Is Zika virus the definitive culprit in cases of Microcephaly?

The World Health Organisation (WHO) situational report shows that 62 countries and territories have reported cases of mosquito-borne Zika virus transmission since 2007. The report added that cases of person-to-person transmission of the Zika virus were reported in 11 countries from February 2016 (WHO, 2016). The world was alarmed at the beginning of 2016 by the sudden and explosive emergence of a Zika virus outbreak in the majority of Latin American and Caribbean countries, with estimated cases of 440 000–1 300 000 in Brazil alone (PAHO, 2016). Zika virus is thought to have led to more than 11,000 deaths and nearly 4,000 cases of microcephaly in Brazil since the start of the outbreak in May 2015 (WHO, 2016).The American Centers for Disease Control and Prevention (CDC) reported 150 cases if Zika virus in 2014, which is a very small number for its population, compared to the outbreak in 2015. The outbreak in May 2015 was unprecedented and is reported to have resulted in more than 1 million cases, with 4,000 suspected cases of microcephaly, and 270 confirmed cases that health officials believe are linked to the Zika virus (CDC, 2016). Microcephaly is described as a rare congenital disease that is linked with incomplete brain development and causes babies to be born with unusually small heads and, in the majority of cases, brain damage(Gyawali, et al., 2016).Zika virus related microcephaly has now been reported in 20 countries or territories and WHO recently predicted that as many as four million people might be infected with the virus (WHO, 2016). By January 2016, A total of 3,530 suspected microcephaly cases had been reported by January 2016 compared to 4,000 suspected cases of microcephaly reported in May 2015, many of which occurred in infants born to women who lived in or had visited areas where Zika virus transmission was occurring. The birth prevalence of microcephaly in Brazil increased sharply during 2015–2016 with the largest increase occurred in the Northeast region, where Zika virus transmission was first reported in Brazil (CDC, 2016). The Zika virus, linked in Brazil to the birth defect microcephaly, was first identified in the Ugandan Zika forest in 1947. The initial review of literature for this book shows that the Zika virus spread slowly to other parts of Africa, and eventually appeared in Southeast Asia. The evidence from the review also shows the current globalization of the Zika epidemic began on the Pacific island of Yap in the Federated States of Polynesia. The virus subsequently spread into French Polynesia where microcephaly and other congenital abnormalities were observed in the infants of women who were pregnant when they contracted the disease. The epidemic rapidly spread to the Cook Islands and Easter Island, Brazil, Caribbean Islands, the Americas and many other parts of the globe. In May 2016, the WHO tests confirmed two hundred cases of Zika virus with 7,557 suspected cases in the African island chain of Cape Verde. Cape Verde is an Atlantic archipelago that is about 350 miles (570km) west of Senegal and which has historic ties to Brazil (Icheku, 2016, who, 2016, Davis, 2016). Aim and objective of the book Until the recent WHO reported cases, there was no documented evidence of Zika-associated to microcephaly in any part of Africa, where the virus originated. This raises the question as to what is the connection between Zika virus and microcephaly. In other words, is mosquito-borne infection actually the cause of the defects in babies born to Zika-virus-infected mothers? The answer to that question could provide essential clues as to why microcephaly leading to birth defects suddenly appeared in Africa 70 years after Zika virus was first discovered in 1947. The aim of this book is to provide a single document that evaluates current evidence linking Zika virus to microcephaly in an epidemiological context of the disease and thus provide possible explanations as to why there was no microcephaly in Africa between 1947 and 2016. The objective is divided into the following five chapters of the book: Chapter 1 focuses on Zika virus transmission by exploring the scientific studies that implicated Aedes aegypti mosquitosas the main vector transmitting the Zika virus. The chapter discussed the most common symptoms of Zika virus but noted that most people infected with Zika virus would have no symptoms or fall ill; only one in five of the people infected with the disease become symptomatic. Thus, the chapter argues that the asymptomatic nature of Zika virus has public health implication. For example, those who are asymptomatic and those who are in the