per 100ml of CSF (normal range is 10 to 40mg/100ml). Sugar content ranged between 20 to 60mg per 100ml CFS (normal range 45 to 72mg/100ml). The white blood cell (WBC) counts in the ten specimens ranged from 15 to 40 WBC/mm^3 of CSF (normal range up to 5 WBC/mm^3). Gram stain on the deposits, showed capsulated Cryptococcus (Cr.) neoformans var. neoformans which were further demonstrated in Odongo-Aginya stain using 5% eosin in 10% formalin mixed in equal volume with 7.5% nigrosin in 10% formalin (Odongo-Aginya et al., 1995). Ziehl Neelsen stain on the deposits, for acid alcohol fast bacilli was negative. Cr. neoformans var. neoformans were isolated from all CSF specimens and all patients investigated, died within one week from the time of admission to the hospitals

Induction of humoral immune response to multiple recombinant Rhipicephalus appendiculatus antigens and their effect on tick feeding success and pathogen transmission

BACKGROUND: Rhipicephalus appendiculatus is the primary vector of Theileria parva, the etiological agent of East Coast fever (ECF), a devastating disease of cattle in sub-Saharan Africa. We hypothesized that a vaccine targeting tick proteins that are involved in attachment and feeding might affect feeding success and possibly reduce tick-borne transmission of T. parva. Here we report the evaluation of a multivalent vaccine cocktail of tick antigens for their ability to reduce R. appendiculatus feeding success and possibly reduce tick-transmission of T. parva in a natural host-tick-parasite challenge model. METHODS: Cattle were inoculated with a multivalent antigen cocktail containing recombinant tick protective antigen subolesin as well as two additional R. appendiculatus saliva antigens: the cement protein TRP64, and three different histamine binding proteins. The cocktail also contained the T. parva sporozoite antigen p67C. The effect of vaccination on the feeding success of nymphal and adult R. appendiculatus ticks was evaluated together with the effect on transmission of T. parva using a tick challenge model. RESULTS: To our knowledge, this is the first evaluation of the anti-tick effects of these antigens in the natural host-tick-parasite combination. In spite of evidence of strong immune responses to all of the antigens in the cocktail, vaccination with this combination of tick and parasite antigens did not appear to effect tick feeding success or reduce transmission of T. parva. CONCLUSION: The results of this study highlight the importance of early evaluation of anti-tick vaccine candidates in biologically relevant challenge systems using the natural tick-host-parasite combination

A generic materials and operations planning approach for inventory turnover optimization in the chemical industry

Chemical industries usually involve continuous and large-scale production processes that require demanding inventory control systems. This paper aims to show the results of the implementation of a mixed-integer programming model (MIP) based on the Generic Materials and Operations Planning Problem (GMOP) for optimizing the inventory turnover in a fertilizer company. Results showed significant improvements for Inventory Turnover Ratios and overall costs when compared with an empirical production planning method

EVIDENCE OF LONG TERM BENEFIT OF MORBIDITY REDUCTION DUE TO PRAZIQUANTEL TREATMENT AGAINST SCHISTOSOMA MANSONI IN KIGUNGU FISHING VILLAGE IN ENTEBBE, UGANDA

Praziquantel (PZQ) is efficacious against Schistosoma mansoni. This was prospective cohort study. This study was carried out at Kigungu fishing village, Entebbe, Uganda. The goal of the study was to establish cost effective regiment for mass drug administration (MDA) of Praziquentel in the morbidity reduction of S.mansoni infection. In January 2004, nine hundred and forty five (945) participants were registered in this study. Our analysis was based on examining microscopically three slides prepared from each of 945 stool specimens delivered by each of the participant using modified Kato/Katz method. These included male and female, children and adults living in Kigungu fishing village in Entebbe Uganda. In total 901, cohorts were re-examined for infections clearance six months later in July 2004 and 18 months later in June 2005, 625 cohorts were again re-evaluated for S.mansoni infections after the baseline study. At baseline, (448) of 945 (47.5%) cohorts were S. mansoni positive. All these participants were treatment with a single oral dose of praziquantel at 40mg/kg. At the same time, 495 (52.5%) were S. mansoni negative. Of the 625 (66.3%) cohorts who came back for final review, 80 (12.8%) were still positive for S. mansoni while 210 (33.6%) remained negative after the base line treatment with praziquantel. On the other hand 103 (16.3%) of cohorts who were initially negative at the base line became S.mansoni positive after 18 months and 213(34.1%) remained negative for S.mansoni. The force of re-infection after six months was significant {(P=0.0001), (OR 0.47) CI at 95% (0.31-0.71)}. Nevertheless the force of reinfection was not significant after 18 months {(P=0.766), (OR 0.95) CI at 95% (0.68-1.34)}.The geometric mean eggs excretion of the 80 cohorts who were S.mansoni positive at 18 months was 151.967.This did not reach the geometric mean egg excreted by the same cohorts at baseline which was 285.05. The egg excretion was reduced by 46.8%. Similarly there was marked decrease in clinical symptoms amongst the cohorts. Our study suggests evidence of long-term benefit of praziquantel in Kigungu and that a yearly administration of praziquantel to the community could be a regiment for mass drug administration (MAD) for this community to control schistosomiasis morbidity

