Investigation of GSM Signal Strength in Rural Communities in the South-Eastern Region of Nigeria

This paper focuses on the investigation of GSM networks’ signal strength coverage in rural communities in the South-Eastern region of Nigeria. The Network Cell Info Lite application installed in two Gionee M5 phones was used to carry out measurement of the signal strength received from the transmitting stations of various GSM networks. Signal strength obtained from the application was compared with the Gionee android inbuilt signal meter for authentication purposes. The signal strength measurements were conducted in Amaigbo from 18th August to 26 th August 2018, Uli from 29th August to 6 th September 2018 and Amasa from 8 th September to 16th September 2018, all in South-Eastern region of Nigeria. The data obtained was analyzed to determine the GSM networks coverage levels, the availability of the networks, and the quality of the network provided in the aforementioned rural communities. The result of the study shows that most rural communities in the South-East region of Nigeria, like Amaigbo and Amasa, experiences a lot of periods of out of service as a result of poor network coverage level. It was also observed that in some rural communities in the east with high population density such as Uli, the network coverage level is relatively high. Thus, quality network services were recorded in Uli. It is therefore recommended that more booster stations be sited to enhance good network coverage level in rural communities within the South-Eastern region of Nigeria

HIV assessment and testing for hospital inpatients: still a weak link in the cascade

Since 2007, the World Health Organization has recommended that in countries with generalized HIV epidemics, HIV testing and counselling should be offered to all adults and adolescents seen in a health facility (1). This recommendation had been policy in Uganda since 2005 (2). However, evidence suggests that translation of this policy to practice in real-world settings has been patchy and that missed opportunities with HIV testing in the inpatient setting are still contributing to HIV related deaths (3,4)

Circulating resistance to first-line HIV drug regimens in sub-Saharan Africa: a sheep in wolf’s clothing?

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Institutional responses to drought in a high HIV prevalence setting in rural South Africa

In 2015, South Africa experienced one of the worst (El Niño-induced) droughts in 35 years. This affected economic activities, individual and community livelihoods and wellbeing especially in rural communities in northern KwaZulu-Natal. Drought’s direct and indirect impacts on public health require urgent institutional responses, especially in South Africa’s stride to eliminate HIV as a public health threat by 2030 in line with the UNAIDS goals. This paper draws on qualitative data from interviews and policy documents to discuss how the devastating effect of the 2015 drought experience in the rural Hlabisa sub-district of uMkhanyakude, a high HIV prevalence area, imposes an imperative for more proactive institutional responses to drought and other climate-related events capable of derailing progress made in South Africa’s HIV/AIDS response. We found that drought had a negative impact on individual and community livelihoods and made it more difficult for people living with HIV to consistently engage with care due to economic losses from deaths of livestock, crop failure, food insecurity, time spent in search of appropriate water sources and forced relocations. It also affected government institutions and their interventions. Interviewed participants’ reflections on drought-related challenges, especially those related to institutional and coordination challenges, showed that although current policy frameworks are robust, their implementation has been stalled due to complex reporting systems, and inadequate interdepartmental collaboration and information sharing. We thus argue that to address the gaps in the institutional responses, there is a need for more inclusive systems of drought-relief implementation, in which government departments, especially at the provincial and district levels, work with national institutions to better share data/information about drought-risks in order to improve preparedness and implementation of effective mitigation measure

Perception and Adaptation to Climate Change among Artisanal Fishermen in Fishing Communities along Anambra River Nigeria

Climate change is threatening the attainment of self-sufficiency in fish production in Nigeria. As a result, artisanal fishermen are developing adaptation practices that will reduce their vulnerability to climate change. The study therefore investigated perceptions and adaptation behavior of climate change among Artisanal Fishermen in Fishing Communities along Anambra River in South East Nigeria. The study adopted multistage sampling technique to select 240 Artisanal Fishermen. The results showed that the mean age of Artisanal Fishermen was 50 years and household size of 4 persons, with 52.5% married. On average, the Artisanal Fishermen have spent about 15 years. Majority (85%) of the respondents have formal education.  Also, majority of the Artisanal Fishermen had access to credit for male (67.5%). Furthermore the result revealed that Artisanal Fishermen ()  were aware of the occurrence of climate change and the most widely used adaptation practice of the Artisanal Fishermen were changing of Diversification of livelihoods (), Information dissemination (), Improved housing (), Financial Support () and Community representative in disaster management (). Ordinary least Square regression result factors influencing adaptation behavior of climate change among artisanal fishermen in fishing communities along Anambra river Nigeria with an R2  value of 88.3% shows that marital status (5%), member of cooperative society (10%) and extension services (1%) were positively related to number of mitigation strategies used by artisanal fishermen in fishing communities, while household size (1%) was significant and negative. The study therefore, recommends that extension workers should be continuously trained and educated on current information about climate change to enable them enlighten and disseminate to fish farmers. This will enable update and synchronization of ideas with the Artisanal Fishermen