incubation period of Zika virus could potentially donate infected blood or exchange contaminated body fluid, thereby, increasing human to human transmission of the disease. The chapter also uses Table 1.1 to illustrate four categorises of Zika virus transmission. For example, category 1 shows area with new introduction or re-introduction with ongoing Zika virus transmission; category 2 identified area either with evidence of virus circulation before 2015 or area with ongoing transmission that is no longer in the new or re-introduction phase, but where there is no evidence of interruption; category 3 involves area with interrupted transmission and with potential for future transmission and category 4 shows area with established competent vector but no known documented past or current transmission. Also, chapter 1 explores the modes of Zika virus transmission (Vector-borne and non- vector-borne transmission) and reinforces the view that mosquitoes are not the only means of Zika virus transmission. Thus, the chapter uses figure 1.3 to illustrate the vector and non-vector modes of Zika virus transmission cycle. The cycle starts when humans are bitten by an infected mosquito followed by viral replication in humans and viremia. The transmission cycle shows that Zika virus can spread to the reproductive organs and can be transmitted during sexual intercourse. Pregnant women who are infected with the Zika virus can also transmit the virus to their unborn child or the fetus during pregnancy. The Zika virus can then be transmitted from an infected person back to mosquitoes through subsequent mosquito bites. Lastly, the cycle continues when the Zika virus replicated in the mosquitoes and transmitted back to humans. Chapter 2 focuses on the epidemiology of Zika virus with a view to documenting the incidence and geographical distribution of the virus. The chapter traced the origin of Zika virus to the first isolated in 1947 from a febrile sentinel rhesus monkey in the Zika forest in Uganda, where it got its name. The virus spread slowly to other parts of Africa and eventually appeared in Southeast Asia before the current globalization of the Zika virus epidemic, which started on the Pacific island of Yap in the Federated States of Polynesia in 2007.The chapter demonstrates that the Zika virus epidemic that started on the Pacific island of Yap was the first known presence of the Zika virus case outside of Africa and Southeast Asia. The chapter uses figures and tables to show that the wide geographical distribution of the Zika virus and demonstration that the disease spread to French Polynesia, New Caledonia, Cook Islands, and Easter Islands before cases were reported in Brazil in 2015. Chapter 2 also explores globalisation and the risk for Zika virus spread and argued that increased globalisation continues to pose a risk for Zika virus spread. For example, there is clear evidence of a well-established association between global travels and the acquisition or transmission of infectious diseases. The chapter demonstrated that in 2015, there were 9.9 million flights from Brazilian to destinations in North America, Europe, Asia, and Africa. This has public health implication given that the incubation period for Zika virus is 3 to 14 days from the bite of Aedes species mosquito. Travelers and humanitarian health workers returning from affected areas in Brazil may be incubating the virus and become infectious after returning to their home countries. Chapter 3 reviewed the evidence linking Zika virus to microcephaly and Guillain–Barré syndrome (GBS) given that the World Health Organization report of March 2016, claimed that there was a scientific consensus that the mosquito-borne Zika virus was a cause of the neurological disorder Guillain–Barré syndrome (GBS) and of microcephaly and other congenital brain abnormalities. The review is important given that the decisions about causality require a clear understanding of the association of Zika virus complications to guide public health actions. The chapter demonstrated there had been a remarkable increase in cases of microcephaly and other congenital abnormalities in Brazil between 2015 and mid-2016. The table 3.7 was used in the chapter to demonstrate that as of March 2017, 31 countries or territories reported microcephaly and other congenital abnormalities potentially linked to Zika virus infection. Chapter 4 reviewed the evidence linking Microcephaly to birth defect in Africa and found that other factors may beat play in the Zika virus related microcephaly. The chapter discussed the evidence, which suggested that the emergence in 2014 of the microcephaly increase in Brazil occurred within certain "contexts