MICROTUBULES IN RAT LEYDIG CELLS. A MODIFICATION OF SMOOTH ENDOPLASMIC RETICULUM?

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Influence of gendered roles on legume utilization and improved child dietary intake in Malawi

The relationship between gender roles, legume production, utilization and child feeding practices in rural smallholder households of Dedza and Ntcheu districts in Malawi was investigated and analyzed. A cross-sectional research study was conducted with legume farming households with children aged 6-23 months who were part of the Africa RISING ‘mother trial’ or ‘baby trials’ for two farming seasons (2014/2015 to 2015/2016). Africa RISING project encourages smallholder farmers to grow legumes namely, groundnut (Arachis hypogaea), cowpea (Vigna unguiculata), pigeon pea (Cajanus cajan) and soya bean (Glycin max) as one way of improving the wellbeing of smallholder farmers. The key objective of the research was to assess the influence of gender roles, legume production, utilization and infant and young child dietary intake. In total, 291 households with children 6-23 months were targeted. Eight focus group discussions (FDGs) for in-depth qualitative data were conducted. Two 24-hour dietary recalls and food frequency questionnaires were used to collect data on infant and young child feeding (IYCF) practices. Data collected were extracted, arranged, recorded and analyzed by using SPSS version 21. About 18% of children aged 6-23 months received a minimum dietary diversity (the consumption of four or more food groups from the seven food groups), 2.5% received a minimum acceptable diet (indicator measures both the minimum feeding frequency and minimum dietary diversity, as appropriate for various age groups) and 37.5% of children received a minimum meal frequency (frequency of receiving solid, semi-solid, or soft foods at the minimum numbers of two and three times for children aged 6–8 months, and 9–23 months, respectively). Control on use of income by women had a positive and significant association with minimum dietary diversity (P<0.05), minimum meal frequency (P<0.05) and minimum acceptable diets (P<0.05) among children of both sexes. Children aged 6-23 months from households where women were actively involved in partial processing and budgeting of legumes met minimum dietary diversity than children from nonparticipating households. Women farmers were more knowledgeable about legumes; played an important role in seed selection, storage and processing; however, the findings signal an opportunity to increase women’s income by involving them in market information. Increasing legume production at household level does not mean increasing the nutritional status among children (6-23 months). Several factors related to gender roles, markets accessibility and legume utilization have an effect on infant and young child feeding practices

Retroperitoneal Liposarcoma

Liposarcoma is a rare tumor of fatty tissue. The retroperitoneal site accounts for  0.01-O.l% of all malignancies. The location makes early detection difficult and by the time the patient comes to surgery the large size deters surgeons from attempting resection. This is a report of a patient from whom a 10 kilogram retroperitoneal  liposarcoma was successfully removed and one year later a recurrent tumour ling 13.8 kilogram was excised. Size d not be a deterrent to operability if vital s are not involved.Key words: liposarcoma, retroperitoneu

Chronic Hepatitis B Virus Coinfection Is Associated With Renal Impairment Among Zambian HIV-Infected Adults

Among 6789 HIV-infected Zambian adults screened for hepatitis B virus (HBV) coinfection, estimated glomerular filtration rate (eGFR) was 50-90 mL/minute/1.73 m2 in 17.6% and <50 mL/minute/1.73 m2 in 2.5%. Human immunodeficiency virus/HBV coinfection was associated with eGFR <50 mL/minute/1.73 m2 (adjusted odds ratio, 1.96 [95% confidence interval, 1.34-2.86]), adjusted for age, sex, CD4+ count, and World Health Organization disease stag

Epithelial abnormalities in the small intestine of Zambian children with stunting

BACKGROUND: Environmental enteropathy (EE) contributes to impaired linear growth (stunting), in millions of children worldwide. We have previously reported that confocal laser endomicroscopy (CLE) shows fluorescein leaking from blood to gut lumen METHODS: We performed confocal laser endomicroscopy (CLE) in 75 children and collected intestinal biopsies for histology in 91 children. CLE videos were evaluated, employing the Watson score to determine severity of leakiness. Morphometry was carried out on well-orientated mucosa and 3 biopsies were examined by electron microscopy. RESULTS: Confocal laser endomicroscopy demonstrated substantial leakage from circulation to gut lumen in 73 (97%) children. Histology consistently showed characteristic changes of EE: villus blunting, lamina propria and epithelial inflammation, and depletion of secretory cells (Paneth cells and goblet cells). Epithelial abnormalities included marked variability in epithelial height, disorganised and shortened microvilli, dilated intercellular spaces, pseudostratification, formation of synechiae between epithelium on adjacent villi, crypt destruction, and abundant destructive lesions which may correspond to the microerosions identified on CLE. CONCLUSION: Epithelial abnormalities were almost universal in Zambian children with non-responsive stunting, including epithelial microerosions, cell-cell adhesion anomalies, and defects in secretory cells which may all contribute to impairment of mucosal barrier function and microbial translocation