Herbs and Spices: Options for Sustainable Animal Production

Herbs and spices and a host of other plant derivatives used in animal feeding as feed additives are referred to as phytogenic feed additives. This class of feed additives is increasingly gaining popularity in livestock production. A number of studies have demonstrated antioxidative and antimicrobial efficacy in vitro. Methane reducing effects of some herbs and spices in ruminants have also been reported. Studies show that some of these plant materials improved the palatability of feed. There are suggestions that they may specifically enhance activities of digestive enzymes and nutrient absorption. Experimental comparisons of these phytogenic additives with antibiotics and organic acids have suggested similar effects on the gut. This include reduced bacterial colony counts, fewer fermentation products, greater nutrient digestion and probably reflecting an overall improved gut equilibrium. In addition, some of the herbs and spices or their derivatives have been reported to promote intestinal mucus production. This effect may explain improved production performance after including these phytogenic feed additives. In general, available literature suggests that phytogenic feed additives such as herbs and spices may add to the set of non-antibiotic growth promoters for use in livestock like organic acids and probiotics. However, a systematic approach toward the efficacy and safety of phytogenic materials used as feed ingredients or additives is needed. There should also be studies to show the possible interaction of these plant materials with other feed ingredients in vivo. There is also the need to study herbs and spices which are indigenous to the tropics for their utilization in livestock production. Keywords: Herbs, Spices, Antimicrobial, Antioxidant, Phytogenic Feed Additive, Performance

Antiretroviral therapy to prevent HIV acquisition in serodiscordant couples in a hyperendemic community in rural South Africa

Background. Antiretroviral therapy (ART) was highly efficacious in preventing human immunodeficiency virus (HIV) transmission in stable serodiscordant couples in the HPTN-052 study, a resource-intensive randomized controlled trial with near-perfect ART adherence and mutual HIV status disclosure among all participating couples. However, minimal evidence exists of the effectiveness of ART in preventing HIV acquisition in stable serodiscordant couples in "real-life" population-based settings in hyperendemic communities of sub-Saharan Africa, where health systems are typically resource-poor and overburdened, adherence to ART is often low, and partners commonly do not disclose their HIV status to each other. Methods. Data arose from a population-based open cohort in KwaZulu-Natal, South Africa. A total of 17 016 HIV-uninfected individuals present between January 2005 and December 2013 were included. Interval-censored time-updated proportional hazards regression was used to assess how the ART status affected HIV transmission risk in stable serodiscordant relationships. Results. We observed 1619 HIV seroconversions in 17 016 individuals, over 60 349 person-years follow-up time. During the follow-up period, 1846 individuals had an HIV-uninfected and 196 had an HIV-infected stable partner HIV incidence was 3.8/100 person-years (PY) among individuals with an HIV-infected partner (95% confidence interval [CI], 2.3-5.6), 1.4/100 PY (.4-3.5) among those with HIV-infected partners receiving ART, and 5.6/100 PY (3.5-8.4) among those with HIV-infected partners not receiving ART. Use of ART was associated with a 77% decrease in HIV acquisition risk among serodiscordant couples (adjusted hazard ratio, 0.23; 95% CI,. 07-.80). Conclusions. ART initiation was associated with a very large reduction in HIV acquisition in serodiscordant couples in rural KwaZulu-Natal. However, this "real-life" effect was substantially lower than the effect observed in the HPTN-052 trial. To eliminate HIV transmission in serodiscordant couples, additional prevention interventions are probably needed

Evaluation of the Nutritive Value of Mixture of Fermented Bovine Blood and Rumen Digesta for Broiler Finisher