and contingencies." Environmental degradation, poor sanitation and continued use of larvicidal chemicals in the drinking water of families were blamed for the sudden increase microcephaly.These evidence may provide a clue as to why the increase cases of Microcephaly were mostly reported in the Northwest of Brazil where the factors mainly prevalent. As for the absence of microcephaly in Africa, Chapter 4 examines a phenomenon called herd immunity that seems to offer the most plausible explanation. Herd immunity becomes a type of indirect protection from infectious disease, occurring when a significant percentage of a population has become immune to an infection, thereby providing a measure of protection for individuals who are not immune and thus decreasing the number of new infections. Given that the virus is unable to infect the same person twice; the presence of immune system generating antibodies to kill the virus and the epidemic reaching a stage where there are too few people left to infect for transmission to be sustained. The chapter concluded with a warning that until the apparent association between Zika virus infection and microcephaly is either established or disproved, women should be cautious in planning to conceive a baby or to travel to a Zika-endemic country if already pregnant (Gyawali et al. 2016). Chapter 5 will start with the premise that the World Health Organisation is better placed to identify critical areas of public health research; implementation and coordination of global fight against the Zika virus epidemic. Thus, it will explore WHO's Zika Virus Research Agenda that sets out to support the generation of evidence needed to strengthen essential public health guidance; actions to prevent; limit the impact of Zika virus and its complications. The chapter is also based on the premise that research and evidence are the foundations for sound health policies. It will, therefore, explore systematic review of evidence and the use of research evidence to inform Zika virus related public health policies and practices. The readers of this book may be delighted to know that both eheAmerican Centers for Disease Control and Prevention (CDC) and the World Health Organisation (WHO) are driving and encouraging the use of research evidence to underpin public health policy in the global fight against the Zika virus epidemic. Chapter 6 discussedrecommendations for public health interventionsto prevent the global spread Zika virus infection, given that there is no cure, no vaccine or prophylactic treatment for the disease. The chapter recommended primary preventive interventions such as promotion avoidable travel to countries where Zika virus is prevalent especially pregnant women or those planning to get pregnant; use of mosquitoes repellent; practicing safe sex, etc. The chapter also recommended secondary interventions such as reduction of mosquito breeding sites in outdoor and indoor and symptomatic treatment based on a good hydration, pain relief, and anti-histamines for the pruritic rash. Lastly, the chapter examined the scope of current research to developeZika virus vaccines and argues that effective vaccines development is crucial in the fight against the Zika virus infection. In conclusion, the book provided a summary of the current evidence linking Zika virus to microcephaly in historical context, 1947 to 2016 and offered possible explanations as to why there were no cases of microcephaly in Africa for 70 years. The summary of the possible explanations are: the possibility of chemical, Pyriproxyfen, used in a State-controlled programme aimed at eradicating disease-carrying mosquitoes; possibility of existence of inequalities in the low-income countries in the Americas, which are currently ignored in the microcephaly narrative and the possibility of herd immunity occurring in Africa that may haveprovided protection against the Zika virus infection. Lastly, table and maps were used in this book to reinforce and add value to the textual information. They were also used to draw attention to spatial relationships in the global distribution of Zika virus. Their use allows lengthier information in the book to be described in pictures and tabular forms and more memorable because they have colours and in shapes. Also, the table and maps helped to present spatial relationships in a way that is more striking; given that they show the intensity of the Zika virus transmission and global spread. Once the spatial relationships were established, the book was then able to analyse them and used texts to explain the underlying causes of the disease and its complications, which in turn informed the recommended public health interventions