Understanding patient health-seeking behaviour to optimise the uptake of cataract surgery in rural Kenya, Zambia and Uganda: findings from a multisite qualitative study

Background Cataract is a major cause of visual impairment globally, affecting 15.2 million people who are blind, and another 78.8 million who have moderate or severe visual impairment. This study was designed to explore factors that influence the uptake of surgery offered to patients with operable cataract in a free-of-charge, community-based eye health programme. Methods Focus group discussions and in-depth interviews were conducted with patients and healthcare providers in rural Zambia, Kenya and Uganda during 2018–2019. We identified participants using purposive sampling. Thematic analysis was conducted using a combination of an inductive and deductive team-based approach. Results Participants consisted of 131 healthcare providers and 294 patients. Two-thirds of patients had been operated on for cataract. Two major themes emerged: (1) surgery enablers, including a desire to regain control of their lives, the positive testimonies of others, family support, as well as free surgery, medication and food; and (2) barriers to surgery, including cultural and social factors, as well as the inadequacies of the healthcare delivery system. Conclusions Cultural, social and health system realities impact decisions made by patients about cataract surgery uptake. This study highlights the importance of demand segmentation and improving the quality of services, based on patients’ expectations and needs, as strategies for increasing cataract surgery uptake

Risk Factors for Mortality in Children Hospitalized With Severe Malaria in Northern Zambia: A Retrospective Case-Control Study

Malaria remains a public health crisis in areas where it has resisted control efforts. In Nchelenge District, a high-transmission area in northern Zambia, malaria accounts for more than one-third of pediatric hospitalizations and nearly one-half of hospital deaths in children. To identify risk factors for death due to malaria, we conducted a retrospective, time-matched case-control study of 126 children hospitalized with malaria who died (cases) and 126 children who survived (controls). There were no differences in age, gender, hemoglobin concentration, or prevalence of severe anemia between cases and controls. Children who died were more likely to come from villages located at greater distances from the hospital than children who survived (median 13.5 versus 3.2 km). Each additional kilometer of distance from the hospital increased the odds of death by 4% (odds ratio 1.04, 95% confidence interval 1.01–1.07, P \u3c 0.01). Extent of anemia and admission during periods when blood was unavailable for transfusion were associated with early death (P £ 0.03). Delays in initiation of treatment of severe malaria contribute to the increased odds of death in children referred from more distant health centers, and might be mitigated by transportation improvements, capacity at rural health posts to administer treatment before transfer, hospital triage systems that minimize time to treatment, and reliable blood product stores at referral hospitals

Malaria Knowledge and Bed Net Use in Three Transmission Settings in Southern Africa

Background: Insecticide-treated nets (ITNs) reduce malaria morbidity and mortality in endemic areas. Despite increasing availability, the use of ITNs remains limited in some settings. Poor malaria knowledge is a barrier to the widespread use of ITNs. The goal of this study was to assess the levels of malaria knowledge and evaluate factors associated with bed net use among individuals residing in three regions of southern Africa with different levels of malaria transmission and control. Methods: A cross-sectional study was conducted on a sample of 7535 residents recruited from 2066 households in Mutasa District, Zimbabwe (seasonal malaria transmission), Choma District, Zambia (low transmission) and Nchelenge District, Zambia (high transmission), between March 2012 and March 2017. A standardized questionnaire was used to collect data on demographics, malaria-related knowledge and use of preventive measures. Multivariate logistic regression analyses were used to assess determinants of bed net use. Results: Most of the 3836 adult participants correctly linked mosquito bites to malaria (85.0%), mentioned at least one malaria symptom (95.5%) and knew of the benefit of sleeping under an ITN. Bed net ownership and use were highest in Choma and Nchelenge Districts and lowest in Mutasa District. In multivariate analyses, knowledge of ITNs was associated with a 30-40% increased likelihood of bed net use after adjusting for potential confounders across all sites. Other factors significantly associated with bed net use were age, household size and socioeconomic status, although the direction, strength and size of association varied by study site. Importantly, participants aged 5-14 years had reduced odds of sleeping under a bed net compared to children younger than 5 years. Conclusion: Relevant knowledge of ITNs translated into the expected preventive behaviour of sleeping under a bed net, underscoring the need for continued health messaging on malaria prevention. The implementation and delivery of malaria control and elimination interventions needs to consider socioeconomic equity gaps, and target school-age children to ensure access to and improve utilization of ITNs