A 35-day feeding trials involving three hundred (300) 5 week old broilers was carried out in a completely randomized design to evaluate the performance, organ characteristics, nutrient utilization and economic analysis of broiler finishers fed diets containing a mixture of fermented dried bovine blood and rumen digesta (FBBRD) at dietary levels of 0, 5, 10, 15 and 20% respectively. At the end of the feeding trials, two birds were randomly selected from each treatment and transferred to a metabolism cage for faecal collection and determination of nutrient digestibility. Another set of five (5) birds were randomly selected from each treatment for carcass and organ weight evaluation. Birds on the test material performed generally better in all the parameters measured than the control group. There were no significant (P<0.05) difference among the groups in relative organ weight. The groups on the test materials (FBBRD) also recorded better nutrient nutrient utilization values than the control group. The results suggest that up to 20% inclusion level of FBBRD meal could be tolerated by broiler finisher without any adverse effects on performance. Keywords: Fermented Bovine Blood and Rumen Digesta, Performance, Broiler Finisher

Impact of next-generation sequencing defined human immunodeficiency virus pretreatment drug resistance on virological outcomes in the ANRS 12249 treatment-as-prevention trial

Background Previous studies in human immunodeficiency virus (HIV)-positive individuals on thymidine analogue backbone antiretroviral therapy (ART) with either nevirapine or efavirenz have suggested poorer virological outcomes in the presence of pretreatment drug resistance (PDR). We assessed the impact of PDR on virological suppression (VS; <50 copies/mL) in individuals prescribed primarily tenofovir/emtricitabine/efavirenz in rural KwaZulu-Natal within a treatment-as-prevention trial. Methods Among 1557 HIV-positive individuals who reported no prior ART at study entry and provided plasma samples, 1328 individuals with entry viral load (VL) >1000 copies/mL had next-generation sequencing (NGS) of the HIV pol gene with MiSeq technology. Results were obtained for 1148 individuals, and the presence of PDR was assessed at 5% and 20% detection thresholds. Virological outcome was assessed using Cox regression in 837 of 920 ART initiators with at least 1 follow-up VL after ART initiation. Results PDR prevalence was 9.5% (109/1148) and 12.8% (147/1148) at 20% and 5% thresholds, respectively. After a median of 1.36 years (interquartile range, 0.91–2.13), mostly on fixed-dose combination tenofovir/emtricitabine/efavirenz, presence of both nonnucleoside reverse transcriptase inhibitor (NNRTI)/nucleoside reverse transcriptase inhibitor PDR vs no PDR was associated with longer time to VS (adjusted hazard ratio [aHR], 0.32; 95% confidence interval [CI], 0.12–0.86), while there was no difference between those with only NNRTI PDR vs no PDR (aHR, 1.05; 95% CI, 0.82–1.34) at the 5% threshold. Similar differences were observed for mutations detected at the 20% threshold, although without statistical significance. Conclusions NGS uncovered a high prevalence of PDR among participants enrolled in trial clinics in rural KwaZulu-Natal. Dual-class PDR to a mainly tenofovir/emtricitabine/efavirenz regimen was associated with poorer VS. However, there was no impact of NNRTI PDR alone

Clinical outcomes after first-line HIV treatment failure in South Africa: the next cascade of care

Introduction There is limited literature on the appropriateness of viral load (VL) monitoring and management of detectable VL in public health settings in rural South Africa. Methods We analysed data captured in the electronic patient register from HIV‐positive patients ≥ 15 years old initiating antiretroviral therapy (ART) in 17 public sector clinics in rural KwaZulu‐Natal, during 2010–2016. We estimated the completion rate for VL monitoring at 6, 12, and 24 months. We described the cascade of care for those with any VL measurement ≥ 1000 HIV‐1 RNA copies/mL after ≥ 20 weeks on ART, including the following proportions: (1) repeat VL within 6 months; (2) re‐suppressed; (3) switched to second‐line regimen. Results There were 29 384 individuals who initiated ART during the period [69% female, median age 31 years (interquartile range 25–39)]. Of those in care at 6, 12, and 24 months, 40.7% (9861/24 199), 34% (7765/22 807), and 25.5% (4334/16 965) had a VL test at each recommended time‐point, respectively. The VL results were documented at all recommended time‐points for 12% (2730/22 807) and 6.2% (1054/16 965) of ART‐treated patients for 12 and 24 months, respectively. Only 391 (18.3%) of 2135 individuals with VL ≥ 1000 copies/mL on first‐line ART had a repeat VL documenting re‐suppression or were appropriately changed to second‐line with persistent failure. Completion of the treatment failure cascade occurred a median of 338 days after failure was detected. Conclusion We found suboptimal VL monitoring and poor responses to virologic failure in public‐sector ART clinics in rural South Arica. Implications include increased likelihood of morbidity and transmission of drug‐resistant HIV