A review of the evidence linking Zika virus to the developmental abnormalities that lead to microcephaly in view of recent cases of birth defects in Africa

The World Health Organization (WHO) in May 2016 confirmed an outbreak of the Zika virus on the African island chain of Cape Verde, linking it to cases of the brain disease, microcephaly. This finding is of concern because Zika was first discovered in East Africa in 1947 with no known link to brain or birth disorders until the WHO reported findings. The question, therefore, is: if the Zika virus has been in Africa for 69 years, why wasn’t any association to microcephaly detected before the recent WHO findings in Brazil (see below) and Cape Verde? This study reviews the evidence linking Zika to microcephaly in view of recent cases of birth defects in Africa, with the aim of providing vital clues as to why there was no documented case of such birth defects in Africa, where the Zika virus originated. The literature for this review was gathered through internet searches, including the websites of the European Centre for Disease Prevention and Control (ECDC), the United States Centre for Disease Control and Prevention (CDC), the World Health Organization (WHO) and Public Health England (PHE). Materials from these sources were reviewed on the link between the Zika virus and microcephaly in relation to the recent cases of birth defects in Africa. Two possible explanations emerged from the review. The first explanation suggests that the phenomenon called herd immunity may have taken place in Africa. The Zika virus cannot infect the same person twice because it reaches a stage where there are too few people left to be infected for transmission to be sustained. The second explanation suggests that microcephaly linked to birth defects is caused by other conditions. In conclusion, the findings of this review opens up the debate on the connection between the Zika virus and the birth defect attributed to mosquito-borne microcephaly, given that there is no documented case of birth defect in Africa 69 years after the discovery of the Zika virus. Large-scale research is recommended on the Zika virus and pregnancy in Africa for better understanding of the ecology and epidemiology of the virus in the continent

What interventions work to improve relationships between birth parents and children in foster care?

The number of looked after children in the United Kingdom (UK) is at a thirty year high culminating in the current reduction in adoption placements and subsequently leading to case stagnation(DOE 2015). It is, therefore, imperative that caseworkers throughout the country are knowledgeable about effective interventions that improve birth parent and foster child relationships. The number of looked after children in the United Kingdom (UK) is at a thirty year high (DOE 2015). With a current reduction in adoption placements (DOE 2015), it is imperative caseworkers throughout the country are knowledgeable about effective interventions that improve birth parent and foster child relationships. This paper conducted a systematic literature review through a combination of hand and electronic database searches to select, appraise, extract synthesis and analyse primary articles to establish what works. Both a heterogeneous group of participants and interventions were included. Through a narrative and cross studies synthesis findings demonstrate that a variety of appropriately targeted interventions provided collaboratively and inclusively may work to improve relationships between birth parents and foster children. These include a variety of parenting programmes (birth parent, joint birth parent-foster carer or foster carer training), Family Centred Practice, Outreach case work, a Parent Partner mentoring service and Family Treatment and Drug Courts. Parent Partner mentors were of particular interest in their potential ability to engage birth parents. They were able to offer a unique perspective and present as excellent role models, having successfully reunified with their own children via welfare assistance. Results also demonstrate that a variety of parenting programs were effective when incorporating birth children and taking a whole family approach, for example parent-child therapy and allowing opportunity for contact to practice learnt skills, open foster carer approaches and collaborative case work. Birth fathers were further highlighted as a potentially missed resource and if engaged appropriately through the use of written agreements birth family relationships could be improved at no added governmental cost. If effective evidence based interventions and approaches are used more widely in practice, there is potential for increased birth family reunification and/or ongoing positive relations, contributing to child and parental wellbeing and easing pressure on the care system in the process. However, further research is required to establish if Parent Partner mentors are as promising as they appear within the UK and also whether written agreements alone will be enough to engage fathers to impact positively on family relationships

Integrated Care by the Health and Social Services Staff in Joint Emergency Team (JET) to Prevent Unnecessary Hospital Admissions in London Borough of Greenwich

Background: The Joint Emergency Team (JET) sees patients that require assessment and care package within 24 hours of referral in their own home, Accident, and Emergency (A and E) department or the Acute Medical Unit (AMU) at the local hospital. The JET Integrated team accepts referrals from all primary, community, acute and social services. There has been greater emphasis on evaluating JET working and the outcomes, studies show more of the differences in policies and design with little evidence on how the integrated team of health and social service carry their daily work. The purpose of the study is to ascertain how JET interventions can help to avoid unnecessary hospital admissions. Method: The researchers interviewed eight JET professionals taken from Nursing, Occupational Therapy, Physiotherapy and Social Services who have been involved in integrated care for two years. The interview was recorded and transcribed verbatim and a thematic analysis was carried out. Findings: The study found that the Joint Emergency Team provides integrated care using multidisciplinary and Trans-disciplinary team approaches to prevent unnecessary hospital admissions in the Accident and Emergency department, Acute Medical Unit (AMU) and the Community in Greenwich borough. Conclusion: The integrated care provided by JET helps to ensure timely assessment and management of patients in the hospital and community which helps to prevent unnecessary hospital admissions