Continuous observations of CO2 and CH4 exchange from East-African rangelands

Semi-arid rangelands in Sub-Saharan Africa (SSA) are an important source of food security and nutrition but are under increased anthropogenic pressure by a growing population. These rangelands are characterized by nutrient poor soils and distinct wet and dry season(s). Due to the soil and climate combination, conventional crop agriculture is rarely feasible without irrigation and mineral fertilizer amendments, which in turn are limited by prohibitively high fertilizer prices and lack of water. Instead, pastoral livestock keeping is a valuable option to use these marginal lands and – under the right management – can be a sustainable form of food production and biodiversity protection given that most of these landscapes have co-evolved with megafauna over millennia. Despite the global role of livestock systems on climate change, there is still limited understanding on the role of SSA rangelands. At the same time, livestock systems emit greenhouse gases (GHG) and can promote global warming. But despite the impact of livestock systems on climate change, our understanding of the role of SSA rangelands is limited. To date, a thorough assessment that includes continuous GHG exchange measurement in combined wildlife-livestock systems on the African continent has not been undertaken. Here we provide the first eddy covariance (EC) measurements of CO2/CH4/H2O fluxes from the ILRI Kapiti Wildlife Conservancy - a benchmark rangeland site in East Africa that is grazed by livestock and wildlife. Our results show continuous ecosystem CO2 uptake from the wet to dry seasons with considerable CO2 emission pulses following precipitation events after long dry periods that turn the landscape into short-term net CO2 emitters. In contrast to CO2, CH4 fluxes are highly variable and depend particularly on wildlife and/or livestock being present in the fetch of the EC tower. In addition to EC measurements and given the need for scaling of our results, we relate CO2 and CH4 fluxes to simple remote sensing measurements of vegetation greenness derived from phenological cameras. Our results show good agreement between the two approaches. Yet, more observations across a climatic gradient and along varying management intensities are needed to reduce existing uncertainties in the effect of SSA rangelands on climate change. To build a complete GHG budget, hot spots of greenhouse gas emissions such as from livestock enclosures or water bodies as well as soil carbon sequestration have yet to be accounted for

Identification of simple sequence repeat markers for sweetpotato weevil resistance

The development of sweetpotato [Ipomoea batatas (L.) Lam] germplasm with resistance to sweetpotato weevil (SPW) requires an understanding of the biochemical and genetic mechanisms of resistance to optimize crop resistance. The African sweetpotato landrace, ‘New Kawogo’, was reported to be moderately resistant to two species of SPW, Cylas puncticollis and Cylas brunneus. Resistance has been associated with the presence of hydroxycinnamic acids esters (HCAs), but the underlying genetic basis remains unknown. To determine the genetic basis of this resistance, a bi-parental sweetpotato population from a cross between the moderately resistant, white-fleshed ‘New Kawogo’ and the highly susceptible, orange-fleshed North American variety ‘Beauregard’ was evaluated for SPW resistance and genotyped with simple sequence repeat (SSR) markers to identify weevil resistance loci. SPW resistance was measured on the basis of field storage root SPW damage severity and total HCA ester concentrations. Moderate broad sense heritability (H2 = 0.49) was observed for weevil resistance in the population. Mean genotype SPW severity scores ranged from 1.0 to 9.0 and 25 progeny exhibited transgressive segregation for SPW resistance. Mean genotype total HCA ester concentrations were significantly different (P < 0.0001). A weak but significant correlation (r = 0.103, P = 0.015) was observed between total HCA ester concentration and SPW severity. A total of five and seven SSR markers were associated with field SPW severity and total HCA ester concentration, respectively. Markers IBS11, IbE5 and IbJ544b showed significant association with both field and HCA-based resistance, representing potential markers for the development of SPW resistant sweetpotato cultivars