Evidence based interventions to improve fostering relationships

The number of looked after children in the United Kingdom (UK) is at a thirty year high (DOE 2015). With a current decline in adoption placements (DOE 2015), it is imperative social workers throughout the country are knowledgeable about effective interventions that improve birth parent and foster child relationships. Mullen (2014) postulated that social work practitioners require evidence-based knowledge as a guide to the development of interventions in practice. The Professional Capabilities Framework (PCF), which is an overarching professional standards framework for Social Work requires the use of research to inform practice (BASW, 2018). The Social Work Knowledge and Skills Statement for child and family practitioners, in addition, require social workers to make use of best evidence from research to support families and protect children. In other words, social workers must understand and use research evidence in practice if they are to provide effective support for families and safeguard children (Community Care, 2017). The evidence from systematic review of literature is often required to support effective social work interventions for specific social problems and populations (Mullen, 2011). The recommended interventions in this book is the result of a systematic review of literature conducted through a combination of hand and electronic database searches to select, appraise, extract, synthesis and analyse primary articles to find interventions that work. The book demonstrates that through a narrative and cross studies synthesis; a variety of appropriately targeted interventions provided collaboratively and inclusively work to improve relationships between birth parents and foster children. These include an assortment of parenting programmes (birth parent, joint birth parent-foster carer or foster carer training), Family Treatment and Drug Courts, Family Centred Practice, Outreach case work and a Parent Partner mentoring service. Parent Partner mentors were of particular interest in their potential ability to engage birth parents. They were able to offer a unique perspective and present as excellent role models, having successfully reunified with their own children via welfare assistance. The book also discusses evidence, which shows that a number of parenting programs were effective when incorporating birth children and taking a whole family approach. For example parent-child therapy, allowing opportunity for contact to practice learnt skills, open foster carer approaches and collaborative case work. Furthermore, the book argues that fathers were a potentially missed resource and if engaged appropriately through the use of written agreements, birth family relationships could be improved at no added cost to the government. The book also highlights that if effective evidence based interventions and approaches are used more widely in practice, there is potential for increased birth family reunification and/or on-going positive relations, contributing to child/parent wellbeing and easing pressure on the care system in the process. Finally, the book recommends further research to establish if Parent Partner mentors are as promising as they appear, within the UK and also whether written agreements alone will be enough to engage fathers to impact positively on family relationships

Procurement as an instrument for radical local economic transformation: case study of Transnet port terminals.

Masters Degree. University of KwaZulu-Natal, Durban.The implementation of radical economic transformation as initiated by the government of South Africa has been hinged on the fulcrum of supply chain management (SCM) processes particularly procurement processes in state-owned enterprises (SOEs) of which Transnet Port Terminals (TPT) is one. Primarily procurement is concerned with acquisition of goods and services for the running of businesses. As a secondary function, it can be used as a vehicle to transfer skills necessary for economic empowerment from providers of goods and services to local entities. This study drew upon the concept of targeted procurement and two complimentary theories of governance, and enforced cooperation. Targeted Procurement has been used in South Africa mainly to target those segments and groups of the society that were disadvantaged under the apartheid system. It has also been used to support local economic development, to promote growth within the small business sector and to target the unemployed through poverty alleviation programmes. Targeted Procurement also promotes business linkages between large and small scale enterprises. Sanctions are supposed to be applied on contractors who, in the execution of their contracts, failed to deliver their contracted social deliverables. In this way, the government can make use of private sector expertise and knowledge of the markets to develop targeted groups in the most effective way possible. Targeted Procurement is executed within a defined governance framework. Thus, the theory of governance provides a clearer understanding of the context within which it is implemented and the challenges associated with it. Difficulties and challenges become more intense in the pursuit of collective actions when regimes propose more radical and socially inclusive change. These dilemmas can be resolved by bringing some form of authoritative control. This can be done by the enforcement of compliance and cooperation. This is even more critical in situations in which actors may not cooperate where there is lack of effective central control to enforce cooperation on them or where there is no common overriding motive to benefit the welfare of the community. This study is a practitioner research which is an aspect of action research (AR). The primary purpose of the researcher is to improve existing practices and produce information to implement and enhance what is already in place. Qualitative methods were used to examine how procurement can be used as instrument of radical local economic development and transformation using TPT as a case study. A purposive sampling technique was employed by the researcher to select key informants who were involved in TPT procurement, as well as key informants from contractor entities that provide services to TPT and businesses owned by PDIs. Semi-structured personal interviews, focus group discussions, and document review as tools for data collection. Documents such as minutes of meetings, policy documents, contractual documents and agreements enriched the analysis of the processes and content of TPT ESD programmes. Desk research, needs and market analysis by cross-functional teams (CFT), and analysis of monitoring and evaluation of the performances of beneficiaries of ESD initiatives were used. This study found that there are reasonably high levels of knowledge and understanding of radical economic transformation as a concept. There were failings in the contribution of TPT to ET particularly in the areas of local content and localization. However, to a certain extent, TPT has been successful in promoting ET by vigorously developing emerging black owned enterprises to become bigger suppliers to Transnet thus improving the transformation process. There were also challenges that confront TPT in using its procurement process to contribute to the implementation of ET policies. Policy and procedural hiccups were common challenges. For example, PPPFA is not fully applied, tendering templates are complicated for small commodities, and there is apparent lack of will power of the management and employees to pursue transformation, among others. It was also noted that at this stage, TPT cannot really pursue Radical Economic Transformation as it primarily exists as a political concept that has not been translated into policy document or linked to legislation. However, TPT can play a role in pursuit of RET within the current policy and legislative frameworks by deliberate efforts and investments in SMEs, as well as by monitoring ESD subcontracting more vigorously and enforce consequences for non-compliance. Suggestions were made as to how TPT procurement can become more amenable to RET. ESD which is a critical aspect of empowerment can become a veritable instrument for RET. However, ESD in its current form and execution has been bedevilled by the challenges that faced previous ET policies. Nevertheless, ESD can contribute to RET if correctly implemented. Government’s transformation agenda depends on effective implementation of proposed policies in order to achieve desired transformation and serious and effective sanctions against violations and circumventions of RET principles

What Social Impact Does Exposure to Domestic Violence Have on Adolescent Males? A Systemic Review of Literature

Domestic violence is widespread in the United Kingdom (UK) and accounts for 14 per cent of all violent crimes. It is a significant health concern, as it damages physical and emotional health and can have long lasting negative impact across a wide range of health, social and economic outcomes for families as well as having a major impact on the social development of young people. A recent report shows that in 2002 there were 750,000 children in Britain estimated to have witnessed domestic violence. However, studies demonstrated that children’s exposure to domestic violence between parents tend to seal its “inexpugnably prints” on “their impressionable minds”, they are thought to express more anger, antisocial behaviour, as well as fear, anxiety and depression have greater risk of behavioural, emotional, and psychological problems. It shows that exposure to domestic violence in adolescence is thought to be having more of an impact than exposure in younger children, with earlier exposure having little or no impact without adolescent exposure. This systemic review focuses on the exposure of male adolescents to domestic violence and the impact of domestic violence on them. The review highlights that there were a number of disparate ways in which domestic violence impacted on adolescent males. This ranged from animal cruelty, drug taking, violence and aggression, through to feelings of depression, suicidal ideations, and feelings of sadness and ambivalence. However, the results suggest that while the exposure to domestic violence does indeed have an impact on adolescent males, there appears to be no agreement on any single way in which this impact may be experienced. However, we recommend that combating the scourge of domestic violence requires skilled practitioners to intervene at any given stage. As such, practice educators must ensure that staff under their remit are adequately equipped with the necessary knowledge and skills of detection, to impact on the root causes of domestic violence. This must include increasing awareness among staff of the knowledge of the latest legislation and policies. In addition, training should emphasize the need to maintain liaison with external agencies in developing pathways into services, and timely responses by stakeholder and associate institutions to adequately address this issue that is impacting negatively on male adolescent

The church and poverty reduction : the case of the Hope Empowerment Scheme of Durban Christian Centre Church.

Thesis (M.A.)-University of KwaZulu-Natal, 2006.In recent times, the church has been involved in various development programmes. Church based non-governmental organisations (NGOs) have emerged in response to development needs especially in the developing countries. Among the issues engaging the attention of the church, the problems of HIV/AIDS and poverty seem to be most prominent. In South Africa, the activities of Christian organizations in response to these problems are evident. This study evaluated the role of the church in poverty reduction with special reference to the Help Our People Everywhere (HOPE) Empowennent Scheme of the Durban Christian Centre Church, in KwaZulu-Natal. It examined the poverty reduction programme of the church and explored how Christian theology has shaped the church's response to the problem of poverty and associated problems. The study was based on primary infonnation obtained from interviews with the managers and beneficiaries of the projects of the Empowennent Scheme. Qualitative analysis was used to gauge the extent to which the projects ofthe scheme have improved the well-being ofthe beneficiaries. Significant improvement in the well-being of the respondents was found. First, there was a restoration of self-esteem, confidence to achieve success despite odds, and hope for a prosperous future. Second, and more measurable, there was an improvement in the incomes of the beneficiaries. Although the scheme showed promises of a sustainable progress in poverty reduction, there were a number of challenges and shortcomings particularly with funding of the projects and the reach or coverage of the scheme's activities

Comparative cross-sectional quantitative study of health status among consumers of bitter kola in Igbuzor community living in Oshilmili North Local Government area of Delta state.

Background: The use of bitter kola as plant medicine is common among Africans for centuries, yet there is little or no scientific evidence to demonstrate that its use provides health benefits. The purpose of this study, therefore, is ascertain whether or not bitter kola provides any health benefits to its regular users. Methods: A study sample of n=274 adults living in Igbuzor town in Oshimili North Local Government Area of Delta State of Nigeria was selected using simple random sampling technique. Likert Scale was used as data collection tool. The data analysis was carried out using SPSS computer software. Results: The results show that irrespective of gender n=139 regular users agreed to excellent and good health while ingesting bitter kola in comparison to n=37 non-regular users who agreed to the same statements (see table 3 & 4). The results further show that both genders n=142 (94.66%) male and n=110 (95.65%) female respondents agree that they ingest better kola for its health benefits (see table 5). Conclusion: This study found that regular users of bitter kola enjoy better health than non-regular users and that both regular and non-regular user agrees to the medicinal properties of bitter kola. These research findings help to remove the assumptions about the health benefits of bitter kola and replaced them with actual research evidence

Exploration of Zika virus travel-related transmission and a review of travel advice to minimise health risk to UK travellers

The World Health Organization (WHO) on 1 February 2016 declared the Zika virus outbreak is a global public health emergency. Zika virus is thought to have led to more than 11,000 deaths and nearly 4,000 cases of microcephaly in Brazil since the start of the outbreak in May 2015. WHO predicted that, in 2016, as many as four million people may be infected with the virus. [1] Health experts have warned that the risk of transmitting Zika virus in the United Kingdom (UK) is very high because South America has become an increasingly popular tourist destination for UK travellers. [2] Given the declaration of Zika virus outbreak as a global public health emergency, this study explores Zika virus travel-related transmission and review current travel advice to minimise health risks to UK travellers. The evidence from our initial literature review showed that there is a paucity of research information on the recent Zika virus outbreak. Thus, the evidence used in this study was gathered from surveillance reports published by the European Centre for Disease Prevention and Control (ECDC), the United States Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO). Public Health England (PHE), Fitfortravel (NHS Scotland) and NHS Choices reports were reviewed for Zika virus outbreak alerts and travel advice. The study finds that Zika virus, which originated in East Africa, is now transmitted in South and North American countries and the Caribbean islands through travel and, to prevent the disease epidemic in the UK, health care professionals are required by PHE to offer advice to travellers to and from the Zika-affected countries. [3] As travel advice is likely to change as more information becomes available, we recommend that professionals supplying this service should be checking on the National Travel Health Network and Centre (NaTHNaC) website to stay abreast of the latest Zika virus updates